| Study BackgroundNerve root type cervical spondylosis (nerve root type cervical spondylosis; CSR) is cervical intervertebral disc degeneration, leading to a series of secondary pathology (intervertebral joint dysplasia, cervical dislocation of joints and ligaments, yellow ligament thickening), involving the organizational structure around and a corresponding clinical symptoms, is a common disease in the elderly. In recent years, life style changes, prolonged use of mobile phones and tablet PCs, so that the age of onset of nerve root type cervical spondylosis getting younger and younger In recent years, the number of patients diagnosed with CSR has increased dramatically and the age trend has moved significantly to the younger population.ObjectiveTo observe and compare the therapeutic effect of acupuncture at "Cervial Jiaji points" between "Cervical Three Points" (BL10, EX-HN14, BL11) in the treatment of CSR, including clinical efficacy, analgesic effects, improvemnet of life quality, the inflammatory cytokine levels in plasma for further understanding the mechanism and efficacy of "Cervical Three Points" in order to get more clinical promotion.MethodsThis clinical trial performed from June.2014 to Dec.2014.We selected the 60 diagnosed patients in the SHNANG-HO Hospital (New Taipei City, Taiwan) and Hospital of Guangzhou University of Traditional, according to the inclusion and exclusion criteria of Cervical Spondylotic Radiculopathy. The patients of research group were treated by acupuncture at "Cervical Three Points" and control group were treated by acupuncture at "Cervial Jiaji Points" 。 The Simplified McGill Questionaire was used to measure pain of cervical, shoulder and arm at the beginning and ending of the course, and the Symptoms and Signs Questionaire was used to measure the improvement of the symptoms and signs. An immunological test were carried out before and after the treatment.Two parameters were compared including interleukin-6 (IL-6), the serum levels of human tumor factor (TNF-α),and Hemorheology parameters were also compared. Finally, we investigated the CSR life quality scores by MOS SF-36 Questionnaire to understand difference between two groups. In order to complete statistical tasks, all experimental data processing were using statistical software SPSS 16.0 for windows.Results1. Clinical Efficacy ComparisonAfter treatment, symptoms progress of all 30 patients in group A has improved, calculated excellent improvement rate data is 86.67% and it also calculated in group B is 73.33%. It reveals the truth that the efficacy in group A is better than gouup B by Ridit analysis, (P= 0.0382 <0.05).2. Symptoms and Signs improvement (S&S rate)After treatment, S&S rate in group A calculated by the formula of symptoms and signs improvement is 77.89% and S&S rate calculated in the group B is 61.08%. Through comparison of improvement rate and improvemen index in two group, we can know the symptoms and signs improvement is better in group A.3. Analgesic efficacyAfter two courses of treatment,23 cases cured,5 cases effective,2 cases ineffective, the total efficiency is 93.33% in group A and 11 cases cured, 14 cases effective,5 cases ineffective, the total efficiency is 83.33% in group B. Based on the above information, it told us that analgesic efficacy in group A is statistically significant than B.4. The Simplified McGill Questionaire:Compared two groups situation and points from The Simplified McGill Questionnaire, it got the conclusion that difference of PRI, VAS, PPI points has statistically significant. (P<0.01), indicating that acupuncture "Cervical Three point" got better improvement than group B.5. Total PRI points comparison:Emotional PRI and feelings PRI points added up to be total PRI. After two cycle treatment, there were statistically significant differences(P<0.01) between total PRIs in each cycle and in the end.6. MOS SF-36 Questionaire:Compare the two groups before and after treatment, MOS SF-36 each set of points in eight dimensions were significantly increased, suggesting that the two groups of acupuncture points on the nerve root type cervical spondylosis have a good effect. It is to be found particularly that six dimensions (physiology, physical function, bodily pain, general health, energy, social function) has statistically significant difference between the two groups, (P< 0.05).7. IL-6, TNF-a comparison:After treatment, the TNF-a values and IL-6 values are found lower than the beginnings in both groups can provide powerful evidences that acupuncture therapy have the effect of reducing inflammation. After indepent t-test (P <0.01), it prove that acupuncture "Cervical Three point" has better inflammatory protection effect.8. Hemorheology comparison:After treatment, plasma viscosity (mPas), hematocrit (%), high-shear reduced viscosity of whole blood, whole blood low-shear reduced viscosity, erythrocyte aggregation index were significant differences(P< 0.05). It provides the evidences that "Cervical Three point" has better acupuncture effectiveness in reducing hemorheology values than "Cervical Jiaji points " without any electro-acupuncture instruments.Summarized the statistical results of the above experiment, It provides the evidences that "Cervical Three point" has better acupuncture improvement effectiveness in pain-relief, hemorheology values, IL6, TNF-α levels than "Cervical Jiaji points ". It also make a strong explanation that the "Cervical Three point" has better ability in life quality improving than "Cervical Jiaji points "... |
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