| ObjectiveTo observe the difference of therapeutic effect between lumbar fixed point obsequence-pulling and floating needling in the treatment of lumbar disc herniation.Methods1.Source of casesAccording to the objective outpatient quantity of acupuncture and massage department in the second traditional Chinese hospital of guangdong province,and combined with the opinions of tutors and experts,a total of 60 patients were included in this study.The ratio of the two groups was 1:1,so the sample content of each group was 30 cases.2.OperationLumbar fixed-point inclined pull method:first to carry on the simple lumbar di ministry and coxal muscle relaxation,adopt rolling method and by rubbing method for relaxation technique,from top to bottom to relax 2-3 times,lumbar vertebral body touch,combined with nerve localization diagnosis knowledge,according to the patient’ s symptoms combined with imaging support(provides),first determine the specific lesion segment,lumbar fixed-point inclined pull method of treatment,the relaxation method was performed twice after the treatment.Patients with floating needle therapy:set the position,the healer first clear with muscle,then determine the needle point,clear mark,after local treatment and healer fingers routine disinfection,patients with right hand into a floating needle placed Yu Jinzhen point and direction toward the muscle",the needles are inserted into the needle after a successful withdrawal needles,line fan sweeping movements,sweeping away time about 2 minutes,100 times/min.At the same time,the patients were combined with reperfusion activity and performed 3 reperfusion activities for 10 seconds each time.After the operation,the floating device was removed,and the needle mouth was pressed with sterile cotton swab,followed by wound paste,to complete the treatment.3.The courseCourse of treatment is 4 weeks,1 week 2 times,interval is more than 2 days.A total of 8 times of treatment were completed,and the effective cases were defined as the treatment time was over.4.Evaluation timingIntra-group and inter-group comparisons were conducted before treatment,2 weeks after treatment,and 4 weeks after treatment.5.Efficacy observation indexJOA score scale and VAS score were used as the main outcome indicators,the effective rate was calculated,and adverse reactions were recorded.6.Statistical analysis1)according to data types,the data were divided into measurement data and counting data,and the statistical results were listed as mean standard deviation(x±s)and composition ratio or rate(%),respectively.2)in this study,independent sample t test or rank sum test were used to describe the baseline comparison of measurement data,and chi-square test or Fisher test were used to describe the baseline comparison of count data;As for the inter-group comparison of rank data,rank sum test was used in this study.The comparison of measurement data at multiple time points was statistically analyzed by repeated measurement anova,and the panywise comparison among groups at each time point was statistically analyzed by multivariate anova.Results1.Baseline comparison between the two groups of patientsA total of 60 cases were included in this study,including 30 cases in each oblique-pulling group and floating needling group with a ratio of 1:1.Shedding of 0 cases;Treatment group male and female ratio of brake,the treatment group is same,gender,there was no statistically significant difference(P=0.559),age,oblique pull with floating needle group average age was(42.067±9.850,41.800±9.155),there is no statistically significant difference between groups(P=0.914).In terms of course of disease,the average course of disease of the two groups was(8.267±3.676,8.600±3.212)months,and the difference between the two groups was not statistically significant(P=0.71).On JOA scale,reset and floating needle group average(15.433±3.224,15.367±2.632),the difference between the two groups had no statistical difference(P=0.930),on the VAS scale,reset and floating needle group average(6.667±1.446,6.633±1.326)difference between the two groups had no statistical difference(P=0.926),the above baseline differences between the two way without statistical significance,comparable.2.JOA scale1)after 2 weeks of treatment,JOA scores of the patients in the two groups showed an upward trend compared with that before treatment,and after 4 weeks of treatment,JOA scores also showed an upward trend.2)repeated measurement anova:it met the test conditions of ball test(P=0.703),indicating that there was a statistical difference in time factor between the two groups(F=215.70,P<0.01).There were statistically significant differences in grouping factors(F=4.28,P=0.043),and there were interaction effects between time and grouping factors(F=3.86,P=0.02).3)comparison between groups at each time point.After 2 weeks of treatment,there was no statistically significant difference between groups,P=0.712;After 4 weeks of treatment,the difference between groups was statistically significant(P<0.01).4)intra-group comparison:oblique-pulling group and fu-needling group were compared after 2 weeks of treatment and before treatment,and the comparison after 4 weeks of treatment and before treatment was statistically significant(P<0.01).3.VAS score1)after treatment,VAS scores of patients in the two groups showed a downward trend after 2 weeks of treatment compared with that before treatment,and the scores decreased again after 4 weeks of treatment.2)repeated measurement anova was used,and the results indicated that the sphericity test did not meet the requirements(P=0.005),so it was selectedFor the Greenhouse-Geisser model,there was a’statistical difference in time factor between the two groups(F=156.021,P<0.01).There were statistically significant differences in grouping factors(F=4.407,P=0.040),and there were interaction effects between time and grouping factors(F=6.034,P=0.005)·3)comparison between groups at each time point.After 2 weeks of treatment,there was no statistically significant difference between groups(P=0.842).After 4 weeks of treatment,the difference between groups was statistically significant(P<0.01).Intra-group comparison:oblique-pulling group and fu-needling group were compared after 2 weeks of treatment and before treatment,and the comparison after 4 weeks of treatment and before treatment was statistically significant(P<0.01).4.EfficientAfter 4 weeks of treatment,the total effective rate was 96.66%in oblique-pulling group and 93.33%in floating needling group.According to the rank sum test,Z=-2.156 P=0.031,P<0.05,and the difference was statistically significant.5.SecurityA total of 2 adverse events(mild)occurred in the study,which were caused by tension and hypoglycemia.Can be relieved after.Conclusion1.Lumbar fixed obsequence-pulling method and floating needling therapy for lumbar intervertebral disc herniation were effective,but lumbar fixed obsequence-pulling method had better efficacy.2.In terms of the improvement of JOA and VAS score,lumbar fixed-point obsequence-pulling method is better than floating needling therapy. |
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