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There are a large number of clinical reports that acupoint injection therapy is effective, but there are still some basic problems that have not been effectively resolved, such as the type, dosage, concentration and compatibility of acupoint injection drugs. This article analyzes and discusses the problems of acupoint injection therapy in five aspects: the effect of acupoint injection on local tissues, the study of mechanism, the best treatment plan and advantages, and the similarities and differences with local injection therapy.
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Acupuncture Points , Acupuncture Therapy , InjectionsABSTRACT
OBJECTIVE@#Based on the establishment of a rat model of trigger point, this study was to intervene with warm acupuncture, and to evaluate the effect on pathological morphology and pain-induced inflammation of the rat model by microscopic pathology and microdialysis.@*METHODS@#Sixty-four SD rats were randomly divided into group A (blank control), group B (model control) and group C (model and intervention control). Groups A and B were divided into 3 groups (A0, A1, A2 and B0, B1, B2), the group C was divided into 2 groups (C1 and C2). The MTrPs model was established in both groups B and C, warm acupuncture intervention were given to the C1 group for 7 days and the C2 group for 15 days. Rats were sacrificed in batches. MTrPs were locally sampled and stained with hematoxylin-eosin after the preparation. The pathological changes were observed under light microscopy. The iocal interleukin-1β and prostaglandin E2 were detected by microdialysis technique.@*RESULTS@#Microscopically, the muscle fibers of the model were arranged disorderly, broken, twisted, local fibrosis, contracture thickening and so on; macrophage and other inflammatory cell invasion in local area and a large area of adhesion occurred on the contracture nodule, the pathological state of local muscle fibers was significantly improved after warm needle intervention, local microvascular formation and maturation, local muscle fiber repair. After successful modeling, the amount of interleukin-1β and prostaglandin E2 in group B0 was significantly higher than that in group A0 before warm needle intervention (0.05). Group C1 and B1 were significantly higher than group A1 (<0.01); warm needle intervention for 15 days, the amount of interleukin-1β and prostaglandin E2 in group C2 were lower than those in group B2 (<0.05), but those in group C2 and B2 were significantly higher than group A2 (<0.01), and the amount of interleukin-1β and prostaglandin E2 in group C2 was lower than group C1 (<0.05).@*CONCLUSIONS@#The modeling method of exercise combined hitting used in this study was proved to be effective by histopathology; warm acupuncture can improve the pathological and inflammatory state of local muscle fiber in myofascial pain trigger of rat, promote local microvascular formation and maturation, and help the trigger point local muscle fiber repair.
Subject(s)
Animals , Rats , Acupuncture Therapy , Inflammation Mediators , Myofascial Pain Syndromes , Rats, Sprague-Dawley , Trigger PointsABSTRACT
BACKGROUND: Local soft tissue lysis has been widely used in clinical rehabilitation treatment of chronic soft tissue injuries, and has achieved certain clinical outcomes. However, it is an invasive treatment, and there is little information about the pathological changes and prognosis of the local tissues post-treatment. OBJECTIVE: To observe the repair process and pathologic changes of the muscles after local soft tissue lysis with several needles. METHOD:Songjin-needle,Yinzhi-needle,Changyuan-needle,Xiaozhen-needle,Ren-needle and Pi-needle were inserted into the belly of rat gastrocnemius gastrocnemius with a depth of 0.5-1.0 cm, twice or thrice. Then the rats were killed at 3, 7, 14, 21 and 30 days after acupuncture. The corresponding parts of tissues were removed and fixed with paraformaldehyde, and stained with hematoxylin and eosin and immunohistochemistry to observe the histomorphological features and pathological changes under light microscope. The CellSens-Entry 1.15 software was used for image acquisition, and the number of fibroblast cells and microvessel density were calculated. The integral absorbance values of collagen type Ⅰ were calculated by Image Pro plus 6 software. RESULTS AND CONCLUSION: On day 3 after intervention, muscle fiber dissolution, necrosis and inflammatory cell infiltration were visible. On day 7, there was a reduction in inflammatory cells, fibroblast activation and proliferation, and granulation tissue hyperplasia. On day 14, there was local accumulation of collagen with substantial granulation tissues. On day 21, collagen fibers decreased and granulation tissues organized. On day 30, there was local scar formation. Immunohistochemical staining results showed that there was collagen type Ⅰ in the surgical area after intervention. The microvessel density, fibroblast count and integral absorbance value increased firstly and then decreased, which showed significant differences among groups (P < 0.01). These findings imply that the new types of needles for local soft tissue lysis do certain damage to the gastrocnemius muscle, and the inflammatory changes of the local tissue and granulation tissue organized will result in local scar formation after loosening therapies.
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<p><b>OBJECTIVE</b>To explore the hemodynamic changes in cynomolgus monkeys with mild carotid atherosclerotic (CAS) plaques after therapy with pushing manipulation on Qiaogong acupoint (MPQ).</p><p><b>METHODS</b>Nine cynomolgus monkeys were equally randomized into MPQ group, mild CAS model group and blank control group. Mild CAS models were established in the monkeys in MPQ and model groups, and the monkeys in MPQ group received treatment with MPQ intervention after the modeling. The conditions of the carotid artery and the hemodynamic changes in the 3 groups were evaluated after the treatment.</p><p><b>RESULTS</b>Formation of CAS plaques was detected in monkeys in both MPQ and model groups. The vascular cross?sectional area, plaque cross?sectional area and stenosis rate of the plaques in the two groups all differed significantly from those in the blank control group (P<0.05), but these parameters were similar between MPQ group and the model group (P>0.05). Compared with those in the blank control group, the hemodynamic parameters showed significant changes in MPQ and the model groups (P<0.05) but remained similar between the latter two groups (P>0.05).</p><p><b>CONCLUSION</b>CAS plaques can cause changes in hemodynamic parameters. Short?term therapy with MPQ does not affect the stability of the plaques or cause adverse effects on hemodynamics in cynomolgus monkeys with mild CAS plaques.</p>
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<p><b>OBJECTIVE</b>To study the effect of electroacupuncture on proprioception in cynomolgus monkeys after unilateral anterior cruciate ligament (ACL) injury.</p><p><b>METHODS</b>Twenty-seven cynomolgus monkeys were randomized equally into 3 groups, namely unilateral ACL injury with electroacupuncture group, unilateral ACL injury model group and blank control group. One week after modeling, the monkeys in electroacupuncture group were treated daily for 12 weeks with electroacupuncture at the acupoints Wei Yang, Yin Gu, Xi Yangguan and Qu Quan. At 4, 8, and 12 weeks during the treatment, the changes in the somatosensory evoked potentials (SEPs) and motor nerve conduction velocity (MCV) of the nerves of the ACL were examined with neural electrophysiological method; the changes in the morphology and the total and variable number of the proprioceptors in the ACL were observed with gold chloride staining. RESULTS; In the mokeys in the model group, the incubation period of the SEPs and MCV on the injured side of the knee were significantly extended and the amplitudes were decreased with the passage of time (P<0.05). Intervention with electroacupuncture significantly reduced the incubation period and increased the amplitudes of the SEPs and MCV (P<0.05). The total number of the proprioceptors in the ACL was significantly decreased and the variable number of the proprioceptors in ACL was increased with time in the monkeys in the model group (P<0.05); electroacupuncture intervention obviously slowed the reduction rate of total number of the proprioceptors (P<0.05) but without affecting the variable number of the proprioceptors (P>0.05). CoONCLUSION: ACL injury causes attenuation of the proprioception on the injury side, and electroacupuncture intervention can produce a positive effect on the proprioception in cynomolgus monkeys.</p>
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<p><b>OBJECTIVE</b>To study the contribution of medial or lateral stabilizer to the stability of the patella, to explore the function and effect of releasing the LPR clinically and to provide a biomechanical basis for the clinical treatment of patellar instability(PI).</p><p><b>METHODS</b>The quadriceps femoris of 6 fresh human cadaver knees were loaded to simulate a normal condition of muscle strength. First the loading force was measured and recorded, which subluxated the patella with the different degrees of knee flexion. Intervention 1:released the medial patellar retinaculum(MPR) to simulate pathologic conditions, then repeated the above manipulates and recorded the loading force. Intervention 2:released the LPR furthermore to simulate clinical surgical treatment, then repeated the above manipulates and recorded the loading force.</p><p><b>RESULTS</b>After releasing the MPR, the loading force which subluxated the patella were decreased obviously, and there were significant differences between the two groups(<0.05). The above loading force was further decreased after the further release of LPR, but the difference was not significant(>0.05).</p><p><b>CONCLUSIONS</b>MPR plays an important role in maintaining the stability of the patella and in the normal trajectory of the patellofemoral joint. The attention should be paid to the repair or reconstruction of the MPR in the treatment for patella recurrent lateral dislocation subluxation. Releasing the LPR is not a best choice.</p>
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Objective To explore the effect of cervical rotatory manipulation on tensile mechanical properties of carotid artery with atherosclerotic plaque. Methods Thirty healthy male New Zealand rabbits were selected and randomly divided into experimental group, model control group and blank control group. Carotid atherosclerosis model were made in the experimental group and model control group. The experimental group received the intervention of cervical rotatory manipulation, but the model control group did not. The blank control group did not receive any intervention. After 3 groups received different interventions, the differences in tensile mechanical properties of rabbit carotid artery in three groups were observed. Results The ultimate strain, ultimate load and physiological elastic modulus of rabbit carotid arteries in 3 groups were statistically significant (P<0.05); The ultimate strain in the experimental group was 24.87% and 52.09% smaller than that in the model control group and blank control group, respectively; The ultimate load in the experimental group was 2.21 and 3.47 times of the model control group and blank control group, respectively; The physiological elastic modulus in the experimental group was 1.60 and 1.89 times of the model control group and blank control group, respectively. Conclusions Compared with normal carotid artery, the presence of carotid atherosclerotic plaque will reduce tensile mechanical properties of the carotid artery, and cervical rotatory manipulation will further reduce tensile mechanical properties of the carotid artery with carotid atherosclerotic plaque. Therefore, for patients with carotid atherosclerotic plaque, it is better to avoid cervical manipulation.
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Objective To explore the effect of cervical rotatory manipulation on tensile mechanical properties of carotid artery with atherosclerotic plaque.Methods Thirty healthy male New Zealand rabbits were selected and randomly divided into experimental group,model control group and blank control group.Carotid atherosclerosis models were made in the experimental group and model control group.The experimental group received the intervention of cervical rotatory manipulation,but the model control group did not.The blank control group did not receive any intervention.After 3 groups received different interventions,their differences in tensile mechanical properties of rabbit carotid artery were observed.Results The ultimate strain,ultimate load and physiological elastic modulus of rabbit carotid arteries in 3 groups were statistically significant (P ＜0.05);The ultimate strain in the experimental group was 24.87％ and 52.09％ lower than that in the model control group and blank control group,respectively;the ultimate load in the experimental group was 2.21 and 3.47 times of the model control group and blank control group,respectively;the physiological elastic modulus in the experimental group was 1.60 and 1.89 times of the model control group and blank control group,respectively.Conclusions Compared with normal carotid artery,the presence of carotid atherosclerotic plaque will reduce tensile mechanical properties of the carotid artery,and cervical rotatory manipulation will further reduce tensile mechanical properties of the carotid artery with carotid atherosclerotic plaque.Therefore,for patients with carotid atherosclerotic plaque,it is better to avoid cervical manipulation.
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Objective To explore the effect of cervical rotatory manipulation on tensile mechanical properties of carotid artery with atherosclerotic plaque.Methods Thirty healthy male New Zealand rabbits were selected and randomly divided into experimental group,model control group and blank control group.Carotid atherosclerosis models were made in the experimental group and model control group.The experimental group received the intervention of cervical rotatory manipulation,but the model control group did not.The blank control group did not receive any intervention.After 3 groups received different interventions,their differences in tensile mechanical properties of rabbit carotid artery were observed.Results The ultimate strain,ultimate load and physiological elastic modulus of rabbit carotid arteries in 3 groups were statistically significant (P ＜0.05);The ultimate strain in the experimental group was 24.87％ and 52.09％ lower than that in the model control group and blank control group,respectively;the ultimate load in the experimental group was 2.21 and 3.47 times of the model control group and blank control group,respectively;the physiological elastic modulus in the experimental group was 1.60 and 1.89 times of the model control group and blank control group,respectively.Conclusions Compared with normal carotid artery,the presence of carotid atherosclerotic plaque will reduce tensile mechanical properties of the carotid artery,and cervical rotatory manipulation will further reduce tensile mechanical properties of the carotid artery with carotid atherosclerotic plaque.Therefore,for patients with carotid atherosclerotic plaque,it is better to avoid cervical manipulation.
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Objective To investigate the influence from compressing manipulation by flexing hip and knee in supine position on stress distributions in the pelvis and strain distributions in the sacroiliac joints by 3D finite element method, and discuss the possibility of moving the whole sacroiliac joints under such manipulation. Methods A 3D finite element model of the normal pelvis was constructed based on CT images. According to the manipulation principle, the compressing force in flexing hip and knee was decomposed in two directions, and loaded on the 3D finite element model to calculate stress of the pelvis and strain of the sacroiliac joints. Results Under the loading of simulative manipulation, stress of the pelvis was mainly located at 1/3 part of the anterior inferior of the sacroiliac joints, the greater sciatic notch, and the middle 1/3 part of the inferior and anterior of gluteal lines. The maximum strain of the sacroiliac joints was mainly located in the posterior superior, posterior inferior and central 1/2 part of the sacroiliac joints. Conclusions The compressing manipulation by flexing hip and knee can only move 1/3 part of the interior of the sacroiliac joints, rather than the whole of the sacroiliac joints.
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Objective To observe the effect of cervical rotatory manipulation on tensile mechanical properties of atherosclerotic carotid artery in rabbits, so as to provide safety references for such manipulation. Methods Twenty male New Zealand rabbits were randomly divided into control group (n=10) and experimental group (n=10), then all fed with high-cholesterol diet for 12 weeks. The rabbits in experimental group were then applied with cervical rotatory manipulation (rotating on each side once a day during a total of 4 weeks), while no manipulation for rabbits in control group. The bilateral carotid arteries were obtained after all the rabbits were executed, and measured for the maximum load, the maximum displacement, the average load, the elastic modulus, elongation at break and stress-strain by the material testing machine. Results The maximum tension, the maximum displacement, the average tension, the elastic modulus and elongation at break in experimental group were (1.36±0.35) N, (6.84±2.08) mm, (0.44±0.30) N, (4.30±2.66) MPa and (83.08±51.32)%, respectively, while the corresponding data in control group were (2.92±0.65) N, (9.23±2.62) mm, (1.17±0.63) N, (3.71±0.60) MPa and (154.19±34.32)%. The maximum load, the average load and elongation at break in experimental group were obviously smaller than those in control group (P0.05). Conclusions The tensile mechanical properties of atherosclerotic carotid artery after cervical rotatory manipulation were declined; thus, intensity and magnitude of cervical rotatory manipulation should be proper so as to avoid harm to carotid artery.
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<p><b>OBJECTIVE</b>To investigate the relationship between the risk of osteoporotic fracture in old people and the spinal morphology.</p><p><b>METHODS</b>From June 2010 to January 2011, 107 old people's BMD of femoral neck were measured by Dual energy X-ray. A questionnaire survey on fracture risk factors of the 107 aged and data collection were adopted. Among the aged,41 were male and 66 were female,ranging in age from 48 to 82 years old,with an averaged of (67 +/- 6) years old. The fracture risk assessment tools (FRAX) recommended by WHO were adopted. A risk assessment on osteoporotic fracture in old people was done,followed with the calculation of the probability of the hip fracture and the main bone fractures (spine,hip,forearm or shoulder fractures) in ten years. The angles of spine vertebra, spine curvature in the upright positions of the old people were measured by using Spinalmouse. The correlation analysis along with curve fitting analysis between the probability of fracture risk and included angles of spine vertebra, spine curvature were done.</p><p><b>RESULTS</b>The probability of osteoporotic fracture had a positive relation with thoracic vertebra T7 and T8, thoracic spine curvature,lumbar curvature and incline angle in upright position (P < 0.05).</p><p><b>CONCLUSION</b>The old people's morphological characteristics of spine have the ability to reflect the risk level o osteoporotic fracture.</p>
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Osteoporotic Fractures , Risk , Spinal Curvatures , Spinal FracturesABSTRACT
Objective To study the frequency and effective work/time ratio of pushing manipulation with one finger (PMOF). Methods One skilled expert and nine beginners of PMOF were chosen. The frequency, effective work time/ratio during different work periods were recorded and compared after the technique information of each subject operating PMOF was collected by Novel Pliance Mobile System software. Results The operation frequency of each subject was all below 110/min, while the frequency of skilled expert was about 78/min. The time ratio between secondary work period and primary work period for the skilled expert was smaller than that of beginners. Conclusions The operation frequency of PMOF is preferably at 78/min, and the preferred time ratio between secondary work period and primary work period should be slightly larger than 0.28.
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The science of Tuina(Chinese therapeutic massage) with its long history plays an important role in traditional Chinese medicine. Due to its simple operating skill and unique curative effect, Tuina manipulation has a good reputation for treating traumatological diseases and pain syndromes. Although spinal manipulation is widely used in clinic, its basic research is still weak. In this paper, the relationship between manipulative forces and movements, cracking sounds, real-time measurement on intra-stress of lumbar disc during spinal manipulation, as well as deformation and displacement of lumbar canal and changes of vertebral structures in Cartesian coordinate system were discussed, so to provide a more solid experimental reference and theoretical basis for scientific explanation about mechanism of spinal manipulation.
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<p><b>OBJECTIVE</b>To investigate the three-dimensional anatomical position of the rotatory center in cervical rotatory and local manipulation.</p><p><b>METHODS</b>A three-dimensional model was constructed based on CT data from cadaveric specimens of axial spinous process deviation. Cervical rotation was simulated on this model, and the graphic outcome was analyzed.</p><p><b>RESULTS</b>The rotatory center of this model was at the dens axis, not at the apex of the axial spionus process, and the angle of rotation exceeded observable angle.</p><p><b>CONCLUSION</b>The new concept of anisotropic rotation of the cervical vertebrae should be established and its principles must be comprehended in clinical practice of cervical rotatory manipulation.</p>
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Adult , Humans , Male , Cadaver , Cervical Vertebrae , Diagnostic Imaging , Imaging, Three-Dimensional , Methods , Manipulation, Spinal , Methods , Range of Motion, Articular , Rotation , Tomography, X-Ray ComputedABSTRACT
<p><b>OBJECTIVE</b>To localize the facet joints that give rise to the cracking sounds caused by cervical rotatory and local manipulation.</p><p><b>METHODS</b>Cervical rotatory and local manipulation was performed in 30 healthy adults at the spinous process at the C(4 )level once on each of the left and right side, and a set of equipment we designed for acoustic signal acquisition was applied to collect and locate the cracking sounds, followed by statistical analysis of the data collected.</p><p><b>RESULTS</b>The cracking sounds caused by cervical rotatory and local manipulation were localized mainly at C(3-7) facet joints, and the times of cracking sounds at these facet joints had significant differences from those at the other facet joints.</p><p><b>CONCLUSION</b>The location of cervical rotatory and local manipulation can be only relative, and definite localization seems impossible.</p>