| BackgroundSciatic nerve is the human body's largest nerve. Sciatica is a radiated pain syndrome of sciatic nervous pathway and its distribution area caused by sciatic nerve disease or surrounding structure disorder. According to its etiopathogenisis, Sciatica can be divided to primary and secondary sciatica. Secondary sciatica can be divided to radicular sciatica and dry Sciatica. Radicular sciatica is more frequently seen due to lumbar disc protrusion, lumbar disc protrusion and abnormal, intraspinal tumor and Lumbar spinal stenosis. It mainly display as paroxysmal or persistent pain, worse at night, and mainly at waist, hips, back of the thigh, calf and foot lateral posterolateral. Coughing, sneezing or exertion can exacerbate the pain. Knee or hip flexion can mitigate the pain. Straight leg raising test is positive. Traditional Chinese medicine classified it as "Arthralgia" category. The pathological mechanism is based on kidney-oriented, evils invasion or sprain or servant as the standard, leading to meridians Juji, blood runs sluggish, meridian unreasonable, pain and even affect motor function. This disease most often occurs in old man and diseased region mainly at foot-taiyang and foot-shaoyin. It may be unilateral or bilateral and be induced by tired and cold. Heavier patients are often unbearable and the qualities of life are affected severely.Currently there is no generally accepted and effective treatment at home and abroad with sciatica. Western medical therapies make slow progress, which advocate repose on bed and aimed at pathogeny cure, for example that lumbar disc protrusion patients should be in bed and accepted operative treatment. Patients often given painkillers to alleviate the symptoms and take sedative, angiotenic, Vitamin B1 and B2 at the same time. Adrenal cortical hormone also could be used, but it has created a considerable side effect.Along with the development of traditional Chinese medicine, especially acupuncture, treatments of sciatica have arosen increasing attention. Dozens of studies have shown that acupuncture could increase pain threshold, improve microcirculation, eliminate inflammatory reaction of nerve, effect signaling pathway of analgesia and release of transmittance. Many scholars have gained curative effects though different acupuncture and manipulation methods on sciatica. Therefore, acupuncture and manipulation method has curative effects and is an ideal method.Recently, L. Yuan had put forward a new hypothesis, fasciology hypothesis. In fasciology, the human body is classified into two major systems. One is the supporting-storing system, which is consisted of is constituted of undifferentiated cells from the network of unspecialized connective tissues (fascia network). The other one is the functional system, which is consisted of differentiated functional cells and is enclosed by the supporting-storing system. Connective tissues that link all parts of the body compose the anatomical basis of meridian. Acupuncture point means a place that rich in nerve receptor with intense bioinformation and connective tissue of competent cell. Therefore, acupuncture point and un-acupuncture point only differ at quantitative of bioinformation, but not qualitative, which means that acupuncture point filled our whole body. Though stimulating the acupuncture point, fascia tissue could generate intense bioinformation in the supporting-storing system, and stimulate the function regulation (activity of tissue and cells) and life regulation (repair and regenerate of tissue and cells) of body, finally promoting repair the function system. So fasciology hypothesis thought that though high-intensity stimulating fascia tissue in the supporting-storing system could promote repairing of body function."Bars the groove, bone staggered joint" is a kind of special name called in TCM. It is the name of disease, but also the pathomechanisms, and was not uncommon historical documents. But it did not get enough regards due to relatively scattered. From the angle of modern medicine, bone staggered joint generally divided into two cases. One is different losses between joints induce the normal anatomical structure form a small staggered joint. The other serious one is that suture is Uneven or subluxation, which can be displayed in X-ray and pain are more obvious. "Bars the groove" means when injury, tendon and other soft tissue slippage, or changes in the anatomical location, which affects mobility, even appear more intense pain and affect the normal work and life. It has close relationship between "Bars the groove" and "bone staggered joint". Injury by "Bars the groove" can induce interlocking suture dislocation of bone suture. Dislocation of bone suture can also induce tendon injury. So treatment on "bone staggered joint" in Golden Mirror of Medicine thought that massage treatment should be first used to cure muscle injury.This topic is based on the theory of fasciology hypothesis, along with the treatment concept of "Bars the groove, bone staggered joint". We raised a new, systemic and standardized method to cure sciatica, which called the new Yi-Jin therapy. First, through the cross-joint the maximum angle traction, pulling and rotating to stimulate joint capsule and the capsule of the deep sensory receptors, then through traditional methods such as acupuncture and floating needles to give the lesion of connective tissue around the muscle and fascia interval high-intensity stimulation of cutaneous nerve. Finally, use the manual reduction to "Bone reduction, Return slot bars".To observe the clinical effect of the new Yi-Jin therapy with sciatica, our topic made theory research on the mechanism of the new Yi-Jin therapy with sciatica, then made clinical research though designing randomized controlled experiment, and to explore a new effective method to cure sciatica.ObjectiveIn this study, a simple randomized controlled clinical study, compared with traditional acupuncture therapy, was designed to observe the objective clinical efficacy and safety of the new Yi-Jin therapy on root sciatica, to seek a new effective treatment method of root sciatica. MethodsAccording to the inclusive criteria,100 cases were chosen from HONGKONG sunlight treatment centre.100 cases were randomly divided into a treatment group (n=50) and a control group(n=50) by a simple randomized principle.The treatment group was treatment with the new Yi-jin therapy, and the control group was treatment with the traditional acupuncture therapy. Both of them selected the same acupuncture points and the same period of treatment. After one time of therapy, the patient had a rest for two days. Three times were a period of treatment.After 3 months of follow-up, both of the two groups were done by the efficacy evaluation from two aspects:one was the pain of the patient by using the visual analogue scale (Visual Analog Scale, VAS), Chinese Oswestry Disability Index (CODI) and Barthel Index (BI) before and after the treatment; the other one was the behavior and conduct disorders by an objective evaluation.Results1. There was no statistically different in age, gender, pre-treatment visual analog scale, Chinese Oswestry Disability Index score and Barthel Index scores between the treatment group and the control groups (P> 0.05). The two groups were comparable.2. Follow-up after the end of the treatment group and the control group, visual analogue scale were significantly lower than before treatment (P<0.01), and the score difference of the treatment group before and after treatment were significantly more advantage than the control group (P<0.01).3 After follow-up, Chinese Oswestry Disability Index score in the treatment group and the control group were both significantly lower than before treatment (P<0.01), and the scores difference before and after treatment in the treatment group were significantly more advantage than the control group (P<0.01).4. Barthel Index scores of the treatment group and the control group were significantly higher than before treatment (P<0.01), and the scores difference before and after treatment in the treatment group were significantly more advantage than the control group (P<0.01).5. The clinical cure rate in the treatment group (36%) was significantly higher than the control group (4%). The total effective rate (96%) in the treatment group was significantly higher than the control group (70%). The treatment group and control group were significant differences in efficacy (P<0.01), and the treatment group was significantly better than the control group.ConclusionBy the objective evaluation of the new Yi-Jin therapy on the clinical efficacy of root sciatica, this study showed that:the new Yi-Jin therapy could greatly improve the symptoms of sciatica, and enhance the capacity of life of the patients. Its efficacy was better than traditional acupuncture. The new Yi-Jin therapy is a new effective treatment method on root sciatica due to the simple operation, rapid effect and a short course. |
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