Clinical Study on Tuina Manipulation Combined with Warming-Needle Moxibustion in Treating Lumbar Disc Herniation of Blood Stasis Type Based on Myofascial Chain Theory
Abstract:Objective:To observe the clinical effect of tuina manipulation and warming-needle moxibustion in the treatment of lumbar disc herniation (LDH) of blood stasis type based on the myofascial chain theory. Methods:A total of 82 LDH patients of blood stasis type treated at Hainan Cancer Hospital from May 2021 to May 2023 were selected and divided into the control group and the study group according to random number table method,with 41 patients in each group. The control group was treated with conventional therapy,and the study group was additionally treated with tuina manipulation and warming-needle moxibustion according to the myofascial chain theory on the basis of the control group. Both groups were treated for eight weeks. Clinical effects, walking ability (6-minute walking distance and 10-meter walking time),scores of Visual Analogue Scale (VAS) and Japanese Orthopedic Association (JOA),lumbar spinerelated indicators (lumbar sagittal Cobb angle and intervertebral height),and biomechanical indicators of lumbar spine muscle [average surface electromyography (AEMG) during extension and flexion] were compared between the two groups. Results: After eight weeks of treatment, the total effective rate in the study group was 90.24% (37/41), which was higher than that of 70.73 (29/41) in the control group (P<0.05). The 6-minute walking distance in the two groups was longer than that before treatment (P<0.05),and the study group had a longer 6-minute walking distance than the control group (P<0.05). The 10-meter walking time in the two groups was shorter than that before treatment( P<0.05),and the study group had a shorter 10-minute walking time than the control group( P<0.05). The VAS scores in the two groups were decreased when compared with those before treatment (P<0.05), and the VAS scores in the study group were lower than those in the control group (P<0.05). Both groups showed an increase in JOA scores compared to that before treatment (P<0.05),with the study group having a higher JOA score than the control group (P<0.05). The sagittal Cobb angle and intervertebral height in the two groups were increased when compared with those before treatment (P<0.05),and the sagittal Cobb angle and intervertebral height in the study group were larger than those in the control group (P<0.05). The AEMG during the extension process was increased in the two groups when compared with that before treatment (P<0.05),and the AEMG during the extension process in the study group was greater than that in the control group (P<0.05). The AEMG during the flexion process in the two groups was decreased when compared with that before treatment (P<0.05),and the AEMG during the flexion process in the study group was smaller than that in the control group (P<0.05). Conclusion: Based on the theory of myofascial chains, tuina manipulation and warming-needle moxibustion has a positive effect on LDH of blood stasis type, which can improve walking ability and lumbar function,and relieve pain.