Research Progress of Acupuncture Treatment of Sciatica

TANG Di

（Dengzhou Hospital of Traditional Chinese Medicine, Dengzhou Henan）

ABSTRACT: Sciatica is a common and frequently-occurring disease. The clinical manifestations are mostly pain along the sciatic nerve pathway and its distribution area. The severe pain is unbearable, seriously affecting people's work and life. In the treatment, there is no recognized, effective special drugs and specific methods. Acupuncture therapy has no toxic and side effects, is simple, easy to operate, low cost, and is widely used in clinical practice. This paper reviews the literature on acupuncture therapy for sciatica in recent years, so as to better guide clinical practice.

KEY WORDS:Acupuncture; Sciatica; Research progress

0 Introduction

Sciatica is a syndrome characterized by radiation pain along the sciatic nerve pathways (the lower back, buttocks,the back of the thigh, the posterolateral leg, and the lateral foot). This disease belongs to the category of Chinese medicine“arthralgia”, “waist and leg pain”, “kidney paralysis”, “waist pain” and “partial arthralgia”. Traditional Chinese medicine has a long history in treating sciatica, especially acupuncture.Compared with other therapies, acupuncture and moxibustion therapy is characterized by its lack of toxic and side effects,simplicity and low cost. It is suitable for China's national conditions and popularization. This paper reviews the literature on acupuncture treatment of sciatica in recent years.

1 Simple acupuncture

Liu Yuanyue[1]selected the single acupuncture point (the experience point, located at the junction between the proximal 2/3 and the distal1/3 of the connection between the ulna microcephalus and olecranon of the upper limb) in the treatment group. In the control group, points such as Dachangshu,Shenshu, Chicbian, Chengfu, Zhizhong, Chengshan, Kunlun,Huandao, Yanglingquan and Xuanzhong were taken. Patients in both groups received acupuncture treatment once every other day, 7 to10 times for a course of treatment. Statistical effect was observed after1-2 courses of treatment. The total effective rate was 95% in the treatment group and 83% in the control group (P＜0.05). Chen Junyi[2]selected Dachangshu, Huandao,Yanglingquan at the main points, zhongwei, Chengshan and other points from the back of the calf to the heel of the foot, and Yang and Bone-breaking points from the antrum of the calf to the back of the foot. Secondary plus primary local acupoints,chronic muscular atrophy with taixi, Sanyin jiao, zusanli and other points. Once a day, 7 times as a course of treatment,100 patients after treatment1-2 courses, follow-up more than1 year, clinical cure 72 cases, significant15 cases,10 cases of improvement, ineffective 3 cases, the total effective rate 97%. Chen Feng et al.[3]treated 80 patients with sciatica with acupuncture at Zhongzhu and Houxi. In the control group, 80 patients with sciatica were treated with quick-acting sciatica pill. Results The treatment group was significantly better than the control group (P＜0.05); Follow-up for 3 months showed that there were17 cases of recurrence in the treatment group and 41 cases of recurrence in the control group, and the recurrence rate in the treatment group was significantly lower than that in the control group.

2 Including

Chen Tuanzhen[4]In the treatment group, 25 patients with sciatica were treated with electroacupuncture, in which the main point was taken for loop jump and Chengfu, and in which the pain was followed by the sun meridian at the acupoint, shenshu, Yinmen, Weizhong and Chengshan were added. People with pain following Shaoyang meridian add Fengshi, Yangling Spring: those with pain over the bones add Chi Liao, waist 2-5 Jiaji points; A long illness plus three li, Shen Shu. In the control group, 25 patients with sciatica were treated with electroacupuncture and lDB-type desktop ultrashort wave therapy made in Shanghai. Treatment Results in the treatment group,10 cases were cured,12 cases were obvious, 3 cases were effective, and 0 cases were invalid. The total effective rate was100%, and 3, 5, 8, 9 cases were in the control group. Comparison between the two groups,P＜0.05,the treatment group was significantly better than the control group. Zhou Guanghui et al[5]randomly divided120 cases of patients with lumbar disc herniation combined with sciatica into the observation group of 60 cases: lumbar traction, low cycle and electroacupuncture treatment. Control group of 60 cases:lumbar traction combined with low cycle treatment. Results the analgesic effect and lumbar improvement index of both groups were significantly better than those before treatment (P＜0.0l),and the analgesic effect and lumbar improvement index of the observation group were higher than those of the control group (P＜0.05). The cure rate and total effective rate in the observation group were significantly better than those in the control group (P＜0.01).

3 The fire

Yan Yufen[6]treated 23 patients with sciatica with fire acupuncture. Methods Huandao, Fengshi, Yinshi, Yanglingquan and Jue Bone were taken from the main acupoints. With points to take The Waist jiaji, Yin Men, Zusanli, Chengshan,Kunlun, Jixi, A is points. Methods The 28th-silver-handled stainless steel needle was used.1.5 inch needle was used for the acupuncture point above the knee joint, and 0.5-1 inch needle was used for the acupuncture point below the knee joint.After selecting the acupuncture point, routine disinfection was conducted. Once every other day, every 7 times is1 course of treatment. Results among the 23 patients,18 were cured,4 were effective and1 was ineffective, the effective rate was 95%.Ji zhong et al[7]5 to10 pain points in the distribution area of sciatic nerve were selected as injection points. After routine disinfection, hold the red-hot no. 26 fire needle in and out quickly with a depth of about 2-3mm, pay attention to avoid superficial veins, and then insert the fine paper with erythromycin ointment. The exposed part can be cut off with scissors and sealed with adhesive tape. Change it once every 3 days. Among the 30 patients,19 were cured, 6 were improved and 5 were ineffective, with a total effective rate of 83.3%.

4 Embedding thread at acupoints

Tang Jinan et al[8]used acupoint catgut embedding method to treat sciatica. According to modern medical research, after intestinal catgut is embedded in the human body, a series of local biochemical reactions can occur, such as increased muscle anabolism, decreased catabolism, increased myosin carbohydrate synthesis, and decreased lactate creatine decomposition. Also can make local blood circulation increase,blood vessel nerve fiber new birth, microcirculation perfusion increase, peripheral tissue ischemia improvement, inflammatory edema disappear, so as to improve the peripheral tissue of the sciatic nerve compression, to activate blood stasis, tongluo qi analgesic role. Zhao Jingwen[9]selected points based on syndrome differentiation in treatment, and selected Shenshu,Guan Yuanshu, Chicbian, Yin Men and Chengshan by foot sun meridians. The foot shaoyang classics take Large Intestine Shu, ring jump, wind city, Yangling spring, must bone; For the mixed type, take 4-5 points at each time. Escort walking pain, plus the wind market, three Yin jiao; With spleen and stomach weakness, poor reception, plus spleen Shu, zusanli;Accompany liver and kidney deficient, waist and knee sour and soft, add Shen Shu, three Yin jiao; Accompanied by severe pain or external injuries, pricking bloodletting and cupping at the three-edged needle point of Weizhong point. Select 6-8 holes to bury the wire each time. Among the 85 cases in this group, 62 cases were cured (72.94%),13 cases were effective (15.29%), 8 cases were improved (9.41%), 2 cases were ineffective (2.35%),and the total effective rate was 97.64%. There were 57 cases of dry sciatica and primary sciatica, all of which were effective,28 cases of root sciatica, 26 cases of which were effective and 2 cases of which were not.

5 Blood pricking cupping

Xie Henghui et al[10]used blood pricking cupping combined with acupuncture to treat 50 cases of sciatica. Take a is point,Large intestine Shu, Rank edge, ring jump, Yangling Spring,hang Zhong, Chengshan, Kunlun, Foot linwei, between lines, etc.The needle was kept for 30min and treated once every other day,and l0d was a course of treatment. After the end of acupuncture,the popliteal popliteal veins with obvious purple and cyan veins in the popliteal ministries and commissions were selected, and the blood was used to stop the cupping. Results total efficiency 96%. Du Hui[11]pricking blood to treat 60 cases of sciatica. Lv in Ⅰ group and find out: shen shu, shu, bl 30, liao liao, times,gb 30 is suitable for low back pain,12 point at a time. Find Ⅱgroup: cheng fu, Yin door, bilateral, wei Yang, Yang, kunlun,Yang, destroyed, suitable for lower limb pain, each time the option 2-4. Operation: Select the point or the exposed veins around the point for routine disinfection, and use the sterile no.16 three-edged needle point to puncture the bleeding. Blood stop the cupping, remove the cupping for 2-3 minutes, press the pinhole with iodophor cotton ball, and finish the operation.At the same time, oral jonggu lumbago pill, zhuanggu joint pill,tonifying kidney tonifying body tablets and other drugs to assist treatment. In this group, there were 60 cases, of which 47 were cured, 6 were obvious, 5 were improved, and 2 were ineffective,with an effective rate of 97%. The shortest cure time is10 days and the longest is1 month.

6 Point injection

Xia Shaogao[12]used Traditional Chinese medicine preparations such as Angelica root, Radix Paeoniae Alba and Safflower or 20M1 of 10% glucose solution, and added a mixture of vitamin B1 injection of 100mg and Vitamin B12 injection of 0.lmg to inject the needle after local disinfection in Huandao,Yanglingquan, Chicbian, Chengfu, Yinmen, Weizhong and Chengshan points. Once a day, 7 times for a course of treatment.After 4 courses of treatment, 50 cases were basically cured, 30 cases were obvious,15 cases were effective and 5 cases were ineffective, with a total effective rate of 95%. Pan Shulin et al[13]used gastrodia elata injection to treat100 patients with sciatica.Results 68 cases were cured, 21 cases were effective,11 cases were improved, the total effective rate was100%.

7 Wen acupuncture

Chen Meilen et al[14]took Shenshu, Dachu, Huandao,Weizhong and Kunlun on the affected side, and applied the technique of “smoothing and replenishing” and “relieving” after acupuncture at each point to obtain gas, which made the local sense of acid and hemp swelling and heaving needle. After 5 min of acupuncture, they inserted an aizao of half olive size into the needle handle and ignited each moxibustion for 3-5 zhuang.Each treatment lasted15-30 min, once a day,10 times for one course of treatment, and then the next course of treatment was performed after 3d rest between the courses. Results the total efficiency is 90%. Liu Shuqin[15]warm acupuncture round jump,Zusanli, Ah is acupoints. Once a day,10 days for1 course of treatment. Results 27 cases (73%) were cured. 5 cases showed obvious effect, accounting for13.5%. There were 5 effective cases, accounting for13.5%. The total efficiency is 100%.

8 Other stitches

Liu Runying et al[16]treated 34 cases of sciatica with Yang Pricking. Main cave: Ring jump, Weizhong, Yanglingquan,Chengshan; Match acupoint: Wind city, Kunlun. Acupuncture once a day, retain the needle for 30min each time,5 times for a course of treatment, rest1-2D between the courses. Results the cure rate was 88.2%. Liao Zijun[17]used bee acupuncture to treat sciatica once a day, 7 times a course of treatment.Usually a course of treatment with sciatica stops the pain.Yao Xiaoping[18]treated 86 cases of sciatica with acupuncture and mind-regulating method and sanyang Qitai acupuncture.Acupuncture once a day, seven times for one course of treatment, after one course of treatment, continue the second course of treatment 3 days apart. Three courses of treatment were observed and followed up for 6 months. Results Among the 86 patients, 24 were cured with one course of treatment, 48 with two courses of treatment,11 with three courses of treatment and 3 with no effect. The total clinical cure rate was 96.50%.Sheng Shengkuan et al[19]treated 38 cases of sciatica with qi thorn method. Main acupoint: A is acupoint, with qi thorn method mainly. Acupoints matching: select acupoints according to syndrome differentiation, and the pain follows the path of the sun and skin. Pain along the foot of the sun gallbladder after the ring jump, Yanglingquan, hung bell. The needle should be kept for 30-60 min each time, and the needle should be done once every10 min, with a course of treatment for 10d. The patient should rest for1 week before the next course of treatment.Results The total effective rate was100%, with at least 6 treatments and at most 40 treatments. Chen Meiren et al.[20]treated 80 cases of sciatica with the acupuncture method of Canggu probing point. Point selection: Shenshu, Dachang Shu,Waist Yangguan, Loop Jump, Kunlun, Ah is points. Once every other day,10 times for a course of treatment, after one course of treatment statistical efficacy. Results significant efficiency:88.75%. Zhong Jianguo et al[21]randomly assigned 128 patients to the observation group (Linggui eight-method group) and the control group (routine acupuncture group), with 64 patients in each group. The observation group was treated with linggui eight acupuncture therapy, while the control group was treated with conventional acupuncture therapy. The Results showed that the immediate analgesic effect and the lasting analgesic effect of linggui eight acupuncture on sciatica were significantly better than that of conventional acupuncture. Diaopeng[22]studied the therapeutic effect of acupuncture on sciatic nerve trunk in patients with sciatica caused by lumbar disc herniation.Methods 40 cases of sciatica caused by lumbar disc herniation were randomly divided into study group and control group, 20 cases in each group. The control group was treated with The Methods of Ashi, Waijiaji and Dachang Shu points, combined with dialectical acupoint selection and acupuncture. The study group used sciatic nerve trunk stimulation, acupuncture loop jumping, loop, and combined with conventional acupuncture treatment. Results the difference was statistically significant(P＜0.05). Deng Yadian[23]to fill Yang also five soup oral joint intervertebral foramen floating needle therapy to treat lumbar intervertebral disc protrusion mirror in the study of postoperative residual neurologic symptoms, Chinese medicine combination floating needle therapy can effectively relieve postoperative intervertebral foramen mirror residual lumbar disc prolapse of waist and leg pain and numbness symptoms, of lumbar function recovery has a good role in promoting.

9 Combination therapy

Wang Zehong et al[24]treated sciatica with acupuncture,blood pricking and cupping. Among the168 cases in this group,136 were clinically cured, accounting for 80.9%.15 cases showed significant effect, accounting for 8.9%. Effective10 cases, accounting for 6.0%; 7 cases were invalid, accounting for 4.2%. The total effective rate is 95.8%. The136 patients who were cured were followed up for1.5-6 years, and121 patients were cured without recurrence. Recurrence occurred in 4 cases within1.5 years and11 cases later. Zhang Qiuling[25]randomly divided the 88 patients into 44 patients in the comprehensive acupuncture treatment group, acupuncture points: Jiaji points of the waist 3, 4 and 5 (selected according to the pathological site), Huandao, Weizhong, Yanglingquan, Fengshi, Chengshan,Kunlun, needling Shenshu and Taixi for kidney deficiency,pricking the sea of blood for blood stasis, and pricking wind pool for wind-cold. Two to four acupoints were selected and pulsed electroacupuncture was added each time. The TDP therapeutic apparatus was kept for 20min and irradiated for 30min, once a day and10 times for one course of treatment. In the control group, 44 patients were given The Chinese patent medicine Lumbago capsule orally, 2 capsules per time, 3 times a day. Vitamin B1, Vitamin B12 intramuscular injection, once a day,10 times is1 course of treatment. TDP treatment and precautions are the same as above. After 2 courses of treatment,the cure rate and total effective rate of the treatment group and the control group were significantly different (P＜0.0l).Li Jinyan et al.[26]divided 72 patients with sciatica into acupuncture group and embedding group, with 36 cases in each group. The patients in the acupuncture group were treated with conventional acupuncture, while the patients in the embedding group were treated with common acupuncture plus point embedding therapy. Results After10 days of treatment, the total effective rate (97.22%) in the embedding group was higher than that in the acupuncture group (86.11%), the difference was statistically significant (P＜0.05).Experimental studies on the pathophysiological mechanism of acupuncture in the treatment of sciatica have fully confirmed that acupuncture can treat the pain caused by sciatica by adjusting pain threshold and play a role in the recovery of nerve fiber injury by promoting nerve regeneration[27]. Therefore, acupuncture is widely used in the treatment of sciatica.