经颅重复针刺法作用于足运感区对坐骨神经痛患者的影响*

作者：范程欣1，王松阳2，孙申田1，张 淼1

单位：1.黑龙江中医药大学附属第二医院，黑龙江 哈尔滨 150000； 2.黑龙江中医药大学研究生院，黑龙江 哈尔滨 150040

引用：引用：范程欣，王松阳，孙申田，张淼.经颅重复针刺法作用于足运感区对坐骨神经痛患者的影响[J].中医药导报,2025,31(10):50-54.

DOI：10.13862/j.cn43-1446/r.2025.10.008

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摘要：

目的：观察经颅重复针刺法作用于足运感区对坐骨神经痛患者疼痛和腰椎活动功能的影响。方法：将60例坐骨神经痛患者按照随机数字表法分为治疗组和对照组，每组30例。对照组选取足运感区（对侧）、攒竹（患侧）、瞳子髎（患侧）、L1~L5腰夹脊、环跳（患侧）、阳陵泉（患侧）、悬钟（患侧）、丘墟（患侧）、阿是穴行针刺治疗；治疗组在对照组治疗基础上予经颅重复针刺法作用于足运感区。两组均留针30 min，治疗1次/d，每周5次，2周为1个疗程，共治疗2个疗程。于治疗前、后分别对两组患者视觉模拟评分（VAS）、腰痛疾患疗效评分量表（JOA）评分、腰椎Oswetry功能障碍指数（ODI）评分、血清疼痛介质水平[5-羟色胺（5-HT）、P物质（SP）]进行观察，并评价其临床疗效。结果：治疗过程中，对照组及治疗组各脱落1例病例。治疗后，治疗组总有效率为96.6%（28/29），高于对照组的79.3%（23/29），差异有统计学意义（P<0.05）；治疗后，两组患者VAS评分及ODI评分均较治疗前降低（P<0.05），且治疗组治疗后VAS评分及ODI评分均低于对照组，差异均有统计学意义（P<0.05）；治疗后两组患者JOA评分均较治疗前升高，且治疗组JOA评分高于对照组，差异有统计学意义（P<0.05）；治疗后两组患者疼痛介质水平（5-HT、SP）均较治疗前降低，且治疗组均低于对照组，差异有统计学意义（P<0.05）。结论：经颅重复针刺法作用于足运感区可以改善坐骨神经痛患者疼痛，提高其腰椎活动功能及临床疗效，降低其血清疼痛介质水平。

关键词：坐骨神经痛；经颅重复针刺法；足运感区；腰椎活动度；血清疼痛介质

Abstract：

Objective: To observe the effects of repetitive transcranial acupuncture applied to the foot motor-sensory area on pain improvement and lumbar function in patients with sciatica. Methods: Totally 60 patients with sciatica were randomly divided into treatment group and  control group, with 30 patients in each group. The control group received acupuncture at the foot motor-sensory area (contralateral side), Cuanzhu (BL 2) point (ipsilateral side), Tongziliao (GB 1) point (ipsilateral side), lumbar paraspinal points L1-L5, Huantiao (GB 30) point (ipsilateral side), Yanglingquan (GB 34) point (ipsilateral side), Xuanzhong (GB 39) point (ipsilateral side), Qiuxu (GB 40) point (ipsilateral side), and Ashi points. The treatment group received the same treatment as the control group, with the addition of repetitive transcranial acupuncture applied to the foot motor-sensory area. Both groups had needles retained for 30 minutes per session, with treatment conducted once daily, five times per week, for two weeks per course, and two treatment courses in total. The visual analog scale (VAS) score, Japanese Orthopaedic Association (JOA) score, Oswestry Disability Index (ODI) score, and serum pain mediator [5-hydroxytryptamin (5-HT) and substance P (SP)] levels were observed before and after treatment in both groups. The clinical efficacy was evaluated. Results: During the treatment process, one case was dropped from both the control group and treatment group. After treatment, the total effective rate in the treatment group [96.6%(28/29)] was significantly higher than that in the control group [79.3%(23/29)], with statistically significant difference (P<0.05). The VAS and ODI scores decreased in two groups after treatment (P<0.05), and the treatment group showed lower VAS and ODI scores than control group, with statistically significant difference (P<0.05). The JOA score increased in two groups after treatment, and the treatment group showed higher JOA score than control group, with statistically significant difference (P<0.05). The serum pain mediator (5-HT and SP) levels were reduced in two groups after treatment, and the treatment group showed lower serum pain mediator levels than control group, with statistically significant difference (P<0.05). Conclusion: Repetitive transcranial acupuncture applied to the foot motor-sensory area can improve pain and enhance lumbar function in patients with sciatica, improve clinical efficacy, and reduce serum pain mediator levels.

Key words：sciatica; repetitive transcranial acupuncture; foot motor-sensory area; lumbar motion; serum pain media

发布时间：2026-01-08

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