OBJECTIVE:To compare the therapeutic effects of nine acupuncture-related therapies(acupuncture,scrapping therapy,catgut embedding,blood-letting,electro-acupuncture,warm acupuncture,cupping,moxibustion,and needle knife...OBJECTIVE:To compare the therapeutic effects of nine acupuncture-related therapies(acupuncture,scrapping therapy,catgut embedding,blood-letting,electro-acupuncture,warm acupuncture,cupping,moxibustion,and needle knife)in the treatment of nonspecific low back pain(NLBP),providing evidence-based medical support for clinical treatment.METHODS:Randomized controlled trials evaluating various acupuncture therapies for NLBP were screened from the China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,PubMed,Web of Science,Chinese Biomedical Literature Database,Embase,and the Cochrane Library.Methodological quality was assessed using the Cochrane 5.1.0 risk of bias assessment tool,and the data were analyzed using STATA 15.1.RESULTS:This study included 19 randomized controlled trials involving 1356 participants and assessing pain using the visual analog scale(VAS),improvement in dysfunction using the oswestry disability index(ODI),and the effective rate.Blood-letting[surface under the cumulative ranking curve(SUCRA)=81.4]exhibited a significant clinical effect in relieving NLBP in studies with the VAS score as the outcome indicator,followed by cupping(SUCRA=70.4)and moxibustion(SUCRA=58.5).Scrapping therapy(SUCRA=77.7)had the most significant effect on improving NLBP-related functional impairment,followed by moxibustion(SUCRA=59.8),and then bloodletting(SUCRA=58.2).The effective rates of warm acupuncture(SUCRA=78.0),scrapping therapy(SUCRA=77.2)and blood-letting(SUCRA=58.6)were better than those of acupuncture(SUCRA=12.0),especially for cold and wet NLBP.These findings demonstrate the importance of syndrome differentiation during clinical decision making when determining diagnosis and treatment.CONCLUSION:Blood-letting was the most effective treatment for relieving pain,and scrapping therapy was the most effective treatment for improving dysfunction.Warm acupuncture was the preferred treatment for cold and wet NLBP.However,further high-quality clinical studies are needed for validation.展开更多
Objectives:To investigate the clinical and therapeutic effects of acupuncture at the pain-sensitive points of patients with chronic nonspecific low back pain and optimize the acupuncture treatment for chronic nonspeci...Objectives:To investigate the clinical and therapeutic effects of acupuncture at the pain-sensitive points of patients with chronic nonspecific low back pain and optimize the acupuncture treatment for chronic nonspecific low back pain.Methods:Using the FDK 20 pressure algometer,the pain-sensitive points were probed in 30 patients with chronic nonspecific low back pain.The top 5 points that elicited the most painful reaction were selected and stimulated with an even-needling technique after deqi.The needles were retained for 30 min.TDP irradiation was concurrently administered.The treatment was administered once daily on weekdays(Monday to Friday) and discontinued for 2 days during the weekend(Saturday and Sunday).The treatment lasted for 2 consecutive weeks.The changes in the range of motion(ROM) of the lumbar vertebrae,visual analogous scale(VAS) score,and the Oswestry disability index(ODI) score of the lumbar vertebrae were assessed before treatment and after 5 and 10 treatment sessions.Results:Compared with the data before treatment,the spinal ROM increased after 5 and 10 treatment sessions in the patients with chronic nonspecific low back pain.The ROM after 10 treatment sessions was remarkably wider than that after 5 treatments,with statistical significance(all P<0.05).Compared with that before treatment,the immediate VAS score showed statistically significant reduction after 5 treatment sessions(P<0.05).Moreover,compared with the score after 5 treatment sessions,the immediate VAS score reduced after 10 treatment sessions,but without any statistical significance.After 5 and 10 treatment sessions,the ODI score was reduced in the patients and it was significantly different from that before treatment(both P<0.05).Conclusion:Acupuncture at the pain-sensitive points alleviates pain and improves lumbar vertebral function in patients with chronic nonspecific low back pain.Thus,further research is needed to confirm whether acupuncture can be a better intervention for chronic nonspecific low back pain.展开更多
Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-t...Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-terized as pain lasting over 12 weeks without an identifiable cause,leads to notable functional limitations and reduced quality of life.Traditional rehabil-itation programs,often focusing on dynamic exercises for lumbar strengthening,typically do not target the deep stabilizing muscles crucial for lumbar support and effective recovery.Multi-angular isometric lumbar exercise(MAILE)offers a low-impact method for strengthening lumbar stabilizers through multi-angular isometric contractions,reducing risks from dynamic movements.This article examines MAILE’s potential in addressing motor control dysfunctions in NCLBP,highlighting studies on lumbar muscle activation,core stability,and isometric exercises.The article explores the prevalence and socioeconomic impact of NCLBP in the Middle East,highlighting the need for affordable treatment options in areas like Qatar and Saudi Arabia.This article aims to validate the efficacy of MAILE in reducing pain,enhancing mobility,and improving lumbar stability,offering a valuable option for NCLBP management.Future research should focus on large-scale clinical trials to substantiate these findings and guide clinical practice.展开更多
Background： This study evaluated the efficacy of percutaneous nucleoplasty using coblation technique for the treatment of chronic nonspecific low back pain （LBP）, after 5 years of follow-up. Methods： From Septembe...Background： This study evaluated the efficacy of percutaneous nucleoplasty using coblation technique for the treatment of chronic nonspecific low back pain （LBP）, after 5 years of follow-up. Methods： From September 2004 to November 2006, 172 patients underwent percutaneous nucleoplasty for chronic LBP in our department. Forty-one of these patients were followed up for a mean period of 67 months. Nucleoplasty was performed at L3/4 in 1 patient; L4/5 in 25 patients; L5/$1 in 2 patients; L3/4 and L4/5 in 2 patients; L4/5 and L5/$1 in 7 patients; and L3/4, L4/5, and L5/$1 in 4 patients. Patients were assessed preoperatively and at 1 week, 1 year, 3 years, and 5 years postoperatively. Pain was graded using a 10-cm Visual Analogue Scale （VAS） and the percentage reduction in pain score was calculated at each postoperative time point. The Oswestry Disability Index （ODI） was used to assess disability-related to lumbar spine degeneration, and patient satisfaction was assessed using the modified MacNab criteria. Results： There were significant differences among the preoperative, 1-week postoperative, and 3-year postoperative VAS and ODI scores, but not between the 3- and 5-year postoperative scores. There were no significant differences in age, sex, or preoperative symptoms between patients with effective and ineffective treatment, but there were significant differences in the number of levels treated, Pfirrmann grade of intervertebral disc degeneration, and provocative discography findings between these two groups. Excellent or good patient satisfaction was achieved in 87.9% of patients after 1 week, 72.4% after 1 year, 67.7% after 3 years, and 63.4% at the last follow-up. Conclusions： Although previously published short- and medium-term outcomes after percutaneous nucleoplasty appeared to be satisfactory, our long-term follow-up results show a significant decline in patient satisfaction over time. Percutaneous nucleoplasty is a safe and simple technique, with therapeutic effectiveness for the treatment of chronic LBP in selected patients. The technique is minimally invasive and can be used as part of a stepwise treatment plan for chronic LBP.展开更多
基金Supported by the National Natural Science Foundation of China:Novel Dynamic Regulation Method of Acupoint Stimulation Based on Injectable Magnetic Gel for Myocardial Ischemia-Reperfusion Injury (No. 82074560)Effect Evaluation of Different Combinations of Acupuncture Techniques (No. 8207152951)Sanqin Talent Special Support Program:Leading Talent Project for Technological Innovation (No. 2024)
文摘OBJECTIVE:To compare the therapeutic effects of nine acupuncture-related therapies(acupuncture,scrapping therapy,catgut embedding,blood-letting,electro-acupuncture,warm acupuncture,cupping,moxibustion,and needle knife)in the treatment of nonspecific low back pain(NLBP),providing evidence-based medical support for clinical treatment.METHODS:Randomized controlled trials evaluating various acupuncture therapies for NLBP were screened from the China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,PubMed,Web of Science,Chinese Biomedical Literature Database,Embase,and the Cochrane Library.Methodological quality was assessed using the Cochrane 5.1.0 risk of bias assessment tool,and the data were analyzed using STATA 15.1.RESULTS:This study included 19 randomized controlled trials involving 1356 participants and assessing pain using the visual analog scale(VAS),improvement in dysfunction using the oswestry disability index(ODI),and the effective rate.Blood-letting[surface under the cumulative ranking curve(SUCRA)=81.4]exhibited a significant clinical effect in relieving NLBP in studies with the VAS score as the outcome indicator,followed by cupping(SUCRA=70.4)and moxibustion(SUCRA=58.5).Scrapping therapy(SUCRA=77.7)had the most significant effect on improving NLBP-related functional impairment,followed by moxibustion(SUCRA=59.8),and then bloodletting(SUCRA=58.2).The effective rates of warm acupuncture(SUCRA=78.0),scrapping therapy(SUCRA=77.2)and blood-letting(SUCRA=58.6)were better than those of acupuncture(SUCRA=12.0),especially for cold and wet NLBP.These findings demonstrate the importance of syndrome differentiation during clinical decision making when determining diagnosis and treatment.CONCLUSION:Blood-letting was the most effective treatment for relieving pain,and scrapping therapy was the most effective treatment for improving dysfunction.Warm acupuncture was the preferred treatment for cold and wet NLBP.However,further high-quality clinical studies are needed for validation.
基金Supported by Special Funds of Fujian Provincial Finance Department and Education Department:x2018002Clinical Special Project of School Management of Fujian University of Traditional Chinese Medicine:xb2020150。
文摘Objectives:To investigate the clinical and therapeutic effects of acupuncture at the pain-sensitive points of patients with chronic nonspecific low back pain and optimize the acupuncture treatment for chronic nonspecific low back pain.Methods:Using the FDK 20 pressure algometer,the pain-sensitive points were probed in 30 patients with chronic nonspecific low back pain.The top 5 points that elicited the most painful reaction were selected and stimulated with an even-needling technique after deqi.The needles were retained for 30 min.TDP irradiation was concurrently administered.The treatment was administered once daily on weekdays(Monday to Friday) and discontinued for 2 days during the weekend(Saturday and Sunday).The treatment lasted for 2 consecutive weeks.The changes in the range of motion(ROM) of the lumbar vertebrae,visual analogous scale(VAS) score,and the Oswestry disability index(ODI) score of the lumbar vertebrae were assessed before treatment and after 5 and 10 treatment sessions.Results:Compared with the data before treatment,the spinal ROM increased after 5 and 10 treatment sessions in the patients with chronic nonspecific low back pain.The ROM after 10 treatment sessions was remarkably wider than that after 5 treatments,with statistical significance(all P<0.05).Compared with that before treatment,the immediate VAS score showed statistically significant reduction after 5 treatment sessions(P<0.05).Moreover,compared with the score after 5 treatment sessions,the immediate VAS score reduced after 10 treatment sessions,but without any statistical significance.After 5 and 10 treatment sessions,the ODI score was reduced in the patients and it was significantly different from that before treatment(both P<0.05).Conclusion:Acupuncture at the pain-sensitive points alleviates pain and improves lumbar vertebral function in patients with chronic nonspecific low back pain.Thus,further research is needed to confirm whether acupuncture can be a better intervention for chronic nonspecific low back pain.
文摘Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-terized as pain lasting over 12 weeks without an identifiable cause,leads to notable functional limitations and reduced quality of life.Traditional rehabil-itation programs,often focusing on dynamic exercises for lumbar strengthening,typically do not target the deep stabilizing muscles crucial for lumbar support and effective recovery.Multi-angular isometric lumbar exercise(MAILE)offers a low-impact method for strengthening lumbar stabilizers through multi-angular isometric contractions,reducing risks from dynamic movements.This article examines MAILE’s potential in addressing motor control dysfunctions in NCLBP,highlighting studies on lumbar muscle activation,core stability,and isometric exercises.The article explores the prevalence and socioeconomic impact of NCLBP in the Middle East,highlighting the need for affordable treatment options in areas like Qatar and Saudi Arabia.This article aims to validate the efficacy of MAILE in reducing pain,enhancing mobility,and improving lumbar stability,offering a valuable option for NCLBP management.Future research should focus on large-scale clinical trials to substantiate these findings and guide clinical practice.
文摘Background： This study evaluated the efficacy of percutaneous nucleoplasty using coblation technique for the treatment of chronic nonspecific low back pain （LBP）, after 5 years of follow-up. Methods： From September 2004 to November 2006, 172 patients underwent percutaneous nucleoplasty for chronic LBP in our department. Forty-one of these patients were followed up for a mean period of 67 months. Nucleoplasty was performed at L3/4 in 1 patient; L4/5 in 25 patients; L5/$1 in 2 patients; L3/4 and L4/5 in 2 patients; L4/5 and L5/$1 in 7 patients; and L3/4, L4/5, and L5/$1 in 4 patients. Patients were assessed preoperatively and at 1 week, 1 year, 3 years, and 5 years postoperatively. Pain was graded using a 10-cm Visual Analogue Scale （VAS） and the percentage reduction in pain score was calculated at each postoperative time point. The Oswestry Disability Index （ODI） was used to assess disability-related to lumbar spine degeneration, and patient satisfaction was assessed using the modified MacNab criteria. Results： There were significant differences among the preoperative, 1-week postoperative, and 3-year postoperative VAS and ODI scores, but not between the 3- and 5-year postoperative scores. There were no significant differences in age, sex, or preoperative symptoms between patients with effective and ineffective treatment, but there were significant differences in the number of levels treated, Pfirrmann grade of intervertebral disc degeneration, and provocative discography findings between these two groups. Excellent or good patient satisfaction was achieved in 87.9% of patients after 1 week, 72.4% after 1 year, 67.7% after 3 years, and 63.4% at the last follow-up. Conclusions： Although previously published short- and medium-term outcomes after percutaneous nucleoplasty appeared to be satisfactory, our long-term follow-up results show a significant decline in patient satisfaction over time. Percutaneous nucleoplasty is a safe and simple technique, with therapeutic effectiveness for the treatment of chronic LBP in selected patients. The technique is minimally invasive and can be used as part of a stepwise treatment plan for chronic LBP.
