A Case Series Study On The Treatment Of Degenerative Lumbar Spinal Stenosis By Pricking Collaterals And Bloodletting Combined With Medicinal Bamboo Pot

Objective:To investigate the efficacy,safety and related prognostic factors of degenerative lumbar spinal stenosis(DLSS)treated with puncture and bloodletting combined with bamboo pot therapy through clinical case series studies..Methods:According to the screening criteria for inclusion and exclusion,26 patients who visited the massage clinic of Dongzhimen Hospital,Chinese Medicine of Beijing University from August 2018 to December 2019 were selected and treated with puncture bloodletting combined with drug bamboo cupping therapy.Treatment was performed twice a week for a total of 16 times and completed within 2 months.Clinical efficacy was assessed using the Swiss Spinal Stenosis Questionnaire(SSM),Oswestry(ODI)Disability Index,Quality of Life Evaluation Short Form(SF-12),and evaluation criteria such as patient severity and disease improvement before treatment,after the last treatment,and 1 month after the end of treatment.Mean,standard deviation,median,quartile,maximum and minimum values were used to describe the measurement data,and normal distribution test(Shapiro-Wilk test,etc.)was performed.Cases and composition comparison were used to describe the count data.In case series studies,each outcome indicator involves 3 measurement time points(baseline,2 months of treatment,and 1 month follow-up),so this study uses a single factor(time),multi-level(3 time points)repeated measurement ANOVA method Or non-parametric Friedman test.The statistical software SRSS20.0 was used for statistical analysis of the collected data.Results:A total of 35 patients were screened in this study,26 patients were included,there were no dropouts,and the data of 26 cases were finally analyzed.1 Baseline data analysis:age,gender,occupation,disease duration,BMI,severity and improvement of illness,SF-12 score,S SM score,ODI score and other data.2 Efficacy evaluation:(1)Primary efficacy evaluation-SSM score:symptom dimension score:the mean SSM symptom scores at baseline,2 months of treatment,and 1 month of follow-up were 2.87± 0.59 points,2.24 ± 0.49 points,and 2.21 ± 0.43 points respectively;unctional dimension score:the total SSM function scores at baseline,2 months of treatment,and 1 month of follow-up were 2.34± 0.69 points,1.81 ± 0.49 points,and 1.94± 0.53 points,respectively;satisfaction dimension score:the mean order of disease severity scores at baseline,2 months of treatment,and 1 month of follow-up were 2.85 points,1.65 points,and 1.50 points respectively.(2)Secondary efficacy evaluation-ODI score:the total ODI score at baseline,2 months of treatment,and 1 month of follow-up was 19.06 ± 8.54 points,13.29 ±6.68 points,and 14.02 ± 5.74 points respectively;(3)Secondary efficacy evaluation-SF-12 score:physical dimension score:SF at baseline,2 months of treatment,and 1 month of follow-up were 32.38± 8.55 points,35.38 ± 7.56 points,and 35.65 ± 7.47 points respectively,and psychological dimension score:SF at baseline,2 months of treatment,and 1 month of follow-up were 46.63 ± 9.49 points,47.64 ± 9.51 points,and 50.08 ± 9.28 points respectively;(4)Secondary efficacy evaluation-severity of illness:the mean rank of disease severity score at baseline,2 months of treatment,and 1 month of follow-up was 3.00 points,1.50 points,and 1.50 points respectively.5)Secondary efficacy evaluation-degree of disease improvement:After 2 months of treatment,the physician evaluated that the patient's perceived disease improvement evaluation increased by 3.00±0.75 points compared with the baseline;during 1 month of follow-up,the physician evaluated that the patient's perceived disease improvement evaluation increased by 3.27 ± 0.92 points compared with the baseline.3 safety evaluation:puncture bloodletting combined with drug bamboo cupping therapy in the treatment of DLSS is safe,no adverse reactions.Conclusion:1 After 2 months of treatment,DLSS reduced the patient's pain and improved dysfunction,and the efficacy remained after 1 month of follow-up.2 The therapies were safe without adverse events during treatment and follow-up.3 The prognostic factors of DLSS are mainly related to the severity of baseline symptoms,and the milder the symptoms,the better the efficacy.4 Efficacy and safety require large-sample,multicenter RCT studies.