| Lumbar muscle strain is also known as functional low back pain.It mainly refers to the lumbosacral soft tissue injury,resulting in aseptic local inflammation of the local production,and lead to the waist pain,dysfunction as a major manifestation of a class of diseases.Lumbar muscle strain is categorized as non-specific low back pain in modern medical science.In recent years,the prevalence of low back pain in China has increased,with a peak incidence among those aged from 41 years to 55 years old.At this stage the age of onset of the disease has a younger trend.Other than physical and mental health conditions,lumbar muscle strain also affects people's quality of life.In modern medicine science,this disease can be treated in many ways.The most common methods are Western medicine,topical analgesics,drug injection,physical therapy and rehabilitation exercise etc.Western medicine or drug injection has obvious toxic side effects on liver and kidney function,as well as gastrointestinal discomfort,and can only play a temporary analgesic effect,it is also prone to relapse.Rehabilitation therapy has certain therapeutic effects,but due to the long course of treatment,it is difficult for patients to persist,and when the symptoms recur,it is difficult to play immediate analgesic effect.Traditional Chinese medicine can treat lumbar muscle strain effectively in many ways,most commonly used clinical methods are oral Chinese medicine,topical Chinese medicine,acupuncture,massage,scraping,cupping,acupoint injection etc.,these methods have achieved satisfactory results.Among all,acupuncture is the most commonly used clinical means to treat lumbar muscle strain,it is effective,safe,easy to operate,inexpensive,non-toxic side effects,more acceptable to patients.Nowadays,the clinical acupuncture methods have their own characteristics.Commonly used like electro-acupuncture,floating acupuncture,warm acupuncture,wrist and ankle acupuncture,traditional acupuncture etc.Meta-analysis found that the shallow acupuncture treating lumbar muscle strain has significant therapeutic effect,Tendon acupuncture is a new method of shallow needling.There are few articles on the clinical application of tendon acupuncture in the treatment of lumbar muscle strain,it can provide basis for future clinical development if we can prove the effectiveness of tendon acupuncture in treating lumbar muscle strain.Purpose:1.To evaluate the clinical effectiveness of tendon acupuncture in treating lumbar muscle strain;2.To provide a clear,simple and effective clinical treatment method for lumbar muscle strain,through comparing different acupuncture methods.Method:1.Case Source:All the cases of this study were came from The First Affiliated Hospital of Guangxi Traditional Chinese Medicine between January 2017 to January 2018.2.Treatment:60 patients were selected for this clinical research after the inclusion and exclusion criteria.Using SPSS software to obtain a random code method,all patients were randomly divided into equal numbers of treatment group and control group.Treatment group was treated with tendon acupuncture,specific operation using 0.30 x 40mm needle,needle in the tendons after routine disinfection,along the subcutaneous flat thorn 25-35mm,and then ask patients to move the waist until pain is reduced.If no immediate pain relief,adjust the acupuncture direction until pain is relieved.Needle retained for for 20 minutes,needle treatment twice a week.The method of selecting the tendon acupoints is to look for the tenderness point,tendon node or pain point on both sides of the lumbar muscles.They mostly distributed nearby acupoints like Sanjiaoshu,Shenshu,Qihaishu,Dachangshu,Guanyuanshu,Zhishi,Yaoyanxue.Each treatment does not exceed 4 tendon acupoints.Control group was treated with traditional acupuncture methods,specific operation using 0.30 x 40mm needle,start needling after routine disinfection,using reinforcing-reducing techniques after getting qi.Needle retained for 20minutes,needle treatment twice a week.The method of selecting the acupoints for control group is to look for the tenderness point,tendon node or pain point on both sides of the lumbar muscles.They mostly distributed nearby acupoints like Sanjiaoshu,Shenshu,Qihaishu,Dachangshu,Guanyuanshu,Zhishi,Yaoyanxue.Each treatment does not exceed 4 acupoints.All patients were treated maximum for 2 weeks,and patients can stop treatment earlier when they are completely cured.In order to evaluate the immediate effect,comprehensive efficacy,safety etc.for tendon acupuncture,assessments will be done and recorded with observation indicators for 3 times,prior to the first treatment,right after the first treatment and after the full course of treatment.To evaluate the long-term efficacy,follow-up visits will be done 1 month after the treatment.Outcome measures of this study are:Oswestry Disability Index Questionnaire(ODI),Visual Analogue Score(VAS),Spinal Mobility Score,and Clinical Score Integral Scale.All measurements were done and recorded before the first treatment and after the full course of the treatment,to evaluate the comprehensive efficacy of the tendon acupuncture on lumbar muscle strain.Visual Analogue Score(VAS)and Spinal Mobility Score were recorded immediately after the first treatment,to evaluate the immediate effects of the tendon acupuncture.Oswestry Disability Index Questionnaire(ODI)was done after the full course of the treatment,to evaluate the efficacy of the tendon acupuncture on lumbar muscle strain.Follow-up visits will be done to patients 1 month after the full course of the treatment,by using Oswestry Disability Index Questionnaire(ODI)to evaluate patients'recurrence rate.The Oswestry Disability Index Questionnaire Scale(ODI)was used as the indicator to evaluate the efficacy.Results:Before treatment,two groups of patients were compared in terms of gender,age and all scores.To compare gender for two groups,using chi-square test,x~2=0.073,P=0.787>0.05,results indicated that there was no statistically difference between two groups of patients in terms of gender.To compare age for two groups,using Wilcoxon Mann and whltney test,Z=-0.469,P=0.639>0.05,results indicated that there was no statistically difference between two groups of patients in terms of age.To compare Oswestry Disability Index questionnaire(ODI)for two groups,using independent sample T-test,t=0.047,P=0.963>0.05,results indicated that there was no statistically difference between two groups of patients in terms of ODI.To compare Visual analogue scale(VAS)for two groups,using independent sample T-test,t=0.348,P=0.729>0.05,results indicated that there was no statistically difference between two groups of patients in terms of VAS.To compare Spinal Mobility score for two groups,using independent sample T-test,t=1.481,P=0.144>0.05.results indicated that there was no statistically difference between two groups of patients in terms of spine mobility.Regarding evaluation of Clinical Signs Integral score,Wilcoxon Mann and whltney test was used to compare the scores for two groups,Z=-0.656,P=0.512>0.05.results indicated that there was no statistically difference between two groups of patients in terms of clinical symptom score scale.Two groups of patients were baseline consistency in all aspects before treatment and they were comparable.VAS and Spinal Mobility Score were evaluated immediately after the first treatment.Before-and-after study was done for all patients for both groups on VAS,paired T-test showed that there was a statistically significant difference before and after the treatment(P<0.01),indicating the treatment group has effect on pain relief after the treatment.Data analysis for the control group using paired T-test also showed that there was a statistically significant difference before and after the treatment(P<0.01),indicating that the control group has effect on pain relief after the treatment.Then compared data for the treatment and control group by independent sample T-test,it was found that there was a statistically difference between two groups(P<0.05),the treatment group proved to be more effective than control group in pain relief.Spinal Mobility Score for patients were assessed before and after the treatment,using Wilcoxon test for data analysis for the treatment group,results showed that there was improvement on spinal mobility after the 1st treatment for the treatment group,Z=-4.667,P<0.01.To compare the data for the control group using Wilcoxon test,results also showed that there was improvement on spinal mobility after the 1st treatment for the control group,Z=-4.146,P<0.01.Then compared data for the treatment and control group by Wilcoxon Rank-Sum test,it was found that there was a statistically difference between two groups,Z=-2.360,P<0.05,it indicated that the treatment group proved to be more effective in spinal mobility.Based on the results of the two tables,it showed that immediate effect for the treatment group was more significant,which proved that tendon acupuncture has immediate effect on treating lumbar muscles strain,and more effective than traditional acupuncture.Overall assessment included Oswestry Disability Index questionnaire(ODI),Visual Analogue Score(VAS),Spinal Mobility Score and Clinical Signs Integral score were done to all patients after four treatments.In terms of Oswestry Disability Index questionnaire(ODI),before-and-after study was done for all patients for the treatment group,paired T-test showed that there was a statistically significant difference before and after the treatment(P<0.01),with lower ODI scores after the treatment,indicated that the treatment group had improvement on ODI after the treatment.For the control group,using the Wilcoxon test to evaluate the before-and-after study scores,it showed that there was a statistically significant difference,(P<0.01),with lower ODI scores after the treatment indicated that the control group had improvement on the symptoms.Followed by an independent sample t-test to compare data for the treatment and control group,it was found that there was statistically difference between two groups(P<0.05),the treatment group proved to be more effective than the control group.For Visual Analogue Scale Score(VAS),before-and-after study was done for both groups,paired T-test showed that there was a statistically significant difference before and after the treatment(P<0.01),it indicated that there was improvement on pain relief after the treatment.Then compared data for the treatment and control group,it was found that there was a statistically difference between two groups(P<0.05),it was proved that analgesic effect for the treatment group was better than the control group.For Spinal Mobility score,using Wilcoxon test to evaluate the before-and-after study scores for two groups,it showed that there was a statistically significant difference,(P<0.01),it indicated that there was improvement on spinal mobility for both groups.Then compared data for the two groups,Wilcoxon Mann and whltney test was done and it was found that there was a statistically difference between the two groups(P<0.01),it indicated that the treatment group was more effective on improving the spine mobility.For Clinical Signs Integral score,paired t-test was used to compare the scores of the treatment group before and after the treatment,and there was a statistically significant difference(P<0.01),indicating that the symptoms of the patients after treatment were alleviated.Wilcoxon test was used to compare the scores of the control group before and after the treatment,and there was a statistically significant difference(P<0.01),indicating there was improvement on the symptoms of the patients after treatment.The two groups were compared by independent sample t-test,it was found that there was no statistically significant between the two groups(P>0.05),indicating that the degree of symptoms improvement was the same between two groups.According to Oswestry Disability Index questionnaire(ODI),the overall effect was compared by using the data on the forth treatment and data before the treatment.Results showed that the treatment group had 7 cases cured,20 cases markedly effective,3 cases effective,the total effective rate was 100%,the control group had 5 cases cured,14 cases markedly effective,8 cases effective,3 cases ineffective,the total effective rate is 90%.Using Wilcoxon Mann and whltney test for data analysis between two groups,it was found that the total effective rate of the treatment group was statistically effective than the control group(P<0.05).After one month of the treatment,follow-up visits to patients were done on Simplified Oswestry Disability Index Questionnaire(ODI).In comparing with the scores at end of the treatment,no recurrence was found in both groups(P>0.05).Conclusion:Tendon acupuncture treating lumbar muscle strain has immediate effect on analgesia and improving lumbar mobility;Tendon acupuncture is effective and has long-term efficacy in treating lumbar muscle strain. |
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