| BackgroundScapulohumeral periarthritis is a chronic inflammation disorder which affects tissues, tendons, ligaments, the capsule and the synovium surrounding the shoulder joint with significant morbidity. The chief clinical symptoms of this condition are pain and restriction of the range of motion of the shoulder. It belongs to "Bi syndrome" in Traditional Chinese Medicine and it is also called adhesive shoulder, frozen shoulder, shoulder at age of50years (50jian), leaky shoulder wind (lou jian feng) among other names. The incidence is about2%-5%in the general population. The age of incidence is commonly around age50with higher incidence rates for individuals with deficient liver, spleen, or kidney functions, at same time attacked by external wind cold, or after over work. The initial symptoms of scapulohumeral periarthritis include slow onset of gradually worsening shoulder pain after1-2weeks, severe pain at night, inability to sleep on the affects side, joint stiffness, and gradual limitation of the range of motion. There is a myriad of treatment for scapulohumeral periarthritis in Traditional Chinese Medicine including Chinese herbs, acupuncture, moxibustion, massage (tuina), and acupotomy. Many techniques of acupuncture and moxibustion are gaining acceptance among doctors and acupuncturist around the world due to the easy of treatment and clinical efficacy. Given the complicated nature of many scapulohumeral periarthritis patients, who have concomitant diabetes, hypertension, insomnia or other chronic diseases, how to select safe and effective acupoints for the treatment of scapulohumeral periarthritis based on body conditions continues to be a significant research topic. Here we examined the Tung’s extra points as a treatment modality for scapulohumeral periarthritis.Tung’s extra points, also call Tung’s acupuncture, has its roots from Master Dong Qichang’s family. In recent years, it has gained popularity around the world, included the United States, South Korea, China and Taiwan. Tung’s extra point has unique acupoints selection, needle technique, diagnostic method and theory. Acupoint selection uses the most distant points to balance qi, blood, yin and yang, and seldom use local points. Tung’s extra points only use simple techniques, there are no use of traditional needle manipulation techniques such as "tan""yao","bai," this reduces the likelihood of patients fainting and increases the safe of acupuncture and moxibustion treatments. When using one of Tung’s extra point theories "zang fu tong bie" which treats diseases by bringing yang from yin and yin from yang in combination with extra points, remarkable clinical effect can be achieved. Tung’s extra point Shenguan Xue is a specific point to treat shoulder pain and tonifies the kidneys. When combined with Sihuan Shang or Sihuan Zhong it is empirically effective at treating shoulder pain and frozen shoulder. Until now there has been no randomized clinical trial which assess the combination of Shenguan Xue and Sihuan Zhong Xue to treat scapulohumeral periarthritis, especially for patient with shoulder abduction, flexion and extension limitations. Most scapulohumeral periarthritis patients have clinic symptoms of deficiency with excess such as root deficiency and branch excess, spleen and kidney qi and yin deficiency, liver yin deficiency combine with both yangming stomach channel and shaoyang gallbladder channel qi stagnation and blood stasis, liver qi stagnation and exterior wind cold dampness invading the shoulder. In this study we used Tung’s extra point Shenguan Xue as main treatment point which strengthens both the kidney and spleen and Sihua Zhong Xue as an assist point which strengthens both the spleen and stomach and can moves qi and invigorates blood circulation.ObjectiveTo assess the effectiveness of Tung’s extra points as the treatment of scapulohumeral periarthritis. To evaluate the efficacy and safety of Tung’s extra points Shenguan Xue and Sihuan Zhong Xue on shoulder pain, range of motion of the shoulder and overall quality of life for patients with scapulohumeral periarthritis.MethodSixty patients with scapulohumeral periarthritis who met the inclusion criteria were from Shen Shen Health Harmonize Clinic were included in the study. The patients were randomly divided into two groups:1) observation group (Tung’s extra points group)30cases;2) control group (regular acupuncture)30cases. The observation group (Tung’s extra points group) was treated by Tung’s extra points. The chief point is the healthy side Shenguan Xue, and assistant point is the affected side Sihua Zhong Xue.The control group is treated with healthy side Yinling Quan Xue and affected side Tiao Kou Xue. Both groups received treatments once a week, for a total of10treatments. Efficacy was evaluated after10treatments by assessing the VAS pain scores, the functional mobility of shoulder and quality of life.Results1.Both Tung’s extra point group (Shenguan Xue, Sihuan Zhong Xue) and the control group (Yinling Quan Xue, Tiaokou Xue) showed significant improvement pain reduction and range of motion when compared to pre-treatment (P<0.05).2.During the first treatment after needling for15minutes with only one needle, Tung’s extra point group showed significantly reduced shoulder pain when compared to the control group (P<0.0001). During the first treatment after needling for45minutes, there was significant reduction in shoulder pain when compared to pre-treatment for both groups (P<0.0001); Tung’s extra point group also showed a statiscally significant pain reduction when compared to the control group (P<0.0001).3. Comparing with both groups pre/post treatments, there was significant difference in shoulder pain scores (VAS)(P=0.0035, P<0.05); extra point group had obviously improvement in pain score than control group.4. Compared to shoulder function scores before treatment, there were statistical significant improvement in shoulder function scores post-treatment for both groups; Tung’s extra point group showed a statistically greater improvement in shoulder function, especially flexion (P=0.003, P<0.05) and abduction (p=0.0009, P<0.05) compared to the control group.5. In both groups,100%of patients showed overall improvement.ConclusionTung’s extra points using healthy side Shenguan Xue, and affected side Sihuan Zhong Xue can more significantly and promptly alleviate the pain of scapulohumeral periarthritis compared the control group.Shenguan Xue and Sihuan Zhong Xue can improve shoulder function, especially limited flexion and abduction due to scapulohumeral periarthritis.Both Tung’s extra point group and control group are effective and safety in the treatment of scapulohumeral periarthritis and improve the quality of life for the patients with scapulohumeral periarthritis. |
