足少阳胆经配穴为主针刺治疗坐骨神经痛的临床疗效观察:一项随机对照试验的二次分析OA

Objective:To evaluate the clinical efficacy of acupuncture primarily targeting the Foot Shaoyang Gallbladder Meridian in treatment of sciatica.Methods:A secondary analysis was conducted based on a large-sample,multi-center,randomized controlled trial of acupuncture for sciatica.Using the central block randomization method,91 patients with sciatica classified as the Foot Shaoyang Gallbladder Meridian syndrome type were randomly assigned to the acupuncture group(n=44)and the sham acupuncture group(n=47).The acupuncture group was treated with needling bilateral Dachangshu(BL25)and Guanyuanshu(BL26),as well as Huantiao(GB30),Fengshi(GB31),Xiyangguan(GB33),Yanglingquan(GB34),and Xuanzhong(GB39)along the affected side of Foot Shaoyang Gallbladder Meridian.The sham acupuncture group was treated with shallow needling or non-penetrating stimulation at nine non-meridian,non-acupoint locations between the Foot Shaoyang Gallbladder Meridian and Foot Taiyang Bladder Meridian.Both groups received 30-minute sessions per treatment.During the first 2 weeks,acupuncture was administered three times per week,and during the following 2 weeks,twice per week,for a total treatment duration of 4 weeks,with a follow-up period of 26 weeks.The following outcomes were assessed:Leg pain reduction using the Visual Analog Scale(VAS)at weeks 2,4,8,and 26 compared with baseline;physical and mental health scores from the SF-36 Health Survey at weeks 4,8,and 26;patient self-reported recovery rate using the 7-point Likert scale(score≤2)at weeks 2 and 26;acupuncture-related adverse events.The VAS reduction at week 4 was defined as the primary outcome,while all other measures were considered secondary outcomes to compare the therapeutic effects between the two groups.Results:During the treatment and follow-up periods,the acupuncture group showed significantly greater reductions in leg pain VAS scores at weeks 2,4,8,and 26 than the sham acupuncture group(P＜0.01).The SF-36 physical health scores in the acupuncture group at weeks 4,8,and 26 were significantly higher than those in the sham group(P＜0.01),whereas SF-36 mental health scores showed no significant differences between the two groups(P＞0.05).Regarding patient recovery,the acupuncture group had 30 recovered patients at weeks 4 and 26,compared with 6 and 12 patients in the sham acupuncture group,respectively,showing a significantly higher recovery rate in the acupuncture group(P＜0.01).Conclusion:Acupuncture targeting the Foot Shaoyang Gallbladder Meridian acupoints for treatment of sciatica demonstrates significant clinical efficacy,effectively relieving leg pain,improving physical function,and increasing recovery rates in patients.