Evaluation Of Therapeutic Efficiency And Mechanical Research On Tuina Treating Delayed Onset Muscle Soreness

Objective:To make the evaluation of therapeutic efficiency and mechanical research on Tuina treating DOMS through a systematic literature review and analysis of induction,through clinical research and experimental study of rat model;to explain the pathogenesis of DOMS and mechanical of Tuina treating DOMS;forming an effective therapy to eliminate and mitigate the DOMS.Method:1.Clincal Research30 healthy male voluntary subjects were randomly divided into three groups:control group(C),pre-exercise Tuina group(A),post-exercise Tuina group(B),10 cases in every group. Every male voluntary subject did the eccentric exercise to induce DOMS.Group A was intervened by Tuina before eccentric exercise;group B was intervened by Tuina by Tuina after eccentric exercise 30min,then continued the Tuina treatment once a day between 9am-11am before soreness disappearing.Clinical observation:soreness intensity,soreness lasting time,arm girth,elbow flexing and extending digress.Result:(1) Significant difference was found between Tuina Groups and Control group on soreness lasting time,C＞B＞A.(2)The soreness intensity arrived at crest value on 24h and 48h after exercise in each group.(3)Tuina obviously reduced the soreness intensity,and pre-exercise Tuina group is better than post- exercise Tuina group.(4) arm girth was the biggest on instant time after exercise,then gradually recovered,but Tuina didn't obviously improve it.(5)The elbow flexing obviously reduced on instant time after exercise in each group,and the angle was less than pre-exercise,then gradually recovered,Tuina could improve the elbow flexing.(6) The elbow extending obviously changed on instant time after exercise in each group,then gradually recovered,Tuina could improve the elbow extending.2.Empirical study130 healthy and clean male SD rats of six-week old were randomly divided into 4 groups including normal control group(A),exercise control group(B),pre-exercise Tuina group(C) and post-exercise Tuina(D).Group B,C and D were randomly divided into 1h,12h,24h and 48h groups.Each group consists of 10 rats.3 rats died in B1,C48 and D48 groups,so 3cases were lost,totally 127 rats finished experiment.Except the group A,the other groups 'rats all trained by exhausting swimming with carrying a subject of 3%body weight.Tuina manipulation:Two lower limbs of rat were treated by pinching manipulation and holding-twisting manipulation, 5min.for each limbs,totally 10min each rat.Observe index:serum CK,PGE2,IL-2,IL-6 and IL-8 of rat,chondriosome Ca2+ and Ca2+-ATPase of skeletal muscle,ultrastructure of skeletal muscleResult:(1) In comparison with the normal control group,the level of serum CK in group B,group C and group D rose immediately.But the level of serum CK in 12h after exercise of group B dropped down,then the level of serum CK in 24h and 48h after exercise of group B gradually rose.Tuina reduced the level of serum CK in 1h,12h and 48h before exercise to lever of serum CK of group A.It means that pro-exercise Tuina can protect the muscle in heavy load and long time exercise.(2) The lever of serum IL-2 of group B obviously rose to peak value in 12h,then dropped down to the lever of serum IL-2 of group A in 24h and 48h.The lever of serum IL-2 of group C obviously rose to peak value in 24h,then drop down in 48h,but they were all higher then group A.The lever of serum IL-2 of group D was lower than group A and B in 12h,24h and 48h.In comparison with the group B,the lever of serum IL-2 of group C obviously rose in 24h and 48h. In comparison with the group B,the lever of serum IL-2 of group D obviously rose in 1h,12h,24h and 48h.The lever of serum IL-2 of group D is lower than group C in every time phase.(3) The lever of serum IL-6 was high in 1h after exercise,then dropped down to the lever of group A,but rose again in 24h to 48h gradually,In comparison with the group B,the lever of serum IL-6 of group C reduced in 1h,and the lever of serum IL-6 of group D reduced in 1h and 48h.The lever of serum IL-6 of group D was lower than group C.(4) The lever of serum IL-8 obviously rose in 1h and 48h after exercise.The lever of serum IL-8 of group C obviously rose in 1h and 24h after exercise.The lever of serum IL-8 of group D obviously reduced in 12h,24h and 48h after exercise.The lever of serum IL-8 of group C is obviously lower than group B in 1h.The lever of serum IL-8 of group D is obviously lower than group B in 1h,12h,24h and 48h.The lever of serum IL-8 of group C is obviously lower than group B in 1h,12h,24h and 48h.The lever of serum IL-8 of group C is obviously higher than group D in 1h,24h and 48h.(5) The lever of serum PGE2obviously rose in24h and 48h after exercise.The lever of serum PGE2 of group C obviously rose in12h.The lever of serum PGE2 of group D obviously rose in24h.The lever of serum PGE2 of group C is obviously higher than group B in 12h.The lever of serum PGE2 of group C is lower than group B in the other time.The lever of serum PGE2 of group D is obviously lower than group B in 48h.The lever of serum PGE2 of group C is obviously higher than group D in 12h,but The lever of serum PGE2 of group C is lower than group D in 24h.(6) The lever of the chondriosome Ca²⁺ and Ca²⁺-ATPase of skeletal muscle homogenate arrived at peak value in 12h,the group C and group D all arrived at peak value in 12h.The lever of the chondriosome Ca²⁺ and Ca²⁺-ATPase of skeletal muscle homogenate of group C is higher than group B in 12h.The lever of the chondriosome Ca²⁺-ATPase of skeletal muscle homogenate of group C is higher than group B in 24h.The lever of the chondriosome Ca²⁺ of skeletal muscle homogenate of group C is higher than group B in 48h.The lever of the chondriosome Ca²⁺ of skeletal muscle homogenate of group D is higher than group B in 24h and 48h.The lever of the chondriosome Ca²⁺ and Ca²⁺-ATPase of skeletal muscle homogenate of group D is lower than group C in 12h.The lever of the chondriosome Ca²⁺ of skeletal muscle homogenate of group D is higher than group C in 24h.(7) The ultrastructure of skeletal muscle showed that chondriosome became vacuole and degeneration,sarcoplasmic reticulum was swelling,myocomma and muscular fibril were abnormal after exercise.Then electron microscope showed the Z-line dislocated,muscular fibril twisted and myocomma contracted and pressed.In comparison with the group B,the ultrastructure of skeletal muscle showed that group C and group D all improved,especially group C was nearly same as the group A in electron microscope.Conclusion:(1) DOMS is the tendon disease,the reason of diease is body overwork,so the internal injury is caused by overstrain.Pathogenesis of T.C.M is that Qi,blood and body fluid are consumed by over-fatigue and functional disorders of the viscera is caused by body overwork, inclusion of deficiency and excess,malnutrition of muscle meridian lead to DOMS.(2)The principle of prevention and cure of DOMS is strengthen the spleen and replenish Qi,invigorate the liver and kidney,promoting qi to activate blood and restoring and treating injured soft tissues to stop pain.(3)PGE2 is a effective evaluating index about DOMS.Tuina has a good effect to prevent and intervene DOMS,it is a kind of therapeutic methods to have effective,easy and suitable spreading.(4) The mechanism of DOMS has concern with the inflammation,mechanical damage and oxygenize etc,so it is the combined effect about different factors in different time-interval.(5) The mechanism of Tuina treating DOMS is the combined effect about different factors treated by Tuina in different time-interval.