【目的】 观察基于经筋理论指导下运用火针疗法治疗寒湿型腰椎间盘突出症的临床疗效。【方法】 将 2023 年 3 月至 2023年 12月广东省第二中医院收治的 70例寒湿型腰椎间盘突出症患者按随机数字表法随机分为观察组和对照组，每组各 35 例。对照组给予常规针刺治疗，观察组在对照组治疗的基础上，采用经筋理论指导下的火针治疗，治疗1周为1个疗程， 共治疗3个疗程。治疗3个疗程后，评价2组临床疗效，观察2组患者治疗前后疼痛视觉模拟量表（VAS）评分的变化情况，以 及日本骨科协会（JOA）评分的情况。比较2组患者治疗前后中医证候积分的变化情况。【结果】（1）研究过程中，观察组失访 3 例，对照组失访 5 例。最终观察组 32 例、对照组 30 例纳入疗效统计。（2）观察组总有效率为 93.75%（30/32），对照组为 86.67%（26/30）。观察组疗效优于对照组，差异有统计学意义（P < 0.05）。（3）治疗后，2 组患者的 VAS、JOA 评分明显改善 （P < 0.05），且观察组在改善VAS、JOA评分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组患者的中 医证候评分明显改善（P < 0.05），且观察组在改善中医证候评分方面明显优于对照组，差异有统计学意义（P < 0.05）。 【结论】 基于经筋理论指导下运用火针治疗寒湿型腰椎间盘突出症，能明显降低患者的疼痛程度，改善患者的腰椎功能，减 轻患者的相关症状，从而提高患者的生活质量，临床疗效显著。

Objective To observe the clinical efficacy of fire needling in treating lumbar disc herniation（LDH）of cold-damp type under the guidance of meridian sinew theory. Methods A total of 70 cases of patients with LDH of cold-damp type were randomly divided into observation group and control group，35 cases in each group，the control group was given conventional acupuncture treatment， and the observation group was treated with fire needling under the guidance of meridian sinew theory on the basis of the treatment of the control group，and the course of treatment covered three courses，one week as a course. After three courses of treatment，the clinical efficacy of the two groups was evaluated，and the changes in the Visual Analogue Scale（VAS）scores of pain，the Japanese Orthopedic Association（JOA）scores， and traditional Chinese medicine（TCM）syndrome scores of patients in the two groups before and after treatment were observed. Results（1）During the study， there were three cases in the observation group and five cases in the control group were failed to follow-up. Finally，32 cases in the observation group and 30 cases in the control group were included in the efficacy statistics.（2）The total effective rate was 93.75%（30/32）in the observation group and 86.67%（26/30）in the control group. The clinical efficacy of the observation group was superior to that of the control group，and the difference being statistically significant（P < 0.05）.（3）After treatment，the VAS and JOA scores of patients in the two groups improved significantly （P < 0.05），and the improvement in the observation group was significantly superior to that in the control group， the difference being statistically significant（P < 0.05）.（4）After treatment，the TCM scores of the two groups of patients improved significantly（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group， the difference being statistically significant（P < 0.05）. Conclusion Under the guidance of the meridian sinew theory，fire needling in treating LDH of cold-damp type can significantly reduce the degree of pain，improve the lumbar function，alleviate LDH-related symptoms，so as to improve the patients􀆳 quality of life.

R246.9

广州市科技局重点研发项目（编号：202206010048）；广州地区中西医协同临床重大创新技术建设项目（穗卫函 〔2023〕 2318号）