| Lubar intervertebral disc herniation is a common disease in clinic, patients with clinical symptoms and signs may be due to intervertebral disc protrusion size, range, position, course of disease and different individual differences and different. It can cause serious effect on the patient’s daily life and work.At present the method of treatment of LIDH are also various, operation treatment is one of the important methods, but the vast majority of patients only when the non operation treatment effect is poor, turned to the operation treatment. Conservative treatment is the treatment of disc herniation were preferred by the majority of lumbar. After conservative treatment such as without conditions improve, can consider operation treatment. The traditional Chinese medicine therapy clinical more common applications, high security, is most often used in patients with non operation treatment method.Therefore, in the treatment of multiple methods of Supplementing Qi and activating blood circulation, nourishing liver and kidney, activating collaterals and relieving the pain.The disease according to the bladder meridian of foot Taiyang and belongs to the gallbladder meridian of foot Shaoyang, according to "the meridian, attending the" principle, choose the lesion corresponding lumbar Jiaji therapy. Because the disease is deep, the conventional shallow needling difficult disease, and lumbar Jiaji points located in the lumbar spinous process on both sides after the lateral to the midline between0.5inches, in Du and bladder, the deep anatomy for the corresponding dorsal medial branch and concomitant artery and vein, the clip ridge acupuncture has a close relationship with the spinal nerve segment, so the local acupuncture Jiaji points, can play anti-inflammatory analgesic, relax the muscles, ligaments, improve local blood circulation, promote metabolism, help to eliminate or reduce the nerve root inflammation, found in the needle feeling radiation to the lower limbs is better in clinical practice, to achieve through the meridians, Qi effect of invigorate the circulation of blood.At present, the literature on clinical cases reported, less study on Mechanism of treating various treatment methods; and the different clinical types are unified, not standard therapy itself was not standardized, determine the efficacy of different standards, so it is difficult to evaluate the effect of various treatments.This study selected Jiaji points open and closed with combined with pricking blood therapy on prolapse of lumbar intervertebral disc, a randomized control study, definition of acupoints, methods of operation strictly, efficacy evaluation criteria using a unified, objective evaluation of the clinical curative effect, and objectively evaluate the effect of the therapy in the treatment of LIDH.1. Objective1.1to observe the clinical effect of Jiaji Kaihe reducing method combined with pricking blood therapy for the treatment of lumbar disc herniation;1.2to observe the effect of open and closed with Jiaji points combined with pricking blood therapy on prolapse of lumbar intervertebral disc patients quality of life;1.3the mechanism of Jiaji points open and closed with combined with pricking blood therapy.2. Methods2.1literature researchThe literature research part reviews the research on the mechanisms of lumbar disc herniation in recent years, the pathology, physiology, molecular biology, pharmacology and so on to separate; clinical study progress on mechanism and treatment of the disease, a detailed review of acupuncture.2.2clinical study60patients met the inclusion criteria were selected, according to the case were randomly divided into simple randomization will be observed for the treatment group30cases and control group with30cases. Diagnostic criteria light of the1994State Administration of traditional Chinese medicine, the promulgation and implementation of "standards of TCM syndrome diagnosis and treatment, the diagnosis of lumbar disc herniation standard".Treatment group with Jiaji points open and closed with combined with pricking blood therapy. Acupoints:each one vertebral body lesions and Jiaji points on (bilateral); methods of operation:the patient in the prone position, acupoint routine iodophor disinfection. Fast into the needle, the puncture1.5～2.0inch, reinforcing reducing, Jiaji points appear needle feeling to hip radiotherapy is better, to radiate to the ipsilateral lower limb or crus best;30minutes each time the needle, a needle swing big pinhole, no press; a needle immediately after cupping glass adsorption on the hole, observation of hemorrhage, generally not more than10ml, less blood can be a long time, blood immediately take cans, general can stay for3to5minutes.The control group was treated with conventional acupuncture treatment. Acupoints:with reference to the fifth version of "acupuncture":Shenshu, Dachangshu, Zhibian, Huantiao, Yin door, Weizhong, Chengshan, Yang Lingquan, the bone. The skin of the point75%conventional alcohol disinfection, the needle after the gas and G6805type needle machine, continuous wave, the frequency of15Hz, intensity of patients tolerated for degrees,30minutes retention.Observation indexes included:lumbar function assessment, the use of "improved Department of orthopedics Association low back pain score"(JOA); pain score, the description and measurement of pain of the internationally recognized McGill pain questionnaire; comprehensive assessment of the quality of life, the use of the general quality of life questionnaire (Generic Quality of Life Inventory74); curative effect according to JOA score, score table formulation.3. Results3.1baseline of dataPatients enrolled in the average age and sex structure, the average duration of no significant difference, suggesting that the baseline data are basically the same, have a better comparability.3.2Results of JOAThe two groups were compared before treatment JOA score, inter group comparison, after treatment between two groups after the treatment, the difference between the two groups after the treatment, the change rate between the two groups, there was no significant difference (P>0.05). Comparison within groups before and after treatment in the two groups within the group, after comparison, the differences were statistically significant (P<0.05).3.3McGill pain questionnaire scorePRI evaluation before treatment between two groups after the treatment, the difference between the two groups, there was no significant difference (P>0.05), after treatment between two groups after the treatment, the change rate between the two groups, the difference was statistically significant (P<0.05). Comparison within groups before and after, the difference between the two groups were statistically significant (P<0.05)PPI comparative analysis shows that, before the treatment groups, no significant difference (P>0.05); after treatment between two groups after treatment, changes of rank comparison between groups, disappeared after treatment/recovery rate between the two groups, the difference was statistically significant (P<0.05)The results showed that the VAS score before treatment, inter group comparison, after treatment between two groups after the treatment, the difference between the two groups after the treatment, the change rate between the two groups, there was no significant difference (P>0.05). Compared before and after the group, with significant difference between two groups (P<0.05).3.4quality of life assessment resultsScore in physical function, before treatment between two groups after the treatment, the difference between the two groups after the treatment, the change rate between the two groups, there was no significant difference (P>0.05).After treatment, scores the difference was statistically significant (P<0.05), the treatment group were higher than those in control group were increased more significantly. Comparison within groups before and after treatment in the two groups within the group, after comparison, the differences were statistically significant (P<0.05), suggesting that the two treatment methods can improve physical function scores of patients.Scores in psychological function, before treatment between two groups after the treatment, the difference between the two groups after the treatment, the change rate between the two groups, there was no significant difference (P>0.05), suggesting that groups with comparable. After treatment, scores the difference was statistically significant (P>0.05), the treatment group can significantly improve psychological function score. After treatment between two groups, the difference between the two groups were statistically significant (P<0.05), suggesting that the two treatment methods can improve mental function in the patients with grade.In terms of social function score, before treatment between the two groups, the difference was statistically significant (P<0.05), indicating that the treatment of groups are not comparable. Comparison within groups before and after treatment in the two groups within the group, after comparison, the differences were statistically significant (P<0.05), suggesting that the two groups of patients social function scores than before treatment improved.Score in the material life, before treatment, after treatment between two groups after treatment were compared between groups, the difference between the two groups after the treatment, the change rate between the two groups, there was no significant difference (P>0.05). Comparison within groups before and after the control group, the difference was statistically significant (P<0.05), suggesting that can effectively improve the material life of score; the treatment group showed no statistical significance (P>0.05).3.5clinical resultsClinical effects were evaluated according to the JOA standards, the results show that the comparison chart, in the comprehensive curative effect between group, the cure rate was13.33%, the effective rate was33.33%, effective rate was36.67%, no efficiency of16.67%; control group, the cure rate was6.67%, the effective rate was23.33%, effective rate was46.67%, no efficiency23.33%, through the unidirectional ordered CMH chi square test., no statistically significant difference between groups (P>0.05), suggesting that the curative effect of two kinds of treatment methods are basically the same.In the cure and effective rate, treatment group markedly effective rate (cure+markedly effective rate) is46.67%, effective and non efficiency of53.33%; control group markedly effective rate (cure+markedly effective rate was30%, effective)+no efficiency is70%, the chi square test, no statistically significant difference between groups (P>0.05). Two kinds of treatment methods are consistent in that more rate.The total effective rate, total effective rate of the treatment group (cure+markedly+efficiency) is83.33%, no efficiency was16.67%; the control group total effective rate (cure+markedly+efficiency) is76.67%, no efficiency is23.33%, the chi square test, no statistically significant difference between groups (P>0.05). Hint two treatments in the total efficiency is basically the same.4. ConclusionJiaji points open and closed with combined with pricking blood therapy and routine acupuncture treatment can be effective for the treatment of lumbar disc herniation, can relieve pain, improve the lumbar vertebral function, improve the quality of life of patients. To improve the present pain intensity (PPI), Jiaji points open and closed with combined with pricking blood therapy effect is better than that of routine acupuncture treatment, that has good therapeutic effect on the immediate pain symptoms.The conventional non operation treatment of lumbar disc herniation to alleviate clinical as the main purpose, and the disease has a high recurrence rate characteristics, therefore, Jiaji points open and closed with combined with pricking blood therapy better ease the immediate pain effect shows the unique advantages, and this therapy has the advantages of simple operation, suitable for application in clinical practice. |
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