A Clinical Trial On Efficacy Of The Jing-moxibustion Treatment For Neck Pain Of Cervical Spondylosis

ObjectiveTo objectively evaluate the clinical efficacy and safety of neck pain of cervical spondylosis with Jing-moxibustion compared to grain-shape moxibustion and non-heat moxibustion in order to explore an sustained and effective method of treatment for neck pain of cervical spondylosis.MethodsVolunteers conforming to the inclusion criteria of neck pain were recruited in the acupuncture department of Guangdong Hospital of Traditional Chinese Medical. A total of 90 vounteers wfere randomly averagely divided into Jing-moxibustion group、grain-shape moxibustion group and non-heat moxibustion group.The selected acupoints were the same in 3 groups. Acupoints seleting(a pair)①EX-CA1、SI15、GB21、BL15、BL23②EX-HN21、SI14、 BL12、 BL17、 BL19.This two group points were used interchangeably. Jing-moxibustion group used the small-shapd moxibustion (diameter 2mm×high 3mm)placeing on the skin of the acupoint, lighted on the top, then removed the moxibustion with tweezers until the 1/4moxa left while the skin appeared blush and mild burning pain, replaced another moxibustion,2 moxa each acupoint. The acupoint location was confirmed according to PRC National Standard. Grain-shape moxibustion group(size: diameter 3mm X high 5mm) operated as above,1/2 moxa left while the skin appeared blush. Non-heat moxibustion group added a pastice mat (diameter 5mm) on the skin to separate the heat, the operation and moxibustion size was smilar to Jing-moxibustion group.For a course of treatment once every 3 days, twice every week,10 were treated and followed for 28 days.NPQ Neck Pain Scale was applied for the primary outcome measure while Short Form McGill Pain Scale as secondary outcome measures, TESS as a safety indicators.3 evaluating point:before treatment,at the end of treatment, one month after the end of treatment. Measurement results used SPSS19.0 statistical analysis software.Result1. The trial included 95 cases of subjects,10 of dropped out and 3 of excluded. Grain-shape moxibustion group included 34 cases of subjects,3 of dropped out, the drop out rate was 9%; Jing-moxibustion group included 32 cases of subjects,2 of excluded, the excluded rate was 6.3%;Non-heat moxibustion group included 29 cases of subjects,7 of dropped out and 1 of excluded, the drop out rate was 9% and the excluded rate was 3.4%.2. Baseline imformation:General imformation:The difference in terms of sex, age, course, degree of educationand the types of diagnosis among 3 groups were no statistical significant (P=0.611、 P=0.252、 P=0.998、 P=0.090、 P=0.448、 P=0.140). The average age of three groups were 49.39±14.27、50.77±11.16、 47.71±8.93. The average course of 3 groups were 76.45±59.77、85.13±75.96、 86.73±81.29. Efficacy observation imformation:The difference in terms of the score of NPQ Neck Pain Scale, McGill Pain Scale and VAS Scale among 3 group were no statistical significant (P=0.075、 P=0.170、 P=0.142). the result above showed that the baseline of 3 groups had no difference, they had comparability.3. NPQ Neck Pain ScaleNPQ scores at the end of the treatment in 3 groups decreased, Jing——moxibustion group declined more than grain-shape moxibustion group, non-heat moxibustion group attained the slowest decline;There was a statistical significant difference(P=0.048, P=0.000)comparing before and after the intervention in Jing-moxibustion group and grain-shape moxibustion group, while non-heat moxibustion group showed a statistical insignificant difference (P=0.8080);28 days follow-up, NPQ scores in 3 groups increased a little bit, grain-shape moxibustion group>Jing-moxibustion group> non-heat moxibustion group.The difference between 3 groups was statistical significance(P= 0.033, P=0.046) both at the end of the treatment and 28 days follow-up.4. McGill Pain ScaleMcGill scores at the end of the treatment in 3 groups decreased, Jing——moxibustion group declined more than grain-shape moxibustion group and non-heat moxibustion group, the latter two were the same; There was a statistical significant difference (P=0.019、P=0.000) comparing before and after the intervention in Jing-moxibustion group and grain-shape moxibustion group, while non-heat moxibustion group showed a statistical insignificant difference (P=0.280); 28 days follow-up, NPQ scores in 3 groups increased a little bit, grain-shape moxibustion group> Jing-moxibustion group> non-heat moxibustion group.The difference between 3 groups was statistical significance(P= 0.030、 P=0.041) both at the end of the treatment and 28 days follow-up.5. VAS ScaleVAS scores at the end of the treatment in 3 groups decreased, Jing——moxibustion group declined more than grain-shape moxibustion group,non-heat moxibustion group attained the slowest decline;There was a statistical significant difference (P=0.036、P=0.000)comparing before and after the intervention in Jing-moxibustion group and grain-shape moxibustion group,while non-heat moxibustion group showed a statistical insignificant difference (P=0.293); 28 days follow-up, NPQ scores in 3 groups increased a little bit, grain-shape moxibustion group>Jing-moxibustion group> non-heat moxibustion group.The difference between 3 groups was statistical significance(P=0.000、 P=0.007) both at the end of the treatment and 28 days follow-up.6. Total effective rateAt the end of the treatment, the effective rate among Jing-moxibustion group、grain-shape moxibustion group and non-heat moxibustion group were 93.3%、 61.3%、33.3%; The differences between three groups was statistically significant (P=0.000)28 days follow-up, the effective rate among three groups were 60%、20.0%、 14.2%;The differences between three groups was statistically significant (P =0.000)7. Evaluation of SafetyIn this trial, a total of 3 cases of adverse events were directly related to the present trial, three cases of adverse reaction were mild, One case was due to tension feeling, two cases were due to the improper operation of the researcher. TESS scale research process does not appear in the side effects of each system. Above all, we can see that the whole teatment of Jing-moxibustion belongs to secure treatment, fewer adverse reactions.Conclusion1. Jing-moxibustion grain-shape moxibustion have clinical efficacy on relieving the neck pain of cervical spondylosis, Jing-moxibustion has asignificant clinical efficacy compared to grain-shape moxibustion.2. Those 3 threpy can lower the score of NPQ Neck Pain Scale、McGill Pain Scale and VAS Scale. Jing-moxibustion has asignificant reduce than grain-shape moxibustion, and grain-shape moxibustion is superior to non-heat moxibustion.