Clinical Research Of Root Sciatica Treatment By Blood-letting Plus Needling Therapy

Sciatica is a common disease in clinic and occurs more frequently to young and middle-aged male. It's a syndrome caused by multiple reasons and its major symptom is pain in sciatic nerve pathway. Paroxysic or rest pain usually occurs in lumbar and legs at one side. The major symptoms are radiative, scorching or darting pain at rumps, posterior part of legs, extro-posterior part of shanks and feet which aggravate at walk. Straight-leg raising test shows positive result and the Achilles ref lx decreases. The sciatic nerves are formed by L4-S3 nerve roots. The pain originates from rumps and emits to distal end along the posterior part of thighs and the exterior part of shanks. It aggravates when walking, moving or distracting the sciatic nerves, and patients cannot move or squat or carry load weight which seriously affects patients'life and work.Needling therapy to treat sciatica has a long history and has obvious clinical advantages. The clinical report says the effect is satisfying and it has high application and research values. At present, research on needling therapy to treat sciatica has made some achievements, but the related clinical research reports on blood-letting and needling therapy to treat sciatica are few. This research intends to make curative effect observation of sciatica treatment by blood-letting plus needling therapy.ObjectiveThis randomized controlled study observes the clinical curative effect and safety of blood-letting plus needling therapy to treat sciatica.Methods100 subjects of sciatica were selected who have been treated in He Shanwei's Chinese Medicine Clinic in Taiwan from February to December 2009 and who have met the case inclusion criteria. The prospective randomized controlled trial methods are adopted and the qualified subjects were randomly classified into the Blood-letting and Needling Group (Treatment Group) and the Pure Acupuncture Group (Controlled Group) with 50 in each group. The acupoints were selected according to the guidelines listed in the National Chinese Medicine Planned Textbook named Acupuncture (Version 1). Based on the theory of collaterals, the related acupoints on the Urinary Bladder Meridian of Foot-Taiyang and the Gall Bladder Meridian of Foot-Shaoyang were selected. Based on the differentiation of types including cold and dampness, qi and blood stagnation and liver and kidney deficiency, supplementary acupoints were selected. Major acupoints:Foot-taiyang Meridian:Yibian, Fucheng, Yinmen, Weizhong, Chengshan and Kunlun; Foot-shangyang Meridian:Fengshi, Xiyangguan, Yangfu, Xuanzhong, and Zulinqi; acupoints selected based on syndrome differentiation:add Xuehai and Taichong for qi and blood stagnation type; add Kidney-shu and Taixi for liver and kidney deficiency; add Yinlingquan and Sanyinjiao for humid heat type. Needling therapy:According to patients' figure, the doctors choose one-time needles of 25,40 or 80 mm and give focal sterilization by 75% alcohol. Insert needle quickly with single hand. Life, twist and rotate the needle to achieve qi and mildly reinforce and attenuate with rotating techniques. Manipulate the needles every 10 minutes and maintain for 20 minutes. The blood-letting techniques:apply it after needling. Choose the purple and blue veins at Weizhong Point in popliteal places. Prick to cause bleeding with three edged needles of type 16. When blood stops, conduct cupping and maintain for 5 minutes. Clean the bleeding part by sterilized dry cotton ball and sterilize pin hole with iodophor. Ask patients to protect the bleeding focal area from water or other infecting factors in 24 hours. Treatment courses: once every day and 5 days make a treatment course. Rest for 2 days during the course and there are 2 courses in total.Before and after treatment, observe VAS score, BRS-6, the clinical symptoms and body signs and safety indexes. Evaluate the clinical curative effect at the end of the treatment course.Data processing:Collect clinical material in time at the end of the clinical research. Use software EPIDATA 3.01 to set up the database for data management. The measurement material is expressed by x±s; the numeration material by ratio or percentage; comparison within the groups before and after treatment takes pair t test; the interclass comparison of the measurement material takes single-factor variance analysis; the numeration material analysis takes chi square test; the comparison of the ranked material takes Ridit analysis; the significance test a=0.05 and P value takes double value. Use software SPSS 17.0 for statistics and analysis. Draw the statistics graphs with software Graph Pad Prism 4.03.ResultThis research takes randomized controlled trial methods and has 100 qualified subjects with 50 in the Treatment Group and 50 in the Controlled Group. Compare the age and gender and other indexes, the author finds the difference has no statistical significance (P>0.05) which indicates that the interclass conditions are equal and have comparability.The clinical research results are listed as follows:1. Clinical curative effect:In the Treatment Group, the recovery rate is 42.0%, the excellence rate is 28.0%, the effective power is 16.0%, and the total effective power is 86.0%; those of the Controlled Group are 26.0%,22.0%, 30.0%, and 78%. Compare the curative effect of the two groups and the author finds that the difference has statistical significance (R<0.05) which indicates the Treatment Group has better curative effect than the Controlled Group.2. The difference has statistical significance (P<0.05) in comparing the two groups'change in pain level after treatment. It indicates the Treatment Group has better curative effect than the Controlled Group in relieving pain.3. The difference has statistical significance (P<0.05) in comparing the two groups'BRS-6 score after treatment. It indicates the Treatment Group has better curative effect than the Controlled Group in improving patients' capability.Conclusion1. Blood-letting plus Acupuncture Therapy has better curative effect in treating sciatica than the Pure Needling Therapy.2. Blood-letting plus Acupuncture Therapy has better curative effect than the Pure Needling Therapy in lessening patients'pain level and improving their capability.