| Objective:To evaluate the clinical efficacy of silver needle therapy in the treatment of NLBP based on "movement assessment",and to explore its mechanism.Methods: A total of 120 patients with NLBP who met the research criteria in the pain department and inpatient department of Xinghua Yingzhi Demei Rehabilitation Hospital from March 2021 to June 2022 were selected and randomly divided into experimental group,control group 1 and control group 2,with 40 cases in each group.The experimental group were treated with silver needle under the "movement assessment",the control group 1 were treated with silver needle therapy,and the control group 2 were treated with warm acupuncture.Before and after two courses of treatment,the visual analogue scale(VAS),Japanese orthopaedic association low back pain score(JOA),Roland-Morris Disability Questionnaire(RMDQ),traditional Chinese Medicine syndrome score and clinical efficacy were evaluated in the three groups.Serumβ-endorphin(β-EP),Calcitonin gene related peptide(CGRP)and Intercellular adhesion molecule-1(ICAM-1),P-selectin(P-s),C reactive protein(CRP),Tumor necrosis factor-α(TNF-α)and local infrared thermal imaging were detected.The patients in each group were followed up at 1 and 6 months after the end of the treatment,and VAS,JOA,RMDQ,traditional Chinese Medicine syndrome score and short-term and long-term efficacy were evaluated.Results:(1)The curative effect of different acupuncture methods on NLBP patients:Compared with before treatment,VAS,RMDQ,traditional Chinese Medicine syndrome score of three groups after treatment were significantly lower,JOA scores were significantly higher,the differences were statistically significant(P<0.05).After treatment,the VAS,RMDQ and traditional Chinese Medicine syndrome score of the experimental group were significantly lower than the control group 2,and the JOA score was significantly higher than the control group 2,the differences were statistically significant(P<0.05).The overall clinical efficacy and the excellent rate of follow-up efficacy in the experimental group were significantly higher than the control group 2,and the difference was statistically significant(P<0.05).(2)The effects of different acupuncture methods on inflammatory factors,cell adhesion factors,β-EP and CGRP:compared with before treatment,the levels of CRP,TNF-α,ICAM-1,CGRP and P-s in the three groups after treatment were significantly decreased,and the level of β-EP was significantly increased(P<0.05).After treatment,the CRP and TNF-α in the experimental group were lower than the control group 2,and the β-EP was higher than the control group 2,and the differences were statistically significant(P<0.05).While ICAM-1,CGRP and P-s had no significant difference(P>0.05).(3)The influence of different acupuncture methods on local infrared thermal imaging: after treatment,the infrared thermal imaging temperature of the three groups increased,and the difference was statistically significant(P<0.05).After treatment,the temperature of the experimental group were lower than the control group 1,and higher than the control group 2,and the differences were statistically significant(P<0.05).(4)Safety: during the treatment,there were no abnormalities in blood pressure,heart rate,respiration,body temperature,and blood oxygen in the three groups,except for 2 cases of mild skin scald caused by moxa strips falling off in control group 1.There was 1 case in the experimental group and 1 case in the control group 2 who had mild subcutaneous hematoma due to short pressing time after pulling out the needle.No adverse reactions occurred in all patients during follow-up.Conclusion:Silver needle therapy after "motion evaluation" could relieve pain,improve dysfunction and daily living ability,and improve the quality of life in patients with NLBP,and has a good clinical effect.Its mechanism may be to reduce the levels of inflammatory factors,cell adhesion factors and CGRP,increase the expression of β-EP,and increase the local temperature of the affected area. |
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