按摩推移肌注法在肥胖患者治疗中的临床应用

目的探讨两种臀部肌肉注射方法对药物吸收的效果。方法选取2010年6月至2013年5月需肌肉注射的肥胖患者50名,按双侧臀部轮流交替肌肉注射的原则,左侧臀部为对照组,给予常规肌内注射,右侧臀部给予按摩推移后进行肌内注射,72小时后观察不同注射部位皮肤情况。结果对照组常规法臀大肌注射肿胀发生率明显高于观察组按摩推移肌注法。结论采用按摩推移后进行肌内注射,药物吸收效果好。

Influence of Acupuncture plus LONG＇s Manual Manipulations on Functional Improvement in Lumbar Intervertebral Disc Protrusion

Objective： To observe the effect of acupuncture plus LONG＇s manual manipulations on the functional improvement of the patients with lumbar intervertebral disc protrusion. Methods： 60 cases of the patients were randomly divided into a observation group and a control group, 30 cases in each group. The observation group was treated with acupuncture plus LONG＇s manual manipulations, and the control group was treated with single acupuncture. The functions of the lumber vertebrae were processed in accordance with the assessment system of Japanese Orthopedic Association （JOA）, and the therapeutic effects were assessed by Visual Analog Scale （VAS）. Results： After the treatments, the differences in JOA and improvement indexes were statistically significant （P〈0.05） between the two groups. VAS was decreased much remarkably in the observation group （P〈0.01） than before the treatments and decreased remarkably in the control group （P〈0.05） than before the treatments. There was a remarkable difference in VAS between the two groups after the treatments （P〈0.05）. Conclusion： Acupuncture plus LONG＇s manual manipulations are better than single acupuncture in improving the functions of the patients with lumbar intervertebral disc protrusion.

Discussion on the application principle of tuina manipulations for lumbar intervertebral disc herniation in Chinese literatures in recent 30 years

Objective: To discuss the application principle in tuina manipulation for lumbar intervertebral disc herniation (LIDH) in Chinese literatures published in recent 30 years. Methods: The three major Chinese databases, Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP) and China National Knowledge Infrastructure (CNKI), were searched to collect the studies of tuina man ipulati ons in treatment of LIDH published in rece nt 30 years. Clusteri ng an alysis was applied to an a lyze the top 20 tuina manipulati ons for LIDH. Results: The top 20 most frequently used manipulations for LIDH were Gun-rolling, Rou-kneading, Dian-digital pressing, oblique Ban-pulli ng, An-pressi ng, Tan bo-plucki ng,*Bashe rvpulli ng and exte nding, horiz on tai Tui-pushi ng, Na-graspi ng, Anrou-pressing and kneading, Dou-shaking, Yao-rocking, Ca-scrubbing, Pai-patting, post-extension Ban-pulling, Mo-rubbing, Zhen-vibrating, Nie-pinching, fist-back Ji-tapping, and dorsal Shen-extending methods. The involved manipulations can be divided into two categories by the treated body areas. One category is applied to the soft tissues, including Gun-rolling, Rou-k neading, Dian-digital pressi ng, An-pressi ng, Tan bo-plucking, horiz ontal Tui-pushi ng, Na-graspi ng, An rou-pressi ng and kneading, Ca-scrubbing, Pai-patting, Mo-rubbing, Zhervvibrating, Nie-pinching, and fist-back Ji-tapping methods. The other category is applied to bones and joints, including oblique Ban-pulling, Bashen-pulling and extending, Dou-shaking, Yao-rocking, post-extension Ban-pulling, and dorsal Shen-extending methods. Conclusion: Based on the treated body area, the tuina manipulations applied to treat LIDH are predominated by the ones performed on soft tissues, assisted by those on bones and joints. From the way of force exertion, the involved manipulations are majorly the swinging methods, followed by squeezing and pressing ones. The manipulations applied to bones and joints are predominated by the Ban-pulling ones, followed by the Bashepulling and extending ones.

Tuina Treatment of 150 Cases with Lumbar Intervertebral Disc Herniation

Objective： To observe the clinical efficacy of tuina treatment for lumbar intervertebral disc herniation. Methods： 150 cases with lumbar intervertebral disc herniation were treated with tuina, followed by a retrospective analysis and summarization on the clinical efficacy. Results： 43 cases obtained clinical recovery, 67 cases had a marked effect, 34 cases had improvement and 6 cases failed. The total effective rate was 96.0%. Conclusion： Tuina is effective for lumbar intervertebral disc herniation.

Clinical Research on Tuina plus Hydro-acupuncture for Lumbar Intervertebral Disc Herniation

Objective： To observe the clinical effects of mina plus hydro-acupuncture on lumbar intervertebral disc herniation. Methods： One hundred and twenty cases of lumbar intervertebral disc herniation were randomly divided into an observation group and a control group. Patients in the observation group were treated with tuina plus hydro-acupuncture, and the control group with tuina. Results： The total effective rate was 93.3% and 75.0% respectively in the observation group and the control group, with a significant difference （P〈0.01）. Conclusion： Tuina plus hydro-acupuncture has better effects than tuina on the lumbar intervertebral disc herniation.

Treatment of 89 Cases of Lumbar Intervertebral Disc Herniation with Acupuncture

Eightynine cases of lumbar intervertebral disc herniation were mainly dealt with acupuncture method, supplementing with traction and Tuina at lumbar region. After 4 courses of treatment, 65 cases were cured, 12 cases got marked effects, 7 some effects, and 3 no effect. This integrated treatment had good effects on lumbar intervertebral disc herniation, and are worthy of being applied widely in clinic.

Clinical Study on Combined Tuina with Qi Zheng Qing Peng Paste for Herniation of the Lumbar Intervertebral Disc

Objective： To observe the clinical efficacy of combined tuina manipulations with Qi Zheng Qing Peng paste for herniation of the lumbar intervertebral disc. Method： All 568 cases were randomly allocated into an observation group （189 cases）, control Ⅰ group （187 cases） and control Ⅱ group （192 cases）. Combined tuina with Qi Zheng Qing Peng paste, combined tuina with diclofenac diethylamine emulsions and tuina alone were adopted in the above three groups respectively. The efficacies in the three groups were compared after 4 weeks of treatment. Results： The total effective rates in the observation group, control Ⅰ group and control Ⅱ group were 89.9%, 86.6% and 84.9% respectively, showing a significant difference （P 〈 0.05） . Conclusion： Combined tuina manipulations with Qi Zheng Qing Peng paste works well for herniation of the lumbar intervertebral disc.

Therapeutic Observation on Treatment of 68 Cases of Prolapse of Lumbar Intervertebral Disc with Lumber Vertebral Traction plus Ding＇s Rolling Technique

To observe the clinical therapeutic efficacy of treatment of prolapse of lumbar intervertebral disc with lumber vertebral traction plus Ding＇s Rolling Technique. Methods： 133 cases of prolapse of lumbar intervertebral disc were randomly divided into two groups. There were 68 cases in the treatment group, which were treated with lumber vertebral traction plus Tuina. There were 65 cases in the control group, which were treated with simple lumber vertebral traction. Results： There were statistic differences in the two groups （X^2=6.86, P〈0.01）. The therapeutic efficacy in the treatment group was better than the control group. Conclusion： The clinical therapeutic efficacy treated with lumber vertebral traction plus Ding＇s Rolling Technique was better than simple lumber vertebral traction in treating prolapse of lumbar intervertebral disc.

Intensive stimulation tuina at tender points plus medication for cervical intervertebral disc herniation

Objective： To observe the clinical efficacy of tuina with intensive stimulation at tender points plus medication in treating cervical intervertebral disc herniation（CIDH）.Methods： Totally 158 CIDH patients were randomized into an observation group and a control group by their visit sequence, 79 cases in each group. The control group was intervened by oral administration of Meloxicam tablets, 7.5 mg for each dose, once each day. The observation group was additionally intervened by tuina with intensive stimulation at tender points based on the treatment given to the control group, once each day. The therapeutic efficacy was evaluated after successive 14-day treatment for the two groups. Results： The total effective rate was 92.4% in the observation group, significantly higher than 81.0% in the control group（P〈0.05）. The visual analogue scale（VAS） scores dropped significantly after the treatment in both groups（both P〈0.01）, and the VAS score of the observation group was significantly lower than that of the control group（P〈0.01）. Conclusion： Tuina with intensive stimulation at tender points plus oral administration of Meloxicam tablets can produce a more significant efficacy in treating CIDH than taking Meloxicam alone, thus worth promoting in clinic.

Observation on therapeutic effect of acupuncture at abdomen acupoints plus tuina for lumbar intervertebral disc herniation

Objective: To observe the clinical efficacy of acupuncture at abdomen acupoints plus tuina for lumbar intervertebral disc herniation (LIDH). Methods: A total of 70 patients with LIDH were randomized into an observation group and a control group, with 35 cases in each group. The observation group was treated with acupuncture at abdomen acupoints plus tuina, while the control group was treated only with tuina treatment. The clinical efficacy was observed after one course of treatment. Results: The cure rate and the total effective rate of the observation group were 83.3% and 96.7%, respectively. The cure rate and the total effective rate of the control group were 39.4% and 78.8%, respectively. There were significant differences in the cured rate and the total effective rate between the two groups (both P<0.05). There was no significant differenee in Japanese Orthopedic Association (JOA) score between the two groups before treatment (P>0.05). After treatment, the JOA scores of both groups in creased sign ifica ntly, and the in tra-group differe nces were statistically sign ifica nt (both P<0.05);the JOA score of the observation group was significantly higher than that of the control group (P<0.05). Conclusion: Acupuncture at abdomen acupoints plus tuina has a better therapeutic effect than tuina alone in the treatment of LIDH.

Clinical Observation on the Treatment of Lumbar Disk Herniation with Hydro-acupuncture plus Tuina

Objective： To observe the therapeutic effect of the treatment of lumbar disk herniation with hydro-acupuncture in combination with tuina. Methods： 380 patients were randomized into two groups, 290 in the treatment group receiving hydro-acupuncture together with tuina therapy, and 60 in the control group receiving acupuncture therapy plus pharmacotherapy. The therapeutic results were evaluated at the end of the third treatment session. Results： The total effective rate of the treatment group was 95.5%, and that of the control group was 57.8%, and the difference was statistically significant （P〈0.01）. Conclusion： Lumbar disk herniation responds well to the treatment of combined hydro-acupuncture and tuina therapy.

Clinical Study on Tuina Therapy for Degenerative Spondylolisthesis of the Lumbar Spine

Objective： There is definite therapeutic effect in tuina treating low back pain. The comparative observation was performed on the two types of tuina manipulation for degenerative lumbar spondylolisthesis, in order to explore the best tuina manipulation for lumbar spondylolisthesis. Methods： All of 121 cases with degenerative lumbar spondylolisthesis were divided into the experimental group and control group randomly by the visit orders and pathological gradations, 61 cases in the experimental group, including 34 cases of grade Ⅰ and 27 cases of grade Ⅱ, and 60 in the control group, including 34 cases of grade Ⅰ and 26 cases of grade Ⅱ. There was no significant difference in the general materials of the two groups. Based upon the similar tuina therapy applied on the soft tissues in the two groups, micro-regulating manual technique of the spine was applied in the experimental group, and the hip and knee-flexed and pillow method was applied in the control group. The treatment was given 3 sessions a week, with 10 sessions as one course of the treatments. The therapeutic effects were assessed after one course of the treatments. Results： There was significant difference （P〈0.01） in the total effective rate and in the remarkable effective rate and curative rate of the patients with grade Ⅰ between the experimental group and control group, also there was significant difference （P〈0.05） in the total effective rate of the patients with grade Ⅱ. Conclusions： The therapeutic effects by the micro-regulatory manual technique are comparatively better for degenerative lumbar spondylolisthesis, and the milder the pathological condition is, the better the therapeutic effects would be.

Clinical Observation on Treatment of Herniated Lumbar Disc by Manual Manipulations plus External Herbal Application

162 cases of the in-patients sick with herniated lumbar disc were randomly divided into three groups, including 82 cases in the observation group treated by manual manipulations plus external herbal application, 40 cases in the control group Ⅰ treated only by external application of herbal drugs, and 40 cases in the control group Ⅱ treated only by manual manipulations. The total effective rate was 90.2% in the observation group, 82.5% in the control group Ⅰ and 85.0% in the control group Ⅱ, indicating a significant difference （P〈 0.05） in comparison of the therapeutic effects between the observation group, the control group I and control group II. In the treatment of herniated lumbar disc by manual manipulations plus external herbal application, the therapeutic effect is precise and obviously higher than that in the treatment by single manual manipulations or by external aoolication of herbal drugs.

Therapeutic observation of tuina manipulation for lumbar intervertebral disc herniation

Objective: To observe the clinical efficacy of balance-impact tuina therapy for lumbar intervertebral disc herniation (LIDH). Methods: A total of 118 eligible LIDH patients were randomized into an observation group and a control group by the random number table method, with 59 cases in each group. The observation group was intervened by balance-impact tuina therapy, while the control group was intervened by conventional tuina therapy, both for consecutive two weeks. The scores of visual analog scale (VAS), Oswestry disability index (ODI)Z quality of life questionnaire-core 30 (QOL-C30) were observed before and after treatment;the relapse rate was estimated at the sixth month and twelfth month following the treatment. The data were statistically an a lyzed. Results: After intervention, the total effective rate was 96.6% in the observation group versus 91.5% in the control group, and the between-group differenee was statistically significant (P<0.05). The VAS and ODI scores declined significantly after treatment in both groups (all Pv0.05), and the observation group was markedly lower than the control group (P<0.05, P<0.01). The QOL-C30 score in creased significantly after treatme nt in both groups (both P<0.05), and the observatio n group was markedly higher than the control group (P<0.05). The relapse rates at the post-treatment sixth month and twelfth month in the observation group were lower than those in the control group (P<0.05, P<0.01). Conclusion: Compared with the conventional tuina therapy, the balance-impact tuina therapy shows advantage in lessening pain, improving the function and enhancing the quality of life in the treatment of LIDH, and it has a lower relapse rate. Thus, this therapy is worth promoting in clinic.

Clinical Experience on Treatment of Lumbar Intervertebral Disc Protrusion by Traditional Manual Techniques plus Electric Acupuncture

52 cases of the patients with L4-S1 intervertebral disc protrusion were first treated by traditional Tuina manual techniques, including the rolling method, pressing method, oblique-plucking method and shaking method, and then treated by electric acupuncture on Shenshu （BL 23）, Yaoyangguan （GV 3）, Dachangshu （BL 25）, Xiaochangshu （BL 27）, Mingmen （GV 4） and Shangliao （BL 31）. After 7-28 sessions of the treatments, the results showed cure in 40 cases, remarkable effect in 8 cases, effect in 3 cases, failure in 1 case, and the total effective rate in 98.1%.

Clinical Observation on Tuina Treatment for Cervical Intervertebral Disc Herniation

Objective： To observe the clinical effect of tuina for cervical intervertebral disc herniation. Methods： Eighty seven cases were randomized into a treatment and a control group. 39 cases in the treatment group were treated with tuina manipulation, while 48 cases in the control group were treated with combined cervical traction and medium-frequency impulse. Cases in both groups were treated 3 times a week, and 10 times constitute a course of treatment. Results： Of 39 cases in the treatment group, 22 obtained recovery, 13 obtained marked effects and 4 obtained improvement, manifesting a marked effect rate of 89.7% and an effective rate of 100.0%. Of 48 cases in the control group, 23 obtained recoveries, 17 obtained marked effects, 7 obtained improvements and 1 saw no improvement, manifesting a marked effect rate of 83.3% and an effective rate of 97.9%. There were no statistical differences in the marked effect rate and total effective rate. Cases in the treatment group were treated 17.8 times on average, while cases in the control group were treated 26.6 times on average. Conclusion： Despite the equivalent effects in the treatment of cervical intervertebral disc herniation, tuina is superior to combined traction and medium-frequency impulse in terms of a faster effect and shorter course of treatment.

Clinical efficacy of Tuina manipulations for lumbar disc herniation and its influence on posture-associated indicators

Objective:To observe the clinical efficacy of sinew-bone balancing manipulation in treating lumbar disc herniation(LDH)and offer clinical evidence to support the concept of paying equal attention to sinew and bone.Methods:Sixty LDH patients were randomized into an observation group and a control group,with 30 cases in each group.The observation group was treated with the sinew-bone balancing manipulation,and the control group received conventional Tuina(Chinese therapeutic massage)manipulation.The clinical efficacy and posterior muscle chain tone effect were compared between the two groups by observing the visual analog scale(VAS)score,Japanese Orthopaedic Association(JOA)score,and posture-associated indicators.Results:The total effective rate was 86.7%in the observation group,higher than 76.7%in the control group,but the between-group difference in efficacy was statistically insignificant(P>0.05).After treatment,the VAS and JOA scores,angle-dependent muscle tone indicator of the posterior muscle chain,and lumbar posture symmetry showed significant changes in both groups(P<0.05).The VAS and JOA scores,angle-dependent muscle tone indicator of the posterior muscle chain,and lumbar posture symmetry in the observation group were significantly different from those in the control group after treatment(P<0.05),but the between-group difference in the general posture symmetry was statistically insignificant(P>0.05).Conclusion:Both the sinew-bone balancing and conventional Tuina manipulations can reduce pain in LDH patients,improve lumbar function,and adjust the angle-dependent muscle tone coefficient of the posterior muscle chain and lumbar posture symmetry;except for the general posture symmetry of the posterior muscle chain,the sinew-bone balancing manipulation wins out over the conventional Tuina manipulation.

Clinical Observation on the Treatment of Lumbar Intervertebral disc Protrusion with Electroacupuncture, TDP plus Tuina

One hundred and twenty-eight cases of lumbar randomly divided into treatment group, in which intervertebral disc protrusion 70 cases were treated were with electroacupuncture, TDP plus Tuina, and control group, in which 58 cases were treated with electroacupuncture plus TDP. The curative rate in the treatment group was higher than that in the control group （64.3% vs 31.0%, P〈 0.01）. The total effective rate was 100% in the treatment group, 91.3% in the control group; the effect of the former was better than that of the latter （P〈 0.05）.

Comparison of biomechanical effect between oblique Ban-pulling manipulation and lumbar erection-rotation manipulation in sitting position for lumbar intervertebral disc herniation

Objective： To compare the biomechanical effects between oblique Ban-pulling manipulation and lumbar erection-rotation manipulation in sitting position in treating lumbar intervertebral disc herniation （LIDH）. Methods： A three-dimensional finite element model of L3-S1 was developed to carry out a comparative study between oblique Ban-pulling manipulation and lumbar erection and rotation manipulation in sitting position. The disc protrusion was assumed to be on the rear left of L4 disc, and the manipulations were performed on the right side. The loading process was simulated by two steps, in the first step, only the compression loading was imposed, and in the second step, both the compression loading and axial rotation moment were imposed. The displacement and stress distribution in L4 disc were investigated. Results： The values of stress and displacement in the second step were lower than those in the first step in each manipulation. The stress and displacement differences between the two steps were respectively 1.79 times and 3.03 times larger in oblique Ban-pulling manipulation than those in lumbar erection-rotation manipulation in sitting position. Conclusion： Oblique Ban-pulling manipulation may result in a better biomechanical effect than lumbar erection-rotation manipulation in sitting position for LIDH.

Electroacupuncture combined with traction and tuina for lumber intervertebral disc herniation

Objective： To observe the effect of electroacupuncture （EA） combined with traction and modified oblique Ban-pulling manipulation on lumber intervertebral disc herniation （LIDH）. 〈br〉 Methods：A total of 90 eligible cases were randomly allocated into three groups, 30 in each group. Cases in group A were treated with EA, traction and tuina of modified oblique Ban-pulling manipulation; cases in group B were treated with traction and tuina （same as group A）;and cases in group C were treated with traction alone （same as the other two groups）. Then the therapeutic efficacies in the three groups were evaluated using the Japanese Orthopedic Association （JOA） score rating system. 〈br〉 Results：The results after treatment and 1-month follow up showed that JOA scores in all three groups were improved （P〈0.01）; the total effective rate in Group A was 96.7%, versus 90.0% in group B and 70.0% in group C, showing a significantly better effect than the other two groups （P〈0.01）. 〈br〉 Conclusion： EA combined with traction and modified oblique Ban-pulling manipulation can obtain better effect than traction alone and traction combined with modified oblique Ban-pulling manipulation for LIDH.