Lumbar spondylolisthesis is a common and frequent disease among middle-aged and elderly people in clinical practice, which is characterized by recurrent attacks, persistent treatment and gradual aggravation, causing a lot of inconvenience to patients’ work and life. From 2005 to 2011, the author treated 60 cases of lumbar spondylolisthesis with the use of back acupuncture point through the spine, and achieved satisfactory clinical efficacy, which is reported as follows.
1. Clinical data
1.1 General information
All 120 patients were inpatients or outpatients of the Affiliated Hospital of Gansu College of Traditional Chinese Medicine, and the patients were randomly divided into 2 groups according to the order of consultation using the random number table method. Treatment group 60 cases, including 34 male cases, 26 female cases; age minimum 36 years, maximum 83 years, average 59.5 years; the shortest duration of 15 days, the longest 35 years, average days 70.6 days; including 10 cases of left-sided low back pain, 25 cases on the right side, 25 cases on both sides. In the control group, there were 60 cases, including 22 men and 38 women; the minimum age was 38 years, the maximum age was 80 years, and the average age was 59 years; the shortest duration of the disease was 18 days, the longest was 34 years, and the average day was 69.2 days; there were 16 cases of left-sided low back pain, 21 cases of right-sided, and 23 cases of both sides. The gender, age and disease duration of the two groups of patients were statistically processed p>0.05, and their differences were not statistically significant and comparable.
1.2 Diagnostic criteria
The diagnostic criteria of lumbar spondylolisthesis were formulated with reference to the Diagnostic Efficacy Criteria of Chinese Medicine Evidence issued by the State Administration of Traditional Chinese Medicine in 1994:
①History of lumbar trauma, chronic strain or cold and dampness, most patients had a history of chronic lumbar pain before the onset of the disease;
②Often occurs in middle and old age;
③Lumbar pain radiates to the buttocks and lower limbs, and the pain increases when abdominal pressure increases;
④The physical examination of the lumbar spine has pressure pain and percussion pain at the spinous process of the lumbar spine, and the movement of the lumbar spine is limited;
⑤ X-ray film or CT indicates different degrees of osteophytes in the lumbar spine, and exclude those caused by other diseases such as rheumatism, tumor, lumbar disc herniation and spinal stenosis.
2.Treatment methods
2.1 Treatment group
Acupuncture points: according to the site of lumbar spine hyperplasia, the main acupuncture points are taken from L1-L5 corresponding dorsal points and interspinous points. Addition and subtraction: cold-damp lumbar pain plus lumbar yangguan, stasis lumbar pain plus diaphragmatic yu, kidney deficiency lumbar pain plus vital gate and shiguro. Operation: The patient is placed in a prone position, the acupuncture site is exposed, the acupuncture point is routinely disinfected, the 2.5-inch milli-needle is used to enter the acupuncture point from the dorsal yu point, the needle tip is stabbed at an angle of 60o with the skin after entering the acupuncture point towards the pinched spine point, the depth is about 1.5 inches, after the acupuncture sensation such as soreness, numbness, swelling and pain, the twisting and twisting complementary diarrhea technique is performed to make the acupuncture sensation reach the lesion. Retain the needle for 30 min, 15 min acupuncture once a day, 10 times for a course of treatment. Treatment interval 2-3 days, a total of 3 courses of treatment, stop other treatments during the treatment period.
2.2 Control group
The control group was treated with Chinese herbal medicine Lumbar Pain Ning Capsule (produced by Chengde Neck Fukang Pharmaceutical Group Co. It was taken 4-6 capsules once, once a day, half an hour before bedtime. 10 days was a course of treatment, 3 courses of treatment in total.
3.Efficacy observation
3.1 Efficacy criteria
According to the “Diagnostic Efficacy Criteria for Chinese Medicine Evidence” formulated by the State Administration of Traditional Chinese Medicine [2].
Cured: clinical symptoms completely disappeared, free movement, no recurrence in six months of follow-up;
Significantly effective: the pain symptoms are significantly reduced, the function of joint movement is basically normal, and life and work are not affected;
Effective: slight reduction of pain and slight improvement of joint function;
Ineffective: no significant improvement in symptoms or no improvement at all.
3.2 Treatment results (see Table 1)
Table 1 Comparison of the efficacy of the two groups Cases (%)
Group
Number of cases
Cured
Effective
Effective
Ineffective
Total effective
Treatment group
60
38(63.3)
15(25.0)
5(8.3)
2(3.3)
96.7
Control group
60
8(13.3)
17(28.3)
20(33.3)
15(25.0)
75.0
As shown in Table 1, the total effective rate of the treatment group was 96.7% and the total effective rate of the control group was 75.5%. By statistical analysis, 2=38.64,<0.0< span="">1, the efficacy of the treatment group was significantly better than that of the control group.
4. Discussion
Lumbar vertebral osteophytes belong to the category of “bone paralysis” in Chinese medicine. The formation of this disease may be due to the loss of liver and kidney, lack of blood, loss of bone nourishment, degenerative changes in the lumbar spine and osteophytes, the internal cause is the key to the pathogenesis. Or due to wind, cold and dampness, traumatic injury and other factors remain in the vertebral body, resulting in the lumbar spine local qi stagnation, blood stasis, meridian paralysis blockage caused by external factors can trigger and aggravate the formation of lumbar vertebral osteophytes.
In long-term clinical practice, the author has obtained satisfactory clinical efficacy in treating this disease with the use of dorsal acupuncture point penetrating pinch points.
First, from the meridian point of view, the dorsal yu point belongs to the bladder meridian, and the pinched spine point, also known as the supervisory meridian pinched spine point, is located between the bladder meridian and the supervisory meridian. In the circulation of the meridians, the bladder meridian “reaches the middle of the waist, enters the brawn, … from the middle of the waist, and goes down to the spine”, and the Governor’s Vessel “is in the spine”. Therefore, acupuncture of the bladder meridian and the duo meridian is a part of the “where the meridians pass, where the main treatment reaches”, which can achieve the effect of unblocking the meridians and harmonizing yin and yang.
Second, in terms of acupuncture points, the selection of back and spinal points belongs to the scope of local selection, so acupuncture of Sanjiao Yu, Kidney Yu, Qihai Yu, Large Intestine Yu, Guan Yuan Yu and related spinal points belongs to “where the acupuncture point is, where the main treatment is”, which can achieve the effect of strengthening the waist and kidney, tonifying Qi and activating blood, activating the channels and relieving pain.
Third, from modern research, each of the lumbar dorsal and spinal points has a posterior branch of the spinal nerve and its accompanying arterial and venous plexus branches emanating from the lower part of the corresponding vertebrae, and degenerative lesions of the lumbar vertebrae with osteophytes often affect the local nerves and blood vessels of the lumbar vertebrae and exhibit corresponding clinical symptoms. Therefore, acupuncture of the dorsal and spinal points can maximize the function of the lumbar spinal nerves and blood vessels, enhance blood circulation, reduce the stimulation and compression of the nerves, blood vessels and surrounding tissues, eliminate inflammation and edema, and relieve or disappear clinical symptoms.
In conclusion, the treatment of lumbar spondylolisthesis with the dorsal point through the interspinous spine has remarkable efficacy and unique effect, and it is worth to be vigorously promoted and applied in clinical practice.