| ObjectiveThe gastrocnemius spasm refers to a suddenly intense contraction of the gastrocnemius muscle,as a result of tendon and vessel constraints and severe pain,which usually stimulates by cold or exercise during sleeping especially in cold night.It is believed that spasm does affect sleeping quality,since patients are easily aroused from sleep due to tremendous pain caused by the spasm.Sleeping quality is directly proportional to the health-related quality of life,as a results poor sleeping quality may indirectly affects the daily life of the patient such as poor work performance.The severe muscle pain will not only affect sleeping quality,but also lead to difficulty in walking due to leg pain in,a few days,causing tremendous trouble to the patients.This study mainly observes the curative effect on the contrast of acupuncture at Zhigou acupoint and Chengshan acupoint on the gastrocnemius spasm,and preliminarily discusses the clinical efficacy on the treatment of upper portion for lower and the local acupoint selection on pain,broadens the clinical treatment ideas,and provides better treatment methods for this disease.MethodsSixty patients with gastrocnemius spasm who met the inclusion criteria were randomly divided into Zhigou group and Chengshan group.30 patients in the Zhigou group,30 patients in the Chengshan group.The test group was treated with acupuncture at Zhigou acupoint,while the control group was treated with acupuncture at Chengshan acupoint.The patients in two groups were treated once every day,and every five times was a course of treatment,with a total of 5 days.Three follow-up visits were conducted at the end of the first week and the first month.The symptom score and sign score of the patients in two groups were observed after one course of treatment,and the curative effects of the patients in two groups were evaluated according to the symptom score,sign score,VAS score,ISI score,ODI score and SF-36 score.The database was set up for the above data,and the statistical analysis was conducted with Stata 13.0.Results1.Baseline condition:The age,sex and course of disease of the patients in two groups were compared,and the symptom grading score,sign grading score,VAS score,ISI score,ODI score and SF-36 score of the gastrocnemius muscle before the treatment were compared.There was no statistically significant difference(P>0.05),and the baseline data were comparable.The comparison of ISI score of the patients in two groups were compared before the treatment,P=0.431,P<0.05,the difference was statistically significant.2.Symptom grading scores:The difference between the first treatment,the fifth treatment,the first week of follow-up,the first month of follow-up and the before the treatment of the Zhigou group were statistically significant(P<0.05);the difference between the fifth treatment and the first treatment was statistically significant(P<0.05);the fifth time of treatment,the first week of follow-up,the first month of follow-up were compared with each other,and the difference was not statistically significant(p>0.05).The difference between before the treatment and the first treatment,the fifth treatment,the first week of follow-up,the first month of follow-up of the Chengshan group were statistically significant(P<0.05);the difference between the first treatment and fifth treatment,the third month of follow-up and the sixth month of follow-up were statistically significant(p<0.05);there were no statistically significant difference between the fifth treatment,the third month of follow-up,the sixth month of follow-up(P>0.05);the difference between the first week of follow-up and the first month of follow-up were statistically significant(P<0.05).There was also statistical significance of the first treatment,the fifth treatment,the first month,the third month of follow-up and the sixth month of follow-up comparison of the patients of two groups(P<0.05);indicating that the curative effect of alleviating the symptoms of the gastrocnemius spasm by the acupuncture at Zhigou acupoint was better than that of acupuncture at Chengshan acupoint.There were statistically significant differences between the two groups after symptom grading score treatment and before the treatment(P<0.05).It indicates that the acupuncture at Zhigou acupoint and Chengshan acupoint is effective in alleviating the symptoms of the gastrocnemius spasm.There was also statistical significance between the first treatment and the fifth treatment in the patients of two groups,indicating that the curative effect of alleviating the gastrocnemius spasm was related to the length of the course of treatment.There was no statistical significance of the post-treatment and follow-up comparison of the patients of two groups(P>0.05),It shows that the symptom relief in both groups is stable after treatment.3.Sign grading score:The fifth time of treatment,the first week of follow-up,the first month of follow-up of the Zhigou group were compared with each other,and the difference was not statistically significant(p>0.05);the difference between the fifth treatment and the first treatment was statistically significant(P<0.05);the fifth time of treatment,the first week of follow-up,the first month of follow-up were compared with each other,and the difference was not statistically significant(P>O.05).The fifth time of treatment,the first week of follow-up,the first month of follow-up of the Chengshan group were compared with each other,and the difference was not statistically significant(P>0.05);the difference between the first treatment and the fifth treatment,the first week of follow-up,the first month of follow-up were statistically significant(P<0.05);there were no statistically significant difference between the fifth treatment and firth month of follow-up,third month of follow-up,and the sixth month of follow-up(P>0.05).There was also statistical significance of the first treatment,the fifth treatment,the first month,the third month of follow-up and the sixth month of follow-up comparison of the patients of two groups(P<0.05),indicating that the curative effect of alleviating the symptoms of the gastrocnemius spasm by the acupuncture at Zhigou acupoint was better than that of acupuncture at Chengshan acupoint.There were statistically significant differences between the two groups after sign grading score treatment and before the treatment(p<0.05).It indicates that the acupuncture at Zhigou acupoint and Chengshan acupoint is effective in alleviating the symptoms of the gastrocnemius spasm.There was also statistical significance between the first treatment and the fifth treatment in the patients of two groups,indicating that the curative effect of alleviating the gastrocnemius spasm was related to the length of the course of treatment.There was no statistical significance of the post-treatment and follow-up comparison of the patients of two groups(p>0.05),It shows that the relief of the signs after treatment in both groups is stable.4.Evaluation of curative effects:The comparison of curative effects of the patients in two groups was conducted after the treatment.The Zhigou group was 13 cases of clinically cured(43.4%),14 cases of markedly effective(46.7%),2 cases of effective(7%),1 case of ineffective(3%),the total effective rate is 96.7%;The Chengshan group was 8 cases of clinically cured(26.7%),12 cases of markedly effective(40%),8 cases of effective(26.7%),2 case of ineffective(7%),the total effective rate is 93.3%;.According to the rank sum test,the difference of the curative effects of patients in two groups was statistically significant(P<0.05).Both groups have obvious curative effects on the treatment of gastrocnemius spasm,but the clinical cure rate of the Zhigou group is higher than that of the Chengshan group.Indicating that the curative effect of alleviating the symptoms of the gastrocnemius spasm by the acupuncture at Zhigou acupoint was better than that of acupuncture at Chengshan acupoint.5.VAS score:(1)Comparison of pain index at the first treatment between the patients of two groups:There was no significant difference between the treatment group and the Chengshan group before treatment(P=0.73>0.05),and the baseline data were comparable.For results of 2min acupuncturing and 5min acupuncturing,10min acupuncturing,after taking out needles,the difference between the two groups was statistically significant(P<0.05),indicating that the analgesic effect of the treatment group was better than that of the Chengshan group in different time periods.The statistical analysis method used one-way repeated measurement experiment.If P<0.05,it did not conform to the sphericity test conditions,indicating that there was a correlation between repeated measurement data,so it cannot be processed according to one-way analysis of variance.The multivariate analysis of variance was needed,and the multivariate test results prevailed.The results of multivariate analysis of variance showed that the P of time and time*group interaction was<0.05,indicating that the interaction of time factor and group had statistical significance,that is,VAS score had a tendency to change with time,and the effect of time factor varied with different groups.If F=3.734 and P=0.058>0.05 for the inter-group effect test,it indicated that the curative effect of the Zhigou group and the Chengshan group after treatment was similar.(2)Comparison of pain index at the second treatment between the patients of two groups:The difference between the treatment group and the Chengshan group before treatment was statistically significant(P=0.000<0.05).At the beginning of the second treatment,the pain degree of the patients in the treatment group began to be less than that of the Chengshan group.For results of 2min acupuncturing and 5min acupuncturing,10min acupuncturing,after taking out needles,the difference between the two groups was statistically significant(P<0.05),indicating that the analgesic effect of the treatment group was better than that of the Chengshan group in different time periods.The statistical analysis method used one-way repeated measurement experiment.If P<0.05,it did not conform to the sphericity test conditions,indicating that there was a correlation between repeated measurement data,so it cannot be processed according to one-way analysis of variance.The multivariate analysis of variance was needed,and the multivariate test results prevailed.The results of multivariate analysis of variance showed that the P of time was<0.05,time*group interaction was>0.05,indicating that the interaction of time factor had statistical significance,that is,VAS score had a tendency to change with time factor varied with different groups.There was no significant difference in the interaction between time factor and group,indicating that the effect of time factors did not vary with the different groups.If F=7.642 and P=0.008<0.05 for the inter-group effect test,it indicated that the curative effect of the Zhigou group was better than the Chengshan group after treatment.(3)Comparison of pain index at the third treatment between the patients of two groups:The difference between the treatment group and the Chengshan group before treatment was statistically significant(=0.000<0.05).At the beginning of the third treatment,the pain degree of the patients in the treatment group began to be less than that of the Chengshan group.For results of 2min acupuncturing and 5min acupuncturing,10min acupuncturing,after taking out needles,the difference between the two groups was statistically significant(P<0.05),indicating that the analgesic effect of the treatment group was better than that of the Chengshan group in different time periods.The statistical analysis method used one-way repeated measurement experiment.If P<0.05,it did not conform to the sphericity test conditions,indicating that there was a correlation between repeated measurement data,so it cannot be processed according to one-way analysis of variance.The multivariate analysis of variance was needed,and the multivariate test results prevailed.The results of multivariate analysis of variance showed that the P of time and*group interaction was<0.05,indicating that the interaction of time factor and group had statistical significance,that is,VAS score had a tendency to change with time,and the effect of time factor varied with different groups.If F=22.395 and P=0.000<0.05 for the inter-group effect test,it indicated that the curative effect of the Zhigou group was better than the Chengshan group after treatment.(4)Comparison of pain index at the fourth treatment between the patients of two groups:The difference between the treatment group and the Chengshan group before treatment was statistically significant(P=0.000<0.05).At the beginning of the fourth treatment,the pain degree of the patients in the treatment group began to be less than that of the Chengshan group.For results of 2min acupuncturing and 5min acupuncturing,10min acupuncturing,after taking out needles,the difference between the two groups was statistically significant(P<0.05),indicating that the analgesic effect of the treatment group was better than that of the Chengshan group in different time periods.The statistical analysis method used one-way repeated measurement experiment.If P<0.05,it did not conform to the sphericity test conditions,indicating that there was a correlation between repeated measurement data,so it cannot be processed according to one-way analysis of variance.The multivariate analysis of variance was needed,and the multivariate test results prevailed.The results of multivariate analysis of variance showed that the P of time and*group interaction was<0.05,indicating that the interaction of time factor and group had statistical significance,that is,VAS score had a tendency to change with time,and the effect of time factor varied with different groups.If F=30.353 and P=0.000<0.05 for the inter-group effect test,it indicated that the curative effect of the Zhigou group was better than the Chengshan group after treatment.(5)Comparison of pain index at the first treatment between the patients of two groups:The difference between the treatment group and the Chengshan group before treatment was statistically significant(P=0.000<0.05).At the beginning of the fifth treatment,the pain degree of the patients in the treatment group began to be less than that of the Chengshan group.For results of 2min acupuncturing and 5min acupuncturing,10min acupuncturing,after taking out needles,the difference between the two groups was statistically significant(P<0.05),indicating that the analgesic effect of the treatment group was better than that of the Chengshan group in different time periods.The statistical analysis method used one-way repeated measurement experiment.If P<0.05,it did not conform to the sphericity test conditions,indicating that there was a correlation between repeated measurement data,so it cannot be processed according to one-way analysis of variance.The multivariate analysis of variance was needed,and the multivariate test results prevailed.The results of multivariate analysis of variance showed that the P of time was<0.05,time*group interaction was>0.05,It indicated that the time factor had statistical significance,and the interaction between time factor and group had no statistical significance,that is,VAS score varied with time,but the effect of time factors did not vary with different groups,indicating that the improvement of the pain in the fifth treatment between the Zhigou group and the Chengshan group was similar over time.If F=48.465 and 000<0.05 for the inter-group effect test,it indicated that the curative effect of the Zhigou group was better than the Chengshan group after treatment.(6)Comparison of pain index before and after treatment between the patients of two groups:The difference between before the treatment and the first treatment,the second treatment,the third treatment,the fourth treatment,the fifth treatment,the first week of follow-up,the first month of follow-up of the Zhigou group were statistically significant(P<0.05);the difference between the first treatment and the first week of follow-up,the first month of follow-up were statistically significant(P<0.05);the difference between the second treatment and the first week of follow-up,the first month of follow-up were statistically significant(P<0.05);the third time of treatment,the fourth treatment,the first treatment,the first week of follow-up,the first month of follow-up were compared with each other,and the difference was not statistically significant(P>0.05).The difference between before the treatment and the first treatment,the second treatment,the third treatment,the fourth treatment,the fifth treatment,the first week of follow-up,the first month of follow-up of the Chengshan group were statistically significant(P<0.05);the difference between the first treatment and the second treatment,the third treatment,the fourth treatment,the fifth treatment,the first week of follow-up,the first month of follow-up were statistically significant(P<0.05);there was no statistically significant difference between before the treatment and the sixth month of follow-up(P>0.05).There was no significant difference between the two groups before the treatment(P>0.05),the rest with each other,and the difference was also statistically significant(P<0.05).It indicates that the pain relief of the Zhigou group is better than that of the Chengshan group in the curative effects of both post-treatment and follow-up.6.ISI score:The difference between before the treatment and after the treatment,the first week of follow-up,the first month of followup of the Zhigou group were statistically significant(P<0.05);The difference between after the treatment and the first week of follow-up,the first month of follow-up were statistically significant(P<0.05);the first week of follow-up,the first month of follow-up were compared with each other,and the difference was not statistically significant(P>0.05).The difference between before the treatment and after·the treatment,the first week of follow-up,the first month of follow-up of the Chengshan group were statistically significant(P<0.05);The difference between after the treatment and the first week of follow-up,the first month of follow-up were statistically significant 05);the first week of follow-up,the first month of follow-up were compared with each other,and the difference was not statistically significant(P>0.05).The difference between two groups was statistically significant(P<0.05)after the treatment,and in the first month,the third month and the sixth month of follow-up visit.In the inter-group comparison,the difference between two groups was statistically significant(P<0.05)after the treatment,and in the first month,the third month and the sixth month of follow-up visit,indicating that the sleep condition of the patients in two groups was improved and stable in the later follow-up visit period compared with that after treatment.7.ODI score:The difference between before the treatment and after the treatment,the first week of follow-up,the first month of follow-up of the Zhigou group were statistically significant(P<0.05);the difference between after the treatment and the first week of follow-up,the first month of follow-up were statistically significant(P<0.05);the first week of follow-up,the first month of follow-up were compared with each other,and the difference was not statistically significant(P>0.05).The difference between before the treatment and after the treatment,the first week of follow-up,the first month of follow-up of the Chengshan group were statistically significant(P<0.05).The difference between after the treatment and the first week of follow-up,the first month of follow-up were statistically significant(P<0.05);the difference between the first week of follow-up and the first month of follow-up were statistically significant(P<0.05);there was no statistically significant difference between the third month of follow-up and the sixth month of follow-up(P>0.05).The difference between two groups was statistically significant(P<0.05)after the treatment,and in the first month,the third month and the sixth month of follow-up visit.In the inter-group comparison,the difference between two groups was statistically significant(P<0.05)after the treatment,and in the first month,the third month and the sixth month of follow-up visit,there was no difference between the two groups in the Zhigou group after three months of follow-up(P>0.05),The difference between the first month of the Chengshan group and the third month and the sixth month was statistically significant(P<0.05).Iindicating that the improvement of limb dysfunction of the patients in two groups was improved and stable in the later follow-up visit period compared with that after treatment.Relatively speaking,the efficacy of the Zhigou group is relatively stable.8.SF-36 score:BP was statistically significant in the treatment group and the Chengshan group after treatment(P<0.05),the rest was no statistically significant(P>0.05).The difference between the two groups after the treatment,the third month of follow-up,the sixth month of follow-up,BP had statistically significant(P<0.05).There were no statistically significant differences among the remaining SF-36 items between the groups(P>0.05).This indicates that the patients with the gastrocnemius spasm have lower health-related quality of life,which mainly affects health,daily activities and body pain.There were no statistically significant differences among the remaining SF-36 items between the groups(P>0.05).It indicates that the improvement in pain of the Zhigou group is better than that of the Chengshan group in the curative effects of both post-treatment and follow-up.ConclusionBoth the acupuncture at Zhigou acupoint and the acupuncture at Chengshan acupoint are the effective methods for treating the gastrocnemius spasm.However,the curative effect of the symptom grading,sign grading,VAS score,ISI score,ODI score and SF-36 score index of the patients in the test group is better than that of the control group,regardless of post-treatment and follow-up.In conclusion,it indicates that the acupuncture at Zhigou acupoint is effective and safe in treating the gastrocnemius spasm,and it is worth popularizing widely. |
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