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External treatment of Traditional Chinese Medicine (TCM) is a common treatment for lumbar disc herniation, which mainly includes fumigation and washing of TCM, and hot ironing therapy. It can cooperate with oral administration of TCM, Tuina, acupuncture and other therapies to play a synergistic effect and enhance the efficacy. External application of TCM in the treatment of lumbar intervertebral disc herniation is effective with long duration, easy-operated and safe It has showed curative effect in alleviating clinical symptoms and improving lumbar function. Its mechanism mainly includes regulating nerve inflammatory reaction, improving hemorheology and exerting analgesic effect.
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OBJECTIVE@#To observe the clinical effect of single acupoint [Yaotu (extra)] electroacupuncture (EA) therapy on lumbar intervertebral disc herniation (LIDH) and its promotion and application in community medical institutions.@*METHODS@#This research adopted a three-level promotion model, and used multi-center collaboration topics as a platform. A total of 240 patients with LIDH were divided into a group A (top three hospital, 80 cases, 3 cases dropped off), a group B (secondary hospital, 80 cases, 8 cases dropped off), and a group C (community health center, 80 cases, 7 cases dropped off). All groups were treated with EA at a single acupoint [Yaotu (extra)] under the guidance of a unified experimental protocol. The EA was given 60 min each time and performed 3 times a week for a total of 2 weeks. The changes of visual analogue scale (VAS) scores of three groups before and after each treatment were compared, and the clinical efficacy was evaluated.@*RESULTS@#Compared with before each treatment, the VAS scores of three groups after each treatment decreased (@*CONCLUSION@#The single acupoint EA therapy has a significant effect in the treatment of LIDH, can quickly relieve the pain symptoms, and has the characteristics of simple operation and easy control, suitable for promotion and application in primary hospitals.
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Humans , Acupuncture Points , Electroacupuncture , Intervertebral Disc , Intervertebral Disc Degeneration , Intervertebral Disc Displacement/therapyABSTRACT
Introduction: Intraspinal tumors were primary and secondarytumors that occurred in the spinal cord, nerve roots, meningesand the tissue of the wall of vertebral canal. Study aimedto analyze the misdiagnosis causes of intraspinal tumorsmisdiagnosed as lumbar intervertebral disc herniation, and toreduce the rate of clinical misdiagnosis.Material and Methods: Clinical data of 19 patients withintraspinal tumors misdiagnosed as lumbar intervertebral discherniation were retrospectively analyzed, and the respectivecharacteristics, essentials for diagnosis and differentialdiagnosis of the two different kinds of diseases weresummarized. The misdiagnosis causes were analyzed, and theprevention measures were put forward.Results: All the misdiagnosed patients’ data on MRI werecollected, and then they received operative treatment.Histological diagnosis results showed that there were 13cases of schwannomas, 3 cases of meningiomas, 2 casesof ependymomas, and 1 case of angiomyolipoma. In 1~36months’ follow-up, pain of all the patients was alleviated.Eighteen patients were healed, and only one patient still feltnumbness at left hip and left leg. No patient reoccurred ordied.Conclusion: Though there were similarities in early clinicalmanifestations between intraspinal tumors and lumbarintervertebral disc herniation, these two different kinds ofdiseases can be identified by collecting the case historydetailedly, performing physical examination carefully, andchoosing the imaging examination appropriately to avoidmisdiagnosis.
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Objective To study the relationship between the pain of the patients with lumbar intervertebral disc herniation (LIDH) and the changes of serum cytokine,and to discuss the clinical significance.Methods From January 2014 to December 2016,74 cases of LIDH diagnosed in the 323rd Hospital of the PLA were selected,including 45 males and 29 females,whose age was 46.2± 16.1 years,and the duration 22.6± 7.8 months.According to the VAS pain score,37 cases were mild,23 cases were moderate and 14 cases were severe.The control was 30 cases of healthy physical examination in the same period,18 males and 12 females,age 45.3 ± 15.8 years.All subjects were collected for venous blood on fasting.MDA,superoxide dismutase (SOD),interleukin-6 (IL-6),tumor necrosis factor (TNF),thromboxane (TX),endothelin (ET),prostaglandin E (PGE) and calcitonin (CA) were all measured by radioimmunoassay.The results were analyzed statistically.Results The compared with normal control group,serum cytokines MDA,SOD,IL-6,TNF,TX,ET,PGE and CA increased in different degrees (P＜0.05～0.01).The VAS assessment of severe pain in LIDH was significantly higher than that of mod erate or mild pain (P＜0.05～0.01).Logistic analysis showed that these serum cytokines were closely related to the pain of LIDH (OR=2.415～4.127,95％CI=1.146～11.735,P＜0.05).Conclusion The serum cytokines in patients with LIDH are closely related to the degree of pain,suggesting that these cytokines in serum may affect biochemical metabolism in the process of pain.
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Objective To investigate the clinical efficacy of heat-sensitive point medicinal moxibustion plus percutaneous administration of tetrandrine in treating lumbar intervertebral disc herniation. Methods One hundred and twenty patients with lumbar intervertebral disc herniation were randomized to treatment and control groups, 60 cases each. The treatment group received heat-sensitive point medicinal moxibustion plus percutaneous administration of tetrandrine and the control group, heat-sensitive point medicinal moxibustion alone. The VAS score and the JOA Score for Back Pain score were recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant pre-/post-treatment differences in the JOA Score for Back Pain score and the VAS score in the two groups (P<0.01). There were statistically significant post-treatment differences in the JOA Score for Back Pain score and the VAS score between the treatment and control groups (P<0.01). The excellent and good rate was 80.0％ in the treatment group and 55.0％ in the control group; there was a statistically significant difference between the two groups (P<0.01). Conclusion Heat-sensitive point medicinal moxibustion plus percutaneous administration of tetrandrine is an effective way to treat lumbar intervertebral disc herniation.
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Objective To observe the clinical efficacy of Bai Xiao moxibustion plus electroacupuncture in treating lumbar intervertebral disc herniation (LIDH). Method Ninety-six LIDH patients were randomized into a treatment group and a control group, 48 cases each. The treatment group was intervened by Bai Xiao moxibustion plus electroacupuncture, while the control group was intervened by electroacupuncture alone. Before and after the treatment, the lower back pain scores of Japanese Orthopedic Association (JOA) and Visual Analogue Scale (VAS) were evaluated, and the clinical efficacies of the two groups were compared. Result The JOA and VAS lower back pain scores were changed significantly after the treatment in both groups (P<0.05). After the treatment, the JOA and VAS lower back pain scores of the treatment group were significantly different from those of the control group (P<0.05). The pain release time was (2.95±0.59)d after the intervention in the treatment group versus (4.26±0.68)d in the control group, and the between-group difference was statistically significant (P<0.05). The total effective rate was 95.7％ in the treatment group versus 91.7％ in the control group, and the between-group difference was statistically significant (P<0.05). Conclusion Bai Xiao moxibustion plus electroacupuncture is an effective method in treating LIDH and it can reduce the lower back pain.
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Objective To investigate the effect of Supplementing Qi and activating blood and tonifying kidney therapy on the function and quality of life in patients with prolapse of lumbar intervertebral disc after operation.Methods92 cases of lumbar disc herniation treated in Fuyang Hangzhou Hospital of traditional Chinese Medicine hospital from November 2015 to October 2016 were selected,divided into observation group and control group, there were 46 cases in each group, the observation group were treated with Supplementing Qi and activating blood and tonifying kidney therapy,the control group were given conventional western medicine treatment, the improvement of VAS score, JOA score and WHQOL-BREF score were compared between the two groups after treatment, and the clinical effects were compared between the two groups after treatment and the incidence of adverse reaction.ResultsAfter treatment,the VAS scores of the two groups were decreased, the observation group (1.85±0.43) is lower than the control group (2.97±0.69), the difference between the two groups was statistically significant(P<0.05);After treatment, patients withthe JOA scores of the two groups were increased, the observation group (25.78±5.89) higher than the control group (20.45±4.82), the difference between the two groups was statistically significant(P<0.05);After treatment, the total efficiency of observation group was 93.48% higher than 76.09% in the control group, the difference between the two groups was statistically significant(P<0.05);There was no significant difference in WHOQOL-BREF scores between the two groups before treatment;After treatment, the WHOQOL-BREF scores of the two groups were increased, the observation group was higher than the control group, the difference between the two groups was statistically significant(P<0.05), there was no significant difference in the incidence rate of complications between the two groups after treatment.ConclusionThe patients with lumbar disc herniation after operation to give Supplementing Qi and activating blood and tonifying kidney therapy,can effectively helpe patients to recover, improve the pain of patients, improve the patient's functional activities and quality of life, the effect is significant.
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Objective To investigate the application of lower limb electromyography in guiding preoperative localization for multiple segment intervertebral disc herniation treated with ozone injection and in predicting the curative efficacy.Methods A total of 51 patients with MRI-proved multiple segment lumbar intervertebral disc herniation,who were admitted to authors' hospital during the period from January 2012 to December 2013 and who had complete clinical materials,were included in this study.Guided by DSA,intradiscal injection of ozone together with the injection of ozone plus compound betamethasone and bupivacaine into the space around the spinal nerve was carried out in all patients.The degree of lower lumbago was evaluated with M-JOA score,and Oswestry disability index (ODI) was adopted to assess the curative effect.Results Preoperative electromyography showed that 43 patients had nerve root injury,the positive rate was 84.3％.The positive HIZ sign was detected in 30 patients,with the positive rate being 58.8％.The positive Modic sign was observed in 24 patients,the positive rate was 47.1％.Postoperative MJOA scores indicated that one-,3-and 6-month effective rates were 90.1％,86.2％ and 78.5％ respectively;and postoperative ODI values showed that one-,3-and 6-month effective rates were 87.3％,79.5％ and 74.6％ respectively.Conclusion In treating multiple segment intervertebral disc hemiation with ozone injection,lower limb electromyography is very valuable in accurately making preoperative localization as well as in precisely predicting the curative efficacy,thus this technique is worth popularizing in clinical practice.
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Objective To investigate the clinical improving effect on the symptoms of acupuncture at point Weizhong(BL40) plus following lumbar vertebra-stabilizing core muscle group training in patients with lumbar intervertebral disc herniation. Method Sixty patients with lumbar intervertebral disc herniation were randomized to a treatment group (30 cases) and a control group (30 cases). The treatment group received acupuncture at point Weizhong plus following lumbar vertebra-stabilizing core muscle group training and the control group, oral administration of celecoxib capsules. After treatment, the clinical improving effect on the symptoms was evaluated in the patients using the NRS, JOA Lumbar Scoring and ODI. Result The total efficacy rate was 100% in the treatment group and 53.3%in the control group. Post-treatment NRS, JOA and ODI scores were better in the treatment group than in the control group; there were statistically significant differences (P<0.001). Conclusion Acupuncture at point Weizhong plus following lumbar vertebra-stabilizing core muscle group training can effectively treat lumbar intervertebral disc herniation.
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Objective To investigate the clinical efficacy of electroacupuncture plus indirect moxibustion treating lumbar intervertebral disc herniation of blood stasis type. Method Sixty patients diagnosed with lumbar intervertebral disc herniation (blood stasis type) were randomized to treatment and control groups, 30 cases each. The treatment group received electroacupuncture plus medicine separated moxibustion and the control group, electroacupuncture alone. treatment was given once daily, 10times as a course. Pre- and post-treatment JOA lumbar scores were compared in the patients after two courses of treatment. The clinical therapeutic effects were evaluated in the patients using the TCM Criteria of the Diagnosis of and Therapeutic Effect on Diseases. Result Lumbar function was improved significantly in both treatment and control groups of patients (P<0.01) but improved more significantly in the treatment group than in the control group (P<0.05). The total efficacy rate was 96.7% in the treatment group and 83.3% in the control group. There was a statistically significant difference in the total efficacy rate between the two groups (P<0.05). Conclusion Electroacupuncture plus indirect moxibustion is a better way to treat lumbar intervertebral disc herniation of blood stasis type. Its therapeutic effect is better than that of electroacupuncture alone.
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Objective To investigate the clinical efficacy of She medicine therapy in rehabilitation after endoscopic surgery for lumbar intervertebral disc herniation.Methods Sixty patients with lumbar intervertebral disc herniation were allocated, using random number table method following registration order, to treatment and control groups, 30 cases each. The treatment group received She medicine therapy and the control group, oral administration of conventional drugs. The excellent and good rate was observed in the two groups after treatment. Post-treatment active straight leg raising times and analgesic dosages were compared between the two groups.Results Active straight leg raising time was significantly advanced (P<0.01) and the number of potent analgesic uses was significantly decreased (P<0.01) in the treatment group after endoscopic surgery for lumbar intervertebral disc herniation. The excellent and good rate was 93.3％ in the treatment group and 80.0％ in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion She medicine therapy can help rapid rehabilitation after endoscopic surgery for lumbar intervertebral disc herniation.
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Objective To investigate the clinical efficacy of She medicine therapy in rehabilitation after endoscopic surgery for lumbar intervertebral disc herniation.Methods Sixty patients with lumbar intervertebral disc herniation were allocated, using random number table method following registration order, to treatment and control groups, 30 cases each. The treatment group received She medicine therapy and the control group, oral administration of conventional drugs. The excellent and good rate was observed in the two groups after treatment. Post-treatment active straight leg raising times and analgesic dosages were compared between the two groups.Results Active straight leg raising time was significantly advanced (P<0.01) and the number of potent analgesic uses was significantly decreased (P<0.01) in the treatment group after endoscopic surgery for lumbar intervertebral disc herniation. The excellent and good rate was 93.3％ in the treatment group and 80.0％ in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion She medicine therapy can help rapid rehabilitation after endoscopic surgery for lumbar intervertebral disc herniation.
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By sorting out 2005-2015's literature on the mechanism of acupuncture and moxibustuion treatment for lumbar intervertebral disc herniation, this article concludes that the studies focused mainly on six aspects: improvement in nail fold microcirculation, improvement in neural ultrastructure, regulation of bodily autoimmunity, improvement in hemorheological indicators, regulation of neuroelectrophysiology and regulation of chemical neuroinflamma- tory mediators. A summary is made from the six aspects.
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Objective To study the effect of herbal reyanbao combined with rehabilitation training on the rehabilitation of patients with lumbar disc herniation.Methods 120 cases with lumbar disc prolapse as the research object from January 2015 to December 2016 in Wuhan integrated traditional Chinese and western medicine hospital were divided into two groups(the control group and the observation group).The control group were treated with routine conservative+conventional nursing plan, and the observe group were given herbal reyanbao combined with rehabilitation training.Clinical data were compared in the two groups.Results The clinical effect and rehabilitation degree in the observation group were better than those in the control group, the difference was statistically significant(P< 0.05).Conclusion It can help patients with lumbar disc herniation recover as soon as possible which herbal reyanbao combined with rehabilitation training were used on the rehabilitation of patients, and it is worthy of application.
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Objective To compare the therapeutic efficacy between medicinal cupping and collateral-pricking bloodletting therapy in treating lumbar intervertebral disc herniation (LIDH) and non-specific low back pain.Method Sixty LIDH patients were randomized into treatment group 1 and control group 1, 30 cases in each group. Sixty non-specific low back pain patients were randomized into treatment group 2 and control group 2, 30 cases in each group. Treatment group 1 and 2 were intervened by medicinal cupping, while control group 1 and 2 were by collateral-pricking bloodletting. The Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were observed before and after intervention.Result The VAS and ODI scores were significantly changed after intervention in treatment group 1, treatment group 2, and control group 2 (P0.05). After treatment, there was a significant difference in comparing the ODI score between control group 1 and control group 2 (P<0.05).Conclusion Medicinal cupping and collateral-pricking bloodletting are both effective in treating chronic low back pain, and medicinal cupping has its advantage in improving ODI compared to the bloodletting therapy.
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Objective To evaluate the efficacy of Huayu-Zhentong capsule combined with traditional manipulation in patients with inflammatory cytokines after operation of lumbar intervertebral disc herniation.Methods A total of 80 patients with orthopedic inpatients were enrolled and divided into two group by random number table method:a treatment group (40 patients) and a control group (40 patients).On this basis,the control group was added to loxoprofen sodium dispersible tablets,the treatment group was added to Huayu-Zhentong capsule.2 groups were continuous treated for 2 courses.Flow cytometry was used to detect the level of IL-8 and IL-6 before and after treatment,and the patients were evaluated by VAS.The clinical efficacy was evaluated by Oswestry ODI.Results After treatment,the VAS score (2.22 ± 0.31 vs.3.54 ± 0.67,t=11.309) and ODI (10.51 ± 3.22 vs.15.54 ± 6.21,t=4.548) of the treatment group were decreased than the control group (both P＜0.01).Lymphocyte IL-6(0.58％ ± 0.20％ vs.0.84％ ± 0.32％,t=4.358),IL-8(0.41％ ± 0.11％ vs.0.61％ ± 0.20％,t=5.542),mononuclear cells IL-6(25.31％ ± 4.26％ vs.29.19％ ± 5.32％,t=3.604),IL-8(17.80％ ± 2.81％ vs.3.31％ ± 3.77％,t=7.411) of the treatment group were lower than the control group (all P＜0.01).The total effective rate (100％ vs.75.0％) of the treatment group was better than the control group (x2=9.257,P=0.002).Conclusions Huayu-Zhentong capsule combinated with traditional manipulation can reduce inflammatory cytokines IL-6 and IL-8 levels in patients with LIDH.Its curative effect is better than traditional manipulation with loxoprofen sodium dispersible tablets.
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Objective To compare the clinical efficacies of electroacupuncture plus rehabilitation training versus electroacupuncture alone in treating lumbar intervertebral disc herniation and evaluate the therapeutic effect of electroacupuncture plus rehabilitation training. Method Seventy-two patients with lumbar intervertebral disc herniation were randomly allocated to a treatment group of 36 cases and a control group of 36 cases. The control group received electroacupuncture at Huatuo jiaji(Ex-B2) points. In addition to electroacupuncture, the treatment group received lumbodorsal muscle stretch training according to the outcome (forward flexion and backward extension) obtained using the Turgunmed testing and evaluating system. Isokinetic muscle strength and the activity were measured and the ODI lumbago score and the VAS pain score were recorded before and after treatment. Result There were statistically significant differences in isokinetic muscle strength and the VAS pain score (P0.05) between the treatment and control groups. Conclusion Electroacupuncture plus rehabilitation training is more effective than electroacupuncture alone in improving isokinetic muscle strength and the VAS pain score in patients with lumbar intervertebral disc herniation.
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Objective To observe the clinical efficacy of grain-sized moxibustion at Yongquan (KI 1) plus electroacupuncture in treating lumbar intervertebral disc herniation (LIDH).Method Fifty LIDH patients were randomized into a treatment group and a control group, 25 cases in each group. The treatment group was intervened by grain-sized moxibustion plus electroacupuncture, while the control group was by dry electroacupuncture. The Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) score were observed, and the clinical efficacies were compared.Result After treatment, the VAS and JOA scores were significantly different from that before treatment in both groups (P<0.01). After treatment, the VAS and JOA scores in the treatment group were significantly different from that in the control group (P<0.01,P<0.05). The recovery plus markedly-effective rate and total effective rate were respectively 72.0% and 96.0% in the treatment group, versus 52.0% and 80.0% in the control group, and there was a significant difference in comparing the recovery plus markedly-effective rate (P<0.01).Conclusion Grain-sized moxibustion at Yongquan (KI 1) plus electroacupuncture is an effective approach in treating LIDH.
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Objective To observe the clinical efficacy of acupoint injection of mouse nerve growth factor in treating lumbar intervertebral disc herniation (LIDH).Method Totally 120 LIDH patients were randomized into a treatment group, control group 1, and control group 2, 40 cases in each group. Control group 2 was intervened by dehydration therapy; the treatment group was by acupoint injection of mouse nerve growth factor in addition to the intervention given to control group 2; control group 1 was by muscular injection of Trivitamin B in addition to the intervention given to control group 2. The common peroneal nerve and posterior tibial nerve conduction velocities and Visual Analogue Scale (VAS) were observed before and after treatment, and the clinical efficacies were compared among the three groups.Result The recovery and markedly effective rate was 97.5% in the treatment group, versus 92.5% in control group 1 and 85.0% in control group 2, and the rate in the treatment group was significantly different from that in control group 1 and 2 (P<0.05). Respectively 14 d and a month after intervention, the VAS scores were significantly different from that before treatment in the three groups (P<0.05). Respectively 14 d and 1 month after the intervention, the VAS score in the treatment group was significantly different from that in control group 1 and 2 (P<0.05). The common peroneal nerve and posterior tibial nerve conduction velocities a month after the intervention were significantly different from that before the intervention in the three groups (P<0.05). A month after the intervention, the posterior tibial nerve and peroneal nerve conduction velocities in the treatment group were significantly different from that in control group 1 and 2 (P<0.05). Conclusion Acupoint injection of mouse nerve growth factor is an effective way in treating LIDH.
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Objective To observe the clinical efficacy of acupuncture-moxibustion plusMEI Te-lan’s manipulations in treating lumbar intervertebral disc herniation (LIDH) due to blood stagnation.Method Totally 248 LIDH patients due to blood stagnation were randomized into a treatment group of 123 cases and a control group of 125 cases. The treatment group was intervened by acupuncture-moxibustion plusMEI Te-lan’s manipulations, while the control group was by acupuncture-moxibustion plus tuina at lower back. The short-form McGill Pain Questionnaire (SF-MPQ) and Oswestry disability index (ODI) were observed before and after intervention, and the clinical efficacies were compared between the two groups.Result The total effective rate and recovery-markedly effective rate were respectively 80.5% and 52.0% in the treatment group, versus 72.8% and 20.0% in the control group. There was a significant difference in comparing the recovery-markedly effective rate between the two groups (P<0.05). In the treatment group, the Pain Rating Index (PRI) score, Visual Analogue Scale (VAS) score, Present Pain Intensity (PPI) score, and ODI score were significantly changed after 3-day, 6-day, and 20-day treatment compared to the scores before treatment (P<0.05). After 20-day treatment, the PRI, VAS, PPI, and ODI scores of the treatment group were significantly different from that of the control group (P<0.05).Conclusion Acupuncture-moxibustion plusMEI Te-lan’s manipulations is an effective method in treating LIDH due to blood stagnation.