The Clinical Study On Treatment Of Sciatica Caused By Lumbar Disc Herniation By Elongated Needle Rapid Needling Combined With Differentiation Of Meridians

Objective:To compare the clinical efficacy of"elongated needle rapid needling combined with differentiation of meridians"and conventional acupuncture in treating sciatica caused by lumbar disc herniation,and explore its effectiveness and advantages,so as to provide a more effective acupuncture treatment scheme for clinical treatment of this disease.Method:In this study,patients diagnosed with LDH-induced sciatica who visited the acupuncture department of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from March to December 2021 were included to compare the clinical efficacy of"elongated needle rapid needling combined with differentiation of meridians"and conventional acupuncture in treating sciatica caused by lumbar disc herniation.SPSS 25.0was used to generate random numbers for grouping,with 33 cases in the treatment group and33 cases in the control group.The treatment group was treated with elongated needle rapid needling combined with differentiation of meridians,the main points are Huantiao（GB30）,Zhibian（BL54）,Weizhong（BL40）,Qihaishu（BL24）,Dachangshu（BL25）,and Guanyuanshu（BL26）;Those with meridian differentiation of foot-sun meridian syndrome are matched with Chengfu（BL36）,Yinmen（BL37）,Chengshan（BL57）,Feiyang（BL58）and Kunlun（BL60）,while those with meridian differentiation of foot-shaoyang meridian syndrome are matched with Fengshi（GB31）,Yanglingquan（GB34）and Xuanzhong（GB39）;All of the above are mixed.The control group was intervened by ordinary acupuncture,and the points were based on the treatment scheme of sciatica in Acupunctureand Moxibustion in the 4th edition of the new century.The foot-sun meridian syndrome:Yaojiaji（EX-B2）,Ashi point,Zhibian（BL54）,Yinmen（BL37）,Weizhong（BL40）,Chengshan（BL57）and Kunlun（BL60）;The foot-shaoyang meridian syndrome:Yaojiaji（EX-B2）,Ashi point,Huantiao（GB30）,Yanglingquan（GB34）,Xuanzhong（GB39）and Qiuxu（GB40）.Patients in both groups were treated with acupuncture once a day,five times a week in a row,and the next week’s treatment was started two days later,with 15 times as a course of treatment.The curative effect was observed after one course of intervention.By observing and recording the VAS,modified ODI and JOA scales before intervention and comparing them with those recorded after a course of intervention,the curative effect and symptom improvement of the treatment group and the control group were objectively tested and evaluated.SPSS25.0 is used for statistical analysis of all the data.For the measurement data conforming to normal distribution by S-W test,mean±standard deviation（?x±s）was used to describe data and t-test was used for statistical inference.And for those that conform to the skewed distribution,the median（upper quartile,lower quartile）namely M(P₂₅,P₇₅)was used to describe data and rank sum test was used for statistical inference.Chi-square test was used for statistical inference of non-grade data in counting data,and rank sum test was used for grade data.P<0.05 was statistically significant.Result:By the end of December 2021,66 patients were enrolled in this project.There were 26 males and 37 females,aged between 23 and 75 years,with a course of disease of14（5,28）months.There were 3 cases of shedding,32 cases in the final treatment group and31 cases in the control group,with a detachment rate of 4.55%.1 There was no significant difference in gender,age,course of disease,TCM syndrome type,meridian type,VAS scores,improved ODI scores and lumbar JOA scores between the two groups before the intervention（P>0.05）,indicating that the baseline was comparable.2 VAS scores:When intra-group comparison was conducted,VAS scores after treatment decreaced compared with before treatment in both groups,and the difference was statistically significant（P<0.05）,which indicated that both elongated needle rapid needling combined with differentiation of meridians and conventional acupuncture could improve the pain;When compared between groups,the VAS score of the treatment group was lower after treatment,and the difference was statistically significant（P<0.05）,indicating that elongated needle rapid needling combined with differentiation of meridians was better in relieving pain.3 Improved ODI scores:When intra-group comparison was conducted,the ODI scores after treatment in both groups decreased compared with before treatment,and the difference was statistically significant（P<0.05）,which indicated that both elongated needle rapid needling combined with differentiation of meridians and conventional acupuncture could improve the dysfunction.When inter-group comparison was conducted,the ODI scores of the treatment group was lower after treatment,and the difference was statistically significant（P<0.05）,indicating that elongated needle rapid needling combined with differentiation of meridians could promote the recovery of dysfunction to a greater extent.4 JOA scores:When intra-group comparison was conducted,JOA scores of the two groups after treatment were increased compared with those before treatment,with a statistically significant difference（P<0.05）,which indicated that both elongated needle rapid needling combined with differentiation of meridians and conventional acupuncture could improve symptoms and signs.When inter-group comparison was conducted,JOA scores of the treatment group are higher after treatment,with a statistically significant difference（P<0.05）,indicating that elongated needle rapid needling combined with differentiation of meridians could improve symptoms and signs better.5 Overall curative effect:The total effective rate of the treatment group was 90.63%,and that of the control group was 77.42%.According to the rank sum test,the overall efficacy difference between the two groups was statistically significant（P<0.05）,indicating that the effect of elongated needle rapid needling combined with differentiation of meridians is better.Conclusion:1 The treatment of sciatica caused by LDH with elongated needle rapid needling combined with differentiation of meridiansis and conventional acupuncture is effective.2 The clinical curative effect of treating sciatica caused by LDH by elongated needle rapid needling combined with differentiation of meridians is better than that of conventional acupuncture group.3 The elongated needle rapid needling combined with differentiation of meridians has more advantages in relieving pain,improving symptoms and signs and improving quality of life in LDH-induced sciatica patients,which is worthy of clinical application.