合谷刺配合恢刺阿是穴治疗血瘀型腰椎间盘突出症临床研究

摘 要:目的 观察合谷刺配合恢刺阿是穴对血瘀型腰椎间盘突出症(Lumbar disc herniation，LDH)患者的临床疗效及对腰椎功能日本骨科协会评估治疗评分（Japanese Orthopaedic Association Scores，JOA）、McGill疼痛量表、疼痛视觉模拟评分(Visual Analogue Scale，VAS)及患者血清(5-hydroxytryptamine,5-HT)、P物质(Substance P，SP)的影响。方法 采用随机数字表法将80例血瘀型LDH患者随机分为合谷刺配合恢刺阿是穴组(治疗组)及常规针刺组(对照组)，每组40例。治疗组常规选穴行合谷刺法，在此基础上配合恢刺局部压痛点；对照组采用平补平泻法。两组均隔日治疗1次，5次为1疗程，共3疗程。疗程结束后进行综合疗效评价及腰椎功能JOA评分、McGill疼痛量表、VAS及血清5-HT、SP比较。结果 治疗组总有效率为89.18%，对照组为64.86%；与治疗前比较，两组治疗后腰椎功能JOA评分升高，McGill疼痛量表、VAS评分及血清5-HT、SP均降低。结论 合谷刺配合恢刺阿是穴较常规针刺更能有效缓解血瘀型LDH疼痛，提高腰椎功能活动度，从而改善临床症状，值得临床进一步推广。

Clinical Study on Hegu Acupuncture Combined with Hui Acupuncture at Ashi Point for Treatment of Blood Stasis Type Lumbar Disc Herniation

Abstract:Objective To observe the clinical effect of Hegu acupuncture combined with Hui acupoint at Ashi point on patients with blood stasis type lumbar disc herniation (LDH) and the effect on the Japanese Orthopaedic Association Scores (JOA),McGill Pain Scale,Visual Analogue Scale (VAS) and patient serum (5-hydroxytryptamine,5-HT) and substance P (SP).Methods 80 patients with blood stasis type LDH were randomly divided into two groups: Hegu acupuncture combined with Hui acupuncture at Ashi point group (treatment group) and routine acupuncture group (control group),with 40 patients in each group.In the treatment group,conventional acupoint selection and Hegu needling were performed,on the basis of which,local tenderness points were recovered;The control group was treated with the method of reinforcing and reducing.Both groups were treated once every other day,five times for a course of treatment,a total of three courses.At the end of the course of treatment,the comprehensive efficacy evaluation and JOA score of lumbar function,McGill pain scale,VAS and serum 5-HT,SP were compared.Results The total effective rate was 89.18% in the treatment group and 64.86% in the control group;Compared with before treatment,JOA score of lumbar function increased,McGill pain scale,VAS score and serum 5-HT and SP decreased in both groups after treatment.Conclusion Hegu needling combined with Hui needling at Ashi point can more effectively relieve the pain of blood stasis type LDH,improve the functional activity of lumbar spine,and thus improve clinical symptoms,which is worthy of further clinical promotion.