Heterogeneity of Outcomes Reporting in Trials Evaluating Traditional Chinese Medicine Breast Massage for Stasis Acute Mastitis: A Methodological Review

Objective To systematically analyze the current status of outcomes reporting in clinical trials on treating stasis acute mastitis with Traditional Chinese Medicine breast massage.Methods We searched CNKI,Wanfang,VIP,Sino Med,Pub Med,Web of Science,Embase,Cochrane library,JBI,CINAHL,Psyc INFO,Clinical Trials Registry Platform portal,Clinical Trials Registry,Australian New Zealand Clinical Trials Registry,Center Watch Registry from inception to May 15,2022 to find randomized controlled trials,non-randomized controlled trials,case series and cohort studies which reported the outcomes of stasis acute mastitis managed with Traditional Chinese Medicine breast massage,with search terms of mastitis,acute mastitis,lactation mastitis,puerperal mastitis,breast problem,breast engorgement,milk stasis,blocked ducked,breast pain,breast massage,and acupoint massage.Outcomes and the measurement schemes(measurement methods,timing of assessing outcome,frequency of assessing outcome,measurers)were extracted from the included studies.We used the Management of Otitis Media with Effusion in Children with Cleft Palate(MOMENT)to assess the quality of each study,then categorized outcomes derived from the included studies into different domains according to the Outcome Measures in Rheumatology Arthritis Clinic Trials(OMERACT)Filter 2.1 framework.Results We identified 85 clinical trials,in which 54 different outcomes were reported.A total of 81.2%(69/85)of studies were assessed as medium quality with a mean score of 2.6,and 18.8%(16/85)as low quality with a mean score of 0.9.These outcomes were organized in three core areas.Lump size(89.4%,76/85)was the most frequently reported outcome,followed by breast pain(69.4%,59/85)and milk excretion(68.2%,58/85).Five methods were used to assess lump size and four methods to assess breast pain.Conclusions The outcomes reported in clinical trials regarding stasis acute mastitis treated by Traditional Chinese Medicine breast massage are heterogeneous.Developing a core outcome set to achieve consistent standards for reporting outcomes and modalities for validation of the outcomes is clearly warranted.

Operating procedures of traditional Chinese medicine breast massage

Traditional Chinese medicine breast massage,also known as breast Tuina or manual expression of breast milk,is a technique of using certain manipulations to act on specific positions or acupoints of the breast to promote blood and lymphatic circulation of breast and facilitate the discharge of stagnant milk.This technique is widely used in China to treat breastfeeding problems such as breast engorgement,mastitis,and postpartum hypogalactia.In this article,we introduce the definition and standardization process of breast massage,elaborate the operating procedures of breast massage in detail,and summarize and discuss the current situation of its clinical application,so as to provide a reference for its wide application and in‑depth research.

Reabsorption of intervertebral disc prolapse after conservative treatment with traditional Chinese medicine:A case report

BACKGROUND Conservative treatments have been reported to diminish or resolve clinical symptoms of lumbar intervertebral disc herniation(LIDH)within a few weeks.CASE SUMMARY Computed tomography and magnetic resonance imaging(MRI)of the lumbar region of a 25-yearold male diagnosed with LIDH showed prolapse of the L5/S2 disc.The disc extended 1.0 cm beyond the vertebral edge and hung along the posterior vertebral edge.The patient elected a conservative treatment regimen that included traditional Chinese medicine(TCM),acupuncture,and massage.During a follow-up period of more than 12 mo,good improvement in pain was reported without complications.MRI of the lumbar region after 12 mo showed obvious reabsorption of the herniation.CONCLUSION A conservative treatment regimen of TCM,acupuncture,and massage promoted reabsorption of a prolapsed disc.

NUMERICAL INVESTIGATION OF EFFECT OF ROLLING MANIPULATION OF TRADITIONAL CHINESE MEDICAL MASSAGE ON BLOOD FLOW

The hemodynamic mechanism of rolling manipulation (RM) of traditional Chinese medical massage (TCMM) is investigated. An axisymmetrical nonlinear model and an arbitrary Lagrangian-Eulerian finite element method (ALE-FEM) with rezoning algorithm were introduced to study the viscous flow through an axisymmetrical rigid tube with axially moving stenosis to simulate the rolling manipulation. Flow rate and wall shear stress were obtained by solving complete Navier-Stokes equations numerically. The numerical results show that the stenosis moving frequency, namely the frequency of rolling manipulation, has great effect on the disturbance of flow and the wall shear stress. The stenosis coefficient, which characterizes the severity of the stenosis, another adjustable parameter in rolling manipulation, also shows the significant effect on flow rate and wall shear stress. These numerical results may provide some data that can be taken into consideration when massage is used in clinic.

Effects of Chiropractic and Traditional Chinese Medicine in Treating Patients with Acute Postpartum Pubis Symphysis Pelvic Girdle Pain

[Objectives]To analyze and study the effects of chiropractic and traditional Chinese medicine on pain score and functional ambyiation category scale rating in patients with cervical spondylosis.[Methods]41 postpartum patients with acute pubic symphysis pelvic girdle pain were treated by Xiao Huoluodan Granules(orally taking one bag of Xiao Huoluodan Granules 20 g three times daily with 120-150 mL warm water after each meal),and combined with sacroiliac joint manipulation,muscle posture relaxation and muscle energy technique.[Results]After treatment,the pain score(VAS)was decreased and Holden walking function rating was improved(all P<0.001).[Conclusions]Chiropractic and traditional Chinese medicine therapy has a significant effect on the treatment of postpartum acute pubic symphysis pelvic girdle pain,and it can effectively relieve pain,improve postpartum quality of life and prevent postpartum complications.Due to its benefits,it is worthy of clinical promotion and application.

Study on the Key to Massage Therapy of Traditional Chinese Medicine

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The effect of traditional Chinesemedicine washing combined withmassage for neonataljaundice： a meta-analysis

目的：系统评价中药外洗联合抚触对新生儿黄疸的治疗效果.方法：计算机检索 PubMed、the Cochrane Library、Embase、Web of Science、CBM、CNKI 和万方数据库,收集中药外洗联合抚触治疗新生儿黄疸的随机对照试验,检索时间均为建库至 2017年 7 月.采用 Cochrane偏倚风险评估工具对纳入的文献进行质量评价,Meta 分析采用 RevMan5.3 软件.结果：共纳入 13 个研究,共 1998 人.Meta 分析结果显示：①中药外洗联合抚触可以加快首次胎便的排出[MD=-16.67, 95%CI （-24.59, -8.74） , P〈0.001]; ②缩短胎便变黄的时间[MD=-15.44, 95%CI （-23.59,-7.28） ,P〈0.001];③降低经皮测黄疸指数：治疗3天[MD=-1.99, 95%CI（-2.57, -1.40） , P〈0.001],治疗 4天[MD=-1.86, 95%CI（-2.77, -0.95） , P〈0.001],治疗 5 天[MD=-2.44, 95%CI（-3.47, -1.42） , P〈0.001],治疗 6天[MD=-2.23, 95%CI （-3.30, -1.16） , P〈0.001];④降低血清胆红素值：治疗 5天[MD=-3.17, 95%CI（-5.83, -0.50） , P=0.02],治疗 6 天[MD=-1.63, 95%CI（-3.10, -0.16） , P=0.03],治疗 15 天[MD=-1.20,95%CI（-1.99, -0.41） , P=0.003].结论：中药外洗联合抚触治疗新生儿黄疸的临床疗效显著,但该结论需谨慎对待,以后应该进行设计良好的、高质量的试验来进-步证实该结论.

Traditional Chinese medicine manipulative reduction combined with percutaneous vertebroplasty for treating type Ⅲ Kummell's disease: A case report

BACKGROUND A patient with type Ⅲ Kummell’s disease had a ruptured posterior cortex of the fractured vertebral body, which caused spinal cord compression. An open surgery was considered the best choice of operation. However, the patient and her family refused open surgery and instead demanded a minimally invasive surgical treatment such as percutaneous vertebroplasty(PVP). After preoperative discussion, we finally adopted the novel therapy of traditional Chinese medicine manipulative reduction(TCMMR) combined with PVP.CASE SUMMARY A patient with type Ⅲ Kummell’s disease exhibiting bone block-induced spinal cord compression was admitted to our hospital. She suffered from a variety of medical disorders but refused open surgery, and instead asked for PVP surgery. TCMMR, in parallel with PVP, was used to restore the height of the compressed vertebral body and reduce the symptoms of spinal cord compression by the bone block in order to strengthen the vertebral body and prevent further collapse. The surgery was very successful. The height of the compressed vertebra was restored, and the symptom of spinal cord compression by bone block was reduced successfully via TCMMR. The fractured vertebra was solidified by the PVP. The pain visual analog score declined from preoperative 7 scores to postoperative 2 scores, and the Frankel spinal cord scale increased from preoperative D degree to postoperative E degree.CONCLUSION The new method has advantages in treating patients with type Ⅲ Kummell’s disease who cannot be treated with open surgery.

Quantitative and Qualitative Investigation of Traditional Chinese Medicine Nursing Protocols for Type 2 Diabetes Mellitus

Objective:To analyze the implementation status of traditional Chinese medicine(TCM)nursing protocols for type 2 diabetes mellitus.Methods:Totally 420 hospitalized patients with type 2 diabetes mellitus were given TCM nursing protocols by syndrome differentiation.A quantitative and qualitative investigation was conducted to patients who received TCM nursing and nurses who performed TCM nursing techniques.Results:According to the self-evaluation outcomes of patients,TCM nursing protocols were effective to relieve polydipsia,polyuria,fatigue and other symptoms.Patients exhibited a high level of compliance with nursing techniques such as auricular point pressing,acupoint massage,Chinese herbal foot-bath and moxibustion.The interview showed that patients could benefit from the TCM nursing protocols,and nurses considered that application of TCM nursing protocols could enhance their awareness of TCM knowledge and practice skills.Conclusion:The application of TCM nursing protocols is effective to relieve clinical symptoms of type 2 diabetes mellitus.It can also improve the knowledge level and practice skills of nurses in TCM hospitals.

Research progress of external therapies of traditional Chinese medicine in the treatment of non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease(NAFLD)is a common chronic liver disease characterized by diffuse hepatic steatosis.With the improvement of people's living standard,the incidence rate of NAFLD has been increasing,which has become one of the global health problems in 21st Century.However,there is no specific drug or standard treatment for NAFLD,which brings challenges to treatment.Acupuncture,moxibustion,massage and other external therapies based on the characteristics of traditional Chinese medicine have obvious curative effect in the clinical treatment of NAFLD,but the mechanism has not been systematically explained,which makes the clinical promotion evidence insufficient.This paper aims to summarize the researches on the treatment of NAFLD by external therapies of traditional Chinese medicine in recent years,and analyze its possible mechanism,so as to provide a scientific theoretical basis for future basic experiments and clinical research,and form a set of standardized clinical diagnosis and treatment scheme with the characteristics of traditional Chinese medicine.

Mining the rules of acupoint selection and manipulation scheme of massage in reducing or substituting drug treatment of simple obesity based on association rules and entropy cluster analysis

Based on the data mining of clinical literature,we analyzed the characteristics of Acupoint Selection and manipulation in the clinical treatment of“simple obesity”,in order to optimize the compatibility of clinical acupoints,simplify the manipulation,and summarize the core prescription of Massage in the treatment of simple obesity.Methods:First we search and screen the clinical literature of Chinese Massage therapy for“simple obesity”by scholars at home and abroad.Then we analyze the Acupoint Selection and manipulation rules of Chinese Massage therapy for“simple obesity”by using data mining technology and traditional Chinese Medicine Inheritance assistant system.Finally we obtain the optimal new prescription based on complex system entropy clustering and unsupervised entropy hierarchical clustering analysis.Results:Fifty-seven prescriptions meeting the inclusion criteria were selected,including TIANSHU(ST25)(36),ZHONGWAN(RN12)(32),GUANYUAN(RN4)(30),ZUSANLI(ST36)(27),QIHAI(RN6)(23),“Stomach Meridians”(10),“Spleen Meridians”(8),Renmai(7),Abdomen(36),Umbilicus(8),Pressing(33),Holding(27),Pressing(26),and get 4 core Prescriptions like ST25-RN12-Renmai-Stomach Meridians-Abdominal Rub-Rubbing-Pushing thumb-Rubbing-Palm Pushing-Thumb Point Acupuncture-Palm Vibration and 4 new prescription of Massage manipulation for the treatment of simple obesity.Conclusion:The results of clinical diagnosis and treatment data are mined and analyzed by traditional Chinese medicine inheritance assistant system.The acupoint compatibility,manipulation rules and core prescriptions obtained can provide statistical basis and references for clinical Massage manipulation in the treatment of simple obesity.

Immediate effects of scalp acupuncture with twirling reinforcing manipulation on hemiplegia following acute ischemic stroke: a hidden association study

Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.

Reduction in nerve root compression by the nucleus pulposus after Feng's Spinal Manipulation

Ninety-four patients with lumbar intervertebral disc herniation were enrolled in this study. Of these, 48 were treated with Feng＇s Spinal Manipulation, hot fomentation, and bed rest （treatment group）. The remaining 46 patients were treated with hot fomentation and bed rest only （control group）. After 3 weeks of treatment, clinical parameters including the angle of straight-leg raising, visual analogue scale pain score, and Japanese Orthopaedic Association score for low back pain were improved. The treatment group had significantly better improvement in scores than the control group. Magnetic resonance myelography three-dimensional reconstruction imaging of the vertebral canal demonstrated that filling of the compressed nerve root sleeve with cerebrospinal fluid increased significantly in the treatment group. The diameter of the nerve root sleeve was significantly larger in the treatment group than in the control group. However, the sagittal diameter index of the herniated nucleus pulposus and the angle between the nerve root sleeve and the thecal sac did not change significantly in either the treatment or control groups. The effectiveness of Feng＇s Spinal Manipulation for the treatment of symptoms associated with lumbar intervertebral disc herniation may be attributable to the relief of nerve root compression, without affecting the herniated nucleus pulposus or changing the morphology or position of the nerve root.

Therapeutic efficacy of traditional Chinese exercises and massage treatment on lumbar instability:a randomized controlled trial

OBJECTIVE:To determine the effect of traditional Chinese exercises combined with traditional Chinese massage on lumbar instability.METHODS:Seventy patients with lumbar instability were randomly divided into experimental group and control group.The experimental group was treated with traditional Chinese exercises combined with traditional Chinese massage,while the control group was only treated with traditional Chinese exercises.The Japanese Orthopaedic Association(JOA)scores,Oswestry Disability Index(ODI)and dynamic imaging indexes were used to assess treatment outcomes.RESULTS:After 8 weeks of treatment,the JOA scores of both groups were significantly higher than those before treatment(P<0.05),while ODI was significantly lower(P<0.05).In addition,compared with the control group,the JOA score of the experimental group was significantly increased(P<0.05),and the ODI was significantly decreased(P<0.05).Besides,the dynamic imaging indexes of patients with lumbar instability significantly changed after treatment.The lumbar vertebral laxity was significantly decreased(P<0.05)than those before treatment.CONCLUSION:The traditional Chinese exercises and massage may improve the symptoms of lumbar instability,and traditional Chinese exercises combined with massage treatment may be better than exercises alone.

Dredging hand Yang meridians with deep tissue massage combined with neck movement in stiff-neck syndrome:A randomized controlled trial

Objective:The objective of this study is to observe the therapeutic effects of dredging hand Yang meridian with deep tissue massage combined with neck movement on stiff-neck syndrome.Materials and Methods:This is a randomized controlled trial.The consecutive patients with the stiff-neck syndrome were randomly allocated into the intervention group and patch group(1:1)according to the random number table.The intervention group was treated with dredging hand Yang meridian with deep tissue massage combined with neck movement once a day for 3 days,while the patch group therapy was treated with a 3-patch therapy and every patch included 24-h patch and 24-h patch-free.A needle electromyogram would be exerted if the patients were at their willingness in different stages.The pain of patients was assessed by Visual Analog Scale in the two groups at every 24 h time point.Results:Finally,212 patients completed the trial,106 in each group.The curative rate in the intervention group was higher than in the patch group(99.06%vs.84.91%,χ^(2)=0.890,P<0.01).Repeated measures of the general linear model showed a significant difference in pain score within the subject-factors(factor of time F=4548.577,P<0.001;factor of time-group F=490.034,P<0.001).There was a significant difference between groups regarding pain score(F=3016.315,P<0.001).Conclusion:Dredging hand Yang meridian with deep tissue massage combined with neck movement is better than patch therapy in stiff-neck syndrome,with a shorter duration and instant effects.

扶阳罐循经温推联合益肾活血汤治疗腰椎间盘突出症的临床研究

目的观察扶阳罐循经温推联合益肾活血汤治疗腰椎间盘突出症的临床疗效。方法选取2019年9月至2020年5月收治的138例腰椎间盘突出症患者为研究对象,按照随机数字表法分为2组,对照组69例采用常规推拿治疗,治疗组69例予扶阳罐循经温推联合益肾活血汤治疗。2组均治疗10天后统计疗效,比较2组治疗前后疼痛症状[分别用日本骨科学会(JOA)下腰痛评分及疼痛视觉模拟评分法(VAS)评分进行评定]及炎症因子[包括白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)及IL-4]水平变化情况,比较2组治疗期间不良反应发生状况。结果与本组治疗前比较,2组治疗后JOA下腰痛评分均升高(P<0.05),疼痛VAS评分均降低(P<0.05),且治疗组治疗后JOA下腰痛评分高于对照组(P<0.05),疼痛VAS评分低于对照组(P<0.05)。与本组治疗前比较,2组治疗后血清炎症因子IL-6、TNF-α水平均降低(P<0.05),IL-4水平均升高(P<0.05),且治疗组治疗后IL-6、TNF-α水平均低于对照组(P<0.05),IL-4水平高于对照组(P<0.05)。治疗组不良反应总发生率4.3%(3/69),对照组不良反应总发生率7.2%(5/69),2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论扶阳罐循经温推联合益肾活血汤治疗腰椎间盘突出症疗效确切,可有效改善患者疼痛症状,抑制炎症反应,临床应用安全可靠。

基于筋骨理论对青少年颈痛的临床新思考

青少年颈痛症状类似于成人颈椎病,但其病理改变并不完全符合颈椎椎间盘退变。因此,应积极探索更符合其临床特点的病因学和病理学理论,实现临床对青少年颈痛的有效诊断与治疗。在石氏伤科百年治伤临床经验和最新科学研究认识的基础上,探讨青少年颈痛的诊断名称和基于“筋骨合和”理论的病因病机,并针对颈部“筋出槽、骨错缝”核心病机建立“四以相和”的诊治策略。

推拿联合中药治疗儿童腺样体肥大临床疗效观察

目的 观察推拿联合中药治疗儿童腺样体肥大的临床疗效。方法 将符合纳入标准的90例患儿随机分为西药对照组(糠酸莫米松鼻喷剂喷鼻)、中药治疗组(内服自拟化痰散结方)和综合治疗组(内服自拟化痰散结方联合小儿推拿),每组各30例。3组患儿均连续治疗1个月,观察3组患儿治疗后的总有效率、治疗前后中医主次症状积分以及鼻咽部X线侧位片腺样体厚度/鼻咽腔宽度(A/N)值的变化情况。结果 综合治疗组总有效率为96.43%,明显高于中药治疗组(79.31%)和西药对照组(50.00%),差异有统计学意义(P<0.05)。治疗后,3组患儿主次症状(除腺样体面容外)积分、A/N值均明显低于本组治疗前(P<0.05),且综合治疗组明显低于中药治疗组和西药对照组(P<0.05)。结论 推拿联合中药治疗儿童腺样体肥大,可提高疗效,明显改善患儿临床症状,缩小腺样体体积,同时接受度及安全性高,值得临床推广与应用。

传统中医药文化渗透式教学模式在小儿推拿的应用

目的 评价传统中医药文化在小儿推拿教学中的应用效果。方法 随机选取上海中医药大学2021—2022学期推拿学课堂教学学生60人作为研究对象,实验组和对照组各30人。实验组采用中医药文化渗透式教学模式,对照组采用常规教学模式,教学结束后评价两组学生的教学满意度。结果 不同教学模式教学后,两组学生临床技能、学习兴趣、师生互动、人文素养、职业道德、医患关系、知识掌握度、人际沟通能力及课堂参与度的差异有统计学意义(P<0.05),两组学生自学能力差异无统计学意义(P>0.05)。结论 中医药文化渗透式教学模式使学生的临床技能、学习兴趣、职业道德、人文素养、知识掌握度、课堂参与度均有所提高,可以增强学生的人际沟通能力,并加强师生间的互动,还可以培养良好的医患关系,值得提倡。

经穴推拿联合中药穴位贴敷对急性心肌梗死病人便秘及心血管事件的预防作用

目的:分析急性心肌梗死(AMI)病人采用经穴推拿联合中药穴位贴敷对便秘及心血管事件的预防作用。方法:选取2022年1月—12月于我院心血管内科收治的100例AMI病人作为研究对象,按照随机数字表法分为对照组和观察组,各50例。对照组实施常规护理干预;观察组在对照组基础上给予经穴推拿和中药穴位贴敷。比较两组便秘及心血管事件发生率、心功能指标、生活质量等。结果:干预期间,观察组病人便秘发生率(8.00%)低于对照组(40.00%),差异有统计学意义(P<0.05);观察组心血管事件发生率(6.00%)低于对照组(26.00%),差异有统计学意义(P<0.05);干预后,观察组肌钙蛋白、脑钠肽水平低于对照组,左室射血分数高于对照组,差异有统计学意义(P<0.05);随访后时,观察组生活质量量表(SF-36)各维度评分均高于对照组,差异均有统计学意义(P<0.05)。结论:经穴推拿联合中药穴位贴敷可有效预防AMI病人便秘,降低心血管事件风险,有利于促进心功能恢复,提高生活质量。