PENG Jian-ming, et al.

Treatment of Senile Intervertebral Disc Herniation with Acupuncture, Tuina and Traction

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Treatment of Senile Intervertebral Disc Herniation with

Acupuncture, Tuina and Traction
PENG Jian-ming(~J ~Y] ), LU Hong()~ '~,)
People's Hospital of Wangcheng County, Hu'nan 410200, P.ILChina

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Abstract Objective: To observe the therapeutic effect of treating senile intervertebral disc
Herniation with acupuncture, tuina and traction and with physiotherapy and traction. Meth-
ods: Altogether 150 cases above 65 years old were randomly allocated into treatment group
and control group, each containing 75 cases. Traction, acupuncture and tuina therapy were
adopted in the treatment group, while traction and physiotherapy were adopted in the control
group. Results: After one-month treatment, the recovery rate of the treatment group were
70.7%, which was significantly better than 53.3% of the control group ( P < 0.05). C o n c l u s i o n :
Combination of acupuncture, tuina and traction has very good efficacy in treating senile
intervertebral disc Herniation.
Key Words Traction; Acupuncture Therapy; Tuina; Massage; Intervertebral disk
Displacement
CLC number: R246.9
Document code: A

Herniation of lumber intervertebral disc has a
quite high incidence and usually occurs in population
aged between 20-50 years old ~1~ and the older ones.
We've treated senile intervertebral disc herniation
with combination of traction, acupuncture and
Tuina since 2002, and now the report is as follows.
Clinical Data
1. Diagnostic criteria
The diagnosis of all cases conformed to the diag-
nostic basis listed in Diagnostic and Therapeutic
Effect Criteria for TCM Diseases and Symptoms
and what's more, all the cases were confirmed with
CT scanning or MRI.
2. General data
Among 150 cases, male cases: 67; female cases: 83;
all aged above 65 years old (including 65), the
oldest: 84; mean age: 72. 1; the shortest disease
duration: 1 week; and the longest disease duration:
30 years.
Author: PENG Jian-ming (1967-), male, attending physician
9 42 9 [ Copyright@2006 Shanghai Research Institute of Acupuncture and Meridian
The 150 cases were randomly allocated into
treatment group and control group according to
their odd or even serial numbers of visit order, each
group included 75 cases.
Therapeutic Approaches
1. Acupuncture
Points: Shenshu (BL 23), Qihaishu (BL 24),
Zhibian (BL 54), Weizhong (BL 40), Jiaji (Ex-B 2)
points from L3-$1, Huantiao (GB 30), Yanglingquan
(GB 34), and Kunlun (BL 60). Each time 3-5 points
in the lumbar area and the affected side of the body
were selected for acupuncture.
Needling method: the patients were asked to take
the prone or side-lying posture, and the above-men-
tioned points were punctured with filiform needles after
routine sterilization. After arrival of the needling
sensation (Deqi), Shenshu (BL 23) and Qihaishu
(BL 24) were manipulated with reinforcing technique
and the rest of the points were manipulated with
even reinforcing-reducing technique. In addition,
each time, two points were connected with Cr6805
 Journal of Acpuncture and Tuina Science, Volume 4. Number 1. 2006 February
electric stimulator. The needles retained for 30 min.
2. Tuina
The patients were asked to take the prone posture
and the practitioner did one-thumb pushing, knead-
ing, rolling, pressure and rubbing manipulations by
order in the lumbar area and the affected side of
the body for about 15 min. Generally such heavy
stimulating manipulations as pulling and shaking
were avoided.
3. Traction of the lumbar vertebra
The lumbar vertebra traction was done with
200015 YHZ- type traction bed controlled by micro-
computer. The patients were asked to take the
supine posture for intermittent traction, each time
lasting 30 min with about 250-420 Newton of the
traction force.
4. Physiotherapy
The physiotherapy was done with ST-F type
multi-functional moderate-frequency and ultra-
short wave treatment instrument, and each treatment
lasted 20 min respectively.
In general, the treatment was done once a day,
and 10 times made up a course and the therapeutic
effect was evaluated after one month. Traction, acu-
puncture and tuina therapy were adopted in the
treatment group, while traction and physiotherapy
were adopted in the control group.
Therapeutic Effect Observation
1. Criteria of the therapeutic effect
Recovery: normal movement of the low back, pain
in the low back and leg disappeared, the straight
leg raising test showed more than 70~ and restoration
of the normal work.
Better: normal movement of the low back and
pain in the low back and leg alleviated.
Failure: no improvement of symptoms and signs.
2. Therapeutic result(Table 1)
Table 1. Comparison of therapeutic effect between two groups
( Cases)
Recovery
Group N Recovery Better Failure
rate(% )
Treatment 75 53 22 0 70.7
Control 75 40 33 2 53.3
Experience
As the connecting part of two vertebras, interver-
tebral disc is composed of three parts: anulus
Copyright9 Shanghai Research Institute of Acupuncture and Meridian I 9 43 9
fibrosus, nucleus pulposus and cartilage plate.
With aging process or external force exertion, the
intervertebral disc degenerated, the elasticity of
nucleus pulposus weakened, the intervertebral space
narrowed and thus the nerve root was compressed.
When this compressive irritation reached certain
degrees to produce a series of chemical algogenic
substance, the nerve root and tissues surrounding
the herniated intervertebral disc became swollen,
inflammatory, congestive and adhesive to cause
pain. Consequently the key solution to this disease
is to eliminate the edema, congestion and adhesion
of the nerves. Traction has exact therapeutic effect
on intervertebral disc herniation by widening the
intervertebral space, reducing the pressure inside
the disc, partially or completely returning the hern-
iated part, dislocating the compressed nerve and
then reducing the concentration of algogenic sub-
stance E2~. Modern research indicated that acupuncture
can promote endorphin release from the surround-
ing inflammatory tissues and inhibit the pain-prod-
ucing process through opioid peptide system. And
tuina manipulations can correct the small facet
disorder of the lumbar vertebras, improve the local
microcirculation, reduce the inflammatory exudation
and help to the return the herniated part.
With the aging process and alterations of bone
substance, the senile patients suffering from interv-
ertebral disc herniation always get different degrees
of osteoporosis or bone hyperplasia. According to
the TCM theory, kidney controls bones, liver controls
tendons, and the aging process can result in gradual
kidney-qi deficiency, liver-yin deficiency and malnu-
trition of bones and muscles. Therefore, it's especia-
lly important to tonify liver and kidney for the
senile patients. In addition, the senile patients
always have weak constitution with lower tolerance,
traction, tuina force and needling stimulation are
all supposed to be moderate to avoid side effects
and unnecessary injury.
References
[1] CENG Ze-bo. TCM Traumatology, Shanghai: Shanghai
Science & Technology Press, 1985: 220.
[2] GUO Gen-ping, WANGJue, SHEN Feng-qing. 3-D Multi-
functional Traction and Intervertebral Disc Herniation.
Theory and Practice of China Rehabilitation, 2005, (3):
198-199.
Translator: HAN Chou-ping (~.B. ~)
Received date:August 10, 2005