疼痛程度对针刺治疗椎间盘源性坐骨神经痛疗效的影响OA

Objective To investigate the impact of pain intensity on the effect of acupuncture in patients with sciatica from a herniated disk.Methods A total of 216 patients with sciatica from a herniated disk were randomly assigned to an acupuncture group(n=108)or a sham acupuncture group(n=108).The patients in the acupuncture group received a semi-standardized acupuncture scheme,including Dachangshu(BL25)and Guanyuanshu(BL26)supplemented by 5 acupoints selected according to meridian-based pattern differentiation.The patients in the sham acupuncture group received treatment at 7 non-acupoint locations.The patients in both groups underwent 10 sessions over 4 weeks.Pain intensity and functional disability were assessed before treatment and at week 4 using the visual analogue scale(VAS)and the Oswestry Disability Index(ODI).Patients were stratified into a moderate pain subgroup(40 mm≤VAS<70 mm)and a severe pain subgroup(VAS≥70 mm)according to leg pain intensity before treatment.Exploratory subgroup and interaction analyses were conducted with pain intensity and acupuncture intervention as grouping variables.Results Of the total 216 patients,160(74.07%)were classified into the moderate pain subgroup and 56(25.93%)into the severe pain subgroup.In each pain intensity subgroup,improvements in VAS and ODI scores are greater in the acupuncture group compared with the sham group,and the differences between acupuncture and sham acupuncture groups were found statistically significant(P<0.05).No interaction effect was observed between pain intensity and acupuncture intervention on VAS or ODI outcomes after 4 weeks of treatment(P>0.05).Conclusion Acupuncture alleviates pain and improves functional outcomes in patients with sciatica from a herniated disk,regardless of pain intensity.The effect is not influenced by pain intensity before treatment.