Clinical Study On Trigger Points With Acupoints By Acupuncture For Subjective Tinnitus

Objective: To assess the different therapeutic efficacy between trigger points with acupoints and routine acupoints by needle for subjective tinnitus, and to discuss the relationship of Tr Ps acupuncture inactivation and the releasing of symptom, such as tinnitus severity and living quality, thus gave a possible basis for pathological mechanism of ST. At the same time, formulate initially operation standard of trigger point acupuncture for ST in order to promote the clinical spread and application.Methods: Patients with ST were randomly divided into trial group and control group by random numbers generated by computer, those in trial group were acupunctured with Tr Ps combined with acupoints(n=30), and those in control group employ regular acupoints(n=30). Every patient have experiented 3 treatment phase in total of 30 days. The scores, tinnitus severity and efficacy evaluation standard questionnaire and tinnitus handicap inventory(THI), were avalible for effect evaluation. Then, checked the size and tenderness degree of Tr Ps contraction knots located in ipsilateral sternocleidomastoid muscle or trapezius, and compared Tr Ps local thermal infrared spectrum by infrared camera to evaluate the therapeutic efficacy of trigger points with acupoints by acupuncture for ST. Further to explore the relationship between Tr Ps inactivation by acupuncture and relief of tinnitus severity and quality of life through analysis of the correlation between knots size, tenderness, temperature difference of Tr Ps and tinnitus symptom, THI integral difference before and after treatment.Results TINNITUS SEVERITY SCORES: The post-treatment tinnitus severity scores of each patient had an extremely significant difference when compared with pretherapy in each group(P<0.01). The tinnitus severity scores of post-treatment had an extremely significant difference when compared between groups(P<0.01), and tinnitus severity scores had a similar situation. THI SCORES:The post-treatment THI scores of each patient had an extremely significant difference when compared with pretherapy in each group(P<0.01). The THI scores of post-treatment had an extremely significant difference when compared between groups(P<0.01), and the THI scores had a similar situation as well. TOTAL EFFECTIVE PERCENTAGE: Trial group with 93.33% was obviously higher than control group with86.67%.The total effective percentage of two groups hadan extremely significant difference(P<0.05). CONTRACTION KNOTS AREA, TENDERNESS AND TEMPERATURE OF Tr Ps: The post-treatment and pretherapy contraction knots size, tenderness and temperature differerce of Tr Ps within trial groups had a very significant difference(P<0.01). ST patients with Tr Ps local abnormal thermal infrared spectrum was characterized with abnormal high temperature area, in different shapes, but the high temperature area was reduced significantly, even disappeared absolutely after treatment. CORRELATION:The difference of tenderness and temperature of patients’ Tr Ps in experimental groups had a positive correlation with the tinnitus severity scores and THI scores before and after treatment(P<0.01), while the contraction knots area of Tr Ps had not significant correlation with the tinnitus severity scores and THI scores(P>0.05).Conclusions: Trigger points with acupoints by acupuncture for ST patients were better than conventional acupoints in improving clinical symptoms and quality of life, it was worthy to promote and applicate in clinical. One or more Tr Ps with abnormal thermal infrared spectrum were found in ipsilateral sternocleidomastoid muscle or trapezius muscle. Acupuncture did obviously inactivate Tr Ps, manifested as contraction knots area and tenderness reduced, high temperature recovered. The deactivation of Tr Ps Closely related to tinnitus symptoms and living quality, therefore, the pathognomonic index-temperature and tenderness-can be employed to assist in the diagnosis, or evaluated the tinnitus severity and therapeutic efficacy, it was valuable for clinical application. Formulate initially operation standard of trigger point acupuncture for ST, including Tr Ps positioning, operation steps, important factor in treatment and matters needing attention, to provide references for clinical application.