[1]龙小荣,李莎莎,刘芊芊,等.子午流注纳支法针刺京骨、昆仑治疗腰椎间盘突出症疗效研究[J].陕西中医,2025,46(7):983-986.[doi:DOI:10.3969/j.issn.1000-7369.2025.07.024]
　LONG Xiaorong,LI Shasha,LIU Qianqian,et al.Research on therapeutic efficacy of acupuncture at Jinggu and Kunlun using meridian-branching method of midday-meridian circulation in treatment of lumbar disc herniation[J].,2025,46(7):983-986.[doi:DOI:10.3969/j.issn.1000-7369.2025.07.024]
点击复制

子午流注纳支法针刺京骨、昆仑治疗腰椎间盘突出症疗效研究

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年7期
页码:
983-986
栏目:
针灸经络
出版日期:
2025-07-05

文章信息/Info

Title:
Research on therapeutic efficacy of acupuncture at Jinggu and Kunlun using meridian-branching method of midday-meridian circulation in treatment of lumbar disc herniation
作者:
龙小荣1; 李莎莎1; 刘芊芊1; 李思棋1; 廖珂莹1; 邱志芳1; 周魁明2; 刘妮杰2; 蒋学余2
（1.湖南中医药大学，湖南 长沙 410208；2.岳阳市中医医院，湖南 岳阳 414000）
Author(s):
LONG Xiaorong1; LI Shasha1; LIU Qianqian1; LI Siqi1; LIAO Keying1; QIU Zhifang1; ZHOU Kuiming2; LIU Nijie2; JIANG Xueyu2
（1.Hunan University of Chinese Medicine,Changsha 410208,China；2.Yueyang Hospital of Traditional Chinese Medicine，Yueyang 414000，China）
关键词:
腰椎间盘突出症; 子午流注; 纳支法; 申时; 京骨穴; 昆仑穴; 炎症因子; 椎间盘回纳
Keywords:
Lumbar disc herniation; Meridian-branching method; Na-Zhi method; Shenshi; Jinggu; Kunlun; Inflammatory factors; Disc retraction
分类号:
R 245.31
DOI:
DOI:10.3969/j.issn.1000-7369.2025.07.024
文献标志码:
A
摘要:
目的：探讨子午流注纳支法联合腰痛八穴治疗腰椎间盘突出症（LDH）的临床疗效及作用机制。方法：将 120例LDH患者随机分为观察组和对照组，每组60例。观察组采用子午流注纳支法，于申时针刺京骨、昆仑，得气后加腰痛八穴（肾俞、气海俞、大肠俞、关元俞、环跳、委中、阳陵泉、照海）行平补平泻手法治疗。对照组仅取腰痛八穴，针法同观察组。两组均每日1次，5次为1个疗程，每个疗程间隔2 d，共2个疗程。于治疗前后评定视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）评分、椎间盘突出量。于治疗前后检测外周血炎症因子［白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）］水平，并评估临床疗效及安全性。结果：与治疗前相比，两组 VAS、ODI评分降低且腰椎间盘突出量减少（均P＜0.05），IL-6、TNF-α水平降低（均P＜0.05），且观察组各项指标降低较对照组更显著。观察组总有效率95.0%高于对照组的83.3%（P＜0.05）。研究期间两组均未出现严重不良反应。结论：子午流注纳支法针刺京骨、昆仑能改善LDH患者的症状和体征，其作用机制可能是通过调控血清炎症因子、促进椎间盘回纳实现多靶点治疗。
Abstract:
Objective:Investigate clinical efficacy and underlying mechanism of meridian-branching method combined with eight acupoints for low-back pain in treating lumbar disc herniation (LDH).Methods:A total of 120 patients with LDH were randomly allocated into observation group and control group,with 60 patients in each group.In the observation group,the meridian-branchin method was adopted.At Shenshi,acupuncture was performed on Jinggu and Kunlun.After De Qi was achieved,the eight acupoints for low-back pain,namely Shenshu,Qi Hai Shu,Da Chang Shu,Guan Yuan Shu,Huantiao,Weizhong,Yang Ling Quan,and Zhaohai were treated using reinforcing-reducing manipulation.In the control group,only the eight acupoints for low-back pain were selected,and the acupuncture manipulation was the same as that in the observation group.Both groups received treatment once a day.Five treatments constituted one course,with two-day interval between courses.A total of two courses were carried out.VAS ODI score,and the degree of lumbar disc herniation were assessed before and after treatment.The levels of peripheral blood inflammatory factors,including interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) were measured before and after treatment.Additionally,the clinical efficacy and safety were evaluated.Results:Compared with those before treatment,VAS and ODI scores in both groups decreased significantly,and the degree of lumbar disc herniation was reduced (all P＜0.05).Moreover,the levels of IL-6 and TNF-α decreased (all P＜0.05).Notably,the reductions in all these indices in the observation group were more pronounced than those in the control group.The total effective rate in the observation group was 95.0%,which was significantly higher than 83.3% in the control group(P＜0.05).No severe adverse reactions were observed in either group during the study period.Conclusion:Acupuncture at Jinggu and Kunlun points using the meridian-branching method can ameliorate the symptoms and signs of patients with LDH.Its potential mechanism may involve regulating serum inflammatory factors and promoting the retraction of intervertebral disc,thereby achieving multi-target therapeutic effects.

参考文献/References:

[1]周谋望,岳寿伟,何成奇,等.“腰椎间盘突出症的康复治疗”中国专家共识[J].中国康复医学杂志,2017,32(2):129-135.
[2]陈建华,罗振群,王东超,等.腰椎板切开后移回植术治疗腰椎间盘突出5例[J].陕西医学杂志,2009,38(7):935-936.
[3]DEYO R A,MIRZA S K,CLINICAL PRACTICE.Herniated lumbar intervertebral disk[J].N Engl J Med,2016,374(18):1763-1772.
[4]梁雪珊.腰椎间盘突出症的危险因素分析[J].中国当代医药,2016,23(22):180-182.
[5]裴丽敏,杜武勋,李晓凤.中医气化理论探讨[J].陕西中医,2021,42(11):1586-1590.
[6]AIRAKSINEN O,BROX J I,CEDRASCHI C,et al.European guidelines for the management of chronic nonspecific low back pain[J].Eur Spine J,2006,15（2）:s192-s300.
[7]聂道芳.子午流注纳支法治疗腰椎间盘突出症疼痛的临床研究[D].成都：成都中医药大学,2008.
[8]崔学军,梁倩倩.腰椎间盘突出症中西医结合诊疗专家共识[J].世界中医药,2023,18(7):945-952.
[9]石学敏.针灸学[M].北京：中国中医药出版社,2004:127-135.
[10]张玉梅,宋鲁平.康复评定常用量表[M].科学技术文献出版社,2018:501.
[11]郑魁山.子午流注与灵龟八法[M].兰州：甘肃科学技术出版社,2008:10-11.
[12]吴跃男,吴晓红.疼痛按“时间”论治[J].新疆中医药,1995，12(3):8-9.
[13]佟黎.子午流注针法联合运动疗法治疗腰椎间盘突出症的疗效观察研究[D].广州：广州体育学院,2023.
[14]陈华,肖鲁伟.试从经脉循行探讨足太阳膀胱经与腰腿痛的相关性[J].中华中医药杂志,2014,29(11):3537-3539.
[15]胡强,汪春春.针刺京骨穴配合推拿阳性激发点治疗腰背肌筋膜炎临床观察[J].中国中医药现代远程教育,2021,19(16):123-125.
[16]杨洁,余思奕,杨明晓,等.穴位具有特异性作用——“973计划”经穴特异性项目概览[J].成都中医药大学学报,2015,38(2):93-95.
[17]娄睿智.针刺健康志愿者昆仑穴激活脑区fMRI研究[D].哈尔滨：黑龙江中医药大学,2023.
[18]刘宜军,杨勇,周斌,等.基于功能磁共振成像技术研究踝三针对第5腰椎神经根性痛镇痛作用的中枢机制[J].北京中医药大学学报,2017,40(3):259-264.
[19]禤科成,陈永锋,殷贤勤.正脊手法联合背俞穴针刺治疗腰椎间盘突出症的临床疗效观察[J].大众科技,2021,23(4):92-95.
[20]金末淑,陈思宇,徐杉,等.背俞穴研究进展[J].中国中医药信息杂志,2009,16(s1):106-109.
[21]林志刚,林坚,龚德贵,等.腰部推拿配合拍打委中穴治疗急性腰椎间盘突出症的临床研究[J].河北中医,2017,39(7):1082-1085.
[22]王晓晨,吉爱国.NF-κB信号通路与炎症反应[J].生理科学进展,2014,45(1):68-71.
[23]李阳,郝艺照,傅熠俊,等.针刺天枢穴对结肠炎肠上皮细胞NF-κB信号通路的影响[J].中华中医药杂志,2017,32(11):5143-5147.
[24]马天明,李然,程为平.针刺百会和风池穴对神经性皮炎模型大鼠NF-κB信号通路的影响[J].辽宁中医药大学学报,2017,19(8):124-127.
[25]张王华,王峰,金诚久,等.刺腰夹脊联合四指推脊柱调整手法对腰椎间盘突出症患者腰椎功能及疼痛程度的影响[J].陕西中医,2021,42(1):109-111.

相似文献/References:

[1]王权亮,高根建,杨 勇.搓飞针刺手法治疗急性腰椎间盘突出症疗效评价及机制研究*[J].陕西中医,2019,(1):116.
[2]肖 伟,龚明发,向文海,等.肌筋膜松弛术结合针灸治疗腰椎间盘突出症临床研究*[J].陕西中医,2019,(7):902.
[3]李道通,毛书歌.手法整骨复位结合中医定向透药疗法治疗腰椎间盘突出症疗效研究*[J].陕西中医,2019,(8):1077.
　LI Daotong,MAO Shuge..Therapeutic effect of manual orthopedic reduction combined with traditional Chinese medicine directed drug therapy for lumbar disc herniation[J].,2019,(7):1077.
[4]陈天良,练子荣,陈博来△,等.针灸治疗经皮椎间孔镜治疗腰椎间盘突出症术后残余症状临床研究[J].陕西中医,2019,(8):1138.
[5]李俊龙,周 景,刘斯文,等.中医外治法在腰椎间盘突出症急性期的应用进展*[J].陕西中医,2019,(8):1145.
　LI Junlong,ZHOU Jing,LIU Siwen,et al.Clinical research progress of external therapy of TCM for acute lumbar disc herniation[J].,2019,(7):1145.
[6]王 雷,郭运岭,王 壮,等.“柔筋调脊”针法治疗腰椎间盘突出症所致慢性腰腿痛疗效研究*[J].陕西中医,2019,(10):1464.
　WANG Lei,GUO Yunling,WANG Zhuang,et al.Observation of the clinical effects on chronic lumbar and leg pain caused by lumbar disc herniation treated with soft muscle and adjust spine acupuncture[J].,2019,(7):1464.
[7]周锡奎,高璟△,徐东华.针刺联合麻黄附子细辛汤加味治疗腰椎间盘突出症临床研究[J].陕西中医,2019,(11):1627.
　ZHOU Xikui,GAO Jing,XU Donghua..Clinical study on treatment of lumbar intervertebral disc herniation with acupuncture combined with Mahuang Fuzi Xixin decoction[J].,2019,(7):1627.
[8]王智群,刘汝专△,张 磊,等.桃红四物汤联合经皮椎间孔镜治疗腰椎间盘突出症疗效研究*[J].陕西中医,2019,(12):1676.
　WANG Zhiqun,LIU Ruzhuan,ZHANG Lei,et al.Clinical study on the treatment of lumbar disc herniation with Taohong Siwu decoction combined with percutaneous endoscopic transluminal discectomy[J].,2019,(7):1676.
[9]刘晶晶,许晓爽,赵 婧,等.独活续断汤辅助治疗老年腰椎间盘突出症疗效〖JZ〗及对患者血清代谢组学的影响*[J].陕西中医,2020,(1):76.
[10]王远庆,吴耀持.超微针刀网点状松解法对腰椎间盘突出症患者VAS评分和JOA腰椎疾患评分的影响[J].陕西中医,2020,(4):541.
　WANG Yuanqing,WU Yaochi..The effect of ultra fine needle knife on VAS score and JOA lumbar disease score in patients with lumbar disc herniation[J].,2020,(7):541.

备注/Memo

备注/Memo:
湖南省自然科学基金资助项目（2024JJ7603）；湖南省中医药管理局局市（州）联合中医药科研课题（E2023039，E2023040）；湖南省卫生健康委员会科研课题（D202304079413）；湖南中医药大学校院联合基金资助项目（2022XYLH190，2023XYLH062，2023XYLH065，2023XYLH066）
更新日期/Last Update: 2025-07-09