Clinical study on the treatment of functional constipation in infants and younger children with pediatric Tuina based on Baliao points

Objective:To observe the clinical efficacy of Tuina(Chinese therapeutic massage),basically Yi Zhi Chan pushing at Baliao points in the treatment of functional constipation in infants and children aged 1-3 years old.Methods:Seventy kids were randomly divided into an observation group and a control group,with 35 cases in each group.The control group was treated with conventional Tuina manipulation,while the observation group was treated with Tuina manipulation based on Yi Zhi Chan pushing at Baliao points.Both groups were treated once every other day,with 10 times as 1 course of treatment.The score on the self-developed constipation rating scale and clinical efficacy were compared after 1 course of treatment.Results:The total effective rate was 90.6%in the observation group and 76.7%in the control group,and the difference between the two groups was statistically significant(P<0.05).The degree of defecation difficulty in the children in the observation group was milder than that in the control group(P<0.01).Conclusion:Tuina manipulation based on Yi Zhi Chan pushing at Baliao points can significantly improve the degree of defecation difficulty in children,and the total effective rate is better than that of conventional Tuina manipulation.

Clinical observation of Tuina plus Chinese medication hot compress for lumbar muscle strain

Objective:To discuss the clinical efficacy of treating lumbar muscle strain(LMS)with Tuina(Chinese therapeutic massage)plus Chinese medication hot compress.Methods:A total of 147 LMS patients were randomized into a Tuina group,a Chinese medication hot compress group,and a combined group,each consisting of 49 cases.The Tuina group received Tuina treatment;the Chinese medication hot compress group received Chinese medication hot compress treatment;and the combined group received the forementioned two therapies alternately.The three groups of patients were assessed using the visual analog scale(VAS)and Oswestry disability index(ODI)before treatment and after 2 weeks of treatment.A 2-month follow-up was also conducted to observe the relapse rate.Results:The VAS and ODI scores dropped significantly after treatment in all three groups compared with their baseline(P<0.05),and the combined group surpassed the other two groups in comparing the ODI score(P<0.05).The 2-month follow-up showed that the combined group had the lowest relapse rate among the three groups(P<0.05).Conclusion:Compared to each therapy used alone,Tuina plus Chinese medication hot compress can relieve pain,improve daily living function,and reduce the short-term relapse rate better in treating LMS patients.

Modulation effects of pressing manipulation on local inflammatory responses and ERK/NF-κB pathway in trigger point model rats

Objective:To investigate the mechanism of trigger point deactivation induced by pressing manipulation in a rat model and to explore its potential regulation of the inflammatory response through the extracellular signal-regulated kinase(ERK)/nuclear factor-κB(NF-κB)pathway.Methods:Fifty male Sprague-Dawley rats were randomly divided into a blank group,a model group,a pressing manipulation group,an ERK agonist group,and a pressing manipulation+ERK agonist group,with 10 rats in each group.Except for the blank group,rats in other groups were used to establish the trigger point rat model using the blunt blow combined with the eccentric exercise method.The pressing manipulation group underwent pressing manipulation intervention at the trigger points.The ERK agonist group received an injection of recombinant human epidermal growth factor via the tail vein.The pressing manipulation+ERK agonist group received interventions from both the pressing manipulation and ERK agonist groups.The pressure pain threshold(PPT)was measured by a mechanical pain threshold detector before and after the intervention.The histological changes were evaluated by hematoxylin-eosin staining after the intervention;the expression levels of ERK,phosphorylated ERK(p-ERK),NF-κB p65(p65),phosphorylated NF-κB p65(p-p65),and phosphorylated NF-κB inhibitor(p-IκB)were detected by Western blotting;the levels of interleukin(IL)-1β,IL-6,and tumor necrosis factor(TNF)-αwere detected by enzyme-linked immunosorbent assay.Results:The PPT increased(P<0.05);the inflammatory cells disappeared;the ratios of p-ERK/ERK,p-p65/p65,and p-IκB/β-actin,also the levels of IL-1β,IL-6,and TNF-αall decreased in the pressing manipulation group after the intervention compared with the model group(P<0.05).The PPT decreased significantly(P<0.05),the inflammatory cell presence increased,and the ratios of p-ERK/ERK and p-p65/p65 were elevated(P<0.05);additionally,the levels of IL-6 and TNF-αwere significantly higher in the pressing manipulation+ERK agonist group compared with the pressing manipulation group(P<0.05).The PPT was significantly lower(P<0.05),the inflammatory cell count was higher,the ratios of p-ERK/ERK and p-IκB/β-actin and the levels of IL-1βand TNF-αwere significantly higher in the ERK agonist group compared with the pressing manipulation+ERK agonist group(P<0.05).Conclusion:Pressing manipulation can effectively alleviate inflammation and pain in trigger point model rats,potentially by inhibiting the ERK/NF-κB signaling pathway.

Therapeutic effect observation on Nie-pinching the spine manipulation for infantile diarrhea due to spleen deficiency

Objective： To observe the influence of Nie-pinching the spine manipulation on the excretory rate ot urine D-xylose in the infants with diarrhea due to spleen deficiency, and to assess the clinical effects. Methods： Sixty infants in conformity with the diagnostic criteria of diarrhea due to spleen deficiency were randomly divided into a treatment group and a control group by the random digital table, 30 cases in each group. The infants in the treatment group were treated by Nie-pinching the spine manipulation and traditional infantile tuina, in addition to the routine basic treatment. The infants in the control group were treated by the same traditional infantile tuina in addition to the routine basic treatment. The infants in the two groups were treated once every day, 4 weeks as a course. Totally, the treatment was given for a course. The symptom integrals of spleen deficiency were used to assess the improvement in the symptoms. The colorimetry was used to determine the excretory rate of urine D-xylose. Results： in the comparison of the same group before and after the treatment, the differences in the global score of spleen deficiency symptoms and the excretory rate of urine D-xylose in the two groups were statistically significant （all P〈0.01）. After the treatment, the differences in the global score of spleen deficiency symptoms and the excretory rate of urine D-xylose between the two groups were all statistically significant （both P〈0.01）. Conclusion： Chiropractics can reduce the integrals of spleen deficiency symptoms and elevate the excretory rate of urine D-xylose in the infants with diarrhea due to spleen deficiency, so as to enhance the therapeutic effects by alleviating the symptoms of spleen deficiency and the absorptive function of the small intestine.

Discussion on the theory of paying equal attention to sinew and bone in China osteosynthesis

‘Paying equal attention to sinew and bone＇ is an important principle in China osteosynthesis （CO）. Traditional bone-setting manipulations not only pay high attention to fracture reduction, but also to sinew-regulating and soft tissues protection. The advantage of this principle has also been confirmed by modern medicine. To understand the principle better, it is essential to learn its historical origin, its important role in traumatology and its significant influence on modern orthopedics. In addition, we should inherit and further develop its theory, innovate and promote the development of CO constantly.

Therapeutic effect observation of Shanghai-style tuina method for infantile diarrhea

Objective： To observe the clinical efficacy of Shanghai-style tuina method based on syndrome differentiation in treating infantile diarrhea. Methods： Sixty patients were randomly divided into an observation group and a control group, 30 cases in each group. The patients in the observation group were treated by Shanghai-style tuina method based on syndrome differentiation, while the patients in the control group were treated by conventional Shanghai-style tuina method, once per day, continuous 5 d for a treatment course. The efficacy was evaluated according to the score of the quantization table for symptoms differentiation in infantile diarrhea after one course. Results： During the treatment, two cases in the control group dropped out. After treatment, the scores were significantly decreased in both groups and the intra-group differences were statistically significant （both P〈0.01）, indicating the two treatment methods were effective with infantile diarrhea. In the efficacies of traditional Chinese medicine （TCM） syndrome, the cured and markedly effective rate in the observation group was significantly higher than that in the control group （P〈0.05）, suggesting that Shanghai-style tuina method based on syndrome differentiation was more effective than conventional Shanghai-style tuina method. Conclusion： Conventional Shanghai-style tuina method is characterized by fixed acupoints, remembering easily and operating conveniently. It has a significant effect in treating children with diarrhea, and is worthy of clinical promotion and popularization. However, Shanghai-style tuina method based on syndromes differentiation requires the solid theoretical foundation and rich clinical experience of TCM. And because Shanghai-style tuina method based on syndromes differentiation is applied under the guidance of syndrome differentiation and TCM theory, it can improve the clinical efficacy.

Clinical observation of treatment of infantile diarrhea due to spleen deficiency using five-step pediatric tuina of Huxiang school

Objective:To observe the clinical efficacy of treating infantile diarrhea due to spleen deficiency with five-step pediatric tuina of Huxiang school.Methods:Using a randomized controlled trial design,sixty eligible kids with diarrhea due to spleen deficiency were randomized into an observation group and a control group,with 30 cases in each group.The observation group was intervened by the five-step pediatric tuina method of Huxiang school,and the control group received conventional tuina treatment.The intervention was conducted once a day,consecutive 5-day treatment as 1 course,at a 2-day interval between courses,successively for a total of 4 courses.Changes in the primary and secondary symptoms of diarrhea due to spleen deficiency were observed,and the clinical efficacy was evaluated.Results:After treatment,the scores of primary and secondary symptoms and the general score of diarrhea due to spleen deficiency were improved;the improvements in fecal form and frequency,decreased appetite,bloating after meals and fatigue and sluggishness were more significant in the observation group than in the control group.Conclusion:The five-step pediatric tuina method of Huxiang school and conventional tuina both can improve the primary and secondary symptoms in infantile diarrhea due to spleen deficiency,while the former one can produce more significant efficacy.

Efficacy observation on pediatric tuina plus Chinese medicine for exogenous fever in children

Objective: To observe the clinical effects of pediatric tuina plus Chinese medicine for exogenous fever in children. Methods: A total of 150 children withexogenous fever were randomly divided based on the random digital table into a control group (75 cases) and a treatment group (75 cases). The control group was treated with oral Xiao'er Chaigui Tuire Keli (<1 year old, 0.5 bag/time;1-3 years old, 1 bag/time;4-6 years old, 1.5 bags/time), 4 times/day. The treatment group was treated with pediatric tuina plus the intervention of the control group. The amount and usage of Chinese medicine were the same as those of the control group;tuina was conducted 1 time/day. The clinical effects and adverse reactions were observed after 3 d of treatment in both groups. The recurrence was observed within 7 d after the end of treatment. Results: The total effective rate was 92.0% in the treatment group and 81.3% in the control group. The difference between the two groups was statistically significant (P<0.05). There were no obvious adverse reactions in the two groups after treatment. The recurrence rate was 1.5% in the treatment group and 13.1% in the control group. The difference in the recurrence rate between the two groups was statistically significant (P<0.05). Conclusion: Pediatric tuina plus Chinese medicine is effective in treating children with exogenous fever.

Clinical experience of Xiangxi Liu's infantile tuina for exogenous fever in children

Xiangxi (the western part of Hunan province) Liu's infantile tuina,as one main school of current infantile tuina in China,highlights the compatibility of the specific points of Wujing in children,the idea of treatment by syndrome differentiation,and produces unique efficacy in the treatment of common diseases in children.Exogenous fever in children can be treated with this method with excellent efficacy.Based on the clinical experience and effective cases treated by this tuina school,the authors elaborated the clinical thought and experience from the perspective view of tuina,for the promotion of Xiangxi Liu's infantile tuina in clinic.

Clinical Efficacy Evaluation on Electroacupuncture for Osteoarthritis and Observation on Biomechanical Indexes

Objective： To observe the clinical efficacy of electroacupuncture for knee osteoarthritis （KOA）. Method： Forty KOA cases were randomized into an electroacupuncture and a tuina group （20 cases in each group） by their visit order. The therapeutic efficacy was evaluated by the WOMAC osteoarthritis index obtained prior to the treatment, and 2 or 4 weeks afterwards. In addition, the gait prior to the treatment and afterwards were tested by a gait analyzer. Results： The WOMAC scale revealed that after 4 weeks of treatment, cases in both groups got significant improvement （P〈0.01 in both electroacupuncture and tuina group） in pain relief, stiffness improvement and management of daily activities; cases in the electroacupuncture group showed a better result after 2 weeks of treatment, coupled with a better result than tuina group in managing daily activities and pain relief after 4-week treatment, however, there was no significant difference between the two groups in stiffness improvement. Cases in the electroacupuncture group also showed a significant improvement （P 〈0.05） in step length, stride length, step speed and walking cycles after the treatment, but no significant difference in the Q angle. Conclusion： Electroacupuncture has better effect for knee osteoarthritis than tuina, and it can also improve the gait performance of the patients.

Comparison of curative effect of different media in pediatric tuina for infantile muscular torticollis

Objective:To observe the clinical efficacy of different media in pediatric tuina treatment for children with muscular torticollis.Methods:A total of 80 children with muscular torticollis were randomized into an observation group and a control group,40 cases in each group.Both groups received conventional pediatric tuina therapy.The observation group was treated with Bai Mai ointment as the massage medium,while the common lubrication oil was used as medium in the control group.Both groups were treated five times a week,20 min for each time,20 times constituted a course of treatment.The traditional Chinese medicine(TCM)syndrome scores were evaluated before and after treatment,and the curative effect was observed after 3 courses and 6 courses of treatment respectively.Results:The TCM syndrome scores improved in both groups after treatment,and the intra-group differences were statistically significant(both P〈0.01).The score of the observation group was statistically different from that in the control group(P〈0.05).In the observation group,the total effective rates after 3 courses and 6 courses of treatment were 95.0%and 100.0%,respectively,versus 87.5%and 95.0%in the control group.The total effective rates of the two groups were statistically different(both P〈0.05).Conclusion:Bai Mai ointment has a better curative effect than the common lubricating oil as a massage medium in the treatment of children with muscular torticollis.

Holistic View of Chinese Spinal Manipulation and Its Clinical Application

Objective： To improve the clinical efficacy by applying the holistic view to the spinal manipulations. Method： The anatomical structure and physio-pathological characteristics of the spine have been studied by using modern scientific knowledge, such as, anatomy, image, biomechanics and pathophysiology. Results： The spine and its surrounding muscles and ligaments, the whole spine, spine and nerves, vessels in between intervertebral foramen as well as the spinal cord within the spinal canal, and spine, pelvis and the lower limbs all constitute an organic whole. Conclusion： The TCM holistic view in bones and tendons, spine, spine- nerve-vessel-spinal cord and spine-pelvis-lower limbs are still guiding the clinical practice of spinal manipulations.

Clinical Observation on Treatment of Knee Osteoarthritis by Acupuncture and Tuina Therapy

Objective： To observe the effect of acupuncture and Chinese tuina manipulation therapy in treating knee osteoarthritis, and analyze the alteration of musculus quadriceps femoris strength. Methods： A total of 80 patients were randomly assigned to a treatment group receiving acupuncture combined Chinese tuina manipulation therapy （n=40） and a control group receiving Fenbid treatment （n=40）, curative effective score, Lequene ＆ Mery assessment tests, and isokinetic evaluation were recorded before and after the treatment course. Results： The total effective rate was 90.0 % in the treatment group and 87.5% in the control group, without a significant difference between the two groups. Lequene ＆ Mery assessment tests had no significant change. Musculus quadriceps femoris isokinetic evaluation improved significantly after the treatment course in the two groups （/9〈0.05）, and there was a significant difference between the two groups （P〈0.05）. Conclusion： Acupuncture combined with tuina manipulation therapy and Fenbid treatment both can reduce knee pain and joint disability in the short term, though no improvement was shown in the severity of the disease. Acupuncture combined with tuina manipulation therapy is better than Fenbid in improving the strength, total work and explosive force of the musculus quadriceps femoris.

Action of Tuina on Retro-positioning of Skull Spatial Offset in Patients with Cervical Vertigo

Objective： To investigate the onset mechanism of cervical vertigo from the proprioceptive sensation and provide clinical basis for its treatment. Methods： Among the 121 cases that conformed to the diagnostic criteria of cervical vertigo, 70 cases who presented with negative neck-rotation test and cervical vertigo without obvious vascular factors by transcranial Doppler （TCD） were assigned to the observation group, while 51 cases who presented with positive neck-rotation test and cervical vertigo due to spasm of vertebral basal artery or insufficient blood supply by TCD were assigned to the control group. The cases in the two groups were treated once every day, 5 days make up one treatment course and the results were statistically analyzed after one treatment course. Results： The skull triaxial spatial offset of the cases in the two groups were significantly reduced after the treatment （P〈0.01）. However, there was no statistically significant difference between the skull triaxial spatial offset between the two groups （P〉0.05）. It is not conclusive that the therapeutic effect in the two groups was significantly different after one treatment course. Conclusion： Tuina manipulation therapy can improve the skull spatial offset repositioning ability of the patients.

Mechanisms of Spinal Micro-adjustment Manipulations in Treating Cervical Spondylotic Radiculopathy

Summary： On the basis of the investigation of the pathogenesis of cervical spondylotic radiculopathy, this paper studies the mechanisms of spinal micro-adjustment manipulations in recovering and improving cervical dynamic and stationary balance from the perspective of biomechanics.

Manipulation parameter optimization in Liu's back tuina therapy for kids'cough variant asthma in remission stage

Objective:To determine the optimal manipulation parameters in Liu's back tuina therapy for remission-stage cough variant asthma(CVA)in kids.Methods:A 5-factor 3-level L18(37)orthogonal design was adopted.The experimental factors and levels were selected:A,the number of times of Rou-kneading Feishu(BL 13);B,the frequency of Rou-kneading Feishu(BL 13);C,the number of times of Tui-pushing in a'介'-like pattern;D,the frequency of Tui-pushing in a'介'-like pattern;E,the intensity of red color after Ca-scrubbing Feishu(BL 13)with salt.A1,A2 and A3 stood for 10 times,20 times and 30 times,respectively;B1,B2 and B3 stood for 200 times/min,240 times/min and 280 times/min,respectively;C1,C2 and C3 stood for 50 times,75 times and 100 times,respectively;D1,D2 and D3 stood for 150 times/min,175 times/min and 200 times/min,respectively;E1,E2 and E3 stood for pinkish,bright red and dark red,respectively.A total of 108 kids with CVA in remission stage were divided into 18 groups using the random number table method,with 6 cases in each group.Changes in the cough score and fractional exhaled nitric oxide(FENO)level were observed after 15-day treatment.Results:The cough score and FENO level changed significantly in every group after treatment(all P<0.01).By the effect in improving cough score,the factors were listed as D,B,A,C and E in descending order;the most optimal manipulation parameter combination was group 17(A3B2C1D3E1);the second optimal parameter combinations were group 7(A3B1C2D1E3),group 13(A2B1C2D3E1)and group 14(A2B2C3D1E2).Regarding the effect in down-regulating the level of FENO,the factors were listed as C,A,E,B and D in descending order;the most optimal manipulation parameter combination was group 13(A2B1C2D3E1);the second optimal parameter combinations were group 18(A3B3C2D1E2),group 16(A3B1C3D2E3)and group 14(A2B2C3D1E2).Conclusion:Two most effective manipulation parameter combinations were selected out of 18 different parameter combinations in Liu's back tuina therapy for remission-stage CVA in kids.Doctors can choose an appropriate manipulation based on the symptom features of the disease.

Role of Cervical Soft Tissue Lesion in Cervical Spondylosis and Tuina Intervention

Cervical spondylosis is markedly characterized by degenerative changes. The studies in recent years on the role of cervical soft tissue lesion in cervical spondylosis indicated that cervical soft tissue lesion runs through the whole process of cervical spondylosis and is dominantly responsible for varieties of clinical symptoms. Cervical osseous lesion can be regarded as a result of soft tissue lesion and subordinated to soft tissue lesion in the course of cervical spondylosis.

Clinical Observation on Treatment of Cervical Spondylotic Radiculopathy with Combined Electroacupuncture Tuina and Traction

Objective： To observe the clinical effect of combined electroacupuncture, tuina. and traction treating cervical spondylotic radiculopathy. Method： Depending on the orders of the patient＇s first visit, 120 cases were randomized into a treatment group （60 cases）, receiving electroacupuncture, tuina and traction treatment, and a control group （60 cases）, receiving electroacupuncture and tuina treatment. The treatment was done once a day, and 5 times constitute one course of treatment. A 2-day interval is set between the courses. The therapeutic effect was evaluated after 6 courses of treatment. Result： The total effective rate and recovery rate in the treatment group were 93.3% and 61.7%, respectively, whereas that of the control group were 78.3% and 31.7%, respectively, showing a significant statistical difference. Conclusion： Combined acupuncture, tuina and traction worked well for cervical spondylotic radiculopathy.

Clinical observation on electroacupuncture plus tuina for chronic tension-type headache

Objective：To observe the clinical efficacy of electroacupuncture （EA） combined with tuina for chronic tension-type headache （CTTH）. Methods：A total of 97 CTTH cases were randomly allocated into an observation group （n=52） and a control group （n=45）. Patients in the observation group were treated with EA plus tuina based on pattern identification, whereas patients in the control group were treated with oral amitriptyline and oryzanol. Patients in both groups were treated for 8 weeks. A follow-up was conducted 3 months after the treatment. The intensity, duration, and frequency of the headache were recorded and compared before and after the treatment. Additionally, the patients＇ psychological state and quality of life （QOL） were compared between the two groups. Results：There were intra-group statistically significant differences in headache intensity score, headache duration, and headache frequency after the treatment and during the follow-up compared with those before the treatment （allP〈0.05）; and there were between-group statistically significant differences during the same time frame （allP〈0.05）. The Hamilton depression scale-17 items （HAMD-17） and Hamilton anxiety scale （HAMA） scores were significantly reduced in both groups after the treatment or during the follow-up （allP〈0.01）; and there were no between-group statistical significances during the same time frame （allP〉0.05）. The World Health Organization quality of life-BREF （WHOQOL-BREF） scores were significantly reduced in both groups after the treatment or during the follow-up （allP〈0.05）; and the scores in the observation group were significantly lower than those in the control group （allP〈0.05） during the same time frame. The total effective rate was 88.0% in the observation group, versus 71.4% in the control group, showing a significant difference （P〈0.05）. Conclusion：EA combined with tuina can significantly decrease the frequency of chronic tension-type headache, alleviate headache intensity, shorten headache duration, and improve the patients＆#39; wellness. It is better than amitriptyline plus oryzanol.

Summarization of Constipation Treated with Tuina Therapeutics

A review of Tuina treating constipation was done, and it is believed that Tuina is an effective, safe, and convenient method for treating constipation. It should be popularized in clinic.