【目的】 观察针刺联合西药治疗气滞血瘀型腰椎间盘突出症（LDH）的临床疗效。【方法】 将2023年9月至2024年1月广东 省第二中医院病房及门诊收治的62例气滞血瘀型LDH患者按随机数表法随机分为观察组和对照组，每组各31例，对照组给 予常规西药治疗，观察组在对照组治疗的基础上，给予针刺治疗，连续治疗3周。治疗3周后，评价2组临床疗效，观察2组患 者治疗前后日本骨科协会（JOA）评分和 Oswestry功能障碍指数（ODI）评分的变化情况，以及疼痛视觉模拟量表（VAS）评分的 情况。比较2组患者治疗前后多裂肌和腰方肌的肌张力、肌肉硬度、肌肉弹性的变化情况。并评价2组的安全性及不良反应 的发生情况。【结果】（1）观察组总有效率为96.77%（30/31），对照组为74.19%（23/ 31）。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VAS、JOA、ODI评分明显改善（P < 0.05），且观察组在改善VAS、JOA、ODI评分 方面明显优于对照组，差异有统计学意义（P < 0.01）。（3）治疗后，2组患者的腰方肌与多裂肌的张力、硬度和弹性明显改善 （P < 0.05），且观察组在改善腰方肌与多裂肌的张力、硬度和弹性方面明显优于对照组，差异有统计学意义（P < 0.05）。（4）观 察组不良反应发生率为 9.68%（3/31），对照组为 9.68%（3/31）；观察组与对照组的不良反应发生率比较，差异无统计学意义 （P > 0.05）。【结论】 针刺联合西药治疗气滞血瘀型LDH，能够明显改善患者的腰椎功能和临床症状，提高患者腰方肌与多裂 肌的肌肉性能，从而提高患者的生活质量，疗效显著。

Objective To observe the clinical efficacy of acupuncture combined with western medicine in the treatment of lumbar disc herniation（LDH）of qi stagnation and blood stasis type. Methods A total of 62 cases of patients with LDH of qi stagnation and blood stasis type were randomly divided into observation group and control group，with 31 cases in each group. The control group was given conventional western medicine for treatment，and the observation group was treated by acupuncture on the basis of the control group，the course of treatment covered three consecutive weeks. After three weeks of treatment，the clinical efficacy of the two groups was evaluated，and the changes in the Japanese Orthopedic Association（JOA）scores and Oswestry Disability Index（ODI）scores，as well as the Visual Analogue Scale（VAS）scores of pain， were observed before and after the treatment of the patients in the two groups. The changes in muscle tension，muscle hardness，and muscle elasticity of the multifidus muscle（MM）and lumbar multifidus muscle（LMM）before and after treatment were compared between the two groups. And the safety and the occurrence of adverse reactions in the two groups were evaluated. Results（1）The total effective rate was 96.77%（30/31）in the observation group and 74.19%（23/31）in the control group. The efficacy of the observation group was superior to that of the control group， the difference being statistically significant（P < 0.05）.（2）After treatment，the VAS，JOA，and ODI scores of the 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，with a statistically significant difference（P < 0.01）.（3）After treatment，the muscle tension， muscle hardness，and muscle elasticity of LMM and MM of patients in the two groups were significantly improved （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）The incidence rate of adverse reactions was 9.68%（3/31） in the observation group and 9.68%（3/31）in the control group；the intergroup comparison showed that there being no statistically significant difference（P > 0.05）. Conclusion Acupuncture combined with western medicine in the treatment of LDH of qi stagnation and blood stasis type can significantly improve the lumbar function and clinical symptoms of the patients，and improve the muscular performance of the patients􀆳 LMM and MM，so as to enhance their quality of life.

R246.9

广东省自然科学基金面上项目（编号：2021A1515011723）；广东省企联合基金面上项目（编号：2022A1515220093）