A Prospective Cohort Study Of Electroacupuncture Combined With Infrared Therapy For Lumbar Disc Herniation

Objective:To investigate the causal relationship between electro-acupuncture combined infrared therapy and the clinical improvement of patients with lumbar disc herniation; Contrast the curative effect between the electric-acupuncture combined with infrared ray therapy and the traditional Chinese and western combined conservative therapy. To explore the better use group of electric-acupuncture combined with infrared ray therapy.Method:Adopt the method of prospective cohort studies and divided patients into exposure group and control group according to their different clinical treatment. Exposure group include patients treated with electric-acupuncture combined with infrared ray, control group treated with traditional Chinese and western conservative therapy. Collected the JOA and VAS score at before and after 6 times of treatment in both groups, and divided patients into different subgroups according to their gender, age, course of the disease, TCM syndrome types, body mass index (BMI) and lesion segment, the level of labor for data analysis, to evaluate the improvement of the degree of pain and lumbar function in patients. To find the factors influencing the effect of two groups and calculate the regression equation by Logistic regression analysis.Results:216 patients were included in the data analysis, including 150 cases in exposure group and 66 cases in control group. There are 124 patients get clinical symptoms improved in exposure group and the total effective rate was 82.67 %; Compared with the data before treatment, the VAS and JOA scores were significant differences (P< 0.01) after 6 times treatment in exposure group; Subgroup analysis results show that:by comparing the improvement of pain in two groups patients, in groups of 51-60 years old, damp heat syndrome, normal BMI, lesions in three segment and above, heavy manual labor, with stenosis and no lumbar trauma, patients in exposure group get significantly higher mean of score between before and after treatment than the control group. By comparing the improvement of lumbar function in two groups patients, in groups of 61-70 years old, cold dampness syndrome, damp heat syndrome, blood stasis syndrome, course more than five years, overweight BMI, lesions in single segment and three or more, no heavy manual labor, with stenosis and no lumbar trauma, patients in exposure group get significantly higher mean of score between before and after treatment than the control group.Through the logistic regression analysis of influencing factors, we found that:whether patients with lesions maybe the possible factors influencing the effect of two groups. The regression equation:logit(the probability of effective)=1.94+0.116 ×I (the patient in the exposed group)-0.754 ×I (the course of the disease from half a year to five years)-0.439 ×I (the course of more than five years)-1.019×I (with accompanying lesions)-0.15×I (with stenosis)+0.248×I (used physical therapy before treatment)-0.281×I (used acupuncture therapy before treatment).Conclusion:Electric-acupuncture combined with infrared treatment can obviously reduce VAS score and improve JOA score in patients with lumbar disc herniation, and this treatment has really improved the degree of pain and the lumbar function of patients. Compared with traditional Chinese and western conservative treatment, in groups of 51-60 years old, damp heat syndrome, normal BMI, lesions in three segment and above, heavy manual labor, with stenosis and no lumbar trauma, electric-acupuncture combined with infrared ray therapy can effectively improve the patient’s pain; in groups of 61-70 years old, cold dampness syndrome, damp heat syndrome, blood stasis syndrome, course more than five years, overweight BMI, lesions in single segment and three or more, no heavy manual labor, with stenosis and no lumbar trauma, electric-acupuncture combined with infrared ray therapy can effectively improve the lumbar function of patients. Prompt that electric-acupuncture combined with infrared ray therapy have its better use patients group, doctor can recommended this therapy to those patients with above characteristics.