Selection Of The Optimal Acupuncture Treatment Scheme For Scapulohumeral Periarthritis Based On Orthogonal Experimental Design

ObjectiveIn this study,the orthogonal experimental design scheme,for the acupuncture treatment of scapulohumeral periarthritis to provide optimal treatment scheme,for the treatment of scapulohumeral periarthritis to provide new ideas.MethodBased on the acupoint statistics of more than 170 related papers on"scapulohumeral periarthritis"on CNKI from January 2018 to February 2019,the search terms include"scapulohumeral periarthritis","frozen shoulder","Fifty shoulders","shoulder congealing wind"and"shoulder congealing syndrome".The basic database is obtained,and the acupoints with frequency above 25 are selected to optimize the scheme and realize the principle of fewer acupoints and fewer needles According to the statistics of acupoint selection data in the early stage of scapulohumeral periarthritis,the acupoints closely related to the treatment of scapulohumeral periarthritis were selected.According to the theory of"meridian tendon","meridian passing through and main treatment",the acupoint selection principles and clinical experience such as"upper disease and lower selection","local selection of acupoints","left disease right selection","giant needling and Miao needling"were summarized as Jian sanzhen（Jianzhen acupoint,Jianyu acupoint,Jianliao acupoint）,Houxi acupoint,Yanglingquan acupoint,Tiaokou To Chengshan,and Fenglong To Chengshan.Five groups of acupoints were selected as the factors to carry out the experiment.On the basis of deqi,the appropriate stimulation intensity was adjusted by selecting the operation of interaction and non interaction,moving needle once and not,affected side and healthy side.Select the same needle,needle depth,needle retention time,strictly control other factors to maintain consistency as far as possible.On the basis of gender,age,course of disease,medical history and other non statistical significance,default the consistency of other relatively uncontrollable influencing factors,import the above factors and level into the SPSSAU Web page,get L₁₀（5¹×2³）orthogonal test design table,complete the design scheme,according to the ten groups of patients with 3 cases in each group were included.30 cases were randomly divided into 10 groups according to the random number generated by SPSS 21.0 statistical analysis system.The patient takes the sitting position,instructs the patient to move the shoulder and look for the most painful part.After disinfection,the patient is punctured with 40mm disposable sterile acupuncture,and the resistance acupuncture is performed.The acupuncture is performed in one direction,and the muscle fiber is wound.After the patient has a feeling of stagnation,the needle is released quickly.If the patient still has pain here,the amount of stimulation is increased,and the resistance acupuncture is performed with two disposable sterile acupuncture needles.If the pain point of the patient is transferred,Resistance needling was performed at the new pain point until the patient could not find the pain point.All the patients were treated according to the acupuncture treatment plan of their group.According to the treatment plan,the appropriate needles were taken,the fingers were cut into the needles after 75%alcohol was sterilized,and then the flat tonic and flat diarrhea techniques were used after getting Qi,with the frequency of more than 100 times/minute.The patients in the interactive group were asked to move their shoulders slowly and substantially for about 1 minute;the patients with the stimulation amount of 1 time of acupuncture were given 1 time of acupuncture at 15-20 minutes Tonifying,smoothing and reducing technique,increasing stimulation.Keep the needle for 30 minutes,press the needle with cotton ball after the needle retention time,and clean up the waste.Once a day,five times as a course of treatment,a total of two courses of treatment,two days of rest between the two courses.Before and after the treatment,VAS,Constant score of shoulder joint and activity record of shoulder joint were used to evaluate the treatment results.The results of statistical data analysis processing,evaluation of the treatment effect,to get the best treatment plan.Result1 Compared with before treatment,the different combinations of the ten groups can reduce the visual analogue score（VAS）of patients with periarthritis of shoulder,improve the constant score of shoulder joint,and improve the shoulder joint activity of patients,the difference is statistically significant（P<0.05）.2 For VAS score,in the first treatment,the effect of stimulation is the greatest.The best treatment plan is:Houxi acupoint on the side of the patient,no interaction,once acupuncture;in the first treatment course,the effect of acupoint selection and stimulation is greater.The best treatment plan is:Tiaokou To Chenshan on the side of the patient,interaction,once acupuncture;in the second treatment course,the effect of acupoint selection is the greatest,and the best treatment plan is Tiaokou To Chenshan on the side of the healthy,interactive,needle transport once.3 For the Constant score,in the first treatment,the amount of stimulation has the greatest impact,and the best treatment plan is:Houxi acupoint on the healthy side,interactive,once acupuncture;in the first treatment course,acupoint selection and manipulation have a greater impact,and the best treatment plan is:Tiaokou To Chenshan on the side of the healthy,interactive,once acupuncture;in the second treatment course,acupoint selection has the greatest impact,and the best treatment plan is Tiaokou To Chenshan on the side of the healthy,interactive,needle transport once.Conclusion1 Through the analysis of the experimental results,for the treatment of scapulohumeral periarthritis,on the basis of Ashi point combined with resistance acupuncture,Houxi acupoint and Tiaokou To Chenshan have better adverse effects on pain and activity,and they have effects of interaction and non interaction,healthy side and affected side,and one-time delivery of acupuncture is better than non delivery of acupuncture.In the clinical bed,Houxi acupoint and Tiaokou To Chenshan on the healthy side or affected side can be alternately combined with interaction and non interaction It is possible to obtain certain curative effect and avoid acupoint fatigue in the process of acupuncture,which needs further clinical verification.2 Select the appropriate factors and levels through the orthogonal test,and select the optimized treatment scheme with a relatively simple,convenient and efficient experiment.However,it is only a way to look at the relationship between different acupoint compatibility and different manipulation,operation and efficacy from another perspective,which can not replace the clinical treatment means under the guidance of traditional Chinese medicine theory,just a point of view.