Distribution Of Abdominal Positive Reactants In Patients With Chronic Low Back Pain

OBJECTIVE:Patients with chronic low back pain can often find positive reactions in the abdomen,such as tenderness and cords.This study is to investigate the presence and distribution of abdominal positive reaction products in patients with chronic low back pain and whether there is contact with the location of low back pain,and what kind of connection,so as to provide a clinical basis for abdomen acupuncture treatment for low back pain,enrich diagnosis and treatment methods,and optimize treatment programs.METHODS:We collected data on patients with chronic low back pain and included patients with low back pain as the main symptom due to lower lumbar bone joints,intervertebral discs,or soft tissue lesions.Common diseases were lumbar disc herniation and lumbar muscle strain,and finally 112 patients were included in the standard.The examination range of the waist was from the 12 th thoracic spine to the level of the sacral hiatal hole,and the abdominal examination range was from the xiphoid below to the upper edge of the pubic symphysis.Patients were asked with examinations about low back pain,abdominal positive reactions such as tenderness,cords,etc.Basic patient information,VAS scores,low back pain lesions,and abdominal positivity were recorded.Use Excel,SPSS20.0 and other software for data recording,processing and analysis.The position of the positive reaction points was recorded in vertical two-dimensional coordinates,and a heat map was made with cavas to show the intuitive distribution of pain points.RESULTS:1.According to statistics,among 112 patients with chronic low back pain,8 patients were not found any pressure points in the abdomen.The remaining 104 patients were found to have tender points in the abdomen.In descending order,the abdominal tender acupoints with highest positive rates were Huangshu,Zhongzhu,Wailing,Tianshu,Daju,Siman,Shuifen,and Siman.In general,acupoints close to Shenque have the highest positive rate,mainly concentrated on the Kidney and Stomach meridians,and firstly are acupoints on the level of the umbilicus,1 cun and 2 cuns below the umbilicus,secondly the one on the Renmai which is 1 cun higher than the umbilicus,named Shuifen,and then the one 1 cun higher than the umbilicus on the Stomach meridian named Huaroumen.2.Among 104 patients with chronic low back pain who had abdominal tenderness,40 also had cords in the abdomen,including 28 women and 12 men.The cords were distributed in different meridians:29 in the Kidney meridian,28 in the Stomach meridian,6 in the Renmai,and 4 in the Spleen meridian.Their average VAS score was 6.3,while the totle 112 patients' average VAS score was 6.14.3.Among 104 patients with chronic low back pain who had abdominal tenderness,76 patients had unilateral low back pain,7 had intermediate low back pain,and 21 had bilateral low back pain.Of the 76 patients with unilateral low back pain,42 patients' abdominal tenderness were on the same side of low back pain,accounting for 55.26%,11 were on the contralateral side,accounting for 14,47%,22 had bilateral abdominal tenderness,accounting for 28.95%,and 1 person had tenderness on Renmai.Among the 7 patients with intermediate low back pain,1 had abdominal tenderness on Renmai.In 21 patients with bilateral low back pain,there were 12 persons with bilateral abdominal tenderness,accounting for 57.14%.In summary,there were 55 patients with abdominal tenderness consistent with the location of low back pain,accounting for 52.88%,and the ratio was much higher than other types.CONCLUSION:1.Most patients with chronic low back pain have a positive reaction in the abdomen.The main symptoms are tenderness,which can be accompanied by cords.Patients with more severe low back pain are more likely to have positive reactions in the abdomen.2.The abdominal tender points in patients with chronic low back pain are most distributed in the umbilical circumference,and Renmai,Kidney;Stomach,Spleen,and Biliary meridians are all distributed.Among abdominal acupoints with tenderness,the positive rates of umbilical level,I cun and 2 cuns below on the Kidney and Stomach meridian were the highest.3.There is a consistent trend between chronic low back pain patients' abdominal tenderness and low back pain location,that is,unilateral low back pain appears ipsilateral abdominal tenderness,bilateral low back pain appears bilateral abdominal tenderness.