委中穴齐刺法治疗寒湿型腰椎间盘突出症的临床研究

Clinical effect of triple needling at Weizhong（BL 40）on cold-dampness type lumbar intervertebral disc herniation

关键词:  委中穴  齐刺  腰椎间盘突出症  红外热成像技术  多裂肌

Key words:  Weizhong(BL40)  triple needling  lumbar disc herniation  infrared thermography  multifidus

摘要:

[目的] 观察委中穴齐刺法治疗寒湿型腰椎间盘突出症患者的临床疗效。[方法] 将2023年8月—2024年3月就诊于上海市第六人民医院针推伤科门诊且符合纳入标准的79例寒湿型腰椎间盘突出症患者随机分为治疗组（40例）和对照组（39例）。治疗组患者采用委中穴齐刺法，对照组采用委中穴普通针刺法，均针刺腰夹脊、肾俞、大肠俞，共计治疗2个疗程。观察治疗前后患者疼痛视觉模拟（VAS）评分、日本骨科协会下腰痛（JOA）评分、下腰部温度以及超声下多裂肌形态的变化，比较两组患者临床疗效。[结果] 治疗组有效率为95%高于对照组74.4%。经治疗，两组患者治疗2个疗程后VAS评分、JOA评分显著改善，治疗组优于对照组（P<0.05）；治疗组下腰部温度及收缩状态下多裂肌横截面积、厚度前后差值变化显著高于对照组（P<0.05）。[结论] 委中穴齐刺法可以有效减轻寒湿型腰椎间盘突出患者腰痛症状，改善患者生活质量，同时提高下腰部温度，控制多裂肌萎缩，提高多裂肌收缩能力。

Abstract:

[Objective] To observe the clinical efficacy of triple needling at Weizhong（BL40） in the treatment of patients with cold-dampness type lumbar disc herniation. [Methods] From August 2023 to March 2024，79 patients with cold-dampness lumbar disc herniation who met the inclusion criteria in the outpatient department of the Department of Acupuncture and Traumatology of Shanghai Sixth People’s Hospital were randomly divided into treatment group（40 cases） and control group（39 cases）. The patients in the treatment group were treated with triple needling at Weizhong（BL40），while the patients in the control group were treated with common acupuncture at Weizhong（BL40）. Both groups were treated with acupuncture at lumbar Jiaji（EX-B2），Shenshu（BL23），and Dachangshu（BL25） for 2 courses. The changes in pain VAS score，JOA score，lower lumbar temperature，and multifidus muscle morphology under ultrasound were observed before and after treatment，and the clinical efficacy of the two groups was compared. [Results] The effective rate of the treatment group was 95% higher than that of the control group 74.4%. After treatment，the pain VAS score and JOA score of the two groups were significantly improved after 2 courses of treatment，and the treatment group was better than the control group（P<0.05）. The changes in lower lumbar temperature，cross-sectional area，and thickness of multifidus muscle in the treatment group were significantly higher than those in the control group（P<0.05）. [Conclusion] Triple needling at Weizhong（BL40）can effectively reduce the symptoms of low back pain in patients with cold-dampness type lumbar disc herniation，improve the quality of life of patients，increase the temperature of the lower waist，control the atrophy of the multifidus muscle，improve multifidus muscle contraction ability.