Preliminary observation on the clinical application of rehabilitation support for lumbar disc herniation based on 3D printing technology / 中国骨伤

OBJECTIVE@#To analyze the important effect of 3D printing personalized lumbar support on lumbar pain and lumbar function in patients with lumbar disc herniation.@*METHODS@#From October 2018 to May 2021, 60 patients initially diagnosed with lumbar disc herniation were selected and divided into an observation group and a control group, with 30 patients in each group. Among them, there were 18 males and 12 females in the observation group;the age ranged from 24 to 56 years old, with an average of (45.23±6.07) years old. The course of disease ranged from 1 to 24 months, with an average of(6.25±0.82) months, and rehabilitation treatment was carried out by wearing 3D printed personalized lumbar support. There were 19 males and 11 females in the control group;the age ranged from 25 to 57 years old, with an average of (42.78±7.58) years old. The course of disease ranged from 1 to 24 months, with an average of (6.72±1.36) months, and rehabilitation treatment is carried out by wearing traditional lumbar protective equipment. The Japanese Orthopaedic Association (JOA) scores, lumbar Oswestry dysfunction index (ODI) and visual analogue scale (VAS) were evaluated and compared between the two groups before and 1 course after treatment (3 weeks).@*RESULTS@#There was no statistically significant difference in JOA, ODI, and VAS between two groups before treatment (P>0.05). After one course of treatment (3 weeks), JOA scores of both groups was increased compared to before treatment (P<0.05), while ODI and VAS decreased compared to before treatment (P<0.05). After treatment, JOA score of observation group was higher than that of control group (P<0.05), while ODI and VAS scores were lower than those of control group. No adverse events occurred in both groups.@*CONCLUSION@#The application of 3D printing personalized lumbar support can effectively alleviate the pain of patients with lumbar disc herniation and improve their lumbar function of patients.

Effect of acupotomy on the fat infiltration degree of lumbar multifidus muscle in patients with lumbar disc herniation after percutaneous transforaminal endoscopic discectomy / 中国针灸

OBJECTIVE@#To observe the effect of acupotomy on the fat infiltration degree of lumbar multifidus muscle (LMM) in patients with lumbar disc herniation after percutaneous transforaminal endoscopic discectomy (PTED).@*METHODS@#A total of 104 patients with lumbar disc herniation treated with PTED were randomly divided into an observation group (52 cases, 3 cases dropped off) and a control group (52 cases, 4 cases dropped off). Patients of both groups received rehabilitation training of two weeks 48 h after PTED treatment. The observation group was treated with acupotomy (L3-L5 Jiaji [EX-B 2]) once within 24 h after PTED. In the two groups, the fat infiltration cross sectional area (CSA) of LMM was compared before and 6 months after PTED, the visual analogue scale (VAS) score and Oswestry disability index (ODI) score were observed before and 1, 6 months after PTED. The correlation between fat infiltration CSA of LMM in each segment and VAS score was analyzed.@*RESULTS@#Six months after PTED, the fat infiltration CSA of LMM in L4/L5 and the total L3-S1 segments of the observation group was lower than that before PTED (P<0.05), and the fat infiltration CSA of LMM in L4/L5 of the observation group was lower than the control group (P<0.01). One month after PTED, the ODI and VAS scores of the two groups were lower than those before PTED (P<0.01), and those in the observation group were lower than the control group (P<0.05). Six months after PTED, the ODI and VAS scores of the two groups were lower than those before PTED and 1 month after PTED (P<0.01), and those in the observation group were lower than the control group (P<0.01). There was a positive correlation between the fat infiltration CSA of LMM in the total L3-S1 segments and VAS scores in the two groups before PTED (r = 0.64, P<0.01). Six months after PTED, there was no correlation between the fat infiltration CSA of LMM in each segment and VAS scores in the two groups (P>0.05).@*CONCLUSION@#Acupotomy can improve the fat infiltration degree of LMM, pain symptoms and activities of daily living in patients with lumbar disc herniation after PTED.

Effect of acupotomy intervention on the morphology and ultrastructure of rectus femoris muscle in rabbits with knee osteoarthritis / 中国骨伤

OBJECTIVE@#To observe the effect of acupotomy on the morphology and ultrastructure of rectus femoris muscle in rabbits with knee osteoarthritis and to reveal the possible therapeutic mechanism involved in the effect of acupotomology on the treatment of knee osteoarthritis(KOA).@*METHODS@#Twenty-four male New Zealand rabbits aged 6 months and weighed (2.0±0.5) kg were randomly divided into blank group, model group and acupotomy group, 8 rabbits in each group. KOA model was established by modified Videman method with left hind limb extended plaster immobility for 6 weeks. In acupotomy group, the transfascial focal points of quadriceps femoris muscle were released by acupotomy under the guidance of Jingjin theory for 4 times and once a week, and the treatment points include Hedingci, Binwaixia, Binneixia. Blank group and model group were fed normally without intervention. One week after the end of the intervention, the pennation angle(PA), muscle thickness(MT), cross-sectional area(CSA) and strain ratio(SR) of rectus femoris were measured by ultrasound. HE staining was used to observe the changes of the tissue morphology, the number of muscle fibers and the average area of muscle fibers. The myofibril of rectus femoris, sarcomere and myofilament were observed by transmission electron microscope.@*RESULTS@#The PA of rectus femoris muscle in the blank group was (9.05±0.21)°. The MT was(1.09±0.09) cm and the CSA was(1.30±0.01) cm2. The PA of rectus femoris muscle in the model group was (3.06±0.15)°. The MT was (0.71±0.02) cm and the CSA was(0.77±0.02) cm2. The PA of rectus femoris muscle in the acupotomy group was (6.94±0.28)°. The MT was (0.80±0.05) cm and the CSA was(0.94±0.03) cm2. The muscle PA, MT and CSA of rectus femoris in the model group were significantly smaller than those in the blank group (P<0.05). Those in acupotomy group were significantly increased compared with those in model group (P<0.05). The SR of rectus femoris muscle was 1.19±0.02 in the blank group, 3.50±0.05 in the model group and 1.99±0.07 in the acupotomy group. The elastic SR of the model group was significantly higher than that of the blank group (P<0.05). These in acupotomy group was significantly lower than that in model group(P<0.05). The results of HE staining showed:in blank group, the fascicles of rectus femoris were arranged neatly, the number of beam of muscle fibers within the fixed visual field was 94.38±3.50 and the average CSA was(0.75±0.22) mm2. In model group, the fascicles of rectus femoris with different sizes were disorganized with a small amount of inflammatory cell infiltration, the number of beam of muscle fibers within the fixed visual field was 196.63±2.62 and the average CSA was(0.26±0.03) mm2. Compared to the blank group, a significant increase in the number of muscle fibers in the fixed field in the model group (P<0.05) and the average CSA decreased significantly(P<0.05). In acupotomy group, the rectus femoris fascicles in the acupotomy group tended to be arranged in a more orderly manner, with the inflammatory cells decreased, the number of beam of muscle fibers within the fixed visual field was 132.88±4.61 and the average CSA was(0.70±0.07) mm2. Compared to the model group, a significant decrease in the number of muscle fibers in the fixed field in the model group(P<0.05) and the average CSA increased significantly(P<0.05). The results of transmission electron microscope showed:compared with the blank group, the overall arrangement of the myofibrils of the rectus femoris in the model group was less structured. There was fracture between the muscle fibers and the sarcomere, the myofilaments were disordered, and the fracture of the Z line was discontinuous. Compared with the model group, the myofibrillar texture of rectus femoris in acupotomy group was clearer, and the Z line was more continuous.@*CONCLUSION@#Based on the jingjin theory, the release of quadriceps femoris by acupotomy can effectively improve the morphology and structure of rectus femoris, and promote the repair and reconstruction of chronic skeletal muscle injury in rabbits with KOA, which may be one of the mechanisms of acupotomy in the treatment of KOA.

A case control study:the treatment of cervical vertigo with micro needle knife / 中国骨伤

OBJECTIVE@#To observe the clinical efficacy of micro needle knife therapy on cervical vertigo.@*METHODS@#A total of 300 patients with cervical vertigo treated from January 1, 2017 to December 31, 2019 were randomly divided into micro needle knife group (96 cases, 4 cases falling off), traditional acupuncture group (96 cases, 4 cases falling off) and oral drug group(95 cases, 5 cases falling off). The micro needle knife group was treated with micro needle knife in the local upper cervical segment once every other day for 7 times; the traditional acupuncture group was treated with traditional acupuncture once a day for 2 weeks;the oral drug group was given Merislon (betahistine mesilate tablets) orally, 6 mg each time, 3 times a day for 2 weeks. The patients were followed up before treatment, at the end of treatment and 3 months after treatment. The dizziness handicap inventory(DHI) was observed and the curative effect was evaluated according to the DHI score.@*RESULTS@#At the end of the course of treatment and 3 months after the treatment, DHI scores of the three groups were significantly lower than those before treatment(P<0.01), and the DHI scores of micro needle knife group were lower than those of traditional acupuncture group and oral drug group at the same time point after treatment (P<0.01). There was no statistically significant difference in DHI scores between traditional acupuncture group and oral drug group at the same time after treatment(P< 0.05). The curative effect was evaluated according to DHI score:in micro needle knife group, 50 cases were cured, 28 cases were markedly effective, 14 cases were improved, the total effective rate was 95.83%; in traditional acupuncture group, 28 cases were cured, 26 cases were markedly effective, and 24 cases were improved, with the total effective rate of 81.25%;in oral drug group, 18 cases were cured, 20 cases were markedly effective, and 28 cases were improved, with the total effective rate of 69.47%. The total effective rate of micro needle knife group was significantly higher than that of other two groups (χ2=45.956, P=0.000). Among the cured patients in the three groups, the time required in the micro needle knife group was significantly less than that in the traditional acupuncture group and oral drug group(F=18.796, P=0.000).@*CONCLUSION@#Micro needle knife loosening atlantoaxial soft tissue has obvious curative effect on cervical vertigo which clinical cure rate, effective rate and treatment time required for cured patients are better than traditional acupuncture and oral drug.

Clinical efficacy of ultrasound-guided radiofrequency acupotomy therapy in treatment of early and middle-stage knee osteoarthritis / 国际生物医学工程杂志

Objective:To study the clinical efficacy of ultrasound-guided radiofrequency acupotomy in early and middle-stage knee osteoarthritis (KOA).Methods:A total of 62 patients with KOA were enrolled and then randomly divided into the radiofrequency acupuncture group and the control group. The two groups were treated with radiofrequency acupotomy and conventional acupotomy under ultrasound guidance, respectively. The treatments were conducted once a week, twice in total. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) of all the patients was evaluated before the treatment as well as the day, 2 weeks, and 1 month after the treatment.Results:Before the treatment, the differences between the two groups in gender, age, body mass index (BMI), WOMAC pain score, WOMAC stiffness score, WOMAC function score, and WOMAC total score were not statistically significant (all P>0.05), indicating the two groups were comparable. On the day, 2 weeks, and 1 month after the treatment, the above WOMAC scores of the two groups were lower than those before the treatment, and the differences were statistically significant (all P<0.01). The WOMAC scores of the radiofrequency acupotomy group were lower than those of the control group at the same period, and the differences were statistically significant (all P<0.05). Conclusions:For patients with early and middle-stage KOA, ultrasound-guided radiofrequency acupotomy therapy has proven clinical efficacy in relieving pain and improving knee joint function.

Effect of acupotomy therapy on the expression of bcl-2/bax in synovial tissue of collagen-induced arthritis rats / 中国组织工程研究

BACKGROUND: It has been shown that acupotomy therapy can improve the symptoms of rheumatoid arthritis, reduce the swelling of the joints, and improve the function of the damaged joints in clinical practice. However, the specific mechanism has not been reported in animal experiments. OBJECTIVE: To observe the effect of acupotomy therapy on the expression of Bcl-2 and Bax in synovial tissue of collagen-induced arthritis rats. METHODS: Forty rats were prepared for the experiment. Ten of them were randomly selected as normal controls, and the other 30 rats were used to manufacture collagen-induced arthritis models via secondary immunization. After the modeling, 20 successful models were randomly selected for subsequent experiments and randomly divided into a model group and an acupotomy group, with 10 in each group. Normal group and model group remain untreated. The medial and lateral patellofemoral ligament, the tibial and fibular collateral ligament, the midpoint of the upper margin of the patella and the midpoint of the patellar ligament around the left knee joint were selected as points of acupotomy treatment, two of which were selected for each acupotomy session. Rats in the acupotomy group were treated once a week for 3 continuous weeks. The general condition of experimental rats was monitored daily, thickness of the left posterior toe was measured and arthritis index was evaluated. Hematoxylin-eosin staining was executed to observe the pathological morphology of the synovial tissue. Real-time quantitative PCR and immunofluorescence staining were implemented to measure gene expression and immunofluorescence intensity of Bcl-2 and Bax in synovial tissue, respectively. The study protocol was approved by the Animal Ethic Committee of Hubei University of Traditional Chinese Medicine with an approval No. 00127518. RESULTS AND CONCLUSION: Compared with the normal group, the thickness of the left posterior toe and arthritis index score of the model group were significantly increased (P 0.05). The expressions of Bcl-2 mRNA and Bcl-2/Bax mRNA were significantly reduced in the acupotomy group compared with the model group (P < 0.01, P < 0.01). Immunofluorescence detection indicated that the fluorescence intensity of Bcl-2/Bax in the acupotomy group was significantly reduced compared with the model group (P < 0.01). To conclude, the down-regulation of Bcl-2 expression and Bcl-2/Bax ratio in the synovial tissue may be one of its mechanisms for improving rheumatoid arthritis.

Clinical Efficacy and Safety of Miniscalpel-Needle Treatment for Tension-Type Headache: A Systematic Review and Meta-Analysis / 中国结合医学杂志

OBJECTIVE@#To investigate the clinical efficacy and safety of miniscalpel-needle (MSN) treatment for tension-type headache (TTH).@*METHOD@#Seven medical databases were searched to identify randomized controlled trials (RCTs) evaluating the effect and safety of MSN treatment. All articles published up to November 15, 2018 were retrieved. A meta-analysis was conducted for the included studies, and the risk of bias was assessed. Primary outcomes were visual analogue scale (VAS) or numeric rating scale (NRS) score. Secondary outcomes were clinical effective rates including total effective rate (TER), markedly effective rate (MER), and totally cured rate (TCR) determined by improvement in clinical symptoms or VAS scores, the frequency of adverse events (AEs) that occurred during the study, and participant quality of life (QOL).@*RESULTS@#Seven RCTs involving 724 participants were included. MSN treatment showed significantly higher MER and TCR [relative risk (RR) 1.27, 95% confidence interval (CI) 1.01 to 1.61; RR 1.31, 95% CI 1.09 to 1.57, respectively], but not TER (RR 1.03, 95% CI 0.96 to 1.10) compared to acupuncture. MSN treatment plus conventional treatment showed significant lower VAS and higher TER, MER, and TCR (mean difference -3.54, 95% CI -3.80 to -3.28; RR 1.14, 95% CI 1.06 to 1.23; RR 2.31, 95% CI 1.50 to 3.58; RR 3.01, 95% CI 2.25 to 4.02, respectively) compared to conventional treatment.@*CONCLUSIONS@#According to current evidence, MSN treatment as a monotherapy or as an adjunctive treatment to other existing treatments might have benefits on treating TTH. However, since the number and the sample size of studies included were both small and the methodological quality was poor, the findings of this review should be interpreted with great caution, and our confidence in the results is low. A high quality RCT using objective outcomes should be performed on this topic.

Clinical anatomical study on the treatment of carpal tunnel syndrome with classic Acupotomy / 中国骨伤

OBJECTIVE@#To explore the safety of classic Acupotomy in the treatment of carpal tunnel syndrome.@*METHODS@#Twenty six adult specimens (15 males and 11 females), aged 60 to 95(82.54±6.94) years old, were selected from 10% formalin antiseptic fixation. There were 52 sides(two of them could not be tested). The study period was from November 2017 to May 2018. The specimens were collected from the body donation center of the school of basic medicine, Peking University. The operation of releasing the transverse carpal ligament on the human body specimen was simulated by the classic acupotomy, and the distance from the four points to the surrounding anatomical structure was measured to calculate the direct injury rate to the nerve and blood vessels, and the shortest distance between the acupotomy and the nerve and blood vessels was defined as ≥2 mm as safety.@*RESULTS@#In the experimental operation, the direct injury rate of nerve and blood vessel was 14% and 12% respectively. There was significant difference in the rate of direct nerve injury between the four injection points (0.05). Among the four points, there was a statistically significant difference in the safety of nerves(<0.05), and the safety of point 1 and point 3 of radial injection was higher than that of point 2 and point 4 of ulnar injection(<0.05). There was significant difference in the safety of blood vessels between the four points(<0.05), and the safety of radial point 1 was higher than that of ulnar point 2 and point 4 (<0.05).@*CONCLUSION@#The safety of the classic Acupotomy for carpal tunnel syndrome is related to the location of the needle entry point, and the safety of theradial proximal end of the needle is the highest.

Clinical analysis of Shenzhuo Decoction combined with massage manipulation, acupotomy and lumbar traction in treatment of lumbar disc herniation / 中草药

Objective To analyze the clinical effects of Shenzhuo Decoction combined with massage manipulation, acupotomy and lumbar traction in treatment of lumbar disc herniation. Methods A total of 495 cases of lumbar disc herniation from January 2015 to December 2018 were divided into the observation group and control group, with 259 and 236 cases respectively in observation and control groups. The patients in control group were only given regular massage manipulation, acupotomy and lumbar traction, and the patients in observation group were given Shenzhuo Decoction based on the treatment of control group. The clinical effects of the two groups was analyzed after 2 weeks of treatment. Results The total effective rate and JOA Score of observation group were significantly better than that in the control group (P < 0.05). Conclusion Shenzhuo Decoction in the treatment of lumbar disc herniation has good curative effect. It has the advantages of quick curative effect and short courses of treatment with the regular massage manipulation, acupotomy and lumbar traction, which can be promoted in clinical practice as a conservative treatment for lumbar disc herniation.

Current Usage of Terminologies Related to Acupotomy: A Literature Research and Standardization Suggestion / 中国结合医学杂志

OBJECTIVE@#investigate the current usage of terminologies related to acupotomy through systematic search and analyze the pros and cons of each for proposing a standard terminology.@*METHODS@#Seven medical journal databases were searched including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Oriental Medicine Advanced Searching Integrated System, KoreaMed, and Korean studies Information Service System using 10 candidate terminologies as searching terms. All studies published from their inception to July 26, 2017 were collected. Articles were included if the title stated one of the 10 candidate terminologies consistent with the definition of acupotomy. Priorly established frequency and consistency of each candidate terminology from medical databases were calculated and evaluated. Moreover, the pros and cons of each were analyzed to propose a standard terminology.@*RESULTS@#A total of 112 studies in English databases, 1,129 studies in Chinese database, and 44 studies in Korean databases were included. The most frequently used terminologies were needle knife (35.71%), acupotomy (48.54%) and acupotomy (90.90%) in English, Chinese and Korean database, respectively. Overall, acupotomy and needle knife were the most frequently used. Others like acupotomology, needle scalpel, miniscalpel acupuncture and miniscalpel needle were used within 10% of the total searched literature. Acupotome, stiletto needle, sword like needle, and Xiaozhendao were rarely used. Acupotomy had the advantages of high frequency and consistency but lacked representativeness. Needle knife also showed a high frequency, but the consistency was poor. Though miniscalpel acupuncture and miniscule needle were used less frequently, they had advantages of inclusiveness and clarity.@*CONCLUSION@#A debate for standardization of the terminology is necessary. This preliminary research can provide a basic outline for the standardization consensus process, and we believe it is noteworthy to discuss miniscalpel needle and miniscalpel acupuncture along with acupotomy and needle knife on the subject.

Clinical effectiveness of small needle knife in autologous fat grafting for treatment of atrophic scar / 中华医学美学美容杂志

Objective To explore the clinical effect of using small needle knife in autologous fat grafting for the treatment of atrophic scar.Methods Twelve patients with atrophic scar were included in this study during March 2014 and December 2016 in the Hangzhou First People's Hospital,Zhejiang University School of Medicine.We used small needle knife during fat grafting to treat the atrophic scar.Observer Scar Assessment Scale (POSAS) was used to assess the clinical effect of the patients.Results Aesthetic and functional improvements were observed.Resolution of pain and increases in scar elasticity were objectively assessable.Improvement of both clinical evaluation and patient perception was obtained.Conclusions Use of small needle knife during fat grafting is a good alternative for the treatment of atrophic scars.

Percutaneous dynamic release in stress position by acupotomy in treating severe scapulohumeral periarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical efficacy of acupotomy stress position percutaneous dynamic release for severe shoulder periarthritis.</p><p><b>METHODS</b>From April 2012 to August 2016, 160 patients with severe shoulder periarthritis were randomly divided into treatment group and control group. Among them, 80 patients in treatment group were treated with acupotomy stress position percutaneous dynamic release including 32 males and 48 females with an average of(52.47±9.04)years old ranging from 40 to 74 years old;the courses of disease was(20.72±9.55)months on average. The other 80 patients in control group were treated with simple joint loosening according to Maitland technique in grade III-IV therapy, once a day, 15 to 20 min each time, and 10 d for 1 course, for a total of 2 courses, including 33 males and 47 females with an average of (53.19±10.18) years old ranging from 42 to 75 years old; the average course of disease was (21.98 ±8.99) months. After operation, the shoulder muscles training and shoulder joint activity training were routinely conducted, the treatment lasted for 3 weeks. The visual analogue scale(VAS) and Constant-Murley shoulder function score were observed and compared between the two groups before treatment and 3 weeks, 3, 6 months after treatment.</p><p><b>RESULTS</b>The VAS scores of the treatment group at 3 weeks, 3 and 6 months after treatment were all lower than those of the control group(<0.05). The shoulder joint function Constant-Murley scores of the treatment group at 3 weeks, 3 and 6 months after treatment were higher than those of the control group (<0.05); the result was excellent in 59 cases, good in 18 cases, fair in 3 cases in the treatment group; excellent in 15 cases, good in 31 cases, fair in 23 cases, poor in 11 cases in the control group, and the difference between the two groups was statistically significant(<0.01).</p><p><b>CONCLUSIONS</b>Treatment of severe shoulder periarthritis with acupotomy stress position percutaneous dynamic release can obviously improve the shoulder joint function and pain, according to the different parts of the shoulder joint pain and function limitation, the corresponding shoulder stress and body position should be designed and maintained during the treatment process, and the angle of stress position gradually increased by loosening the adhesion, which is the key to ensure the curative effect.</p>

A case-control study on the treatment of carpal tunnel syndrome with needle Dao / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical effects of needle Dao for the treatment of carpal tunnel syndrome.</p><p><b>METHODS</b>From July 2014 to December 2016, 60 patients with carpal tunnel syndrome were divided into two groups: needle Dao treatment group(treatment group), and brace and medicine treatment group(control group), 30 cases in each group. There were 8 males and 22 females in the treatment group, with an average age of (49.38±7.43) years old. There were 7 males and 23 females in the control group, with an average age of (50.23±8.71) years old. There were no statistically significant differences between two groups before treatment in age, sex, course of disease, sensory nerve conduction velocity (SCV), sensory nerve action potential (SNAP), and distal motor latency(DML). The patients in the treatment group were treated with needle Dao for 1 to 2 times, while the patients in the control group were given celecoxib, vitamin B1 and vitamin B12, with the brace fixed. After treatment, the changes of SCV, SNAP and DML in two groups were observed.</p><p><b>RESULTS</b>After treatment, the SCV were (48.63±7.33) m/s and (41.24±6.15) m/s in treatment group and control group separately, the SNAP were (9.89±3.71) m/s and (8.22±2.19) m/s, and the DML were(5.11±2.28) m/s and (6.13±2.23) m/s. The SCV, SNAP and DML after treatment were better than those before treatment(<0.05). And the results of SCV, SNAP and DML of patients in the treatment group were better than those of patients in the control group(<0.001).</p><p><b>CONCLUSIONS</b>Needle Dao can effectively improve the overall treatment efficiency of patients with carpal tunnel syndrome and reduce the symptoms of patients, which is feasible and suitable to use in clinical.</p>

Analysis on adverse event in acupotomy therapy based on literature research / 中国针灸

OBJECTIVE@#To explore the current domestic situation of the adverse event in acupotomy so as to promote the standardization of acupotomy and improve the clinical effect and safety of acupotomy therapy.@*METHODS@#The method of retrospective journal researching was used. The case report about the adverse event in acupotomy from CNKI, WANFANG and VIP databases was retrieved and the types, the features, the causes, the numbers of the papers and the cases were analyzed.@*RESULTS@#Fifty-eight papers were included, with total 343 cases. It was indicated that the adverse events in acupotomy were mainly postoperative local pain, hematoma, swelling, nerve damage, tendon rupture, adhesion, injury, infection, syncope, anesthesia accident, undeserved hormone use, etc. The lower level of standardization of acupotomy in the clinical use may lead to adverse events.@*CONCLUSION@#Safe acupotomy treatment for some complicated diseases and dangerous parts remains to be improved, and the standardization of the acupotomy is an important approach to improve its safety. The related work needs to be carried out.

Effects of Acupotomy Therapy on mRNA Expressions of Bcl-2, Bax, Caspase-3 in Posterior Cervical Extensor Muscles in Cervical Spondylosis Rabbits / 针刺研究

OBJECTIVE: To observe the effect of acupotomy therapy on mRNA expressions of Bcl-2, Bax , Caspase-3 in posterior cervical extensor muscles in cervical spondylosis rabbits, and explore its mechanisms for apoptosis of cervical muscles. METHODS: New Zealand rabbits were randomly divided into normal, model, electroacupuncture (EA) and acupotomy groups, 6 in each group. The cervical spondylosis model was established by forced head-bowing for a long term. After model establishment, acupotomy was used at the trapezius muscle starting point and attachment site of sternocleidomastoid muscle, etc., once a week, total 3 times. EA was used at "Tianzhu" (BL 10), "Jingbailao" (EX-HN 15) and "Dazhu" (BL 11) for 3 weeks, 20 min a time, 3 times a week. Bcl-2, Bax, Caspase-3 mRNA expressions in posterior cervical extensor muscles were detected by real-time PCR. RESULTS: There was no significant difference in the expression of Bcl-2 mRNA among all the groups (P>0.05). Compared with the normal group, Bax mRNA increased in the model group (P<0.01), and that in the acupotomy group was lower than that in the model group (P<0.01). The ratio of Bcl-2/Bax mRNA in the model group decreased significantly compared with that in the normal group (P<0.01); in comparison with the model group, the ratio in the acupotomy group increased (P<0.01); and that in the acupotomy group was higher than the ratio in the EA group (P<0.05). The Caspase-3 mRNA expression in the model group increased compared with that in the normal group (P<0.05), and its expression in the acupotomy group decreased compared with those in the model and EA groups (P<0.05). CONCLUSIONS: Acupotomy therapy can regulate the mRNA expressions of Bax and Caspase-3, and retard apoptosis in posterior cervical extensor muscles, therefore the strained muscles are relieved, which may be one of its mechanisms for improving cervical spondylosis.

System Review of Acupotomy Treatment for Stenosing Tenovaginitis of Flexor Digitorum / 中国中医药信息杂志

Objective To systematically evaluate the efficacy of acupotomy treatment for the stenosing tenovaginitis of flexor digitorum.Methods Articles about RCTs of acupotomy treatment and local blocking for the treatment of stenosing tenovaginitis of flexor digitorum were retrieved from CBM, CNKI, VIP, Wanfang database, PubMed, Embase, and Cochrane library. And then according to the requirement of Cochrane Handbook for Systemetic Reviews 5.1.0, two reviewers independently chose tests, extracted data, had a cross check, accessed methodological qualities and finally used RevMan 5.3 software for Meta analysis. The total effective rate, cure rate and improvement rate of acupotomy treatment and local blocking in treating stenosing tenovaginitis of flexor digitorum were assessed by using odds ratio (OR).Results Totally 10 articles involving 1426 cases were included. The cure rate in acupotomy treatment group was higher than that of local blocking group [OR=13.11 (95% CI: 8.23–20.89),Z=10.83 (P<0.000 01)], funnel plot Begg’s testP=0.858, Egger’s testP=0.579; the improvement rate of local blocking rate was higher than that of acupotomy treatment group [OR=0.14 (95% CI: 0.10–0.19),Z=11.60 (P<0.000 01)], funnel plot Begg’s test P=1.000, Egger’s testP=0.926; the total effective rate of acupotomy treatment group was higher than that of local blocking group [OR=18.26 (95% CI: 9.95–33.50),Z=9.38 (P<0.000 01)], funnel plot Begg’s testP=0.592, Egger’s testP=0.936.Conclusion Acupotomy treatment for stenosing tenovaginitis of flexor digitorum is superior to local blocking injection. However, the quality of the RCTs is low, so more large-sample, multi-center, and high-quality clinical RCTs are required for further verification.

Acupotomy and acupuncture in the treatment of avascular necrosis of femoral head at the early and middle stages:a clinical randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To compare the efficacy difference between acupotomy and acupuncture in the treatment of avascular necrosis of femoral head at the early and middle stages.</p><p><b>METHODS</b>The randomized controlled prospective study method was adopted. Sixty cases of avascular necrosis of femoral head at Ficat-ArletⅠto Ⅱ stages were randomized into an acupotomy group (32 cases) and an acupuncture group (28 cases) by the third part. In the acupotomy group, the acupotomy was adopted for the loose solution at the treatment sites of hip joint, once every two weeks, totally for 3 times. In the acupuncture group,points around the hip joint were selected and stimulated with warm acupuncture therapy, once every day, for 6 weeks. Harris hip score was observed before and after treatment. The efficacy was evaluated in the two groups.</p><p><b>RESULTS</b>Harris hip score was improved significantly after treatment in the two groups (both<0.05). The result in acupotomy group was better than that in the acupuncture group (<0.05). The effective rate was 90.6% (29/32) in the acupotomy group, better than 75.0% (21/28) in the acupuncture group after treatment (<0.05).</p><p><b>CONCLUSIONS</b>Harris hip score and the effective rate in the acupotomy group are better than those in the treatment with routine acupuncture for avascular necrosis of femoral head at the early and middle stages.</p>

Understanding of needle-knife medicine onpoint / 中国针灸

The concept ofpoint and the understanding of modern acupoint research onpoints were analyzed. According to the bowstring mechanics anatomy of needle-knife medicine and mesh theory, it was believedpoint was the warning of mechanical imbalance of bowstring mechanics anatomy.points were mainly distributed in the joint part of bowstring or stress concentration of string; the acupotomy could compensate for the subjectivity and arbitrariness of point selection of, which also emphasized the importance ofpoint anatomy.

Clinical Observation of Lumbar Intervertebral Disc Protrusion Patients Treated with Acupotomy Therapy Combined with Acupuncture Based on Distal Points Selection / 广州中医药大学学报

Objective To evaluate the clinical effect of acupotomy therapy combined with acupuncture based on distal points selection for lumbar intervertebral disc protrusion ( LIDP) . Methods Sixty-eight LIDP patients were randomly divided into treatment group (N=33) and control group(N=35). The treatment group were given acupotomy therapy on the proximal positive response points in the lumbosacral region for relaxing the tendons,and acupuncture therapy based on distal points selection of Shugu, the Shu-stream point of the foot Taiyang bladder meridian, Zulinqi and Weizhong, the shu-stream point and the blood xi-cleft point of the foot Shaoyang gallbladder meridian respectively, twice a week, 2 weeks constituting one course of treatment. The control group was given conventional electroacupuncture therapy on Huatuo clip points, Dachangshu point, bilateral Shenshu points, Yinmen point, bilateral Zibian points and bilateral Yanglingquan points, and together with TDP radiation therapy, 5 times a week, 2 weeks constituting one course of treatment. The two groups received follow-up for one month. The low back pain scores of Japanese orthopaedic society ( JOA) and visual analog scores ( VAS) of pain were used for the evaluation of therapeutic effect after the treatment. Results ( 1) After treatment, the JOA scores were increased and VAS scores were decreased in both groups compared with those before treatment ( P< 0.05) , and the increase of JOA scores and the decrease of VAS in the treatment group were superior to those in the control group ( P< 0.05) . There was statistically significant difference of VAS scores between the two groups ( P < 0.05) during the follow-up period. ( 2) The total effective rate was 87.9%in the treatment group, and was 77.1%in the control group, the difference being significant (P<0.05) . Conclusion The acupotomy therapy combined with acupuncture based on distal points selection is effective and safe for lumbar intervertebral disc protrusion, which has the advantages of reliable long-term effect and low recurrence rate, showing good prospects for extensive clinical application.