Clinical Observation Of The Treatment Of Senile Non - Specific Low Back Pain With

BackgroundLow back pain (LBP) refers to the pain of lumbar muscles, fascia, joints, ligaments and other anatomical structures between the gluteal fold and the lower edge of the costal arch,which may be associated with sciatica. It is the second most common clinical symptoms ranking behind the respiratory disorders,with an incidence of between 40-60% in adults,and the United States spend about 500-100 billion dollars on IBP each year.85% of patients with IBP can not be given the exact diagnosis, which is called non-specific LBP(NLBP). NLBP is a kind of disease with the symptoms originated from the waist. Neiter nerve root are involved, nor histopathological changes happen. The main symptom of this disease is having a pain in lower part of the waist,which is more common in people over the age of 60.The features of it is easy to relapse but difficult to cure,affecting people’s quality of life seriously.Currently, the etiology and pathology of IBP is still unclear, the mearures of treating IBP is limited,the surgery is inaccurate and western medicine manifestate lots of side effects and toxicity on the digestive tract, liver and kidney s. Compared with the western medicine,the Chinese traditional medicine treatment has certain unique advantages. Under the guideline of such principle "Acupuncture at pain points, to use", the knife therapy has been widely used in clinical, with advantages of easy to operation, low cost, small irritation, less bleeding, minimally invasive, etc. But the operation of knife therapy cannot be done in straight vinsion. Even though one is very familiar with the anatomical level,he still can not avoids organ damage to blood vessels and nerves,which is a certain risk. The main difference between the tendons knife and the kinfe is in the blunt needle-shaped front, greatly reducing the blood vessels and nerves and other soft tissue damage during the operation, not only having the advantages of the knife, but also reducing the risk above-mentioned.Objective1. Objective To evaluate the clinical efficacy of NLBP tendons knife treatment.2. To anlyse the data on clinical cases of NLBP tendon junction and o explore its distribution.MethodsUsing the case observational research methods,study subjects were from 1 January 2014 to 31 December 2014 at the China Academy of Traditional Wangjing Hospital outpatient spine Second Department, who met the inclusion and exclusion criteria, with a total number of 60 cases. Having given the tendons knife treatment(1 week,1-2 times for a course of treatment),we take four time pionts (before treatment, immediately after treatment, three days after treatment and 7 days after treatment) to observe and record the lumbar JOA score, VOA score and ODI index to estimate the improvement after treatment and make a summary of the tendon junction distribution.The resultVAS scores before and after comparison dataThe results showed that before treatment, immediately after treatment, three days and one week after the treatment of the four time points in patients with VAS scores were significantly lower (P<0.01), prompting that the tendons knife treatment can effectively reduce the patient’s NLBP pain index and significantly improve pain symptoms; VAS scores of immediately after treatment, three days after treatment and one week after treatment were significantly lower (P<0.01), prompting that the treatment of pain gradually eased, and the cumulative effect is obvious. The cumulative effect is maximized after one week of treatmentPain improvement rateThe results showed that the effective pain improvement rate of immediately after tendon pain knife treatment is 96.6%, and the significant effective rate is 58.3%; 3 days after treatment, the effective pain improvement rate is 100%,and the significant effective rate is 88.3%; one week after the treatment of the pain improve the efficiency and the significant effective rate is 100%.Lumbar JOA score comparisonThe results shows that before treatment, immediately after treatment, three days after treatment, after one week of the four time points in patients,the JOA scores were significantly higher (P<0.01), suggesting that there is a significant improvement in subjective and objective symptoms,signs of everyday life capacity and terms of functionality, which means that tendons knife treatment is effective; immediately after treatment, three days after treatment, within one week after treatment compared, the JOA scores were significantly higher(P<0.01), prompting that the effect is more obvious over time.JOA score improvement rate treatmentThe results shows that immediately after treatment,the JOA score of improvement rate is 98.4%,and the significant rate is 76.7%;The effective rate is 100% after 3 days of treatment JOA score improvement rate of treatment, and the significant rate is 98.3%; 1 week after treatment,both the effective and the significant rate are 100%.Oswestry disability index contrastThe results shows that before treatment, immediately after treatment, three days after treatment, after one week of the four time points in patients ODI scores were significantly lower (P<0.01), prompting that lumbar dysfunction had significantly improved after treatment. Immediately, three days after treatment,one week after treatment,the ODI scores were significantly lower (P<0.01), which prompts treatment effect is more obvious over time, lumbar functional improvement were better after one week’s treatment.ODI significant effect efficiencyThe results shows that ODI significant rate immediately after treatment is 83.3%; 3 days after treatment, the significant effect of ODI is 93.3%; ODI effective rate is 100%.Tendon junction distributionIn 60 cases of patients with NLBP, tendons involvement of foot TAIYANG bladder channel is 90%, indicating that the foot TAIYANG bladder channel in the ages of NLBP is more susceptible to injury; distribution is independent of gender tendon junction (P>0.05); The number of tendon junction in everybody is 1-4. In 11 tendon junctions, where the large intestine times, Guan Yuan times, small intestine Yu times together accounted for 75.6%, according to the anatomical location of these tendons nodes mainly in the L4-5 facet joints, L5S1 facet and sacroiliac joints joints,which shows that part of diseased senile NLBP is mainly in the lumbosacral region, which is significant in the diagnosis, treatment and rehabilitation.Incorporate the clinical diagnosis of non-specific low back pain in 60 patients, including radiological tips spinal stenosis in 22 patients, 21 cases of patients with lumbar disc herniation, lumbar spine in patients with severe osteoarthritis in 11 cases, accounting for 90% of the patients included in the case, but no clear symptoms and signs support after treatment were significantly relieve symptoms, suggesting that IBP symptoms may not be caused by spinal NLBP factors but by factors outside the spinal symptoms, which also prompts that in the future the tendons knife therapy might be a possible method to identify the internal and external spinal factors.In conclusion1 Tendons knife can effectively relieve symptoms of nonspecific low back pain in ages and its short-term effect is stable.2 Distribution of tendon junction in senile patient with nonspecific low back pain mainly local in lumbosacral region.