Clinical Research On Treatment Of Acupuncture In Treating Cervical Spondylosis Of Vertebral Artery Type Based On Orthogonal Design

Objective:To investigate the treatment of acupuncture in treating Cervical Spondylosis of Vertebral Artery Type on instant and long-term efficacy, observe and analyze curative effect of 3 factors and 2 levels of each factors by using orthogonal design, eventually selected which is the best treatment.Methods:This research was performed on cases with CSA, which came from the Department of Clinical Laboratory, the First Affiliated Hospital of Guangzhou TCM University and Department of Medical Technology of GuangDong Second Provincial TCM, collected from March 2010 to March 2011. Cases were treated in accordance with the orthogonal design treatment programs by using randomized block design.1. Observe 3 factors and 2 levels, including:A (methods: Electro-acupuncture and the reinforcing and reducing methods of acupuncture, B(point selection:Cervical Paravertebral Point 4-7 and Cervical three needles), C(needle retentions:5min,15min for instant efficacy or 20min,40min for long-term efficacy), using L8(27) orthogonal design table.2. For instant efficacy:cases were divided into eight groups by using Orthogonal design treatment programs, consisting the method which included Electro-acupuncture (continuous wave) and the reinforcing or reducing methods of acupuncture, the time of needle retention which included 5 min or 15min according to the orthogonal table, observing the changes of Vm, Vd, Vs and PI of BA and VA before and after treatment.3. For long-term efficacy:cases were divided into eight groups by using orthogonal design. The time of needle retention was 20 min or 40 min according to the orthogonal table, observing the changes of the symptoms and functional rating scale score, TCD values (Vm, Vd, Vs and PI of BA and VA) and hemorheology index before and after treatment.4. Statistical analysis was done on Excel and SPSS software. Analysis of orthogonal design was done by analysis of intuition and variance, compared among each group and in the group by analysis of variance and t-test. Data were treated through statistical conversion.Results:1.For instant efficacy:After treatment, there were significant short-term therapeutic effect on all high blood flow in vertebrobasilar hemodynamics (P<.0.05, P<0.01). The changes of high blood flow were more significant than low blood flow group. The flow of high group became lower and the low group opposite.2. For instant efficacy:Point selections have the greatest impact over methods and needle retentions. The best scheme were:A2>Al, B1>B2, C1>C2 (Electro-acupuncture+Cervical Paravertebral Point 4～7+ 5minutes). The analysis of variance revealed that the three factors and the interaction of factor A and factor B were significant.3. For long-term efficacy: the treatment total effective rate was 84.38%. Each factor from greatest to smallest was A>C>B, which was methods>needle retentions>point selections. Analysis of variance were A(methods), C(retentions) and AXB for clinical effect and TCD detection, synchronous A(methods), B(point selections), C(retentions), A×B and A×C for hemorheology index. The best combinations treatment for curative effect was as follow:A1B2C2 (Reinforcing and reducing methods+Cervical Three needles+40 minutes). The best group for laboratory parameters was A1B2C2 (Electro-acupuncture+Cervical Three needles+40 minutes).Conclusions:1. It had curative effect affirmatively on CSA by acupuncture, which changes the status of high blood flow better than low blood flow. Acupuncture have dual regulation on blood supply of vertebrobasilar arteries and correct the disturbance status of hemodynamics for CSA.2. Point selections were the main factor of affecting instant efficacy, which revealed the point specificity according hemodynamics. The optimum acupuncture treatment that the expressive level influenced by each factor from greatest to smallest was Electro-acupuncture+Cervical Paravertebral Point 4～7+5 minutes.3. Methods were the main factors of affecting long-term efficacy. The optimum acupuncture treatment that the expressive level influenced by each factor from greatest to smallest was Electro-acupuncture+Cervical three needles+40 minutes. The best combination treatment for curative effect was as follow:A,B2C2 (Reinforcing and reducing methods+Cervical Three needles+40 minutes). The best group for laboratory parameters was A1B2C2 (Electro-acupuncture+Cervical Three needles+40 minutes). Maybe the good regulating effect on blood flow and hemorheology was one of the mechanisms of achieving the therapeutic results. 4. From many aspects and many levels, orthogonal design is one of the highest effective design method on acupuncture experiment which was proven through the study of clinical research on treatment of acupuncture in treating Cervical Spondylosis of Vertebral Artery Type.