| Lumbar disc herniation (Lumbar Disc Herniation, LDH) is a common disease in domestic and abroad clinical orthopedics, caused by degeneration of intervetebral disc annulus or fractures occurred by trauma, and rupture of annul us fibrosus, resulting in bulging out of nuclei pulposus tissue swelling backwards or post-exterior that stimulate and compress nerve roots and further lead to nerve root inflammation, nutritional disturbance and conductivedamage, lumbar pain, sciatica, and even significant neurological dysfunction. The main symptoms are low back pain and melosalgia, with features of severe clinical symptoms and easily recurrence. Severe or inseparable pain not only physically, but also cause serious psychological trauma to the patient, greatly affect patient's daily life and work, even paralysis of lower limbs, thus Loss of labor and self-care ability. Domestic statistics reported the disease occupied 15%～20% clients with lumber pain in the outpatients. Scholar abroad found, according to the investigation of 2684 staff, patients with LDH occupied 17.2%. Every year, merely in America,$ 16 billions was paid by patients with lumbar and legs pain for medical cost and economic lost. Recently, the therapy methods for LDH could mainly be divided as nonoperative therapy and operative therapy. There is about 90% patients can be treated with the former method, moreover most of those can gain excellent efficacy. Yet only a few of LDH patients with central type or liberation type or patients, after fail of long term nonoperative therapy and life or work is seriously affected, would receive operation therapy. However, the surgeon indicatio must be strictly managed as there is some risks for operation because of the pathomechanism and clinical manifestation of LDH is quite complexed. There are various nonoperative therapy methods, including traditional Chinese medicine therapy, western medicine therapy and integrated Chinese and western medicine, and the effects all show excellent. However, the standard of how to select a best therapy is worthy researching. With the current increase in medical costs, choose a reliable and effective, and affordable treatment is the best help to the majority of patients.ObjectiveTo observe efficacy and safety on wrist-ankle acupuncture for Lumbar Disc Herniation (LDH) and to offer a new thought and method to therapy (LDH),this clinical trial was undertaken.MethodsAccording to the request of perspective study, a randomized-controlled trial was designed and there were 90 patients with LDH in the trial. All cases were strictly selected by the unified standard of diagnosis criteria, including criteria and excluding criteria.30 patients in wrist-ankle acupuncture group were treated with wrist-ankle acupuncture plus scientific Chinese drug,30 patients in body acupuncture group were treated with body acupuncture plus scientific Chinese drug and 30 patients in control group were accepted therapy of merely scientific Chinese drug.10 times was one course and total 3 courses were carried out.Pre and post treatment, all cases in three groups were evaluated on composite score by the standard of composite score for Lumbar and leg disorders, on pain score by the visual simulation scoring, both of which were established by Japanese orthopedic institute. Additionally, when the trial was over, patients were taken grading assessment in accordance with clinical effects. In the end, Epi Data software was used to set up database and administrate data.After treatment, the clinical total effects, clinical symptoms and signs were analyzed statistically and compared; at last, clinical therapeutic effects and safety were evaluated objectively. Classification data usedχ2 test, rank data used multi-samples comparison Wilcoxon rank sum test (corrected), multi-samples mean comparison used analysis of variance or Wilcoxon rank sum test, before and after self-comparison matching t test or Wilcoxon matching rank sum test. All statistic analysis used SPSS17.0 software to finish.ResultsWrist-Ankle acupuncture group, the total effective rate was 96.67%, and body acupuncture group, the total effective rate was 76.67%, while in the control group, the total effective rate was 60%. The total effective rate of the three groups by chi-square test, the difference was statistically significant (P<0.05). Among them, the total effective rate of wrist-ankle acupuncture group was higher than the other two groups (P<0.05) while the effective rate of body acupuncture group was higher than that of control group, but without statistically significant difference (P> 0.05), this may due to the small sample size.But the four types of syndrome differentiation of the total effective rate was significantly (P<0.05), in which blood stasis syndrome, damp-heat syndrome was higher,88.57% and 89.47% respectively. The total effective rate of cold-damp syndrome was 75% and that of deficiency of liver and kidney syndrome was the lowest 50%.After treatment of every course in each of the three groups, compare mean score of the pre-course with VAS and JOA, which means that comparing the first course with that of before treatment, the second course with the first course, the third course with the second course, mean score of VAS and JOA, there were significant differences between three groups, indicating three treatments were all effective.ConclusionWrist-ankle acupuncture group and body acupuncture group and control group, Those three therapies for the treatment of lumbar disc herniation all have definite clinical effect, but the wrist-ankle acupuncture group treatment can significantly improve the curative rate of lumbar disc herniation and is better than the other two groups in relieving patient's pain. Therapy of wrist-ankle acupuncture group for patients with lumbar disc herniation has great advantages in improving patient's subjective symptoms, clinical signs and activities of daily living.This study showed that therapy of wrist-ankle acupuncture combined with Chinese herbal medicine for oral has clinical value in raising treatment effect for lumbar disc herniation. During the whole treatment there were no significant aggravation and other adverse reactions. Treat results of patients'blood, urine, feces, liver and kidney function before and after treatment showed no abnormal changes and toxicity, meaning that three kinds of treatments have better safety.
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