| Lumbar disc herniation(LDH)is a clinical syndrome in which the lumbar disc annulus disrupts,the nucleus pulposus protrudes backwards and it compresses the nerve roots and spinal cord,leading to nutritional disorders in the spinal cord or nerve roots and subsequent inflammation,finally causing nerve compression or dysfunction.Its main pathological mechanisms include nerve compression mechanism,inflammatory chemical nerve root stimulation,and autoimmune mechanism.The main pathological process is that part of the lumbar intervertebral disc fiber ring is broken,the nucleus pulposus and other related tissues protruding or even bulging to the back of the spine under the action of extrusion,which will stimulate and compress the nerve root and cause the inflammation of the nerve root,resulting in the damage of the nutrient supply and nerve conduction characteristics of the nerve root.Compression of adjacent ligaments and nerve roots leads to a series of clinical symptoms such as low back pain and lower limb pain,which is the most common cause of low back and leg pain.According to relevant epidemiological studies,the incidence of lumbar disc herniation increased year by year and tended to be younger due to the changes of modern people,living habits and working environment.Researchers in the United States have found that nine out of 10 adults,20 percent of which were diagnosed with lumbar disc herniation,experience pain in their lower back and legs.,Lumbar intervertebral disc herniation is a threat to people’ s health and has a significant impact on people’s lives.The increasing morbidity not only brings great hardship to individuals,but also great burdens to the medical expenses of the country,and reduces the overall work efficiency of the society.How to prevent and treat lumbar intervertebral disc herniation is the focus of doctors.Currently the modern medicine treatment of lumbar intervertebral disc herniation can only play the role of relieving pain and symptomatic treatment,in which the short-term curative effect is better,but the adverse reaction is large because long-term large quantities of painkillers are likely to produce drug resistance and irreversible damage of gastric mucosa.Chinese medicine has a long history and unique advantages in the treatment of pain.Based on Chinese medicine,this disease is subordinate to the category of lumbago.In ancient medical books,there is no "lumbar disc herniation".The records of this disease are mainly recognized by the symptoms of lumbago,such as "waist pain" and "waist and leg pain".In traditional Chinese medicine It is believed that the disease is mainly based on deficiency of liver and kidney(especially kidney),and is closely related to other factors such as trauma,blood stasis,deficiency of qi and blood,and exogenous pathogens.Acupuncture and moxibustion can dredge local qi and blood,clear the channels and collaterals and relieve pain quickly.Common methods for acupoint selection include local acupuncture of jiaji acupoint,ashi acupoint and acupoint selection by circulation on the premise of syndrome differentiation.Acupuncture often cooperates with electric acupuncture and moxibustion in clinical use is also frequent.Clinically common treatment methods also have massage,in which through different technique like chiropractic,massage and reset to the operation and adjustment in patients’ lumbar joints as well as local muscle so as to achieve smoothing tendons and reduction,dredging meridian qi and blood and terminally making internal and external equilibrium.In addition,other traditional Chinese medicine treatment methods remain traction,thermal moxibustion therapy,hot compress and so on.In clinical practice,it is rare to apply one therapy alone.Mostly several therapies are often combined,including combining western medicine methods such as closed therapy,so as to achieve better efficacy.Existing studies have shown that acupuncture and moxibustion has certain effects in improving the main symptoms of lumbar intervertebral disc herniation and can delay the development of the disease to a certain extent,fully reflecting the overall concept of traditional Chinese medicine and the theoretical advantages of syndrome differentiation and treatment.Acupuncture and moxibustion has a good effect on the treatment of lumbar disc herniation and has a variety of methods.A large number of randomized controlled trials have proved the effectiveness,safety and tolerance of acupuncture and moxibustion in the treatment of lumbar disc herniation.ObjectiveTo observe the curative effect of patients with lumbar disc herniation treated with Fang’s scalp acupuncture combined with waist three needles therapy,we choose small sample randomized controlled trials and Fang’s scalp acupuncture as well as Waist Three Needles therapy as the control group,eomparing patients’ JOA score,McGill score and clinical curative effect evaluation in the three groups before and after treatment.The purpose of this study was to explore the mechanism of traditional Chinese medicine(TCM)in the treatment lumbar disc herniation with Fang’ s scalp acupuncture combined with Waist Three Needles therapy,so as to provide corresponding clinical ideas and reference materials for the treatment of lumbar disc herniation with acupuncture,and lay a foundation for the standardization and scientific treatment of lumbar disc herniation with acupuncture.MethodsThe subjects included in this trial were from January 2018 to December 2018,99 patients with lumbar disc herniation who were treated in the acupuncture department of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine and met the diagnostic criteria of Western medicine.According to the method of random number table,it was distributed to the treatment group(Fang’s scalp needle combined with waist three-needle group),the control group(Fang’s scalp needle group)and the control group two groups(waist three needles group)in a ratio of 1:1:1,33 cases in each group,then began clinical trial treatment and related efficacy observation.Fang’s scalp acupuncture combined with the waist three-needle group:Fang’s scalp needle reference Fang Yunpeng,Fang Benzheng "Fang’s micro-acupuncture" for acupuncture treatment,waist three needle from Yuan Qing’s "Three-Acupuncture Therapy,standard selected:Shenshu,Dachangshu,and Weizhong.The two control groups were completed according to the treatment group criteria.The treatment group Fang’s scalp needle and the waist three needles were performed simultaneously for 3 times a week,two weeks for one course of treatment,continuous treatment for 1 month or two courses.Before and after treatment,the JOA score,McGill score and clinical efficacy were evaluated,and the data were recorded into SPSS 23.0 for statistical analysis.ResultsThe number of cases selected according to the inclusion criteria of the subject was 99 cases,including 33 cases in the treatment group and 33 cases in the two control groups,no cases of shedding or rejection.All the patients completed the clinical treatment.After treatment,statistical analysis are as follow:Before treatment,the gender distribution,age,duration of disease,lower back pain score,and McGill pain scale scores of the Fang’s scalp needle combined with the waist three-needle group,Fang’s scalp acupuncture group,and waist three-needle group were statistically analyzed.The results showed that there were no statistical differences in clinical baseline data the of three groups,suggesting that the three groups were comparable.1.Lower back pain score(JOA score)After two courses of treatment,the JOA scores of the three groups were improved compared with those before treatment statistically significant(P<0.05),while the JOA score of the treatment group increased more significantly compared with the two control group,the difference was statistically significant(P<0.05),indicating that the Fang’s scalp acupuncture combined with the waist three needles,the Fang’s scalp needle,and the waist three-needle therapy can improve the JOA score of patients with lumbar disc herniation,the effect of Fang’s scalp needle combined with the waist three-needle group is significantly better than the single Fang’s scalp acupuncture group or the waist three-needle group,while the clinical effect of simple Fang’s scalp needle group is equal compared with the waist three-needle group.2.The McGill pain scale scoreAfter 2 courses of treatment,the McGill pain scale scores of the three groups of lumbar disc herniation decreased to different degrees,and the decrease was statistically significant(P<0.05).A comparative analysis showed that there was a significant difference between the Fang’s scalp acupuncture group with the two control groups(P<0.05).The Fang’s scalp needle group and waist three group was no significant difference(P>0.05),indicating that Fang’s scalp acupuncture combined with lumbar three-needle was superior to simple scalp needle or simple waist three-needle therapy in reducing the score of McGill pain scale in patients with lumbar disc herniation.3.The evaluation of therapeutic effectsAccording to Kruskal Wallis H rank sum test,the clinical efficacy of Fang’s scalp acupuncture combined with lumbar three-needle group,Fang’s scalp acupuncture group and waist three-needle group was statistically significant(P<0.05).After multiple comparisons,the method of Fang’s scalp needle combined with waist three needles can decrease the pain level of lumbar disc herniation patients,improve lumbar activity and improve the quality of life of patients with simple scalp needle or waist three-needle method.Conclusion1.Fang’s scalp acupuncture combined with waist three needle or simple Fang scalp acupuncture therapy,simple waist three-needle therapy has certain clinical effects for lumbar disc herniation,which can alleviate the pain symptoms of patients,improve the relevant signs and recovery of patients physical function as well as improves the quality of life of patients.2.After 33 courses of treatment,Fang’s scalp acupuncture combined with waist three needles can relieve pain,relieve clinical symptoms and improve limb function of patients more than simple scalp acupuncture or simple waist three needles.3.The overall effect of Fang’s scalp acupuncture combined with waist disc herniation on lumbar disc herniation is better than simple Fang’s scalp needle or simple waist three needle. |
