Electroacupuncture For Treatment Of Chronic Low Back Pain, Clinical Observation And Experimental Research

Chronic lumbago and leg pain is a clinically common disease in acupuncture and moxibustion department. "chronic" is characterized by following acute stage, prolonged course and recurrent onset. Lumbago and leg pain is not a disease but a clinical syndrome with complex cause and high incidence. Except children, it affects people in various age especially those in their youth and prime of life. According to the statistics in foreign countries, 80% residents of America and 65% of Sweden suffered from lumbago and leg pain in their work. Out-patient services of lumbago and leg pain are only next to common cold and cardiovascular diseases based on domestic statistics. Therefore, lumbago and leg pain is a pandemic disease in the world influencing work, study and life.This research reviewed systematically the traditional knowledge of lumbago and leg pain in traditional Chinese medicine (short for TCM), acupuncture and moxibustion as well as the research development of experimental mechanism and clinical treatment. Then the clinics and experiment of elctropuncture treating lumbago and leg pain were observed and studied based on basic theory of TCM.In clinics, treatment of lumbago and leg pain by acupuncture and moxibustion is focused on the meridian which the affected location belongs to. "Meridian can mainly treat the lesion where the meridian runs by." So the affecting meridian should confirmed by syndrome differentiation of meridians which can underlie the choose of acupoints and formula to enhance the pertinence of acupuncture and moxibustion. Meanwhile, the combination of local and distal acupoints along the meridian should be based on treatment according to syndrome differentiation. This research chose most relative symptoms, functional activities of legs, clinical signs, daily living ability and so on to evaluate and score by reference of relative documents which were proved to objectively evaluate lumbago and leg pain. Moreover, this evaluation method is convenient to do and can detect small variation which can reflect the curative effect of filiform needle and electropuncture groups. There was marked effect in two groups after treatments and there was very significant difference of curative effect between the two groups. The two kinds of scores showed that the curative effect of lumbago and leg pain in electropuncture group was obviously better than that in filiform needle group. It was objective, effective and human to evaluate curative effect of acupuncture and moxibustion by "questionnaire of patients with lumbago and leg pain". The effect and mechanism of acupuncture and moxibustion treating lumbago and leg pain were based on modern medical theories. Acupuncture and moxibustion can prevent and inhibit the occurrence and development of lumbar vertebrae's degeneration to some degree which should be popularized and applied. The therapeutic mechanism of acupuncture and moxibustion treating lumbago and leg pain is to improve the micro-environment surrounding nerve roots, remove inflammatory media, inhibit conducting of harmful information, relieve muscles' contraction, reduce or eliminate the inflammation and edema of nerve roots to ease pain.We observed that both filiform needle group and electropuncture group had satisfactory curative effect when treating lumbago and leg pain. However, electropuncture group had obviously better curative effect than filiform needle group and there was very significant difference between the two groups in total effective rate. The time used to relieve symptoms in electropuncture was shorter than filiform needle group. The former had higher curative rate than the later and there was significant difference between the two. Moreover, the symptoms, signs and function in electropuncture group were more relieved than filiform needle group. So electropuncture has definitely clinical significance to help patients with chronic lumbago and leg pain achieve health as soon as possible.In experimental study, sciatica is the main clinical manifestations of lumbago and leg pain as it belongs to the category of pathological pain of nerve. Therefore, the study chose damaged pain model of sciatic branch to mimic the symptom of lumbago and leg pain's pathological pain of nerve. The pain-relieving mechanism of electropuncture was studied by observing index of rats' neurological behavior and mensurating the content ofβ-EP in peripheral blood and spinal cord. The experiment showed that the electropuncture group and filiform needle group had no significant effect on rats' pain-threshold after heat-stimulation. But acupuncture could enhance mechanical pain threshold of rats' operated side especially electropuncture. The occurrence of mechanical hypersensitivity of pain may be related with the method and degree of nerves' damage. Electropuncture not only can improve damaged symptoms of peripheral nerve but also relieve pain by stimulating central nerves, which may be the cause why electropuncture had better effect on enhancing mechanical pain threshold of rats' operated side. Relieving pain by acupuncture is related withβ-EP. The acupuncture may stimulate central nerves, promote the production and the release ofβ-EP which causes the increased level of central and peripheralβ-EP to relieve pain. In this experiment, the combination of common needling and electro-stimulation in electropuncture group improved symptoms more than manual-needling group, which may be due to the change ofβ-EP level.