Clinical Study Of The Treatment Of Moxa Acupuncture Combined With Massage Treatment Of Frozen Shoulder In Acute Stage

ObjectiveComputer-generated random allocation software were used to assign the patients into three groups:warm needling group, massage group, and the warm needle and massage combined group. Base on the clinical result to explore the warm needle (or) Massage for Treating frozen shoulder and to optimize the warm needle, massage and the two together efficacy of the treatment of frozen shoulder, quality of life of frozen shoulder patients. Propose to prove that which can be an effective treatment of frozen shoulder, once got it, time will save, and reduce the burden on the patients, that means a big effectiveness and value of health economics.METHODS1. Subjects sourceIn this study,80patients were collected from January2012to March2013from Taiwan DA-TONG Chinese medicine clinic2. Diagnosis standerThe diagnosis standard of frozen shoulder was selected to the State Administration of Traditional Chinese Medicine in1994"TCM Syndrome Diagnostic efficacy of the standard" in the frozen shoulder diagnostic criteria formulated strict inclusion, exclusion and removed off.3. Randomization and treatment methodReference the Orthopaedic Rehabilitation Medicine "frozen shoulder staging criteria" edited by Fan Zhenhua.4. GroupsRandomized method:According to the diagnostic criteria, inclusion criteria and exclusion criteria to determine eligible subjects, using computer-generated random allocation software, the patient in the order of1to80, were randomly assigned to warm needle group, the massage group, and the moxa needle combined with massage therapy group.5. Treatment5.1Moxa acupuncture: According to the point that press hurt in the shoulder, depend on local acupoints and acupoints along meridians. Take ipsilateral shoulder skull, shoulder iliac, shoulder, A shi xue, Tiao kou; Yangling quan; Distribution Points according the symptom:With the card on the arm pain plus arm Ru Qu pool and the scapular pain plus Qu Yuan, Tian zong. Alignment points after patients take the contralateral decubitus physician with a2-inch needle to be routine disinfection of local skin piercing, acupuncture gas impose reducing method, needle retention, take the shoulder3-4acupuncture points, moxa (length2.5-3cm appropriate) sets the needle handle on the lower end of the moxa from the skin about4cm. Allowed to burn out self-destruction, lit from the upper end, remove the ashes after the needle removed. To prevent epidermal accidental burns that can be used the cardboard round hole in the middle through the needle handle on the skin. Daily acupuncture needle retention30min. Treatment of10times for a course, the middle interval2-3d after the second course.5.2Massage therapy:Steps:①kneading method:the patient is sitting, hands drooping naturally relax, take off their clothes to expose the suffering shoulder. The surgeon stood ipsilateral affixed to the skin of the patient’s shoulder with the palm or pulp, gently knead3-5min. Then thumb point shoulder iliac shoulder skull, day cases, shoulder well points1min. Then, with the thumb, index middle, three fingers pinch method to relieve grip the deltoid beam and shoulder pain tendon the shoulder swelling numbness and pain.②The Show tendons rotation method:a hand surgeon pressed suffering from shoulder, the other hand limb traction slowly repeated outreach, extension, internal rotation, adduction, etc. on the move to make. The surgeon then stood in front of the patient, one hand pressed suffering from shoulder, hand and lift the limb elbow limb for the shrug action five times. Then lift the affected arm to flush with the shoulder for shoulder joint rotation.③The jitter method:patients who stand in the ipsilateral and two the palms clasped patients thenar, its limbs in outreach posture, then gently shake the limb1min.1times/d,10d courses of treatment, the middle of the interval after the2-3d to start the second course.5.3Moxa acupuncture combined with massageMoxa Acupuncture first and then follow the massage therapy group.6. Treatment regimensAfter treated by Moxa Acupuncture, massage or combination therapy, a research will be going on follow-up period of1week after treatment.7. Result AssessmentEvaluation of the severity of local symptoms, pain visual analog scale (VAS), pain time and nature, and Constant Murley shoulder joint score will be studied before middle or after treatment.The resultsThere were70subjects completed the research including moxa acupuncture group (22cases), massage therapy group27cases, moxa acupuncture combined with massage therapy group21cases. The age range of Patients is43-62years old, the mean onset period is1.3months. There was no statically significant difference between the three groups at baseline in terms of gender, age, onset time, local severity, pain duration and nature, VAS and Constant Murley shoulder score. Local severity was improved after each treatment session and a follow visit after the course completed for both group(p<0.05). There was no statically significant difference between the treatment group and the control group from the baseline to the end of treatment and the followvisit(p>0.05). This indicates the therapeutic effect of three groups is fairy equal. VAS scores of the three groups before and after treatment showed significant improvement, compared with before treatment there were very significant differences (P<0.01); follow-up period VAS between the three groups have a significant difference (P<0.05), suggesting increased with the number of treatments, moxa analgesic effect of acupuncture combined with massage therapy group than pure moxa needle or massage. There were highly significant differences (P<0.01)between Three groups treatment after compared with before treatment; Compared among the3groups, the results had no significant difference (P>0.05) moxa needle, massage, and a combination of both treatment of frozen shoulder after a certain period of time, can effectively reduce the patient’s pain duration, to reduce the burning sensation, the efficacy of the three groups in this respect quite. The follow-up period pain time, the nature of scoring showed moxa acupuncture combined with massage treatment is better than the two separate treatment groups. The Constant Murley shoulder score of the three groups before and after treatment showed significant improvement, but between the three groups showed no significant difference, moxa acupuncture, massage can effectively improve the patient’s Constant Murley shoulder score (including degree of joint pain, level of activities of daily living, range of motion, and joint muscle strength), but the follow-up of results show that the combination of massage and moxibustion moxa needle needle effect better than a simple massage therapy. Three considerable efficacy in this regard. Each observation point, three groups in treatment efficacy evaluation in accordance with the evaluation country standard showed no significant difference, prompted the efficacy of the two groups is considerable.Conelusion(1) The methods of moxa acupuncture, massage and moax acupuncture combined with massage to treat frozen shoulder could improve the shoulder local symptoms, reduce pain, and improve mobility, increasing range of motion and muscle strength. They are easy to implement, and also safe and reliable.(2) The date after the end of treatment indicated that the combination of massage and moxa acupuncture is better than moxa acupuncture or massage used alone to treat the frozen shoulder. For it can be more effective to reduce shoulder pain, improve the cure rate. That means it will be a better way in clinical treatment of frozen shoulder, especially in the later stage of the treatment moxa acupuncture and massage use together will improve the cure rate and reduce the patient’s pain.