| Cervical Spondylosis (short for CS in this paper) is a degenerative condition ofintervertebral disks, intervertebral joints, ligaments of the neck that affects thesurrounding tissues (such as nerve roots, spinal cord, sympathetic nerve, cervicalartery, etc), which causes corresponding clinical manifestations. The incidence of CSis about 3.6 %～9% clinically.Cervical Spondylosis is a common condition in middle-aged and old people.Popularization of computers in our daily life and work has made us bend neck formore time, which causes the increasing incidence of CS. CS has been a moderndisease. Now, CS is still difficult to treat and affects more and more young peoplewhich always bothers most of people in their daily life and work. The incidence ofcervical radiculopathy (short for CR in this paper) is the highest among CS whichreaches 50-60%. CR always occurs in 40-60 aged people.Because the pathogenesis of CR has not been understand fully for a long time,the choose and application of treatment plan has met lots of difficulties. Sometimes,some patients suffered a lot from accidentally iatrogenic damage. Therefore, studyingan effective and convenient treatment of CR and lowering iatrogenic damage are ofgreat social and economical significance.Based on studying CS’ knowledge and diagnostic and therapeutic experience intraditional Chinese medicine (short for TCM), the paper summarized systematicallytherapeutic mechanism of Chinese herbs and related research evolution in terms ofCR. Moreover, the paper reviewed and summarized documents on Tuina treating CR.In TCM perspective, CR belongs to "Bi syndrome". Pathogenic wind, cold, dampnessaffecting neck, local trauma and prolonged bad position contribute tense and spasticcervical muscle and then blockage of meridians, which is the external cause. Thedegeneration of cervical intervertebral disc, thickening and ossification of cervicalligaments, changed cervical physiological curvature, subluxation of the facet jointsand osteophytes of cervixes block the circulation of Qi and blood. The stagnation ofQi and blood and blockage of meridians causes malnutrition of sinews and bonesaround, which is the internal cause. The combination of internal and external causesmixed cold and blood stasis to linger in neck, which leads to degeneration of sinewsand bones around. Therefore, the physiological balance of neck has been disturbed,which results in subluxation of sinews and bones, and CS arise. So far, TCM treatingCR has certain advantages, such as acupuncture, moxibustion, Tuina, Chinese herbs,traction and physiotherapy. Among them, Tuina has good curative effect on CR. Butthere are negative reports about Tuina malpractices. Meanwhile, clinical researchesare believed poor-standardized, randomized and lack of objective and systemicevaluation. So studying CS vigorously, bringing the advantages of Tuina treating CRinto full play and searching effective treatment are of great significance.The paper also reviewed and summarized modern medical researches on etiology,pathology, diagnosis and treatment of CR at home and abroad. With the developmentof basic research of CR in the latest decades, people have further knowledge of CR’spathogenesis in terms of anatomy, physiology and pathology. There are three maintheories about CR’s pathogenesis, that is, theory of mechanical compression, theory of chemical stimulation and autoimmune theory where compression, inflammatorystimulation and immune reaction can cause radiculopathic pain in CR. Moreover,they relate with and act on each other.So far there are surgery and conventional treatment as for CR. The surgery hasseveral approaches. In the surgery, spinal canal, spinal cord and nerve roots can beobserved, protruded disc, osteophytes can be removed and cervical vertebra can bestabilized by grafted bone. However, a series of complication (such as surgery’strauma, the damage of cervical stability, infection after surgery, rejection and graftedbone’s falling off) and expensive treatment charge make most of patients with CRchoose conventional treatment at home and abroad except some typically indicatedfor surgery.Based on clinical experience of my tutor—Professor Jin Hongzhu anddocuments’ review on CR, the study adopted randomized, paralleled controlledmethod so that Tuina’s curative effect on CR by unblocking meridians and governorvessel method can be objectively evaluated. In the study, several indexes of curativeeffect were evaluated. The significance of this study is to further know the mechanismof Tuina treating CR which can provide objective foundation on curative effect andsecurity of Tuina manipulation treating CR. All these can guide Tuina treating CRwhich can benefit clinical popularization of Tuina.Objective: to observe Tuina treating CR by unblocking meridians and governorvessel method and to discuss the therapeutic mechanism.Methods: the clinical study was randomized, paralleled controlled. 90 patientswith CR were divided into 3 groups evenly—1 research group and 2 control group.They were treated by Tuina method of unblocking meridians and governor vessel,traditional massage and oral administration of Celecoxib(cyclooxygenase-2inhibitors). Then the indexes’ change of clinical symptoms, signs and bloodrheoIogy, NO,NOS,5-HT before and after treatment were observed.Results: in clinical observation, Tuina manipulations of unblocking meridiansand governor vessel can markedly improve clinical symptoms and signs of patientswith CR. Moreover, curative effect of treatment group was better than that of controlgroups and the former can improve clinical indexes more effectively with 93.33%effective rate. These Tuina manipulations can especially relieve radiculopathic painand achieve good curative effect.Conclusion: Tuina method of unblocking meridians and governor vessel hasgood curative effect on treating CR and can improve the security of manipulationtreating CR. The mechanism is that this method can improve microcirculation,effectively readjust cervical balance and spacial relationship between nerve roots andsurrounding tissues, reduce anatomical structure to relieve symptoms. Therefore, thismethod is worthy to popularize in clinic. |
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