Clinical Research Of Umbilical Acupuncture On The Neck Type Cervical Spondylosis

ObjectivesTrace the history of the umbilicus treated as a special site for the treatments,and summarize the content and mechanism of umbilical therapy,to discuss the theoretical basis of umbilical acupuncture.Select the neck type cervical spondylosis patients under certain conditions for clinical research,then treat them by umbilical acupuncture and acupuncture respectively.Use the indications and scales such as NPQ,Mcgill,Vernon,the MF value of EMG power spectrum and the comprehensive curative effects,as well as the side effects and recurrence,to study the clinical effects of umbilical acupuncture in treating neck type cervical spondylosis and the role it plays in reducing the neck pains and muscle stiffness,improving the neck functions and the patients' quality of life.Then evaluate the efficacy and safety of umbilical acupuncture in treating neck type cervical spondylosis objectively and scientifically,and establish a set of standardized and effective treatments.MethodsAccording to clinical research sample size estimation formula,120 cases are needed to be studied,then divided into the research group and the control group,each group with 60 cases.The 120 cases were randomly divided into research group and control group.The research group are treated by umbilical acupuncture.The acupoints are directions of xun,li,kun and qian in the Eight Diagrams,which selected on the basis of the umbilical acupuncture principle.The sequence of acupuncture is symptoms first,then systems,and diseases last,so xun,li,kun,and qian are acupunctured one by one.After disinfecting the skin,acupuncture umbilical wall into 10-20 mm horizontally with 0.25 mm x 25 mm needles,making the needle handle contacted.Manipulate the needles with mild reinforcing-attenuating,the total time of each treatment is 20 min.The patients were treated once a day,and continuous 5 days as a course,with 2 days interval between two courses,2 courses of treatments were observed.The control group are treated by acupuncture.The acupoints are Jingjiaji,Tianzhu,Fengchi,Jingbailao and Ashi,which selected on the basis of the subject of acupuncture and moxibustion theraphy.After disinfecting the skin,acupuncture into 0.5-0.8 cun with 0.25 mm x 25 mm needles.Manipulate the needles with mild reinforcing-attenuating,the total time of each treatment is 20 min.The patients were treated once a day,and continuous 5 days as a course,with 2 days interval between two courses,2 courses of treatments were observed.The observation scales were as follows.Northwick Park Query : used to assess the extent of the patients' life quality affected by the disease,which contained the neck pain degree,tingling feeling,duration of symptoms,whether affected sleeping,carrying heavy things,reading,watching TV,driving and social activities.The higher the total score was,the greater the influence was.Mcgill: used to assess the pain of patients,which contained three aspects,pain rating index(PRI),visual analogue scale(VAS),present pain intensity(PPI),the PRI included sensory items and affective items.The pain in the neck was proportional to the total score,and the higher the score was,the more severe the pain was.Vernon: used to assess the functional activities of the neck,which contained the neck pain degree,life self-care ability level,lifting weights,sleeping,reading,attention,driving,working and playing.The higher the total score was,the higher the limitation of cervical function was.The MF value of EMG power spectrum: used to assess the functional state of the neck muscles,which applicated electromyographic acquisition system to collect the median frequency of power spectrum values of sternocleidomastoid and trapezius in isometric contraction process before and after treatment.Before the treatment,after one treatment and after two courses of treatment,every patient fill in the NPQ scale,and the doctor fill in the Mcgill and Vernon scales,as well as the MF value of EMG power spectrum.Evaluate the comprehensive effect of the two therapies under the evaluation criteria of cure,improvement and failure.Record the side effects such as fainting on acupuncture,sticking and bending of the needle,and hematomaduring the treatments.Each patient was followed up for 3 months after four courses of treatment,record the recurrence of patients who had improved or been cured.The data was collected and collated by another researcher.The statistics processing was done with the SPSS19.0 statistical package.The measurement data of normal distribution is recorded as mean±standard deviation,which is compared with t-test.The counting data was compared with the chi-square test and Fisher's exact test.The non-normal distribution of quantitative data and hierarchical data is compared by non-parametric tests such as rank and sum test.The difference was statistically significant with p < 0.05.ResultsWestern medicine believes that neck type cervical spondylosis is the most common and precursor type.There is no surgery indication of the disease,so the western medicine treatment method is mainly composed of nonsurgical conservative treatment,such as exercise therapy,traction and non-steroidal anti-inflammatory analgesics.Traditional Chinese medicine diagnose and treat the disease as “xiangbi”.The etiology and pathogenesis of the disease is empty inside without solid outside,so the wind and other pathogenic factor can violate the human body,which causes meridian stagnation and qi and blood blockage.The neck and head pain and inhibited bending and stretching occurs,even with the numbness of the limbs.There are five types of syndromes according to the clinical symptoms,such as the wind cold dampness type,phlegm-wet blocking type,qi stagnation blood stasis type,qi and blood deficiency type,liver and kidney deficit type.The methods of treating cervical spondylosis in traditional Chinese medicine are rich and varied.Acupuncture is one of the the most common treatment,with curative effect and less side effects.The five types are available to be treated by acupuncture treatment.The main acupoints are EX-B2,GB20,BL10 and ouch points,which can be added and subtracted dialectically.Umbilicus is treated as a special part in traditional Chinese medicine.There are many kinds of methods applied here for the treatment of diseases,namely the umbilical therapy.Umbilical acupuncture is also an umbilical therapy,which is a new kind of acupuncture and moxibustion therapy.It can be used in treating various diseases,and the effect is striking.When using umbilicalacupuncture to treat neck-shoulder and lumbocrural pain,the symptoms like pain and activity limitation can relieve quickly.There were no statistically significant difference from the age,sexuality and course,as well as NPQ,Mcgill,Vernon and the MF value of EMG power spectrum before the treatment of the two groups(P > 0.05).After one and two courses of treatment,the NPQ percentage,Mcgill score,Vernon and the MF value of EMG power spectrum of two groups compared with the pre-treatment,the difference was statistically significant(P < 0.05).These results of research group compared with control group,the difference was statistically significant(P < 0.05).In the research group,there were 21 cases cured,35 cases improved,4 cases failed,56 cases effective,so the effective rate was 91.33%.In the control group,there were 12 cases cured,34 cases improved,14 cases failed,46 cases effective,so the effective rate was 76.67%.The difference between the two groups was statistically significant(P < 0.05).After 3 months of follow-up,there were 5 cases having recurrence in 56 patients effective in research group,the recurrence rate was 8.92%.There were 11 cases having recurrence in 46 patients effective in control group,the recurrence rate was 23.91%.The difference was statistically significant(P < 0.05).There were 2 cases having the side effects such as fainting on acupuncture,sticking and bending of the needle,and hematoma during the treatments in research group,while there were 3 cases in control group.The rate were 3.33%and 5%.The difference was no statistically significant(P > 0.05).ConclusionsThe indexes such as age,sexuality and course,as well as NPQ,Mcgill,Vernon and the MF value of EMG power spectrum before the treatment of the two groups could be compared.Both umbilical acupuncture and acupuncture can reduce the neck pains and muscle stiffness,improving the neck functions and the patients' quality of life,but the effect of umbilical acupuncture was better.Both umbilical acupuncture and acupuncture could obtain curative effects and immediate effect,but the umbilical acupuncture was better,and it could also reduce the recurrence rate.Both of them were simple,safe and minor side effects therapies.In summary,umbilical acupuncture is an effective method for the treatmentof neck type cervical spondylosis,and it's easily manipulated,with minor side effects,which is worth popularizing in clinical practice.