1.The effects on lumbar disc herniation of supplementing rehabilitation training with repeated transcranial magnetic stimulation
Ming WANG ; Ling YANG ; Xin HUANG ; Shupei LIU ; Shun ZHENG
Chinese Journal of Physical Medicine and Rehabilitation 2023;45(3):243-247
Objective:To observe any effect of supplementing conventional rehabilitation training with repeated transcranial magnetic stimulation (rTMS) in the treatment of lumbar disc herniation (LDH).Methods:Seventy-two LDH patients were randomly divided into an rTMS group ( n=24), a training group ( n=24), and a combined group ( n=24). The rTMS group received 2Hz rTMS at an intensity of 80% resting motor threshold with a total of 1000 pulses, the training group was given Mackenzie therapy and lumbar core muscle stability training, while the combined group was provided with both. Each group was treated once a day, 6 times a week for 8 weeks. The participants rated their pain using a visual analog scale (VAS), and the Oswestry dysfunction index (ODI) was also used to evaluate the degree of pain and dysfunction in all three groups before and right after the treatment, as well as 8 weeks later. After the treatment, its therapeutic effect was evaluated using the improved Macnab standard. Each patient was followed up for 12 months and any recurrence was recorded. Results:Before treatment there was no significant difference in average VAS ratings or ODI scores among the three groups. Afterward, pain and dysfunction were relieved significantly in all three groups. Compared with the rTMS group, the average VAS rating in the training group was significantly higher and the average ODI score was significantly lower after the treatment and during the follow-up. Moreover, the average VAS rating and ODI score of the combined group were significantly lower than those in the other two groups after the treatment and during follow-up. The total effectiveness rate in the rTMS group was assessed as 62.5% compared with 95.8% in the training group and 100% in the combined group-a significant difference for the rTMS group. Follow-up showed that the recurrence rates of the rTMS group, training group and combined group were 37.5%, 25% and 8.3%, respectively-a significant difference in the case of the combined group.Conclusion:rTMS combined with rehabilitation training can relieve pain, improve lumbar function and reduce the recurrence of LDH.
2.Clinical Efficacy of Qiangxin Decoction Combined with Baduanjin in Treatment of Elderly Patients with Chronic Heart Failure and Weakness
Yan PANG ; Hao LIN ; Jianqi LU ; Shupei HUANG ; Zhilin PENG ; Meiling TANG ; Puwei HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(4):104-109
ObjectiveChronic heart failure (CHF) is the terminal stage of cardiovascular disease. The adverse cardiovascular events of CHF patients with weakness have increased significantly. Traditional Chinese medicine (TCM) has a good effect on CHF. However,there are few reports on the clinical observation of the treatment of CHF with weakness in elderly patients by TCM combined with conventional health-preserving exercises. This study aimed to explore the clinical efficacy of Qiangxin decoction combined with Baduanjin in the treatment of elderly patients with CHF and weakness. MethodSixty CHF patients with Qi deficiency,blood stasis,and water retention syndrome admitted to the Cardiovascular Department of the First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2020 to December 2021 were enrolled. The patients in the control group were treated with conventional western medicine according to the guidelines,while those in the treatment group received additional Qiangxin decoction and Baduanjin exercise based on the therapeutic protocol of the control group. The levels of serum N-terminal B-type brain natriuretic peptide precursor (NT-proBNP),creatine kinase (CK),lactate dehydrogenase (LDH),free fatty acid (FFA),left ventricular ejection fraction (LVEF),left ventricular end-diastolic dimension (LEVDD),6-minute walk distance (6MWD),Minnesota Living with Heart Failure Questionnaire (MLHFQ), and Tilburg Frailty Indicator (TFI) scores of the two groups were observed before and one month after treatment. At the same time,the re-admission within three months was compared between the two groups. ResultThere was no significant difference between the two groups in terms of the general data and the therapeutic indexes before treatment. After treatment,the NT-proBNP,CK,LDH,FFA,LVEDD,MLHFQ, and TFI scores of the two groups were lower than those before treatment(P<0.05,P<0.01), and the LVEF and 6MWD were higher(P<0.05,P<0.01). The efficacy of the treatment group was superior to that of the control group after treatment (P<0.05,P<0.01). The re-admission rate within three months in the treatment group was 7.1% (2/28), lower than 30.8% (8/26) in the control group (χ2=4.897,P<0.05). ConclusionQiangxin decoction combined with Baduanjin is helpful to improve the body energy metabolism,heart function,quality of life,and weakness level of elderly CHF patients with weakness, and reduce the rate of re-admission.