| BackgroundLumbar muscle strain, also known as lumbar back myofascitis, functional lumbago, lumbar fibroids, poses fascia pain syndrome, is the aseptic inflammation in lumbar muscle and fascia. It is divided into acute injury and lumbar muscle strain. This study only focused on chronic waist soft tissue injury. It belongs in the category of low back pain. Lumbar muscle strain accounts for a large portion of chronic low back pain (70%), whose clinical incidence occupies80%of the patients suffering from Lumbago and Leg pain. This is a common disease in clinical. Lumbar muscle strain specifically refers to chronic soft tissue injury which includes waist muscles, ligament, fascia etc. Its cardinal symptom includes pain, dysfunction, and dysfunction of autonomic nervous system. Adhesion, cicatrix, contracture and blockages are the main pathologic changes.From the first China International Lumbar Spine Summit Forum that ended on Mar.23,2009we have got the news that80%adults have a history of lumbago. The lumbar spine disease patients in China were more than200million. And this trend has been increasing. Therefore, the disease which is getting more and more attention is not only known as Medical Problems, but also social issue. Currently the more common approach is to take analgesics anti-inflammatory in western medicine, while when there are gastrointestinal side-effects such as hemorrhage. And therapy effect will not last for long time. Blockade and physiotherapy are often short lived as well.Lumbar muscle strain is included in Chinese Traditional medicine’s lumbago, injury of tendon and muscle, Arthralgia Syndrome. Traditional Chinese Medicine argues that the external causes of this disease are related to catching exogenous evil, trauma deferment, lumbar muscle strain. And the internal causes are involved in the deficiency of qi and blood, insufficiency of liver and kidney. Treatments such as internal governance and external use of TCM, acupuncture and moxibustion, Massage, fire cupping, scraping, exercise etc. were used clinically. Chinese traditional approach has its own features in treatment for chronic lumbar strain. Its clinical effect is significant. And there are also some literatures and reports which shows Chinese acupuncture and scraping treatment have it are the clinical effectiveness as well.My tutor treated a large number of lumbar muscle strain patients by acupuncture in clinic, concluding that a set of specific points for lumbar muscle strain, and achieved better clinical efficacy. Scrape therapy, also acting as traditional external treatment, has the virtue of simplicity of operation, less side effect and high safety, striking effect, and was easily accepted by patients. With development of the clinical and experimental study, its therapy coverage is extending and its clinical effect has been highly appreciated. By indexing the literature published in cnki during past10years, I found that if various illnesses were treated by acupuncture combined with scraping, its effect is obviously higher than that of single-applied acupuncture. But the reports related to the treatment for lumbar muscle strain by acupuncture and scraping are rare at the present. In order to evaluate its clinical effect objectively and to provide an objective basis for clinical application or expansion, I adopt randomized controlled trial to perform clinical observation in patients who were treated by acupuncture combined with scraping and in patients who were treated only by acupuncture.PurposesBy the method of randomized controlled trial, we perform clinical observation in lumbar muscle strain patients who were treated by acupuncture combined with scraping. Our aim of the study is to observe and to evaluate the short-term and long-term clinical effect and safety of clinical application. Thus, we can clarify the advantages and features in treatment for chronic lumbar strain by acupuncture combined with scraping and provide a reliable evidence-based medicine for clinical application.MethodsAccording to established inclusion criteria and random number table,60patients with chronic lumbar strain, who were in accordance with the accepting criteria, were randomly divided into trial group and control group. These two groups were treated by single-applied acupuncture and by acupuncture combined with scraping respectively. Based on the evaluation index such as lumbar muscle strain’s VAS scores, waist dysfunction’s ODI scores and the scores of lumbar segment motion, a statistical analysis was conducted on the two groups of patients in order to evaluate the clinical effect of treatment by acupuncture combined with scraping.The date was statistically analyzed with SPSS16.0software. All the metering data was shown by mean and standard deviation. T test was used for comparison between groups. Count data was compared by using Chi-squared test. P<0.05, the differences was statically significant.ResultsComparison of the two groups’ VAS scores,ODI scores and the scores of lumbar segment motion, from the beginning of the first further consultation, when any point was compared with the first diagnosis, the differences were statistically significant(P<0.01).Comparison between the two groups’VAS scores, from the beginning of the third return visit, the differences among all time points observed are statistically significant. And the mean in the experiment group were less than these of the control group (P<0.05).Comparison between the two groups’ODI index, from the beginning of the first further consultation, the differences were statistically significant (P<0.05). From the beginning of the second return visit, the differences among all time points observed are statistically significant (P<0.01). And the mean in the experiment group were less than these of the control group.Comparison between the two groups’lumbar segment motion’s score, any further consultation time points observed have no statistically significant (P>0.05).Checked by the Chi-squared test, Comparison between the two groups’ODI curative effect, the differences were statistically significant (P<0.05). Cure rate was86.7%in the experiment group,73.3%in the control group.After the second treatment, the differences between VAS scores in all time points observed and first further consultation has statistically significant. And the mean in the experiment group was greater than these of the control group. After the first treatment, the differences between ODI index in all time points observed and first further consultation has statistically significant (P<0.05). And the mean in the experiment group was greater than these of the control group. After the first treatment, the differences between the lumbar segment motion in all time points observed and first further consultation has no statistically significant (P>0.05).The differences among all groups’VAS scores, ODI scores, lumbar segment motion scores in the second follow-up and the last treatment has no statistically significant (P>0.05).The2times follow-up’s VAS scores in the experiment group was less than these of the control group (P<0.01). The2times follow-up’s ODI scores in the experiment group was less than these of the control group (P<0.05). While the lumbar segment motion’s scores in experiment group were basically consistent with these of the control group (P>0.05).During the treatment, a total of60patients in2groups whose basic vital signs included blood pressure, pulse, breath, temperature etc. were not changed abnormally. Serious adverse events were not seen during the experimental process.ConclusionBoth acupuncture combined with scraping and single-applied acupuncture have good effects on treatment for lumbar muscle strain. And acupuncture combined with scraping has better effect than single-applied acupuncture.Both acupuncture combined with scraping and single-applied acupuncture have stable and lasting effect. And patients treated by acupuncture combined with scraping have better improvement in lumbago and dysfunction than patients treated by single-applied acupuncture.In the treatment for lumbar muscle strain, acupuncture combined with scraping can enhance each other.Acupuncture combined with scraping in the treatment for lumbar muscle strain has good security. |
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