The Prospective, Randomized Clinical Study About Munipulation (Hui Huan Tong Bi) For Lumbar Disc Herniation

Object:Comparing with the common manipulation,To Evaluate the validity and safety of the manipulation(hui huan tong bi) to lumbar disc herniation(LDH); systematic review the literature about the recongnization of LDH in modern medicine and traditional chinese medicine.Method:Through research on modern literature about lumbar disc herniation,discuss the basic theory and clinical keypoint of LDH;Through research on acient TCM literature relation with lumbar disc herniation,discuss the rule of diagnosis and treatment for LDH in TCM;About manipulation,systemic review the literature about massage treatment to LDH in ancient and modern time;In the clinical study,we prospectively randomizedly evaluate the effectiveness and safety of munipulation(hui huan tong bi)(test group) for LDH,comparing with the common massage(control group),which is originate from the literature and our previous experience,we invetigate the effectiveness by the Oswestry Disability Index(ODI),Visual Analogue Scale(VAS) and the low back pain JOA(29 fen),we define the safety by observe the adverse reaction,for example the iatrogenic muscle injury and fracture,et al.Result:Through research on modern literature about lumbar disc herniation,it point out that diagosis of LDH should be done with the combination of clinical symptoms and radiology;Treatment should be given with the integration of TCM and modern medicine,and combination of conservative treatment and operation; Through research on acient TCM literature relation with lumbar disc herniation,it reckons the causative factors are deficiency,pathogen,and stagnation.The pathogenesis is kidney Qi deficiency,essence and Qi declining,resulting in malnourishing to tendons,or pathogenic wind and cold flow into channel,or retention of exogenous and accumulation of blood stagnation,resulting in Qi retention and blood stagnation;About manipulation,systemic review the literature about massage treatment to LDH in ancient and modern time,it considers manipulation is very important way for treating LDH conservatively;In the clinical study,For the test group,the value of ODIand VAS before management are lower than 1 month,3 months,6 months after treatment(P＜0.05);For the control group,the value of ODIand VAS before management are also lower than 1 month,3 months,6 months after treatment (P＜0.05);For the test group,The value of ODIand VAS in the times of 1 month,3 months,6 months after treatment are lower than the control group(P＜0.05);Comparing these two group with currative effect,which is calculated by the low back pain JOA(29 fen),the effect of test group is superior to the control group(P＜0.05).Conclusion:munipulation(hui huan tong bi) is effective and safe for lumbar disc herniation,which is more effective than the common massage.