浅谈针灸治疗坐骨神经痛的临床研究进展及展望

Brief Discussion on the Clinical Research Progress and Prospects of Acupuncture and Moxibustion in the Treatment of Sciatica

摘要: 坐骨神经痛是临床高发的周围神经病症，以腰臀部沿坐骨神经走行区域出现放射性疼痛、麻木或肌力减弱为核心表现，严重干扰患者日常活动与生活质量。目前西医治疗以对症干预为主，常用非甾体抗炎药缓解疼痛、神经营养剂改善神经功能，必要时采取手术解除压迫，但长期用药易引发胃肠道损伤、肝肾功能异常等副作用，手术治疗还存在术后粘连、疗效不稳定等风险，临床应用存在明显局限。近年临床研究表明，温针灸、电针、浮针等不同针灸疗法可通过改善局部血液循环、调节神经递质水平、减轻炎症反应缓解症状，部分研究证实其总有效率超85%，且远期复发率低于西医常规治疗。本文回顾近年针灸治疗坐骨神经痛的临床研究进展，分析不同疗法的应用特点与疗效差异，同时展望未来在规范化诊疗方案制定、作用机制深入探索等方面的研究方向，为临床实践提供参考。

Abstract: Sciatica is a common peripheral nerve disorder in clinical practice, characterized by radiating pain, numbness, or muscle weakness in the lumbosacral region and along the distribution of the sciatic nerve. These symptoms severely interfere with patients’ daily activities and quality of life. At present, Western medicine mainly adopts symptomatic interventions: non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to relieve pain, neurotrophic agents to improve nerve function, and surgery to relieve compression when necessary. However, long-term medication is prone to side effects such as gastrointestinal damage and abnormal liver and kidney function, while surgical treatment carries risks like postoperative adhesions and unstable therapeutic effects, leading to obvious limitations in clinical application. In recent years, clinical studies have shown that different acupuncture therapies such as warm acupuncture, electroacupuncture, and floating acupuncture can alleviate symptoms by improving local blood circulation, regulating neurotransmitter levels, and reducing inflammatory responses. Some studies have confirmed that their total effective rate exceeds 85%, with a long-term recurrence rate lower than that of conventional Western medicine treatment. This article reviews the progress of clinical research on acupuncture for sciatica in recent years, analyzes the application characteristics and therapeutic effects of different therapies, and looks forward to future research directions in the formulation of standardized diagnosis and treatment protocols and in-depth exploration of mechanisms of action, so as to provide reference for clinical practice.