Twenty2one patients with shoulder pain as well as 24 patients with. neous Electric Nerve Stimulation, TENS), ; (2)

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1 ( 1, ; 2 ),53 27 ( HANS) ( Transcuta2 neous Electric Nerve Stimulation, TENS),, 21 24,, (1) TENS, ; (2), TENS, HANS, ;, ; ; A CONTROLL ED STUDY ON THE TREATMENT OF SHOULD ER PAIN AND HER2 NIATED L UMBER D ISC WITH TRANSCUTANEOUS EL ECTRIC NERVE STIMU2 LATION WAN G Ning2Hua 1, L UO Fei 2, YIN Xiu2Zhen 1, HAN Ji2Sheng 2 1 Department of Physiotherapy, the First Teaching Hospital of Beijing Medical Universi2 ty, Beijing Neuroscience Research Institute, Beijing Medical University, Beijing Abstract Fifty2three patients with shoulder pain as well as 27 patients with herniated lumber disc were t reated wit h t ranscutaneous elect ric nerve stimulation ( TENS). TENS was delivered using Han s Acupoint Nerve Stimulator ( HANS) t hrough t radi2 tional acupoints. Twenty2one patients with shoulder pain as well as 24 patients with herniated lumber disc accepted conventional p hysiot herapy served as t he cont rol. The result shows t hat (1) TENS of acupoint s displays instant as well as long2term anal2 gesic effect in bot h conditions. In t he case of shoulder pain, HANS is significantly more effective t han conventional p hysiot herapy ; ( 2 ) TENS displays a similar efficacy in prompting t he improvement of joint f unction and t he life activities as p hysiot herapy. We conclude that, since treatment with HANS is simple and easy to operate, it could be recommended for more popular use in clinical practice, and that a better therapeutic ef2 fect would be expected if it is used in combination with conventional physiotherapy. Key words Shoulder pain ; Herniated lumber disc ; Transcutaneous electric nerve stim2 ulation ; Pain treatment

2 210 [14 ] [15 ], (2) (L I10) ( GB34),, ( L I14 ) ( GB21 ) (UB10 ) ( L I15 ) ( SI9 ) ( t ranscutaneous elect ric nerve stimula2 (SJ 14) ( ) ( P6) [7,8 tion, TENS) ] (L I11 ) ( L I4 ) ( ST38 ) ( Han s Acupoint Nerve Stimulator, HANS) (DU3) (UB54) ( UB57), TENS, ( DU4) ( ST36), (UB56) 1.,, 12 ) (,) ; [14 ] ( ) ( ) ( ) 3, 30 [15 ] 60, HANS 2. (1) HANS : (Visual Analogue Scale, VAS) TENS HANS (L Y2 357 ), 10cm,, (2/ 15Hz 2/, 100Hz, 2Hz 15Hz 2Hz 100Hz, 3,6 ) ; 2Hz 0. 6 ( GB40 ) ; (3) ( ) ( ) ( 3. (1),15Hz 0. 4,100Hz 0. 2 (2) ( ),, 10 ( 180, 20mA 3, 30 50, 180 ),, 10 (, 90, 5 ) ; (10,

3 211 5, 0, 10, TENS 0 ), 4. ( 90, 25, 40 ), 10 ( ) ; t ( ), (500 10,45 5, 0 ) 1. 74, 30,, HANS, Table 1 General information of patients with shoulder pain (/ ) n (M/ F) age (yr) () history (month) treatments HANS 53 (20/ 33) ( PT) 21 (10/ 11) (total) 74 (30/ 44) :, PT : Physiotherapy Data are expressed as mean S x 51, 26, ,27 HANS,24 ( P < 0. 05) 2 HANS 2 Table 1 General information of patients with herniated lumber disc. (/ ) n (M/ F) age (yr) () history (month) treatments HANS 27 (14/ 13) ( PT) 24 (12/ 12) (total) 51 (26/ 25) P < P < compared with physiotherapy, ( , P < 0. ( ) 05) ( , P < 0. 01), ( ) 2. HANS

4 212 3 HANS ( P < 0. 05), ( (35 %, P < 0. 01),HANS ) VAS, HANS, HANS 25 %, VAS 17 % ( P < 0. 01), 34 %, ( P < 0. HANS 01), HANS ;,HANS ; VAS 30 % ( P < 0. 01),, VAS, 11 %, 34 %, ; ( P < 0. 05),HANS 3 HANS (VAS ) Table 3 Instant and long2term analgesia of HANS on shoulder and low back pain ( VAS score) n shoulder pain instant long2term n low back pain instant long2term HANS ( PT) instant : immediately the first TENS session ; long2term : scores the last TENS session. 3 P < P < compared with treatment 3. HANS 6 4 ( P < 0. 05) ; HANS HANS, ( P < 0. 01), ( P < 0.,HANS 01) 5 HANS, ( P < 0. 01) ; ( P < 0. 05) ( P < ),HANS ( P < 0. 05), HANS 4.,, ( P < 0. 05),, ( P < 0. 01)

5 213 n 4 Table 4 Effect of treatments on shoulder mobility score (flexion) (extension) (abduction) (total) HANS (PT) Before : the first TENS session ; : the last TENS session. 3 P < 0. 05, 3 3 P < P < 0. 05, 3 3 P < compared with scores treatment n 5 Table 5 Effect of treatments on daily life activity of patients with shoulder pain (bathing) (W. C. ) (dressing) (combing) (total) HANS (PT) P < 0. 05, 3 3 P < P < 0. 05, 3 3 P < compared with scores treatment n (flexion) 6 Table 6 Effect of treatments on lumber mobility score (extension) (left flexion) (right flexion) (total) HANS (PT) P < P < compared with treatment 7 Table 7 Effect of treatments on daily life activity of patients with herniated lumber disc n (bathing) (W. C. ) (socking) (walking) (total) HANS (PT) P 3 < P < compared with scores treatment, [12 ],, :,,,

6 214, ; Croft,,,, [4 ] Bao [1 ], Berrazueta,,, [2 ] ; Gado Emery ; [5 ],, TENS,, [10 ], TENS TENS,, TENS,, [7 ] ;,,, TENS ( ),, Marchand [6 ] ; [7 ] ;, [18 ],,, : :, As2 TENS sendelft (1995) Table 8 Global therapeutic effect of the two treatments (VAS) Instant analgesia (VAS) Long2term analgesia Joint mobility Lift activities (shoulder) (lumbar) (shoulder) (lumbar) (shoulder) (lumbar) (shoulder) (lumbar) HANS ( PT) 17 % % 25 % % % % % % % 57 % % 30 % % 3 62 % % 3 3 P < P < compared with scores treatment

7 215 8 Successful treatment of shoulder pain syn2, drome due to supraspinat us tendinitis wit h : (1) HANS, t ransdermal nit roglycerin. A double blind ; study. Pain, 1996, ,3 Cho ZH, Chung SC, Jones J P, et al. New findings of t he correlation between acu2 TENS point s and corresponding brain cortices us2, (2) ing f unctional MR I. USA, 1998, , 4 Croft P, Pope D, Silman A. The clinical, HANS course of shoulder pain : prospective cohort HANS st udy in primary care.,, Journal, 1996, HANS 5 Gado K, Emery P. Intra2articular,guanet hidine injection for resistant (3) shoulder pain : A preliminary double blind st udy of a novel approach. Annals (50 % of the Rheumatic Diseases, 1996, 55 4 ),HANS , 6 Han J S. Acupuncture and stimulation pro2 duced analgesia. In : A Herz Ed, Opioid II, ( Handbook of Experimental p harmacolo2, gy, Vol 104/ II, Chapter 35), Springer, [11 ], 1993, p [3 ], 7 Marchand S, Charest J, Li J X, et al. Is,, TENS purely a placebo effect? 2 A con2 t rolled st udy on chronic low back pain., Pain, 1993, HANS 8 Morgan B, Jones AR, Mulcahy KA, et,al. Transcutaneous elect ric nerve stimula2 tion ( TENS) during distension shoulder 1 Bao QB, Mccullen GM, Higham PA, et al. The artificial disc : Theory, design and metarials. Biomaterials, 1996, Berrazueta J R, Losada A, Poveda J, et al. Proc Natl Acad Sci British Medical art hrograp hy : A cont rolled t rial. Pain, 1996, Snoek W, Weber H, Jorgenson B. Double blind evaluation of ext radural met hyl pred2 nisolone for herniated lumber discs. Acta Orthop Scand, 1977, Spaccarelli KC. Lumbar and caudal epidural corticosteroid injections. Mayo

8 216 Clinic Proceedings, 1996, Takeshige C, Luo CP, Hishida F, et al. Differentiation of acupunct ure and nonacupunct ure point s by difference of associated opioids in t he spinal cord in production of analgesia by acupunct ure and nonacupunct ure point stimulation, and relations between sodium and t hose opioids. Acupunct Elect rot her Res, 1990, Vincent CA, Richardson PH. The evalu2 ation of t herapeutic acupunct ure : con2 cepts and methods. Pain, 1986, ,,,.., 1991, :,,, 1994, pp :,,, 1994, pp (, ) 1990, 96, : 96, 42,54 ; 5172 ; 8 5 ; ; (1) : 30g 10g 30g 30g 7. 5g 10g 2ml,, 75 % 100ml, 7 (2) :, 4cm, 4cm, 5ml,,, 20 O 2 (3) : : ; :,, ; ; 74 (77. 8 %) 14 ( %) 8 (0. 83 %) 96, :,, SPE,

Effects of Acupuncture on Chronic Lower Back Pain. Audience: Upper Division IPHY Majors

1 Effects of Acupuncture on Chronic Lower Back Pain Audience: Upper Division IPHY Majors Introduction: Lower back pain is the leading cause of limited physical activity and the second most frequent reason