Objective: To investigate the therapeutic effect of acupuncture stimulation combined with administration of Gu Shen Zhu Yu Tang (decoction for consolidating kidney to eliminate blood stasis) in the treatment of lumbar disc herniation patients.
Methods: A total of 147 patients with lumbar disc herniation were randomly divided into Gu Shen Zhu Yu Tang, acupuncture and Gu Shen Zhu Yu Tang+acupuncture groups (n= 49 cases in each group). The patients of the acupuncture group received a) acupuncture stimulation of Dazhui (GV14), Ganshu (BL18), Shenshu (BL23), Tianshu (ST25), Yanglingquan (GB34), etc., b) fire needle pricking of the topical tendons, cord-like points, tender-points, c) row-needles stimulation of the attachment sites of muscles of the sacroiliac joint or crista iliaca, and d) acupotomy-debonding of the topical high-tension muscles, twice a week for 4 weeks.
Those patients of the Gu Shen Zhu Yu Tang group were ordered to take Gu Shen Zhu Yu Tang [containing fried Yiyiren (Semen Coicis), Shanzhuyu (Fructus Corni), fried Baizhu (Rhizoma Astractylodis), Sangjisheng (Ramulus Loranthi), Duzhong (Cortex Eucommiae), Buguzhi (Fructus Psoraieae), etc.] 150 mL, twice daily, continuously for 4 weeks, and those of the Gu Shen Zhu Yu Tang+acupuncture group received the combined treatment mentioned above in the acupuncture and Gu Shen Zhu Yu Tang groups.
The pain severity was assessed by using visual ana-logue scale (VAS, 0-10 points) and the modified Japan Orthopaedic Association questionnaire (M-JOA) score (0-30 points), separately, and the lumbar range of motion (ROM) and lumbar muscle strength were tested to evaluate the lumbar motor function. The levels of serum tumor necrosis factor α(TNF-α), matrix metalloproteinase-2 (MMP-2), and apoptosis related factors Caspase-3 and Caspase-9 were assayed using ELISA. The total effective rates of the three groups were compared.
Results: After the treatment, the VAS and M-JOA scores, contents of serum TNF-α, MMP-2, Caspase-3 and Caspase-9 were significantly decreased (P<0.01), and the myodynamia of lumbar muscular flexor and extensor was considerably increased (P<0.01) in the three groups, and the ROM angles of lumbar extending and buckling were increased (P<0.01) in the Gu Shen Zhu Yu Tang+acupuncture group compared with pretreatment.
Comparison among the 3 groups showed that the VAS and M-JOA scores, and serum TNF-α, MMP-2, Caspase-3 and Caspase-9 contents of the Gu Shen Zhu Yu Tang+acupuncture group were significantly lower than those of both DCKEBS and acupuncture groups (P<0.01), while the ROM angles of lumbar extending and buckling, and the myodynamia of lumbar muscular flexor and extensor were obviously higher in the Gu Shen Zhu Yu Tang+acupuncture group than those of the Gu Shen Zhu Yu Tang and acupuncture groups (P<0.01). The total effective rate was 93.88%(46/49) in the DCKEBS+acupuncture group, higher than 75.51%(37/49) in the Gu Shen Zhu Yu Tang group and 71.43%(35/49) in the acupuncture group (P<0.05).
Conclusion: Acupuncture combined with Gu Shen Zhu Yu Tang can relieve pain, improve lumbar muscle strength and lumbar movement function, and reduce serum TNF-α, MMP-2, Caspase-3 and Caspase-9 levels in lumbar disc herniation patients.