[Clinical randomized controlled trials of treatment of neck-back myofascial pain syndrome by acupuncture of Ashi-points combined with moxibustion of heat-sensitive points].

Objective: To observe the therapeutic effect of acupuncture of Ashi points in combination with moxibustion of heat-sensitive points for neck-back myofascial pain syndrome, so as to find a better combined therapy.

Methods: A total of 62 eligible patients were randomly divided into treatment group (acupuncture of Ashi-points plus moxibustion of heat-sensitive points, n=32) and control group (acupuncture of Ashi-points plus TDP irradiation, n=30) by using single-blind method. Ashi-points were the tenderpoints or subcutaneous induration spots determined by digital pressure in the focus region, and the heat-sensitive points were the acupoints around the subcutaneous induration spots in the neck-back regions determined by patients' feeling (heat from the ignited moxa transmitting toward the deep muscle layer, extending toward the surrounding region of the Ashi-points, etc. and the distal part of the body) during moxibustion. Ashi-points were punctured with filiform needles and stimulated with reducing method by lifting, thrusting and twirling the acupuncture needle repeatedly till "Deqi", followed by retaining the needle for 30 min. Moxibustion was given to the patients for 10-90 min (when the patient began to feel heat penetrating into the deeper muscle layer to the termination of the heat transmission). TDP irradiation was given to the Ashi-points for 30 min in every session of treatment. The treatment was conducted once daily, 5 times a week, two weeks altogether. McGill pain questionnaire containing pain rating index (PRI), visual analogue scale (VAS) and present pain intensity (PPI) and "the criteria for assessing the therapeutic effect of back-myofascitis" recorded in "Standards for Diagnosis and Efficacy Evaluation of Clinical Conditions in Chinese Medicine" (published in 1994 in China) were used to evaluate the analgesic effect.

Results: Before the treatment, no significant differences were found between the treatment and control groups in PRI, VAS and PPI. After the treatment, PRI, VAS and PPI were all significantly lower in the treatment group than in the control group (P < 0.01). Of the 32 and 30 myofascitis patients in the treatment and control groups, 11 (34.4%) and 3 (10.0%) were cured, 20 (62.5%) and 25 (83.3%) experienced improvement in their symptoms, 1 (3.1%) and 2 (6.7%) had no apparent changes. The cure rate of the treatment group was significant bigger than that of the control group (P < 0.05).

Conclusion: Acupuncture combined with moxibustion of Ashi-points can effectively relieve pain reaction in neck-back myofascial pain syndrome patients, which is significantly superior to that of acupuncture plus TDP irradiation therapy.