Massage Technique Selecting And Clinical Effect Evaluation Research On Cervical Spondylotic Radiculopathy

Objective:Establish a index system which was suitable for rural Chinese medicine appropriate technology—cervical spondylotic radiculopathy massage technique for screening grass-roots, and provide decision-making basis of Chinese massage screening of appropriate technology; Establishing a rural Chinese mode of appropriate technology screening of appropriate technology grass-roots TCM screening and providing a set of effective and feasible method of selecting, and also establishing screening verified index system by the efficacy and safety of index from the evaluation of clinical curative effect.Methods:(1)The establishment of the system of screening index was based on the research of literature and the Delphi method. The CSR and percent-weight method were used to calculate the weight-value of the indexes. (2) This study aims to analyze the technical demand through the baseline survey of appropriate technology. (3) Using the screening of the establishment of index system of appropriate technology for preliminary evaluation, screen appropriate technology for cervical spondylotic radiculopathy and the optimum appropriate technology application of TCM grass-roots appropriate technology in Sichuan province. (4)Methods of Positive control test and randomized controlled trial were adapted in the research; 288 cases of nerve root type cervical spondylosis were divided into treatment group (manipulation of appropriate technology) and control group (traction combined approach), respectively, the two treatment courses (12 times) to symptoms and signs, VAS, blood rheology; X-ray examination and quality of life index for the main index. Evaluate clinical curative effect of appropriate technology of cervical spondylosis of nerve root type by multicenter, randomized methods.Results:(1) The system of screening index included 6 primary and the weight-values of the primary indexes which were as follows:the effectiveness(0.21), the security(0.18), the characteristics(0.15), the economy(0.13), the social suitability(0.16) and the degree of satisfaction(0.17). Besides, the 16 secondary indexes were also screened the adverse reaction intensity (0.0285), the adverse reaction rate (0.0931) and the effect (0.09), the quality of life (0.0882), the technology requirement(0.0525), the technical operability (0.0495), the technology maturity (0.0465), the technology operating costs (cost 0.0338), the economic cost of patients (0.0351), the time costs of patients (0.0312), the time costs of medical staff time(0.0299), and the government acceptance (0.0496), the promotion of unit acceptability (0.0528), the patients acceptability (0.0572). the technical satisfaction for patients (0.0867), medical personnel of technology satisfaction (0.0833). (2) Screening supine hand pull method as a appropriated technology to treat the cervical spondylotic radiculopathy technology. (3) After two courses of treatment, two groups in two treatment of various symptoms were significantly improvement, they had statistical difference (P< 0.05). For neck shoulder pain and numbness, upper limb pain and numbness, intervertebral foramen extrusion test, muscle, the ability of living and cervical activities, the integral function, treatment group marked change than control group, and they had significant statistical difference (P< 0.01); For pain of fingers, the function of hand,tendinous reflex and upper limbs feeling changes, two groups of integral change was not statistical difference (P> 0.05). (4) After two courses of treatment two total score of symptoms were obviously improved, compared with before treatment, it had significant statistical difference(P< 0.01); after total score more obvious symptoms, two groups had statistical significant difference (P< 0.01); the treatment group improve than control group; in the symptoms that total scores. (5) Two groups of cervical X line were signs of change and in improving the physiological curvature two groups had significant statistical difference (p< 0.01), the control group was obviously better than the treatment group. And in the vertebral stability, the intervertebral foramen and vertebral clearance improvement had not statistical difference (p> 0.05). But in bone hyperplasia, both groups had not improvement.(6) After treatment two groups of blood rheology, all had obvious improvement and they had significant statistical difference (p< 0.01), for whole blood viscosity 30 (1/s), two groups had significant statistical difference (p< 0.01);for worth 200,5,1, plasma viscosity value, ESR,two group had not statistical difference(p> 0.05), for red rigid index two groups had significant statistical difference (p< 0.05).(7) After two groups treating, quality of life, were obviously increased, it had statistical significant difference (P< 0.01); the two groups quality of life had not significant difference (p> 0.05). (8)The total effectiveness and markedly effective rate of using supine hand pull appropriate technology to treat cervical spondylotic radiculopathy was 61.76%and 93.38%. The control group was 91.79%,46.27%. The total effectiveness between two groups had no significant difference (p> 0.05), and there was obvious difference about the markedly effective rate. Conclusion:(1) The screening index system established in the study about the appropriate massage technology of cervical spondylosis of nerve root type was reasonable practicable and also can be used for screening index system of TCM appropriate technology and evaluate the appropriate technology objectively. (2) Skill base of Chinese medicine appropriate technology recommended by national cannot satisfy the local actual requirement. The investigation of TCM appropriate technology can use for the basic foundation of appropriate technology screening. (3) The method of using supine hand pull method to treat cervical spondylotic radiculopathy technology was effective, safe and accorded with appropriate technical requirements.