[Effect of prior acupuncture experience on the efficacy of acupuncture treatment for discogenic sciatica： a secondary analysis of a multicenter randomized controlled trial]

To investigate the effect of prior acupuncture experience on the clinical efficacy of acupuncture for discogenic sciatica.

A secondary analysis was conducted on a multicenter, randomized controlled trial. A total of 216 patients with discogenic sciatica were randomly divided into an acupuncture group and a sham acupuncture group, with 108 patients in each group. The acupuncture group received a semi-standardized treatment protocol based on meridian pattern differentiation for acupoint selection, and manual manipulation was applied to achieve the deqi sensation. The sham acupuncture group received needling at non-acupoints without manipulation or the pursuit of deqi. Each session lasted for 30 min. The treatment continued for 4 weeks, with 3 sessions per week for the first 2 weeks and 2 sessions per week for the subsequent 2 weeks. The visual analog scale (VAS) score for leg pain and the Oswestry disability index (ODI) score for lumbar function were recorded at baseline and after 4 weeks of treatment. The differences in VAS and ODI scores from baseline to week 4 were used as the primary outcome measures to evaluate the efficacy. Subgroup analysis were performed to compare the efficacy between the acupuncture and sham acupuncture groups based on the presence or absence of previous acupuncture experience.

Among the 216 patients, 81 had prior acupuncture experience and 135 had no prior acupuncture experience. In the subgroup with prior acupuncture experience or without previous acupuncture experience, the changes of VAS score for leg pain and the ODI score for lumbar function in the acupuncture group were significantly higher than those in the sham acupuncture group after 4 weeks of intervention (P<0.001, P<0.01). Interaction analysis showed that there was no interaction effect between prior acupuncture experience and intervention factors on the changes in VAS and ODI scores.

Acupuncture has a favorable effect on improving leg pain and lumbar dysfunction in patients with discogenic sciatica, regardless of prior acupuncture experience.