体质量指数对针刺治疗椎间盘源性坐骨神经痛疗效的影响:一项多中心随机对照试验的二次分析OA

Objective To explore the effect of body mass index(BMI)on the efficacy of acupuncture for discogenic sciatica.Methods A secondary analysis was conducted based on data from a multicenter randomized controlled trial.A total of 216 patients with discogenic sciatica were randomly assigned to an acupuncture group(108 cases,4 cases dropped out)and a sham acupuncture group(108 cases,12 cases dropped out).The patients in the acupuncture group were treated with acupuncture,bilateral Dachangshu(BL25)and Guanyuanshu(BL26)were selected as the main points,with five additional acupoints based on meridian syndrome differentiation.The patients in the sham acupuncture group were treated with acupuncture at seven non-meridian and non-acupoint points.Each treatment lasted 30 min,with a total of 10 sessions for 4 weeks.Patients in each group were further divided into two subgroups according to BMI:normal body type(BMI＜24 kg/m2)and overweight/obese type(BMI≥24 kg/m2).Visual analogue scale(VAS)score for leg pain and Oswestry disability index(ODI)score were recorded before and after treatment in the two BMI subgroups.The interaction between BMI and treatment method was also analyzed.Results There were 113 patients in the normal BMI subgroup and 103 in the overweight/obese subgroup,with a higher proportion of female patients.In the acupuncture group,the differences between pre-treatment and post-treatment leg pain VAS scores and ODI scores in both normal BMI patients and overweight/obese patients were greater than those in the sham acupuncture group(P＜0.001,P＜0.05).After treatment,no interaction was found between BMI and treatment method in terms of VAS and ODI scores(P＞0.05).Conclusion Acupuncture is effective in treating discogenic sciatica patients regardless of BMI,and its efficacy is not influenced by BMI.