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Wu CY, Chou LW, Huang SW, Liao WL, Chang SM, Lee HC, Chiu CD, Tang CH, Hsieh CL. Effects of Fu's Subcutaneous Needling on Postoperative Pain in Patients Receiving Surgery for Degenerative Lumbar Spinal Disorders: A Single-Blind, Randomized Controlled Trial. J Pain Res 2024; 17:2325-2339. [PMID: 38974828 PMCID: PMC11227350 DOI: 10.2147/jpr.s465417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 06/25/2024] [Indexed: 07/09/2024] Open
Abstract
Background Fu's subcutaneous needling (FSN) is a novel acupuncture technique for pain treatment. This study investigated the effects of postsurgical FSN on postoperative pain in patients receiving surgery for degenerative spinal disorders. Methods This single-center, single-blind, randomized-controlled study involved patients undergoing surgery for degenerative spinal disorders. Participants were randomized into either an FSN group or a control group that received sham FSN. The primary outcomes were scores on the Brief Pain Inventory Taiwan version (BPI-T) and Oswestry Disability Index before and at 1, 24, and 48 hours after surgery. Secondary outcomes were muscle hardness, pethidine use, and inflammatory biomarker presence. Results Initially, 51 patients met the inclusion criteria and were allocated (26 in the FSN group and 25 in the control group). Two patients were lost to follow-up, and finally, 49 patients (25 in the FSN group and 24 in the control group) who completed the study were analyzed. The FSN group had significantly lower pain intensity measured on the BPI-T compared with the control group at 1, 24, 48, and 72 hours after surgical treatment (all p < 0.001). Additionally, pain interference as measured on the BPI-T was lower in the FSN group than in the control group 1 hour (p = 0.001), 24 hours (p = 0.018), 48 hours (p = 0.001), and 72 hours (p = 0.017) after surgical treatment. Finally, the FSN group exhibited less muscle hardness in the latissimus dorsi and gluteus maximus 24, 48, and 72 hours (all p < 0.05) after surgery compared with the control group; patients in the FSN group also exhibited less muscle hardness in the L3 paraspinal muscle 48 hours (p = 0.001) and 72 hours (p < 0.001) after surgery compared with the control group. There were no significant differences in serum CRP, IL-1β, IL-2, IL-6, and TNF-α levels between the FSN and control groups at 24 hours, 72 hours, and 1-month post-surgery (all p > 0.05). Conclusion FSN treatment can reduce postoperative pain in patients receiving surgery for degenerative spinal disorders. However, larger sample sizes and multicenter clinical trials are required to verify these findings.
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Affiliation(s)
- Chih-Ying Wu
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
- Department of Neurosurgery, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
- Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan
| | - Li-Wei Chou
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan
- Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung, Taiwan
| | - Shih-Wei Huang
- Department of Traditional Chinese Medicine, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
| | - Wen-Ling Liao
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
- Center for Personalized Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Shiaw-Meng Chang
- Department of Industrial Engineering and Engineering Management, National Tsing Hua University, Hsinchu, Taiwan
| | - Han-Chung Lee
- Neuroscience center, Everan Hospital, Taichung, Taiwan
| | - Cheng-Di Chiu
- Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan
- Spine Center, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Hsin Tang
- Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan
- Department of Pharmacology, School of Medicine, China Medical University, Taichung, Taiwan
- Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, College of Health Science, Asia University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Ching-Liang Hsieh
- Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
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Li H, Yang CC, Bai T, Sun J, Fu Z, Chou LW. Fu's subcutaneous needling as an adjunctive therapy for diaphragmatic dysfunction in a critically ill patient with severe neurologic disability: A case report. Medicine (Baltimore) 2023; 102:e35550. [PMID: 37933049 PMCID: PMC10627591 DOI: 10.1097/md.0000000000035550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/11/2023] [Indexed: 11/08/2023] Open
Abstract
RATIONALE Diaphragmatic dysfunction is prevalent among intensive care unit patients. The use of Fu's subcutaneous needling (FSN) for respiratory problems is a new issue and few study has been conducted so far. PATIENT CONCERNS Despite conventional treatments, the patient continued using noninvasive ventilation after discharge from the intensive care unit due to diaphragmatic dysfunction. DIAGNOSIS Diaphragmatic dysfunction. INTERVENTIONS After the myofascial trigger points were confirmed in the neck, chest, and abdomen area, FSN therapy was performed using disposable FSN needles. FSN needles were penetrated into the subcutaneous layer. OUTCOMES The patient dyspnea and tachypnea improved, and noninvasive ventilation time dropped significantly. The patient was successfully weaned from the ventilator after 3 sessions of FSN therapy, and there was an increase in diaphragmatic excursion and tidal fraction of the diaphragm via the ultrasound imaging. We found no evidence of relapse 12 months after treatment. LESSONS FSN therapy has potential as an alternative strategy for patients with diaphragmatic dysfunction and severe neurologic disabilities who do not respond well to conventional therapies, but further research is still required to establish the effects of FSN on diaphragmatic function.
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Affiliation(s)
- Hu Li
- Shandong Provincial Third Hospital, Shandong University, Jinan, China
- Shandong University of Traditional Chinese Medicine, Jinan, China, Clinical Medical College of Acupuncture and Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Cong Cong Yang
- Shandong Provincial Third Hospital, Shandong University, Jinan, China
| | - Tianyu Bai
- Shandong Provincial Third Hospital, Shandong University, Jinan, China
| | - Jian Sun
- Shandong University of Traditional Chinese Medicine, Jinan, China, Clinical Medical College of Acupuncture and Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhonghua Fu
- Shandong University of Traditional Chinese Medicine, Jinan, China, Clinical Medical College of Acupuncture and Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- Institute of Fu’s Subcutaneous Needling, Beijing University of Chinese Medicine, Beijing, China
| | - Li-Wei Chou
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan
- Department of physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung, Taiwan
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Rapid Improvement in Neck Disability, Mobility, and Sleep Quality with Chronic Neck Pain Treated by Fu’s Subcutaneous Needling: A Randomized Control Study. Pain Res Manag 2022; 2022:7592873. [PMID: 36247101 PMCID: PMC9553660 DOI: 10.1155/2022/7592873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 09/16/2022] [Indexed: 11/28/2022]
Abstract
Background Chronic neck pain is a common musculoskeletal disorder caused by overuse of neck and upper back muscles or poor posture, and it is commonly combined with a limited range of motion in the neck and shoulders. Most cases will recover within a few days; however, the symptoms often recur easily. Fu's subcutaneous needling (FSN) is a new therapeutic approach used to treat patients with chronic neck pain. However, there is no solid evidence to support the effectiveness of FSN on chronic neck pain and disability. Methods Participants (n = 60) with chronic neck pain for more than 2 months with pain intensity scored by visual analog scale (VAS) more than five were enrolled in this trial. Participants were equally randomized into the FSN or transcutaneous electrical nerve stimulation (TENS) group who received interventions once a day on day 1, day 2, and day 4. They were assessed by outcome measurements during pre- and post-treatment and followed up for 15 days. Results The VAS was immediately reduced in the FSN and TENS groups and sustained for 15 days of follow-up (all P < 0.001). The immediate effects were also observed as the pressure pain threshold increased in the FSN group on day 2 (P=0.006) and day 4 (P=0.023) after treatment, and tissue hardness decreased by FSN on day 1 and day 2 after treatment (both P < 0.001). FSN and TENS treatment improved neck disability and mobility; moreover, FSN promoted participants to receive better sleep quality, as determined by PSQI assessment (P=0.030). TENS had no benefit on sleep quality. Conclusion FSN was able to relieve pain and relax muscle tightness. Notably, FSN significantly improved neck disability and mobility and enhanced sleep quality. These findings demonstrated that FSN could be an effective alternative treatment option for patients with chronic neck pain. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT03605576, registered on July 30, 2018.
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Li Y, Gao X, Huang H, Zhou X, Zang Y, Chou LW. Effects of Fu's Subcutaneous Needling on Mitochondrial Structure and Function in Rats with Sciatica. Mol Pain 2022; 18:17448069221108717. [PMID: 35670088 PMCID: PMC9210095 DOI: 10.1177/17448069221108717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
To observe the effects of Fu’s subcutaneous needling (FSN) and acupuncture treatment on the mitochondrial structure and function of the skeletal muscle tissue of rats with sciatica. Forty Sprague–Dawley rats were divided into control, model, acupuncture, and FSN groups (10 each) according to a random number table. The control group was left untreated. Rats in the FSN group were treated with FSN once every 2 days for three times, respectively (days 1, 3, 5, and 7), to cooperate with reperfusion approach. The acupuncture group was treated at the same timeline as that of the FSN group. Changes in the mechanical pain threshold, mitochondrial ultrastructure, mitochondrial citrate synthase (CS) activities, mitochondrial respiratory chain complex II, and mitochondrial COX- I protein expression in the skeletal muscle of rats treated with different treatments were compared with those of the model group. The pain thresholds of the rats were remarkably higher after FSN treatment and acupuncture, and the pain threshold of the FSN group was higher than that of the acupuncture group. Compared with the control group, the mitochondria of the model group had a damaged ultrastructure, were arranged in a disorganized manner, accumulated under the basement membrane, and appeared vacuolated with autophagosomes. The state of mitochondria in the FSN group was close to that in the control group and was remarkably better than that in the acupuncture group. The activities of mitochondrial CS and respiratory chain complex II in the skeletal muscle of the treated rats decreased compared with the control group (p < 0.05), and their levels were better in the FSN group than in the acupuncture group (p < 0.05). FSN treatment for 1 week considerably improved the pain thresholds and improved the skeletal muscle mitochondrial ultrastructure and mitochondrial function in rats with sciatica.
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Affiliation(s)
| | | | - Hailiang Huang
- 74738Shandong University of Traditional Chinese Medicine
| | - Xiyan Zhou
- 155177Qingdao Hospital of Traditional Chinese Medicine
| | - Yunhua Zang
- 155177Qingdao Hospital of Traditional Chinese Medicine
| | - Li-Wei Chou
- Department of Physical Medicine and Rehabilitation38020China Medical University Hospital
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