Clinical effects of digital acupoint pressure combined with hot ironing for scapulohumeral periarthritis in Zhuang medicine

Objective:To observe the clinical effect of digital acupoint pressure combined with hot ironing of Zhuang medicine in the therapy of scapulohumeral periarthritis.Methods:160 patients with scapulohumeral periarthritis were randomly divided into the treatment group and control group with 80 patients in each group.The treatment group was treated with digital acupoint pressure combined with hot ironing of Zhuang medicine.The control group was treated with intermediate frequency therapy apparatus.All the treatments were given once a day for 4 weeks,Then the effective rate as well as the scores of shoulder pain and joint inflammation,were calculated.Results:The shoulder pain score of the treatment group was 3.49±0.98,while that of control group was 5.33±1.26(P<0.05).The shoulder joint inflammation score in the treatment group was higher than that of the control group(73.24±7.20 vs 60.71±10.46,P<0.05).these results suggested that 4 weeks of treatments improved the shoulder function.Moreover,the effective rate of the treatment group was higher than that of the control group(86.25%vs 63.75%).Conclusion:Digital acupoint pressure combined with hot ironing in Zhuang medicine could relieve joint pain of patients with scapulohumeral periarthritis and improve their shoulder mobility.

OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE TREATMENT OF 123 CASES OF SCAPULOHUMERAL PERIARTHRITIS

Objective: To observe the therapeutic effect of Qinglong Bai Wei Zhen Fa (Green Dragon Shaking Tail Needling) in the treatment of scapulohumeral periarthritis. Methods: A total of 231 cases of scapulohumeral periarthritis patients were randomized into treatment group (n=123) and control group (n=108). In treatment and control groups, Jianyu (LI 15), Jianqian and Jianhou were used as the main acupoints and stimulated with Green Dragon Shaking Tail Needling and conventional needling separately. Additionally, in control group, Waiguan (TE 5) and Binao (LI 14) were supplemented. The treatment was given once daily, with 10 days being a therapeutic course, 2 courses altogether. Results: After the first course of treatment, in treatment and control groups, the cured, the markedly improved, the effective and ineffective cases were 49 and 12, 61 and 33, 11 and 40, 2 and 23, with the total effective rates being 98.4% and 78.7% respectively. There was a marked difference between two groups in the therapeutic effect (P<0.05). Following 2 courses of treatment, the cured, the markedly improved, the effective and ineffective cases were 66 and 21, 47 and 41, 10 and 39, 0 and 7, with the total effective rates being 100% and 93.5% separately. No significant difference between two groups in the total effective rates, but the cure rate of treatment group was strikingly higher than that of control group. Conclusion: Green Dragon Shaking Tail Needling is significantly superior to that of conventional needling in the treatment of scapulohumeral periarthritis.

TREATMENT OF 36 CASES OF SCAPULOHUMERAL PERIARTHRITIS MAINLY BY CONTRALATERAL NEEDLING

Objective: To analyze the therapeutic effect of contralateral needling in the treatment of scapulohumeral periarthritis. Methods: A total of 68 cases of scapulohumeral periarthritis were outpatients and were randomized into treatment group (n=36) and control group (n=32). In treatment group, Zhiyin (BL 67), Jinmen (BL 63) and Yanglao (SI 6) on the contralateral side of the affected shoulder and local tenderpoints (Ashi-points) were punctured once every other day, with 7 days being a therapeutic course; while in control group, local Ashi-points were used for injection of Procaine and Prednisolone Acetate, once every 7 days and with 3～4 sessions being a therapeutic course. Results: Following 2 courses of treatment, of the 32 cases in control group, 8 (25.0%) were cured, 17 (53.1%) experienced improvement and 7 failed in the treatment, with a total of effective rate of 78.1%; of the 36 cases in treatment group, 18 (50.0%) were cured, 16 (44.4%) experienced improvement and 2 (5.6%) failed in the treatment, with a total effective rate of 94.4%. The therapeutic effect of contralateral needling is significantly higher than that of Ashi-point blocking method (P<0.05). Conclusion: Contralateral needling is superior to Ashi-point in the treatment of scapulohumeral periarthritis.

OBSERVATIONS ON THE THERAPEUTIC EFFECT OF THE TREATMENT OF 100 SCAPULOHUMERAL PERIARTHRITIS CASES BY "HEGUCI" (MUSCLE NEEDLING) COMBINED WITH MASSAGE

Objective： To explore an effective method for managing middle and late stages of scapulohumeral periarthritis. Methods： A total of 182 cases of scapulohumeral periarthritis were randomized into treatment group （100 cases） and control group （ 82 cases）; those in treatment group were managed by “Heguci” （合谷刺 muscle needling） at the reactionary spot of focus （found out via palpation around the shoulder region） in combination with reinforcing needling manipulation of “Setting the Mountain on Fire” and topical massage; whereas, those in control group treated by conventional method of “selecting aoupoints E Jianqian （肩前 extra point）, Jianyu （肩髃 LI 15）, Jianliao （肩髎 TE 14）, etc] along the course of the affected meridians in combination with massage”. The treatment was given once daily, with 10 sessions being a therapeutic course, 20 sessions altogether. Results： Of the 100 cases and 82 cases in control and treatment groups, 36 （43.90%） and 69 （69.00%） were cured, 42 （51.21% ） and 26 （26.00%） improved, 4 （4.87%） and 5 （5.00%） failed, with the total effective rates being 95.13% and 95.00% respectively. The average treatment sessions of control and treatment groups were 16.32±4.24 and 9.66±8.44 separately. The curative rate of treatment group was significantly higher than that of control group and the rumber of the therapeutic sessions required of the former group was evidently fewer than that of the later group （ P 〈 0.01 ）. Conclusion： The therapeutic effect of “Heguci” combined with massage is significantly superior to that of conventional acupuncture plus massage in the treatment of middle and late stages of scapulohumeral periarthritis.

"Scapular heat penetration"technique of acupuncture in treatment of scapulohumeral periarthritis:An exploratory research

Objective:To observe the clinical effect of"scapular heat penetration"technique of acupuncture in treatment of scapulohumeral periarthritis.Design:It was a single-central randomized controlled trial,the participants,outcome assessors and statisticians were blinded.Setting:The trial was undertaken in Department of Acupuncture and Moxibustion,Yueyang Hospital of Integrated Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,from June 2021 to January 2022.Participants:Sixty-seven patients with scalpulohumeral periarthritis were participated.Interventions:In the control group,the routine acupuncture was given,while in the trial group,the"scapular heat penetration"technique of acupuncture was adopted.The intervention was delivered once every two days,3 treatments a week;and one course included 9 treatments.Before the 1st treatment and after the 9th treatment,the symptoms and physical signs were observed and recorded in each group.Outcomes:Primary outcome:the score of visual analogy scale(VAS)before treatment and after treatment completion.Secondary outcomes:the range of movement(ROM)of shoulder joint,the score of Japanese Orthopaedic Association(JOA)of shoulder joint and the infrared thermal imaging temperature around the shoulder.Results:A total of 102 cases were collected,72 cases of them were eligible and 5 cases were withdrawn.Sixty-seven cases were included in analysis.In the within-group comparison,VAS score,ROM and JOA score as well as the shoulder temperature were all ameliorated after 9 treatments in either the trial group or the control group,compared with those before treatment(P<0.05).In the comparison between two groups,after 9 treatments,VAS score in the trial group was lower than that of the control group(P<0.05);and the improvements in ROM and shoulder temperature in the trial group were better than those of the control group(P<0.05).No adverse reactions were found in the two groups.Conclusion:Both the"scapular heat penetration"technique of acupuncture and the conventional acupuncture are effective on scapulohumeral periarthritis.But,regarding the improvements in pain,ROM of shoulder joint,the activity of daily life and shoulder temperature,the"scapular heat penetration"technique of acupuncture is superior to the conventional acupuncture.

Treatment of 90 patients with scapulohumeral periarthritis in different phases by combining therapy centering on Fu's subcutaneous needling

Objective To observe the efficacy of combining therapy in treatment of 90 patients with scapulohumeral periarthritis in different phases. Method Ninety patients with scapulohumeral periarthritis were treated with Fu＇s subcutaneous needling（FSN） combined with physiotherapy in painful phase, acupotomology and massage in adhesion phase, and appropriate functional exercise in rehabilitation phase. Seven days were considered as one course of treatment, and efficacy evaluation was performed after three courses. Function evaluation of shoulder joint was made. Result The total effective rate was 100%（38/38） in acute phase, 93.5%（29/31） in adhesion phase, and 100%（21/21） in rehabilitation phase. After treatment, the range of motion（ROM） of shoulder joint, pain, muscle force, activities of daily living（ADL） and joint local morphology of the patient have been improved obviously. Conclusion Better clinical efficacy is achieved in treatment of scapulohumeral periarthritis in different phases by combining therapy centering on FSN.

Comparative observation of scapulohumeral periarthritis treated with kinetic acupuncture on the distal points of the affected meridians

Objective To compare the clinical therapeutic effects on scapulohumeral periarthritis between kinetic acupuncture on the distal points of the affected meridians and shoulder three-needle therapy.Methods Fifty cases of scapulohumeral periarthritis were randomly divided into an observation group and a control group,25 cases for each.The cases in observation group were treated with kinetic acupuncture on the distal points of the affected meridians.For example,the case of Hand-Taiyin type was treated with Yújì （鱼际 LU 10） and the case of Hand-Yangming type was treated with Hégǔ （合谷 LI 4）,etc.The cases in control group were treated with shoulder three-needle therapy,in which,Jiānqián （肩前 Extral）,Jiānyú （肩髃 LI 15） and Jiānliáo （肩髎 TE 14） were selected;7 days of treatment made one session,totally 2 sessions were required.Results In observation group,the curative rate based on ROM of shoulder joint was 72.0% （18/25）,which was superior to that of 40.0% （10/25） in control group （P0.05）.After treatment,the improvements of McGill SF-MPQ score,VAS and PPI in observation group were all superior to those in control group （all P0.05）.Conclusion The kinetic acupuncture on the distal points of the affected meridians is advantageous at analgesia and motor improvements of shoulder joint in treatment of scapulohumeral periarthritis as compared with shoulder three-needle therapy.

Evidence-based clinical practice guidelines for acupuncture-moxibustion treatment of scapulohumeral periarthritis

The aim of this study was to establish clinical practice guidelines for acupuncture-moxibustion by retrieving relevant literature and adopting the best current national and international evidence, according to experts＇ experience and patients＇ values. This was achieved using the Grade of Recommendations Assessment, Development and Evaluation（GRADE） system combined with a wide range of national experts＇ consensus, in order to provide reliable evidence for acupuncture-moxibustion treatment of scapulohumeral periarthritis, and to ensure the safety and effectiveness of the treatment.

Regular acupuncture at combined with join valley needling at ashi point for scapulohumeral periarthritis: A randomized controlled trial

Objective:To observe clinical efficacy differences of regular acupuncture at empirical acupoints combined with join valley needling at ashi point compared with simple join valley needling at ashi point for scapulohumeral periarthritis.Methods:Sixty-four patients of scapulohumeral periarthritis were randomly divided into an observation group and a control group,32 cases in each one.Both groups underwent basic rehabilitation training.Patients in the observation group were treated with acupuncture at empirical acupoints combined with join valley needling at ashi point,while the patients of the control group were treated with simple join valley needling at ashi point.Both groups were all treated once a day,6 times a week.Patients were treated for one course which lasted for 4 weeks.The visual analog scale(VAS)score,the Constant-Murley score and the Hamilton Anxiety Scale(HAMA)are compared between the two groups before and after the treatment,and the efficacy was evaluated after the treatment.Telephone investigation was applied as the followed-up after one month of the treatment.Results:The total effective rate in the observation group was 87.5%(28/32),and that in the control group was 71.9%(23/32),and there was statistically significant difference between the two groups(P<0.05).The VAS scores,Constant-Murley scores,and HAMA scores in the patients of the observation group were lower than those of the corresponding indicators in the patients of the control group respectively,and there were statistically significant differences(all P<0.05).Conclusions:Compared with simple join valley needling at ashi point,regular acupuncture at empirical acupoints combined with join valley needling at ashi point can relieve the clinical symptoms of patients with scapulohumeral periarthritis,attenuate pains,ease anxiety and improve daily life activities better.

Discussion on the treatment of scapulohumeral periarthritis

The severity and location of scapulohumeral periarthritis should be identified for determining its treatment method： when the wei exterior is initially invaded by external pathogens for the first time, the location of disease is shallow, therefore, the shallow needling should be performed, which can contribute to diffusing and discharging pathogens of wei exterior. If pathogens had invaded for a long time, they can enter the ying level from wei level, so the acupuncture on ying level should be conducted to discharge the blood stasis and stagnation, thus removing the pathogenic qi and maintaining the healthy qi. If pathogens had invaded for a long time, the meridians and collaterals will be obstructed, and the penetration moxibustion method should be adopted to make the heat penetrate deeply, thereby achieving the effects of warming the meridians and expelling bi. The therapy should be chosen based on syndromes, so meridians can be dredged, and qi-blood can be harmonized, finally the disease will be cured. The precise determination of the location can ensure the success of manipulations. After the nature of disease is identified, targeted methods of acupuncture, bloodletting and fire needling can be performed for treatment of diseases, as a result, ＂normal physiological activities can be maintained＂.

Assessment of therapeutic effect of superficial needling therapy on scapulohumeral periarthritis

ABSTRACT Objective To compare the efficacies on scapulohumeral periarthritis between superficial needling therapy （SN） and warm needling method. Methods Sixty-six cases were randomized into two groups, 33 cases in each one. In SN group, Superficial needling therapy was adopted. In warm needling group, warm acupuncture was applied to Jianyu （肩髃 LI 15）, Tianzong（天宗 SI 11） , Ashi, etc. Functional exercise was assisted in both groups. After 2 courses of treatment, it was to assess the efficacy, relevant pain scale on movement （VAS）, decrease range of motion of shoulder joint （ROM） and comprehensive score in two groups. Results In SN group, the basic curative rate was 27.3 % and total effective rate was 97.0 %. In warm needling group, the basic curative rate was 6. 1% and total effective rate was 75.8%. The efficacy in SN group was superior to that in warm needling group （P〈0.05）. The improvements of VAS, ROM and comprehensive score in SN group were all superior significantly to those in warm needling group （P〈0. 001）. Conclusion Superficial needling therapy achieves quite significant efficacy on scapulohumeral periarthritis and is convenient in operation and good in adherence.

CLINICAL OBSERVATION ON 36 CASES OF SCAPULOHUMERAL PERIARTHRITIS TREATED BY ABDOMINAL ACUPUNCTURE AND BODY ACUPUNCTURE

Objective: To compare the therapeutic effect of abdominal acupuncture plus body acupuncture and simple body acupuncture in treatment of scapulohumeral periarthritis. Methods: 68 cases of scapulohumeral periarthritis patients were randomly divided into abdominal acupuncture plus body acupuncture (AABA) group (n=36) and simple body acupuncture (BA) group (n=32). In AABA group, abdominal acupuncture points used were Zhongwan(CV 12),Shangqu (KI 17) (on the healthy side) and Huaroumen sanjiao (on the affected side); and body acupoints employed were Jianyu (LI 15), Jianliao(TE 14), Binao (LI 14), Quchi (LI 11), Waiguan (TE 5) and Hegu (LI 4) on the affected side. In BA group, the body acupoints used were the same to those mentioned above. The acupuncture needles were retained for 20 min. Acupuncture treatment was given once daily, with 10 sessions being a therapeutic course and the interval between two courses being one week. 2 courses of treatment were conducted altogether. Results: Following 2 courses of treatment, in AABA and BA groups, 6 (16.7%) and 1 (3.1%) cases were cured, 19 (52.8%) and 12 (37.5%) had remarkable improvement, 11 (30.6%) and 17 (53.1%) had improvement, 0 and 2(6.25%) had no effect respectively. There was a significant difference between two groups in the therapeutic effect (P<0.05). Conclusion: The therapeutic effect of abdominal acupuncture plus body acupuncture is superior to that of simple body acupuncture in treatment of scapulohumeral periarthritis.

Application of Huangqi Guizhi Wuwu Decoction in Orthopaedics and Traumatology

The Huangqi Guizhi Wuwu Decoction(HQGZWWT)is composed of Huangqi(Astragali Radix),Shaoyao(Paeoniae Radix Alba),Guizhi(Cinnamomi Ramulus),Shengjiang(Zingiberis Rhizoma Recens),and Dazao(Jujubae Fructus)which has various pharmacological anti-inflammatory,analgesic,antioxidant,antitumor,lipid-lowering,and immunity-regulating activities.It has certain advantages in the treatment of orthopaedic diseases,such as cervical spondylosis,scapulohumeral periarthritis,lumbar disc herniation,knee osteoarthritis,rheumatoid arthritis,myofascial pain syndrome,etc.,with outstanding clinical efficacy,few adverse reactions,and high patient compliance.However,modern pharmacological researches on the whole prescription of HQGZWWT are insufficient and the therapeutic targets are not clear which needs further exploration.Besides,this prescription cannot treat ll orthopaedic diseases,so we should adhere to the thinking of four diagnostics in traditional Chinese medicine(TCM),select prescriptions based on syndrome differentiation,closely follow the pathogenesis,innovate and expand its scope of application,reflect the application advantages of this prescription in orthopaedics and traumatology and improve the total clinical efficiency.