Diagnosis,treatment And Modeling Study Of Cervical Spondylosis Of Vertebral Artery Type Based On Combination Of Disease And Syndrome

Purpose: 1.To evaluate the efficacy of hyperbaric oxygen combined with traditional Chinese medicine in the treatment of cervical spondylosis of vertebral artery type.2.To establish a simple and reliable model of CSA in rats with hyperactivity of liveryang syndrome,and to establish a simple and feasible method for evaluating the degree of vertigo in animals.Methods: 1.A total of 4 database including Pub Med,CNKI,VIP and Wan Fang Data were searched on computer(before 2018.12.31).The inclusion and exclusion criteria were selected and the risk assessment tools were used to evaluate the quality of the literature.Meta analysis was performed by Revman 5.3.2.SPF male SD rats(aged 8 weeks,weighing 280-320g)were randomly divided into 4 groups.The model of CSA of hyperactivity of liver-yang syndrome(joint modeling group)was established by combining local injection of lauromacrogol(hardener)and receiving fuzi decoction by gavage.The joint modeling group was compared with the hardener group,the fuzi decoction group and the blank control group.The vertigo degree of rats was measured by the time of passing through a glass tube(running time),and was measured before modeling,2 weeks and 3 weeks after the establishment of the model.Results: 1.A total of 99 articles were retrieved,and 12 articles were finally included.The total number of samples was 1110,including 555 in the control group and 555 in the experimental group.Meta-analysis showed that the ESCV score of hyperbaric oxygen combined with traditional Chinese medicine treatment group had significant advantages compared with other treatment control groups,the difference was statistically significant(MD=4.78,95% CI=[2.02,7.53],Z=3.39,P=0.0007);blood flow rate in the hyperbaric oxygen combined with Chinese medicine treatment group(LVA(MD=0.98,95% CI=[-0.14,2.10],Z=1.71,P=0.09),RVA(MD=0.97,95%)CI=[-0.04,1.97],Z=1.89,P=0.06),BA(MD=0.84,95% CI=[-0.16,1.84],Z=1.65,P=0.10))compared with the control group,There was no significant change,and the difference was not statistically significant.The vertebral artery vascular resistance index(VARI)of hyperbaric oxygen combined with traditional Chinese medicine treatment group showed no significant advantage compared with other treatment methods.The difference was not statistically significant(MD=-1.01,95% CI=[-2.88,0.85],Z=1.07,P=0.29);the total effective rate of hyperbaric oxygen combined with traditional Chinese medicine treatment group has obvious advantages compared with other treatment methods,the difference is statistically significant(RR= 1.16,95% CI = [1.08,1.24],Z = 4.06,P < 0.0001);when using random number tables as a random method in the literature,the total effective rate of hyperbaric oxygen combined with Chinese medicine treatment group has no significant advantage in the control group.The difference was not statistically significant(RR=1.22,95% CI=[0.98,1.52],Z=1.76,P=0.08).When using waiting order as a random method in the literature,there was no significant advantage in the total effective rate between HBO combined with traditional Chinese medicine group compared with other treatment methods.The difference was not statistically significant(RR=1.15,95%CI=[0.99,1.34],Z=1.85,P=0.06).When the randomized method only mentions "random",The total effective rate of hyperbaric oxygen combined with traditional Chinese medicine treatment group has obvious advantages compared with other treatment methods.The difference is statistically significant(RR=1.16,95%CI= [1.05,1.28],Z=3.00,P=0.003);The total effective rate of hyperbaric oxygen combined with traditional Chinese medicine treatment group has obvious advantages compared with other treatment methods,the difference is statistically significant(RR=1.25,95%CI= [1.10,1.42],Z=3.46,P=0.0005);The total effective rate of the treatment group of hyperbaric oxygen combined with traditional Chinese medicine single-flavor active ingredient extract was not significantly different from other treatment methods,and the difference was not statistically significant(RR=1.09,95% CI=[0.97,1.23],Z=1.46,P=0.14);The total effective rate of the hyperbaric oxygen combined with traditional Chinese medicine group was significantly better than that of the other treatment groups.The difference was statistically significant(RR=1.13,95% CI=[1.03,1.24],Z=2.58,P=0.01);The total effective rate of the TCM physiotherapy group was significantly different from that of the other treatments.The difference was statistically significant(RR=1.13,95% CI=[1.02,1.25],Z=2.41,P=0.02).The total effective rate of hyperbaric oxygen combined with combining traditional Chinese medicine treatment group had obvious advantages compared with other treatment methods.The difference was statistically significant(RR=1.26,95%CI=[1.11,1.44],Z=3.50,P= 0.0005);The total effective rate of the treatment group with adding hyperbaric oxygen intervention was significantly superior to the other treatment groups,and the difference was statistically significant(RR=1.16,95%CI=[1.02,1.31],Z=2.31,P = 0.02);The total effective rate of the treatment group with adding Chinese medicine intervention method has obvious advantages compared with other treatment methods,the difference is statistically significant(RR=1.12,95%CI=[1.04,1.21],Z = 2.91,P = 0.004).No adverse reactions or other safety indicators were reported in the literature.2.Compared with the control group,the running time in the fuzi decoction group was slightly shorter,but there was no statistical difference;the running time in the joint modeling group was slightly longer than that in the hardener group,but there was no statistical difference;the running time in the hardener group and the joint modeling group was longer than that in the control group(p < 0.05),and was even longer than that in the fuzi decoction group(p < 0.005).There was significant difference in running time after modeling compared with that before modeling(p < 0.05);there was no significant difference in running time between 2 and 3 weeks after modeling(p > 0.05).Conclusion: 1.Hyperbaric oxygen combined with traditional Chinese medicine is more effective than other treatments in the treatment of cervical spondylosis of vertebral artery type.2.This method can effectively establish a rat model of CSA with hyperactivity of liveryang syndrome,and the "running time" can reflect the degree of vertigo in rats to a certain extent.This experiment provides a simple and feasible animal model and detection method for research of cervical vertigo in the future.