| Objects:To Looking for the 5 points with the largest changes in the pressure pain threshold and evaluate the clinical efficacy.Methods:Using a prospective,randomized controlled clinical research method,111 patients with CNP who met the inclusion criteria were randomly divided into 56 patients in Group A(the pain group)and 55 patients in Group C(the false point group)through the central random system.The subjects were all from the Department of Acupuncture and Orthopedics of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine(April 2018 to November 2019).Combined with the patient's self-reported pain site,the 5 detection areas and 4 remote acupoints of the patient's neck,shoulder and back were subjected to an orderly acupressure palpation and WANGER tenderness meter measurement.The 5 sensitized points(points)with the most significant changes in the tenderness threshold were selected as acupuncture points;the 5 acupuncture points(non-sensitized points)fixed by acupuncture in the sham point group were used as controls.Subjects in each group were treated with acupuncture 3 times a week for the first 2 weeks and twice a week for the next 2 weeks,a total of 10 times for 30 minutes each time.The neck pain discomfort visual analogue score(VAS)from baseline period to 4 weeks after the end of treatment was used as the main efficacy index,and the Northwick Park neck pain scale(NPQ)and anxiety self-rating scale score(Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),days and duration of onset of neck pain,and Pressure Pain Threshold(PPT)are secondary efficacy evaluation indicators.The scale scores were evaluated at 0-4 weeks(baseline period),4-8 weeks(treatment period),8-12 weeks(follow-up period),and the tenderness threshold(PPT)was at 0-4 weeks,4-6 weeks.Evaluate once every 6-8 weeks to analyze the efficacy and safety of treating pain patients with CNP.In addition,observe the distribution of acupuncture sensitization points(points),and provide a reference for clinical "acupuncture point selection".Use the Full Analysis Set(FAS)to perform statistical analysis on all evaluation indicators.Results:A total of 111 subjects were included in this study,11 cases were dropped,and 2 cases were excluded.Use the Full Analysis Set(FAS)for statistical analysis.1.The two groups of subjects had the same baseline and were comparable(p> 0.05).2.Distribution of acupuncture sensitization points(points): the first 5 meridian points with the highest frequency of acupuncture before treatment are Tianjiao,Jianwaishu,Jugu,Dazhu,Jianzhongshu.After 2 weeks of treatment,acupuncture The top 5 meridian points with the highest frequency are Tianjiao,Dazhu,Jianwaishu,Dazhui,Jianzhongshu.3.The results of the VAS scale showed that the pain-prone group and the sham point group had significantly lower VAS scores at 4-8 weeks and 8-12 weeks after acupuncture treatment compared with 0-4 weeks before treatment(P <0.01);VAS scores and difference between VAS scores at 4-8 weeks and 8-12 weeks after treatment in the group with pain as compared with the VAS scores and VAS scores at the corresponding time points in the false point group are significantly different(P <0.05).4.The results of the NPQ scale show that the NPQ scores of the group with pain as the acupuncture group and the sham point group were improved 4-8 weeks and 8-12 weeks after acupuncture treatment compared with 0-4 weeks before treatment,but the pain was The improvement of the NPQ score of the acupoint group(p <0.01)was more significant than that of the fake point group(p <0.05);the difference in the NPQ score of the pain-based group at 4-8 weeks and 8-12 weeks after treatment was corresponding to the false point group There were significant differences in the NPQ score difference between groups at the time point(P <0.05).5.The results of SDS scale showed that: the pain as a group of SDS scores at two time points after acupuncture treatment were significantly different from those before treatment(p <0.05);the SDS scores of the false point group were 2 after treatment The time point was not statistically significant compared with before treatment(p> 0.05);comparison between groups found that there was no statistical difference in the SDS score and SDS difference between the two groups of patients at 4-8 weeks and 8-12 weeks of treatment Significance(P> 0.05).6.The results of the SAS scale showed that the SDS score of the group taking pain as the pain had a significant difference at two time points after acupuncture treatment compared with before treatment(p <0.05);the SDS score of the false point group was 2 after treatment The time point was not statistically significant compared with before treatment(p> 0.05);the difference between the SAS scores of the two evaluation time points of the group taking pain as the treatment after treatment and the corresponding time point of the sham point group were significantly different(P < 0.05).7.The average number of days of neck pain episodes per week in the past 4 weeks showed that the number of days of neck pain episodes at 4-8 weeks and 8-12 weeks after acupuncture treatment in the group with pain as compared with the false point group was 0-4 weeks before treatment All of them were significantly reduced(P <0.01);the difference between the average number of days of neck pain episodes in the past 4 weeks and the average number of days of neck pain episodes in the past 4 weeks after treatment at the 2 evaluation time points in the group with pain There were significant differences between the groups at the corresponding time points(P <0.05).8.The results of the average daily duration of neck pain in the past 4 weeks showed that the time of onset of neck pain in the group treated with pain was significantly different from that before treatment(p <0.05)at two time points after acupuncture treatment;false points The length of neck pain onset in the group was statistically different from 8-12 weeks after treatment compared with before treatment(p <0.05);the scores of the length of neck pain onset and the length of neck pain onset in the two groups at 4-8 weeks and 8-12 weeks of treatment The difference between the difference and the group before treatment was not statistically significant(P> 0.05).9.PPT results showed that after treatment,there was no significant change in PPT between 4-6 weeks and 6-8 weeks compared with 0-4 weeks(p> 0.05);the group with pain as the focus was 4-6 weeks and 6 There was no significant difference between PPT group at 6-8 weeks and PPT group at the same time point(p> 0.05).Conclusions:1.Acupoint selection with "pain as acupuncture" has a definite therapeutic effect on CNP,and the therapeutic effect has a continuous effect.In addition,the effect of "pain as acupuncture" acupuncture treatment of CNP is significantly better than that of false point acupuncture,especially in reducing neck pain,improving quality of life,and regulating emotional state.It suggests that the acupuncture cannot be explained by placebo Therapeutic effect.2.According to "Taking pain as acupuncture point",the five points with the highest acupuncture frequency are Tianliu,Dazhu,Jianwaishu,Jianzhongshu and giant bone,which are mainly distributed in the neck area,suggesting that CNP patients can be based on priority The principle of local acupoint selection is acupoint treatment.3.Acupuncture is safe for CNP patients,and no serious life-threatening side effects have occurred in this study. |
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