| Objective:The topic of research to this thesis uses the National973Project "The basic research for treatment of neck and back pain using balance acupuncture therapy "as the main basis of research, coming off as a part of the subtopic "Clinical foundation research for Balance Acupuncture treatment of frozen shoulder". This clinical study completely and accurately collected and organized patient data of the249cases of frozen shoulder from the six clinical trials center:People’s Liberation Army General Hospital of Beijing Military Region, Beijing Geriatric Hospital, China Academy of Traditional Chinese Medicine, Wangjing Hospital, Linyi City, Shandong Province, People’s Hospital, Peking University Third Hospital, Beijing Tiantan Hospital. Balance Acupuncture treatment of frozen shoulder activity effect is evaluated based on data mining analysis and clinical significance of the balancing acupuncture is evaluated.Methods:In this study, using a multicenter, randomized, controlled study method, in strict accordance with the diagnosis, inclusion and exclusion criteria, patients from the six centers were randomly divided into balance acupuncture group (111cases) and traditional acupuncture group (111cases), two groups adding to a total of222cases. Balance acupuncture group to take shoulder pain point of balance acupuncture, traditional acupuncture group to take routine point therapy, the patients were followed up after a course of treatment, follow-up is done through telephone or outpatient follow-up, respectively done after20treatments, and at2,4,6months, a total of3follow ups. The long term efficacy of balance acupuncture treatment for frozen shoulder was observed. During the treatment, records were made in the clinical efficacy portion (symptoms, signs cumulative rating) of the CRF form and Melle score sheet, the improvement of the shoulder activity movement was evaluated with the above data and each indicator data was organized. Observation was made for the condition of the frozen shoulder with treatment from balance acupuncture of the shoulder pain point and traditional acupuncture.Results:1. baseline analysisBasic information:basic information includes gender, age, symptoms and signs for baseline analysis (each indicators were compared with that before treatment). Through group comparisons, the results that were not statistically different (P>0.05). indicates that the general clinical data before treatment for balance acupuncture group and traditional acupuncture group were comparable. Outcome measures:through clinical observation, the overall efficacy of the treatment of frozen shoulder, efficacy onset time, immediate efficacy of Melle rated indicators, the treatment effect, long-term effect, the analysis of various indicators efficiency, the indicator data are indicative of the balance acupuncture needle and traditional needle therapy in the treatment of patients with frozen shoulder have good regulatory effect.2. Overall efficacy analysis(1)Comparison of overall efficiency of treatment, balance acupuncture group and traditional acupuncture group has no significant statistical difference (P>0.05).(2)Comparison of overall maintenance rate during the follow-up period, there is significant statistical difference (P<0.05) between the two groups.3.Onset time analysisShoulder abduction, shoulder neutral position and external rotation, hand-to-neck, hand-to-spine, hand to mouth onset efficacy time comparison, the onset time for indicators of balance acupuncture group and traditional acupuncture group has no significant difference (P>0.05).4.Analysis for improvement of each indicator4.1.immediate efficacy analysis (before treatment compared with after the first treatment)(1)Comparison of instant efficacy between balance acupuncture group and traditional acupuncture group:①comparison of the shoulder abduction, hand-to-mouth balancing acupuncture group and the traditional acupuncture group shoulder abduction group was significantly different (P <0.05).②immediate efficacy of shoulder neutral position external rotation, hand-to-neck, and hand-to-spine, various indicators of the immediate efficacy between balance acupuncture group and traditional acupuncture group has no significant difference (P>0.05).(2)comparison of the immediate efficacy of balance acupuncture group and the traditional acupuncture group:shoulder abduction, shoulder external rotation of the neutral position, the hand to the neck, hands to the spine, hand to mouth, There were significant differences (P<0.05) in the comparison of various indicators of immediate efficacy for balance acupuncture group and traditional acupuncture group.4.2. Analysis of treatment effect (comparison of before treatment and after the last treatment)(1)Comparison of treatment effects of Balance acupuncture group and traditional acupuncture group:Shoulder abduction, shoulder neutral position and external rotation, hancl-to-neck, hand to the spine, hand to mouth, by rank-sum test, the various indicators lor the comparison of treatment efficacy of balance acupuncture group and traditional acupuncture group showed no significant difference (P>0.05). (2)The treatment efficacy of Balance acupuncture group when compared with that of traditional acupuncture group:Shoulder abduction, shoulder neutral position and external rotation, hand-to-neck, hand to the spine, hand-to-mouth, by rank sum test, the various indicators for the comparison of treatment efficacy of balance acupuncture group and traditional acupuncture group showed significant difference (P<0.05).4.3. Analysis of long term treatment efficacy(1)Improvement of shoulder abduction during the follow-up period:①overall sustainment, by rank sum test, P>0.05, overall maintenance rate of shoulder abduction during follow-up period between the two groups shows no significant statistical difference.②Within group comparison, by rank-sum test, the overall balance acupuncture group during follow-up period, shoulder abduction group within group comparison (P<0.05), showed statistically significant difference. Traditional acupuncture group last treatment and follow-up1, follow-up1and follow-up2, overall follow-up period, shoulder abduction within group comparison (P<0.05), showed statistically significant difference.③Between group comparison, by rank-sum test. P>0.05, follow-up1, two shoulder abduction groups showed no significant difference. P<0.05. Two shoulder abduction groups of Follow-up2, follow-up3showed significant differences.(2)Improvement of shoulder external rotation in neutral position during follow-up period:①overall sustainment, by rank sum test, P>0.05. external rotation of shoulder in neutral position during follow-up period overall maintenance rate showed no significant statistical difference.②Within group comparison, by rank-sum test, within group comparison of the balance acupuncture group for shoulder external rotation group in neutral position during follow-up period (P>0.05), showed no statistically significant difference. Within group comparison of the traditional acupuncture group for shoulder external rotation group in neutral position during follow-up period (P>0.05), showed no statistically significant difference.③Between group comparison, by rank-sum test. P>0.05, follow-up1, follow-up2, follow-up3two shoulder neutral position external rotation group comparison showed no significant difference.(3)Improvement of hand-to-neck during follow-up period:①overall sustainment, rank sum test, P>0.05, comparison of the two groups overall maintenance rate of hand to neck during follow-up period showed no significant statistical difference.②Within group compared by rank sum test, balance acupuncture group last treatment and follow-up treatment, overall follow-up, hand-to-neck group (P<0.05), showed a statistical significant difference. Traditional acupuncture group last treatment and follow-up1, follow- up2and follow-up3,overall follow-up period, hand-to-neck group(P<0.05),showed a statistical significant difference.③between group comparison, by rank-sum test P>0.05, follow-upl, follow-up2, two groups of hand-to-neck between group comparison showed no significant difference. P<0.05, comparison of two groups of hands to neck during follow-up3were significantly different.(4)Improvement of hand-to-spine during follow-up period:①overall sustainment,rank sum test.P>0.05,comparison of the two groups overall maintenance rate of hand to spine during follow-up period showed no significant statistical difference.②Within group compared by rank sum test, comparison of balance acupuncture group last treatment and follow-up1, follow up1and follow up2, overall follow up, hand-to-spine group (P<0.05), showed a statistical significant difference. Comparison of traditional acupuncture group last treatment and follow-up1. follow-up1and follow-up2, overall follow-up period, hand-to-spine group(P<0.05).showed a statistical significant difference.③Between group comparison, by rank-sum test,P>0.05,between groups comparison in follow-up1, follow-up2,follow-up3hand to spine showed no significant difference.(5)Improvement of hand-to-mouth during follow-up period:①Coverall sustainment. rank sum test, P>0.05, comparison of the two groups overall maintenance rate of hand to mouth during follow-up period showed no significant statistical difference.②Within group compared by rank sum test, within group comparison of balance acupuncture for hand to mouth (P>0.05). no statistically significant difference. Within group comparison of traditional acupuncture group during follow-up for hand-to-mouth (P>0.05),no statistically significant difference.③Between group comparison, by rank-sum tcst,P>0.05, between groups comparison in follow-up1, follow-up2, follow-up3hand to mouth showed no significant difference.4.4.Analysis of indicators of efficiencyComparison of efficiency of two groups of shoulder abduction and external rotation of the shoulder in neutral position, hand to neck, hand to spine, hand-to-mouth, by rank sum test. comparison of efficiency of two groups of shoulder abduction has no significant difference (P>0.05).Conclusion:1.The clinical effect of balance acupuncture and traditional acupuncture for the treatment of frozen shoulder is much equivalent, both showed good clinical efficiency. The various indicators for improvement of shoulder abduction, external rotation of the shoulder in neutral position, hand to neck, hand to spine, hand-to-mouth in balance acupuncture group and traditional acupuncture group and the overall clinical efficiency (treatment period, follow-up period) showed relative efficiency.2.Balance Acupuncture and traditional acupuncture therapy in showing immediate effect of shoulder function activity and treatment effect were significant, both therapeutic effect is considerable.3.Within group comparison of shoulder abduction, hand-to-neck and hand-to-spine during follow-up shows that balance acupuncture and traditional acupuncture both have long-term effect. Within group comparison of external rotation of the shoulder in neutral position and hand-to-mouth during follow-up shows that the self-recovery effect of balance acupuncture and traditional acupuncture is not obvious.4.Points selection for balance acupuncture is simple, easy to operate, quick in taking effect, having no significant difference in its clinical efficacy, its clinical use,5.This clinical trial is designed for frozen shoulder, the amount of time from the onset of the illness, the length of time of the adhesions, hence the clinical efficacy of the balance acupuncture for the illness is not very prominent, but Wang Wenyuan claimed that the balance acupuncture needle that he used on training troops belonged to the acute condition with the characteristics of "three seconds reduction" And based on the characteristics of the balance acupuncture, efficacy studies showed that this treatment has a good effect for analgesia and improving the activity of the frozen shoulder as mentioned in this thesis. |
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