穴位电针刺激对腰椎间盘突出症术后残留神经功能损害的治疗作用

目的探讨穴位电针刺激对腰椎间盘突出症行经皮椎间孔镜髓核摘除术术后仍残留神经功能损害的治疗效果。方法选取2015年1月至2018年1月铜川市人民医院骨科、宁夏回族自治区中医医院骨科及陕西省宝鸡市扶风县中医院骨科收治的腰椎间盘突出症行经皮椎间孔镜髓核摘除术后仍残留神经功能损害的患者80例,按照随机数字表法分为穴位电针治疗组和对照组各40例,两组术后均给以相同的基础治疗,而穴位电针治疗组自术后第1天开始,每日双侧下肢足三里、丰隆穴电针刺激治疗。每次30min,每日1次,共持续4周。两组不同时间点的足拇趾背伸肌肌力和日本骨科协会评估治疗评分(JOA评分)进行比较。结果穴位电针治疗组术后2、4周拇趾背伸肌力与对照组比较,差异有统计学意义(P<0.05)。穴位电针治疗组术后4周JOA评分与对照组比较,差异有统计学意义(P<0.05)。结论穴位电针刺激治疗可促进腰椎间盘突出症术后患者的神经根功能恢复,促进受损神经根支配骨骼肌肌力的恢复,提高治疗效果。

INFLUENCE OF DIFFERENT NEEDLE-RETAINING TIME ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE IN THE TREATMENT OF ISCHEMIC STROKE

Objective：To explore the relationship between the needle-retaining time and the therapeutic effect of acupuncture in the treatment of ischemic stroke patients. Methods： Based on the level of the severity of the patient＇s disease and the duration of acupuncture needle-retaining, 245 ischemic stroke inpatients were divided into 20 min, 40 min and 60 min groups according to the stratified random method. Acupoints used were Jianyu （肩髃LI 15）, Quchi （曲池LI 11）, Waiguan （外关TE 5）, Hegu （合谷LI 4）, etc. and stimulated electrically （2 Hz, sparse waves, an endurable strength） for 20 min, 40 min and 60 min respectively by using an electroacupuncture therapeutic apparatus. The treatment was given once daily, with 10 sessions being a therapeutic course. The severity of clinical neurological deficit was scored before and after the treatment Results： The results showed that acupuncture could improve the neurological deficit severity of ischemic stroke patients. The therapeutic effect of acupuncture in improving myodynamia of the upper limbs and hands, and the total score of 60 min group was the best, followed by 40 min group and 20 min group respectively,of acupuncture needle retention has a better therapeutic effect in the treatment indicating that longer duration of acupuncture needle retention has a better therapeutic effect in the treatment of stroke. Conclusion： There is a positive relationship between the needle-retaining time and the curative effect in improving ischemic stroke patients＇clinical symptoms and signs by acupuncture.

Economic Evaluation of Treating Herpes Zoster with Various Methods of Acupuncture and Moxibustion

OBJECTIVE:To analyze the cost effect of surrounding acupuncture plus electric acupuncture,cotton-sheet moxibustion,puncturing with red-hot needles,tapping plus cupping on herpes zoster.METHODS:Five hundred patients with herpes zoster were randomly divided into group A(surrounding acupuncture plus electric acupuncture),group B(cotton-sheet moxibustion),group C(puncturing with red-hot needles),group D(tapping plus cupping),and group E(Western medicine).The treatment was carried out twice a day in group E and once a day in the other four groups.The curative effect was observed on the 10th day of treatment;the cost was calculated for the five therapies,and the cost-effect ratio(C/E) and increment ratio(△ C/△ E) were analyzed.RESULTS:After the 10-day treatment,there was no statistical difference(P>0.05) in the curative effect among the five groups.Pain being alleviated one day faster than in group E amounted to a saving of RMB 21.90 yuan in group A,a saving of RMB 21.87 yuan in group B,a saving of RMB 26.00 yuan in group C,and a saving of RMB 20.23 yuan in group D.Compared with group C,the values of △ C/△ E were RMB 1.55,2.81,and 0.21 yuan in groups A,B,and D,respectively.CONCLUSIONS:The curative effect in groups A,B,C,and D was similar to that in group E,but the C/E was better than in group E.

Therapeutic effect of electroacupuncture,massage,and blocking therapy on external humeral epicondylitis

OBJECTIVE:To compare two therapeutic methods:electroacupuncture + massage + blocking therapy,and blocking therapy alone in the treatment of external humeral epicondylitis.METHODS:Eighty-six patients were randomized into two groups with 43 in each. The treatment group received electroacupuncture + massage +blocking therapy, while the control group received blocking therapy only. A course of electroacupuncture treatment included therapy once a day for 10days. There were 10 treatments in a massage course and massage was given once a day, with a1-week interval given before the next course. A course of blocking treatment included therapy once a week, for twototaltreatments,andgenerallyno more than three times. The therapeutic effects were evaluated with the visual analog scale(VAS),grip strength index(GSI) score, and Mayo elbow performance score(MEPS) before treatment and at0, 6, 12, and 24 months after treatment to observe thetotaleffectiverate.RESULTS: In the treatment and control groups before treatment and at 0, 6, 12, and 24 months after treatment, the VAS scores were: 6.5±1.9 and 6.4±1.6; 4.6±1.3 and 4.6±1.7; 4.8±1.3 and 4.8±1.2; 4.6±1.2 and 6.6±1.6; and 6.5±1.6 and 6.5±1.3, respectively. The GSI scores were 63±8 and 63±8; 84±6and82±7;82±7and82±6;84±6and62±8;and64±6 and 64±7, respectively.The MEPS of both groups were65±7and66±8;85±6and84±7;84±5and84±7;80±7and66±6;and65±6and65±7,respectively.The total effective rates of the treatment and control groups at 0, 6, 12, and 24 months after treatment were 87.5% and 85.0%; 85.0% and 82.5%;80.0% and 12.5%; and 2.5% and 5.0%, respectively.Compared with the treatment group, the control group had greater joint function, better the rapeutic effect, and lower pain intensity(P<0.01), indicating a high recurrence rate in the 12th month after treatment.There were no differences inVAS, GSI, or MEPS at 0, 6, and 24 months after treatment(P>0.05)betweenthetwogroups.CONCLUSION: We found that both methods were effective for external humeral epicondylitis. After 6months of treatment,the effects were good in both groups. However, in the 12th month, the control group had a relatively severe relapse. After 24months, both groups relapsed. The effect of electroacupuncture, massage, and blocking therapy used in combination lasted longer, delaying the recurrence of the disease.

44 Cases of Peripheral Facial Paralysis Treated by the SXDZ-100 Nerve and Muscle Stimulator

Objective: To observe the clinical effects of the Hua Tuo Manual Acupuncture Therapeutic Stimulator for peripheral facial paralysis. Methods: 87 patients with peripheral facial paralysis were divided randomly into the SXDZ-100 Nerve and Muscle Stimulator treatment group (44 cases) and the G6805 Electric Stimulator control group (43 cases). The acupoints selected for both the two groups were local points as well as distal points as Hegu (LI 4), Waiguan (TE 5), Sanyinjiao (SP 6), Taichong (LR 3). Effectiveness was compared between the two groups. Results: Both groups had a total effective rate of 100%. But the cure rate was 90.9% in the treatment group, and 73.0% in the control group, indicating a significant difference (P<0.05). No side effects were found in either of the two groups. Conclusion: The SXDZ-100 stimulator is more effective than the G6805 electroacupuncture stimulator for treatment of peripheral facial paralysis.