Chronic low-back pain(CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP...Chronic low-back pain(CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP in older adults. Clinical acupuncture experts in the American Traditional Chinese Medicine Association(ATCMA) were interested in the recent grant on CLBP research announced by the National Center for Complementary and Integrative Health. The ATCMA experts held an online discussion on the subject of real-world acupuncture treatments for CLBP in older adults. Seven participants, each with more than 20 years of acupuncture practice, discussed their own unique clinical experience while another participant talked about the potential mechanism of acupuncture in pain management. As a result of the discussion, a picture of a similar treatment strategy emerged across the participants for CLBP in older adults. This discussion shows that acupuncture may have complicated mechanisms in pain management, yet it is effective for the treatment of chronic pain involving maladaptive neuroplasticity;therefore, it should be effective for CLBP in older adults.展开更多
Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain p...Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain patients with lumbar disc herniation were treated with balanced acupuncture or body acupuncture. Central mechanisms of vaded acupunctures were compared using resting-state functional MRI. Patients from both groups received functional MRI before and after acupuncture. Functional connectivity in brain regions that were strongly associated with the bilatera amygdala was analyzed utilizing AFNI software. Visual analogue scale scores were greater in the balanced acupuncture group compared with the body acupuncture group. Function of the endogenous pain regulation network was enhanced in patients in the balanced acupuncture group, but was not changed in the body acupuncture group. This result indicates that the analgesic effects of body acupuncture do not work through the central nervous system. These data suggest that balanced acupuncture exerts analgesic effects on low-back and leg pain patients with lumbar disc herniation by regulating the function of the endogenous pain regulation network.展开更多
Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rat...Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising.Recent guidelines indicate a reduced role for medicines in the management of CNLBP.Objective The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm,compared to nonsteroidal anti-inflammatory drug(NSAID)with a capsaicin plaster,in the treatment of CNLBP.Design,setting,participants and interventions We designed a prospective multicenter randomized clinical trial enrolling patients from January 1,2022 to December 31,2022.A total of 156 patients with CNLBP were randomized into two parallel groups.Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally.Patients in the test group were treated with cupping and scraping using a medical device and medicated balm.Main outcome measures Primary outcome was pain recorded using the visual analogue scale(VAS).Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale(JOA)and the traditional Chinese medicine(TCM)syndrome integral scale(TCMS)as assessment tools.Results Between baseline and postintervention,all changes in outcome metric scales were statistically significant(P<0.001).Compared to the control group,patients in the test group had a significantly greater treatment effect in all outcome variables,as indicated by lower VAS and TCMS scores and higher JOA scores,after the one-week intervention period(P<0.001).Further,according to the findings of multivariate linear regression analysis,the participants’pain(VAS score)was related to their marital status,age,smoking habits and body mass index.No adverse reactions were reported for any participants in this trial.Conclusion The effectiveness of TCM combined with the new physiotherapy tool is superior to that of NSAID combined with topical plasters,regarding to pain intensity,TCM symptoms and quality of life.The TCM plus physiotherapy also showed more stable and long-lasting therapeutic effects.展开更多
目的观察电针联合悬吊训练(sling exercise therapy,SET)治疗慢性非特异性下腰痛(chronic nonspecific low back pain,CNLBP)的临床疗效。方法将72例CNLBP患者随机分为观察组和对照组,每组36例。对照组行SET治疗,观察组在对照组基础上...目的观察电针联合悬吊训练(sling exercise therapy,SET)治疗慢性非特异性下腰痛(chronic nonspecific low back pain,CNLBP)的临床疗效。方法将72例CNLBP患者随机分为观察组和对照组,每组36例。对照组行SET治疗,观察组在对照组基础上采用电针腰夹脊穴治疗。观察两组治疗前后视觉模拟评分法(visual analog scale,VAS)、腰椎功能障碍指数(oswestry disability index,ODI)、日本骨科协会(Japanese Orthopaedc Association,JOA)评分的变化,并比较两组治疗前后竖脊肌、多裂肌表面肌电图(surface electromyography,sEMG)中的指标均方根值(root mean square,RMS)和中位频率值(median frequency value,MF)。结果两组治疗2周后VAS、ODI评分低于治疗前,治疗后VAS、ODI评分低于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后VAS、ODI评分低于对照组,差异有统计学意义(P<0.05)。两组治疗2周后JOA评分高于治疗前,治疗后JOA评分高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后JOA评分高于对照组,差异有统计学意义(P<0.05)。对照组竖脊肌、多裂肌双侧RMS值治疗2周后与治疗前比较,差异无统计学意义(P>0.05);治疗后竖脊肌、多裂肌双侧RMS值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后竖脊肌、多裂肌双侧RMS值高于治疗前,治疗后竖脊肌、多裂肌双侧RMS值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后、治疗后竖脊肌和多裂肌双侧RMS值高于对照组,差异有统计学意义(P<0.05)。两组治疗2周后竖脊肌、多裂肌双侧MF值高于治疗前,治疗后竖脊肌、多裂肌双侧MF值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后竖脊肌、多裂肌双侧MF值高于对照组,差异有统计学意义(P<0.05)。结论电针联合SET训练能更好地减轻患者疼痛,改善椎旁核心肌(多裂肌、竖脊肌)的肌电信号,促进腰椎核心肌群功能恢复。展开更多
Objective:To assess the efficacy and safety of Bushen Huoxue Formula(BSHXF)for the treatment of discogenic low-back pain(DLBP).Methods:This was a parallel,double-blind,randomized,clinical trial performed between May 2...Objective:To assess the efficacy and safety of Bushen Huoxue Formula(BSHXF)for the treatment of discogenic low-back pain(DLBP).Methods:This was a parallel,double-blind,randomized,clinical trial performed between May 2019 and June 2020.Seventy patients were assigned by computerized random number table to the treatment group(lumbar traction and BSHXF,35 cases)or the control group(lumbar traction and placebo,35 cases).The patients received intervention for 3 weeks.Assessment was conducted before treatment and at week 1,2,3 during treatment.Primary outcome was the self-reported score of Oswestry Disability Index(ODI).Secondary outcomes included Visual Analog Scale(VAS),clinical efficacy rate by minimal clinically important difference(MCID)as well as lumbar tenderness,muscle tone and lumbar spine mobility.Adverse reactions were recorded.Follow-up was performed at 1 and 3 months after the end of treatment.Results:In the treatment group,ODI score was significantly decreased compared with baseline(P<0.05)and the control group at 2-and 3-week treatment.Similarly,VAS score decreased compared with the baseline(P<0.05)and was lower than that in the control group at 2-and 3-week treatment(P<0.05).The clinical efficacy rate of the treatment group was higher than that of the control group after treatment[32.35%(11/34)vs.3.13%(1/32),P<0.05].Moreover,the tenderness,and muscle tone,as well as the back extension and left flexion in lumbar spine mobility in the treatment group at 3-week treatment were significantly improved compared with the control group(P<0.05).Follow-up showed that at 1-month after treatment,the treatment group had better outcomes than the control group with regard to a total score of ODI and VAS scores,as well as clinical efficacy rate(all P<0.05).Moreover,VAS score was still significantly lower than the control group at 3-month follow-up(P<0.05).No adverse reactions were reported during the study.Conclusion:BSXHF combined with lumbar traction can significantly improve the clinical symptoms including pain intensity,functionality,muscle tone,and lumbar spine mobility in DLBP patients.(Registration No.Chi CTR1900027777).展开更多
非特异性腰痛(nonspecific low back pain,NLBP)在中医归属“痹证”范畴,此疾病严重影响患者的日常生活。现代医学多采用改善患者局部组织血液循环、促进生物体新陈代谢和组织恢复,松解机体筋膜和软组织粘连等方法进行治疗。目前已有治...非特异性腰痛(nonspecific low back pain,NLBP)在中医归属“痹证”范畴,此疾病严重影响患者的日常生活。现代医学多采用改善患者局部组织血液循环、促进生物体新陈代谢和组织恢复,松解机体筋膜和软组织粘连等方法进行治疗。目前已有治疗方法的疗效并不显著。为治疗该疾病,作者基于前期动物实验结果,以“经筋-脾肾”理论展开叙述,认为寒凝筋脉、脾肾虚衰为非特异性腰痛的主要病因。故采用疏解经筋、固护脾肾的治疗方法,针对性地提出“针膏结合”的治疗手段,即皮内针针刺关元穴配以独活寄生汤膏药贴敷进行治疗。该手段为中医药在临床上治疗NLBP提供了新的思路及方法。展开更多
文摘Chronic low-back pain(CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP in older adults. Clinical acupuncture experts in the American Traditional Chinese Medicine Association(ATCMA) were interested in the recent grant on CLBP research announced by the National Center for Complementary and Integrative Health. The ATCMA experts held an online discussion on the subject of real-world acupuncture treatments for CLBP in older adults. Seven participants, each with more than 20 years of acupuncture practice, discussed their own unique clinical experience while another participant talked about the potential mechanism of acupuncture in pain management. As a result of the discussion, a picture of a similar treatment strategy emerged across the participants for CLBP in older adults. This discussion shows that acupuncture may have complicated mechanisms in pain management, yet it is effective for the treatment of chronic pain involving maladaptive neuroplasticity;therefore, it should be effective for CLBP in older adults.
基金funded by the Scientific Research Innovation Program regarding Traditional Chinese Medicine of Guangzhou University of Chinese Medicine (Central mechanism of balanced acupuncture for lumbar disc herniationusing functional MRI), No. 09CX068
文摘Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain patients with lumbar disc herniation were treated with balanced acupuncture or body acupuncture. Central mechanisms of vaded acupunctures were compared using resting-state functional MRI. Patients from both groups received functional MRI before and after acupuncture. Functional connectivity in brain regions that were strongly associated with the bilatera amygdala was analyzed utilizing AFNI software. Visual analogue scale scores were greater in the balanced acupuncture group compared with the body acupuncture group. Function of the endogenous pain regulation network was enhanced in patients in the balanced acupuncture group, but was not changed in the body acupuncture group. This result indicates that the analgesic effects of body acupuncture do not work through the central nervous system. These data suggest that balanced acupuncture exerts analgesic effects on low-back and leg pain patients with lumbar disc herniation by regulating the function of the endogenous pain regulation network.
基金supported by the 13th Five-Year Army Key Discipline Construction Project(No.2020SZ06-17).
文摘Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising.Recent guidelines indicate a reduced role for medicines in the management of CNLBP.Objective The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm,compared to nonsteroidal anti-inflammatory drug(NSAID)with a capsaicin plaster,in the treatment of CNLBP.Design,setting,participants and interventions We designed a prospective multicenter randomized clinical trial enrolling patients from January 1,2022 to December 31,2022.A total of 156 patients with CNLBP were randomized into two parallel groups.Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally.Patients in the test group were treated with cupping and scraping using a medical device and medicated balm.Main outcome measures Primary outcome was pain recorded using the visual analogue scale(VAS).Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale(JOA)and the traditional Chinese medicine(TCM)syndrome integral scale(TCMS)as assessment tools.Results Between baseline and postintervention,all changes in outcome metric scales were statistically significant(P<0.001).Compared to the control group,patients in the test group had a significantly greater treatment effect in all outcome variables,as indicated by lower VAS and TCMS scores and higher JOA scores,after the one-week intervention period(P<0.001).Further,according to the findings of multivariate linear regression analysis,the participants’pain(VAS score)was related to their marital status,age,smoking habits and body mass index.No adverse reactions were reported for any participants in this trial.Conclusion The effectiveness of TCM combined with the new physiotherapy tool is superior to that of NSAID combined with topical plasters,regarding to pain intensity,TCM symptoms and quality of life.The TCM plus physiotherapy also showed more stable and long-lasting therapeutic effects.
文摘目的观察电针联合悬吊训练(sling exercise therapy,SET)治疗慢性非特异性下腰痛(chronic nonspecific low back pain,CNLBP)的临床疗效。方法将72例CNLBP患者随机分为观察组和对照组,每组36例。对照组行SET治疗,观察组在对照组基础上采用电针腰夹脊穴治疗。观察两组治疗前后视觉模拟评分法(visual analog scale,VAS)、腰椎功能障碍指数(oswestry disability index,ODI)、日本骨科协会(Japanese Orthopaedc Association,JOA)评分的变化,并比较两组治疗前后竖脊肌、多裂肌表面肌电图(surface electromyography,sEMG)中的指标均方根值(root mean square,RMS)和中位频率值(median frequency value,MF)。结果两组治疗2周后VAS、ODI评分低于治疗前,治疗后VAS、ODI评分低于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后VAS、ODI评分低于对照组,差异有统计学意义(P<0.05)。两组治疗2周后JOA评分高于治疗前,治疗后JOA评分高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后JOA评分高于对照组,差异有统计学意义(P<0.05)。对照组竖脊肌、多裂肌双侧RMS值治疗2周后与治疗前比较,差异无统计学意义(P>0.05);治疗后竖脊肌、多裂肌双侧RMS值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后竖脊肌、多裂肌双侧RMS值高于治疗前,治疗后竖脊肌、多裂肌双侧RMS值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后、治疗后竖脊肌和多裂肌双侧RMS值高于对照组,差异有统计学意义(P<0.05)。两组治疗2周后竖脊肌、多裂肌双侧MF值高于治疗前,治疗后竖脊肌、多裂肌双侧MF值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后竖脊肌、多裂肌双侧MF值高于对照组,差异有统计学意义(P<0.05)。结论电针联合SET训练能更好地减轻患者疼痛,改善椎旁核心肌(多裂肌、竖脊肌)的肌电信号,促进腰椎核心肌群功能恢复。
基金Supported by National Natural Science Foundation of China(No.81930118)Central Public Welfare Research Institutes(No.ZZ13-YQ-038)+1 种基金Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(No.ZYYCXTD-C-202003)National Key R&D Program of China(No.2021YFC1712800)。
文摘Objective:To assess the efficacy and safety of Bushen Huoxue Formula(BSHXF)for the treatment of discogenic low-back pain(DLBP).Methods:This was a parallel,double-blind,randomized,clinical trial performed between May 2019 and June 2020.Seventy patients were assigned by computerized random number table to the treatment group(lumbar traction and BSHXF,35 cases)or the control group(lumbar traction and placebo,35 cases).The patients received intervention for 3 weeks.Assessment was conducted before treatment and at week 1,2,3 during treatment.Primary outcome was the self-reported score of Oswestry Disability Index(ODI).Secondary outcomes included Visual Analog Scale(VAS),clinical efficacy rate by minimal clinically important difference(MCID)as well as lumbar tenderness,muscle tone and lumbar spine mobility.Adverse reactions were recorded.Follow-up was performed at 1 and 3 months after the end of treatment.Results:In the treatment group,ODI score was significantly decreased compared with baseline(P<0.05)and the control group at 2-and 3-week treatment.Similarly,VAS score decreased compared with the baseline(P<0.05)and was lower than that in the control group at 2-and 3-week treatment(P<0.05).The clinical efficacy rate of the treatment group was higher than that of the control group after treatment[32.35%(11/34)vs.3.13%(1/32),P<0.05].Moreover,the tenderness,and muscle tone,as well as the back extension and left flexion in lumbar spine mobility in the treatment group at 3-week treatment were significantly improved compared with the control group(P<0.05).Follow-up showed that at 1-month after treatment,the treatment group had better outcomes than the control group with regard to a total score of ODI and VAS scores,as well as clinical efficacy rate(all P<0.05).Moreover,VAS score was still significantly lower than the control group at 3-month follow-up(P<0.05).No adverse reactions were reported during the study.Conclusion:BSXHF combined with lumbar traction can significantly improve the clinical symptoms including pain intensity,functionality,muscle tone,and lumbar spine mobility in DLBP patients.(Registration No.Chi CTR1900027777).
文摘非特异性腰痛(nonspecific low back pain,NLBP)在中医归属“痹证”范畴,此疾病严重影响患者的日常生活。现代医学多采用改善患者局部组织血液循环、促进生物体新陈代谢和组织恢复,松解机体筋膜和软组织粘连等方法进行治疗。目前已有治疗方法的疗效并不显著。为治疗该疾病,作者基于前期动物实验结果,以“经筋-脾肾”理论展开叙述,认为寒凝筋脉、脾肾虚衰为非特异性腰痛的主要病因。故采用疏解经筋、固护脾肾的治疗方法,针对性地提出“针膏结合”的治疗手段,即皮内针针刺关元穴配以独活寄生汤膏药贴敷进行治疗。该手段为中医药在临床上治疗NLBP提供了新的思路及方法。
