| Objective:To investigate the distribution pattern of force-sensitive acupoints and their pressure pain threshold quantification characteristics in patients with lumbar disc herniation(LDH);to compare and analyse the efficacy of force-sensitive acupuncture and traditional acupuncture in the treatment of LDH,and to provide an optimal solution for the clinical treatment of LDH.Methods:1.Test 1: 110 patients with LDH who met the criteria for nadir were included,and their force-sensitive acupoints were explored.The force-sensitive acupoints explored by each patient were recorded,and the distribution pattern of force-sensitive acupoints in various meridians and limb areas of all patients was analysed by frequency statistics after all explorations were completed.2.Trial 2: 80 patients with LDH were included in this trial according to the diagnostic criteria,inclusion criteria and exclusion criteria.40 patients were randomly assigned to each of the force sensitive acupuncture group(trial group)and the traditional acupuncture group(control group)by the randomized controlled trial method.Test group:According to the results of force-sensitive acupuncture point exploration,the five force-sensitive acupuncture points with the strongest sensitization response of the patient were selected,sterilized and then acupuncture force-sensitive acupuncture points were routinely performed,and the needles were retained for 30min;Control group: According to the treatment protocol of LDH in the national "14th Five-Year Plan" textbook "Acupuncture and Moxibustion Therapy" published by the Chinese Medicine Publishing House,Shenshu,Dachangshu,Minmeng,Yaoyangguan,and Weizhong were selected,and the operation was the same as that of the experimental group.Patients in both groups were treated for a total of two sessions of 6 consecutive days,with a break of 1 day between sessions,and were followed up 1 month after the completion of the two sessions.To observe the changes in the Japanese Orthopaedic Association Scores(JOA),Range Of Motion(ROM)and Visual Analogue Score(VAS)of the lumbar spine before and after treatment,and to assess the efficacy of the treatment;To detect changes in pressure pain thresholds before and after treatment at the force sensitive acupuncture point in the test group,and to analyse the quantitative characteristics of pressure pain thresholds at the force sensitive acupuncture point before and after treatment.Results:1.the results of the trial 1 study showed that the presence of force-sensitive acupoints in LDH patients was 78.1%,with a total of 47 acupuncture areas and 740 frequencies being detected;the top 10 force-sensitive acupuncture points in terms of frequency of occurrence were: Yinggu,Zhuibin,Huangshu,Qihaishu 2 inch away from the side,Dachangshu 2 inch away from the side,Ququan,Yinlian 1 inch away from the side,Yinlingquan,Yaoyangguan and Yinbao.The frequency of force-sensitive acupuncture points on the meridians,in descending order,is Kidney,Spleen,Liver,Bladder,Ren,Governor,Stomach,Gallbladder and Large Intestine meridians;the frequency of force-sensitive acupuncture points on the limbs,in descending order,is Lower Extremities,Chest and Abdomen,Waist and Back,Upper Extremities and Head and Face.2.The results of the Trial 2 study showed that.(1)Baseline data: The two groups were well comparable in terms of gender,age,duration of disease and pre-treatment JOA,lumbar ROM and VAS scores.(2)Recent efficacy: After one and two courses of treatment,JOA and lumbar ROM scores increased and VAS scores decreased in both groups,and the differences were statistically significant when compared with the baseline period(all P < 0.05);compared with the control group,the differences in JOA scores,lumbar ROM scores and VAS scores in the test group were statistically significant(all P < 0.05).This indicates that both force-sensitive acupuncture and conventional acupuncture can effectively treat LDH during the short-term treatment period,but force-sensitive acupuncture is more effective than conventional acupuncture in improving the clinical symptoms of LDH patients.(3)Long-term efficacy: 1 month after the end of treatment,the JOA scores of both groups increased and the VAS scores decreased compared with the pre-treatment period,and the differences were statistically significant(both P < 0.05).The differences in JOA scores and VAS scores between the test group and the control group were statistically significant(all P < 0.05).This indicates that both force-sensitive acupuncture and traditional acupuncture can effectively improve the clinical symptoms of LDH patients and maintain long-term efficacy,but force-sensitive acupuncture is more effective and can maintain long-term efficacy better.(4)Evaluation of efficacy: At the end of the two courses of treatment,the total effective rate of the test group was 90%;the total effective rate of the control group was 77.5%,with statistically significant differences(P < 0.05).(5)Pressure pain threshold of force sensitive acupuncture points:after two courses of treatment,the pressure pain threshold of the sensitized acupuncture point area was significantly higher compared with that before treatment,and the difference was statistically significant(P < 0.05).This indicates that the pressure pain threshold in the sensitized acupuncture point area was significantly higher after treatment with force sensitive needling.Conclusion.1.The top four force-sensitive acupoints in LDH patients according to meridian distribution are Foot Shao Yin Kidney Meridian,Foot Tai Yin Spleen Meridian,Foot Convulsive Yin Liver Meridian,and Foot Sun Bladder Meridian,and in the limb areas mainly on the medial side of the lower limbs,chest and abdomen and lower back;The top three acupuncture areas in terms of frequency of occurrence are Yingu,Zhubin and Huangshu.2.Both force-sensitive acupuncture and conventional acupuncture are effective in the treatment of LDH,but force-sensitive acupuncture is significantly more effective than conventional acupuncture in terms of both immediate and long-term outcomes.3.Force-sensitive acupuncture treatment can effectively increase the pressure and pain threshold of sensitized acupoints,transforming them from a sensitized state to a resting state,or even to a state of near desensitization. |
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