[Effect of administration of acupuncture stimulation combined with Gushen Zhuyu Decoction on lumbar function in patients with disc herniation].

OBJECTIVE: To investigate the therapeutic effect of acupuncture stimulation combined with administration of"Gushen Zhuyu Tang"(decoction for consolidating kidney to eliminate blood stasis, DCKEBS) in the treatment of lumbar disc herniation (LDH) patients. METHODS: A total of 147 patients with LDH were randomly divided into DCKEBS, acupuncture and DCKEBS+acupuncture groups (n= 49 cases in each group). The patients of the acupuncture group received a) acupuncture stimulation of Dazhui (GV14), Ganshu (BL18), Shenshu (BL23), Tianshu (ST25), Yanglingquan (GB34), etc., b) fire needle pricking of the topical tendons, cord-like points, tender-points, c) row-needles stimulation of the attachment sites of muscles of the sacroiliac joint or crista iliaca, and d) acupotomy-debonding of the topical high-tension muscles, twice a week for 4 weeks. Those patients of the DCKEBS group were ordered to take DCKEBS [containing fried Yiyiren (Semen Coicis), Shanzhuyu (Fructus Corni), fried Baizhu (Rhizoma Astractylodis), Sangjisheng (Ramulus Loranthi), Duzhong (Cortex Eucommiae), Buguzhi (Fructus Psoraieae), etc.] 150 mL, twice daily, continuously for 4 weeks, and those of the DCKEBS+acupuncture group received the combined treatment mentioned above in the acupuncture and DCKEBS groups. The pain severity was assessed by using visual ana-logue scale (VAS, 0-10 points) and the modified Japan Orthopaedic Association questionnaire (M-JOA) score (0-30 points), separately, and the lumbar range of motion (ROM) and lumbar muscle strength were tested to evaluate the lumbar motor function. The levels of serum tumor necrosis factor α(TNF-α), matrix metalloproteinase-2 (MMP-2), and apoptosis related factors Caspase-3 and Caspase-9 were assayed using ELISA. The total effective rates of the three groups were compared. RESULTS: After the treatment, the VAS and M-JOA scores, contents of serum TNF-α, MMP-2, Caspase-3 and Caspase-9 were significantly decreased (P<0.01), and the myodynamia of lumbar muscular flexor and extensor was considerably increased (P<0.01) in the three groups, and the ROM angles of lumbar extending and buckling were increased (P<0.01) in the DCKEBS+acupuncture group compared with pretreatment. Comparison among the 3 groups showed that the VAS and M-JOA scores, and serum TNF-α, MMP-2, Caspase-3 and Caspase-9 contents of the DCKEBS+acupuncture group were significantly lower than those of both DCKEBS and acupuncture groups (P<0.01), while the ROM angles of lumbar extending and buckling, and the myodynamia of lumbar muscular flexor and extensor were obviously higher in the DCKEBS+acupuncture group than those of the DCKEBS and acupuncture groups (P<0.01). The total effective rate was 93.88%(46/49) in the DCKEBS+acupuncture group, higher than 75.51%(37/49) in the DCKEBS group and 71.43%(35/49) in the acupuncture group (P<0.05). CONCLUSION: Acupuncture combined with DCKEBS can relieve pain, improve lumbar muscle strength and lumbar movement function, and reduce serum TNF-α, MMP-2, Caspase-3 and Caspase-9 levels in LDH patients.

[Core stability training combined with acupuncture in treatment of chronic nonspecific low back pain: a prospective randomized controlled trial].

OBJECTIVE: To investigate the clinical effect of core stability training combined with acupuncture in the treatment of chronic nonspecific low back pain (CLBP). METHODS: Seventy-five CLBP patients were randomly divided into experimental group (n=38) and control group (n=37) according to a random number table. Patients in the control group were required to perform core stability training, whereas those in the experimental group received core stability training combined with fire needle acupuncture, once every two days, three times per week, for four successive weeks. The Oswestry disability index (ODI), visual analogue scale (VAS), lumbar muscular endurance index, clinical efficacy, as well as average electromyographic (AEMG), root mean square (RMS), median frequency (MF), and average median frequency (AMF) values during multifidus muscle contraction in the two groups before and after the treatment were compared. RESULTS: After treatment, ODI, VAS, MF, and AMF of the two groups were lower than those before the treatment (P<0.01), while the lumbar static and dynamic muscular endurance, AEMG, and RMS values were higher (P<0.01). The ODI, VAS, MF, and AMF of the experimental group significantly declined as compared with those of the control group (P<0.01), whereas the lumbar static and dynamic muscular endurance, AEMG, and RMS values were elevated (P<0.01). The total effective rate of the experimental group was 97.14%(34/35), higher than 85.71%(30/35) of the control group(P<0.01). CONCLUSION: Core stability training combined with acupuncture effectively enhances lumbar muscular endurance, improves electromyographic signals of multifidus muscle and lumbar function, and relieves pain, implying the good efficacy of such combined therapy in treating CLBP.