[Effect of long-snake moxibustion on nonspecific low back pain with symptom of cold and dampness].

OBJECTIVE: To compare the clinical therapeutic effect of long-snake moxibustion and ginger-partitioned moxibustion at ashi point on nonspecific low back pain (NLBP) with symptom of cold and dampness. METHODS: A total of 120 patients were randomized into a long-snake moxibustion group, an ashi point group and a waiting for treatment group, 40 cases in each one. Ginger-partitioned moxibustion was applied from Dazhui (GV 14) to Yaoshu (GV 2) of governor vessel in the long-snake moxibustion group, and was applied at ashi point of affected area in the ashi point group, 40 min each time, once every other day and totally 8 times were required. No intervention was adopted in the waiting for treatment group, and after the trial, long-snake moxibustion was applied. Before and after treatment, the visual analogue scale (VAS) scores of rest and activity, the Oswestry disability index (ODI) score and the score of cold and dampness symptom were observed in the 3 groups. RESULTS: Compared before treatment, the VAS scores of rest and activity, the ODI scores and the scores of cold and dampness symptom after treatment were decreased in the long-snake moxibustion group and the ashi point group (P<0.05). After treatment, the variations of the above indexes in the long-snake moxibustion group and the ashi point group were larger than those in the waiting for treatment group (P<0.05), and the variations of the above indexes in the long-snake moxibustion group were larger than those in the ashi point group (P<0.05). CONCLUSION: Long-snake moxibustion can effectively improve the pain, dysfunction and the symptom of cold and dampness in patients with nonspecific low back pain, and the improvement is superior to the ginger-partitioned moxibustion at ashi point.

[Clinical effect of long-snake moxibustion on lumbago of cold-dampness type].

OBJECTIVE: To observe the effect of long-snake moxibustion on pain, functional disorder and body constitution in the patients with lumbago of cold-dampness type. METHODS: A total of 90 patients with lumbago of cold-dampness type were randomized into long-snake moxibustion, acupuncture and medication groups, 30 cases in each group. In the long-snake moxibustion group, long-snake moxibustion was exerted on the spinal (between Dazhui[GV14] and Yaoshu[GV2]) with the self-prepared moxa powder formula combined with fresh ginger and moxa wool, once a week, for 4 weeks. Regular acupuncture was given to the acupuncture group, 30 min each time, once a day, 8 times as a treatment course, at the interval of 2 days between the courses. The duration of treatment was 1 month. In the medication group, Diclofenac Sodium was prescribed for oral administration, 25 mg each time, three times a day, and Mecobalamine tablets, 0.5 mg each time, 3 times a day. The duration of medication was 1 month. Before and after treatment, the differences were evaluated in the scores of visual analog scale (VAS), the present pain intensity(PPI), Oswestry disability index (ODI) and the scale of yang-deficiency body constitution among the 3 groups. RESULTS: After the treatment, VAS and PPI score and ODI were significantly reduced in the patients of the 3 groups as compared with those before treatment (all P<0.05). Compared with the medication group, ODI score was significantly reduced in the long-snake moxibustion group and the acupuncture group (P<0.05). After the treatment, the scores of the scale of yang-deficiency body constitution were significantly reduced in the long-snake moxibustion group and the acupuncture group (P<0.05) as compared with those before the treatment, but not statistically significant in the medication group in comparison before and after the treatment (P>0.05). The score of the scale of yang-deficiency body constitution in the long-snake moxibustion group was significantly lower than that in the acupuncture group and the medication group (P<0.05). Regarding the clinical effect, the effective rate was 93.33% (28/30) in the long-snake moxibustion group and it was 86.67% (26/30) in the acupuncture group and 73.33% (22/30) in the medication group after the treatment. The effective rate in the long-snake moxibustion group was significantly higher than those in the acupuncture group and the medication group (P<0.05). CONCLUSION: The long-snake moxibustion therapy can achieve significant effect on lumbago of cold-dampness type. This therapy can alleviate pain, relieve the functional disorders and improve the conditions of body constitution in the patients. Hence, it is applicable for the clinical promotion.

[Clinical effectiveness of "long snake moxibustion" for cold-dampness type chronic non-specific low back pain patients with negative emotions].

OBJECTIVE: To observe the clinical efficacy of long snake moxibustion and Ashi-point moxibustion in the treatment of cold-dampness type chronic non-specific low back pain (CNLBP) patients. METHODS: A total of 120 cold-dampness type CNLBP patients who signed the informed consent were randomly and equally divided into control, long snake moxibustion and Ashi-point moxibustion groups. Ginger-separated moxibustion was applied to the region between Dazhui (GV14) and Yaoshu (GV2) for patients of the long-snake moxibustion group, or to the tenderness spot of the waist for patients of the Ashi-point moxibustion group. The treatment was conducted for 40 min each time, once every other day for a total of 8 sessions. Patients of the control group did not receive any intervention. The visual analogue scale (VAS) was used to assess low back pain severity. The Oswestry Disability Index (ODI) was employed to assess ten aspects of patients' daily-life activities (pain intensity, personal care, lif-ting, walking, sitting, standing, sleeping, sex life, social life, and traveling). The cold-damp syndrome scores (pain property, symptoms, ranges of motion, waist palpation, tongue and pulse condition) were achieved by consulting the textbook "Differential Diagnostics of Traditional Chinese Medicine Syndromes". The Hospital Anxiety and Depression Scale (HADS, a self-made assessment instrument) was used to assess the patients' severity of emotional disorder.The plasma cortisol level was detected by ELISA. RESULTS: Before treatment, there were no significant differences among the three groups in the levels of all the indexes (P>0.05). After moxibustion, the VAS scores during rest and movement, ODI score, cold-damp syndrome score and anxiety score in both long snake moxibustion and Ashi-point moxibustion groups, and the HADS depression score and plasma cortisol content in the long snake moxibustion group were significantly reduced compared with their own pre-treatment (P<0.05). The difference values between pre and post-treatment of VAS scores during rest and movement, ODI score, cold-damp syndrome score, anxiety score, depression score and cortisol content were obviously higher in the long snake moxibustion and Ashi-point moxibustion groups than those in the control group. The difference values between pre- and post-treatment of VAS scores during rest and movement, ODI score, cold-damp syndrome score, anxiety score, depression score and cortisol content were obviously higher in the long snake moxibustion group than in the Ashi-point group (P<0.05). CONCLUSION: Both ginger-separated long snake moxibustion and Ashi-point moxibustion can relieve low back pain, daily-life activities, cold-damp syndrome, negative emotions, and reducing cortisol level in cold-dampness type CNLBP patients，and the therapeutic efficacy of long snake moxibustion is obviously better.

[Ginger-separated Snake Moxibustion Improves Yang Deficiency Constitution by Up-regulating Serum Adrenocorticotropic Hormone and Cortisol Levels in Yang Deficiency Constitution Volunteers].

OBJECTIVE: Yang deficiency constitution may bring with different types of illnesses in many people. The present study was designed to observe the effect of ginger-separated snake moxibustion on yang deficiency symptom, and serum adrenocorticotropic hormone (ACTH) and cortisol (CORT) contents in yang deficiency constitution subjects, so as to explore its mechanism underlying improvement of yang deficiency constitution. METHODS: Ninety subjects with yang deficiency type constitution were equally and randomly assigned to control A group (19 men and 26 women, 18－60 years in age) and moxibustion group (16 men and 29 women, 18－60 years in age) and 45 normal subjects with mild constitution (18 men and 27 women, 18－60 years in age) were assigned to control B group. An snake-like moxa-cone was placed at a moxa-holder covering the middle back of human body from Dazhui (GV 14) to Yaoshu (GV 2) after paving a layer (about 1 cm thick) of fresh ginger in the holder, and then ignited, followed by the next moxa-cone, 3 cones altogether every time for each participant. The treatment was conducted once a week, 12 times in total. The subjects' constitution was scored according to the "Classification and Evaluation of Constitution of Traditional Chinese Medicine" formulated by China Association of Chinese Medicine. The serum ACTH and CORT contents were measured by radioimmunoassay before and at the end of the treatment and 6 months after the treatment. RESULTS: The constitation scores of the moxibustion group and control A group were significantly higher than that of the control B group before treatment (P<0.01). At the end of the treatment, the constitution score was significantly decreased in the moxibustion group (P<0.01) rather than in the control A group relevant to its own pre-treatment (P>0.05). The serum CORT and ACTH contents were significantly decreased in both the moxibustion and control A groups in comparison to the control B group before treatment (P<0.01), and obviously increased at the end of treatment in the moxibustion group compared with its own pre-treatment (P<0.01). No significant differences were found among the three groups in the constitution score, and serum CORT and ACTH levels at the 6th month after the treatment compared with their own post-treatment (P>0.05)．. CONCLUSION: The ginger-separated snake moxibustion treatment may improve the constitution of yang deficiency participants by increasing the levels of serum ACTH and CORT, which may be helpful in resisting diseases.