| Part one:Theory ResearchThis part is mainly to summarize the content of the neck type of cervical spondylosis related literature reports.Under the guidance of the basic theory of TCM, the related literatures about neck type of cervical spondylosis have been reviewed, mainly including the anatomy of the cervical spine, the etiological theory of neck type of cervical spondylosis, the experimental animal model and acupotomy intervention research of this disease, as well as the induction and summary about TCM treatment on cervical spondylosis of poliomyelitis type. The purpose is to comprehensively master the knowledge about neck type of cervical spondylosis researches on macroscopic and microscopic levels, in order to provide theoretical and technical support for the acupotomy therapy on the disease.Part two:Animal ExperimentExperimentl:Objective:To design a new method for preparing noninvasive animal model of neck type of cervical spondylosis and test its practicability. That would provide animal models and experimental carrier for the research on prevention and treatment of cervical syndrome. Methods:24 male white rabbits were divided into model group and control group randomly, each group had 12 rabbits. Model group in modified rabbit boxes, which were removed neck hair and applied with special ice packs, people should adjust the tightness between the ice pack and the buckle on box in order to make the neck of the rabbit into 45 degree flexion and aim the outlet at the rabbit neck. Wind power level is 5. Making the model needed 2 hours every time and 2 times a day, it would use 4 hours one day in total. Control group in rabbit boxes were allowed to move freely. X-ray was used to observe imaging changes, meanwhile, light microscope was applied to observe histopathological changes in 28 days. TNF-a in degeneration of cervical intervertebral discs would be detected. Results:In model group, the cervical physiological curvature was straightened and intervertebral disc space became narrow, there were small bone hyperplasia on the edges of vertebrae and dehydration shrinkage of nucleus pulposus. Fiber ring could produce radial crack, as well as collagen fibers were in degeneration, disorder and even rupture. There was marked increase in the concentration of TNF-a which was in degeneration of cervical intervertebral discs(P< 0.01). There were no significant histological changes in control group. Conclusion:The present method offered an ideal animal model to further study the prevention and treatment of this disease.Experiment 2:Objective:To observe the histological variations of the degenerated cervical intervertebral discs impacted by acupotomy, at the same time to observe this solution how to adjust the level of TNF-αwhich existed in the degenerated nucleus pulposus and played the leading role of inflammation factors, and the related proteins expression changes in this signaling pathways:TNF-α-TNFR1-Caspase8. Which would provide morphological data for the fundamental mechanism research on acupotomy medical therapeutics. Methods:40 healthy male New Zealand rabbits at 6±0.5 months age were chosen for modeling and then we evaluated the success of random grouping:control group, acupotomy-intervened group A (1 week after intervention), acupotomy-intervened group B (4 weeks after intervention). All of them were treated simultaneously. Rabbits in Group A were put to death in 7 days after intervention as well as group B put to death in 28 days. Corresponding indexes would be measured. Results:After the intervention, it was significant that acupotomy intervention would reduce the speed of degeneration of the cervical intervertebral discs and control the expression of related proteins (TNFR1, Caspase8) which could promote the fibrous cartilage cell apoptosis. The level of TNF-α decreased significantly after treatment (P<0.01) which produced by degenerated cervical intervertebral discs. Therefore, it indicated that the treatment could not only relieve pain, but also restrain the trend of intervertebral disc cells apoptosis, alleviating the symptoms related. Conclusion:Acupotomy had a good inhibitory action on TNF-α and reduced the malignant of spinal nerve stimulation. It inhibited the related factors expression in promoting apoptosis signaling pathway of TNF- α -TNFR1 -Caspase8. It could significantly reduce the speed of degeneration of cervical intervertebral disc. This might be an important mechanism of the prevention and treatment to neck type of cervical spondylosis by acupotomy.Part Three:Clinical ResearchObjective:To observe and evaluate the clinical efficacy through the 107 cases of neck type of cervical spondylosis patients with acupotomy treatment, in order to explore the mechanism of acupotomy for the treatment of the disease. Methods:Acupotomy was used to loosen the tender points and nodules on the neck which could be fond by touching the muscles on both sides of the spine near the joints in the distance of 1.5～2cm. People could be treated once every 7 days. The general treatment had 1～2 courses,2 times a course. Finally, we could evaluate the efficacy. Results:The result is:Cured:66 patients; Improved:29 patients; Invalid:0, the cured rate was 69.5%, totally effective rate was 100%. Through selecting 107 cases to be treated by acupotomy with 1-2 courses, except the lost cases of 12 patients, the rest of 95 cases had completely finished the treatment methods and follow-up investigation. Conclusion:Acupotomy therapy did not only have quickly effect, but also held sustained curative effect, the recurrence rate was relatively low. It could relieve high stress of fascia and muscle belly, muscle and ligament. Thus sedimentation was taken away by circulating metabolites and a new metabolic environment would be established. This therapy could promote repair and regeneration of the cut part, reduce the release of inflammatory factors and malignant of spinal nerve stimulation, make the degenerate speed of cervical intervertebral disc slowly. Therefore, the dynamic and static force system would gradually restore balance. This study provided clinical experience about acupotomy therapy on neck type of cervical spondylosis.SummaryThis subject had carried on the research and exploration from the theory research, animal experiment and clinical application of acupotomy therapy on the neck type of cervical spondylosis, which had not only elaborated the intervention could promote cervical dynamic and static force system biomechanical rebalancing from the macroscopic aspect, but also had observed that the intervention had good effect at reducing the concentration of related factors from the microscopic aspect. In general, the expression of the related factors included the initiating inflammatory factor TNF alpha and its apoptosis signaling pathways:TNF alpha-TNFR1-Caspase8. So we could prove the validity of the acupotomy on this disease. |
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