【目的】 观察针刺核心肌群联合康复训练治疗慢性非特异性腰痛的临床疗效。【方法】 将96例慢性非特异性腰痛患者随 机分为观察组和对照组，每组各48例，对照组给予康复训练，观察组在对照组治疗的基础上，给予针刺核心肌群训练。2组 患者均连续治疗2周。治疗2周后，评价2组临床疗效，观察2组患者治疗前后腹横肌与多裂肌均方根（RMS）值的变化情况， 以及Oswestry功能障碍指数评分、Roland-Morris功能障碍调查表评分、魁北克腰痛障碍量表评分的情况。比较2组患者治疗 前后血清β-内啡肽、血清P物质、血清前列腺素E2水平的变化情况。治疗后随访5个月，评价2组患者的复发情况。【结果】 （1）观察组总有效率为 93.75%（45/48），对照组为 81.25%（39/48）。观察组疗效优于对照组，差异有统计学意义（P＜0.05）。 （2）治疗后，2组患者的 Oswestry 功能障碍指数评分、Roland-Morris功能障碍调查表评分、魁北克腰痛障碍量表评分明显改 善（P＜0.05），且观察组在改善 Oswestry功能障碍指数评分、Roland-Morris功能障碍调查表评分、魁北克腰痛障碍量表评分 方面明显优于对照组，差异有统计学意义（P＜0.05）。（3）治疗后，2组患者的腹横肌、多裂肌RMS值明显改善（P＜0.05），且 观察组在改善腹横肌、多裂肌 RMS值方面明显优于对照组，差异有统计学意义（P＜0.05）。（4）治疗后，2组患者 β-内啡肽、 P物质、前列腺素E2水平均明显改善（P＜0.05），且观察组在改善β-内啡肽、P物质、前列腺素E2水平方面均明显优于对照 组，差异均有统计学意义（P＜0.05）。（5）治疗后观察组复发率为6.25%（3/48），对照组为20.83%（10/48），观察组复发率明显 低于对照组，差异有统计学意义（P＜0.05）。【结论】 针刺核心肌群联合康复训练治疗慢性非特异性腰痛，能明显改善患者的 临床症状，改善患者β-内啡肽、P物质、前列腺素E2水平，临床疗效显著。

Objective To observe the clinical effect of acupuncture at the core muscle group combined with rehabilitation training in the treatment of chronic non-specific low back pain. Methods A total of 96 patients with chronic non-specific low back pain were randomly divided into observation group and control group，48 cases in each group. The control group was given rehabilitation training，and the observation group was given acupuncture at core muscle group training on the basis of the control group. Patients in both groups were treated continuously for two weeks. After two weeks of treatment，the clinical efficacy of the two groups was evaluated. The changes of root mean square（RMS）values of transverse abdominal muscle and multifidus muscle were observed before and after treatment，as well as the scores of Oswestry Dysfunction Index，Roland-Morris Dysfunction Questionnaire and Quebec Low Back Pain Scale. The changes of serum β-endorphin，serum substance P and serum prostaglandin E2 levels were compared before and after treatment between the two groups. The patients were followed up for five months after treatment，and the recurrence of the two groups was evaluated. Results（1）The total effective rate was 93.75%（45/48）in the observation group and 81.25%（39/48）in the control group. The curative effect of the observation group was superior to that of the control group，and the difference was statistically significant（P＜ 0.05）.（2）After treatment， the Oswestry Dysfunction Index score， Roland-Morris Dysfunction Questionnaire score and Quebec Low Back Pain Disorder Scale score of the two groups were significantly improved（P＜0.05）， and the improvement of Oswestry Dysfunction Index score，Roland-Morris Dysfunction Questionnaire score and Quebec Low Back Pain Disorder Scale score in the observation group was significantly superior to that in the control group，the difference was statistically significant（P＜0.05）.（3）After treatment，the RMS values of transverse abdominal muscle and multifidus muscle in the two groups were significantly improved（P＜0.05）， and the observation group was significantly superior to the control group in improving the RMS values of transverse abdominal muscle and multifidus muscle， the difference being significant（P＜0.05）.（4）After treatment， the levels of β -endorphin， substance P and prostaglandin E2 in the two groups were significantly improved（P＜ 0.05）， and the observation group was significantly superior to the control group in improving the levels of β-endorphin，substance P and prostaglandin E2，the differences were statistically significant（P＜0.05）.（5）After treatment， the recurrence rate of the observation group was 6.25%（3/48）， and that of the control group was 20.83%（10/48）. The recurrence rate of the observation group was significantly lower than that of the control group， and the difference was statistically significant（P＜0.05）. Conclusion Acupuncture at the core muscle group combined with rehabilitation training in the treatment of chronic non-specific low back pain can significantly improve the clinical symptoms of patients，improve the levels of β-endorphin，substance P and prostaglandin E2， and the clinical effect is significant.

R246.9

中央军委后勤保障部卫生局军队中医药服务能力培育与提升专项计划项目（编号：2021ZY052）