Clinical Study On The Treatment Of Lumbar Intervertebral Disc Herniation By Tapping The Psoas Major Muscle Combined With Blade Acupuncture

Background:The needle knife therapy can relieve excessive stress caused by musculoskeletal soft tissues,and regulate bio-information.It is a special therapy applied for chronic pain of motor system treatment.The symptoms of lumbar disc herniation(LDH)can be significantly improved by needle knife treatment.As a spinal stabilizing muscle in front of the lumbar spine,the tension of psoas major muscle and the increase of muscle tension are important factors for the occurrence and development of lumbar diseases.The psoas major muscle management is meaningful for LDH treatment.Would the efficiency be better if LDH patient is treated by combination of plucking psoas major muscle and needle knife?Objective:This project aimed to observe the efficacy of LDH treatment by combination of plucking psoas major muscle and needle knife,and compared with the effect of treatment by needle knife,to explore whether the method of plucking psoas major muscle played a supplementary role in LDH treatment by needle knife.Methods:Selected 60 low back pain patients who met the diagnostic criteria of LDH and voluntarily accepted treatment as the subjects,according to the ratio 1:1 were randomly allocated into psoas muscle plucking and needle knife group(PNG)and needle knife group(NG),30 patients in each group.In PNG,the patient was treated by plucking psoas muscle at first,and then given needle knife treatment.Each treatment was given at 7 day intervals.In NG,the patient was given needle knife treatment.Each treatment was given at 7 day intervals.The course is 4 weeks.The Japanese Orthopaedic Association(JOA)scores and Visual Analogue Scale(VAS)scores were recorded before treatment,after the first treatment,after the second treatment,after the third treatment and after the forth treatment.Lumbar curvature value was recorded measured before and after treatment.Clinical effective rate and adverse events were recorded.Clinical data were analyzed by statistical software SPSS 17.0.Results:1.This study included 60 cases,30 cases in each group.There were no significant differences in gender,age,course of disease,intervertebral disc herniation,JOA scores and VAS scores between the two groups(P>0.05).The general clinical data of the two groups were comparable.2.After weekly treatment,the JOA score of patients all increased,and VAS scores of patients all declined in PNG and NG.In PNG group,there was no significant difference in JOA score between after 3 weeks and after 4 weeks treatment,but there was significant difference in JOA score between each other observation point and the previous one point(P<0.01).In NG group,there was no significant difference in JOA score between after 2 weeks and after 3 weeks treatment,also between after 3 weeks and after 4 weeks treatment too;but there was significant difference in JOA score between each other observation point and the previous one point(P<0.01).The JOA scores had the increasing trend with treatment time increase in PNG group.After 2 weeks,3 weeks,4 weeks treatment,the JOA scores in PNG were significantly higher than that in NG(P<0.01).In the same group,there were statistically significant in the VAS scores at different time points(P<0.01).The VAS scores had the declining trend with treatment time increase.After 1 week,2 weeks,3 weeks,4 weeks treatment,the VAS scores in PNG were significantly lower than that in NG(P<0.01).After the same treatment time,the effects of treatment by combination of plucking psoas major muscle and needle knife on JOA score increase and VAS scores decline were the better in PNG.It is more effective in relieving pain and improving clinical signs.3.After 4 weeks treatment,the lumbar curvature values in each group increased,but it was lower than the normal value(1.8-2.3cm).The value-added in the PNG was higher than that in NG(P<0.05).4.After 4 weeks treatment,the clinical ineffective rate was 6.67%,the effective rate was 10%,the obvious effective rate was 80%,the curative rate was 3.33%,and the total effective rate was 93.3%in PNG.The clinical ineffective rate was 10%,the effective rate was 36.67%,the obvious effective rate was 53.33%,the curative rate was 0,and the total effective rate was 90%in NG.The obvious effective rate in the PNG was significantly higher than that in NG(P<0.05).There was no adverse event during treatment both in two groups such as hematoma,fainting during treatment and nerve damage.Conclusion:The better effect on improvement of symptoms and lumbar curvature was produced by psoas major muscle plucking combined with needle knife treatment The method of plucking psoas major muscle played a supplementary role in LDH treatment by needle knife.A perfect experitment design should be done to provide scientific data for clinical application in further research.