Effectiveness and safety of warm needle acupuncture on lumbar muscles strain: A protocol for systematic review and meta analysis.

BACKGROUND: Lumbar muscle strain (LMS) is the most common orthopedic syndrome, with high incidence globally and lingering disease, which seriously affects patients' work efficiency and quality of life. Warm needle acupuncture (WNA) is a treatment method combining acupuncture technology with warm and medicinal effect of moxibustion. It has outstanding curative effect and wide range of treatment, especially in the treatment of pain diseases. We aim to collect clinical evidence and demonstrate the efficacy and safety of WNA on LMS. METHODS/DESIGN: We will search the following database sources for the randomized controlled trials: PubMed, Cochrane Library, Excerpta Medica Database (EMBASE), Web of Science, WHO International Clinical Trials Registry Platform (TCTRP), Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure Database (CNKI), Chinese Scientific Journals Database (VIP), and the Wanfang Database.All randomized controlled trials of WNA for lumbar muscle strain (LMS) in the above database will be considered for inclusion, and high-quality articles will be screened for data extraction and analysis, to summarize the therapeutic effect of WNA on LMS patients. RESULT: This study will provide a rational synthesis of current evidences for warm needle acupuncture on lumbar muscle strain. CONCLUSION: The conclusion of this study will provide evidence to judge the effectiveness and safety of WNA on LMS. TRIAL REGISTRATION: INPLASY2020120100 (DOI number: 10.37766/inplasy2020.12.0100).

Treatment outcomes of peri-articular steroid injection for patients with work-related sacroiliac joint pain and lumbar para-spinal muscle strain.

OBJECTIVES: Evaluating treatment outcomes of local corticosteroid injections for work-related lower back pain (LBP) as the current evidence for the American College of Occupational and Environmental Medicine guidelines is considered insufficient to recommend this practice. MATERIAL AND METHODS: The authors conducted a retrospective study involving the patients who were treated with peri-articular and lower lumbar corticosteroid injections for work-related LBP at their occupational medicine clinic. RESULTS: Sixty-four patients met the inclusion criteria. The average pain level was reduced from M±SD 5.1±2.0 to M±SD 3.1±2.3 after the corticosteroid injection (p < 0.0001). Thirty-five patients (55%) were discharged to regular duty; 23 (36%) were transferred to orthopedics due to persistent pain; and 6 (9%) were lost to follow-up. CONCLUSIONS: Corticosteroid injections for work-related LBP are effective in reducing pain and enhancing discharge to regular duty. Nonetheless, larger prospective trials are needed to validate these findings. Int J Occup Med Environ Health. 2021;34(1):111-20.

Wrist ankle acupuncture in the treatment of acute lumbar sprain: A protocol for systematic review and meta-analysis.

BACKGROUND: Acute lumbar sprain (ALS) frequently occurs in the young and middle-aged people, causing great harm to people's quality of life. The systematic review program was designed to describe a meta-analysis to evaluate the efficacy and safety of wrist-ankle acupuncture (WAA) in treating patients with ALS. METHODS AND ANALYSIS: Our systematic review will search electronically and manually for WAA treatments for ALS by August, 2020, regardless of publication status and language. Databases include: MEDLINE, PubMed, EMBASE, Springer, Web of Science, Cochrane Library, WHO International Clinical Trial Registration Platform (ICTRP), Chinese Medicine Database (TCMD), China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), China Science Journal Database (VIP), and Wanfang Database. Other sources of information, including bibliographies and meeting minutes for identified publications, will also be searched. Manually search for grey literature, including unpublished conference articles. Any clinical randomized controlled trials related to WAA treatments for ALS, regardless of publication status and language limitations, will be included in the study. Study selection, data extraction, and research quality assessment will be done independently by 2 researchers. The primary outcome included the effective rate and visual analogue scale (VAS) or other validated scales used to relieve pain after the treatment. If possible, meta-analysis will be performed using RevMan V.5.3 statistical software. If it is not suitable for meta-analysis, a descriptive analysis or subgroup analysis is performed. RESULTS: This study will provide a comprehensive review and evaluation of the available evidence for the treatment of ALS using WAA. CONCLUSION: This study will provide new evidence to evaluate the effectiveness and side effects of WAA on ALS. Because the data is not personalized, no formal ethical approval is required. REGISTRATION NUMBER: PROSPERO CRD42020162945.

A systematic review and meta-analysis for Chinese herbal medicine Duhuo Jisheng decoction in treatment of lumbar disc herniation: A protocol for a systematic review.

BACKGROUND: Lumbar disc herniation (LDH) is 1 of the most common diseases in orthopedics, which seriously affects people's daily life and brings a heavy burden on society and families. Chinese herbal medicine has been used in clinical practice for a long time and Duhuo Jisheng Decoction (DHJSD) is believed to help alleviate the symptoms of LDH. This systematic review aims to collect evidences from randomized clinical trials and evaluate the efficacy of DHJSD on LDH in order to provide a reference for clinicians and researchers. METHODS: We will comprehensively search the 8 electronic databases until December 2019 to identify related randomized controlled trials, including 4 foreign databases (PubMed, MEDLINE, EMBASE, Cochrane Library) and 4 Chinese databases (China National Knowledge Infrastructure Database, VIP Database, Wanfang Database and China Biology Medicine disc). The data of the World Health Organization International Clinical Trial Registry Platform and the Chinese Clinical Trial Registry also will be searched. The primary outcomes are Japanese Orthopaedic Association scores and visual analog scale scores. The risk of bias will be assessed using the Cochrane Collaboration tool. RevMan (V.5.3) software will be used for meta-analysis. RESULTS: This study will report the results of DHJSD for the treatment of LDH from the literature screening, the basic information of the included studies, the risk of bias of the included studies, treatment effects, safety, and so on. CONCLUSION: This systematic review will evaluate the effectiveness and safety of DHJSD for the treatment of LDH and provide the latest evidence for its clinical application. ETHICS AND DISSEMINATION: This is a literature-based study, therefore it does not require ethical approval. PROSPERO REGISTRATION NUMBER: CRD42019147302.

Effects of a Progressive Stabilization Exercise Program Using Respiratory Resistance for Patients with Lumbar Instability: A Randomized Controlled Trial.

BACKGROUND This study investigated the effects of progressive stabilization exercise program carried out with respiratory resistance in patients with lumbar instability. MATERIAL AND METHODS Forty-three patients with lumbar instability were randomly assigned to experimental (n=20) and control groups (n=23). The experimental group performed progressive lumbar stabilization exercises along with respiratory resistance, and the control group only performed progressive lumbar stabilization exercises, for 40 min per session, 3 sessions a week, for 4 weeks. Numeric rating scale (NRS), Korean-Oswestry disability index (K-ODI), static balance ability, Fear-Avoidance Beliefs Questionnaire (FABQ), and pulmonary function test (PFT) were performed before and after the intervention program for comparison. RESULTS The 2 groups showed significant differences in NRS, K-ODI, balance ability, and FABQ after the interventions (p<0.05), but greater improvements were shown by the experimental group in balance ability and FABQ values. PFT results in the experimental group showed a significant increase (p<0.05) in forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and maximum voluntary ventilation (MVV). The experimental group showed a greater improvement (p<0.05) in FVC and MVV compared to the control group. CONCLUSIONS Progressive stabilization exercise program with respiratory resistance is an effective method with clinical significance in pain reduction, psychosocial stability, and enhancement of motor and respiratory functions.

[Clinical Trials for Treatment of Acute Lumbar Sprain by Acupuncture Stimulation of "Yaotong" and Local Ashi-points in Combination with Patients' Lumbar Movement].

OBJECTIVE: To observe the clinical effect of acupuncture stimulation of "Yaotong"-point (one acupoint of balance acupuncture therapy) and Ashi-points combined with patients' lumbar movement in the treatment of acute lumbar sprain. METHODS: Forty-six acute lumbar sprain patients were randomized into treatment group (26 cases) and control group (20 cases) using a random number table. The patients of the treatment group were treated by acupuncture stimulation of "Yaotong"-point[above Yintang (EX-HN 3)] and local Ashi-points for 20 min, and were asked to move the waist simultaneously during acupuncture stimulation. The treatment was conducted once every other day, 3 times a week, one week in total. Those of the control group were treated by oral administration of loxoprofen sodium tablets (60 mg, twice a day, for one week). The pain severity of lumbago and motor function were assessed by using visual analogue scale(VAS) and present pain intensity(PPI)and lumbar range of motion(ROM) separately. RESULTS: Following the treatment, of the 20 and 26 acute lumbar sprain patients in the control and treatment groups, 6(30.0%)and 14(53.8%)were cured, 9 (45.0%) and 11 (42.4%) experienced an improvement in their symptoms, 5 (25.0%) and 1 (3.8%) was invalid, with the effective rates being 75.0% and 96.2%, respectively. Compared with pre-treatment, the ROM and VAS scores were significantly decreased in both the control and treatment groups post-treatment (P<0.01), and the therapeutic effects of the treatment group were obviously superior to those of the control group in the effective rate and in the improvement of lumbar motion function and in pain relief (P<0.05,P<0.01). CONCLUSIONS: Acupuncture treatment plus patients' lumbar movement is effective in reducing lumbar pain and improving lumbar motor function in the treatment of acute lumbar sprain.

Acupuncture-movement therapy for acute lumbar sprain: a randomized controlled clinical trial.

OBJECTIVE: Several studies have reported that acupuncture is effective for treatment of acute lumbar sprain, but they neglected to consider that acupuncture cannot remarkably improve lumbar activity. We performed a randomized controlled trial to evaluate the effect of acupuncture-movement therapy versus conventional acupuncture in the treatment of acute lumbar sprain. METHODS: Sixty patients were randomized into four groups: the acupuncture-movement (AM) group, sham acupuncture-movement (SAM) group, conventional acupuncture (CA) group, and physical therapy (PT) group. Patients in the AM group were treated with acupuncture at Yintang (EX-HN 3) and exercise of the lumbar region during acupuncture. Patients in the SAM group were treated with sham acupuncture at Yintang (EX-HN 3) and exercise of the lumbar region during sham acupuncture. Conventional acupuncture was performed in the CA group, and physical therapy was applied in the PT group. Each treatment lasted for 20 min. Patients were assessed before and after treatment using a visual analogue scale (VAS) and the Roland Morris Questionnaire (RMQ). RESULTS: The VAS and RMQ scores in the AM group were significantly lower after than before treatment (P < 0.01). The AM group reported lower RMQ scores in after-treatment and 24 h after treatment and lower VAS score in 24 h after treatment in comparison with those of the CA, SAM, and PT groups (P < 0.05). CONCULSION: Acupuncture-movement therapy is effective for treating acute lumbar sprain with a persistent pain-relief and remarkable improvement of lumbar activity. Movement, that is, lumbar exercise during acupuncture, enhances the effect of acupuncture.

[Acute lumbar sprain treated with massage combined with acupuncture at different distal acupoints: a randomized controlled trial].

OBJECTIVE: To observe treatment efficacy of acupuncture at different distal acupoints for acute lumbar sprain after massage. METHODS: One hundred and fifty patients with acute lumbar sprain were randomly divided into a Yaotongdian (Extra) group, a Houxi (SI 3) group, a Weizhong (BL 40) group, a Chengshan (BL 57) group and a Shuigou (GV 26) group, total 5 groups, 30 cases in each one. After the same massage treatment and based on groups divided, different distal acupoints above-mentioned were selected to be acupunctured. Visual analogue scale (VAS) scores, lumbar activity and treatment efficacy of patients in 5 groups were evaluated. RESULTS: With acupuncture at distal acupoints after massage,VAS scores of patients in 5 groups were decreased compared with those after massage treatment (all P<0.05); lumbar activity was all obviously improved (all P<0.01); and cured and markedly effective rates were all increased in comparison with those after massage (all P<0.01). But among 5 groups the differences of VAS scores, lumbar activity and cured and markedly effective rates were not statistically significant(all P>0.05). CONCLUSION: Based on massage treatment, acupuncture at distal acupoints could further improve the treatment efficacy for acute lumbar sprain, but there is no obvious effective difference among every distal acupoint. As long as choosing acupoints with lower pain threshold and stimulating enough, good efficacy could be acquired for acute lumbar sprain.

Unexpected lumbar abscess due to scarification wet cupping: a case report.

OBJECTIVE: This case presents a rare cause of lumbar abscess. METHODS: A 51-year-old male patient was admitted to the emergency department with a complaint of lumbar pain. Spinal magnetic resonance imaging revealed a lumbar abscess. RESULTS: The abscess was treated with drainage of the abscess and antibiotic. CONCLUSION: Scarification wet cupping therapy should be taken into consideration as a rare cause of lumbar abscesses in patients who present with skin findings indicative of scarification. Scarification wet cupping therapy practitioners must pay attention to hygienic measures.

[Structural changes in the sensory ganglia of the spinal nerves after repeated magnetic stimulation on the model of ischemic myelopathy].

The aim of this study was to examine the association of morphological changes in the-sensory ganglia of the spinal nerves (SGSN) with the cilinical symptomatology in rats with the experimentally induced ischemic myelopathy (IM), untreated or treated with repeated magnetic stimulation (RMS). The efficacy and mechanisms of RMS action on SGSN were studied by electron microscopy in 16 rats with IM. According to the results of treatment, in SGSN both at a distance from the damaged area (lumbar SGSN) and close to it (cervical SGSN) the morphological signs of regenerative-reparative processes were found in the cells and nerve fibers (restoration of the organelle structure in the cytoplasm o0f neurons and neurolemmocytes, the increase in the number of he latter and fiber remyelination). The expression of the structural changes correlated with the degree of functional recovery.

[Clinical observation on warming-promotion acupuncture for lumbar muscle strain].

OBJECTIVE: To observe the theraputic effect of warming-promotion acupuncture for lumbar muscle strain. METHODS: Sixty-four cases were randomly divided into a warming-promotion acupuncture group(group A) and a routine acupuncture group (group B), 32 cases in each group. The group A was treated with acupuncture at Shenshu (BL 23) and Guanyuanshu (BL 26) with warming-promotion acupuncture method, (Guanyuanshu (BL 26), Yaoyangguan (GV 3), Weizhong (BL 40) with twirling uniform reinforcing-reducing method. The group B was treated with acupuncture at same acupoints only with twirling uniform reinforcing-reducing method. After four-session treatment, the theraputic effect of two groups was compared. RESULTS: The cured and markedly effective rate of 65.6% (21/32) in the group A, which was superior to that of 40.6% (13/32)in the group B (P < 0.05). CONCLUSION: The efficiency on lumbar muscle strain treated with warming-promotion acupuncture is superior to that with routine acupuncture, means a suitable manipulation can enhance the therapeutic effect.

[Analysis of Liqi decoction for treatment of false intestinal obstruction caused by retroperitoneal hematoma].

OBJECTIVE: To study the efficiency of Liqi decoction on false intestinal obstruction caused by retroperitoneal hematoma. METHODS: Seventy-five patients were randomly divided into two groups involving Liqi groups and control group. In Liqi group, therer were 45 patients including 28 males and 17 females with an average age of (41.45+/-13.58) years, 32 cases of pelvic fracture, 13 cases of lumber fracture and Liqi decoction were given oral for 2 to 3 days. In control group, there were 30 cases including 19 males and 11 females with an average age of (43.28+/-9.49) years, 24 cases of pelvic fracture, lumber fracture in 6 cases, and 30 cases was fasting and enema, 14 cases were gastrointestinal decompression. RESULTS: According to New Chinese Medicine Clinical Research on the Guiding Principles, the efficacy of intestinal obstruction was evaluated, in Liqi group the results were excellent in 25 cases, good in 13, fair in 7, and in control group,excellent in 5, good in 7, fair in 18. The fineness rate were compared between two groups by chi2 test, the difference was significant (P<0.05). CONCLUSION: Liqi decoction is a simple and effective way to treated the retroperitoneal hecatomb caused by pseudo-obstruction.

[Observation on short-term and long-term therapeutic effects of electroacupuncture at Houxi (SI 3) on acute lumbar sprain].

OBJECTIVE: To compare therapeutic effects of electroacupuncture at Houxi (SI 3) and medicine on acute lumbar sprain. METHODS: Three hundred cases of acute lumbar sprain were randomly divided into two groups, a electroacupuncture (EA) group and a medication group, 150 cases in each group. The EA group were treated with EA at Houxi (SI 3), once each day, 3 sessions constituting one course, and the medication group with Mobike, once daily, 7. 5 mg each time. Their therapeutic effects were evaluated after treatment for 7 days and one month respectively. RESULTS: For the short-term therapeutic effect, the effective rate was 97. 3% in the EA group and 89. 2% in the medication group with a very significant difference between the two groups (P<0. 01); for the long-term therapeutic effect, the effective rate was 99. 3% in the EA group and 93. 2% in the medication group with a very significant difference between the two groups (P<0. 01). CONCLUSION: Both the short-term and the long-term therapeutic effects of EA at Houxi (SI 3) on acute lumbar sprain are better than those in the medication group.

Acute and late effects on induction of allodynia by acromelic acid, a mushroom poison related structurally to kainic acid.

1. Ingestion of a poisonous mushroom Clitocybe acromelalga is known to cause severe tactile pain (allodynia) in the extremities for a month and acromelic acid (ACRO), a kainate analogue isolated from the mushroom, produces selective damage of interneurons of the rat lower spinal cord when injected either systemically or intrathecally. Since ACRO has two isomers, ACRO-A and ACRO-B, here we examined their acute and late effects on induction of allodynia. 2. Intrathecal administration of ACRO-A and ACRO-B provoked marked allodynia by the first stimulus 5 min after injection, which lasted over the 50-min experimental period. Dose-dependency of the acute effect of ACRO-A on induction of allodynia showed a bell-shaped pattern from 50 ag x kg(-1) to 0.5 pg x kg(-1) and the maximum effect was observed at 50 fg x kg(-1). On the other hand, ACRO-B induced allodynia in a dose-dependent manner from 50 pg x kg(-1) to 50 ng x kg(-1). 3. N-methyl-d-aspartate (NMDA) receptor antagonists and Joro spider toxin, a Ca(2+)-permeable AMPA receptor antagonist, inhibited the allodynia induced by ACRO-A, but not by ACRO-B. However, other AMPA/kainate antagonists did not affect the allodynia induced by ACRO. 4. Whereas no neuronal damage was observed in the spinal cord in ACRO-A-treated mice, induction of allodynia by ACRO-A (50 fg x kg(-1)) and ACRO-B (50 ng x kg(-1)) was selectively lost 1 week after i.t. injection of a sublethal dose of ACRO-A (50 ng x kg(-1)) or ACRO-B (250 ng x kg(-1)). Higher doses of ACRO-A, however, could evoke allodynia dose-dependently from 50 pg x kg(-1) to 500 ng x kg(-1) in the ACRO-A-treated mice. The allodynia induced by ACRO-A (500 ng x kg(-1)) was not inhibited by Joro spider toxin or NMDA receptor antagonists. These properties of the late allodynia induced by ACRO-A were quite similar to those of the acute allodynia induced by ACRO-B. 5. ACRO-A could increase [Ca(2+)](i) in the deeper laminae, rather than in the superficial laminae, of the spinal cord. This increase was not blocked by the AMPA-preferring antagonist GYKI52466 and Joro spider toxin. 6. Taken together, these results demonstrate the stereospecificity of ACRO for the induction of allodynia and suggest the presence of a receptor specific to ACRO.