The simple obesity is a common clinical disease and its incidence is increasing year by year.With the increasing pace of work,increasing pressure,and changing eating habits,the incidence of simple obesity tends to be ...The simple obesity is a common clinical disease and its incidence is increasing year by year.With the increasing pace of work,increasing pressure,and changing eating habits,the incidence of simple obesity tends to be younger.Among the treatment protocols for this disease,TCM manipulative(Tuina)therapy has remarkable curative effect and few adverse reactions,and has been well recognized.Modern research has also proposed a variety of treatment protocols with different characteristics and good curative effects.This paper reviews the related literature on simple obesity and its manipulative therapy in the past ten years,and summarizes its disease name,etiology and pathogenesis,manipulation and related therapies,so as to provide new ideas and new angles for the treatment of the simple obesity.展开更多
Objective:To elucidate how spinal manipulative therapy(SMT)exerts its analgesic effects through regulating brain function in lumbar disc herniation(LDH)patients by utilizing resting-state functional magnetic resonance...Objective:To elucidate how spinal manipulative therapy(SMT)exerts its analgesic effects through regulating brain function in lumbar disc herniation(LDH)patients by utilizing resting-state functional magnetic resonance imaging(rs-f MRI).Methods:From September 2021 to September 2023,we enrolled LDH patients(LDH group,n=31)and age-and sex-matched healthy controls(HCs,n=28).LDH group underwent rs-f MRI at 2 distinct time points(TPs):prior to the initiation of SMT(TP1)and subsequent to the completion of the SMT sessions(TP2).SMT was administered once every other day for 30 min per session,totally 14 treatment sessions over a span of 4 weeks.HCs did not receive SMT treatment and underwent only one f MRI scan.Additionally,participants in LDH group completed clinical questionnaires on pain using the Visual Analog Scale(VAS)and the Japanese Orthopedic Association(JOA)score,whereas HCs did not undergo clinical scale assessments.The effects on the brain were jointly characterized using the amplitude of low-frequency fluctuations(ALFF)and regional homogeneity(Re Ho).Correlation analyses were conducted between specific brain regions and clinical scales.Results:Following SMT treatment,pain symptoms in LDH patients were notably alleviated and accompanied by evident activation of effects in the brain.In comparison to TP1,TP2 exhibited the most significant increase in ALFF values for Temporal_Sup_R and the most notable decrease in ALFF values for Paracentral_Lobule_L(voxelwise P<0.005;clusters>30;FDR correction).Additionally,the most substantial enhancement in Re Ho values was observed for the Cuneus_R,while the most prominent reduction was noted for the Olfactory_R(voxelwise P<0.005;clusters>30;FDR correction).Moreover,a comparative analysis revealed that,in contrast to HCs,LDH patients at TP1 exhibited the most significant increase in ALFF values for Temporal_Pole_Sup_L and the most notable decrease in ALFF values for Frontal_Mid_L(voxelwise P<0.005;clusters>30;FDR correction).Furthermore,the most significant enhancement in Re Ho values was observed for Postcentral_L,while the most prominent reduction was identified for Para Hippocampal_L(voxelwise P<0.005;clusters>30;FDR correction).Notably,correlation analysis with clinical scales revealed a robust positive correlation between the Cuneus_R score and the rate of change in the VAS score(r=0.9333,P<0.0001).Conclusions:Long-term chronic lower back pain in patients with LDH manifests significant activation of the"AUN-DMN-S1-SAN"neural circuitry.The visual network,represented by the Cuneus_R,is highly likely to be a key brain network in which the analgesic efficacy of SMT becomes effective in treating LDH patients.(Trial registration No.NCT 06277739)展开更多
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...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.展开更多
With introduction of three heavy manipulations therapy at Dazhui （大椎 GV 14） for unclear enunciation case of acute cerebral infarction, acute attack case of chronic asthmatic bronchitis, amyotrophic lateral scleros...With introduction of three heavy manipulations therapy at Dazhui （大椎 GV 14） for unclear enunciation case of acute cerebral infarction, acute attack case of chronic asthmatic bronchitis, amyotrophic lateral sclerosis case of motor neuron disease, ankylosing spondylitis case and chronic fatigue syndrome case, it is confirmed thatDazhui （大椎 GV 14） combined with three heavy manipulations therapy of blood-letting acupuncture, cupping and moxibust-ion has efficacy for external and endogenous wind, promoting and tonifying yang- qi, strengthening the body timely, removing wind and dampness, and relieving the pain and spasm in the clinical practice.展开更多
BACKGROUND Spinal manipulation therapy(SMT)has been widely used worldwide to treat musculoskeletal diseases,but it can cause serious adverse events.Spinal epidural hematoma(SEH)caused by SMT is a rare emergency that c...BACKGROUND Spinal manipulation therapy(SMT)has been widely used worldwide to treat musculoskeletal diseases,but it can cause serious adverse events.Spinal epidural hematoma(SEH)caused by SMT is a rare emergency that can cause neurological dysfunction.We herein report three cases of SEH after SMT.CASE SUMMARY The first case was a 30-year-old woman who experienced neck pain and numbness in both upper limbs immediately after SMT.Her symptoms persisted after 3 d of conservative treatment,and she was admitted to our hospital.Magnetic resonance imaging(MRI)demonstrated an SEH,extending from C6 to C7.The second case was a 55-year-old man with sudden back pain 1 d after SMT,numbness in both lower limbs,an inability to stand or walk,and difficulty urinating.MRI revealed an SEH,extending from T1 to T3.The third case was a 28-year-old man who suddenly developed symptoms of numbness in both lower limbs 4 h after SMT.He was unable to stand or walk and experienced mild back pain.MRI revealed an SEH,extending from T1 to T2.All three patients underwent surgery after failed conservative treatment.The three cases recovered to ASIA grade E on day 5,1 wk,and day 10 after surgery,respectively.All patients returned to normal after 3 mo of follow-up.CONCLUSION SEH caused by SMT is very rare,and the condition of each patient should be evaluated in full detail before operation.SEH should be diagnosed immediately and actively treated by surgery.展开更多
基金Supported by Project of National Natural Science Foundation of China (82174525)National Training Program for College Students’Innovation and Entrepreneurship (202110199019)Jilin Provincial Training Program for College Students’Innovation and Entrepreneurship (S202110199117X)
文摘The simple obesity is a common clinical disease and its incidence is increasing year by year.With the increasing pace of work,increasing pressure,and changing eating habits,the incidence of simple obesity tends to be younger.Among the treatment protocols for this disease,TCM manipulative(Tuina)therapy has remarkable curative effect and few adverse reactions,and has been well recognized.Modern research has also proposed a variety of treatment protocols with different characteristics and good curative effects.This paper reviews the related literature on simple obesity and its manipulative therapy in the past ten years,and summarizes its disease name,etiology and pathogenesis,manipulation and related therapies,so as to provide new ideas and new angles for the treatment of the simple obesity.
基金Supported by the General Program of the National Natural Science Foundation of China(No.82274672)the"Pioneer"and"Leading Goose"R&D Program of Zhejiang Province(No.2022C03123)the Scientific Research Project of the Zhejiang Provincial Department of Education(No.Y202351266)。
文摘Objective:To elucidate how spinal manipulative therapy(SMT)exerts its analgesic effects through regulating brain function in lumbar disc herniation(LDH)patients by utilizing resting-state functional magnetic resonance imaging(rs-f MRI).Methods:From September 2021 to September 2023,we enrolled LDH patients(LDH group,n=31)and age-and sex-matched healthy controls(HCs,n=28).LDH group underwent rs-f MRI at 2 distinct time points(TPs):prior to the initiation of SMT(TP1)and subsequent to the completion of the SMT sessions(TP2).SMT was administered once every other day for 30 min per session,totally 14 treatment sessions over a span of 4 weeks.HCs did not receive SMT treatment and underwent only one f MRI scan.Additionally,participants in LDH group completed clinical questionnaires on pain using the Visual Analog Scale(VAS)and the Japanese Orthopedic Association(JOA)score,whereas HCs did not undergo clinical scale assessments.The effects on the brain were jointly characterized using the amplitude of low-frequency fluctuations(ALFF)and regional homogeneity(Re Ho).Correlation analyses were conducted between specific brain regions and clinical scales.Results:Following SMT treatment,pain symptoms in LDH patients were notably alleviated and accompanied by evident activation of effects in the brain.In comparison to TP1,TP2 exhibited the most significant increase in ALFF values for Temporal_Sup_R and the most notable decrease in ALFF values for Paracentral_Lobule_L(voxelwise P<0.005;clusters>30;FDR correction).Additionally,the most substantial enhancement in Re Ho values was observed for the Cuneus_R,while the most prominent reduction was noted for the Olfactory_R(voxelwise P<0.005;clusters>30;FDR correction).Moreover,a comparative analysis revealed that,in contrast to HCs,LDH patients at TP1 exhibited the most significant increase in ALFF values for Temporal_Pole_Sup_L and the most notable decrease in ALFF values for Frontal_Mid_L(voxelwise P<0.005;clusters>30;FDR correction).Furthermore,the most significant enhancement in Re Ho values was observed for Postcentral_L,while the most prominent reduction was identified for Para Hippocampal_L(voxelwise P<0.005;clusters>30;FDR correction).Notably,correlation analysis with clinical scales revealed a robust positive correlation between the Cuneus_R score and the rate of change in the VAS score(r=0.9333,P<0.0001).Conclusions:Long-term chronic lower back pain in patients with LDH manifests significant activation of the"AUN-DMN-S1-SAN"neural circuitry.The visual network,represented by the Cuneus_R,is highly likely to be a key brain network in which the analgesic efficacy of SMT becomes effective in treating LDH patients.(Trial registration No.NCT 06277739)
基金Supported by the National Natural Science Foundation of China(No.81373666)Municipal Hospitals Cutting-Edge Technologies Emerging Joint Project(No.SHDC12013113)+3 种基金Municipal Science and Technology Commission of Shanghai Chinese Medicine Key Project(No.14401970400)National Research Projects of the State Administration of Traditional Chinese Medicine(No.201407001-2)Traditional Chinese Medicine Research Foundation(No.2012L032A)Special Project of Scientific Research Base by State Administration of Traditional Chinese Medicine(No.JDZX2012118),China
文摘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.
文摘With introduction of three heavy manipulations therapy at Dazhui （大椎 GV 14） for unclear enunciation case of acute cerebral infarction, acute attack case of chronic asthmatic bronchitis, amyotrophic lateral sclerosis case of motor neuron disease, ankylosing spondylitis case and chronic fatigue syndrome case, it is confirmed thatDazhui （大椎 GV 14） combined with three heavy manipulations therapy of blood-letting acupuncture, cupping and moxibust-ion has efficacy for external and endogenous wind, promoting and tonifying yang- qi, strengthening the body timely, removing wind and dampness, and relieving the pain and spasm in the clinical practice.
基金Supported by Chinese People’s Liberation Army Medical Technology Youth Training Program,No.20QNPY071.
文摘BACKGROUND Spinal manipulation therapy(SMT)has been widely used worldwide to treat musculoskeletal diseases,but it can cause serious adverse events.Spinal epidural hematoma(SEH)caused by SMT is a rare emergency that can cause neurological dysfunction.We herein report three cases of SEH after SMT.CASE SUMMARY The first case was a 30-year-old woman who experienced neck pain and numbness in both upper limbs immediately after SMT.Her symptoms persisted after 3 d of conservative treatment,and she was admitted to our hospital.Magnetic resonance imaging(MRI)demonstrated an SEH,extending from C6 to C7.The second case was a 55-year-old man with sudden back pain 1 d after SMT,numbness in both lower limbs,an inability to stand or walk,and difficulty urinating.MRI revealed an SEH,extending from T1 to T3.The third case was a 28-year-old man who suddenly developed symptoms of numbness in both lower limbs 4 h after SMT.He was unable to stand or walk and experienced mild back pain.MRI revealed an SEH,extending from T1 to T2.All three patients underwent surgery after failed conservative treatment.The three cases recovered to ASIA grade E on day 5,1 wk,and day 10 after surgery,respectively.All patients returned to normal after 3 mo of follow-up.CONCLUSION SEH caused by SMT is very rare,and the condition of each patient should be evaluated in full detail before operation.SEH should be diagnosed immediately and actively treated by surgery.
