不同频次针刺疗法治疗腰椎间盘突出症的临床疗效观察

Clinical Efficacy of Acupuncture at Different Frequencies for Lumbar Disc Herniation

摘要: 目的：对比每日针刺1次与每日2次治疗腰椎间盘突出症(LDH)的临床疗效差异，以优化针刺治疗方案，提升临床诊疗水平。方法：采用随机单盲对照试验设计。选取2024年1月至2025年12月平江县中医医院收治的符合中西医诊断标准的LDH患者，利用随机数表法分为对照组(每日针刺1次)和试验组(每日针刺2次)。两组取穴及操作手法一致。主要评价指标采用简式McGill疼痛问卷(SF-MPQ)，并记录不良反应。数据采用SPSS 25.0软件进行统计分析。结果：两组患者基线资料比较差异无统计学意义(P > 0.05)。治疗后及随访期间，两组疼痛评分均较治疗前显著降低(P < 0.01)。在治疗第4天、疗程结束时及随访期，试验组的疼痛评分(PRI总分、VAS评分等)改善程度均优于对照组，差异有统计学意义(P < 0.01)。疗程结束时，试验组的总体有效率(96.0%)及显效率(78.0%)均高于对照组(88.0%、64.0%)，差异有统计学意义(P < 0.05)。两组不良事件发生率相当，均为轻微反应。结论：针刺治疗LDH疗效确切。在相同取穴和操作下，每日2次的针刺方案相较于每日1次，能更快速、显著地缓解疼痛并提高临床显效率，且不增加不良反应风险。该方案可作为急性期或需快速缓解症状的LDH患者的优选治疗策略。

Abstract: Objective: To compare the clinical efficacy of acupuncture administered once daily versus twice daily for the treatment of Lumbar Disc Herniation (LDH), with the aim of optimizing acupuncture protocols and improving clinical therapeutic levels. Methods: A randomized single-blind controlled trial design was employed. Patients meeting both Traditional Chinese Medicine (TCM) and Western medicine diagnostic criteria for LDH were recruited from a county hospital of Traditional Chinese Medicine between January 2024 and December 2025. Using a random number table, patients were allocated into a Control Group (acupuncture once daily) and an Experimental Group (acupuncture twice daily). Both groups received identical acupoint selection and manipulation techniques. The primary outcome measure was the Short-Form McGill Pain Questionnaire (SF-MPQ). Data were analyzed using SPSS statistical software. Results: There were no significant differences in baseline characteristics between the two groups (P > 0.05). Post-treatment and during follow-up, pain scores in both groups decreased significantly compared to pre-treatment levels (P < 0.01). On day 4 of treatment, at the end of the treatment course, and during the follow-up period, the pain scores (PRI total score, VAS score, etc.) of the experimental group were significantly better than those of the control group (P < 0.01). At the end of the treatment course, the overall effective rate (96.0%) and significant effective rate (78.0%) in the experimental group were higher than those in the control group (88.0% and 64.0%, respectively), and the differences were statistically significant (P < 0.05). The incidence of adverse events was similar in both groups, and all were mild reactions. Conclusion: Acupuncture is an effective treatment for LDH. Under the same acupoint selection and procedure, twice-daily acupuncture provides faster and more significant pain relief and improves clinical efficacy compared to once-daily acupuncture, without increasing the risk of adverse reactions. This regimen can be considered a preferred treatment strategy for LDH patients in the acute phase or those requiring rapid symptom relief.