| ObjectiveThrough comparison with the control group--the routine acupuncture therapy, the overall clinical effects of treating the scapulohumeral periarthritis with milli-fire needle needling the muscle meridian focus (the experimental therapy) are observed, as well as the respective changes in curative effect which the experimental therapy and the routine acupuncture therapy present in different periods. The paper preliminarily explores the experimental therapy’s clinical effectiveness and timeliness in treating scapulohumeral periarthritis as well as its possible mechanism, and illustrates the clinical value as well as the extended significance in treating the disease, providing the medical basis for choosing a more effective treatment method for scapulohumeral periarthritis in the future.MethodMost cases in the research are from outpatients who visited the Traditional Chinese Medicine Hospital of Guangdong Province and the first affiliated hospital of Guangzhou university of TCM during December 2014 and December 2015. In accordance with the standard the research set to select cases,60 cases were equally randomized into treatment group (the group using fire needles to needle the muscle meridian focus) and control group (the group using routine acupuncture therapy), with 30 cases each. The channel and sinew physical examination method in the "China Meridian and Tendon Learning" is referenced by treatment group to find the muscle meridian focus in the promixal and distal end around shoulder joint for the milli-fire needle acupuncture treatment, while the scapulohumeral periarthritis treatment method in Wang Qi’s "study of acupuncture moxibustion treatment " is referenced by the control group to select relevant acupuncture points for routine acupuncture treatment. Patients from both the treatment group and the routine group were required to receive acupuncture treatment every other day. As every six treatments were counted as one course, the research required both groups’ patients to complete two courses. The overall standard for clinical curative effect of the research refers to the relevant standard of scapulohumeral periarthritis in the "Standards for Diagnosis and Curative Effect of Chinese Medical Symptom", and the curative effect index is Constant-Murley score shoulder joint rating method (CMS).The overall clinical curative effect was evaluated when two courses were completed. Cases from two groups were randomly visited in three different periods (these were period after the first treatment, period after the second treatment and one month after two courses), during which curative effect index was evaluated. The research’s data was analyzed with SPSS20.0.Results1. Comparison of the baseline information between treatment group and control group before treatment:through statistic analysis and comparison, we can know that two groups’patients had no statistical significance in sex, age, course of disease, syndrome of TCM, total point in SCM scale or ingredient and integral in SCM scale, indicating that patients from two groups had the same baseline condition before treatment.2. The curative effect comparison of two clinic trial:the differences between the effect of milli-fire needle group and the one of routine acupuncture group are comparable, with statistical significance (P<0.05). Among the 30 cases of scapulohumeral periarthritis in treatment group, there are 4 clinical convalesces example,16 shows results examples and 6 effective examples, which means that it is only 4 invalid examples. Therefore, the total curative effect rate is 86.67%, while the control group is 70.00%. The control is including 3 clinical convalesces examples,7 shows results examples,12 effective examples and 8 invalid examples.3. The curative effect indicator compare of different time:the treatment group and the control group divided into 3 periods of time. The first is the period after first treatment. The second is the one after 2 courses of treatment, and the last one is a month follow-up study after the all treatment. Sum up the CMS rating scales and total scores of every quantity component in the CMS rating scales (including shoulder pain, activity, function and muscle strength). According the result, it made conclusions by comparing the group comparison between the time after follow-up study and the two time before the follow-up. Then it used the data to do the Intra-group comparison of the 3 periods of every group. The intra-group comparison of milli-fire needle: statistics shows that the CMS rating scales scores and every quantity component scores of the period after treatment are higher than the period before treatment (except the muscle strength scores). Intra-group differences are statistical significance (P<0.05). The trial result suggests that milli-fire needle provoking the shoulder lesion area can raise the CMS rating scales scores, release the pain, improve the muscle strength and increase the range of shoulder motion, especially on the CMS scales scores, the pain, the shoulder activity and patient’s daily life are rapidly onset (the CMS scores increase after the first treatment, and the differences statistical significance, P<0.05). But it effects slowly on the change of muscle strength, without statistical significance (P>0.05). The CMS scores between before and after follow-up study is statistically significant only on patient’s daily life, P<0.05, and other quantity components are no statistical differences, which means milli-fire needle effect obviously in daily activity, and effectiveness of the CMS total scores, the pain release, the shoulder activity and the muscle strength is stable. Comparison within the routine acupuncture group:compared with before treatment, the total CMS scores and the component CMS scores after treatment and 1 month after treatment are both significantly higher, with P<0.05. This result indicates that routine acupuncture to treat scapulohumeral periarthritis has efficacy in all aspects, including increasing total CMS scores, relieving shoulder pain, improving daily life and muscle strength, widening motion range of the shoulder. But the effectiveness is slow, that is, there’s no significant difference in CMS scores between after-the-first-treatment and before-treatment, with P>0.05. And it’s the same between the two periods after two-course treatment and lmonth after the treatment, which indicates that the routine acupuncture has a steady long-term efficacy in relieving shoulder pain and so. Comparison between the experiment group and the control group:on one hand, there’s no significant difference between the two groups while comparing the muscle strength scores of CMS after the first treatment, after two-course treatment and 1 month after the treatment, with P＞0.05. This result indicates the two therapy methods have equal in improving muscle strength of the scapulohumeral periarthritis patient in the 3 periods after the treatment. On the other hand, the efficacy of the experiment group is superior to the control group, while comparing the total CMS scores, the pain scores of CMS, the daily life level scores and motion ranges of the shoulder in the 3 periods, with P＜0.05.ConclusionBoth the milli-fire needle needling muscle meridian focus therapy and the routine acupuncture therapy have clinical effectiveness on scapulohumeral periarthritis, and the former is superior to the latter in general. The experiment therapy shows more advantage in increasing total CMS score, relieving shoulder pain, improving daily life and widening motion range of the shoulder than the routine acupuncture therapy, not only for its faster onset of effectiveness but also the better immediate, short-term and long-term effectiveness. With its obvious, steady and safe clinical effectiveness on scapulohumeral periarthritis, the milli-fire needle needling muscle meridian focus therapy is worthy of promotion and further study. |
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