The Anatomic Study Of Applying Penetrating Acupoints In Treating Periarthritis Of Shoulder And Its Clinical Application

Objective:Through the observation of local anatomical morphology of using the commonly used combination of penetrating acupoints, and the analysis of the clinical observation of acupuncture treatment in the treatment of periarthritis of shoulder, to explore the practical value of the penetrating acupoints method in the treatment of periarthritis of shoulder, so as to determine that penetrating acupoints method can improve the clinical curative effect. Method:This project was composed of two parts,including laboratory studies and analysis of clinical curative effect. Laboratory research for the adjacent regional anatomy structure after penetrating deep into the points, so as to analyze the mechanism for the treatment of periarthritis of shoulder with selected acupoints. Clinical research part con- cerned with patients that meet diagnostic criteria of periarthritis of shoulder, by grouping to observe the differences of single pricking acupoints and penetrating acupoints, to determine the curative effect and to determine penetrating method has practical value to improve clinical effectiveness. Laboratory studies 30 cases of adult samples, after positioning the points ready for needle pricking,then penetrating methods was adopted,through regional anatomy of the local fault, to measure the related data analysis through the needle and through regional artery, and skin, the relationship between nerve and stab through penetrating mechanism is discussed in this paper. Clinical re- search was divided into penetrating group and single pricking group. Acupoints in penetrating method: houxi penetrating hegu, neiguan penetrating waiguan, the remaining points single pricking.Single pri- cking group:houxi,hegu,neiguan,waiguan,and other acupoints all adopting single pricking method. 1 times a day for the two groups of acupuncture, seven times as 1 course of treatment, a total of 2 course in the treatment. Results:1. The anatomical features of the structure adjacent to penetrating points for periarthritis of shoulder:(1) Houxi penetrating hegu : according to sequence,the tissue from penetrating into houxi to hegu are: the skin, subcutaneous tissue, Abductor digiti minimi- Flexor digiti minimi brevis,the little finger opponeus, the first dorsal interosseous muscle, Adductor pollicis,subcutaneous tissue of hegu.The main artery that are Closely associated with the penetrating area are the palmar digital artery, radial palmar digital arteries, superficial palmar arch, the proximal arterial digitalis palmaris communis; Nerves mainly with median nerve recurrent branch, deep branch of ulnar nerve, common palmar digital nerve;Muscle mainly with volar between bone muscle, 1 interosseous dorsal thumb adductor muscle, short abductor muscle and the little finger and little finger flexor, little finger on the palm.(2) Neiguan penetrating waiguan: penetrating from neiguan to waig uan,tissues that were passed through were: skin, subcutaneous tissue, between the flexor carpi radialis tendon and palmaris longus, Flexor digit orum superficialis, median nerve and its ulnar side, Flexor digitorum profundus, Pronator quadratus, Extensor digiti minimi, Extensor digitorum, subcutaneous tissue beneath waiguan.Nerves that were closely associated with the penetrating area are median nerve, posterior interosseous nerve and anterior interosseous nerve; arteries were mainly posterior interosseous artery, anterior interosseous artery,median artery. Muscles were tendon of flexor carpi radialis, pronator quadratus, tendon palmaris longus, musculus flexor digitorum sublimis, flexor digitorum profundus.2. Analysis of treatment effects of penetrating method for periarthritis of shoulder(1) According to the standard of comprehensive curative effect of for shoulder joint pain,the penetrating group had a total of 30 cases, 20 cases were cured, 5 cases had marked effects, 3 cases were improved,2 had no effect, the total effective rate was 93.3%, single pricking group had a total of 30 cases, 7 cases cured, 9 cases were markedly effective, improvement in 6 cases, 8 had no effect, the total effective rate was 73.3%, by statistical analysis, penetrating group and single pricking group had remarkable differences in the total effective rate(P = 0.01, P < 0.05), indicating penetrating group is superior to the single pricking group on the clinical curative effects(2) According to the standard of curative effect on pain for shoulder joint pain, conducted subjective sense pain score(VAS score) for the penetrating group and single pricking group and made comparison. After 2 courses of treatment, the pain score for patients with periarthritis of shoulder after penetrating pricking was 0.51 ± 0.11, while that of single pricking was 1.10± 0.30, the pain score of penetrating group was lower than single pricking group, which has extremely significant difference(P < 0.01), suggesting penetrating group was significantly better than single pricking group in pain relief.(3) According to the standard of curative effect of the function of shoulder joint activity, score(Melle score) shoulder joint function activity after penetrating and single pricking and compare them.After 2 courses of treatment, shoulder joint functions of penetrating group and single pricking group of(arm degree of outreach, spin degree, degree of activity to the neck, hand to the spine) were scored and compared, function scores of penetrating group were: 1.03 ±0.18、1.04 ± 0.17、1.03±0.17、1.02±0.19, function scores of single pricking group were: 1.58±0.50 、 1.62±0.48 、 1.59± 、 0.51 、 1.61±0.51, the scores of penetrating group were lower than that of single pricking group, with significant difference(P < 0.01), thus proved that the treatment effect of penetrating group was obviously better than that of single pricking group in terms of improving the shoulder joint activity. Conclusion:The penetrating acupoints method in treating Periarthritis of shoulder can improve the effect of the treatment for periarthritis of shoulder:1. Compared with the single pricking group,treatment of penetrating group can relieve the pain of patients with periarthritis of shoulder;2. Compared with the single pricking group, treatment of penetrating group can significantly improve the function of shoulder joint activity.