Objective

2

To compare the clinical efficacy of acupuncture with

yin

-

yang

regulation method versus local acupuncture in treating chronic low back pain (CLBP) in elderly patients with lumbar disc herniation (LDH)

and to evaluate the changes in the multifidus muscle before and after treatment using musculoskeletal ultrasound.

Methods

2

A total of 128 elderly patients with CLBP due to LDH were randomly assigned to an observation group (64 cases

2 cases dropped out) and a control group (64 cases

2 cases dropped out). The control group received local acupuncture at bilateral L

3

-L

5

Jiaji points (EX-B2)

Shenshu (BL23)

Dachangshu (BL25)

Weizhong (BL40)

Yaoyangguan (GV3)

and

ashi

points. The observation group received acupuncture with

yin

-

yang

regulation method

which included an abd

ominal protocol with Baihui (GV20)

Zhongwan (CV12)

Qihai (CV6)

Guanyuan (CV4)

bilateral Tianshu (ST25)

and Dahe (KI12)

etc.

and a lumbar protocol with Baihui (GV20)

Dazhui (GV14)

Jizhong (GV6)

Yaoyangguan (GV3)

and

ashi

points

etc.

alternated bilaterally. Both groups were treated once every other day

three times per week

for a total of 12 sessions. The visual analogue scale (VAS) score

Oswestry disability index (ODI) score

and the indexs of musculoskeletal ultrasound multifidus muscle (resting and functional thickness and Young's modulus values) were observed before and after treatment

and the clinical efficacy was evaluated in the two groups.

Results

2

After 1 and 4 weeks of treatment

both groups showed lower VAS scores compared to baseline (

P

<

0.05)

the VAS scores in the observation group were lower than those in the control group (

P

<

0.001). ODI scores in both groups were decreased after 1 and 4 weeks of treatment compared to baseline (

P

<

0.05)

with a further reduction at 4 weeks of treatment compared to 1 week of treatment (

P

<

0.05); the observation group showed lower ODI score than the control group after 1 week of treatment (

P

<

0.001). After treatment

both groups demonstrated increased resting and functional multifidus muscle thickness bilaterally compared to baseline (

P

<

0.01)

with an increased right-side thickness change rate (

P

<

0.01)

though no significant difference was observed between groups (

P

>

0.05). Compared to baseline

after treatment

the observation group exhibited decreased Young's modulus values for bilateral resting and functional multifidus muscle (

P

<

0.01)

while the control group showed reductions only in bilateral resting and right-side functional Young's modulus values (

P

<

0.01). After treatment

the bilateral functional Young's mo

dulus values in the observation group were lower than that in the control group (

P

<

0.05)

and the bilateral resting and functional changes in Young's modulus values were greater in the observation group than those in the control group (

P

<

0.01). The overall effective rate was 93.5% (58/62) in the observation group

which was higher than 79.0% (49/62) in the control group (

P

<

0.05).

Conclusion

2

Acupuncture with

yin

-

yang

regulation method effectively alleviates pain

improves functional disability

increases multifidus muscle thickness

and reduces Young's modulus values in elderly patients with CLBP due to LDH

which has superior therapeutic effect compared to local acupuncture.