| ObjectiveShear wave elastography(SWE)was used to investigate the efficacy of acupuncture in the treatment of cervical spondylosis and the influence of acupuncture on the muscle tissue of cervical spondylosis.MethodsA total of 66 patients with cervical spondylosis meeting the inclusion criteria were recruited in the outpatient department of Guangdong Provincial Hospital of Traditional Chinese Medicine during the study period,and randomly divided into acupuncture group and false acupuncture group in a 1:1 ratio.A total of 24 healthy volunteers were recruited through online recruitment.Acupoint selection:The acupoint prescription refers to the acupoint selection of acupuncture and moxibustion for the treatment of cervical spondylosis in the "eleventh fiveyear plan" project.bilateral jiaji points(two pairs in total)on the cervical positive reaction plane,Dazhui,Jianzhongshu and Zhongzhu on both sides.All acupoints were positioned according to the World Health Organization standard acupuncture points,and the acupoints selected in the two groups were the same.Needle selection:in the acupuncture group,disposable aseptic acupuncture steel needles of Huatuo Brand(Huatuo,Suzhou,China;0.3mm ×25 mm/0.3mm ×40 mm);The blunt needle with a diameter of 0.30mm was used in the shame acupuncture group,which could not penetrate the skin or stimulate the deep tissue.Jiaji point,Jianzhongshu,Dazhui all use the length of 40mm needle,zhongzhu point use the length of 25mm needle.Method of operation:The subject takes the seat and conducts routine disinfection on the operation site;In the acupuncture group,the needle was inserted directly into the acupoints,and the depth of the needle was set as 10-20mm according to the body type of the subject.The needle was kept for 25 minutes according to the degree of Qi.The shame acupuncture group covered the acupoints with a rubber pad,pierced the blunt needle directly into the rubber pad,so that the needle touched the patient’s skin,and carried out actions such as turning,to simulate treatment and assist blindness.These actions would be stopped when the subjects feel slight pain,and then kept the needle for 25 minutes.Treatment course:treatment would be given twice a week,once every 3 days,one treatment course was given every 10 times.Effective cases are those completed more than 8 times.Evaluation of efficacy:Young’s modulus,NPQ and MPQ scores were measured before treatment,the fifth time of treatment,at the end of treatment and 28±3 days after the end of treatment.ResultsThere were no significant differences in demographic data between the two groups,including age(P=0.610),gender(P=0.542),educational level(P=0.480),Western medicine diagnosis(P=0.961),and traditional Chinese medicine diagnosis(P=0.630).Before treatment,there was no significant difference in the mean value(P=0.089),minimum value(P=0.098)and maximum value(P=0.156)of the left Young’s modulus,while there was no significant difference in the mean value(P=0.628),minimum value(P=0.361)and maximum value(P=0.887)of the right Young’s modulus.Before treatment,there was no significant difference in NPQ questionnaire between the two groups(P=0.686).Before treatment,there was no significant difference in MPQ questionnaire between the two groups(P=0.394).The two groups of patients had a neat baseline and were comparable.In terms of Young’s modulus value,comparison of bilateral Young’s modulus value(including Emean,Emin and Emax)before and after treatment in the acupuncture group showed statistical differences(P<0.05),while there was no statistical difference within the sham acupuncture group(P>0.05).Repeated measurement ANOVA was performed on bilateral Young’s modulus values(including Emean,Emin and Emax)at each time point in 2 groups of patients,and it was found that the evaluation time point and grouping factors had statistically significant differences in the mean,minimum and maximum values of Young’s modulus on the left and right sides(P<0.001),and the two had an interactive effect(P<0.001).In terms of score reduction rate,there were statistical differences in the mean value,maximum value and minimum value between the two groups at the 5th treatment,the end of treatment and the 1-month follow-up(P<0.001).Young’s modulus values in the acupuncture group decreased significantly after treatment,and the decrease was more obvious on the left side,while there was no significant change in the sham acupuncture group.Young’s modulus value of two groups were compared with that of healthy people.The results showed that young’s modulus value of acupuncture group and fake acupuncture group before treatment of cervical spondylosis patients compared with that of healthy people exist obvious difference(P<0.01).Compared the young’s modulus value after treatment of the acupuncture group with that of healthy people,there is statistical difference between two groups(P<0.05).In terms of NPQ scale,both of two groups had statistically significant differences in NPQ between the time that before and after treatment(P<0.001,P=0.001).Repeated measure ANOVA results showed that the evaluation time point and grouping factors had statistical difference on NPQ score(P<0.05),and the two factors had interaction(P<0.01),indicating that there was difference in efficacy between the two groups.In terms of the reduction rate of NPQ score,there were statistically significant differences between the two groups at the 5th time of treatment,the end of treatment and the 1-month follow-up(P<0.05).NPQ score of the acupuncture group decreased significantly after treatment,while that of the sham acupuncture group improved slightly.In terms of MPQ scale,before and after treatment,there were statistical differences in intra-group comparison(P<0.001).Repeated measure ANOVA results showed that the evaluation time point and grouping factors had a statistical difference on the MPQ score(P<0.001),and the two factors had an interaction(P<0.001),indicating that there was a difference in efficacy between the two groups.In terms of the reduction rate of MPQ score,there were statistically significant differences between the two groups at the 5th time of treatment,the end of treatment and the 1 month follow-up(P<0.001).After treatment,the MPQ score of the acupuncture group decreased significantly,while that of the sham acupuncture group decreased slightly.In terms of effective rate,NPQ Neck Pain Scale was evaluated.In the acupuncture group,2 cases were cured,24 cases were significantly effective,1 case was effective,and 3 cases were ineffective,with a total effective rate of 90%.In the sham acupuncture group,0 cases were cured,6 cases were significantly effective,9 cases were effective,and 15 cases were ineffective,with the total effective rate of 50%.The results showed that there was a statistical difference between the two groups(P<0.001),indicating that there was a difference in the curative effect between the acupuncture group and the sham acupuncture group,and the acupuncture group was better than the sham acupuncture group.ConclusionAcupuncture has obvious curative effect on cervical spondylosis and neck pain,and can effectively reduce the Young’s modulus of the horizontal part of the trapezius muscle in patients with cervical spondylosis and neck pain,relieve the stiffness of the horizontal part of the trapezius muscle in patients with cervical spondylosis and promote the recovery of muscle elasticity. |
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