| BackgroundThoracic facet joint disorders (TFJD) are mainly caused by the dislocation of the thoracic vertebral facet joint and rib joint due to various reasons, stretching the soft tissue to stimulate the nerves and leading to the main symptoms of thoracodorsal pain. In general, it mainly occurs in the upper or middle thoracic vertebras, and more common in the athletes. Thoracic facet joints are formed by the thoracic vertebral facet joint and rib joint. The connections of the joints are often stable, the activity scope of the joints are very small, and usually not easy to cause damage. As the soft tissue around the thoracic vertebra is very weak, if people use computers, to bend over a desk, or maintain a single position for long time, especially in terms of the athletes, need a training to conduct a long-term action, the spinal ligament would turn to fatigue and relaxation, the activity of the vertebras would increase, the spinal facet joints would deviation from the normal position and dislocation, they would cause the clinical symptoms finally. If the dislocations only occur between the articular surface of the joints, they usually cannot be displayed by the X-ray. Thoracic facet joint disorders is a common clinical disease, the incidence rate is showing a young, fast-growing trend. With the growing popularity of computers, they are changing people's life and work styles. Thoracic facet joint disorders will gradually become the most common disease in the modern life, and will bring great burden and pressure both for people and societ. Therefore, studying how to treat thoracic facet joint disorders is of great significance. Currently there is no generally accepted and effective treatment method for thoracic facet joint disorders both in China and abroad. Western medicine treatment mainly given analgesics for pain relief based on symptomatic treatment, such as aspirin, indomethacin, and they also given them some other drugs for supported therapy,such as vasodilator drugs, muscle relaxant's drugs, neurotrophic or regulation drugs, physical therapy and so on. If the disease is very severe, it could give procaine hydrochloride or prednisolone for local injection. Although these treatments can relieve pain temporarily, the effects are not very significant, and easy to relapse.In traditional Chinese medicine, the thoracic facet joint disorders is classified into "chest pain"or "back pain", but also "tendons out of the slot, bone staggered joint", which is a terminology of traditional Chinese medicine. It not only is a disease name, but also can reflect the change of the pathogenesis. "bone staggered joint" generally divided into two cases. One is different losses between joints induce the normal anatomical structure form a small staggered joint. The other serious one is that suture is Uneven or subluxation, which can be displayed in X-ray and pain are more obvious. "Tendons out of the slot" means when injury, tendon and other soft tissue slippage, or changes in the anatomical location, which affects mobility, even appear more intense pain and affect the normal work and life. It has close relationship between "tendons out of the slot" and "bone staggered joint". Injury by "tendons out of the slot" can induce interlocking suture dislocation of bone suture. Dislocation of bone suture can also induce tendon injury. So treatment on "bone staggered joint" in Golden Mirror of Medicine thought that massage treatment should be first used to cure muscle injury. Therefore, in traditional Chinese medicine, acupuncture and massage treat the thoracic facet joint disorder has particular advantages. It is mainly formed a combination of integrated the massage with acupuncture, cupping, topical, needle knife and so on. All of them had unique effects.In recent years, by three-dimensionally reconstructing connective tissue (fascia) in the trunk and limbs of the human body as well as tracing back to tissue origins in light of biological evolution and developmental biology, Prof. Yuan developed fasciology, which states that the human body can be divided into two systems. One is a supporting-storing system consisting of undifferentiated non-specific connective tissues, including loose connective and adipose tissue. The other system is a functional system consisting of a variety of differentiated functional cells, which is surrounded and supported by the fascial frame of the supporting-storing system. In fasciology, connective tissues that link all parts of the human body compose the anatomical basis of meridian. Acupuncture point means a place that rich in nerve receptor with intense bioinformation and connective tissue of competent cell. Therefore, "acupuncture point" and "un-acupuncture point" only differ at quantitative of the bioinformation, but not qualitative, which means that acupuncture point filled our whole body. Though stimulating the acupuncture point, fascia tissue could generate intense bioinformation in the supporting-storing system, and stimulate the function regulation (activity of tissue and cells) and life regulation (repair and regenerate of tissue and cells) of body, finally promoting repair the function system. Therefore, though high-intensity stimulating fascia tissue in the supporting-storing system could promote repairing of body function based on the fasciology theory.The new Yi-Jin therapy is a system of standardized treatment of thoracic facet joint disorder treatment based on the fasciology theory, combined with the treatment concept of "tendons out of the slot, bone staggered joint". Firstly, the maximum joint angle cross-stretch, pulling and rotating to stimulate the joint capsule of connective tissue capsule and deep fascia sense receptors; Sencodly, through traditional methods such as acupuncture needles, and floating around the lesion given fascia connective tissue septum organizations and high-intensity stimulation of cutaneous nerve; Finally, and through the manual reduction so that the "reset bones, tendons go trough", so as to achieve effective treatment of the disease and prevent recurrence of the goal.This clinical study is to use the simple random control principle, compared with traditional acupuncture to observe the new Yijin thoracic facet joint disorder therapy clinical efficacy, and to explore a new therapeutic method of thoracic facet joint disorders. ObjectiveUsed simple randomized controlled clinical study, compared with traditional acupuncture, to observe the clinical effects of the new Yi-Jin therapy on the thoracic facet joint disorders. To seek a new, more effective treatment method for thoracic facet joint disorders, and it could provide some clinical evidences for the fasciology theory.Methods1. In the study, all the thoracic facet joint disorders patients were chosen from HONGKONG Sunlight Treatment Centre.80 cases were randomly divided into a treatment group (n=40) and a control group(n=40) by a simple randomized principle.2. The treatment group was treatment with the new Yi-jin therapy, and the control group was treatment with the traditional acupuncture therapy. Both of them selected the same acupuncture points and the same period of treatment. After one time of therapy, the patient had a rest for two days. Three times were a period of treatment.3. Rating standard(1) visual analogue scale (visual analog scale, VAS)(2) Determination of the table of pain behavior (behavioral rating scale, BRS-6)(3) McGill Pain Questionnaire (including the PRI perception scores, PRI feeling scores and PRI total score)(4) Clinical EvaluationReference Syndrome Diagnostic efficacy standards of TCM which was put out by State Administration of Traditional Chinese Medicine in the efficacy evaluation of thoracic facet joint disorders standards as follows:Clinical cure:the symptoms disappeared completely, move with esea, thoracic skew correctted, spinous process tenderness disappeared.Improved:the symptoms disappeared mostly, thoracic skew correctted, spinous process tenderness lessened, but still had mild pain when deep breathing and coughing;Invalid:there were no significant improvement both in symptoms and signs. Results1. This study does not appear during the suspension, removed and lacuna cases, all completed a clinical study.2. Before treatment, compared by chi square test between the treatment and control groups was not statistically different gender composition (P> 0.05), by two independent samples t test or Mann-Whitney U test to compare the two groups before treatment, age, visual analog scale, pain behavior Determination of the table, PRI perception, PRI feelings and no significant difference between PRI scores (P> 0.05). Thus, treatment and control groups were comparable.3. After treatment, the treatment group and control group after treatment visual analog scale, pain behavior measurement table, PRI perception, PRI and the PRI out of the feelings are much better than before treatment and compared by Wilcoxon one-sample test before and after treatment was significant differences (P<0.01).4. After treatment, the treatment group after treatment, visual analog scale, pain behavior measurement table, PRI perception, PRI and PRI scores and emotional scores before and after treatment are worse than the control group, and by two independent samples Mann-Whitney U test to compare the treatment group and the control group were significant differences (P<0.01).5. After treatment, the clinical cure rate in treatment group and the total effective rate was significantly higher, and compared by two independent samples Mann-Whitney U test, the treatment group and clinical efficacy of the control group was significant difference (P<0.01).ConclusionThough objective evaluation of the clinical efficacy, this study showed that both the new Yi-Jin therapy and the traditional acupuncture therapy could relieve pain in the thoracic facet joint disorders patients and improve the quality of life, but the new Yi-Jin therapy had the more efficacy and the clinical cure rate and total effective rate was significantly higher. Therefore, the new Yi-Jin therapy is a simple, rapid effect, short course, prevent recurrence, new and more effective treatment method of thoracic facet joint disorders, and this study also could provide some clinical evidences for the fasciology theory. |
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