BACKGROUND: The currently published literatures about Tuina manipulation for lumbar disc herniation include clinical observations, retrospective study and summary of clinical experience, which have shortcomings in the study design, choice of cases and outcome measures. Reviews may enroll randomized and intended references, and has no analysis or evaluation on the quality of involved literatures, leading to the bias and subjective views.
OBJECTIVE: To research the application laws of Tuina manipulation for treating lumbar disc herniation through literature analysis within 10 years.
METHODS: The key words of “lumbar disc herniation, traditional Chinese medicine, Tuina, manipulation, massage, rehabilitation, poking channels, point pressing, palpating pressing, and finger pressing” in Chinese were used to search the literature about Tuina manipulation in treatment of lumbar disc herniation within recent 10 years published in the Wanfang database, Vip database and CNKI database. The top 20 manipulations of Tuina for lumbar disc herniation were and statistical analyzed with hierarchical clustering statistical method.
RESULTS AND CONCLUSION: The hierarchical clustering analysis results showed that, Tuina manipulations for lumbar disc herniation are as follows: (1) manipulations acted on soft tissue, including rolling, holding, pushing and pressing; (2) manipulations acted on acupuncture point, including Urinary Bladder Meridian of Foot-Taiyang acupuncture points (Shengshu, Dachangshu, Guanyuanshu, Zhibian, Chengfu, Weizhong, Chengshan and Kunlun), Gall Bladder Meridian of Foot-Shaoyang acupuncture points (Huantiao and Yanglingquan), Yaoyangguan point in Du Meridian, Zusanli point in Stomach Meridian of Foot-Yangming, and tender points; (3) manipulations acted on human bones and joints, including waist inclined pull method, waist back-stretching method, pelvic traction method and straight-leg raising method. The findings indicate that the potential application laws of Tuina manipulation for treating lumbar disc herniation are given priority to pressing acupuncture points (Urinary Bladder Meridian of Foot-Taiyang acupuncture point, Gall Bladder Meridian of Foot-Shaoyang acupuncture point, Du Meridian, Stomach Meridian of Foot-Yangming acupuncture point and tender points), at the same time companied with manipulations acted on soft tissue (rolling, holding, pushing spinal method), and bones and joints (waist inclined pull method, waist back-stretching method, pelvic traction method and straight-leg raising method).