固元灸联合常规疗法改善肝肾亏虚型退行性腰椎滑脱症患者功能障碍及疼痛：随机对照试验
庄琼霞 1胡根容 1赖秋菊1
作者信息
- 1. 福建泉州市正骨医院推拿科，福建泉州362000
- 折叠
摘要
目的 评价固元灸联合常规疗法对肝肾亏虚型退行性腰椎滑脱症患者短期功能障碍、疼痛及安全性的影响。方法 采用单中心、平行组、结局评价者与统计人员盲法的随机对照设计。纳入106例肝肾亏虚型退行性腰椎滑脱症患者，按1∶1随机分为观察组和对照组（各53例）。两组均接受推拿、针刺、物理治疗及核心肌群训练；观察组在此基础上加用固元灸，取肾俞、太溪、中脘、足三里，每周3次，共2周。比较两组治疗前后Oswestry功能障碍指数（ODI）、视觉模拟量表（VAS）评分、JOA评分。结果 两组基线性别、年龄及病程差异均无统计学意义（P＞0.05）。治疗2周后，两组ODI和VAS评分均低于本组治疗前（P＜0.001）；观察组治疗2周ODI和VAS评分均低于对照组（t=7.093、12.283，P＜0.001）。观察组与对照组总有效率分别为90.57%（48/53）和75.47%（40/53），观察组高于对照组（χ²=4.283，P=0.038）。观察组发生2例轻微局部水疱，对照组未发生治疗相关不良事件（Fisher确切概率法P=0.495），两组均无严重不良事件。结论 在2周观察期内，固元灸联合常规疗法较单纯常规疗法可进一步改善肝肾亏虚型退行性腰椎滑脱症患者的功能障碍与疼痛。鉴于单中心、开放治疗、疗程短及样本量有限，疗效持续性与安全性仍需多中心、前瞻性注册且随访充分的试验验证。
Abstract
Objective To evaluate the short-term efficacy and safety of Guyuan moxibustion added to conventional therapy for functional disability and pain in patients with degenerative lumbar spondylolisthesis (DLS) of the liverkidney deficiency pattern.Methods In this single-center, parallel-group, assessor- and statistician-blinded randomized controlled trial, 106 participants were allocated 1:1 to an observation group or a control group (n=53 each). Both groups received tuina, acupuncture, physical therapy, and core stabilization exercise. The observation group additionally received Guyuan moxibustion at BL23 (Shenshu), KI3 (Taixi), CV12 (Zhongwan), and ST36 (Zusanli), three sessions weekly for two weeks. The primary outcome was the raw Oswestry Disability Index (ODI; range, 050) at week 2. Secondary outcomes were the visual analog scale (VAS), total response rate based on the Japanese Orthopaedic Association improvement rate, and adverse events. Within-group prepost comparisons were performed using paired t tests, and between-group comparisons at each time point using independent-samples t tests. Categorical variables were analyzed using Pearson or Fisher exact tests. All 106 randomized participants were analyzed according to their initially assigned groups under the intention-to-treat principle.Results Baseline sex, age, and disease duration were comparable between groups (all P>.05). At week 2, ODI and VAS scores were lower than baseline in both groups (all P<.001), and posttreatment ODI and VAS scores were lower in the observation group than in the control group (t=7.093 and 12.283, respectively; both P<.001). Total response rates were 90.57% (48/53) in the observation group and 75.47% (40/53) in the control group (=4.283; P=.038). Two mild local blisters occurred in the observation group, whereas no treatment-related adverse events occurred in the control group (Fisher exact P=.495); no serious adverse events occurred in either group.Conclusions Over two weeks, adjunctive Guyuan moxibustion was associated with greater short-term improvements in disability and pain than conventional therapy alone. Given the single-center setting, open-label treatment, short duration, and limited sample size, larger multicenter, prospectively registered trials with longer follow-up are needed to confirm the durability and safety of these findings.关键词
固元灸/退行性腰椎滑脱症/肝肾亏虚/功能障碍/疼痛Key words
Guyuan moxibustion/degenerative lumbar spondylolisthesis/liver–kidney deficiency pattern/disability/pain引用本文复制引用
庄琼霞,胡根容,赖秋菊.固元灸联合常规疗法改善肝肾亏虚型退行性腰椎滑脱症患者功能障碍及疼痛：随机对照试验[EB/OL].(2026-10-11)[2026-10-13].https://chinaxiv.org/abs/202610.00047.学科分类
临床医学
