小针刀松解八髎穴结合穴位贴敷治疗腰痹病的临床研究

Clinical study on the use of small needle knife to release the Baliao acupoint combined with acupoint application for the treatment of lumbar bi disease

关键词:  腰痹病  小针刀  八髎穴  穴位贴敷  腰腿疼痛  腰椎活动度  功能障碍  生活质量

Key words:  lumbar bi disease  small needle knife  Baliao acupoint  acupoint application  lower back and leg pain  lumbar spine mobility  functional impairment  quality of life

摘要:

[目的] 探究小针刀松解八髎穴联合穴位贴敷对腰痹病的临床治疗效果。[方法] 选取84例腰痹病患者，采用随机数字表法均分为两组，每组 42 例。对照组采用双氯芬酸钠缓释片联合牵引治疗，治疗组则运用小针刀松解八髎穴结合穴位贴敷疗法。两组疗程均为3周。对比两组治疗前后的腰腿疼痛视觉模拟评分（VAS）、Oswestry功能障碍指数评分（ODI）、日本骨科协会（JOA）脊柱功能评分、腰椎活动度、疼痛递质因子（5-羟色胺、神经肽Y、P物质）水平，以及 SF-12 生活质量评分（涵盖健康总体自评、躯体疼痛、躯体功能对角色功能的影响等8个维度），并统计分析两组的临床疗效与治疗安全性。[结果] 治疗后，两组VAS、ODI 评分均显著降低，且治疗组低于对照组（P<0.05）；JOA评分均明显升高（P<0.05），治疗组高于对照组（P<0.05）；腰椎屈伸、侧屈及旋转活动度均有所提升（P<0.05），治疗组优于对照组（P<0.05）；5-羟色胺、神经肽Y及P物质水平均下降（P<0.05），治疗组更低（P<0.05）；SF-12 生活质量各维度评分均提高（P<0.05），治疗组高于对照组（P<0.05）。治疗组总有效率（92.86%）明显高于对照组（73.80%，P<0.05）。治疗期间，两组均未出现与小针刀及药物相关的不良事件。[结论] 小针刀松解八髎穴结合穴位贴敷治疗腰痹病效果显著，可抑制疼痛递质表达，减轻腰腿疼痛，改善腰椎功能，提升患者生活质量，且安全性高，具备临床推广价值。

Abstract:

[Objective] To explore the clinical efficacy of small needle-knife release at Baliao acupoints combined with acupoint application in the treatment of lumbago Bi syndrome. [Methods] Eighty-four patients with lumbago Bi syndrome were selected and evenly divided into two groups（42 cases in each group） using the random number table method. The control group received diclofenac sodium sustained-release tablets combined with traction therapy，while the treatment group underwent small needle-knife release at Baliao acupoints combined with acupoint application therapy. Both groups were treated for 3 consecutive weeks. The changes in visual analogue scale（VAS） scores for lumbocrural pain，Oswestry disability index（ODI） scores，Japanese Orthopaedic Association（JOA） scores for spinal function，lumbar mobility，levels of pain neurotransmitter factors（5-hydroxytryptamine，neuropeptide Y，substance P），and SF-12 quality of life scores（covering eight dimensions such as general health，psychogenic pain，role physical，physical functioning，mental health，role emotional，social function，and vitality） before and after treatment were compared between the two groups. The clinical efficacy and treatment safety of the two groups were also statistically analyzed. [Results] Post-treatment，both groups exhibited significant reductions in VAS and ODI scores（P<0.05），with the treatment group showing lower scores than the control group（P<0.05）. Conversely，JOA scores increased significantly in both groups（P<0.05），but were higher in the treatment group versus controls（P<0.05）.The flexion-extension，lateral flexion，and rotation ranges of the lumbar spine increased in both groups（P<0.05），and the treatment group demonstrated superior outcomes versus controls（P<0.05）. The levels of 5-hydroxytryptamine， neuropeptide Y，and substance P decreased in both groups（P<0.05），and were lower in the treatment group（P<0.05）. SF-12 quality-of-life dimensions significantly improved in both groups（P<0.05）， with greater gains in the treatment group （P<0.05）. Treatment efficacy（92.86%） significantly exceeded the control group’s 73.80%（P<0.05）. No adverse events related to small needle-knife treatment or medications occurred in either group during the trial. [Conclusion] Small needle-knife release at Baliao acupoints combined with acupoint application has a remarkable effect in treating lumbago Bi syndrome. It can inhibit the expression of pain neurotransmitters，relieve lumbocrural pain，improve lumbar function，enhance patients’ quality of life，and is safe and reliable，thus worthy of clinical promotion.