Study On Acupotomy For Superior Gluteal Nerves Entrapment Syndrome Following Bowstring Mechanics Anatomical Theory

Superior Gluteal Nerves Entrapment Syndrome is a common disease for lumbocrural pain,which is mainly affecting manual worker.For its’ symptoms,it performs that low back and hip ache which could referred to leg,however,the referred pain hardly beyond the level of knee.Moreover,an obviously press point and abnormal muscular band,which can arouse and augment the painful sensation after pressing,could be always checked at iliopsoas trigone.It is easily to injury the Superior Gluteal Nerves when we changed posture suddenly or bending for a long time.It is because the anatomic characteristic of superior gluteal serves,the part of the nerve is located inside the osseofibrous canal which is stable for the body.Therefore,previous studies reported that 40-60% lumbocrural pain patients are diagnosed with Superior Gluteal Nerves Entrapment Syndrome.Nowadays,conservative treatments were used to cure the symptoms,although some patient was treated with operation.The usually conservative treatments for Superior Gluteal Nerves Entrapment Syndrome contain acupuncture,moxibustion.massage,needle warming moxibustion,fire Needle,acupoint block,acupotomy and so on.However,the present therapy mainly focused on the painful point.Although the intensity of the painful symptoms could be alleviated after treatment,the lower overall response rate and poor long-lasting effect were observed.The poor efficacy for Superior Gluteal Nerves Entrapment Syndrome is mainly related to the balance of mechanics anatomical which was not adjusted by the mentioned treatments.Bowstring Mechanics Anatomical Theory is the theory about the generalization and application for the balance between bone(bowstring) and soft tissue(string),which promotes acupotomy treatment changed from local to the whole.It plays a vital role in the enhancement the overall response rate and long-lasting effect.Objective:The present clinical study chosen the patients with Superior Gluteal Nerves Entrapment Syndrome as subjects.Acupuncture was set as the control group.The aim of the present study is to investigate:1)the efficacy of acupotomy whole debonding treatment on the scale of VAS and JOA of the patients with Superior Gluteal Nerves Entrapment Syndrome;2)comparison the long-lasting effect for the two groups through measuring VAS and JOA scale after 1 and 2 weeks following-up.Above all,the present study would like to report a new treatment method and thinking for Superior Gluteal Nerves Entrapment Syndrome via acupotomy.Methods:All subjects,corresponding to diagnosis standards for Superior Gluteal Nerves Entraplent Syndrome,were recruited from inpatient,outpatient at the department of pain treatment,Jining No.1 people’s hospital,from 2016-06 to 2017-12.60 patients were randomly divided into acupotomy group and acupuncture group.The former group were treated with acupotomy,1 time per week,totally 2 weeks;while the other were applied with acupuncture at pain point,Jiaji point,Zhibian and so on,Itime per day,for 2 weeks.Comparing the change of the VAS and JOA scale at pre-,post-treatment,1st and 2nd week after treatment between two groups.Meanwhile,comparing the overall response rate of acupotomy and acupuncture groups.Results:1.The influence of acupotomy and acupuncture treatment on VAS scaleThe level of VAS were significantly decreased for both groups(P<0.01),which indicated that acupotomy and acupuncture treatment both could improve the intensity of pain sensation;ANOVA for repeated measurement showed that there were significantly difference in group,time and group*time effect between groups(P<0.05).The results demonstrated that the long-lasting effect for acupotomy treatment on Superior Gluteal Nerves Entrapment Syndrome is superior to acupuncture treatment.Comparison with groups at the same time,all data for acupotomy group were lower than that in acupuncture group,indicating that acupotomy treatment was better that acupuncture at reliving pathological pain intensity.2.The influence of acupotomy and acupuncture treatment on JOA scaleAfter treatment,the two interventions elevated JOA scale compared to pre-treatment(P<0.01),indicating that acupotomy and acupuncture therapy could alleviate the lumbar and leg pain symptoms;repeated mesasures two-way ANOVA showed that there were significantly difference in group,time and group*time effect between groups(P<0.05),indicating that the long-lasting effect for acupotomy treatment on Superior Gluteal Nerves Entrapment Syndrome is superior to acupuncture therapy.Comparison with groups at the same time,JOA scale for acupotomy group were all higher than that in acupuncture group,indicating that acupotomy treatment was better that acupuncture at reliving pathological pain intensity.3 Comparison for effective rate between groupsFor 30 cases in acupotomy group,12 patients were cured,the pain symptoms for 16 patients were enhanced and only 2 subjects whose symptoms did not improved.Therefore,the whole effective rate is 93.3%;For the patients in acupuncture group,8 patients were cured,the pain symptoms for 17 patients were enhanced and only 5 subjects whose symptoms did not improved.The whole effective rate is 83.3%.Therefore,the present results showed that the efficacy of acupotomy therapy was better than acupuncture on Superior Gluteal Nerves Entrapment Syndrome.Conclusion:1.Acupotomy and acupuncture treatment could both play a positive in the enhancement of Superior Gluteal Nerves Entrapment Syndrome;what’s more,the long-lasting effect for acupotomy is superior to acupuncture therapy.2.the whole effective rate could be elevated when acupotomy therapy was applied according Bowstring Mechanics Anatomical Theory,and also a long-lasting effect could be observed.