Restless leg syndrome, also known as Ekbom’s syndrome, is an unbearable, non-painful discomfort in the deep part of the lower leg that occurs at night when resting. The main clinical manifestations of Ekbom’s syndrome are pins and needles, insect-like or ant-like sensations in the legs, and restlessness, which are relieved by activity. The cause of the disease is unknown, and modern Western medicine has no specific treatment except symptomatic treatment. From January 2008 to December 2011, the author used acupuncture combined with warm foot therapy to treat 58 cases of restless legs syndrome with satisfactory results, which are reported below.
1. Clinical data
All cases were from the acupuncture department of our hospital, and were outpatients and inpatients from January 2008 to December 2011, and all cases met the diagnostic criteria established by the International Restless Legs Research Group as follows.
1.1 Discomfort (tingling sensation, tingling sensation, tension, pain) in both legs accompanied by uncontrollable body movements.
1.2 Symptoms appear at rest, mainly in the evening, and can interfere with sleep; the severity of the condition changes at any time (e.g., varies weekly and monthly) and can involve the upper extremities.
1.3 Symptoms can be partially or completely relieved by certain manipulation of the limbs (e.g., rubbing, shaking, stomping, walking).
1.4 No other neurological signs and symptoms are present. The patients were divided into two groups according to the order of consultation. 38 cases were in the acupuncture group, including 18 males and 20 females; age ranged from 45 to 76 years, duration of disease ranged from 1 month to 15 years, and 28 cases were with sleep disorder. In the control group, there were 20 cases, 9 males and 11 females, aged 46 to 75 years, with a duration of 2 months to 16 years, and 12 cases with sleep disorders. The difference between the two groups was not significant by statistical treatment (P>0.05), and was comparable.
2. Treatment methods
2.1 Acupuncture group
Treatment: tonifying the liver and kidney, benefiting qi and nourishing blood, dredging tendons and channels, calming the mind and tranquilizing the spirit.
Acupuncture points: Liver Yu, Kidney Yu, Huanjiao, Yanglingquan, Foot Sanli, Zhizhong, Chengshan, Sanyinjiao, Shenmen. Operation: The patient is placed in a prone position, and the milli-needle is used for acupuncture, with the liver and kidney yu stabbed obliquely in the direction of the spine for 25 mm, with the twisting and twisting method of tonicity, and the rest of the acupuncture points are tonic and diarrheal, to the extent of obtaining qi. The needle was kept for 30 min, 10 times for a course of treatment. After two days of rest, proceed to the next course of treatment, and evaluate the efficacy after 3 consecutive courses of treatment. On this basis, the product “nano negative ion far-infrared jade massage pad” produced by Wenzhou Junma Medical Equipment Co., Ltd. is used to warm foot therapy twice a day for half an hour each time, and must be insisted on once a day before going to bed.
2.2 Western medicine group
Methadopa was taken orally, 125mg each time (containing 100mg of levodopa and 25mg of benserazide), every night before bedtime, and the efficacy was evaluated after 30 days of continuous use.
3.Efficacy criteria.
Cured: all symptoms disappeared, no recurrence in six months of follow-up; effective: symptoms basically disappeared, occasionally affecting night sleep; improved: symptoms reduced, but still affecting night sleep; invalid: no change before and after treatment.
4.Treatment results
In the treatment group, 19 cases (50.0%) were cured, 12 cases (31.6%) were effective, 6 cases (15.8%) were improved, 1 case (2.6%) was invalid, and the total effective rate was 97.4%; in the control group, 6 cases (30.0%) were cured, 4 cases (20.0%) were effective, 5 cases (25.0%) were improved, 5 cases (25.0%) were invalid, and the total effective rate was 75.0%. There was a significant difference in the total effective rate between the two groups (p<0.05).
5. Discussion
According to Chinese medicine, restless leg syndrome belongs to the category of “paralysis” and “spasm” in Chinese medicine. The external causes are mainly wind, cold, dampness and other evil guest in the meridians, resulting in unfavorable sui dao, poor flow of qi and blood, and loss of moistening of muscles and tendons; the internal causes are mainly liver and kidney deficiency, insufficient qi and blood, and loss of nourishment of tendons and flesh. This disease is caused by deficiency of liver and kidney, deficiency of qi and blood, while the symptoms are caused by wind, cold, dampness, phlegm, and stasis, which block the blood vessels. Accordingly, we established the treatment principle of “tonifying the liver and kidney, benefiting the qi and nourishing the blood, dredging the tendons and opening the ligaments, calming the mind and tranquilizing the spirit”,
The treatment method is based on the selection of acupuncture points, including Liver and Kidney, which can nourish the liver and kidneys, Foot San Li, which is a Yang Ming meridian point with more qi and blood, and is used to nourish qi and blood, Yang Ling Quan, which is the meeting of tendons and has the effect of relaxing the tendons and opening the ligaments, Shen Men, the original point of the heart, which has the effect of tranquilizing the mind and calming the spirit, Huan Yu, which is a key point of the foot Shao Yang Bile meridian, and is deep in the sciatic nerve trunk, which can make the acupuncture sensation reach the foot and has the effect of unblocking the meridians of the lower limbs. The combination of these acupuncture points has the effect of helping to dispel evil, promoting the flow of qi and blood, unblocking the tendons and channels, and accelerating the healing of the disease by removing the evil, restoring the positive qi, opening the channels and channels, and promoting the flow of qi and blood.
Western medicine believes that the occurrence of RLS may be related to genetic, endocrine, metabolic and nutritional disorders and other factors. It is generally believed that under the influence of cold, trauma, fatigue and mental factors, sympathetic nerve dysfunction, local blood circulation disorders, tissue hypoxia, metabolites stagnation, stimulation of local causes. The use of warm foot therapy, so that the foot acupuncture points by thermal stimulation, direct action on the local lesion, improve the blood circulation of the extremity, effectively play the role of anti-inflammatory pain, moisten the nerve. The clinical test, indeed, has a better therapeutic effect. Clinical experiments have shown that acupuncture can enhance the tension of blood vessels, promote local blood circulation and excretion of metabolites, reduce or eliminate local muscle and soft tissue compression and blockage.
Acupuncture can reduce both elevated sympathetic excitability and elevated parasympathetic excitability, as well as restore symmetry and stabilize asymmetrical plant nerve functions. Therefore, acupuncture combined with warm foot therapy is effective in treating restless leg syndrome. It has no toxic side effects compared with western medicine and is worthy of clinical application. The restless legs syndrome is associated with damage to dopaminergic neurons in the central nervous system, and the disease may occur in dopamine neuron cells rather than in post-synaptic dopamine neuron receptors.
Further evidence suggests that the dopamine neurons in the mesencephalic A11 and paraventricular A14 regions are mainly damaged by the dopamine neurons associated with the upstream regulation of injurious sensory signals. The disease occurs as a result of this.
In recent years, it has been found that iron deficiency is closely related to the disease, and the increased incidence of the disease during pregnancy is probably related to it. Further studies found that iron deficiency interferes with the metabolic function of dopamine neurons in the brain, and that iron is a cofactor of tyrosine hydroxylase, which affects dopamine synthesis in the brain by regulating tyrosine metabolism. This may be the biochemical basis for the use of dopamine supplementation in the treatment of this disease.