基于“治痿独取阳明”探究电针治疗经皮椎间孔镜术后下肢肌肉萎缩的疗效研究
Exploring the Efficacy of Electroacupuncture in Treating Lower Limb Muscle Atrophy after Percutaneous Endoscopic Lumbar Discectomy Based on the Principle of “Treating Weakness by Focusing on the Yangming Meridian”
DOI: 10.12677/tcm.2026.1511623, PDF,   
作者: 王 振, 宋寒冰*：黑龙江中医药大学研究生院，黑龙江 哈尔滨
关键词: 腰椎间盘突出症；术后康复；电针疗法；Lumbar Disc Herniation； Postoperative Rehabilitation； Electroacupuncture Therapy
摘要: 探究以“治痿独取阳明”理论为取穴原则，运用电针疗法联合康复训练治疗经皮椎间孔镜术后下肢肌肉萎缩的疗效。选取符合纳入标准的60名患者，采用随机数字表对患者进行随机分组，分为对照组和试验组，每组各取30名患者作为研究对象。其中对照组病例采用术后第2天常规针刺取穴治疗配合功能锻炼的治疗方案，试验组病例依据“治痿独取阳明”理论取穴进行针刺取穴，于术后第2天以取穴原则取穴并施行电针疗法配合功能锻炼的治疗方案。分别于术后第2天、术后1周、术后2周、术后1个月记录各组患者观察指标结果。结果显示，试验组治疗效果优于对照组，其中，试验组腰椎功能恢复较对照组明显，评分较对照组有所降低(P < 0.05)；试验组关节活动度及下肢肌力恢复程度较对照组改善明显(P < 0.05)；试验组改良Macnab评分改变明显，且略高于对照组(P < 0.05)；试验组患者治疗后血清鸢尾素及骨钙素水平明显上升，较对照组提升明显(P < 0.05)；试验组在治疗后下肢各肌肉的iEMG和RMS值提升，且变化程度高于对照组(P < 0.05)；试验组患者在接受治疗之后下肢各肌肉厚度均有明显提升，且较对照组患者改善效果更佳(P < 0.05)，各统计数据差异均有统计学意义。综上所述，以“治痿独取阳明”取穴原则配合电针治疗腰椎椎间孔镜术后下肢肌肉萎缩疗效较好，可改善患者术后康复状况，缓解患者不适症状，有助于患者的康复过程。
Abstract: To investigate the efficacy of using the theory of “treating weakness by focusing on the Yangming Meridian” as the acupoint selection principle, combined with electroacupuncture therapy and rehabilitation training, for treating lower limb muscle atrophy after percutaneous endoscopic lumbar discectomy. A total of 60 patients who met the inclusion criteria were selected and randomly divided into a control group and an experimental group using a random number table, with 30 patients in each group. The control group received conventional acupuncture at selected points starting on the second day after surgery, along with functional exercise. The experimental group received acupuncture at points selected according to the theory of “treating weakness by focusing on the Yangming Meridian”, with electroacupuncture therapy and functional exercise starting on the second day after surgery. Observation indicators were recorded on the second day, one week, two weeks, and one month after surgery. The results showed that the therapeutic effect in the experimental group was superior to that in the control group. Specifically, lumbar function recovery in the experimental group was significantly better than in the control group, with lower scores (P < 0.05). Joint mobility and lower limb muscle strength recovery improved more significantly in the experimental group than in the control group (P < 0.05). The modified Macnab scores in the experimental group showed significant improvement and were slightly higher than those in the control group (P < 0.05). Serum irisin and osteocalcin levels in the experimental group increased significantly after treatment, with a more pronounced rise compared to the control group (P < 0.05). The iEMG and RMS values of various lower limb muscles in the experimental group increased after treatment, with a greater degree of change than in the control group (P < 0.05). The thickness of each lower limb muscle in the experimental group significantly increased after treatment, with better improvement compared to the control group (P < 0.05). All statistical differences were statistically significant. In conclusion, the acupoint selection principle of “treating weakness by focusing on the Yangming Meridian” combined with electroacupuncture therapy is effective in treating lower limb muscle atrophy after percutaneous endoscopic lumbar discectomy. It improves postoperative rehabilitation, alleviates discomfort, and facilitates the recovery process.
文章引用：王振, 宋寒冰. 基于“治痿独取阳明”探究电针治疗经皮椎间孔镜术后下肢肌肉萎缩的疗效研究[J]. 中医学, 2026, 15(11): 54-65. https://doi.org/10.12677/tcm.2026.1511623

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