[Dong's extraordinary point needling technique combined with medication for postoperative complications of anal fistula: a randomized controlled trial]

OBJECTIVE

To observe the effect of Dong's extraordinary point needling technique on postoperative complications of anal fistula.

METHODS

A total of 241 patients undergoing anal fistula surgery were randomly divided into an observation group (121 cases, 3 cases dropped off) and a control group (120 cases, 2 cases dropped off). The patients in the control group were treated with intramuscular injection of compound diclofenac sodium injection and oral administration of tamsulosin hydrochloride sustained release capsules. In addition to the treatment in the control group, the patients in the observation group were treated with Daoma needling technique at the "Sanqi points" (Qimen point, Qijiao point, and Qizheng point) combined with Dongqi needling technique at "Sanhuang points" (sub-Tianhuang point, Dihuang point, Renhuang point), with each session lasting 30 min. The treatment in the two groups both started on the first day after surgery, and was given once daily for 14 consecutive days. Visual analog scale (VAS) score was compared between the two groups on postoperative day 1, 7, and 14; bladder residual urine volume, spontaneous voiding volume, and urinary catheterization frequency were assessed after treatment on postoperative day 1; and anorectal dynamic indexes (anal canal resting pressure, rectal resting pressure, maximum squeeze pressure of the anal canal, and minimum rectal sensory threshold) were evaluated before surgery and on postoperative day 4. Clinical efficacy was assessed in both groups one month after surgery.

RESULTS

On postoperative day 7 and 14, the VAS scores of both groups were lower than those on postoperative day 1 (P<0.05), and the VAS scores in the observation group were lower than those in the control group (P<0.05). The bladder residual urine volume and urinary catheterization frequency in the observation group were lower than those in the control group (P<0.05), while the spontaneous voiding volume was higher than that in the control group (P<0.05). On postoperative day 4, the anal canal resting pressure, maximum squeeze pressure of the anal canal, and the minimum rectal sensory threshold were lower than preoperative values (P<0.05), while the rectal resting pressure was higher than preoperative value (P<0.05) in both groups. The anal canal resting pressure, maximum squeeze pressure of the anal canal, and minimum rectal sensory threshold were lower than those in the control group, and the rectal resting pressure was higher than that in the control group (P<0.05). The effective rate was 93.2% (110/118) in the observation group, which was higher than 84.7% (100/118) in the control group (P<0.05).

CONCLUSION

Dong's extraordinary point needling technique could reduce postoperative pain, alleviate urinary retention, and improve defecation in patients undergoing anal fistula surgery.

[Clinical treatment of chronic nonbacterial prostatitis of kidney-yang deficiency type by acupuncture of Sanhuang points]

OBJECTIVE

To observe the clinical effect of acupuncture stimulation of Sanhuang points in the treatment of chronic nonbacterial prostatitis (CNP) of kidney-yang deficiency type.

METHODS

A total of 60 CNP outpatients were equally randomized into medication(control) group and acupuncture plus medication (acupuncture) group. Patients of the control group were ordered to take Tamsulosin (0.2 mg/d) for successive 8 weeks. On the basis of medication treatment, for patients of the acupuncture group, bilateral Sanhuang points including Tianhuang-fu Point (Shenguan), Dihuang Point and Renhuang Point (at the lower leg) were needled with filiform needles which were manipulated for a while till Deqi, followed by retaining the needles for 30 min. The treatment was conducted once daily for successive 8 weeks. The therapeutic effect was evaluated in reference to the "Criteria for Diagnosis and Therapeutic Effect Evaluation of Syndromes/Diseases of Traditional Chinese Medicine". The National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores were used to assess the severity of chronic prostatitis. Routine examination of the leukocyte count in the prostatic fluid was performed before and after the treatment.

RESULTS

Of the two 30 cases of the control and acupuncture groups, 9 and 19 were cured, 14 and 10 experienced improvement, and 7 and 1 failed in the treatment, with the effective rates being 76.67% and 96.67%, respectively. The effective rate of the acupuncture plus medication was significantly higher than that of the medication (P<0.05). After the treatment, the scores of NIH-CPSI and white blood cell counts in the prostatic fluid in both groups were significantly decreased in comparison with their own pre-treatment (P<0.05). The therapeutic effect of acupuncture plus medication was significantly superior to that of the medication alone in reducing the NIH-CPSI symptom score and the number of leukocytes in the prostatic fluid (P<0.05).

CONCLUSION

Acupuncture at Sanhuang points is effective in improving symptoms of CNP patients of kidney-yang deficiency type, and the therapeutic effect of acupuncture plus medication is superior to that of medication alone.