OBJECTIVETo evaluate therapeutic effect of the needle-knife closed solution combined with minor adjusting of spine for treatment of neck-shoulder syndrome.

METHODSFrom April 2010 to August 2011,120 patients with neck-shoulder syndrome were treated with the needle-knife closed solution combined with minor adjusting of spine, and included 45 males and 75 females and aged from 40 to 68 years old. The disease course was from 3 days to 10 years. After the operation, all patients taken the medicine of activating blood circulation herbs. At the 3rd, 7th, 10th day after operation, spinal rotation massage was performed on these patients. After the healing of the needle points, traditional Chinese medicine herb fumigation was applied on the needle points, and the patients were directed to do the cervical spine exercise. Therapeutic effect of the patients was evaluated by the neck disability index (NDI).

RESULTSAll patients were followed up after 3 weeks' treatment. The pain of neck-shoulder was relieved, and the range of motion was improved,the NDI score lowered from 49.30 +/- 1.35 before treatment to 10.15 +/- 1.18 at 3 weeks after treatment (t = 2.116, P < 0.05).

CONCLUSIONThe needle-knife closed solution combined with minor adjusting of spine for the treatment of neck-shoulder syndrome can relieve the pain in the neck-shoulder and improved the motion of the neck. The key for the effect is accurate location before operation, sufficient adhesion solution during the operation and spinal minor adjusting after operation.

Adult ; Aged ; Female ; Humans ; Male ; Manipulation, Spinal ; methods ; Middle Aged ; Myofascial Pain Syndromes ; therapy ; Neck Pain ; therapy ; Shoulder Pain ; therapy

ObjectiveTo explore the etiology and pathogenesis of Guizhitang syndrome， clarify the related suspicious cases debated by doctors in the past dynasties， and provide references for the clinical application of Guizhitang. MethodUnder the guidance of the "transformation in accord with constitution" theory， the etiology and pathogenesis of Guizhitang syndrome were analyzed by comparing the relevant articles in the classics such as Treatise on Cold Damage （Shanghanlun） and Synopsis of the Golden Chamber （Jingui Yaolue）. ResultGuizhitang syndrome not only refers to the greater yang wind-invasion syndrome. Instead， it can be divided into two categories， i.e.， exogenous Guizhitang syndrome and miscellaneous Guizhitang syndrome. The basic etiology of exogenous Guizhitang syndrome is internal blood deficiency or yin deficiency after severe diarrhea， which is the physical basis， namely the internal cause， while the wind is the external cause that results in cold. The basic etiology of miscellaneous Guizhitang syndrome is the deficiency of blood and body fluid without the external cause. The pathogenesis of Guizhitang syndrome is neither weak nutrient Qi and defensive qi nor strong nutrient Qi but weak defensive Qi. It attributes to weak nutrient qi and strong defensive qi or disorder of defensive Qi. The essence of the pathogenesis of Guizhitang syndrome is not ″exterior deficiency″ but ″deficiency of nutrient Qi″. ″Floating Yang and weak Yin″ does not refer to the pathogenesis， but the pulse. Yang refers to the Cun pulse and Yin refers to the Chi pulse. ConclusionThe etiology and pathogenesis of Guizhitang syndrome are controversial among ancient and modern doctors and textbooks. Many physicians annotate this problem but few pay attention to the constitution basis. According to the ″transformation in accord with constitution″ theory， the constitution is the internal basis for the formation of diseases and syndromes. The formation of Guizhitang syndrome is underpinned by the inherent constitution. ″Transformation in accord with constitution″ theory is helpful to understand the formation mechanism of Guizhitang syndrome. A new understanding of the etiology and pathogenesis of Guizhitang syndrome based on the ″transformation in accord with constitution″ theory is helpful to reveal the use principle of Guizhitang by ZHANG Zhong-jing. The exploration of the formation mechanism of various syndromes of six-meridian diseases and miscellaneous diseases， as well as the original idea of ZHANG Zhong-jing's prescriptions from the ″transformation in accord with constitution″ theory can provide a new idea for the understanding of ZHANG Zhong-jing's theory.

OBJECTIVETo investigate the clinical efficacy of acupotomy stress position percutaneous dynamic release for severe shoulder periarthritis.

METHODSFrom April 2012 to August 2016, 160 patients with severe shoulder periarthritis were randomly divided into treatment group and control group. Among them, 80 patients in treatment group were treated with acupotomy stress position percutaneous dynamic release including 32 males and 48 females with an average of(52.47±9.04)years old ranging from 40 to 74 years old;the courses of disease was(20.72±9.55)months on average. The other 80 patients in control group were treated with simple joint loosening according to Maitland technique in grade III-IV therapy, once a day, 15 to 20 min each time, and 10 d for 1 course, for a total of 2 courses, including 33 males and 47 females with an average of (53.19±10.18) years old ranging from 42 to 75 years old; the average course of disease was (21.98 ±8.99) months. After operation, the shoulder muscles training and shoulder joint activity training were routinely conducted, the treatment lasted for 3 weeks. The visual analogue scale(VAS) and Constant-Murley shoulder function score were observed and compared between the two groups before treatment and 3 weeks, 3, 6 months after treatment.

RESULTSThe VAS scores of the treatment group at 3 weeks, 3 and 6 months after treatment were all lower than those of the control group(<0.05). The shoulder joint function Constant-Murley scores of the treatment group at 3 weeks, 3 and 6 months after treatment were higher than those of the control group (<0.05); the result was excellent in 59 cases, good in 18 cases, fair in 3 cases in the treatment group; excellent in 15 cases, good in 31 cases, fair in 23 cases, poor in 11 cases in the control group, and the difference between the two groups was statistically significant(<0.01).

CONCLUSIONSTreatment of severe shoulder periarthritis with acupotomy stress position percutaneous dynamic release can obviously improve the shoulder joint function and pain, according to the different parts of the shoulder joint pain and function limitation, the corresponding shoulder stress and body position should be designed and maintained during the treatment process, and the angle of stress position gradually increased by loosening the adhesion, which is the key to ensure the curative effect.