| Research backgroundLumbar intervertebral disc herniation because of chronic fatigue, trauma, age, the disease is on the basis of degenerative disc disease, the damage caused by external ruptured lumbar intervertebral disc annulus, nucleus pulposus, nerve root or spinal cord arising illness. Epidemiological investigations indicated that the Chinese population incidence rate is about0.95%, lumbar disc herniation with lumbar4-5, lumbar intervertebral5sacral highest incidence, accounting for90%to96%. In recent years, its incidence increased year by year, to the younger, younger age development. Releasing pain, promoting functional recovery and reducing the recurrence of the disease are the main goals of treatment and rehabilitation.Current treatment of lumbar disc herniation can be divided into surgical and non-surgical treatment of two clinical methods, two treatment methods have their advantages and disadvantages and indications. Surgical treatment is expensive, risky, long-term efficacy are not plausible; non-surgical therapy, pain medications and nerve root block therapy toxic side effects, efficacy varies, and physical therapy and other methods, and thus only the efficacy of treatment in the affected area also less than ideal, and only showed partial effect. Acupuncture and rehabilitation therapy is currently used for the treatment of lumbar disc herniation common non-surgical therapy clinic, how to make good use of the advantages of the two treatment methods to achieve complementary advantages of the two treatments, the purpose of this study is located.ObjectiveClinical efficacy differences between the three options (the electo-acupuncture of JiaJi points combined with Mckenzie therapy, conventional acupuncture and the rehabilitation therapy) treatment of lumbar disc herniation, the group and the comparison group for each program group differs in a number of observed indicators of clarify the mechanism of action the electo-acupuncture of JiaJi points combined with Mckenzie therapy to treat lumbar disc herniation, explore appropriate therapies to treat the disease, and provide reference for further clinical studies.MethodsLumbar disc herniation patients in this study was collected from Taiwan Chinese medicine clinic for treatment, treatment observation period for the December2012to February2014,105cases were collected, of which the electo-acupuncture of JiaJi points combined with Mckenzie therapy group was35cases Mckenzie, routine acupuncture group was35cases,35cases of group rehabilitation therapy. Western diagnostic criteria of lumbar disc herniation is a reference to the reference to the Chinese Medical Association, eds,2009published the first edition of "Clinical Practice Guidelines-orthopedic volumes" of relevant content, TCM diagnostic criteria is referring to1994State Administration of TCM,"TCM syndrome Diagnostic efficacy standards "regarding lumbar disc herniation related content, TCM standard" Chinese disease diagnosis and efficacy standards "on TCM type of lumbar disc herniation. Treatments for a total of two courses, once daily treatment, continuous treatment five days, rest two days later to continue treatment, two weeks for treatment. Efficacy of specific projects include:JOA lower back pain evaluation form, simplifying the McGill Pain Questionnaire, positive point pressure threshold (PPT) and lumbar flexion range (LFR). The evaluation criteria for the JOA rating scale and comprehensive assessment "Chinese disease diagnosis and efficacy standards".Statistical processing of clinical data for statistical analysis using SPSS13.0software. Descriptive statistical analysis, qualitative indicators to frequency tables, percentages or proportions described; quantitative indicators as mean, standard deviation description; measurement data with the mean+standard deviation (x±S); count data ratio (%) expressed constitutes. Hypothesis testing using a two-sided test unity among groups of homogeneity of variance test, to0.05as the significance level. Measurement data between groups were compared using F test (heterogeneity of variance using the Kruskal-Wallis H rank sum test), pairwise comparisons between groups using LSD test.χ2test was used to compare the count data, the level of data using non-parametric statistical methods (rank sum test). P<0.05was said that the difference was statistically significant.ResultsIn this clinical study, we found that after the electo-acupuncture of JiaJi points combined with Mckenzie therapy, conventional acupuncture and rehabilitationt, before the three groups of patients with lumbar disc herniation clinical symptoms and signs improved to varying degrees over the treatment occurs. However, the first three in the observed indicators and the second course of treatment, JOA lower back pain evaluation form, simplifying the McGill Pain Questionnaire, positive point pressure threshold (PPT), lumbar flexion range (LFR) score shows that three groups of statistics results There were significant differences in the total evaluation form JOA score lower back pain, for example, the electo-acupuncture of Jiaji points combined with Mckenzie therapy group improved the most obvious, and rehabilitation treatment group compared with the conventional acupuncture group, the difference was statistically significant (P<0.05). Help improve lumbar disc herniation in patients with subjective symptoms, clinical signs, subject to the limits daily activities, the effect of the electo-acupuncture of JiaJi points combined with Mckenzie therapy is the best, and long-term treatment effect is significant.Through statistical analysis the following conclusions:1. the electo-acupuncture of JiaJi points combined with Mckenzie therapy group, routine acupuncture group, rehabilitation group in gender, age, duration, TCM comparative analysis between the two groups, there was no significant difference (P>0.05), indicating that the treatment a balanced distribution between the front group, comparable.2. According JOA lower back pain evaluation sheet total score showed that after two courses of treatment, the three groups JOA total score lower back pain evaluation form the electo-acupuncture of JiaJi points combined with Mckenzie therapy group improved scores the most obvious, and with the rehabilitation group routine acupuncture group, the difference was statistically significant (P<0.05). Help improve lumbar disc herniation in patients with subjective symptoms, clinical signs, subject to the limits daily activities, t the electo-acupuncture of JiaJi points combined with Mckenzie therapy, rehabilitation therapy has a good effect, and electrical JiaJi therapy combined with long-term therapy Mckenzie plus. Conventional acupuncture therapy to improve low back pain patients with lumbar disc herniation, the long-term effect is good, but short-term effect is not obvious.3. According to simplify McGill Pain Questionnaire showed that after a course of treatment, the electo-acupuncture of JiaJi points combined with Mckenzie therapy group simplify McGill pain scale rehabilitation treatment group compared to pre-treatment scores and scores decreased (P<0.05); after two courses, the electo-acupuncture of JiaJi points combined with Mckenzie therapy, rehabilitation group simplify McGill pain Questionnaire score compared with conventional acupuncture group, the difference was statistically significant (P<0.05). Instructions for the evaluation of patients before and after treatment of lumbar disc herniation simplify McGill Pain Questionnaire aspects, namely visual analog classification (VAS), pain rating index, existing pain intensity (PPI) rating of three parts. Mckenzie electricity JiaJi combination therapy, rehabilitation after a course of treatment, pain scores declined, but after two courses of treatment of pain symptoms improved more significantly. Three comparisons of different therapies, combined with electric Jiaji Mckenzie improve pain therapy in patients with lumbar disc herniation cases more significant.4. According positive point pressure threshold (PPT) showed that after two courses of treatment, three different therapies positive point pressure threshold (PPT), compared with before treatment, PPT values were significantly increased (P<0.01), but the electo-acupuncture of Jiaji points combined with Mckenzie therapy group positive point pressure threshold (PPT) compared with the other two groups, raise the threshold of statistical significance (P<0.05). Instructions on the long-term efficacy, although the three therapies can improve tenderness tenderness threshold (PPT), but the electo-acupuncture of Jiaji points combined with Mckenzie therapy to ease lower back tenderness combined effect is more obvious.5. According lumbar flexion range (LFR) showed that after a course of treatment, the three groups of lumbar flexion range (LFR) compared with the situation before treatment, no significant improvement (P>0.05). After two courses of treatment, the electo-acupuncture of JiaJi points combined with Mckenzie therapy group, lumbar flexion range of rehabilitation therapy group (LFR) improved situation than before treatment (P<0.05), while the former routine acupuncture group compared with the treatment no noticeable improvement (P>0.05) describes the three different treatments in terms of short-term efficacy for improving lumbar flexion range of patients with lumbar disc herniation (LFR) had no significant effect; after two courses of treatment, electrical JiaJi Mckenzie combination therapy, rehabilitation therapy can increase the patient’s lumbar flexion range of activities in order to ease the rehabilitation of the more obvious advantages. The acupuncture treatment for patients with lumbar disc herniation improve lumbar flexion range is very limited.6. The clinical efficacy of the three groups after treatment comparison results show that the clinical efficacy of the three groups after treatment were rank sum test, Z=4.272, P<0.01, clinical efficacy between the two groups has prompted statistically significant. Among them, t the electo-acupuncture of JiaJi points combined with Mckenzie therapy group effective rate85.29%, markedly effective rate was61.76%; routine acupuncture group effective rate of52.94%, markedly effective rate was38.24%; effective rate of rehabilitation therapy group74.29%, markedly effective rate was48.57%. The results showed that:the electo-acupuncture of JiaJi points combined with Mckenzie therapy in patients with lumbar disc herniation compared with conventional acupuncture, rehabilitation therapy for patients with low back pain improve LIDH case, waist active function, positive point tenderness threshold, daily work and clinical efficacy aspects of life, such as more significant. ConclusionFor the treatment of lumbar disc herniation, the electo-acupuncture of JiaJi points combined with Mckenzie therapy and rehabilitation have shown some advantages, can significantly improve the situation LIDH patients with low back pain, including subjective symptoms (low back pain, leg pain, walking ability), clinical signs (sensory disorders, movement disorders, straight leg raising test and strengthen test), subject to the limits daily activities (supine stand up, stand up, wash, heavy lifting, flexion, etc.), to a certain extent, improve positive patients with lumbar disc herniation reaction point tenderness threshold (PPT), improve the patient’s lumbar flexion range (LFR), with long-term effect is particularly evident; conventional acupuncture treatment although for improving patient symptoms and signs of lumbar pain and improve positive point pressure threshold (PPT) aspects of daily life situations have a certain effect, but the short-term treatment is not satisfactory, and its scope for improvement in lumbar flexion (LFR) had no significant effect. In contrast, the combination of electricity Jiaji Mckenzie therapy in improving the patient’s lower back pain JOA score, McGill pain scores and point tenderness positive reaction threshold, lumbar flexion range compared to other aspects of rehabilitation, acupuncture has a greater general advantage. |
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