Clinical Efficacy Evaluation Of JinGu Needle In The Treatment Of Lumbar Disc Herniation:a Randomized Controlled Study

Objective:1.Evaluate the efficacy and safety of minimally invasive acupuncture in the treatment of Lumbar disc herniation through Meta-analyses,providing evidence-based medical evidence for clinical treatment.2.To observe the curative effect and safety of the Jin Gu needle for the treatment of lumbar disc herniation,and provide a safer and more effective treatment plan.Methods:1.Randomized controlled trials on minimally invasive acupuncture in the treatment of lumbar disc herniation were retrieved by computer from CNKI,CBM,WF,VIP,Pub Med,EMBASE and Cochrane Library from database construction to October 2019.After literature screening,data extraction and literature quality evaluation,Revman5.3 software provided by the Cochrane collaboration was used for data analysis.The main efficacy evaluation indexes were total effective rate,the secondary efficacy evaluation indexes were visual analogue scale(VAS),JOA low back pain scale and adverse reactions.2.Random number table was used to randomly divide 84 LDH patients into the Jin Gu needle group(42 cases)and the filiform needle group(42 cases).In the end,42 patients of the Jin Gu needle group completed the study and 41 cases of the filiform needle group.The Jin Gu needle group was treated once a week for 4 weeks.The filiform needle group was treated once a day and 5 times a week for 4 weeks.Lumbar flexural range(LFR),Mc Gill Pain Questionnaire(MPQ)and Japanese Orthopaedic Association Score(JOA)were used to evaluate the improvement of low back and legs pain symptoms,signs and lumbar function at the time of before treatment,2 weeks and 4 weeks after treatment and 2 month after the end of treatment.Results:1.A total of 12 literatures were included.Meta analysis results show that the minimally invasive needling group in improving total effective rate,JOA score and VAS score are better than the control group.2.In the Jin Gu needle group,10 patients were cured,16 showed apparent effect and 14 improved,with total effective rate of 95.24%;In the filiform needle group,4 patients were cured,7 showed apparent effect and 24 improved,with total effective rate of 85.37%.Therewas statistically significant difference(P<0.05).The curative effect of the Jin Gu needle group was better than that of the filiform needle group.3.2 weeks after treatment,4 weeks after treatment,and 2 months after the end of treatment,the MPQ total score and various scores,LFR,JOA total scores of the two groups were improved compared with before treatment(P<0.01).Comparison between the two groups,except 2 weeks after treatment,the VAS score,LFR,and JOA total score were not significantly improved comparing with before(P>0.05),and at other time points the scores of the Jin Gu needle group were better than those of the filiform needle group(P<0.05).4.The safety evaluation of the treatment of LDH by the Jin Gu needle and the filiform needle is grade 1-2,which is safe and reliable.Conclusion:1.Minimally invasive needling in traditional Chinese medicine is effective and safe in the treatment of LDH.But because of low quality included literatures,relatively small samples and insufficient evidence,more high-quality RCTs are needed to confirm.2.Jin Gu needle therapy has a definite curative effect in treating LDH.It can quickly relieve the symptoms of low back and legs pain,improve lumbar function and improve the quality of life of patients.The overall curative effect is better than the filiform needle,is safe and effective treatment of LDH.