Effects On The Pain Threshold With Therapy Focused Ultrasound Irradiation Of The Right Zu Sanli And The Clinical Preliminary Study Of The Focused Ultrasound Treatment With Chronic Low Back Pain

BackgroundPain is common in the clinical, especially chronic pain. Pain is a subjective feeling, so it is certainly difficulty to assess and to be treated, at present there are many the treatment methods, but the effect is poor. A focused ultrasound may be a treatment of pain as better ,which remains therapeutic dose when the ultrasound wave reach to the deep tissue. Focused ultrasound irradiation with acupoints, which is similar to acupuncture. At the same time, the ultrasound has characteristics including improving the micro circulation, relieving muscle spasm, eliminating edema releasing local adhesion and promoting the repair of soft tissue injury, hence we have carried out a study of the effects on the pain threshold and a clinical preliminary investigation in the chronic low back pain after the focused ultrasound irradiation of acupoints.Part 1The fluctuations of pain threshold for normal bodies Objectives: To study the pain threshold, which tested by Electronic Von Frey. Methods: Ten healthy people have been study with the mechanical pain threshold by Electronic Von Frey. The changes of pain threshold were observed at 0, 10, 20, 30, 40, 50, 60 min after irradiation. Results: The average fluctuations in the pain threshold of each tested points does not exceed 10%, and the largest average fluctuations in the pain threshold of each people does not exceed 30%. There was no significant difference among the various time points (P=0.144), and there are no interaction effects of times and locations (P=0.41).Conclusions: it is stable and feasible to detect the pain threshold by Electronic Von Frey.Part 2 Effects on the pain threshold with the focused ultrasound irradiate the right Zu SanliObjective: To study the effect on the pain threshold with the focused ultrasound irradiation of the right Zu Sanli. Methods: Forty normal and healthy people were randomly selected into focused ultrasonic groups and placebo-controlled groups. 20 people in each group. Of them Zu Sanli irradiated 30 minutes by focused ultrasonic, but the placebo-controlled group were treated with no dosage. The Electronic Von Frey was used for detecting pain threshold. 1 cm away from the Bilateral Zu Sanli and Wuai Guan were detected by Electronic Von Frey .The changes of pain threshold was observed before irradiation and at 10, 20, 30, 40, 50, 60 min after irradiation. While the placebo control group for comparison. Results: The variation of four measured points is very similar in the focused ultrasonic groups, which the rate of pain threshold increased after a focused ultrasound irradiation of the right Zu Sanli, and reached a peak immediately after the irradiation, then the rate declined after stopping irradiating. The rate little change and the fluctuation are much smaller than±10% in the placebo-controlled groups. Through repeated ANOVA, there was significant difference between before and after irradiation in the focused ultrasonic groups(P<0.01); There was no significant difference between before and after irradiation in the placebo-controlled groups(the right Zu Sanli P=0.274, the left Zu Sanli P=0.904,the right Wai Guan P=0.274, the left Wai Guan P=0.192 ). That there was significant difference compared with those of the adjacent time in the focused ultrasonic groups(P<0.01) and There was no significant difference with those of the double different parts(the Zu San P=0.176, the Wai Guan P=0.68),though there was significant difference between the far part and the near part(P<0.01). There was interaction effect between times and parts (P<0.05). Conclusions: Pain threshold was significantly increased after focused ultrasound irradiation of the unilateral Zu Sanli, which has some analgesic effects.Part 3 Treatment of Focused Ultrasound for Patients with chronic Low Back PainObjective: To evaluate the efficacy and safety of focused ultrasound in the treatment of chronic low back pain. Methods: Randomized, controlled and single blind method was adopted, and forty patients with chronic low back pain were divided into two groups of 20 each, treatment group and placebo-controlled group. With the same acupoints (Zu Sanli,Wei Zhong and Yao Jiaji) all of treatment group have accepted the treatment of 10 minutes for each acupoint for 5 days, the same treatment with no energy dosage for placebo-controlled group. For each group VAS scores were evaluated before treatment and immediately, 1day, 7 day, 14 day, 21 day, 28 day after treatment. Results: The effective rate was 100% in the focused ultrasonic group, better than those of 27.8% in the placebo-controlled group immediately after treatment(P< 0.01) .In the follow-up, there was significant difference between each compared groups. Also there was a significant difference between pre-treatment VAS and post-treatment VAS in the focused ultrasonic group (P< 0.01) . In the placebo-controlled group, there existed a significant difference between pre-treatment VAS and immediately after treatment VAS, but not in the follow-up compared groups. Only one patient had a mild side effect. Conclusions: Focused ultrasound in the treatment of chronic low back pain through irradiating acupoints is an effective and safe way.