Effect of low-level laser therapy on tooth-related pain and somatosensory function evoked by orthodontic treatment

Low-level laser therapy(LLLT) may have an effect on the pain associated with orthodontic treatment. The aim of this study was to evaluate the effect of LLLT on pain and somatosensory sensitization induced by orthodontic treatment. Forty individuals(12–33 years old; mean ± standard deviations: 20.8 ± 5.9 years) scheduled to receive orthodontic treatment were randomly divided into a laser group(LG) or a placebo group(PG)(1:1). The LG received LLLT(810-nm gallium-aluminium-arsenic diode laser in continuous mode with the power set at 400 mW, 2 J·cm–2) at 0 h, 2 h, 24 h, 4 d, and 7 d after treatment, and the PG received inactive treatment at the same time points. In both groups, the non-treated side served as a control. A numerical rating scale(NRS) of pain, pressure pain thresholds(PPTs), cold detection thresholds(CDTs), warmth detection thresholds(WDTs), cold pain thresholds(CPTs), and heat pain thresholds(HPTs) were tested on both sides at the gingiva and canine tooth and on the hand. The data were analysed by a repeated measures analysis of variance(ANOVA). The NRS pain scores were significantly lower in the LG group(P = 0.01). The CDTs,CPTs, WDTs, HPTs, and PPTs at the gingiva and the PPTs at the canine tooth were significantly less sensitive on the treatment side of the LG compared with that of the PG(P < 0.033). The parameters tested also showed significantly less sensitivity on the nontreatment side of the LG compared to that of the PG(P < 0.043). There were no differences between the groups for any quantitative sensory testing(QST) measures of the hand. The application of LLLT appears to reduce the pain and sensitivity of the tooth and gingiva associated with orthodontic treatment and may have contralateral effects within the trigeminal system but no generalized QST effects. Thus, the present study indicated a significant analgesia effect of LLLT application during orthodontic treatment.Further clinical applications are suggested.

Effect of microenvironment modulation on stem cell therapy for spinal cord injury pain

Spinal cord injury （SCI） currently ranks second after mental retarda- tion among neurological disorders in terms of cost to society. Pain is a debilitating consequence of SCI related to the nature of the lesion, neurological structures damaged, and secondary pathophysiological changes of surviving tissues （Yezierski, 2005; D＇Angelo et al., 2013）.

Pathogenesis and managenent of pain in chronic pancreatitis

INTRODUCTIONOf the three cardinal manifestations of chronic pancreatitis-pain,diabetes mellitus and steatorrhea,it is pain thatbrings the patient to the physician and is the most difficultto manage.The intractabale pain that is quite

Clinical Study on Extracorporeal Shock Wave Therapy plus Electroacupuncture for Myofascial Pain Syndrome

Objective: To observe the clinical effect of extracorporeal shock wave plus electroacupuncture(EA) on myofascial pain syndrome(MPS) and to investigate its treatment mechanism. Methods: Ninety cases who met the inclusion criteria were randomly allocated into an EA group, an extracorporeal shock wave therapy(ESWT) group and a combined therapy group, 30 in each group. EA was employed in the EA group, extracorporeal shock wave therapy in the ESWT group and EA plus extracorporeal shock wave therapy in the combined therapy group. The VAS, tenderness threshold and therapeutic efficacy were evaluated after three months of treatment. Results: After 2 weeks, 4 weeks and 3 months of treatment, the VAS scores in all three groups were significantly reduced and the tenderness threshold significantly elevated. The recovery rate and total effective rate were 23.3% and 83.3% respectively in the EA group, versus 40.0% and 90.0% in the ESWT group and 63.3% and 96.7% in the combined therapy group, showing statistical differences(P<0.05). Conclusion: EA combined with EWST works remarkably well for MPS.

Is Manipulative Therapy Clinically Necessary for Relief of Neck Pain？A Systematic Review and Meta-Analysis

Objective：To summarize and critically assess the efficacy of Eastern and Western manipulative therapies for the treatment of neck pain in adults. Methods：A search of Pub Med/MEDLINE, the Cochrane Central Register of Controlled Trials, Clinical Trials.gov, EMBASE, etc. from their inception date to January 2014 with Chinese, Japanese, and Korean databases. Two reviewers independently selected randomized controlled trials（RCTs） with negative control or blank control, extracted data and assessed methodological quality. Meta-analysis and levels of evidence were performed by Revman5.1 and Grades of Recommendations Assessment, Development and Evaluation（GRADE） approach. Results：Nineteen clinical trials with adequate randomization were included in this review, 11 of them had a low risk of bias. The primary outcome for shortterm pain had no significant differences, however, the secondary outcome, only the Numerical Pain Rating Scale（NPRS） score of intermediate-term [n=916, pooled mean differences（MD） =–0.29, P=0.02], the Neck Disability Index（NDI） score of short-term（n=1,145, pooled MD=–2.10, P〈0.01）, and intermediate-term（n=987, pooled MD=–1.45, P=0.01） were significantly reduced with moderate quality evidence. However, it supported the minimally clinically important difference（MCID） of the Visual Analogue Scale and NPRS pain score to be 13 mm, while NDI was 3.5 points. The meta-analysis only suggested a trend in favor of manipulative therapy rather than clinical significance. Conclusions：The results do not support the existing evidences for the clinical value of Eastern or Western manipulative therapy for neck pain of short-term follow-up according to MCIDs. The limitations of our review related to blinding, allocation concealment and small sample size.

Clinical efficacy observation of thalamic pain treated with acupuncture under the guidance of evidence-based medicine

Objective To study the feasibility of the crossover trial design and the minimal imbalance index random distribution method in the clinical small-sample-size randomized controlled trial（RCT） research of thalamic pain treated with acupuncture under the guidance of evidence-based medicine（EBM）.Methods The crossover trial design was adopted.Eleven cases with the definite diagnosis were randomized into a program-I group（6 cases,treated with acupuncture before western medicine） and a program-II group（5 cases,treated with western medicine before acupuncture） according to the minimal imbalance index method.In the statistical analysis,the groups were named as an acupuncture group and a western medicine group separately,11 cases in each one.Acupuncture was applied to Xìmén（郄门 PC 4）,Yīnxì（阴郄 HT 6）,Xuèhǎi（血海 SP 10）,etc.In the control treatment,Carbamazepine was prescribed for oral administration.Either the duration of treatment or the wash-out period was 10 days.The visual analogue scale（VAS） was adopted for the efficacy assessment.Results The total effective was 100.0%（11/11） after treatment in either group.The remarkably effective rates were 63.6%（7/11） and 36.4%（4/11） in the acupuncture group and the western medicine group separately,without statistically significant difference in comparison.Conclusion The crossover trial design and the minimal imbalance index distribution method can accomplish RCT of the clinical acupuncture and moxibustion research with the small sample size involved.They can provide the high-quality evidences for clinical acupuncture research.Acupuncture therapy can achieve the same therapeutic effect as Carbamazepine,the common western medicine,and the efficacy of it is potentially superior to that of western medicine.

Effectiveness of bee venom acupuncture in alleviating post-stroke shoulder pain: a systematic review and meta-analysis

BACKGROUND：Shoulder pain is a common complication of stroke.Bee venom acupuncture（BVA）is increasingly used in the treatment of post-stroke shoulder pain.OBJECTIVE：To summarize and evaluate evidence on the effectiveness of BVA in relieving shoulder pain after stroke.SEARCH STRATEGY：Nine databases,namely MEDLINE,EMBASE,the Cochrane Library,the China National Knowledge Infrastructure（CNKI）,the Japan Science and Technology Information Aggregator,Electronic（J-STAGE）,and four Korean medical databases,namely,the National Assembly Library,the Research Information Service System,the National Discovery for Science Leaders,and OASIS,were searched from their inception through August 2014 without language restrictions.INCLUSION CRITERIA：Randomized controlled trials（RCTs）were included if BVA was used at acupoints as the sole treatment,or as an adjunct to other treatments,for shoulder pain after stroke.DATA EXTRACTION AND ANALYSIS：Two review authors independently selected trials for inclusion,assessed methodological quality and extracted data.RESULTS：A total of 138 potentially relevant articles were identifi ed,4 of which were RCTs that met our inclusion criteria.The quality of studies included was generally low,and a preponderance of positive results was demonstrated.All four trials reported favorable effects of BVA on shoulder pain after stroke.Two RCTs assessing the effects of BVA on post-stroke shoulder pain,as opposed to saline injections,were included in the meta-analysis.Pain was signifi cantly lower for BVA than for saline injections（standardized mean difference on 10-cm visual analog scale：1.46 cm,95%CI=0.30–2.62,P=0.02,n=86）CONCLUSION：This review provided evidence suggesting that BVA is effective in relieving shoulder pain after stroke.However,further studies are needed to confi rm the role of BVA in alleviating post-stroke shoulder pain.Future studies should be conducted with large samples and rigorous study designs.

Observations on the Efficacy of Acupuncture plus Tuina Therapy in Treating Supraspinatus Tendinitis

Objective： To investigate the clinical efficacy of acupuncture plus Tuina therapy in treating supraspinatus tendinitis. Methods： One hundred patients with supraspinatus tendinitis were randomly allocated to two groups. The treatment group of 50 cases was treated with acupuncture plus Tuina therapy and the control group of 50 cases, with simple acupuncture. Treatment was given once daily, 10 times as a course. The therapeutic effects were evaluated after two courses of treatment. Results： The total efficacy rate was 96.0% in the treatment group and 74.0% in the control group. X^2 test showed that there was a statistically significant difference in the total efficacy rate between the two groups （P〈0.01）. Conclusion： Acupuncture plus Tuina therapy is superior to simple acupuncture in treating supraspinatus tendinitis.

Contralateral Needling Method and Its Applications in Treating Upper-limb Pain

Contralateral Needling is an ancient needling method recorded in Nei Jing （Inner Canon）. It said in the Guan Zhen chapter of Ling Shu （chapter of needling technique of Spiritual Pivot） that contralateral needling is to needle the points on contralateral side to the affected side of the body.

Effectiveness of external Sanjierupi Gao on mastalgia caused by mammary gland hyperplasia: a placebo controlled trial

OBJECTIVE:To evaluate the curative effect of external application of the Chinese drug,Sanjierupi Gao,on mastalgia caused by mammary gland hyperplasia.METHODS:This randomized,double-blinded,and placebo controlled study enrolled 260 patients with mammary gland hyperplasia from five hospitals.Patients were randomly and equally divided in-to a Sanjierupi Gao treatment group and a placebo control group.An adhesive plaster was applied to the most painful area on either breast for 7 h a day.Treatment lasted for two menstrual cycles without application during menstruation.Mastalgia was used as the main index of curative effect.The change before and after treatment in days of mastalgia,the time to alleviate pain,pain extent,and severe pain scores were observed.RESULTS:Compared to the control group,the treatment group had significantly fewer days of mastalgia(P<0.01),a significantly lower severe pain score(P<0.01),and significantly less subjective pain and tenderness(P<0.05 and P<0.01,respectively).Three days before the follow-up visit,the pain score in the treatment group was significantly lower than that in the control group(P<0.05).A non-parametric test was used to compare the time to alleviate mastalgia between the two groups and found no statistical difference(Z=0.313,P=0.754).CONCLUSION:Application of Sanjierupi Gao can decrease mastalgia duration in patients with mammary gland hyperplasia during menstruation and alleviate the extent of mastalgia.The time to alleviate pain is psychologically influenced.

Therapeutic Observation of Point-towards-point Electroacupuncture for Cervical Spondylotic Radiculopathy

Objective: To compare the therapeutic efficacies of point-towards-point electroacupuncture(EA), EA with Jiaji points(EX-B 2), and Jing Fu Kang in treating cervical spondylotic radiculopathy(CSR), and to explore the optimal treatment protocol. Methods: Totally 160 patients with CSR were randomized into three groups: a point-towards-point group(n=60) treated with EA with point-towards-point method; a Jiaji group(n=60) treated with EA at cervical Jiaji(EX-B 2) points; a medicine group(n=40) treated with oral administration of Jing Fu Kang alone. The clinical efficacies were compared afterwards. Results: After treatment, the recovery rate and total effective rate of the point-towards-point group were significantly better than that of the Jiaji group and medicine group(both P<0.01). After 1-week treatment, the symptom and function score of the point-towards-point group was significantly better than that of the Jiaji group and medicine group(both P<0.01); the point-towards-point group and Jiaji group both achieved significant improvements in the symptom and function score(P<0.01, P<0.05). After 2-week treatment, the three groups all achieved marked improvements in the symptom and function score(P<0.01). At the end of treatment, in comparing the symptom and function score, the point-towards-point group was significantly different from the medicine group(P<0.01) and Jiaji group(P<0.05); the difference between the Jiaji group and medicine group was also statistically significant(P<0.05). Conclusion: Point-towards-point EA can rapidly improve the symptoms and function of CSR patients, and it's superior to EA at Jiaji(EX-B 2) and oral administration of Jing Fu Kang in comparing the clinical efficacy.

Observation on Clinical Effects of Acupotomy plus Cupping for Knee Osteoarthritis

Objective: To observe the clinical effect of acupotomy plus cupping for knee osteoarthritis(KOA). Methods: Sixty cases with KOA were randomly divided into a treatment group and a control group, 30 cases in each group. The patients in the treatment group were given acupotomy and cupping, while the patients in the control group were given injection of Sodium Hyaluronate. The index of severity for osteoarthritis(ISOA), the change of the effusion of knee joint and clinical effects were observed after treatment. Results: The total effective rate was respectively 96.7% in the treatment group and 66.7% in the control group. The difference in the clinical effects between the two groups was statistically significant(P<0.05). After treatment, ISOA scores and scores of knee effusion in the two groups were remarkably reduced than those before treatment(P<0.05). The changes of the scores of the two indexes were statistically significant(both P<0.05). Conclusion: Acupotomy plus cupping is better than injection of Sodium Hyaluronate in treatment of KOA.

Curative effect of scraping therapies on lumbar muscle strain

OBJECTIVE:To explore factors influencing the curative effect of scraping therapies (at acupoints or along channels) and to determine the relationship of scraping site and strength to curative effect. METHODS: Two hundred and ten patients with lumbar muscle strain were divided into five groups with 42 patients each.The "scraping therapy at acupoint until appearance of skin eruptions" and "scraping therapy along channel until appearance of skin eruptions" groups were treated with a 4-daycourse. The "scraping therapy at acupoint without appearance of skin eruptions", "scraping therapy along channel without appearance of skin eruptions", and acupuncture groups were treated with a 2-day course.The five groups were treated with seven courses. The visual analog scale (VAS), oswestry disability index (ODI), and lumbago scores were recorded in the five groups before treatment, after each treatment, and in follow-up visits one month and three months after treatment. RESULTS: VAS, ODI, and lumbago scores after treatment improved in the five groups (P<0.01). There was a statistical difference (P<0.01) in the change of VAS scores by appearance of skin eruptions and scraping site. CONCLUSION: Scraping therapy can effectively alleviate lumbago symptoms. The appearance of skin eruptions and scraping therapy along channels can enhance the curative effect of scraping therapy.

Clinical Study on Treatment of Cervical Spondylotic Radiculopathy by Electroacupuncture plus Tuina

Objective: To observe the clinical effects of electroacupuncture(EA) plus tuina for cervical spondylotic radiculopathy. Methods: One hundred and twenty cases with cervical spondylotic radiculopathy were divided randomly by the digital table into the observation group and control group. The patients in an observation group were treated by EA plus tuina techniques. The patients in the control group were treated by simple tuina techniques. Results: The total effective rate was 91.7% in the observation group and 78.3% in the control group. The effective rates in the two groups were statistically different(P<0.05). Conclusion: EA plus tuina therapy is better than simple tuina therapy in the treatment of cervical spondylotic radiculopathy.

Effect of Electroacupuncture Combined with Tuina on Lumbar Muscle Tone in Patients with Acute Lumbar Sprain

Objective: To observe the clinical effect of electroacupuncture(EA)combined with tuina on acute lumbar sprain and lumbar muscle tone before and after treatment. Methods: A total of 130 acute lumbar sprain cases were randomly allocated into an observation group and a control group, 65 in each group. Cases in the observation group were treated with EA combined with tuina, whereas cases in the control group were treated with Diclofenac Sodium Dual Release Enteric-coated capsules. The muscle tones in two groups were tested before and after treatment. Results: The recovery rate and overall response rate in the observation group were 66.2% and 93.8% respectively, versus 56.9% and 87.7% in the control group, showing no between-group statistical significances(P>0.05). After treatment, the force-displacement area under curve(AUC) in both groups showed a significance difference(P<0.05). Conclusion: Both EA combined with tuina and aforementioned oral medication have remarkable effects for acute lumbar sprain, and the former can better improve the lumbar muscle tone in patients with acute lumbar sprain.