| Objective:To observe the clinical effect of Fu's subcutaneous needling manipulating e sweeping and dispersing the"Five Acupoints of Nonspecific Low Back Pain"(Wailing,Wushu,Jimen,Bangmai,Weishu)combined with reperfusion activity on non-specific low back pain;to observe the changes of the fascia under the "Five Acupoints of NLBP" before and after treatment by ultrasound,and to explore the mechanism of the fascia under the acupoints in acupuncture.Method:In the outpatient clinic of Acupuncture and Moxibustion Department of Chengnan Branch of Nanjing Traditional Chinese Medicine Hospital,60 patients with nonspecific low back pain were randomly divided into Fu's subcutaneous needling group and common needle group(control group,with 30 cases allocated to each group.For the Fu's group,the most painful point near the Five Acupoints of NLBP was searched for and treated by Fu's subcutaneous needle sweeping combined with specific reperfusion activity.The treatment was carried on every second day and a course consists of three times.In the control group,general needle was applied mainly to acupoints among Weishu,Shenshu,Dachangshu and local Ashi,depending on the symptoms.The treatment was further supplemented by electroacupuncture and Shendeng therapeutic apparatus for 30 minutes each time.The treatment was given once a day and the course consists of 5 times.Before enrollment,baseline indicators,pain degree,duration,concomitant symptoms,VAS,Oswestry,RMDQ,JOA scale evaluation,and the thickness and morphology of fascia under acupoint ultrasound in the five groups of Five Acupoints of NLBP were evaluated.VAS,Oswestry,RMDQ and JOA scales began to be assessed from the 7th day of the treatment in both groups.Thickness and morphology of fascia under ultrasound at five groups of Five Acupoints of NLBP.The observation was also made to the people in the control group in respect of the thickness and morphological characteristics of their subfascia at the Five Acupoints of NLBP.All data were statistically processed using the SPSS24.0 statistical analysis software.Measuring data were expressed as mean standard deviation(s),and counting data were tested by X2 test.The outcome would be deemed as having statistic significance when P<0.05.Result:1.Comparison results of rating scaleBoth the floating needle group and the control group see a significant decrease(P<0.01)in patients' VAS,Oswestry,RMDQ and JOA scores after the treatment.There was no significant difference in VAS score,Oswestry score and JOA score before and after treatment between the Fu' s subcutaneous needling group and the ordinary acupuncture group(P>0.05).However,significant difference was found in RMDQ score and JOA improvement rate between the two groups before and after treatment(P<0.05).It is suggested that the Fu's subcutaneous needling group is superior to the ordinary acupuncture group in improving the waist dysfunction and the cure rate.2.Comparison results of fascial observationBefore and after treatment,the thickness of inferior fascia of Jimen(left side)and Weishu(both sides)decreased significantly(P<0.05).The thickness of the inferior fascia of Wailing(right side)and Weishu(right side)in the general acupuncture group decreased significantly(P<0.05).No statistically significant improvement was found for the rest.Before and after treatment,there was no significant difference in the thickness of the inferior fascia between the two groups(P>0.05).The probability of concordance between the thickness side of the fascia underneath Wailing acupoint and the side of pain was 66.7%,and the probability of discordance was 33.3%.The probability of concordance between the fascia thickness side and the pain side at Wushu acupoint was 61.9%,the probability of discordance was 33.3%,and the probability of bilateral fascia thickness being equal was 4.8%.The probability of concordance between the fascia thickness side and the pain side underneath Jimen acupoint was 71.4%;the probability of discordance was 23.8%;and the probability of equal fascia thickness on both sides was 4.8%.The probability of concordance between the thickness side of the fascia underneath Daimai acupoint and the side of pain was 76.2%,and the probability of discordance was 23.8%.The probability of concordance between the fascia thickness side and the pain side under Weishu acupoint was 80.9%,the probability of discordance was 14.3%,and the probability of equal fascia thickness on both sides was 4.8%.There was no significant difference in the average thickness of the fascia underneath the Five Acupoints of NLBP between the NLBP group and the group without low back pain(P>0.05).There was a significant difference in the mean value of the difference between the left and right fascial thickness underneath the Five Acupoints of NLBP measured by ultrasound between the NLBP group and the group without lumbago(P<0.05).Conclusion:1.Fu' s subcutaneous needle treatment and common needle therapy have significant effects on NLBP.The effect of Fu's subcutaneous needle treatment on NLBP is significantly better than that of millineedle acupuncture,which is mainly reflected in that f Fu's subcutaneous needle treatment can shorten the course of treatment,improve the lumbar dysfunction score(RMDQ),and improve the cure rate(JOA improvement rate);2,The difference of the thickness of the fascia under the "five points of low back pain" on both sides has potential correlation with the occurrence of NLBP;3.Preferential observation of subfascia at Weishu point may improve the early diagnosis of NLBP;4.Fu's subcutaneous needle treatment only significantly changed the thickness of fascia under some acupoints;5.The millineedle therapy only significantly changed the thickness of fascia under some acupoints;6.At present,it is not yet possible to accurately judge whether there is a significant difference between Fu's subcutaneous needle treatment and the millineedle in the changes of subacupoint fascia. |
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