Acupuncture is effective for lumbar disc herniation treatment. A recent study conducted at Xinzheng Traditional Chinese Medicine Hospital in Henan, China found that a combination of acupuncture and a modified Shen Tong Zhu Yu Tang herbal formula relieves pain and improves quality of life for patients with lumbar disc herniation. This study compared treatments of acupuncture and herbal medicine with the anti-inflammatory pharmaceutical celecoxib. Acupuncture patients experienced greater relief from pain and improvement in quality of life with a 90.69% total effective rate and no reported adverse effects. [1] In comparison, the control group experienced an 81.40% total effective rate.
Parameters 86 patients afflicted by lumbar disc herniation, and TCM diagnosed with qi stagnation and blood stasis, were recruited for this study and randomly assigned to the control or acupuncture group. The control group was comprised of 35 male and 8 female patients (ages 28–62), with a mean age of 43.5. This group’s disease duration spanned 2 months to 3 years, with a mean duration of 18.6 months. The acupuncture group was comprised of 37 male and 6 female patients (ages 26–65) with a mean age of 44.7. This group’s disease duration spanned 3 months to 4 years, with a mean duration of 20.1 months. There were no statistically significant differences in baseline characteristics between the two groups (p>0.05).
Inclusion criteria for this study required a TCM diagnosis of qi stagnation and blood stasis. Primary symptoms include severe, fixed pain in lower limbs and lumbar region that worsens at night and is aggravated by pressure. This pain induces stiffness, and inhibits bending and rotation. Secondary symptoms include lower limb numbness, heaviness of the lumbar region and knees, dark or purple tongue, tongue with ecchymosis or thin white or yellow coating, and sinking or rough bowstring pulse.
Patients were required to be 25–65 years old, able to give informed consent, and able to comply with treatment in addition to the criteria above. Exclusion criteria included lumbar pain due to diabetes, gastrointestinal disorders, anemia, spinal stenosis or tumors, liver or kidney dysfunction, severe hypertension or heart disease, hypothyroidism or other endocrine disorders, long term use of corticosteroid medication or glucocorticoid hormones, pregnancy or lactation, allergies to any treatment used in the study, and participation in any other clinical trial within the previous 2 months.
Treatment Protocol All patients were treated daily with 200 mg of celecoxib, a COX-2 selective non-steroidal anti-inflammatory drug commonly used to treat musculoskeletal disorders. All patients received standard care, including bed rest, nutritional guidance, tuina massage, traction, exercise, and physical therapy.
Patients assigned to the acupuncture group were prescribed a modified Shen Tong Zhu Yu Tang herbal formula made of the following herbs:
Qin Jiao 6g
Chuan Xiong 10g
Tao Ren 10g
Hong Hua 6g
Qiang Huo 6g
Mo Yao 6g
Dang Gui 9g
Ling Zhi 6g
Xiang Fu 10g
Niu Xi 10g
Di Long 6g
Tu Bie Chong 6g
Dan Shen 15g
Huang Qi 30g
Du Zhong 12g
Xu Duan 15g
Gan Cao 6g
200 ml of this formula was decocted and taken twice daily. Acupuncture was administered at the following acupoints:
Ashi points
Shenshu (BL23)
Yaoyangguan (GV3)
Dachangshu (BL25)
Yaotongxue (NUE19)
Jiaji points
Weizhong (BL40)
Taixi (KD3)
Treatment was administered daily for a total of 14 days.
Results The outcomes for this study were measured using TCM syndrome scores, VAS (Visual Analog Scale), ODI (Oswestry Disability Index), and JOA (Japanese Orthopedic Association) scales. The total effective rate was calculated for each group as well.
TCM syndrome scores measure each symptom on a scale of 1–3, with higher scores indicating higher severity. The mean pretreatment score was 12.85 in the control group and 13.14 in the acupuncture group. Following treatment, scores fell to 8.67 and 5.19 respectively. TCM syndrome scores showed improvements in both groups, although improvements were significantly greater in the acupuncture group (p<0.05).
VAS scores measure pain on a scale of 1–10, with higher scores indicating higher severity. The mean pretreatment score was 7.36 in the control group and 8.14 in the acupuncture group. Following treatment, scores fell to 5.53 and 3.62 respectively. VAS scores showed improvements in both groups, with significantly greater improvements in the acupuncture group (p<0.05).
ODI scores measure disability due to low back pain by assessing pain intensity, as well as impact on factors like lifting, walking, sitting, standing, sleeping, traveling, personal care, sex life, and social life. Higher scores indicate increased disability. The mean pretreatment score was 17.63 in the control group and 18.19 in the acupuncture group. Following treatment, scores fell to 10.57 and 5.14 respectively. ODI scores showed improvements in both groups, with significantly greater improvements in the acupuncture group (p<0.05).
JOA scores measure pain and disability in patients with low back pain, with lower scores indicating increased symptom severity. The mean pretreatment score was 10.11 in the control group and 9.87 in the acupuncture group. Following treatment, scores rose to 18.07 and 24.79 respectively. Like the scores listed above, JOA scores showed improvements in both groups, with significantly greater improvements in the acupuncture group (p<0.05).
The total effective rates were calculated for each group, and each case was classified as recovered, markedly effective, effective, or ineffective depending on the level of improvement. The control group ended with 3 recovered, 14 markedly effective, 18 effective, and 8 ineffective cases, with a total effective rate of 81.40%. The acupuncture group ended with 8 recovered, 21 markedly effective, 10 effective, and 4 ineffective cases, with a total effective rate of 90.69%.
Electrocardiograms, liver and kidney function tests, and blood, urine, and fecal analyses were used to monitor safety throughout the study. No adverse effects were reported in either group.
The results of this study show that acupuncture and herbal medicine enhance the efficiency of traditional anti-inflammatory drugs like celecoxib. This treatment is not only effective, but is reported as safe as well. For more information, contact your licensed acupuncturist.
Reference [1] Ma Zhenlin (2019) “Observation on the Effect of Acupuncture Combined with Modified Shen Tong Zhu Yu Decoction in the Treatment of Lumbar Intervertebral Disc Herniation” Asia -Pacific Traditional Medicine Vol.15 (2) pp.129-141.
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