Clinical Research On Acupuncture At Cervical Jiaji Points For Radicular Type Of Cervical Spondylosis

Objective:Cervical spondylosis is a kind of common syndrome in clinical, it is caused by degeneration of intervertebral disk.which leads to bone hyperplasia and the denaturation of small joints, ligaments and joint capsule, ect,that finally presses or stimulates nerve root, spinal cord and vertebral artery and produces corresponding signs and symptoms.It can be divided into radicular type, cervical spondylotic myelopathy, Vertebral arterial cervical spondylosis and sympathetic nerves type. In the cervical spondylosis, radicular type is the most common one with a percentage of 60 to 70, and is early performance of other types of cervical spondylosis. It seriously affects people's life, work, study with the incidence increases year by year, because the modern social life rhythm is speeding up and the working styles change.About the treatments, in western medicine it generally uses the non-operative treatment and surgical treatment, the Common non-operative treatments for example are cervical traction, drug therapy, physical therapy, psychological family therapy,etc. The understanding about the treatments of cervical spondylosis had been more comprehensive from the basic subject to clinical technical application in recent years. However, as a kind of degenerative diseases, the non-operative treatment for cervical spondylosis needs long time to recover and usually can not reach a ideal effect.The surgical treatments such like invasive surgical treatment, conventional surgery are easy to relapse and may cause serious complications if mistakes.At present, traditional Chinese medicine in treating radicular type of ervical spondylosis is more and more concerned, especially acupuncture, has distinct curative effect without side effects.The common acupuncture methods include acupuncture with fuliform, needle,electroacupuncture, hydro-acupuncture, abdominal needle, needle-knife and other treatments, among them fuliform needle therapy and electroacupuncture are most commonly used. Acupuncture may activate collaterals and dehumidification, relieve pain and detumescence, alleviate local swelling, release the conglutination of organization.According to the reports in the literature, the method of acupuncturing at cervical Jiaji points were widely used in treating cervical spondylosis for its good clinical curative effect, as a result, cervical Jiaji points become common points for cervical spondylosis. Stimulation on the jiaji pionts Can dredge the Du channel and the Taiyang channel, balance Yin and Yang, that is the theory why the pionts are used to treat cervical spondylosis. In modern medicine, acupuncture at cervical Jiaji points can correct the disorder of vertebral artery blood flow that caused by cervical spondylosis, improve the speed of blood flow and bring up cerebral blood flow, so used in the treatment of Vertebral arterial cervical spondylosis, besides, it can relieve local pain and help correct the malposition of vertebral small joints. Therefore, this study choce cervical Jiaji points as the main point, made a observation and analysis of the therapy in treating cervical spondylosis.Reports about acupuncture therapy for the treatment of cervical spondylosis. all had certain clinical curative effect, but lacked of RCT researches, clinical assessment criterias were not objective, standard, unified and the study of mechanism was deficient. How to explore the judgment standard, unify the curative effect, and search for a better treatment are problems that need to be solved. Therefore, this study choce cervical Jiaji points as the main points to explore a more scientific and reasonable effective formula for cervical spondylosis.Methods:The literature research part summarized the diagnosis,location, therapeutic progress and acupuncture treatments of cervical spondylosis, the theory and application about cervical Jiaji Points for cervical spondylosis.Clinical research part,60 cases who met the inclusion criteria according to the order of first to diagnosis and random number table method were randomly divided into the treatment group and control group,30 cases each group. After statistical analysis, two groups of patients' differences had no statistical significance in the gender, age, duration, etc. The treatment group were treated with 6 cervical Jiaji points which were at the cervical section of the impaired nerves. Chose Huatuo brand disposable acupuncture needle 0.30 mm×25mm or 0.30 mm×40mm according to the patients' size Regularly sterilized and inserted the needle straightly for 20-30mm, retained for 30 minutes after the arrival of qi without tonifying and reducing methods While the control group were treated with pionts according to the rule of selecting acupoint along channel and section,which is from the reference" science of acupuncture and moxibustion" (fifth edition, Ed. Shi Xuemin),for example, at shoulder, chose pionts like Jianyu,Jianliao;for elbow, used Quchi, Tianjing, for wrist, Yangchi, Waiguan. All these points were treated with the conventional acupuncture methods. Retained for 30 minutes after the arrival of Qi without tonifying and reducing methods. After 4 courses of treatment, observed the pain intensity according to McGill Simplified scale, clinical signs and symptoms score, cervical mobility and clinical curative effect. Results:Clinical studies showed that, after treatment, both groups had statistically significant difference (P< 0.05)compared with that before treatments, suggested both treatments could greatly alleviate pain symptoms; Comparison between two groups also showed a statistically significant difference (P< 0.05), which indicating acupuncture at cervical Jiaji points could relief the symptoms more and got a more obvious effect.Clinical symptoms and signs, statistically significant difference (P< 0.05)could be seen according to the comparison of two group that before and after treatments, which hint that both treatments can greatly alleviate cervical symptoms and signs; Comparison between two groups also showed a statistically significant difference (P< 0.05), which indicating acupuncture at cervical Jiaji points have a better effect on reliefing the cervical signs and symptomsFor cervical mobility, comparison before and after treatment showed both groups could obviously improve cervical mobility with statistically significant difference (P< 0.05), but no significant difference between two groups after treatment(P>0.05), mean no difference in improving cervical mobility between two groups.Clinical efficacy part, the cure rate of treatment group was 16.67%, while the control group was 6.67%, it showed statistically significant difference (P< 0.01);besides, the total effectiveness also had statistically significant difference (P< 0.05). No statistically significant difference in recovery rate and significant efficiency. Conclusion:Acupuncture at cervical Jiaji points for radicular type of cervical spondylosis have exact clinical curative effect, can significantly improve the clinical symptoms, improve the quality of life, simple but without adverse reaction, easy to be accepted. In choice of acupionts, the cervical Jiaji points are better than selecting acupoint along channel and section in the treatment of cervical spondylosis.