刃针联合电针治疗椎间盘源性腰痛的临床疗效研究

A Clinical Study on the Efficacy of Combined Blade-Needle and Electroacupuncture Therapy for Discogenic Low Back Pain

摘要: 目的：评价刃针联合电针对椎间盘源性腰痛(discogenic low back pain, DLBP)的临床疗效。方法：本研究纳入2025年1月至2025年12月宜宾市中西医结合医院康复科门诊及住院部收治的DLBP患者116例，随机分为观察组(58例刃针联合电针治疗)和对照组(58例电针治疗)。分别于治疗前、治疗2周后及随访3个月时采用视觉模拟评分量表(visual analogue scale, VAS)、日本骨科协会腰痛评分(Japanese Orthopaedic Association, JOA)和改良Oswestry功能障碍指数(modified Oswestry disability index, ODI)进行疗效评价。结果：1) 基线及完成情况：本研究共纳入116例DLBP患者，观察组和对照组各58例；最终104例完成疗效评价，其中观察组51例，对照组53例。两组基线特征比较差异均无统计学意义(P > 0.05)，具有可比性。2) 疗效评价结果显示：治疗2周后及随访3个月时，两组VAS和ODI评分均较基线下降，JOA评分均较基线升高，差异均有统计学意义(均P < 0.05)；与对照组相比，观察组在上述两个时间点VAS和ODI下降幅度更大，JOA升高幅度更大，差异均有统计学意义(均P < 0.05)。3) 两组患者由治疗2周至随访3个月仍有进一步改善，但该阶段VAS、JOA和ODI变化幅度的组间差异均无统计学意义(P > 0.05)。结论：刃针联合电针能够进一步缓解DLBP患者的疼痛、改善腰椎功能，其近期及3个月随访疗效均优于单纯电针治疗。

Abstract: Objective: Evaluating the clinical effectiveness of blade needle combined with electroacupuncture for discogenic low back pain (DLBP). Method: This study included 116 DLBP patients admitted to the Rehabilitation Department Outpatient and Inpatient Units of Yibin Integrated Traditional Chinese and Western Medicine Hospital from January 2025 to December 2025. The patients were randomly divided into an observation group (58 cases treated with a combination of plum-blade needle and electroacupuncture) and a control group (58 cases treated with electroacupuncture). Efficacy was evaluated using the Visual Analogue Scale (VAS), the Japanese Orthopaedic Association low back pain score (JOA), and the Modified Oswestry Disability Index (ODI) before treatment, after 2 weeks of treatment, and during a 3-month follow-up. Result: 1) Baseline and Completion Status: This study included a total of 116 DLBP patients, with 58 cases in the observation group and 58 cases in the control group; ultimately, 104 cases completed the treatment efficacy evaluation, including 51 cases in the observation group and 53 cases in the control group. There were no statistically significant differences in baseline characteristics between the two groups (P > 0.05), indicating comparability. 2) The results of efficacy evaluation showed that after 2 weeks of treatment and at 3 months of follow-up, the VAS and ODI scores in both groups decreased compared to baseline, while the JOA scores increased compared to baseline, with all differences being statistically significant (all P < 0.05); compared with the control group, the observation group showed greater decreases in VAS and ODI and greater increases in JOA at both time points, with all differences being statistically significant (all P < 0.05). 3) Patients in both groups continued to show further improvement from the 2-week treatment to the 3-month follow-up, but the intergroup differences in VAS, JOA, and ODI changes during this period were not statistically significant (P > 0.05). Conclusion: Combining blade needle with electroacupuncture can further relieve pain and improve lumbar function in DLBP patients, with both short-term and 3-month follow-up results being better than electroacupuncture alone.