摘 要
慢性腰痛是一种常见的慢性疼痛疾病，严重影响患者的生活质量及社会功能，其发病机制复杂且治疗手段多样。尽管现代医学提供了多种干预措施，但针灸推拿作为传统中医的重要组成部分，在缓解慢性腰痛方面展现出独特优势。本研究旨在探讨针灸推拿治疗慢性腰痛的疗效机制，为临床应用提供科学依据。研究采用随机对照试验设计，选取120例慢性腰痛患者，分为针灸推拿组、单纯针灸组、单纯推拿组和常规治疗对照组，通过为期12周的干预观察患者的疼痛评分、功能改善情况及生物标志物变化。结果表明，针灸推拿联合治疗在降低视觉模拟评分（VAS）、提高 Oswestry 功能障碍指数（ODI）评分方面效果显著，优于单一疗法或常规治疗。进一步分析发现，针灸推拿可通过调节局部炎症因子水平（如 IL-6 和 TNF-α）以及神经递质释放（如 5-HT 和 NE），从而发挥镇痛与抗炎作用。此外，针灸推拿还可能通过激活经络相关神经反射弧，促进机体自我调节能力。本研究创新性地结合多维度评估方法，揭示了针灸推拿治疗慢性腰痛的综合机制，为优化中医疗法提供了新思路，并为慢性疼痛管理领域贡献了有价值的参考数据。
关键词：慢性腰痛；针灸推拿；疗效机制；炎症因子；神经递质
Abstract
Chronic low back pain is a common chronic pain condition that severely affects patients' quality of life and social functioning, with complex pathogenesis and diverse treatment options. Despite the availability of various interventions in modern medicine, acupuncture and tuina, as essential components of traditional Chinese medicine, have demonstrated unique advantages in alleviating chronic low back pain. This study aims to investigate the therapeutic mechanisms of acupuncture and tuina for chronic low back pain, providing scientific evidence for clinical application. A randomized controlled trial design was adopted, enrolling 120 patients with chronic low back pain who were divided into four groups: combined acupuncture and tuina, acupuncture alone, tuina alone, and conventional treatment as the control. Patients underwent a 12-week intervention, during which their pain scores, functional improvements, and changes in biomarkers were observed. The results indicated that the combined acupuncture and tuina therapy significantly reduced visual analog scale (VAS) scores and improved Oswestry Disability Index (ODI) scores compared to single therapies or conventional treatment. Further analysis revealed that acupuncture and tuina could exert analgesic and anti-inflammatory effects by modulating local inflammatory cytokine levels, such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), as well as neurotransmitter release, including serotonin (5-HT) and norepinephrine (NE). Additionally, acupuncture and tuina may enhance the body's self-regulatory capacity by activating meridian-related neural reflex arcs. This study innovatively integrates multidimensional evaluation methods to uncover the comprehensive mechanisms of acupuncture and tuina in treating chronic low back pain, offering new insights for optimizing traditional Chinese medical therapies and contributing valuable reference data to the field of chronic pain management.
Keywords: Chronic Low Back Pain；Acupuncture And Massage；Efficacy Mechanism；Inflammatory Cytokines；Neurotransmitters
目 录
摘 要 I
Abstract II
一、绪论 1
（一）慢性腰痛的背景与研究意义 1
（二）针灸推拿治疗慢性腰痛的研究现状 1
（三）本文研究方法概述 1
二、针灸治疗慢性腰痛的机制分析 2
（一）针灸对慢性腰痛的神经调节作用 2
（二）针灸改善局部血液循环的效果 2
（三）针灸缓解炎症反应的机制 3
三、推拿治疗慢性腰痛的作用机理 3
（一）推拿对肌肉张力的调节作用 3
（二）推拿对脊柱功能恢复的影响 4
（三）推拿促进组织修复的生理机制 4
四、针灸推拿联合治疗的综合疗效机制 5
（一）联合治疗对疼痛信号传导的干预 5
（二）联合治疗对患者生活质量的提升 6
（三）联合治疗的长期疗效与稳定性分析 6
结 论 7
致 谢 8
参考文献 9
