| Research background:Lumber Disc Herniation(Lumber Disc Herniation,LDH)is a common and frequent disease in the clinic..Intervertebral disc degeneration or fibrous ring rupture,myelin nucleus puffing or prominent compression stimulates the nerve roots of the spinal cord,causing nerve root nutrition disorders,nerve root inflammation and conduction damage,the appearance of low back pain,sciatic nerve pain,numbness of the lower limbs and other symptoms,and even obvious neurological dysfunction.This disease belongs to the category of white vein disease in the lower limbs of the Mongolian medicine.Mainly Badagan and Hei or Badagan and Xi Ra Wu Su into the lower limb white veins-the Gursutu Vein,It was classified yin,five yuan belongging to the water.There are two kinds of therapeutic methods for patients with the lumbar disc herniation,one is surgical treatment;the other is conservative treatment.Surgical treatment is expensive and risky,so long-term efficacy are not plausible;Conservative treatment including intravenous and oral medication,traction therapy,manipulative,rehabilitation and other modern therapy,in particular,the efficacy and course of treatment vary.In recent years traditional Mongolian Medical acupuncture therapy in the application of pain relief has been paid more and more attention especially.Mongolian Medical "wu-wei-gan-lu" fumigation therapy is one of the non-invasive and safe method which combines the heat and herbal molecule to facilitate to the blood circulation.The herbal medicine is absorbed via skin sreface and circulating all body.Mongolian Medical "wu-wei-gan-lu" fumigation therapy can treat white-meridian disease and yellow-water disease.Mongolian Medical warm acupucture with "wu-wei-gan-lu" fumigation therapy is a kind of dual therapy.However,there are few reports about the use of Mongolian Medical warm accupunture and "wu-wei-gan-lu" fumigation therapy for lower limb white meridian by caused LDH on the clinical,and comparatively,no unified conclusion is shown about the clinical efficacy of a single application and its combination.Research objective:In order to evaluate the clinical efficency and choose Mongolian Medical warmacupuncture add traditional Mongolian Medical fumigation as combination,and also quantify the therapeutic effect and compare the Clinical efficacy differences between the three options,the appropriate therapies which treat the disease of Lower limb white Meridian caused by LDH are to be explored and the researcher tries to explain further the efficacy and mechanism of the combination and provide reference for further clinical studies.Research method:In order to choose to meet the diagnostic and inclusion criteria of Lower limb white Meridian caused by LDH,patients in 96 cases were randomly divided into of Mongolian Medical warm acupuncture combined with fumigation group,Mongolian Medical warm acupunctur group,control acupuncture group,Each group includes 32 cases.Mongolian Medical warm acupuncture combined with fumigation group was treated with Mongolian Medical warm acupuncture and "wu-wei-gan-lu"fumigation treatment,whereas Mongolian Medical warm acupuncture group was only treated with Mongolian Medical warm acupuncture treatment;control acupuncture group was only treated with routine acupuncture treatment.The therapy was 1 day 1 time,14 times to be a period of treatment,both groups were treated for 4 weeks.The primary outcome measure was the average leg pain intensity(0,2,4,),the average low back pain intensity(0,2,4,),the lower back pain standard(0,2,4,),Oswestry disability index(0,2,4,),the MOS item short form health survey(0,2,4,).and then the researcher determinated the content change of blood serum inflammatory stress indecators:interleukin 6(IL-6),interleukin 8(IL-8),tumor necrosis factor alpha(TNF-α),Interleukin-lbeta(IL-1β),MMP2、MMP9 and the pain mediators:substance P(SP),5-hydroxytryptaphane(5-HT),calcitonin gene-related peptide(CGRP),beta-endorphin(β-EP)in patients before and after(2,4)week treatment.Then the results were analysed.Research results:1.Before the treatment,the difference in age,gender,course and each index scores of patients these three groups have no statistica significance(P>0.05),which can be compared.2.The result of namely visual analog classification(VAS):(1)the low back pain VAS:Comparison within groups,the scores of the low back PainVAS before and after the therapy with significant difference(P<0.05);Comparison between groups:After the treatment,the total score of the low back Pain VAS in all three groups was decreased.The Mongolian Medical warm acupuncture combined with fumigation groups in the low back Pain VAS score is in the highest rank;compared with the Mongolian Medical warm acupuncture group and control acupunture group,there is the significant difference between the groups(P<0.05);The Mongolian Medical warm acupuncture groups low back Pain VAS score compared with the control acupunture group,there is the significant difference between the groups(P<0.05);(2)the leg pain VAS:Comparison within groups:there are the scores of the leg Pain VAS before and after the therapy with significant difference(P<0.05);Comparison between groups:After the treatment,the total score of the leg Pain VAS in all three groups was decreased.The Mongolian Medical warm acupuncture combined with fumigation groups,the leg Pain VAS score is in the highest rank;compared with the Mongolian Medical warm acupuncture and control acupunture group,there is the significant difference between the groups(P<0.05);The Mongolian Medical warm acupuncture groups:leg Pain VAS score compared with the control acupunture group there is the significant difference between the groups(P<0.05);Tip:The Mongolian Medical warm acupuncture combined with fumigation therapy can effectively decrease the patients low back and leg pain;3.The result of JOA:(1)The result of symptoms of JOA:After the treatment of 2 weeks and 4 weeks,all three groups,symptoms scores were significantly improved versus before treatment(P<0.05);Comparison between groups:After one course of treatment,Mongolian Medical warm acupuncture combined with fumigation group and Mongolian Medical warm acupuncture group,scores of the low back and walking function were improved obviously,versus the control acupunture group(P<0.05),except the leg pain and numbness score;After two courses of treatment,Mongolian Medical warm acupuncture combined with fumigation group and Mongolian Medical warm acupuncture group,scores of the low back and leg pain and numbness were improved obviously,versus the control acupunture group(P<0.05),except the walking function score(P>0.05).(2)The result of signs of JOA:After the treatment of 2 weeks and 4 weeks,all three groups,symptoms scores were significantly improved,versus beforetreatment(P<0.05);Comparison between groups:After two courses of treatment,Mongolian Medical warm acupuncture combined with fumigation group,score of sensory disturbance was significantly improved versus the other two groups(P<0.05);Mongolian Medical warm acupuncture combined with fumigation group and Mongolian Medical warm acupuncture group,score of dyskinesia were significantly improved versus the control acupuncture group(P<0.05);There were no differences between three groups score of straight leg raising test(P>0.05);(3)The result of normal activities scores of JOA:After the treatment of 2 weeks and 4 weeks,the three groups,normal activities scores were significantly improved versus before treatment(P<0.05);After one course of treatment,Mongolian Medical warm acupuncture combined with fumigation group,scores of rolling over from supine position,standing,washing face and brushing teeth,leaning forward were significantly improved versus the other two groups(P<0.05).After two courses of treatment,Mongolian Medical warm acupuncture combined with fumigation group,scores of rolling over from supine position,standing,washing face and brushing teeth,leaning forward,sitting1 hour were significantly improved versus the other two groups(P<0.05);There were no differences between three groups scores of lifting heavy object and walking(P>0.05).The Mongolian Medical warm acupuncture combined with fumigation therapy can help improve patients’ subjective symptom,clinical signs and the limits of daily activities better than the Mongolian Medical warm acupuncture and control acupunture therapy;The Mongolian Medical warm acupuncture combined with fumigation therapy can effectively decrease the patients scores of low back pain and leg pain and numbness.After 4 weeks,it also can improve sensory disturbance;4.The result of Oswestry disability index(ODI):After the treatment of 2 weeks and 4 weeks,the three groups,normal activities scores were significantly declined versus before treatment(P<0.05);After one and two cources of treatment,Mongolian Medical warm acupuncture combined with fumigation group,scores of were significantly declined versus the other two groups(P<0.01);Tip:The Mongolian Medical warm acupuncture combined with fumigation therapy can effectively decrease the patients Oswestry disability index;5.The result of SF-36:After the treatment of 2 weeks and 4 weeks,all three groups,SF-36 scores were significantly improved versus before treatmen(P<0.01);Comparison between groups:After two courses of treatment,Mongolian Medical warm acupuncture combined with fumigation group,score of bodily pain(BP)、physical function(PF)、general health(GH)、role-emotional(RE)were significantly improved versus the other two groups(P<0.01);The Mongolian Medical warm acupuncture combined with fumigation therapy can decrease the patients pain and modulate general health、physical function、emotion;6.Clinical effect:After the treatment,the total effective rate of the Mongolian Medical warm acupuncture combined with fumigation group,the Mongolian Medical warm acupuncture and control acupunture group was 90.7%,84.3%and 78.1%;Tip:The result of combined treatment was satisfied than the other two groups;The Mongolian Medical warm acupuncture combined with fumigation therapy can help improve clinical efficacy,because of lower limb white meridian by caused LDH;7.Safety analysis:No serious adverse events in three groups.The incidence of adverse events was 3%in the Mongolian Medical warm acupuncture combined with fumigation group,0%in the Mongolian Medical warm acupuncture group,and 6%in the acupuncture group.All adverse events were disappeared without additional intervention.8.1 Inflammatory indicators expression in terms of quantity(IL-1β、IL-6、IL-8、TNF-α、MMP2、MMP9)After the treatment of 2 weeks and 4 weeks,the content of IL-1β、IL-6、IL-8、TNF-α、MMP2、MMP9 in all three groups were significantly declined versus before treatment(P<0.05);After the treatment,the content of Inflammatory indicators(IL-1β、IL-6、IL-8、TNF-α、MMP2、MMP9)in all three groups was decreased.Mongolian Medical warm acupuncture combined with fumigation group,content of Inflammatory indicators(IL-1β、IL-6,IL-8、TNF-α、MMP2、MMP9)of were significantly declined versus the other two groups(P<0.01);Tip:The Mongolian Medical warm acupuncture combined with fumigation therapy can reduced inflammation in turn treat the lower limb white meridian by caused LDH cases more significantly;8.2 Pain-related indicators expression in terms of quantity(SP、5-HT、CGRPs、β-EP)(1)After the treatment of 2 weeks and 4 weeks,the content of SP、5-HT、CGRP in all three groups were significantly declined versus before treatment(P<0.05);After the treatment,the content of Pain-related indicators(SP、5-HT、CGRP)in all three groups was decreased.Mongolian Medical warm acupuncture combined with fumigation group,content of Pain-related indicators(SP、5-HT、CGRP)was significantly declined versus the other two groups(P<0.01);Tip:The Mongolian Medical warm acupuncture combined with fumigation therapy can reduced Pain-related indicators expression in turn relieving nerve root stimulation to treat the lower limb white meridian by caused LDH cases more significantly.(2)Beta-endorphin(β-EP)expression in terms of quantity:After the treatment of 2 weeks and 4 weeks,the content of β-EP in all three groups were significantly increased versus before treatment(P<0.05);After the treatment,the content of β-EP in all three groups was increased.Mongolian Medical warm acupuncture combined with fumigation therapy,content of β-EP was significantly increased versus the other two groups(P<0.01);There were no differences between the Mongolian Medical warm acupuncture group and the control acupuncture(P>0.05);Tip:The Mongolian Medical warm acupuncture combined with fumigation therapy can increased β-EP expression in turn relieving nerve root stimulation to treat the lower limb white meridian by caused LDH cases more significantly;Conclusion:1.The lower limb white meridian disease caused by LDH is more severe under cold conditions and the influence of the white meridian type is in the majority.2.Mongolian Medical warm acupuncture combined with "wu-wei-gan-lu"fumigation therapy can significantly improve patient’s subjective symptoms(low back pain,leg pain or numbness,walking ability),clinical signs(sensory disorders,movement disorders,straight leg raising test and strengthen test),subject to the limits of daily activities(such as supining rolling over,standing up,washing up,leaning forward,sitting 1 hour).It also can adjust bodily pain(BP)、physical function(PF)、general health(GH)、mental health(MH);3.The overall improvement rate of Mongolian Medical warm acupuncture combined with " wu-wei-gan-lu" fumigation therapy was significantly better than that of Mongolian Medical warm acupuncture therapy and conventional acupuncture therapy.No serious adverse events in three groups.4.The Mongolian Medical warm acupuncture combined with " wu-wei-gan-lu"fumigation therapy can significantly reduced the effect of serum leukocyte interleukin-6(IL-6),leukocyte interleukin-8(IL-8),tumor necrosis factor-alpha(TNF-α),serum leukocyte interleukin-1 beta(IL-1β),MMP2,MMP9;It also can significantly reduced Pain-related indicators expression of pain substance(SP),serum calcitonin gene-related peptide(CGRP),5-serotonin(5-HT),and increased beta-endorphin(β-EP)expression in turn relieving nerve root stimulation to treat the lower limb white meridian by caused LDH cases;5.The Mongolian Medical warm acupuncture combined with "wu-wei-gan-lu"fumigation therapy is a simple operation can quickly and effectively improve the clinical symptoms of the lower limb white meridian disease caused by LDH,so it has a high practical value and is worthy of promotion. |
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