As sciatica and low back pain are among the most common medical complaints, many studies have duplicated these conditions in animals. Chronic compression of the dorsal root ganglion （CCD） is one of these models. The...As sciatica and low back pain are among the most common medical complaints, many studies have duplicated these conditions in animals. Chronic compression of the dorsal root ganglion （CCD） is one of these models. The surgery is simple： after exposing the L4/L5 intervertebral foramina, stainless steel rods are implanted unilaterally, one rod for each vertebra, to chronically compress the lumbar dorsal root ganglion （DRG）. Then, CCD can be used to simulate the clinical conditions caused by stenosis, such as a laterally herniated disc or foraminal stenosis. As the intraforaminal implantation of a rod results in neuronal somal hyperexcitability and spontaneous action potentials associated with hyperalgesia, spontaneous pain, and mechanical allodynia, CCD provides an animal model that mimics radicular pain in humans. This review concerns the mechanisms of neuronal hyperexcitability, focusing on various patterns of spontaneous discharge including one possible pain signal for mechanical allodynia - evoked bursting. Also, new data regarding its significant property of maintaining peripheral input are also discussed. Investigations using this animal model will enhance our un-derstanding of the neural mechanisms for low back pain and sciatica. Furthermore, the peripheral location of the DRG fa-cilitates its use as a locus for controlling pain with minimal central effects, in the hope of ultimately uncovering analgesics that block neuropathic pain without influencing physiological pain.展开更多
Although the etiology of sciatica remains uncertain,there is increasing evidence that the disease process of sciatica is associated with the levels of inflammatory factors.Piperine,an alkaloid isolated from Piper nigr...Although the etiology of sciatica remains uncertain,there is increasing evidence that the disease process of sciatica is associated with the levels of inflammatory factors.Piperine,an alkaloid isolated from Piper nigrum,has previously been demonstrated to inhibit inflammation and analgesic effects.The purpose of this study is to verify the regulatory relationship between miR-520a and p65 and to explore how miR-520a/P65 affects the level of cytokines under the action of piperine,so as to play a therapeutic role in sciatica.Through ELISA experiment,we confirmed that four inflammatory factors(IL-1β,TNF-α,IL-10,TGF-β1)can be used as evaluation indexes of sciatica.The differentially expressed miRNA was screened as miR-520a,by microarray technology,and the downstream target of miR-520a was P65 by bioinformatics.Real-time fluorescence quantitative PCR confirmed that the expression of miR-520a was negatively correlated with pro-inflammatory cytokines,positively correlated with anti-inflammatory cytokines and negatively correlated with p65 expression at mRNA level.The expression of p65 was positively correlated with pro-inflammatory cytokines and negatively correlated with anti-inflammatory cytokines at the protein level verified by ELISA and Western blot.HE staining analysis showed that the nerve fibers were repaired by piprine,the vacuoles were significantly reduced,and the degree of nerve fiber damage was also improved.Immunohistochemical analysis showed that the expression of p65 decreased after administration of piperine.Dual-luciferase reporter gene assay confirmed that the luciferase signal decreased significantly after cotransfection of miR-520a mimics and p653'UTR recombinant plasmid.To sum up,in the rat model of non-compressed lumbar disc herniation,piperine plays a significant role in analgesia.MiR-520a can specifically and directly target P65,and piperine can promote the expression of miR-520a,then inhibit the expression of p65,down-regulate the pro-inflammatory factors IL-1βand TNF-α,and up-regulate the effects of anti-inflammatory factors IL-10 and TGF-β1,so as to treat sciatica.展开更多
OBJECTIVE: To investigate the effect and underlying mechanisms of combined medicated thread moxibustion therapy plus needle picking therapy of Zhuang nationality medicine on antioxidant levels in a rat model of sciati...OBJECTIVE: To investigate the effect and underlying mechanisms of combined medicated thread moxibustion therapy plus needle picking therapy of Zhuang nationality medicine on antioxidant levels in a rat model of sciatica.METHODS: One hundred Wistar rats, of specific pathogen free level, were randomly divided into five groups: normal control group, model group,medicated thread moxibustion group, needle picking group, and combination group. Each group contained 20 rats. In the model, medicated thread moxibustion, needle picking, and combination groups,sciatica models were established through chronicconstriction injury of the sciatic nerve. After the model was established, the rats in the medicated thread moxibustion, needle picking, and combination groups were given the corresponding therapies for 21 days. The control and model groups received no treatment. Reactive oxygen species, superoxide dismutase, malondialdehyde, and total antioxidant capacity changes were determined.Nicotinamide adenine dinucleotide phosphate(NADPH) oxidase subunit NADPH oxidases 4(NOX4) m RNA expression and the morphology of cells were observed to detect apoptosis of gamma-aminobutyric acid ergic(GABAergic) neurons.RESULTS: Compared with control group, reactive oxygen species and malondialdehyde levels rose significantly in the model group(P < 0.01), while superoxide dismutase and total antioxidant capacity levels were lowered(P < 0.05). Compared with the model group, reactive oxygen species and malondialdehyde decreased in the needle picking group(P < 0.05), while superoxide dismutase levels were increased(P < 0.05); reactive oxygen species and malondialdehyde significantly decreased in the combination group(P < 0.01). In addition, the model group had higher NOX4 m RNA expression than that of the control group(P < 0.05), and the combination group had lower expression levels than that of the model group(P < 0.05). Apoptosis of GABAergic neurons was observed in the model group, and was attenuated after combined therapy.CONCLUSION: The medicated thread moxibustion therapy plus needle picking therapy of Zhuang nationality medicine can prevent oxidative damage in the rat model of sciatica via down-regulating NOX4 expression, improving antioxidant capacity, and in-hibiting the oxidative damage pathway of GABAergic neurons.展开更多
Background:Lumbar disc herniation and sciatica are major causes of disability in health care.A variety of non-operative treatments are available,include acupuncture,while there is little long-term evidence to indicate...Background:Lumbar disc herniation and sciatica are major causes of disability in health care.A variety of non-operative treatments are available,include acupuncture,while there is little long-term evidence to indicate efficacy of acupuncture.Objective:To observe the long-term clinical effects of lumbar disc herniation and sciatica treated by acupuncture.Methods:Based on acupuncture point selections of the traditional Chinese medicine meridian theory,we developed the treatment strategies for acupuncture in a consensus process with the author's clinical and teaching practice.All 112 outpatients previously visited orthopedic surgeons or neurosurgeons and underwent(magnetic resonance imaging)MRI studies prior to having electric acupuncture treatment.This study used Oswestry Disability Index(ODI)-self-comparison and showed that acupuncture treatments for lumber disc herniation and sciatica demonstrated significant improvement in long term clinical outcomes.A total of 112 lumbar disc herniation and sciatica cases were treated with electric acupuncture for pain relief and function improvement from July 1998 to December 2006.Results:All the 112 cases filled out the ODI forms prior to receiving treatment.Among the 112 patients,23 of them did not finish the 6-week treatments.89 cases were evaluated with ODI after 6-week acupuncture treatments.Of those 89 cases,67 cases were followed up with ODI 10 years later.Significant improvement from the pre-to post-acupuncture ODI scores was observed(P<0.05).The 10-year follow-up ODI showed significant improvement with long-term results(P<0.05).Conclusion:Electric acupuncture for lumbar disc herniation and sciatica showed satisfactory long-term clinical effects.展开更多
AIM To study the clinical findings and characteristic features in sciatic notch dumbbell tumors(SNDTs).METHODS We retrospectively reviewed the clinical outcomes and characteristic features of consecutive cases of SNDT...AIM To study the clinical findings and characteristic features in sciatic notch dumbbell tumors(SNDTs).METHODS We retrospectively reviewed the clinical outcomes and characteristic features of consecutive cases of SNDTs(n = 8). RESULTS Buttock masses occurred in three patients with SNDT(37.5%). Severe buttock tenderness and pain at rest were observed in seven patients with SNDTs(87.5%). Remarkably, none of the patients with SNDTs experienced back pain. Mean tumor size was 8.4 ± 2.0 cm(range, 3.9 to 10.6 cm) and part of the tumor mass was detected in 2 patients in the sagittal view of lumbar magnetic resonance imaging(MRI).CONCLUSION The clinical information regarding to SNDTs is scarce. The authors consider that above mentioned characteristic findings may facilitate the suspicion of pelvic pathology and a search for SNDT by MRI or computed tomography should be considered in patients presenting with sciatica without evidence of spinal diseases.展开更多
Acupuncture treatment can often produce a very good analgesic action on radicular sciatica, with quick effect, low recurrence rate and long period without attack, thus worthy of wide application in clinic.Following ar...Acupuncture treatment can often produce a very good analgesic action on radicular sciatica, with quick effect, low recurrence rate and long period without attack, thus worthy of wide application in clinic.Following are the essentials for the acupuncture treatment of this disease.展开更多
Sciatica belongs to the category of Bizheng (arthralgia syndrome) in traditional Chinese medicine (TCM). From March 1997 to September 2000, we treated 50 cases of sciatica by needling Zanzhu (BL 2) and Fengchi (GB 20)...Sciatica belongs to the category of Bizheng (arthralgia syndrome) in traditional Chinese medicine (TCM). From March 1997 to September 2000, we treated 50 cases of sciatica by needling Zanzhu (BL 2) and Fengchi (GB 20) with satisfactory therapeutic results. A report follows.展开更多
Sciatica, mostly clinical-based diagnosis, is a potentially debilitating condition as a result of disco-radicular conflict between L4 and L5 or L5 and S1. This study aims at describing the epidemiological, clinical an...Sciatica, mostly clinical-based diagnosis, is a potentially debilitating condition as a result of disco-radicular conflict between L4 and L5 or L5 and S1. This study aims at describing the epidemiological, clinical and etiological aspects of sciatica in Hubert Koutoukou Maga Teaching Hospital (CNHU-HKM) of Cotonou. It was a prospective, descriptive and analytical study conducted in CNHU-HKM Cotonou neurology department from 1st January to 30th June 2016. The study population comprised 115 low back pain patients seen in consultation. Data collection was carried out through a standard information sheet with socio-demographic, clinical, para-clinical, etiological and therapeutic data. Epi data 3.1 was used for data entry and Stata11 for processing. Frequency of sciatica was 18.6%, with 95% CI [11.5% - 25.7%]. The study population age ranged from 29 to 73 years, with 52 ± 16 as mean value, while sex ratio was estimated at 0.6. Bilateral sciatica representing 53% was present in L5 and S1 nerve roots in 44.4% of cases. It was exacerbated in prolonged standing (24.4%) and relieved in supine position (44.3%), with paresthesia (59.1%) and intermittent radicular claudication (40.9%). Spinal osteoarthritis was the most prevalent etiology (47%). Sciatica is becoming increasing prevalent and should be regarded as problem of health concern.展开更多
In 198 patients with sciatica, 108 cases were randomly chosen as treatment group with point penetration and deep puncture therapies by elongated needle and a group of 9O cases was received filiform needle therapy as c...In 198 patients with sciatica, 108 cases were randomly chosen as treatment group with point penetration and deep puncture therapies by elongated needle and a group of 9O cases was received filiform needle therapy as control group. In the control group, the way of purgation by twirling the needle was used. The results showed that the total effective rate of the treatment group was 93. 52 %,while in the control group, it was 68. 89 %, X2 = 20. 46, P< 0. 01. It proved that point penetration and deep puncture therapies had better analgesic effect than that of the filifom needle.展开更多
98 patients with sciatica are treated.by stimubting acupoints using a self-made electro-thermal moxibustion instrument.Results show that 82 cases arecured,8 improved and 5 effective,with the total effective rate of 9...98 patients with sciatica are treated.by stimubting acupoints using a self-made electro-thermal moxibustion instrument.Results show that 82 cases arecured,8 improved and 5 effective,with the total effective rate of 96.9％.The temperature relesed from this instrument is adjustable.The electro-thermal moxibustion therapy is short in treatment duration and rapid in taking effect.Ithas no needling-induced pain and no side-effects,and is accepted preferably by patients.展开更多
The author selected acupoints according to the meridian that was affected bypain and the primary symptoms to treat 200 cases of sciatica. Of thern, 152 (76. 0% ) cases werecured, 28 (14.0% ) markedly improved, 12 (6.0...The author selected acupoints according to the meridian that was affected bypain and the primary symptoms to treat 200 cases of sciatica. Of thern, 152 (76. 0% ) cases werecured, 28 (14.0% ) markedly improved, 12 (6.0% ) improved and 8(4.0% ) ineffective.展开更多
<Absract> This paper reports the results of 120 cases of sciatica treated with deep insertion of theneedle at Yaoyangguan (GV 3 ) (experimental group). Another 51 cases used as control group weretreated with rou...<Absract> This paper reports the results of 120 cases of sciatica treated with deep insertion of theneedle at Yaoyangguan (GV 3 ) (experimental group). Another 51 cases used as control group weretreated with routine needling method. In the experimental group, the treatment was conducted 20times at most and 5 times at least. After an average of 13 times of treatment, the cured patients constituted 88. 33 % and the effective rate was 99. 16%. In the control group, the treatment was performed for 40 fimes at most, 10 times at least and 25 times on the average. The cure rate was 50. 98 %and the total effective rate 94. 12%. Comparison between the two groups showed a very significantdifference (X2 = 28. 38, P＜0.01 ) in the cure rate. It is cqncluded that deep insertion of the needle atYaoyangguan (GV 3) plus electrical stimulation is faster and stable in producing therapeutic effect.展开更多
In the present paper, 160 cases of sciatica patients were divided into combined treatmentgroup (acupuncture plus point-injection, 100 cases) and acupuncture group (control group, 60 cases).After two courses of treatme...In the present paper, 160 cases of sciatica patients were divided into combined treatmentgroup (acupuncture plus point-injection, 100 cases) and acupuncture group (control group, 60 cases).After two courses of treatment, of the 100 cases in the combined treatment group, 72 (72% ) werecured, 25 (25 % ) effective and 3 (3 % ) had no effect, with an effective rate of 97%; Of the 60 casesin the control group, 30 (50 % ) were cured, 21 (35 % ) effective and 9 (15 % ) had no effect, with aneffective rate of 85 %. Statistical analysis showed a significant difference between the two groups in effective rate (P < 0. 05). It displayed that the effect of acupuncture plus point-injection was apparentlysuperior to that of acupuncture.展开更多
The blood letting and cupping treatment can treat sciatica. The authors treated 106cases, of whom 76 cases were cured (71. 7%), 22 were improved (20.7%) and 8 didn’t show ef-fect (7. 6% ). The total effective rate is...The blood letting and cupping treatment can treat sciatica. The authors treated 106cases, of whom 76 cases were cured (71. 7%), 22 were improved (20.7%) and 8 didn’t show ef-fect (7. 6% ). The total effective rate is 92. 4%. This therapy has advantages of shorter course,less suffering, simple to practise, quick effect and less expense. It is a unique therapy and easy tobe popularized.展开更多
Case HistoryThe patient,Peter Tschun Kert,a 28-year-oldmale player from a German orchestra,paid his ftrstvisit on December 2,1997,with the chief complaintof severe lumbar pain.The patient stated that onemonth before h...Case HistoryThe patient,Peter Tschun Kert,a 28-year-oldmale player from a German orchestra,paid his ftrstvisit on December 2,1997,with the chief complaintof severe lumbar pain.The patient stated that onemonth before he got lumbar sprain while moving thefurniture in his house,which caused him severelumbar pain and motor impairment,and he had to liein bed in the following days.The pain radiated fromthe waist to the thigh,leading to difficult turning展开更多
From 1989 to 1995,the authors used the methodof surrounding puncture to treat 100 cases of sciaticaand obtained satisfactory therapeutic results asreported in the following.General DataIn the treatment group,of 100 ca...From 1989 to 1995,the authors used the methodof surrounding puncture to treat 100 cases of sciaticaand obtained satisfactory therapeutic results asreported in the following.General DataIn the treatment group,of 100 cases,43 weremale and 57 female with the ages ranging from 15 to26 years,averaging 38 years.The duration of diseasewas from 3 days to 1.5 years,averaging 25 days.Ofthem,76 cases were spinal cord type and 24 nerveroot type;29 cases were diagnosed after CT examand 71 by lateral lumbar vertebra X-ray.展开更多
Case 1: Mr. Li, a 55-year farmer from Hebeiprovince, paid his first visit on August 11, 1995. Thepatient complained of a sudden pain in the area fromhis left buttock down to the posterolateral aspect ofthe leg.
Objective To evaluate the effectiveness of CT-guided percutaneous treatment of intervertebraldisc protrusion causing sciatica (PTDPS). Subjects and ANt hods PTDPS were carried out on 306 patients withback or leg pain ...Objective To evaluate the effectiveness of CT-guided percutaneous treatment of intervertebraldisc protrusion causing sciatica (PTDPS). Subjects and ANt hods PTDPS were carried out on 306 patients withback or leg pain from Mar. 1993 to Dec. 1997. CT examination verified the intervertebral disc protrusion. WithCT-guidance a lumbar puncture needle of 20G was advanced to the site or sites around the affected nerve rootsand corticosteroid was injected into the subdural space. Results PTDPS were completed in all 306 patientssuccessfully. A 1-24 month follow -up was carried out on 186 cases. Of these 161 cases (86.5%) had good result, 16cases (8.6%) fair result and 9 cases (4.8%) without favorable result. Conclusion CT guided PTDPS is a safe,accurate, effective and minimally invasive method directing against the pathophysiolgy of sciatica caused byintervertebral disc protrusion. It is suitable for wider clinical application.展开更多
<span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Introduction</span></b></span><span><span><span style="font-family:&...<span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Introduction</span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: Meningiomas are benign tumors most localized in brain. Intraspinal meningiomas are rare and may have an intra or extradural topography. We report the case of a dorsal psammomatous meningioma revealed by sciatica. </span><b><span style="font-family:Verdana;">Case description</span></b><span style="font-family:Verdana;">: We present a 58-year-old female hospitalized for bilateral painful and disabling L5 sciatica rebellious to medical treatment and physiotherapy. At physical examination, she presented a lumbar spinal syndrome without root deficit. MRI</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">(Magnetic Resonance Imaging) showed a borderline lumbar canal with a paramedian L4-L5 herniated disc. She undergone a first surgery a L4 decompressive laminectomy and there </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">was</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> no postoperative complications. The follow-up was marked by partial pain regression. Three months later, after a fall she presented low back pain and progressive worsening gait troubles. A MRI was realized and shown L3-L4, L4-L5 duct narrowing. A second surgery a L3 and L5 decompressive laminectomy was performed. The postoperative follow up </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">was</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> characterized</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">by the worsening of the motor deficit to 2/5 associated with brisk osteotendinous reflexes. A medullary MRI was realized, showing an intradural but extra-medullary compressive lesion facing D1-D2.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The indication of tumor removal was made and complete resection was performed.</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">She totally recovered from the deficit and the pain. The pathology report showed a psammomatous meningioma. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">This case report emphasizes the atypical clinical presentation of spinal meningiomas and the importance of a meticulous neurological examination to avoid misdiagnosis.展开更多
Hijama is an alternative mode of treatment also known as cupping therapy. It involves removal of subcutaneous stagnant blood through suction cups after making superficial incisions at particular area of the body. This...Hijama is an alternative mode of treatment also known as cupping therapy. It involves removal of subcutaneous stagnant blood through suction cups after making superficial incisions at particular area of the body. This study was undertaken to evaluate the efficacy of hijama in sciatica pain at Aligarh Shifa hospital. 92 patients with the history of sciatica were selected randomly between 18 - 75 years of age and hijama cups were applied generally at C7, T2 and L5/S1 vertebrae, while two cups were also applied bilaterally on L4/L5 vertebrae, four cups were additionally applied on hip joint, back of thigh, knee and calf muscle, all cups were applied thrice at an interval of 15 days between each session. The decrease in sciatic pain was assessed after three sessions of Hijama by numeric pain rating scale there was overall significant reduction in pain with 67 percent patients showing relief in pain up to varying degree. Present study suggests that hijama has been found to be effective in relieving pain and improving quality of life in majority of the patient’s, hence may be used as effective alternative tool to alleviate pain.展开更多
基金supported by the National Natural Science Foundation of China(30870829)
文摘As sciatica and low back pain are among the most common medical complaints, many studies have duplicated these conditions in animals. Chronic compression of the dorsal root ganglion （CCD） is one of these models. The surgery is simple： after exposing the L4/L5 intervertebral foramina, stainless steel rods are implanted unilaterally, one rod for each vertebra, to chronically compress the lumbar dorsal root ganglion （DRG）. Then, CCD can be used to simulate the clinical conditions caused by stenosis, such as a laterally herniated disc or foraminal stenosis. As the intraforaminal implantation of a rod results in neuronal somal hyperexcitability and spontaneous action potentials associated with hyperalgesia, spontaneous pain, and mechanical allodynia, CCD provides an animal model that mimics radicular pain in humans. This review concerns the mechanisms of neuronal hyperexcitability, focusing on various patterns of spontaneous discharge including one possible pain signal for mechanical allodynia - evoked bursting. Also, new data regarding its significant property of maintaining peripheral input are also discussed. Investigations using this animal model will enhance our un-derstanding of the neural mechanisms for low back pain and sciatica. Furthermore, the peripheral location of the DRG fa-cilitates its use as a locus for controlling pain with minimal central effects, in the hope of ultimately uncovering analgesics that block neuropathic pain without influencing physiological pain.
基金supported by the National Natural Science Foundation of China(Nos.81760748,81550047)the Natural Science Foundation of Inner Mongolia Autonomous Region(Nos.2018LH08032,2017MS0831)Inner Mongolia Autonomous Region"Prairie Excellence"Project,West Light Foundation of the Chinese Academy of Sciences,the Major Science Foundation of Affiliated Hospital of Inner Mongolia Medical University(No.NY-FY ZD010).
文摘Although the etiology of sciatica remains uncertain,there is increasing evidence that the disease process of sciatica is associated with the levels of inflammatory factors.Piperine,an alkaloid isolated from Piper nigrum,has previously been demonstrated to inhibit inflammation and analgesic effects.The purpose of this study is to verify the regulatory relationship between miR-520a and p65 and to explore how miR-520a/P65 affects the level of cytokines under the action of piperine,so as to play a therapeutic role in sciatica.Through ELISA experiment,we confirmed that four inflammatory factors(IL-1β,TNF-α,IL-10,TGF-β1)can be used as evaluation indexes of sciatica.The differentially expressed miRNA was screened as miR-520a,by microarray technology,and the downstream target of miR-520a was P65 by bioinformatics.Real-time fluorescence quantitative PCR confirmed that the expression of miR-520a was negatively correlated with pro-inflammatory cytokines,positively correlated with anti-inflammatory cytokines and negatively correlated with p65 expression at mRNA level.The expression of p65 was positively correlated with pro-inflammatory cytokines and negatively correlated with anti-inflammatory cytokines at the protein level verified by ELISA and Western blot.HE staining analysis showed that the nerve fibers were repaired by piprine,the vacuoles were significantly reduced,and the degree of nerve fiber damage was also improved.Immunohistochemical analysis showed that the expression of p65 decreased after administration of piperine.Dual-luciferase reporter gene assay confirmed that the luciferase signal decreased significantly after cotransfection of miR-520a mimics and p653'UTR recombinant plasmid.To sum up,in the rat model of non-compressed lumbar disc herniation,piperine plays a significant role in analgesia.MiR-520a can specifically and directly target P65,and piperine can promote the expression of miR-520a,then inhibit the expression of p65,down-regulate the pro-inflammatory factors IL-1βand TNF-α,and up-regulate the effects of anti-inflammatory factors IL-10 and TGF-β1,so as to treat sciatica.
基金Supported by the National Natural Science Foundation of China(Research on Mechanism of Insomnia Treatment Administrated by Acupuncture Combined With Medicated Thread Moxibustion of Zhuang Nationality Medicine,No.81360579)
文摘OBJECTIVE: To investigate the effect and underlying mechanisms of combined medicated thread moxibustion therapy plus needle picking therapy of Zhuang nationality medicine on antioxidant levels in a rat model of sciatica.METHODS: One hundred Wistar rats, of specific pathogen free level, were randomly divided into five groups: normal control group, model group,medicated thread moxibustion group, needle picking group, and combination group. Each group contained 20 rats. In the model, medicated thread moxibustion, needle picking, and combination groups,sciatica models were established through chronicconstriction injury of the sciatic nerve. After the model was established, the rats in the medicated thread moxibustion, needle picking, and combination groups were given the corresponding therapies for 21 days. The control and model groups received no treatment. Reactive oxygen species, superoxide dismutase, malondialdehyde, and total antioxidant capacity changes were determined.Nicotinamide adenine dinucleotide phosphate(NADPH) oxidase subunit NADPH oxidases 4(NOX4) m RNA expression and the morphology of cells were observed to detect apoptosis of gamma-aminobutyric acid ergic(GABAergic) neurons.RESULTS: Compared with control group, reactive oxygen species and malondialdehyde levels rose significantly in the model group(P < 0.01), while superoxide dismutase and total antioxidant capacity levels were lowered(P < 0.05). Compared with the model group, reactive oxygen species and malondialdehyde decreased in the needle picking group(P < 0.05), while superoxide dismutase levels were increased(P < 0.05); reactive oxygen species and malondialdehyde significantly decreased in the combination group(P < 0.01). In addition, the model group had higher NOX4 m RNA expression than that of the control group(P < 0.05), and the combination group had lower expression levels than that of the model group(P < 0.05). Apoptosis of GABAergic neurons was observed in the model group, and was attenuated after combined therapy.CONCLUSION: The medicated thread moxibustion therapy plus needle picking therapy of Zhuang nationality medicine can prevent oxidative damage in the rat model of sciatica via down-regulating NOX4 expression, improving antioxidant capacity, and in-hibiting the oxidative damage pathway of GABAergic neurons.
文摘Background:Lumbar disc herniation and sciatica are major causes of disability in health care.A variety of non-operative treatments are available,include acupuncture,while there is little long-term evidence to indicate efficacy of acupuncture.Objective:To observe the long-term clinical effects of lumbar disc herniation and sciatica treated by acupuncture.Methods:Based on acupuncture point selections of the traditional Chinese medicine meridian theory,we developed the treatment strategies for acupuncture in a consensus process with the author's clinical and teaching practice.All 112 outpatients previously visited orthopedic surgeons or neurosurgeons and underwent(magnetic resonance imaging)MRI studies prior to having electric acupuncture treatment.This study used Oswestry Disability Index(ODI)-self-comparison and showed that acupuncture treatments for lumber disc herniation and sciatica demonstrated significant improvement in long term clinical outcomes.A total of 112 lumbar disc herniation and sciatica cases were treated with electric acupuncture for pain relief and function improvement from July 1998 to December 2006.Results:All the 112 cases filled out the ODI forms prior to receiving treatment.Among the 112 patients,23 of them did not finish the 6-week treatments.89 cases were evaluated with ODI after 6-week acupuncture treatments.Of those 89 cases,67 cases were followed up with ODI 10 years later.Significant improvement from the pre-to post-acupuncture ODI scores was observed(P<0.05).The 10-year follow-up ODI showed significant improvement with long-term results(P<0.05).Conclusion:Electric acupuncture for lumbar disc herniation and sciatica showed satisfactory long-term clinical effects.
文摘AIM To study the clinical findings and characteristic features in sciatic notch dumbbell tumors(SNDTs).METHODS We retrospectively reviewed the clinical outcomes and characteristic features of consecutive cases of SNDTs(n = 8). RESULTS Buttock masses occurred in three patients with SNDT(37.5%). Severe buttock tenderness and pain at rest were observed in seven patients with SNDTs(87.5%). Remarkably, none of the patients with SNDTs experienced back pain. Mean tumor size was 8.4 ± 2.0 cm(range, 3.9 to 10.6 cm) and part of the tumor mass was detected in 2 patients in the sagittal view of lumbar magnetic resonance imaging(MRI).CONCLUSION The clinical information regarding to SNDTs is scarce. The authors consider that above mentioned characteristic findings may facilitate the suspicion of pelvic pathology and a search for SNDT by MRI or computed tomography should be considered in patients presenting with sciatica without evidence of spinal diseases.
文摘Acupuncture treatment can often produce a very good analgesic action on radicular sciatica, with quick effect, low recurrence rate and long period without attack, thus worthy of wide application in clinic.Following are the essentials for the acupuncture treatment of this disease.
文摘Sciatica belongs to the category of Bizheng (arthralgia syndrome) in traditional Chinese medicine (TCM). From March 1997 to September 2000, we treated 50 cases of sciatica by needling Zanzhu (BL 2) and Fengchi (GB 20) with satisfactory therapeutic results. A report follows.
文摘Sciatica, mostly clinical-based diagnosis, is a potentially debilitating condition as a result of disco-radicular conflict between L4 and L5 or L5 and S1. This study aims at describing the epidemiological, clinical and etiological aspects of sciatica in Hubert Koutoukou Maga Teaching Hospital (CNHU-HKM) of Cotonou. It was a prospective, descriptive and analytical study conducted in CNHU-HKM Cotonou neurology department from 1st January to 30th June 2016. The study population comprised 115 low back pain patients seen in consultation. Data collection was carried out through a standard information sheet with socio-demographic, clinical, para-clinical, etiological and therapeutic data. Epi data 3.1 was used for data entry and Stata11 for processing. Frequency of sciatica was 18.6%, with 95% CI [11.5% - 25.7%]. The study population age ranged from 29 to 73 years, with 52 ± 16 as mean value, while sex ratio was estimated at 0.6. Bilateral sciatica representing 53% was present in L5 and S1 nerve roots in 44.4% of cases. It was exacerbated in prolonged standing (24.4%) and relieved in supine position (44.3%), with paresthesia (59.1%) and intermittent radicular claudication (40.9%). Spinal osteoarthritis was the most prevalent etiology (47%). Sciatica is becoming increasing prevalent and should be regarded as problem of health concern.
文摘In 198 patients with sciatica, 108 cases were randomly chosen as treatment group with point penetration and deep puncture therapies by elongated needle and a group of 9O cases was received filiform needle therapy as control group. In the control group, the way of purgation by twirling the needle was used. The results showed that the total effective rate of the treatment group was 93. 52 %,while in the control group, it was 68. 89 %, X2 = 20. 46, P< 0. 01. It proved that point penetration and deep puncture therapies had better analgesic effect than that of the filifom needle.
文摘98 patients with sciatica are treated.by stimubting acupoints using a self-made electro-thermal moxibustion instrument.Results show that 82 cases arecured,8 improved and 5 effective,with the total effective rate of 96.9％.The temperature relesed from this instrument is adjustable.The electro-thermal moxibustion therapy is short in treatment duration and rapid in taking effect.Ithas no needling-induced pain and no side-effects,and is accepted preferably by patients.
文摘The author selected acupoints according to the meridian that was affected bypain and the primary symptoms to treat 200 cases of sciatica. Of thern, 152 (76. 0% ) cases werecured, 28 (14.0% ) markedly improved, 12 (6.0% ) improved and 8(4.0% ) ineffective.
文摘<Absract> This paper reports the results of 120 cases of sciatica treated with deep insertion of theneedle at Yaoyangguan (GV 3 ) (experimental group). Another 51 cases used as control group weretreated with routine needling method. In the experimental group, the treatment was conducted 20times at most and 5 times at least. After an average of 13 times of treatment, the cured patients constituted 88. 33 % and the effective rate was 99. 16%. In the control group, the treatment was performed for 40 fimes at most, 10 times at least and 25 times on the average. The cure rate was 50. 98 %and the total effective rate 94. 12%. Comparison between the two groups showed a very significantdifference (X2 = 28. 38, P＜0.01 ) in the cure rate. It is cqncluded that deep insertion of the needle atYaoyangguan (GV 3) plus electrical stimulation is faster and stable in producing therapeutic effect.
文摘In the present paper, 160 cases of sciatica patients were divided into combined treatmentgroup (acupuncture plus point-injection, 100 cases) and acupuncture group (control group, 60 cases).After two courses of treatment, of the 100 cases in the combined treatment group, 72 (72% ) werecured, 25 (25 % ) effective and 3 (3 % ) had no effect, with an effective rate of 97%; Of the 60 casesin the control group, 30 (50 % ) were cured, 21 (35 % ) effective and 9 (15 % ) had no effect, with aneffective rate of 85 %. Statistical analysis showed a significant difference between the two groups in effective rate (P < 0. 05). It displayed that the effect of acupuncture plus point-injection was apparentlysuperior to that of acupuncture.
文摘The blood letting and cupping treatment can treat sciatica. The authors treated 106cases, of whom 76 cases were cured (71. 7%), 22 were improved (20.7%) and 8 didn’t show ef-fect (7. 6% ). The total effective rate is 92. 4%. This therapy has advantages of shorter course,less suffering, simple to practise, quick effect and less expense. It is a unique therapy and easy tobe popularized.
文摘Case HistoryThe patient,Peter Tschun Kert,a 28-year-oldmale player from a German orchestra,paid his ftrstvisit on December 2,1997,with the chief complaintof severe lumbar pain.The patient stated that onemonth before he got lumbar sprain while moving thefurniture in his house,which caused him severelumbar pain and motor impairment,and he had to liein bed in the following days.The pain radiated fromthe waist to the thigh,leading to difficult turning
文摘From 1989 to 1995,the authors used the methodof surrounding puncture to treat 100 cases of sciaticaand obtained satisfactory therapeutic results asreported in the following.General DataIn the treatment group,of 100 cases,43 weremale and 57 female with the ages ranging from 15 to26 years,averaging 38 years.The duration of diseasewas from 3 days to 1.5 years,averaging 25 days.Ofthem,76 cases were spinal cord type and 24 nerveroot type;29 cases were diagnosed after CT examand 71 by lateral lumbar vertebra X-ray.
文摘Case 1: Mr. Li, a 55-year farmer from Hebeiprovince, paid his first visit on August 11, 1995. Thepatient complained of a sudden pain in the area fromhis left buttock down to the posterolateral aspect ofthe leg.
文摘Objective To evaluate the effectiveness of CT-guided percutaneous treatment of intervertebraldisc protrusion causing sciatica (PTDPS). Subjects and ANt hods PTDPS were carried out on 306 patients withback or leg pain from Mar. 1993 to Dec. 1997. CT examination verified the intervertebral disc protrusion. WithCT-guidance a lumbar puncture needle of 20G was advanced to the site or sites around the affected nerve rootsand corticosteroid was injected into the subdural space. Results PTDPS were completed in all 306 patientssuccessfully. A 1-24 month follow -up was carried out on 186 cases. Of these 161 cases (86.5%) had good result, 16cases (8.6%) fair result and 9 cases (4.8%) without favorable result. Conclusion CT guided PTDPS is a safe,accurate, effective and minimally invasive method directing against the pathophysiolgy of sciatica caused byintervertebral disc protrusion. It is suitable for wider clinical application.
文摘<span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Introduction</span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: Meningiomas are benign tumors most localized in brain. Intraspinal meningiomas are rare and may have an intra or extradural topography. We report the case of a dorsal psammomatous meningioma revealed by sciatica. </span><b><span style="font-family:Verdana;">Case description</span></b><span style="font-family:Verdana;">: We present a 58-year-old female hospitalized for bilateral painful and disabling L5 sciatica rebellious to medical treatment and physiotherapy. At physical examination, she presented a lumbar spinal syndrome without root deficit. MRI</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">(Magnetic Resonance Imaging) showed a borderline lumbar canal with a paramedian L4-L5 herniated disc. She undergone a first surgery a L4 decompressive laminectomy and there </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">was</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> no postoperative complications. The follow-up was marked by partial pain regression. Three months later, after a fall she presented low back pain and progressive worsening gait troubles. A MRI was realized and shown L3-L4, L4-L5 duct narrowing. A second surgery a L3 and L5 decompressive laminectomy was performed. The postoperative follow up </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">was</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> characterized</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">by the worsening of the motor deficit to 2/5 associated with brisk osteotendinous reflexes. A medullary MRI was realized, showing an intradural but extra-medullary compressive lesion facing D1-D2.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The indication of tumor removal was made and complete resection was performed.</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">She totally recovered from the deficit and the pain. The pathology report showed a psammomatous meningioma. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">This case report emphasizes the atypical clinical presentation of spinal meningiomas and the importance of a meticulous neurological examination to avoid misdiagnosis.
文摘Hijama is an alternative mode of treatment also known as cupping therapy. It involves removal of subcutaneous stagnant blood through suction cups after making superficial incisions at particular area of the body. This study was undertaken to evaluate the efficacy of hijama in sciatica pain at Aligarh Shifa hospital. 92 patients with the history of sciatica were selected randomly between 18 - 75 years of age and hijama cups were applied generally at C7, T2 and L5/S1 vertebrae, while two cups were also applied bilaterally on L4/L5 vertebrae, four cups were additionally applied on hip joint, back of thigh, knee and calf muscle, all cups were applied thrice at an interval of 15 days between each session. The decrease in sciatic pain was assessed after three sessions of Hijama by numeric pain rating scale there was overall significant reduction in pain with 67 percent patients showing relief in pain up to varying degree. Present study suggests that hijama has been found to be effective in relieving pain and improving quality of life in majority of the patient’s, hence may be used as effective alternative tool to alleviate pain.
