Ear And Body Acupuncture Randomized Controlled Study Of Lumbar Disc Disease Treatment

This thesis includes:a literature review,clinical research and a discussion on the findings.Literature review:An overview of Lumbar Disc Herniation (LDH) from the Tradtional Chinese Medicine (TCM) perspective is provided. This includes terms from ancient TCM classics that are representative of LDH,as well as an analysis of the pathogenic factors and pathogenesis of the disease. Syndrome differentiation of LDH is based on the current accepted model which comprises four main syndromes. An elaboration on the efficacy,advantages and disadvantages of the different types of acupuncture treatment used for LDH is given. Other treatment methods for LDH such as herbal medicine,massage,and acupuncture point injection treatment will also be mentioned.The second part shows how LDH is understood from the Western Medicine perspective. It includes etiological factors and pathogenesis,clinical manifestations,diagnostic criteria,differential diagnosis and therapies which are being used for LDH. LDH is mainly caused by degeneration of the intervertebral disc,trauma and straining. Diagnosis can be made based on a patient’s history,symptoms and physical examination. Imaging can aid in diagnosis. The Mechanical Pressure Drawing Theory, Chemical Inflammation Theory, Immune Theory are current explanations for LDH pathogenesis. Western medicine treatment includes traction therapy,drugs used orally and intravenously as well as local blocking.Clinical research:Objective:To evaluatethe feasibility and effectiveness of ear point acupuncture in LDH treatment. To verify the effectiveness of stimulating ear points with positive reaction in LDH treatment.Method:38selected patients were randomly divided into the treatment group or the control group, with19patients in each group. The control group was treated with body acupuncture needling. The following acupuncture points were selected:bilateral Shenshu, Weizhong,Fuliu, waist pain points, and Dachangshu, Qihaishu, and Jiaji points on the affected side. According to their lower limb symptoms,patients were divided into three meridian groups:Taiyang group, Shaoyang group and the Yangming group, lower limb acupoints were selected along the said channel. The treatment group was given auricular needling on the affected side in addition to the body acupuncture points used for the control group. Ear acupoint selection is as follow:Taiyang group:gallbladder, small intestine,bladder,internal genitalia;Shaoyang group:gallbladder,internal genitalia,back-ear liver;Yangming group:stomach,cardia,esophagus.Both groups had the needles retained for20minutes. Frequency of the treatment was thrice a week,and every three treatments constituted a cycle. Patients were given four consecutive treatment cycles in total. Each case was graded using VAS and JOA rating scales, and assessment was made before and after treatment. Data analysis was done using SPSS17.0. If a patient made clinical recovery midway through the treatment,no additional treatment was administered.Results:Of the37patients who completed the study,all achieved good curative effect. One week treatment scores of JOA, two weeks treatment scores of VAS,and three weeks treatment scores of VAS and JOA between the control and the treatment groups have significant difference (P<0.05); After two weeks of treatment, scores of JOA, and scores of VAS and JOA after four weeks between two groups have very significant difference (P<0.01). One week treatment scores of VAS between the control and the treatment groups do not have significant difference and statistical significance (P>0.05). This result may be associated with a small sample size. After treatment, VAS scores of the treatment group were lower than the control group and JOA scores of treatment group were higher than the control group. After four treatment cycles,the treatment group had a markedly effective rate of94.73%while the control group had a markedly effective rate of77.78%.Conclusions:Ear and body acupuncture combination therapy can effectively cure LDH. The therapeutic effecton LDH by stimulating positive reaction ear points is verified. These can serve as guidance for clinical treatment.