| Objective To study the prevalence and risk factors of cervical spondylosis(Neck pain and Cervical Spondylotic Radiculopathy)in Shanghai urban population,Analyze the disease characteristics and quality of life of CSR.Evaluate the effect and safety of Chinese herbs of activating blood circulation and removing blood stasis in treating CSR.Evaluate the clinical efficacy of jinbi granules in the treatment of cervical spondylotic radiculopathy by using a randomized,double-blind,double-dummy,parallel-controlled clinical trial.Methods1.From December 2015 to December 2017,a multi-stage random sampling method was used to conduct a cervical spondylosis epidemiological questionnaire survey of3,600 residents in three urban communities.gender,age,marriage,ethnicity,height,weight,information on the degree of education,monthly income,occupational work,physical activity,work intensity,use of electronic products,smoking,drinking,past disease history were collected.;Questionnaire,physical examination and imaging findings were used to diagnose cervical spondylosis.Investigate the disease characteristics and VAS,NDI and SF-36 scale scores of CSR patients.2.Search the Cochrane Library,Pub Med,EMbase,CNKI,VIP,Wanfang databases,collect randomized controlled clinical trials of traditional Chinese medicine preparations for the treatment of CSR.As of January 31,2019.Methodological quality evaluation was carried out on the included literature,and meta-analysis was performed using Review Manager 5.3.3.72 patients were randomly divided into the experimental group(n=36)and the control group(n=36).The experimental group took the jinbi granules and Celebrex Simulated capsule,while the control group took the Celebrex capsules and the jinbi granules placebo.VAS,NDI and SF-36 quality of life scores were recorded before treatment,at 1 and 2 weeks after treatment,and at 8 weeks after follow-up.Patients' adverse reactions were recorded and their clinical efficacy and safety were evaluated.Results1.A total of 3349 urban population surveys were completed,average 53 years old,the youngest was 18 years old,and the largest was 85 years old,47.7% males(1597)and51.9% females(1739).the prevalence rate of cervical spondylosis was 24.66%,males prevalence rate was 18.91%(302/1597),females was 29.96%(521/1739).the prevalence rate increased with age,The prevalence rate was 34.94% in the population over 60 years old.Older,female,drinking alcohol habits,pharyngitis are risk factors for cervical spondylosis.The characteristics of CSR tend to be complicated,and the quality of life is significantly lower than that of normal people.There are mental health problems such as depression and anxiety.2.Totally 41 literatures were selected in the research,including 4079 patients.The sample size ranged from 36 to 480,and the course of medication was 10 to 60 days.Meta-analysis showed that the total effective rate of the traditional Chinese medicine for activating blood circulation or removing non-drug therapy was [OR=3.82,95% CI,(3.01,4.85),P<0.00001],and the cure rate [OR=2.45,95%CI,(2.02,2.98),P<0.00001] were higher than placebo or Western medicine or Western medicine combined with non-drug therapy or simple non-pharmacological treatment;VAS score[MD=-0.84,95% CI,(-0.93,-0.76),P <0.0001],NDI score [MD=-4.6,95% CI,(-7.92,-1.29),P=0.006] and CSR20 score [MD=1.5,95% CI,(0.08,2.92),P = 0.04] were superior to the control group.The main adverse reactions were diarrhea,stomach discomfort,etc.,but the incidence was significantly lower than that of the western medicine group.3.72 patients were included,There was no significant difference in the baseline data between the experimental group and the control group(P>0.05).At the last follow-up of1 week,2 weeks,and 8 weeks of follow-up,the VAS score and cervical dysfunction index NDI scores of the two groups were significantly lower than those before treatment,but there was no significant difference between the two groups.(P>0.05);SF-36 in both groups showed a significant upward trend at different time points.There was no significant difference in SF-36 physical health PCS score at different time points.The MCS score of SF-36 was superior to the control group at the 2nd and 8th week(P<0.05);the total score of SF-36 in the experimental group was better than that in the control group at the 8th week(P<0.05);no serious adverse events occurred in the two groups.Conclusion1.The prevalence rate of cervical spondylosis in Shanghai urban population is 24.66%,the prevalence of CSR is 10.6%.Older,female,drinking alcohol habits,pharyngitis are risks factor for cervical spondylosis;disease characteristics of patients with chronic CSR were Complexity,life and mental health are lower than normal.2.The overall efficacy of traditional Chinese medicine for promoting blood circulation and removing blood stasis in treating CSR is better,and the adverse reaction is lower than that of western medicine;however,the evidence-based medical evidence level of the literature needs to be improved.3.The clinical efficacy of Jinbi granules in the treatment of CSR is not inferior to that of Celebrex,which can reduce the pain level of patients,improve the cervical disability index,improve the quality of life of patients,and special mental health. |
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