针灸治疗梨状肌综合征的研究进展

Research Progress on Acupuncture and Moxibustion Therapy for Piriformis Syndrome

摘要: 梨状肌综合征(Piriformis Syndrome, PS)是临床常见的周围神经卡压性疾病，因梨状肌痉挛、粘连或肥厚卡压坐骨神经引发，以臀部疼痛、下肢放射痛及髋关节活动受限为主要临床表现，显著降低了患者生活质量。中医学将本病归属“痹证”的范畴，核心病机为臀部经络气血阻滞、筋脉失养，针灸作为本病治疗的重要手段，具有安全有效、操作简便、经济易行的优势，已获得广泛临床认可。本文系统梳理近年来针灸治疗梨状肌综合征的研究动态，全面综述毫针刺法、电针、小针刀、浮针、基于《灵枢·官针》的多针刺法、温针灸、雷火灸等单一疗法的临床应用与疗效特点，以及针灸联合中药、推拿等综合方案的研究进展，同时梳理了当前研究存在的共性局限，对未来研究方向予以展望，旨在为梨状肌综合征的针灸临床优化与深入研究提供参考依据。

Abstract: Piriformis syndrome (PS) is a common peripheral nerve entrapment disorder caused by sciatic nerve compression secondary to piriformis spasm, adhesion or hypertrophy. It presents with gluteal pain, radiating lower limb pain and restricted hip mobility, and significantly impairs patients’ quality of life. In traditional Chinese medicine, PS falls into the category of Bi Syndrome, whose core pathogenesis is qi-blood stagnation in gluteal meridians and insufficient nourishment of tendons. As a mainstay treatment for PS, acupuncture-moxibustion is well recognized clinically for its reliable efficacy, favorable safety, easy operation and low cost. This paper systematically reviews the research trends of acupuncture and moxibustion therapy for piriformis syndrome in recent years. It comprehensively summarizes the clinical application and efficacy features of single therapies including filiform acupuncture, electroacupuncture, small needle knife, Fu’s subcutaneous needling, multi-needling methods derived from Lingshu·Guan Zhen, warm acupuncture and thunder-fire moxibustion, as well as the research progress of combined regimens such as acupuncture-moxibustion coupled with Chinese herbal medicine and Tuina manipulation. Meanwhile, it sorts out the common limitations of current studies and puts forward prospects for future research directions, aiming to provide references for the clinical optimization and further research of acupuncture and moxibustion in the treatment of piriformis syndrome.