Clinical Research On The Treatment Of Discogenic Low Back Pain With Acupuncture And Functional Exercises

As a common and frequently occurred disease, low back pain may be caused by multiple vertebral canal diseases. Though more than half of the patients may improve naturally or with or without surgery, however, there are still a large number of back pain patients whose diseases are hard to handle, while neurological handicap, abnormality, serious lumbar instability, fracture and tumor are just a small part of the etiology. With lumbar intervertebral joint osteoarthritis, supraspinal and interspinal ligament desmitis, LIDP and lumbar spinal stenosis being excluded, a large number of lumbar pain can not be well explained, not even to mention the specific treatment methods.Modern Medicine proves that fractures and degenerations themselves inside the fibrous ring of intervertebral disk can cause stubborn lumbar pain; therefore Chinese Medicine should include discogenic low back pain in its category of lumbar pain diseases.ObjectiveDiscuss the relationship between the clinical curative effect of the treatment of discogenic low back pain and the methods of acupuncture and functional exercises, between the curative effect and syndrome types and between the curative effect and age, etc. The randomized controlled clinical test objectively evaluates the curative effect and the safety of acupuncture and functional exercises in the treatment of discogenic low back pain.MethodsMajor acupoints:Ashi, Yaoyangguan, Dachangshu, Huantiao. Coordinated acupoints:posterior part of the lower limbs:Yinmen, Weizhong, Chengshan. Exterior part of the lower limbs:Fengshi, Yanglingquan, Waiqiu, Yangjiao). Lumbar and back muscle exercises:First:simple five-spot or three-spot methods for lumbar and back muscle function exercises; Second:take prone position, use the upper limbs to support the stretching of lumbar and back properly. For patients of older age and weak constitution, use soft articles like quilts to share the burden of the upper limbs. Third:take supine position, raise lower limbs straightly as much as possible so as to stretch the lumbar and back. This test takes 4 weeks as a curative course to observe and summarize the difference of curative effect between lumbar and back muscle functional exercises and routine treatment. Evaluate the curative effect after 2,3, and 4 weeks respectively. No other curative medicine is allowed to use during the test.ResultComparability test before the treatment shows that the difference among the three groups have no statistical significance (P>0.05) in aspects of age, gender, disease course, pain, Chinese Medicine differentiated types, disease position, PRI perception score, PRI sentiment score, PRI total score, VAS score, anguish density score, symptoms and body signs, etc. It indicates that the major factors influencing the prognosis of the three groups have equilibrium.The research results after 1 treatment course is listed as follows:1. The Acupuncture and Lumbar and Back Muscle Exercise Group (Group A) can effectively improve the symptoms like difficulty in turning the lumbar and stiffness of the lumbar with the disappearance rate of 70.0% and 76.66% which are obviously superior to Group B and C. By comparison, the difference has statistical significance (P<0.05). Certain achievements have been achieved in the disappearance rate of symptoms like leg debility, aversion to heat, dry mouth, scanty dark urine, deficient breath, reddish face and cold hands and feet, etc, but the difference has no statistical significance (P<0.05).2. Pain appraisal:the three curative methods can effectively lower the score of each element of the pain appraisal, including PPI perception, PPI sentiment, PPI total score, anguish density score and VAS score. The interclass difference has statistical significance (P<0.05). Results after treatment and the comparison show that Group A's result is the most obvious3. Curative effect of pain:Group A's clinical recovery rate is 36.7% and the total effective power is 93.3%; the Acupuncture Group (Group B) 20.0% and 83.3% respectively; the Lumbar and Back Muscle Functional Exercise Group (Group C) 16.7% and 73.3% respectively. Group A's rates are higher than those of Group B and C and the difference has statistical significance (P<0.05).4. Chinese Medicine syndrome treatment effect:Group A's clinical recovery rate is 30.0% and the total effective power is 83.33%; the Acupuncture Group (Group B) 10.0% and 80.0% respectively; the Lumbar and Back Muscle Functional Exercise Group (Group C) 13.33% and 73.33% respectively. Group A's rates are higher than those of Group B and C and the difference has statistical significance (P<0.05).To summarize, acupuncture plus lumbar and back muscle exercises can effectively decrease the discogenic low back pain and the patients'mental strain and anguish. The method especially has obvious effect in improving the difficulty in turning over and the stiffness of lumbar. It's safe, reliable and effective.ConclusionAcupuncture plus functional exercises have confirmed effect in treating discogenic low back pain and have fewer side effects. This method has good curative effect and its total effective power is superior to that of the other two groups. No obvious detriment to heart, liver, kidney function and blood system is found in the treatment. It enjoys clinical safety and is worth being recommended.