基于“筋经理论”循经透刺法联合核心肌群 松解训练治疗脊柱侧弯腰痛的临床研究

Clinical Study on Treating Scoliosis-Related Low Back Pain with Meridian-Targeted Acupuncture Combined with Core Muscle Release Training Based on “Meridian Theory”

摘要: 目的：探讨基于筋经理论的循经透刺法联合核心肌群松解训练对脊柱侧弯腰痛患者的临床疗效及机制。方法：选取2023年1月至2025年1月黑龙江中医药大学附属第一医院收治的40例脊柱侧弯腰痛患者，按随机数字表分为试验组(20例)和对照组(20例)。两组均接受日常健康管理及核心肌群松解训练，试验组加用循经透刺法(选取足阳明胃经、足少阳胆经、足太阴脾经、带脉及足太阳膀胱经的“筋经病灶点”，行15˚斜刺透穴)，对照组加用常规针刺(腰部穴位、环跳、委中、承山等)。比较两组治疗前后Cobb角、表面肌电均方根值(RMS)、疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、现时疼痛强度(PPI)及临床疗效，随访3个月观察复发率。结果：治疗后，试验组Cobb角矫正率(21.3% ± 5.6%)显著高于对照组(12.1% ± 4.2%, P < 0.05)；试验组腰部肌肉RMS值(0.28 ± 0.06 mV)显著高于对照组(0.21 ± 0.05 mV, P < 0.05)；试验组VAS (2.1 ± 0.8分)、ODI (18.3% ± 5.1%)、PPI (1.2 ± 0.5分)均显著低于对照组(3.5 ± 1.1分、27.6% ± 6.3%、2.1 ± 0.7分，P < 0.05)。试验组总有效率(90.0%)显著高于对照组(70.0%, P < 0.05)；随访3个月，试验组复发率(10.0%)显著低于对照组(35.0%, P < 0.05)。结论：基于筋经理论的循经透刺法联合核心肌群松解训练可有效矫正脊柱侧弯、改善肌肉功能、缓解腰痛，疗效优于常规针刺，且复发率低，值得临床推广。

Abstract: Objective: To investigate the clinical efficacy and mechanism of meridian-targeted acupuncture combined with core muscle release training based on muscle meridian theory in patients with scoliosis and low back pain. Methods: A total of 40 patients with scoliosis and low back pain admitted to The First Affiliated Hospital of Heilongjiang University of Chinese Medicine from January 2023 to January 2025 were selected and divided into experimental group (20 cases) and control group (20 cases) according to a random number table. Both groups received daily health management and core muscle relaxation training, and the experimental group added the meridian-targeted acupuncture (selected the “tendon meridian lesions” of the foot Yangming stomach meridian, foot Shaoyang gallbladder meridian, foot Taiyin spleen meridian, belt pulse and foot taiyang bladder meridian, and performed 15˚ oblique acupuncture points), and the control group added conventional acupuncture (lumbar acupoints, ring jumping, Weizhong, Chengshan, etc.). The Cobb angle, surface electromyography root mean square value (RMS), pain visual analogue score (VAS), Oswestry dysfunction index (ODI), current pain intensity (PPI) and clinical efficacy between the two groups before and after treatment were compared, and the recurrence rate was observed after 3 months of follow-up. Results: After treatment, the Cobb angle correction rate in the experimental group (21.3% ± 5.6%) was significantly higher than that in the control group (12.1% ± 4.2%, P < 0.05). The RMS value of lumbar muscles in the experimental group (0.28 ± 0.06 mV) was significantly higher than that in the control group (0.21 ± 0.05 mV, P < 0.05). VAS (2.1 ± 0.8 points), ODI (18.3% ± 5.1%) and PPI (1.2 ± 0.5 points) in the experimental group were significantly lower than those in the control group (3.5 ± 1.1 points, 27.6% ± 6.3%, 2.1 ± 0.7 points, P < 0.05). The total effective rate of the experimental group (90.0%) was significantly higher than that of the control group (70.0%, P < 0.05). After 3 months of follow-up, the recurrence rate of the experimental group (10.0%) was significantly lower than that of the control group (35.0%, P < 0.05). Conclusion: The meridian-targeted acupuncture based on the theory of meridian combined with core muscle release training can effectively correct scoliosis, improve muscle function, and relieve low back pain, with better efficacy than conventional acupuncture and low recurrence rate, which is worthy of clinical promotion.