| Purpose:This topic discusses whether there is any difference in clinical efficacy between moxa stick warm needle moxibustion and traditional moxa section warm needle moxibustion in the treatment of cervical spondylosis of vertebral artery type(CSA)with the legislation of warming the yang and unblocking the governor,and discusses the correlation between the sensory phenomenon and the efficacy in the treatment process,with a view to providing a convenient,safe and more effective warm acupuncture therapy for clinical treatment of CSA.Methods:1.Case source and grouping: 60 patients with cervical spondylosis of vertebral artery type who were treated in the outpatient and inpatient department of the Acupuncture and Moxibustion Department of the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from June 2021 to December 2022 were collected according to the inclusion and exclusion criteria.The 60 patients were numbered according to the order of treatment(1-60),and the CSA patients were divided into test group and control group by random control method,with 30 patients in each group.2.TreatmentBasic treatment: subjects with basic diseases such as diabetes and hypertension were treated with western medicine to reduce blood sugar and blood pressure and other corresponding symptomatic treatments.(1)The experimental group:The experimental Moxibustion with warm needle and moxa stick is mainly used for treatment.Main acupoints: Baihui,Fengchi,Yuzhen,Tianzhu,Dazhui,Cervical jiaji point(C3-7),Houxi,Xuanzhong,Zusanli,Taixi.Acupoints: Add Zhongwan and Guanyuan for the type of deficiency of qi and blood;For the type of liver and kidney insufficiency,muscle and bone strain,Dazhu,Yanglingquan,Shenshu and Ganshu were added;The type of phlegm-dampness blocking collaterals was added with Fenglong andYinlingquan;The wind-yang disturbance type plus Shenshu,Ganshu and Taichong;For those with mild atrophy and weakness of limb muscles,corresponding acupoints can be added to the local part of the affected limb,such as Quchi,Waiguan,Weizhong,Yanglingquan,etc.Material: Huatuo brand 0.30 × 40 mm disposable sterile flat handle needle.Moxa sticks are "heat-sensitive moxa sticks" produced by the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine.Operation method: All the above points were pricked with filiform needle.Instruct the patient to take a lateral or prone position,expose the skin near the acupoint,and sterilize the hands of the performer and the local skin of the acupoint before acupuncture.After inserting the needle at Baihui point,stab about 1 inch backward along the subcutaneous fascia;When needling Fengchi point,the needle tip should be 0.8-1.2inches away from the nose tip.The other acupoints were punctured as per the routine.All acupoints were treated with the method of calming,tonifying and calming down after getting Qi.After acupuncture at Houxi and Dazhui,apply the moxibustion method of warm needle with moxa stick(hold the moxa stick or fix the moxa stick with a warm moxibustion frame,and burn the needle body and acupoints with the moxa fire close to the needle).When the patient feels warm and comfortable,remove the ash on the surface of the moxa stick with tweezers at an interval of 3-5 minutes to ensure that the heat of the moxibustion points is uniform and continuous.After 30 minutes from the beginning of moxibustion,remove the moxa fire and take the needle.(2)The control group:Moxibustion with moxa segment warm needle was mainly used for treatment.The selection of main points and matching points were the same as those of the test group.Operation method: The acupuncture operation was the same as that of the test group.Take a 2cm moxa section of the heat-sensitive moxibustion moxibustion treaty as a strong one,insert a strong and ignited moxa section on the needle handle after injecting the needle into Dazhui and Houxi,and replace the new moxa section for continuous moxibustion when each strong one burns to the end.The moxa section burns freely within30 minutes(about 2 strong),and take the needle and stop the moxibustion after 30 minutes.(In order to prevent the patients in prone position from being scalded by falling ashes,it is necessary to cut about 4cm×4cm cardboard is placed at the moxibustion place when operating Dazhui acupoint.)3.Observation index: Observe and record the Evaluation Scale for Cervical Vertigo(ESCV),Visual Analogue Score(VAS),Traditional Chinese medicine symptom score scale and sensory phenomenon of the two groups before and after treatment.4.Course of treatment: One course of treatment lasts for 15 consecutive days,and one course of treatment ends in both groups.5.Statistical method:All collected data are statistically analyzed by IBM SPSS 27.0software.The data in the table are taken to two decimal places,and the counting data is chi-square test;After testing the normality data of the measurement data,if the measurement data conforms to the normal distribution,use the t-test,otherwise use the rank sum test;Spearman correlation is used to analyze the correlation between two ordered classification variables.When P<0.05,there is correlation between the two variables,and P>0.05,there is no correlation between the two variables.When P<0.05,the correlation coefficient r>0 indicates that the two variables are positive correlation,and r<0 indicates that the two variables are negative correlation.The closer the absolute value of r is to 1,the stronger the correlation between the two variables.Results:1.Comparison of baseline data: before treatment,the age、 sex、Pre-treatment syndrome type、VAS score and ESCV score of the two groups were compared,P>0.05,which was comparable.2.VAS:After treatment,Intra-group comparison,the VAS scale scores of the test group and the control group were lower than before(P<0.05);Compared with the control group,the decrease of the test group was greater than that of the control group,and the difference was statistically significant(P<0.05).It shows that the two groups of treatment can improve the pain symptoms of CSA patients,and the effect of the test group is better than that of the control group.3.ESCV:After treatment,the scores of patients in the two groups were significantly higher than before(P<0.05),The scores of ESCV in the experimental group were significantly higher than those in the control group(P<0.05).It is suggested that both the experimental group and the control group can relieve the symptoms of vertigo and headache in patients with CSA,but the effect of the experimental group is more outstanding.4.Comparison of comprehensive curative effect: After one course of treatment in both groups,the comprehensive curative effect was evaluated with reference to nimodipine method.In the test group,10 patients were cured,12 patients were significantly effective,6 patients were effective,and 2 patients were ineffective,with a total effective rate of 93.333%;In the control group,4 patients were cured,7 patients were significantly effective,10 patients were effective,and 9 patients were ineffective.The total effective rate was 70.000%.After test and comparison,the difference between the two groups was statistically significant(P<0.05).5.Comparison of the occurrence rate of sensory transmission:During the treatment of this subject,there were 3 people in the test group who had full sensory transmission,22 people who had partial sensory transmission,and 5 people who did not have sensory transmission.The occurrence rate of sensory transmission was 83.333%;In the control group,there was 1 person with complete sensory transmission,13 people with partial sensory transmission,and 16 people without sensory transmission.The occurrence rate of sensory transmission was 46.667%.The difference was statistically significant(P<0.05).It is suggested that the moxa stick warm needle moxibustion in the experimental group is easier to stimulate the occurrence of sensory transmission during treatment than the moxa section warm needle moxibustion in the control group.6.Correlation between sensory transmission and curative effect:The correlation between the occurrence rate of sensory transmission and the curative effect in the test group and the control group was statistically significant,p < 0.05,and both were positively correlated(r > 0),suggesting that the higher the occurrence rate of sensory transmission and the wider the range,the better the curative effect.The correlation coefficient of the test group(r=0.556)is greater than that of the control group(r=0.392),suggesting that the occurrence rate of sensory transmission is higher and the curative effect is better in the treatment of cervical spondylosis of vertebral artery type with moxa warm needle moxibustion.Conclusion:1.From the perspective of the legislation of warming yang and unblocking the governor to treat vertebral artery type cervical spondylosis,both moxa stick warming acupuncture and moxibustion and traditional moxa segment warming acupuncture moxibustion can achieve good therapeutic effects,and the former is significantly better than the latter in improving vertigo,headache and other clinical symptoms of patients with vertebral artery type cervical spondylosis.2.Moxa stick warm needle moxibustion is easier to excite yang qi,promote the movement of qi and blood,and stimulate the phenomenon of sensation transmission than traditional moxa stick warm acupuncture and moxibustion moxibustion.3.There is a positive correlation between the stimulated sensory transmission phenomenon in the treatment of vertebral artery type cervical spondylosis with moxa stick warming acupuncture and moxibustion and the improvement of the comprehensive efficacy,that is,the higher the excitation rate and the larger the range of sensory transmission,the better the efficacy. |
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