| Purpose: The purpose of this study is to explore the clinical efficacy of acupuncture along the abdominal meridian to treat non-specific low back pain at the focal point of foot Yangming Taiyin node tendon.Firstly,a questionnaire survey was conducted to explore the clinical symptoms and characteristics of non-specific low back pain patients.Secondly,the distribution pattern of abdominal lesions and nodules in non-specific low back pain patients was explored.Finally,a randomized controlled trial was conducted to evaluate the clinical efficacy of acupuncture at the focal points of abdominal foot Yangming Taiyin nodules in treating non-specific low back pain,in order to provide a new perspective and method for clinical treatment of non-specific low back pain.Material and method:1.Observation study:Firstly,a questionnaire survey was conducted to collect data from 90 non-specific low back Pain patients who met the inclusion and exclusion criteria,including the course of low back pain,the causes of onset or exacerbation,dietary conditions,whether they have spleen and stomach diseases,tongue and pulse,and traditional Chinese medicine syndrome types.Explore the clinical symptom characteristics of non-specific low back pain patients.Secondly,the method of case observational study was used to explore the condition of the pathological muscle and the focus of the knot in the abdomen of patients with non-specific low back pain.With the abdomen between the xiphoid process level and the pubic symphysis level as the examination scope,the skin fixer pen was used to mark and timely record on the paper version of the abdominal muscle map,mainly including the distribution of the pathological muscle,the frequency of the knot focus,the high-frequency knot focus and the relationship with the symptoms of low back pain.After sorting out the original data,SPSS25.0 software was used for correlation analysis.2.Randomized controlled trial:90 patients with non-specific low back pain were randomly divided into a control group and an experimental group,with 45 cases in each group and 2 cases in each group.Finally,86 cases were counted.The basic information of the two groups of patients before treatment was consistent and comparable.On the basis of diet and routine exercise guidance,the control group was acupuncture at Ashipoint,Dachangshu point and Weizhong point.On this basis,the test group selected the focus of abdominal foot Yangming Taiyin knot tendon for acupuncture.All the above treatments were once a day,five times a week,for four consecutive weeks.Before treatment,4 weeks after treatment and 4 weeks after treatment,VAS,ODI,s EMG,ultrasound,lumbar range of motion,spleen and stomach disease score were used as evaluation indicators.SPSS25.0 software was used for statistical analysis of the data.Results:1.Observation study:1.1 Among the inducements for the onset or aggravation of low back Pain,climate accounted for 50.00%,fatigue accounted for 42.22%,and diet accounted for 21.11%;1.2 81.11% of 90 patients with nonspecific low back pain were accompanied by spleen and stomach disease;1.3 The highest frequency of TCM syndrome type in patients with non-specific low back pain is Qi stagnation and blood stasis syndrome.The proportion of patients with spleen and stomach disease is 91.89%,and the total score of spleen and stomach disease of this syndrome type is the highest(12.91±5.37);1.4 Distribution characteristics of lesions via tendons:of the 90 patients with nonspecific low back pain,82 patients had tendon lesions in the abdomen,accounting for 91.11% of the total number;Among them,there were 2 patients with single meridian lesion,accounting for 2.44%,35 patients with two-meridian complex type,accounting for 42.69%,including 30 patients with foot-yangming Taiyin meridian lesion,5 patients with foot-yangming Shaoyang meridian lesion,and 45 Patients with three-meridian com Plex type,accounting for 54.87%;1.5 Distribution characteristics of the focus points of the tendon:according to the "nine-point method" of the abdomen,the number of cases with nodules in the lower abdominal region is large,including 74 in the shame region,65 in the left inguinal region,and 63 in the right inguinal region;75.61% of Patients with nonspecific low back Pain had abdominal knot lesions between 5-13;The focus points of high frequency knot tendon are Yin Lian,Qu Gu,Heng Gu,Guan Yuan,Wu Shu,Da Ju,Xiawan,pylon and Jingmen,which are mostly distributed on the tendon of the Taiyin meridian of foot Yangming;The proportion of nonspecific low back Pain patients with abdominal nodule lesions in different course of disease in all Patients with low back pain at this stage is: 40.00% with course of disease<6 weeks,50.00% with 6-12 weeks,90.00% with 12-1 years,95.45% with 1-5 years,100.00% with 5-15 years,and100.00% with more than 15 years;1.6 Relationship between abdominal knot focus and low back pain symptoms:the VAS score(6.18 ± 2.06)of NLBP patients with abdominal knot focus was higher than that of NLBP patients without abdominal knot focus(2.73±1.46),and the ODI score(41.76±14.65)of NLBP patients with abdominal knot focus was higher than that of NLBP patients without abdominal knot focus(14.74±11.48).2.Randomized controlled trial:2.1 VAS showed that after treatment and at follow-up,the VAS score of the two groups decreased significantly compared with that before treatment(P<0.01),and the VAS score of the test group decreased significantly compared with that of the control group(P<0.01);2.2 ODI showed that the ODI score of the two groups decreased significantly after treatment and at follow-up compared with that before treatment(P<0.01).Compared with the control group,the ODI score of the test group decreased(P<0.05);2.3 s EMG showed that compared with the two groups,the RMS value of the dorsal muscle in the two groups increased significantly after treatment compared with that before treatment(P<0.01),and the absolute value of MPFs decreased significantly compared with that before treatment(P<0.01);Compared with the control group,there was no significant difference between the two groups in the RMS value and MPFs absolute value of the erector spine muscle after treatment(P>0.05).The RMS value of the test group was higher than that of the control group(P<0.05),while the absolute value of MPFs of the multifidus muscle was lower than that of the control grou P(P<0.05 or P<0.01);Compared with the two groups,the RMS value of abdominal muscles in the test group increased after treatment compared with that before treatment(P<0.05 or P<0.01),while the RMS value of abdominal muscles in the control group had no statistical significance(P>0.05);Compared with the control group,the RMS value of abdominal muscle in the test group was significantly increased(P<0.01);Compared with the two groups,the absolute value of MPFs of abdominal muscles in the control group was not significantly different from that before treatment(P>0.05.),while the absolute value of MPFs of abdominal muscles in the test group was lower than that before treatment(P<0.05 or P<0.01);Com Pared with the control group,the absolute value of MPFs of abdominal muscles in the test group was significantly lower(P<0.01).2.4 Ultrasound showed that the abdominal muscle thickness of the test group increased after treatment compared with that before treatment(P<0.01 or P<0.05).Compared with the control group,the abdominal muscle thickness of the test group increased(P<0.01 or P<0.05).2.5 Lumbar motion: After treatment,the lumbar motion of the two groups increased significantly compared with that before treatment(P<0.01),and the lumbar motion of the test group increased significantly compared with that of the control group(P<0.01).2.6 The score of spleen and stomach disease showed that the score of spleen and stomach disease in the test group was significantly lower than that before treatment after treatment and during follow-up(P<0.01).Compared with the control group,the score of spleen and stomach disease in the test group was lower than that in the control group(P<0.05).2.7 Clinical efficacy evaluation showed that the total effective rate of the test grou P is significantly higher than that of the control group(P<0.05).Conclusion:1.The vast majority of non-specific low back pain patients are accompanied by spleen and stomach diseases,with the most common type of qi stagnation and blood stasis syndrome.2.The vast majority of Patients with nonspecific low back pain have meridian lesions in the abdomen,and the focus of the knot is mainly distributed on the meridian of the foot Yangming Taiyin.According to the "nine points" of the abdomen,it is mainly concentrated in the shame area and the groin area;The presence of focal points of abdominal knot disease prolonged the course of low back pain and aggravated the symptoms of low back pain.3.Combining the differentiation of local meridians and tendons with the differentiation of the whole viscera,acupuncture at the focal point of the abdominal foot Yangming and Taiyin tendons can effectively relieve the symptoms of low back pain and improve the patients’ spleen and stomach diseases. |
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