Observation on Therapeutic Effects of Acupuncture and Tuina in Treatment of Sprains and Strains of Minor Joints at Four Extremities

Objective： To observe the clinical therapeutic effects of acupuncture at the bony clefts in combination with tuina therapy in the treatment of sprains and strains of minor joints at the four extremities. Methods： Ninety cases of sprains and strains of minor joints at four extremities [including metacarpophalangeal （metatarsophalangeal） joints] were divided randomly into three groups by the consulting order. Acupuncture group, in which 30 cases were treated by acupuncture at the bony clefts; tuina group, in which 30 cases were treated by tuina therapy; and observation group, in which 30 cases were treated by acupuncture at the bony clefts and tuina therapy. The treatment was given 6 times a week as one course of treatments, and the therapeutic effects were observed after 2 courses of treatments. Results： The cure rates of the observation group, the acupuncture group and the tuina group reached 50.0%, 20.0% and 16.7% respectively, and the total effective rates reached 93.4%, 70.0% and 73.3% respectively. There were statistical significance between the observation group and the acupuncture and tuina groups （P〈0.05）; while there was not a statistical difference between the acupuncture group and the tuina group. It was indicated that the therapeutic effect of the observation group was better than that of the acupuncture group and the tuina group. Conclusion： Acupuncture at the bony clefts in combination with tuina therapy is quite effective in the treatment of sprains and strains of metacarpophalangeal （metatarsophalangeal） joints.

ON THE INDICATIONS OF ACUPUNCTURE AND MOXIBUSTION

Though with Wide Indications, Acupuncture and Moxibustion are not the Remedy for All Ills Treating diseases with acupuncture-moxibustion has a long history in China, and rich experience has been accumulated in its application. According to a statistics in early 1980’s by prof. Jiao Guorui, a senior researcher from China Academy of Traditional Chinese Medicine, acupuncture-moxibustion therapy has at least been used to treat 307 kinds of diseases, among

Effects of rolling manipulation with different durations on erector spinae muscle tonus and low back pain in patients with lumbar muscle strain

Objective:To observe the effects of rolling manipulation with different durations on erector spinae muscle tonus and low back pain in patients with lumbar muscle strain and to explore the best duration for rolling manipulation in treating lumbar muscle strain.Methods:A total of 75 patients who met the inclusion criteria were randomized into a 5-minute rolling manipulation group,a 10-minute rolling manipulation group,and a 15-minute rolling manipulation group using the random number table method,with 25 cases in each group.All three groups were treated with the same rolling manipulation,while the treatment time was 5 min,10 min,and 15 min,respectively.The treatment was performed 3 times a week for 2 consecutive weeks.The muscle tonus of bilateral erector spinae and visual analog scale(VAS)score for low back pain were compared among the three groups before and after treatment.Results:A total of 63 patients completed the study.Before treatment and after the last treatment,there were no statistical differences in the muscle tonus of the left erector spinae and right erector spinae among the three groups(P>0.05).After the last treatment,bilateral erector spinae muscle tonus dropped compared with the baseline in all three groups(P<0.01).Before treatment and after the last treatment,there were no significant differences in comparing the low back pain VAS score among the three groups(P>0.05).After the last treatment,the VAS score for low back pain in all three groups decreased(P<0.01).Conclusion:Under the condition that the forward swing force is 50-70 N,the backward swing force is 20-40 N,and the frequency is 138 times/min,the 5-minute rolling manipulation can significantly reduce the muscle tonus of erector spinae and relieve low back pain.

Forty-three Cases of Acute Lumbar Sprain Treated by Acupuncture Plus Kinesitherapy

Acute lumbar sprain is commonly encountered among the young and middle-aged. It often occurs at the lower part of the back, which seriously hinders the daily life and work of the patients because of the severe pain. The author has treated 43 cases of acute lumbar sprain by needling Weizhong (BL 40), Houxi (SI 3) and Yaotongdian (EX-UE7) plus kinesitherapy and obtained satisfactory therapeutic results. A report follows.

Thirty Cases of Acute Lumbar Sprain Treated by Acupuncture Combined with Point-Injection at Tianzhu

In recent years, the authors have treated 30 cases of acute lumbar sprain by acupuncture combined with point medicinal injection at Tianzhu (BL 10), and obtained quite good therapeutic results, as is reported in the following.

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.

Magnetic resonance imaging： a valuable method for diagnosing chronic lumbago caused by lumbar muscle strain and monitoring healingprocess

Background Magnetic resonance imaging （MRI） is the most sensitive technique for evaluating the healing process and should be performed before the patients return to their exercise routines. The aim of this research was to diagnose chronic lumbago associated with lumbar muscle strain and to monitor healing process by MRI. Methods Sixty-five symptomatic cases of chronic lumbago caused by lumbar muscle strain were collected from March 2009 to October 2011. MRI was used to examine, diagnose and monitor the healing process. The control group included 65 random cases of asymptomatic volunteers. MRI methods included routine sequences of GRE TlWl, TSE T2WI and special sequences of T2-STIR-FS, combined with DWI. We compared the MRI characteristics of symptomatic cases before and after healing and with asymptomatic controls. Results The important MRI characteristics of chronic lumbago with lumbar muscle strain included： （1） The low back muscle showed edema. （2） The low back intermuscular spaces showed edema and/or fluid. （3） The low back spaces beside the spinous process showed edema and/or fluid. （4） The low back vertebral articular process fossae or transverse process fossae showed fluid. Of these image characteristics, the intermuscular space edema provided the best diagnostic sensitivity, Se=83%, with Y1=0.63, Tr=74%. The low back muscle edema provided the best diagnostic specificity, Sp=100%, with Y1=0.66, Tr=83%. And the spaces edema beside the spinous process provided the best diangnostic accuracy, Tr=86%, with YI = 0.71, Se=80%, Sp=91%. The diagnosis accurate could be improved by combining multiple MRI characteristics. The diagnostic accuracy could achieve n=93%, with Y1=0.86, Se=100% and Sp=86% when two characteristics were combined. After rehabilitation care, the edema disappeared on the repeated MRI. Conclusions MRI may well be a useful diagnostic method for lumbago with lumbar muscle strain. Combining routine sequences with T2-STIR-FS and DWI sequences could demonstrate the pathological changes of lumbar muscle strain and monitor the healing.

Efficacy observation of combining tuina and Chinese herbal fumigation for chronic ankle sprain

Objective： To observe the clinical efficacy of combining tuina and Chinese herbal fumigation for chronic ankle sprain. Methods： A total of 93 cases were randomly allocated into an observation group（n=47） and a control group（n=46） according to the table of random number. Cases in the observation group received tuina combining with Chinese herbal fumigation, whereas cases in the control group received oral blood-circulating and pain-alleviating capsules combining with Chinese herbal fumigation. Both tuina and Chinese herbal fumigation were done once every other day and 10 times made up a course of treatment. The Baird-Jackson ankle scoring system and clinical efficacy were observed after 1 course of treatment.Results： After treatment, except for radiographic findings, there were significant intra-group differences in individual item scores of Baird-Jackson（P〈0.05, P〈0.01）; except for ankle joint range of motion（ROM）, there were significant betweengroup differences in individual item scores and total score（P〈0.01）. The excellence and good rate was 76.6% in the observation group, versus 54.4% in the control group, showing a statistical significance（P〈0.05）. Conclusion： Combining Chinese herbal fumigation and tuina based on the muscle region theory can obtain better effect than combining oral blood-circulating and pain-alleviating capsules and Chinese herbal fumigation for chronic ankle sprain.

Observation of the Clinical Effects of DING＇s Rolling Technique for Acute Lumbar Sprains

Objective： To observe the clinical effects of DING＇s Rolling Technique for acute lumbar sprain. Methods： All of 243 cases of acute lumbar sprain were randomly allocated into two groups. One is the treatment group, in which 131 cases were treated with DING＇s Rolling Technique. The other is the control group, in which 112 cases were treated with needling at Houxi （SI 3）, and routine tuina. Results： In the treatment group, 98 cases were cured, 33 cases improved, and there were no cases exhibiting zero effects. In the control group, 80 cases were cured, 29 cases improved, and 3 cases experienced no effect. There is no significant difference in the effective rate between the two groups. Conclusion： the tuina method, DING＇s Rolling Technique has good clinical effects on acute lumbar sprain with easy manipulation.

Treatment of 120 Cases of Nuchal Ligament Strain by Acupuncture and Tuina

120 cases of nuchal ligament strain were treated with Tuina at the nape, tapping Dazhui （GV 14） with plum-blossom needle, and cupping Dazhui（GV 14）. Clinical observation was made after 14-day treatments. Eighty-seven cases got cure, 28 cases improvement and 5 cases failure; the total effective rate was 95.8%.

Clinical Observation of a Combination of Acupuncture and Drug Administration for Non-specific Acute Lumbar Sprain

Objective： To observe the clinical effects of a combination of acupuncture and drug administration for non-specific acute lumbar sprain. Methods： Sixty-nine cases were randomly allocated into a combination group, an acupuncture group, and a drug group according to the visiting sequence. Patients in the acupuncture group （n=24） were treated with acupuncture daily for 5 d, 20 patients in the drug group were treated with oral Diclofenac Sodium, 50 mg per time, twice per day, for 5 d, and 25 patients in the combination group were treated with methods in both the acupuncture group and the drug group. The Numerical Rating Scale （NRS） and the Roland-Morris Disability Questionnaire （RMDQ） were used to evaluate the therapeutic effects. Results： All patients in the three groups got improvement in pain and movement, the combination group had the best effects （P〈0.01）, and there was no significant difference between the acupuncture group and the drug group. Conclusion： Combination of acupuncture and drug has a better effect than single acupuncture or routine treatment of Diclofenac Sodium on acute lumbar sprain.

Clinical Effect and Infrared Thermogram on Electroacupuncture for Acute Lumbar Sprain

Objective： To observe the clinical effect and infra-red thermogram changes for acute lumbar sprain. Methods： All 295 cases with acute lumbar sprain were randomly divided into an electroacupuncture group （147 cases） and medication group （148 cases）. The cases in electroacupuncture group were treated by needling Houxi （SI 3）, whereas those in the medication group were treated with Meloxicam tablet. The infra-red thermogram was observed before and after treatment. Results： The recovery and effective rates in the electroacupuncture group were 71.4% and 93.9%, whereas the rates in the medication groups were 42.6% and 87.2% （P〈0.01）. The temperature differences via the thermogram in the electroacupuncture and medication groups were 2.52℃ and 0.80℃ （P〈0.01）, indicating a significant difference. Conclusion： Both electroacupuncture and medication could obtain significant effect for acute lumbar sprain; however, electroacupuncture obtained a better overall effect and a more substantial temperature-raising effect in the thermogram than medication.

Electroacupuncture at Houxi(SI 3) for acute lumbar sprain: a meta-analysis of randomized controlled trials

Objective： To assess the efficacy and safety of electroacupuncture （EA） at Houxi （SI 3） in treating acute lumbar sprain. Methods： Randomized controlled trials （RCTs） involving EA at Houxi （SI 3） for acute lumbar sprain were retrieved from PubMed （1966-2014）, EMBASE （1980-2014）, Cochrane Library （Issue 1, 2014）, CO, VIP Database （1989-2014）, Wanfang Digital Journal （1998-2014）, the Chinese Biological Medical Literature Database （CBM, 1978-2014）, and China National Knowledge Internet （CNKI, 1979-2014）. The collection of data also adopted hand-search of the relevant journals from the Library of Shanghai Jiao Tong University. All of the data were first evaluated and extracted by two reviewers independently with a specially designed form. Then, the available data were analyzed by the Cochrane Collaboration＇s RevMan 5.2.0 software. Results： A total of 6 trials involving 1 288 patients were eligible. Meta-analysis showed that the total effectiveness rate in the EA group was significantly different when compared with Nimesulide [RR----1.33; 95% CI （1.19 to 1.49）] and Mobic [RR= 1.08; 95% Cl （1.03 to 1.14）], but similar to that of acupuncture at Yaotongdian （EX-UE 7） [RR=71.09; 95% Cl （1.00 to 1.19）] and Diclofenac Sodium [RR----1.08; （95% CI 0.96 to 1.21）]. The recovery rate in the EA group was significantly different when compared with Mobic [RR----1.67; （95% CI 1.45 to 1.92）] and Nimesulid [RR：1.37; （95% Cl 1.15 to 1.62）], but similar to that of acupuncture at Yaotongdian [（RR=1.35; 95% CI 0.99 to 1.84）] and Diclofenac Sodium [（RR=I.19; 95% Cl 0.88 to 1.61）]. Conclusion： Up to the search date, there are few high quality RCTs to evaluate the clinical efficacy of EA at Houxi （SI 3） for acute lumbar sprain, especially studies in English. Yet EA at Houxi （SI 3） still appeared to be an efficacious method for acute lumbar sprain, despite several inherent defects of the included studies. Further large scale trials are required to define the role of EA at Houxi （SI 3） in the treatment of this disease.

Clinical Observation on Effect of FU＇s Subcutaneous Needling for Acute Lumbar Sprain

Objective： To observe the clinical effect of FU＇s subcutaneous needling on acute lumbar sprain. Method： One hundred acute lumbar sprain cases were randomly allocated into a treatment group and control group, 50 cases in each. FU＇s subcutaneous needling on tenderness were employed in the treatment group, whereas voltaren was administered to the cases in the control group. The changes in symptoms and signs were then observed in the two groups. Results： The total effective rates in the treatment group and control group were 94.0% and 70.0% respectively, showing a statistical difference （P〈0.01）. Conclusion： FU＇s subcutaneous needling is better than voltaren for acute lumbar sprain.

Observation on clinical efficacy of warm needling therapy for chronic lumbar strain

Objective： To observe the clinical efficacy of warm needling therapy for chronic lumbar strain. Methods： A total of 60 patients with chronic lumbar strain who met the inclusion criteria were randomized into a treatment group and a control group by the random number table, with 30 cases in each group. The treatment group was treated with warm needling therapy, while the control group was treated with ordinary acupuncture treatment. The treatments were both performed once every other day, and 7 times constituted a course of treatment. Visual analog scale （VAS） score was used to assess the degree of pain and the clinical efficacy was compared between the two groups. Results： The total effective rate of the treatment group was higher than that of the control group （P〈0.05）. There was no significant difference in VAS score between the two groups before treatment （P〉0.05）. After treatment, the VAS scores of both groups decreased significantly, and the intra-group differences were statistically significant （both P〈0.05）. The VAS score of the treatment group after treatment was statistically different from that in the control group （P〈0.05）. Conclusion： Warm needling therapy has a better curative effect than ordinary acupuncture in the treatment of chronic lumbar strain.

Clinical Study on Puncturing Houxi (SI 3) Toward Hegu (LI 4) plus Lumbar Movement for Acute Lumbar Sprain

Objective： To observe the therapeutic efficacy of puncturing Houxi （SI 3） toward Hegu （LI 4） plus lumbar movement in treating acute lumbar sprain. Methods： A total of 212 patients with acute lumbar sprain were randomized into two groups. There were 106 subjects in the observation group who were treated with puncturing Houxi （SI 3） toward Hegu （LI 4） plus lumbar movement; the other 106 patients in the control group were treated with puncturing Houxi （SI 3） toward Hegu （LI 4） alone. Therapeutic efficacy was evaluated after 2 treatment courses. Results： The total effective rate was 95.3% in the observation group versus 88.7% in the control group, and the difference was statistically insignificant between the two groups （P〉O.05）. However, in comparing the treatment times for achieving recovery and effectiveness, differences between the two groups were statistically significant （both P〈O.05）, indicating that integrated use of acupuncture and exercise is faster in realizing therapeutic effectiveness. Conclusion： By selecting fewer acupoints, puncturing Houxi （Sl 3） toward Hegu （LI 4） is effective in treating acute lumbar sprain, and with the help of lumbar movement, it can achieve even better treatment effect.

Clinical efficacy of sticking-needle acupuncture plus tendon-regulating manipulation in the treatment of acute ankle sprain

Objective To explore the treatment effect of sticking-needle acupuncture plus tendon-regulating manipulation on pain,swelling and joint dysfunction due to acute ankle sprain.Methods A total of 80 patients with acute ankle sprain were recruited and divided into a control group and a treatment group according to the random number table method,with 40 patients in each group.Both groups received the same conventional interventions.The control group was treated with additional tendon-regulating manipulation,and the treatment group was treated with tendon-regulating manipulation plus sticking-needle acupuncture.The pain,swelling and joint dysfunction of the ankle were observed in both groups before and after 3 d,7 d and 14 d of treatment.Results Before treatment,there was no statistically significant difference in the visual analog scale(VAS)score of pain between the two groups(P>0.05).After treatment,the VAS scores of both groups showed a decreasing trend over time,and the differences within the groups were statistically significant(P<0.05).After 3 d,7 d and 14 d of treatment,the VAS scores in the treatment group were lower than those in the control group,with statistically significant differences(P<0.05).Before treatment,there was no statistically significant difference in the degree of swelling between the two groups(P>0.05).After treatment,the degrees of swelling in both groups showed a decreasing trend over time,and the differences within the groups were statistically significant(P<0.05).After 3 d and 7 d of treatment,the degrees of swelling in the treatment group were lower than those in the control group,with statistically significant differences(P<0.05).There was no statistical difference in the degree of swelling between the two groups after 14 d of treatment(P>0.05).Before treatment,there was no statistically significant difference in the American Orthopedic Foot Ankle Society(AOFAS)ankle-hindfoot scale score between the two groups(P>0.05).After treatment,the AOFAS ankle-hindfoot scale scores of both groups showed an increasing trend over time,and all the differences within the groups were statistically significant(P<0.05).After 3 d,7 d and 14 d of treatment,the AOFAS ankle-hindfoot scale scores in the treatment group were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion Based on the routine intervention,the addition of sticking-needle acupuncture and tendon-regulating manipulation was better in alleviating pain and swelling and improving joint function in patients with acute ankle sprain than the addition of tendon-regulating manipulation alone.

A controlled study on treatment of acute lumbar sprain by acupuncture at Yaotongdian(EX-UE 7) plus tuina manipulation

Objective：To observe the clinical effects of acupuncture at Yaotongdian （EX-UE 7） plus the oblique Ban-pulling manipulation for acute lumbar sprain. Methods：A total of 180 patients were divided into an observation group and a control group by drawing lots. The 98 cases in the observation group were treated by puncturing Yaotongdian （EX-UE 7） plus the oblique Ban-pulling manipulation. The 82 cases in the control group were only treated by the oblique Ban-pulling manipulation. After the two groups were treated continuously for three sessions, the therapeutic effects were observed. Results：In the observation group, 96 cases were cured and 2 cases were improved; the curative rate was 98.0% and the total effective rate was 100%. In the control group, 76 cases were cured, 4 cases were improved and 2 cases failed; the curative rate was 92.7% and the total effective rate was 97.6%. In comparison of the curative rate and total effective rate, the differences were not statistically significant （P〉0.05）. But, the curative rate after the first treatment was higher in the observation group than that in the control group, with a significant difference between the two groups （P〈0.05）. Conclusion：The therapeutic effects were similar by acupuncture at Yaotongdian （EX-UE 7） plus oblique Ban-pulling manipulation and by single oblique Ban-pulling manipulation for acute lumbar sprain. But, it took effect quickly by puncturing Yaotongdian （EX-UE 7） plus the oblique Ban-pulling manipulation.

Effect of Auricular Point Sticking on Pain Due to Lumbar Strain

Objective： To observe the effect of auricular point sticking on pain due to lumbar strain. Methods： Sixty patients with lumbar strain were randomized at ratio of 1：1 into two groups. The 30 cases in the observation group were given auricular point sticking plus externally applied medicinal plaster; the other 30 cases in a control group were only treated by the plaster. The Short-form of McGill Pain Questionnaire （SFMPQ） was adopted before treatment, after 3-day treatment, and at the end of 2-week treatment, for scoring and evaluation. Results： After 3-day treatment, the observation group gained significant improvement in Pain Rating Index （PRI）, Visual Analogue Scale （VAS）, and Present Pain Intensity （PPI） （P〈0.05）, while the improvements of PRI, VAS, and PPI in the control group were insignificant. After 2-week treatment, both groups gained significant progress in PRI, VAS, AND PPI compared with pre-treatment （P〈0.01）, and the inter-group comparison of PRI showed marked difference （P〈0.05）, but the differences in comparing VAS and PPI between the two groups were insignificant. There were merely any side effects happening in the two groups, except that some patients felt itchy, and the inter-group comparison did not show statistical significance. Conclusion： Auricular point sticking plus externally applied medicinal plaster has better effect than single plaster in treating lumbar strain induced pain, and it＇s safe and credible.

Treatment of 34 Cases of Acute Lumbar Sprain with Electroacupuncture plus Cupping Therapy

Acute lumbar sprain due to improper exercise is very common in college students. The author has treated 34 patients with acute lumbar sprain by electroacupuncture plus cupping therapy, now it was presented as follows.1 Clinical Data Among 34 cases with acute lumbar sprain, male cases： 21; female cases： 13; the range of age： 18-32 years; the shortest duration： 0.5 h; and the longest duration： 24 h. The patients all had a trauma history of sprains, contusion or undue force. Examinations showed tenderness and swelling in the midline or lateral aspect of the lumbosacral region, and contracture in psoas major muscle or sacrospinalis in most cases, together with limited lumbar function.