To Observe The Effect Of Patients' Willingness On The Efficacy Of Cupping And Electroacupuncture In The Treatment Of Fibromyalgia Syndrome

BackgroundFibromyalgia Syndrome(FMS)is an non articular rheumatism characterized by chronic widespread pain associated with fatigue,anxiety,depression,sleep disorders,morning stiffness and so on.FMS onset is hidden,the disease has long course and seriously affect the patients' quality of life.As the life pressure increased,prevalence of FMS is on the rise.TCM holds that FMS belong to "Ji bi""Zhou bi" category,the basic pathogenesis is liver depression and qi stagnation combine with cold,wind and dampness block,qi and blood block,the obstruction causes pain.Traditional cupping therapy and acupuncture are clinical commonly used therapy for the treatment of the disease.It is a meaningful question that whether the will of patients on choosing the non-drug therapy has influence on treatment effect,because it is difficult to implement blinded in non-drug therapy clinic research.Besides,American College of Rheumatology(ACR)published a new diagnostic criteria in 2010 on the basis of 1990 ACR.The updated criteria have adopted a new scoring system on evaluating the degree of pain,it also added the assessment of accompanying symptoms which made it more comprehensive.But it also increased the influence of subjective evaluation on diagnose.In addition,the patients` mental state has a strong influence on their own objective symptoms.Thus,this research carried out the randomized controlled trials and cohort study at the same time,it combines qualitative and quantitative analysis method,in order to investigate the effect of patients' will on choosing treating method.Cupping therapy is traditional Chinese Non-drug therapy,it can expel wind and remove cold,expel dampness and relieve pain.Cupping therapy is effective in treating a variety of painful disease including FMS.Yet despite the cupping therapy currently used in many clinical studies of modern medicine to verify its effect on the treatment of pain,but researches only use cupping therapy to treat FMS are rarely reported.The FMS treatment guidelines published in 2004 by ACR said moderate evidence proved that acupuncture is effective.Some researches in china also proved that using acupuncture to treat FMS is effective.ObjectiveUsing cupping therapy and acupuncture to observe whether patients' will has impact on the curative effect of FMS.To observe the efficacy and safety of cupping therapy in reducing Fibromyalgia Syndrome patients' pain and in improving the quality of life.MethodThis study is comparat ive effect iveness research model,i t uses the qualitat ive survey of the will of patients as the main reference index,and is designed parallel-group randomized controlled trials and cohort study which is using cupping and acupuncture to treat FMS——a common disease in clinic.A total of 69 FMS patients were selected from Beijing University of Chinese Medicine Oriental Hospital' s acupuncture department and are categorized into 4 groups.The groups are random cupping group(group A),random acupuncture group(group B),willing cupping group(group C),willing acupuncture group(group D).All four groups are treated with 15 sessions of treatment,once a day and 3 times a week.Observe and analysis the results by the Widespread Pain Index(WPI),Symptom Severity(SS),Visual Analogue Scale(VAS),The Revised Fibromyalgia Impact Questionnaire(FIQR),Hamilton Depression Scale(HAMD),MOS 36-item short-form health survey(SF-36).Results69 patients were initially induced into this study,while subsequently 12 cases withdrew from the study,there are 12 patients in group A,12 patients in group B,24 patients in group C,21 patients in group D.The effective rate of four groups are respectively 50.00%,81.81%,47.37%and 72.22%,the chi-square test shows p=0.10>0.05,there was no statistically significant difference.Contrast the sore WPI,SS,VAS,FIQR and SF-36 between four groups,the comparison between 5 times,10 times and 15 times in the group was The difference between four groups was no statistically significant(P>0.05).As for HAMD score,difference between group A and B,B and D was statistically significant(P<0.05),while the difference between other groups was no statistically significant(P>0.05).Incorporate group A and group B data into the group E,group C and group D data into group F,contrast the score of WPI,SS,VAS,HAMD,SF-36 and FIQR between group E and F,the result shows the comparison between two groups P>0.05,there was no statistically significant difference between the groups.ConclusionIn treatment outcome analysis,the influence of patient's choice of intervention did not seen,there is no difference between the treatment effect of patients in willing groups and random groups.This results indicate that in the clinical trials of non-drug therapy,even if not carry out blind method on patients,the patients' selection of treatment also won't produce a great impact on the outcome.In addition,the choice of the patients before treatment will not affect their satisfaction with treatment outcomes.Cupping therapy is effective in treating the fibromyalgia syndrome,it can relieve patients' pain,treat physical symptoms such as fatigue,drowsiness,cognitive dysfunction and morning stiffness as well as psychological symptoms such as sleeping disorder,anxiety,depression and other mental symptoms.In conclusion,cupping improve patients quality of life.Its curative effect is basically the same with the treatment of acupuncture,but its advantage lies in the degree of pain which is light,low cost,easier to be accepted by patients.