| Objective:To review the understanding on nasosinusitis in Chinese and Western medicine systematically with literature research, and summarize the clinical research literatures of the acupuncture treatment of nasosinusitis with YingXiang(LI20). To evaluate the quality of the relevant randomized controlled trials with international standards of the internationally recognized test Consolidated Standards of Reporting CONSORT statement and reporting clinical trials of acupuncture interventions STRICTA according to the concepts and methods of evidence-based medicine. To evaluate the clinical effect of the finger-pressure therapy of YingXiang(LI20) on nasosinusitis, comparing with drug (xanthium powder) therapy and twist nose therapy, then provide a scientific clinical evidence for seeking the effect of fast, no side effects and operable health treatment.Methods:Literature research:Summarized the understanding on nasosinusitis in Chinese and western medicine and reviewed the clinical research literatures of the acupuncture treatment of nasosinusitis with YingXiang(LI20) through the understanding on nasosinusitis of modern medicine, the understanding on nasosinusitis in Chinese medicine, the overview of main symptoms and diseases with YingXiang(LI20) in ancient literatures and the clinical research progress of the treatment of nasosinusitis with YingXiang(LI20) with system review method.Quality Evaluation:Evaluated the quality of domestic acupuncture treatment reporting on nasosinusitis of randomized controlled trials with international standards of the internationally recognized test Consolidated Standards of Reporting CONSORT statement and reporting clinical trials of acupuncture interventions STRICTA. Literature inclusion criteria:①Random allocation, having suggestive terminology in the text such as randomly assigned, the random control and so on.②Comparing two or multiple interventions, and the subjects were divided into different groups.③Used acupuncture or acupuncture combined with other therapies as the treatment means of the test group. Literature exclusion criteria:①Summary, Comments, Discussion, etc. do not belong to the clinical trials.②animal experiments.③non-randomized controlled trials. The④case/control (disease group and the non-disease group comparison) studies.⑤Repeat published literature.⑥non-English and non-Chinese literatures. The methods of obtaining literatures:computer retrieval:Chinese Biomedical Literature Database (CBM,1978-2012), china knowledge network (the CNKI from1979to2012), VIP (the VIP1989through2012), Articles (1998-2012). The key words nasosinusitis, sinusitis and acupuncture and moxibustion, acupuncture, acupuncture therapy, electro-acupuncture. Manual retrieval:all Chinese acupuncture journals, core journals of Chinese medicine, and literature references have been included up to2012-03-31. The search results downloaded managed with NoteExpress2.2and extracted and analyzed them with Excel. Detection strategy is:#1default state "acupuncture" and "moxibustion" or "acupuncture" or "electro-acupuncture" or "moxibustion" or "acupoint" or "acupuncture therapy" or "needle" or "magnetotherapy" or "laser" or "infrared"#2default state "nasosinusitis" or "sinusitis"#3#1and#2#4subject word:nasosinusitis/acupoint therapy, acupuncture therapy#5#3or#4Quality evaluation of literatures:Evaluated the quality of literatures with 25standards of CONSORT and6standards of STRICTA. Before evaluating, the researchers must conduct a systematic training, the evaluation criteria must be understanded and discussed deeply. Then, two researchers made a "yes" or "no" answers respectively according to the literature writer report wether or not with each entry of CONSORT and STRICTA. If they are disagree with each other, then decided by the third researcher. Finally, calculate the number and percentage of each entry report in the CONSORT and STRICTA standards.Clinical randomized controlled trials:The90patients of nasosinusitis were randomly assigned to the finger-pressure therapy group, the drug therapy group and twist nose therapy group. And each group was30cases. But the twist nose group had2shedding cases. The prescription of drug group was xanthium powder in Collection of Prescriptions with Notes of WangAng. And the follows were each group's operations:(1) The finger-pressure group:First, pressed lightly YingXiang (LI20) on the both sides of the nose about1-2minutes with the middle fingers, then did massage at the points gently in order to eliminate the discomfort caused by the pressing. Second, clicked the place flickeringly about1minute. Finally, do massage gently with two fingers from YingXiang(LI20) along the bellow of ala nasi about1-2minutes, and the fingers touched bellow the tip of the nose (philtrum). And it is more effect touching ala nasi gently with two fingers when doing the massage. Then drink a cup of hot water after doing this. Doing the massage at Yingxiang(LI20) can relieve stuffy nose and dispel the evil-wind and the thermal. The massage techniques had to be gently to avoid injuring the skin. Generally, the patient pressed four times everyday by themselves at morning, noon, night and before going to bed respectively.(2) The drug group:The prescription was xanthium powder in Collection of Prescriptions with Notes of WangAng. The channel tropism of angelica was the YangMing meridian of hand and foot. Angelica went up to face and head. Its functions were inducing resuscitation, diaphoresis, dispelling pathogenic wind and removing dampness. Flos Magnoliae can induce all resuscitation, scatter wind-heat and help the stomach clear gas go up to the head. Cocklebur can dispel wind and reduce heat, go up to the top of the head and reach to the skin. Peppermint can adjust lung qi, disperse stagnated liver qi, and remove heat for treating head and ocular disease. Scallion can raise yang and benefit qi. Tea was bitter and cold, ascending lucidity and descending turbidity. The way to take the medicines:The patients took the drug three times a day with3.5grams each time for a month, which was Kampo concentrated pharmaceutical products produced by Sunchon Pharmaceutical Factory.(3) The twist nose group:Rubbed the root and the both sides of the nose. And rubbed the YingXiang(LI20) a little longer. Closed the eyes gently, and rubbed the the root and the both sides of the nose from top to bottom with the index finger pulp of the both hands, and stayed a little longer at YingXiang(LI20), repeated several times until to the nose appeared bulge acid sense. The symptoms would disappeared or mitigated after massage. Then drank a cup of hot water. The massage techniques had to be gently to avoid injuring the skin. Generally, the patient rubbed four times everyday by themselves at morning, noon, night and before going to bed respectively.The observation indexes were the nasosinusitis symptoms integration which contained nasal congestion, nasal mucus, facial pain, headache, bad breath, smell impairment, nasal purulent discharge, nasal mucosa and sinus openings and the their total score. The observation time was before treatment, seven days after treatment,14days after treatment and21days after treatment respectively, and the observation period was1month.After the test, evaluated clinical effect according to diagnostic and effect standards P109of diseases in TCM released in1994by the State Administration of Traditional Chinese MedicineResults:The literature research shows:YingXiang(LI20) is one of the important acupoints for treatment nasosinusitis with acupuncture. Nasosinusitis all treated mainly with YingXiang(LI20) in Zhen Jiu Da Quan, Qian Jin Yao Fang and Experience on Acupuncture and Moxibustion Therapy. Stimulate YingXiang(LI20) can dredge Hand YangMing meridian gas, declared the nasal passage. In recent years, clinical studies have shown that regular acupuncture, electro-acupuncture, auricular point, acupoint injection, acupoint catgut embedding and other acupuncture interventions can be for nasosinusitis treatment.Quality evaluation research showed:The quality evaluation results of the clinical randomized controlled trials about nasosinusitis treatment with acupuncture showed that the literatures were generally low quality wether domestic or foreign according CONSORT statement and STRICTA standards. This gave the reader some difficulties to understand the rationality of the study design, study the correctness of implementation and promote the clinical application. There are some problems in most of included14literatures. Such as the description of random method was unclear and non-random hidden, no intention to treat analysis, acupuncture details reported inadequate and so on. And the sample size was too small, the conclusions were not reliable.The researches of clinical randomized controlled trials had showed:nine kinds nasosinusitis symptoms integration scores of the finger-pressing group, the drug group and the twist nose group were significant differences (P<0.05) before and after treatment, suggest that the three kinds of therapies could improve the nasosinusitis symptoms significantly; The compare of nine kinds nasosinusitis symptoms and their total integration scores showed no significant difference (p>0.05) among three groups after treatment, indicating that no significant differences for three kinds of therapies on the nine kinds of nasosinusitis symptoms efficacy. The twist nose group was less effective, probably due to the deep penetration force was less than finger-pressing group, which was pending further observations. The xanthium powder in Collection of Prescriptions with Notes of WangAng used to treat nasosinusitis had a certain effect, but syndrome differentiation and treatment was important in the clinical application.Conclusion:The nasosinusitis symptoms integration scores of the finger-pressing group, the drug group and the twist nose group were significant differences before and after treatment, suggest that the three kinds of therapies could improve the nasosinusitis symptoms significantly. We can say, the effect of treating nasosinusitis with finger-pressing was obvious. Both There were little difference between finger-pressing group and the twist nose group which both were manipulation treatment. They had a common role in the treatment of nasosinusitis with YingXiang(LI20), that was expelling wind and promoting the restoration of consciousness and regulating the circulation of Qi and alleviating pain, improving blood return of the local and adjacent tissue, and enhancing the adaptability to climate change and the capability defend from Evils.Pool resistance was the main etiology. The adolescent grow rapidly and the immunity growth in vivo failed to keep pace with it. So they are susceptible to infect with nasosinusitis. Press YingXiang(LI20) could improve blood return of local organizations, and enhance their adaptability to climate change and the capability defend from Evils.The integration scores of nasal congestion, nasal mucus, facial pain, headache, bad breath, smell impairment, nasal purulent discharge, nasal mucosa and sinus openings had significant difference (P<0.05) among the different examination of the there groups. The three therapies were worth to choose in the clinical.The twist nose group was less effective. The statistical results of clinical observation showed that it barely can be used. May be due to the deep penetration force was less than finger-pressing, which was pending further observations. The xanthium powder in Collection of Prescriptions with Notes of WangAng used to treat nasosinusitis had a certain effect, but syndrome differentiation and treatment was important in the clinical application. YingXiang(LI20) was used to treat nasosinusitis with acupuncture, which was recorded in Zhen Jiu Da Quan, Qian Jin Yao Fang and Experience on Acupuncture and Moxibustion Therapy. The results of this study showed that it did have a certain effect. In western medicine, it used sulfa drugs, antibiotics and nasal drops mainly to treat nasosinusitis at present. And the fist choice was antibiotics, but long-term use of antibiotics could cause inevitable side effects. Patients and their families would have doubts about it and prohibit it. So press YingXing(LI20) with finger was worth to be choose to treat nasosinusitis.The process of the treatment of nasosinusitis was a long time. Nasosinusitis is not just nasal swelling. It is caused by inflammation of the nasal cavity. If the patient treat it too late, it may lead to many complications. So the patients should diagnosed it early and treat it actively to eradicate troubles.Nasosinusitis is nasal inflammation, which is caused by purulent inflammation of the sinus mucosa. It will affect the patients quality of life and health. And it should be diagnosed early and be treated actively to avoid the complications. Finger-pressing therapy was Simple, convenient, fast, efficient, inexpensive and experience. So patients receive it easily. If the patients treated with it, and coupled with appropriate exercise, regularly life, balanced nutrition, and environmental control. It will alleviate nasosinusitis symptoms.
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