Clinical anatomical study on the treatment of carpal tunnel syndrome with classic Acupotomy / 中国骨伤

OBJECTIVE@#To explore the safety of classic Acupotomy in the treatment of carpal tunnel syndrome.@*METHODS@#Twenty six adult specimens (15 males and 11 females), aged 60 to 95(82.54±6.94) years old, were selected from 10% formalin antiseptic fixation. There were 52 sides(two of them could not be tested). The study period was from November 2017 to May 2018. The specimens were collected from the body donation center of the school of basic medicine, Peking University. The operation of releasing the transverse carpal ligament on the human body specimen was simulated by the classic acupotomy, and the distance from the four points to the surrounding anatomical structure was measured to calculate the direct injury rate to the nerve and blood vessels, and the shortest distance between the acupotomy and the nerve and blood vessels was defined as ≥2 mm as safety.@*RESULTS@#In the experimental operation, the direct injury rate of nerve and blood vessel was 14% and 12% respectively. There was significant difference in the rate of direct nerve injury between the four injection points (0.05). Among the four points, there was a statistically significant difference in the safety of nerves(<0.05), and the safety of point 1 and point 3 of radial injection was higher than that of point 2 and point 4 of ulnar injection(<0.05). There was significant difference in the safety of blood vessels between the four points(<0.05), and the safety of radial point 1 was higher than that of ulnar point 2 and point 4 (<0.05).@*CONCLUSION@#The safety of the classic Acupotomy for carpal tunnel syndrome is related to the location of the needle entry point, and the safety of theradial proximal end of the needle is the highest.

Research progress of stenosing tenosynovitis of radial styloid process based on anatomical structure / 中国骨伤

Stenosing tenosynovitis of styloid process of radius(de Quervain's disease) which abductor pollicis longus and extensor pollicis brevis in the first extensor chamber are affected by resistance when sliding, the incidence is affected by anatomical variations. Symptoms, signs and auxiliary examinations can diagnose the disease. Slight dQS can be improved by rest, brace, restriction activities, and oral medications. Chinese medicine and physiotherapy also reduce the disease. Needle knife therapy is a Traditional Chinese medicine minimally invasive surgery, which is also a step-by-step treatment between conservative treatment and open surgery to loosening the compression of the first extensor chamber. Steroid injection is a more common treatment in this disease, and its efficacy is related to the accuracy of the injection and is affected by the severity of the patient's anatomical variation. Identifying the spacing within the first extensor chamber under ultrasound can help patients better choose conservative or surgical treatment. Surgical treatment can more completely change the condition of dQD from anatomical structure, and clinical should pay attention to the choice of surgical procedure to improve the efficacy and reduce the occurrence of surgical complications. This article discusses the pathogenesis, diagnosis and treatment of the disease from the perspective of anatomical structure. It mainly analyzes the therapeutic targets and the clinical application, which aims to provide reference for the diagnosis and treatment of de Quervain disease.

Clinical study on acupotomy of occipitalia on the treatment of cervicogenic headache / 中国骨伤

<p><b>OBJECTIVE</b>To observe the effects of acupotomy on cervicogenic headache and explore the function of cutaneous nerve entrapment in the mechanism of cervicogenic headache.</p><p><b>METHODS</b>From October 2008 to June 2009, 82 patients with cervicogenic headache were treated with acupotomy. There were 23 males and 59 females, ranging in age from 17 to 73 years (averaged 41.57 years). The course of disease ranged from 0.5 to 50 years,with an average of 10.4 years. The location of treatment was occipitalia, both of left and right side: altogether were 8 points, including tenderness point of postmastoid; the mid-point between mastoid and C2 spinous process; the internal 1/3 attachment between occipital protuberance and mastoid process; the posterior midline of C2 spinous process open to 1.5-2 cm. The chief complaint of all patients was headache. PPI assessment rating was observed.</p><p><b>RESULTS</b>The total effective rate at 1 month after treatment was 81.70% (67/82). Recurrence of headache within 3 months after treatment was obvious. However, 17.07% (14/82) patients did not reoccur at 6 months after treatment.</p><p><b>CONCLUSION</b>17.07% patients with cervicogenic headache recovered by acupotomy, so it shows cutaneous nerve entrapment plays an important role in the mechanism of cervicogenic headache. For the patients whose headache recurred at 3 months after treatment, increasing the treatment time and therapeutic range is suggested.</p>

Effects of acupotomy lysis on local soft tissue tension in patients with the third lumbar vertebrae transverse process syndrome / 中国针灸

<p><b>OBJECTIVE</b>To explore the mechanism of acupotomy lysis in treatment of the third lumbar vertebrae transverse process syndrome.</p><p><b>METHODS</b>One hundred and eighty patients were randomly assigned into an acupotomy group and an electroacupuncture (EA) group, 90 cases in each group. The acupotomy group was treated with acupotomy on the tip of the 3rd lumbar vertebrae transverse process (tender point) combination with massage manipulation of hyperflexion and hyperextension on the waist, once a week for 3 weeks. The EA group was treated with EA at bilateral Shenshu (BL 23), Yaoyangguan (GV 3), Ashi point (local tender point) and ipsilateral Weizhong (BL 40), 3 times a week for 3 weeks. The 500 g pressure displacement and the energy absorption ratio were measured by JZL-II soft tissue tension meter and the clinical effect was evaluated by JOA low back pain scale before treatment, after treatment and 6 months after treatment.</p><p><b>RESULTS</b>After treatment and at follow-up visit, the 500 g pressure displacement in the acupotomy group increased significantly (both P < 0.01), but it was decreased significantly in the EA group (P < 0.05, P < 0.01). The energy absorption ratio in the acupotomy group after treatment and at follow-up visit increased significantly (both P < 0.01), and in the EA group, there was no significant difference after treatment as compared with that before treatment (P > 0.05), but it was increased significantly at follow-up visit (P < 0.01). The total therapeutic level distribution in the acupotomy group was better than that in the EA group after treatment and 6 months after treatment (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>Acupotomy therapy can significantly increase the 500 g pressure displacement and the energy absorption ratio of the local soft tissue around the third lumbar vertebrae transverse process, decrease the local soft tissue tension so as to alleviate pain. The clinical effect of the acupotomy is superior to that of electroacupuncture.</p>

Randomized controlled trials of acupuncture at Tiaokou (ST 38) for treatment of periarthritis of shoulder / 中国针灸

<p><b>OBJECTIVE</b>To study the basic therapeutic function of Tiaokou (ST 38).</p><p><b>METHODS</b>According to clinically multi-central randomized controlled and single-blind test principle, 257 cases of periarthritis of shoulder were divided into two groups, a test group (n = 124) treated with oral anti-inflammatory analgesic medicine combined with acupuncture at Tiaokou (ST 38), and a control group (n = 133) treated with oral anti-inflammatory analgesic medicine. Their therapeutic effects were compared.</p><p><b>RESULTS</b>The total effective rate for stopping pain was 96.0% in the test group and 91.7% in the control group with a very significant difference between the two groups (P< 0.01). And the total effective rate for improvement of shoulder activity was 86.3% in the test group and 59.4% in the control group with a very significant difference between the two groups (P<0.01).</p><p><b>CONCLUSION</b>Oral anti-inflammatory analgesic medicine combined with acupuncture has obvious therapeutic effect on periarthritis of shoulder, which is better than that of simple oral anti-inflammatory analgesic medicine.</p>

Preliminary evaluation of acupuncture and continuous multi-point pulse stimulation for treatment of subjective tinnitus / 中国针灸

<p><b>OBJECTIVE</b>To put forward a method for assessing therapeutic effect on tinnitus and to observe the therapeutic effects of acupuncture and continuous multi-point pulse stimulation on subjective tinnitus.</p><p><b>METHODS</b>Continuous multi-point pulse stimulation was given at Ermen (TE 21)/ Tinggong (SI 19)/ Tinghui (GB 2), Yifeng (TE 17), Shenting (GV 24), Baihui (GV 20), Cong'er No 1-3, etc., once every other day, thrice each week. The therapeutic effects were evaluated with a selfstipulated "tinnitus questionaire".</p><p><b>RESULTS</b>Of the 98 cases, 11 cases were cured, 36 cases were markedly effective, 28 cases were effective and 23 cases were ineffective with a cured rate of 11.2% and a total effective rate of 76.5%.</p><p><b>CONCLUSION</b>Combined acupuncture and continuous multi-point pulse stimulation has a better therapeutic effect on subjective tinnitus.</p>

Effects of acupuncture and continuous multiple points pulse stimulation on linguistic frequency hearing loss in the patient of sensorineural hearing loss / 中国针灸

<p><b>OBJECTIVE</b>To explore effective therapeutic methods for sensorineural hearing loss (SNHL).</p><p><b>METHODS</b>Thirty-four cases of mild and moderate SNHL who were definitely diagnosed with pure tone test and by otologists, including 24 cases of insufficiency of the liver and kidney, 10 cases of excess of liver-fire. They were treated with acupuncture at main points, Ermen (TE 21) or Tinggong (SI 19) or Tinghui (GB 2), and Yifeng (TE 17), Shenting (GV 24), Baihui (GB 20), Houding (GV19), Touwei (ST 9), Conger 1-3, Congnao 1-2; and adjuvant acupoints: Huangshu (KI 16), Qihai (CV 6), Guanyuan (CV 4), Taixi (KI 3) were added for insufficiency of the liver and kidney; Zhongwan (CV 12), Tianshu (ST 25), Yanglingquan (GB 34) and Taichong (LR 3) were added for excess of liver-fire. Sequential multipoint pulse stimulation was adopted, twice each week, for 20 consecutive weeks (40 sessions) and then pure tone test was carried out repeatedly.</p><p><b>RESULTS</b>Of 34 cases (58 affected ears), 13 cases were cured and 21 improved, and the various linguistic frequency hearing threshold pure hearing values before and after treatment increased significantly (P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture and continuous multipoint pulse stimulation has definite therapeutic effect on linguistic frequency hearing loss in the patient of SNHL.</p>