| ObjectiveThis subject was divided into clinical observation and experimental research two parts.In the clinical part,we compared the curative effects of EA at Jiaji points and Beishu points in treating Lumbar Disc Herniation(LDH).We aimed at choosing a better treatment of acupuncture in treating LDH.In the experimental part,we constructed the animal models of lumbar disc degeneration and observed the influence of decorin expression in the tissues of the rabbit lumbar disc degeneration by the treatment of EA at Jiaji points.Through this research we could explore the action mechanism of lumbar disc degenerationc treated by the EA at Jiaji points further. Method1 Clinical observation:Sixty patients chosen by adoption standards were randomly divided into treatment group(EA at Jiaji points group) and control group(EA at Regular points group),each group has 30 cases.Actually there were only 29 patients in each group finally because of 1 patient in each group was eliminate duing the study.Each group was given electroacupuncture therapy once a day,6 times continuous as a course of treatment,before the next course of treatment has one day interval.The treatment were two courses total.Oswestry disability index questionnaire was selected to evaluate the therapeutic effects of two groups before and after treatment.Modified Macnab curative effect evaluation standard was used to evaluate the clinical efficacy of two groups after the treatment.2 Experimental research:Forty New Zealand white rabbits were randomly divided into four groups:normal group,sham operation group,model group and EA group.Each group have ten rabbits.Normal group were given normal feeding without any treatment;Sham operation group were attached to two K-wires inserted into the vertebral bodies L4 and L5 parallel to the adjacent study but without pressure loading devices.There were nothing else treatment in Sham operation group.Model group were given the custom-made external device on the bases of sham operation group and no additional treatment were given in this group too. EA group were given EA theapy at Jiaji points after the disc degenernation model were established.Western blot was used to detect the protein expression of decorin from the tissues of the rabbits in each group at 28-day and 56-day time point. Result1 Clinical observation results:ODI scores in each group were significantly reduced after two weeks, treatment compared with the results before treatment,the differences were statistically significant in each group(both P<0.05);The degree of scores decline in the treatment group were more obviously than the control group and the differences were statistically significant(P<0.05);The total effective rate was 89.66% in the treatment group and 82.76% in the control group which had a significant statistically(P<0.05)2 Experimental research results:The content of decorin in normal group and sharm group both had slightly differences at each point time,there differences were no statistically significant(both P>0.05); The protein expression of decorin in model group on 28 days and on 56 days and EA group on 28 days were both obviously lower than that in control group on 28 days.There differences were both statistically significant(both P<0.05); The protein expression of decorin in model group on 28 days and on 56 days and EA group on 28 days were both obviously lower than that in sharm group on 28 days.There differences were both statistically significant(both P<0.05);The protein expression of decorin in model group on 56 days reduced further than this group on 28 days.The differences were statistically significant(P<0.05);However,the protein expression of decorin in EA group on 56 days were obviously improved than this group on 28 days and model group on 56 days.The differences were statistically significant(P<0.05). Conclusion1 The thearpy of EA at Jiaji points and EA at Regular points both could effectively improve the symptoms of patients with LDH and reduce the affect of waist pain to daily life and work.But thearpy of EA at Jiaji points group had a better effect than EA at Regular points which deserved to be recommended as a good solution of clinical acupuncture thearpy.2 The axial pressure is one of the most important factors on the changes of extracellular matrix by induced rabbit lumbar disc degeneration;Decorin is involved in the process of lumbar disc degeneration and the protein expression of decorin decline with the progress of the lumbar disc degeneration.The treatment of EA at Jiaji points could improving the protein expression of decorin in the tissues of the rabbits with lumbar disc degeneration and delay the intervertebral disc degeneration though rectificate the imbalance between degradation and anabolism in extracellular matrix. |
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