Acupotomy Therapy On Myofascial Pain Syndrome Of Gluteus Minimus Secondary To Lumbar Disc Herniation: A Clinical And Mechanism Study

Myofascial pain syndrome(hereinafter referred to as MPS)is clinically widespread chronic soft tissue disease and as a common bone disease-lumbar disc herniation(hereinafter referred to as LDH)is one of the major sources of lower back pain.MPS especially of hip can be caused by LDH,and ti is quite difficult to identify between radiculopathy caused by LDH and MPS of gluteus minimus secondary to LDH.In view of this,the author puts forward the concept of secondary MPS of gluteus minimus which is due to LDH,expounds mechanism of this,collects patients matched for acupotomy therapy,analyses the results of treatment and discuss es the therapeutic mechanism.This paper is divided into introduction,clinical scheme,results of clinical research,discussion and analysis,summary of five parts.Introduction:First introduces the high prevalence of MPS and importance of the social prevention and treat because of its seriously affects on patient's work and life.Then points out that there are reports of LDH together with MPS of gluteus minimus from domestic and foreign literature,further proposes the breakthrough in concept of secondary MPS of gluteus minimus which is due to LDH and the conffusion between secondary MPS of gluteus minimus and sciatica always leads to missed diagnosis.Treats patients with acupotomy and assesses its effect by multiple indexes comprehensively.Clinical research:Comprehensively exposes effects of acupuncture therapy to 54 cases of secondary MPS of gluteus minimus,shows the clinical data including general information and detailed access standards,treatment process contains detailed steps are described from the front and rear side.Results of clinical research:Displays the evalution datas and the statistical results of before and after acupuncture treatments-comparing with before and after treatment,the score of clinical manifestations on MPS of gluteus minimus and VAS are both statistically significant,the total effective rate of 7-days after treatment and 1-months after treatment is 46.30%and 85.19%respectively.A significant part of the full text-discussion and analysis:Comprehensively discusses on theoretical analysis and investigation of mechanism,theoretical analysis shows a good and stable result of acupotomy therapy for secondary MPS of gluteus minimus according to statistical data,to show a good way of acupotomy therapy for non-surgical treatment on LDH,to distinguish secondary MPS of gluteus minimus from others like fibromyalgia,trochanter bursitis,pain disorders of hip joints,radiculopathy,piriformis syndrome,sciatica,other related MPS is needed,treatment and prevention include six treatment means like drug therapy,physical and rehabilitation therapy,needling and acupuncture therapy,acupotomy-kind devices treatment,RF pain treatment and prevention means like avoiding the cold,tired,heavy physical labor.Investigation of mechanism contains two parts-pathogenesis and treatment mechanism.The pathogenesis point out the theory of neural sensitization,"integrated trigger point hypothesis" and others,the pathogenesis of LDH pain-mechanical compression,inflammatory nerve root pain and immune theory,the pathogenesis of secondary MPS of gluteus minimus due to LDH-"Muscular tension and local neurovascular dysfunction",and,relationship between muscle regions of chinese medicine and MPS of gluteus minimus.Investigation of mechanism explores a comprehensive mechanism of acupuncture therapy,which includes release,adjustment to aseptic inflammation,the nerve-muscle junction reconstruction.Finally,the author analyzed the situation with previous studies and breakthrough of this study.