Dr. KangEditor | ShiwufollowLumbar disc herniation (LDH) refers toA series of clinical syndromes caused by protrusion of the sacral nucleus tissue of the lumbar intervertebral disc, stimulation and compression of nerve roots, cauda equina, etc

Dr. Kang

Editor | Shiwu

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Lumbar disc herniation (LDH) refers toA series of clinical syndromes caused by protrusion of the sacral nucleus tissue of the lumbar intervertebral disc, stimulation and compression of nerve roots, cauda equina, etc.

This includes pain in the waist and buttocks, radiation pain in the lower limbs, or sensory abnormalities. Some patients may experience abnormal sensation in the perineal area, bowel dysfunction, etc.

LDH can appear in different age groups,It is commonly seen in adults and is one of the most common causes of lower back and leg pain in clinical practice.

LDH has both severe pain in the waist and legs during acute attacks and chronic attacks that persist for a long time, seriously affecting the patient's life and work.

Research has shown that due to long-term pain and discomfort, LDH patients not only have a decrease in labor ability, but also are in a state of depression and anxiety,It is easy to experience negative emotions such as poor mental health, fatigue, and loss of interest in life, leading to a decrease in quality of life.

In general, the treatment of LDH can be divided into conservative and surgical treatment. Except a few patients with severe nerve compression symptoms, Spinal stenosis and other surgical indications need surgical treatment, most patients can take Conservative management, including bed rest, drug treatment, physical factors, nerve block, ozone injection and traditional Chinese medicine treatment.

Among them, Chinese medicine therapy is more and more recognized by patients and doctors because of its advantages of safety, effectiveness, simple operation, etc.

Like traditional Chinese medicineOral external application, cupping, scraping, ordinary acupuncture, warm acupuncture, electroacupuncture, fire acupuncture, needle knife, blade acupuncture, needle pulling, massage, etc.

The author found that the navel acupuncture based on the theory of "One Qi Circulates" has a good effect on the treatment of lumbar disc herniation in clinical practice. Now it is reported as follows.

General information: Fifty LDH patients who met the inclusion criteria and were treated in our department from March 2020 to October 2021 were selected. They were divided into two groups using the simple random number table method: the umbilical needle group of 25 cases and the warm needle group of 25 cases.

The two groups of patients have no differences in gender, age, and course of disease, and are comparable.

Diagnostic criteria: meet the diagnostic criteria for lumbar disc herniation in the Clinical Diagnosis and Treatment Guidelines - Orthopaedics Division and the Diagnostic Efficacy Standards of Traditional Chinese Medicine: medical history: experience exopathogens or lumbar trauma and strain; Symptoms: Low back pain, accompanied by radiating pain and numbness in one or both lower limbs, which can radiate to the toes. When abdominal pressure increases such as sneezing and coughing, the pain can be induced to worsen.

Physical signs: There are tenderness points on the side of the lumbar interspinous ligament and buttocks, and there may be sensory abnormalities in the affected innervated area. In severe cases, there may beMuscle strength of gluteus muscle, Gastrocnemius muscle muscle, toe dorsum extension and other muscles on the affected side decreased, tendon reflex weakened or disappeared, straight leg lift test.

Imaging examination: X-ray examination shows narrowing or narrowing of the intervertebral space at the lesion site, as well as marginal osteophytes. MR and CT imaging show the direction and degree of herniation of the intervertebral disc at the lesion site.

Inclusion criteria: Those who meet the above diagnostic criteria; Age 25-75 years old;I have informed consent to this study, have good compliance, and can cooperate with the researcher to complete various diagnosis, treatment, and scale filling.

Exclusion criteria: low back pain caused by Kidney stone disease, tumor and other diseases; Those with severe illness and indications for surgery; Patients with local skin ulceration and bleeding tendency; Those who have merged with other serious systemic diseases; Individuals with mental disorders who are unable to cooperate; Pregnant women; Those with poor compliance.

Treatment method: Both groups of patients were treated with medium frequency pulse electrotherapy as a physical factor therapy. The patients were placed in a supine or prone position, and the electrode was placed on the waist. The treatment intensity was adjusted according to the patient's condition, once a day for 20 minutes each time. Treat continuously for 6 days per week, rest for 1 day, and treat for 2 consecutive courses per week.

Umbilical needle group: Umbilical needle group adopts the theory of "one qi circulation" for umbilical needle treatment.

Acupoint selection: based on the theory of one qi circulation combined with the umbilical eight trigrams hologram, the main acupoints are selected as Gen, Zhen, Xun, Li, and Kun; According to the theory of "wearing nine shoes and one, three left and seven right, two four for shoulders, and six eight for feet" in the holographic map of the navel Luo book, select the waist and leg reflex area of the navel, and use the needle tail to explore the tenderness point in the reflex area and insert the needle.

If there are no obvious tenderness points, acupuncture should be done in the dry and Gen positions.

Specific operation: The patient is in a supine position, exposing the navel, and disinfecting the navel with 0.5% iodophor, including the navel valley, navel stamen, and folds of the navel wall, which should be fully disinfected.

After injection, there is no need to breathe. Leave the needle for 30 minutes before starting the needle. Treat for 8 consecutive days per week, rest for 1 day, and treat for 2 consecutive courses per week.

The warm needle group and the control group were treated withWarm needleTreatment.Select the corresponding Jiaji and Beishu points, Huantiao, Weizhong, and Ashi points for the affected intervertebral disc.

After the needle retention is completed, start the needle in sequence and check for any leakage, local swelling or pain.

Treat continuously for 6 days per week, rest for 1 day, and treat for 2 consecutive courses per week.

Efficacy observation: Visual Analog Scale (VAS); Draw a 10cm ruler on the paper and mark the numbers on a scale of 0-10, with 0 being painless and 10 being the most severe pain. Have the patient mark the corresponding score based on their own situation.

Comparing the VAS scores of patients before and after treatment, the lower the score, the lighter the pain.

Lumbar Function Improvement Rating Scale (JOA): The JOA scoring items include subjective symptoms, clinical signs, and daily activity, with a score of 0-29 points. A higher score indicates better lumbar function, and a score of 29 indicates complete normal.

Clinical efficacy grading: According to the "Diagnosis and Efficacy Standards for Traditional Chinese Medicine Syndrome" and JOA score: Recovery: The patient's symptoms and signs such as low back and leg pain and numbness disappear, and they can move freely. The improvement rate of JOA is 100%; Effective.

The patient's symptoms and signs have significantly improved compared to before, with a JOA improvement rate of>60%; Effective.

The patient's symptoms have alleviated and their functions have improved. The improvement rate of JOA score is 10% to 60%, indicating no effect.

The patient's symptoms and function showed no significant improvement, and the improvement rate of JOA was less than 10%. Total effective rate=cure rate+significant rate+effective rate.

The counting data is expressed in terms of rate, and the X2 test is used as the testing method. The results show a statistically significant difference with P<0.05.

VASJOAWarm needleVAS

VASVASWarm needle

Warm needleJOA

JOAJOAWarm needle

Warm needle

The Theory of "One Qi Flow"Originating from the "Heart Source of the Four Saints" written by the renowned medical expert Huang Yuanyu of the Qing Dynasty,It is a highly summarized academic thought of Huang Yuanyu, with the core being the theory of "the four phenomena of earth pivot and the circulation of one qi".

The source of the Four Saints' Heart "states:" The person with moderate qi is the pivot of the rise and fall of yin and yang, and is named after it. It is called the Four Elephants. "It also states:" The left path is filled with wood fire, the right path is filled with golden water, and the middle path is filled with earth qi

That is to say, the middle air is the central pivot, and the four elephants of gold, wood, water and fire are the wheels in four directions, just like the wheel. The middle air constantly moves to drive the four elephants to run, making the gas rotate to the left to raise the pure air, and to the right to lower the turbid air, thus forming a Circular motion of gas that rises and falls with the middle air, and the four elephants rotate round and round.

Applied to human organs,The qi of the spleen and stomach serves as the pivot, with the liver and heart ascending in a leftward rotation, the lungs and kidneys descending in a rightward rotation, and the flow of qi is endless.

In terms of treatment approach, it is based on the above theory to adjust the four axes of the pivot, so that the circulation of one qi can operate normally.

Among them, the ascending and descending function of the spleen and stomach plays a core role in the circulation of one qi. Adequate yang qi can smooth the ascending and descending of qi, and then turn right to descend into yin water. Therefore, this study also adopts its treatment philosophy of caring for the spleen and stomach and Chongyang suppressing yin.

Currently, relevant literature has been reportedThe Theory of "One Qi Flow"

The Theory of "One Qi Flow"

Therefore,The Theory of "One Qi Flow"

The navel acupuncture therapy was founded by Professor Qi Yong. He combined the traditional theory of the Book of Changes with the theory of acupuncture and moxibustion, and after years of clinical practice, he explored aThe new acupuncture therapy applied to the treatment of the umbilicus has broken the shackles of "only moxibustion without acupuncture" in the umbilicus.

It is said in the Huiyuan acupuncture and moxibustion Study that "the god is the place where the god lives, the navel is in the middle, and the power is innate."

According to the Daozang, "This acupoint serves as the gateway for the communication between the heart and kidneys, hence it is called the Divine Palace.

Therefore,It has the functions of regulating the internal organs, unblocking meridians, balancing yin and yang, and has good therapeutic effects on various diseases of the whole body.

Moreover, after years of research and continuous practice by numerous doctors, literature reports on adverse reactions are extremely rare, proving the safety of umbilical needle therapy.

The Theory of "One Qi Flow"It embodies the idea of "One Qi Flow", which involves ascending from left to right, ascending from the sun and worshipping the earth, and harmonizing the four dimensions to restore the One Qi Flow; Select the reflex area of the waist and legs for acupuncture.

VASWarm needleJOAWarm needleThe Theory of "One Qi Flow"Warm needle

The Theory of "One Qi Flow"

There are currently many research reports on the treatment of systemic diseases with navel acupuncture,There are also studies on the treatment of lumbar disc herniation with navel acupuncture, which confirm the clinical efficacy of navel acupuncture.

The Theory of "One Qi Flow"The Theory of "One Qi Flow"

In addition, this study still faces issues such as a small sample size and a lack of immediate and long-term efficacy comparisons. Further improvement is urgently needed in future studies in order to achieve better clinical outcomes and promote their application.

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