The Effect Mechanism And Clinical Study Of Tuina Intervene On Suboccipital Deltoid Group Of Cervicogenic Headache Based On MR-Diffusion Tensor Imaging

Theory and Literature ResearchFirst,the etiology and pathogenesis of CEH were discussed from the perspective of TCM,and the clinical research progress of the disease was systematically summarized.Meta analysis was carried out on the randomized controlled trial of Tuina for the treatment of CEH.Then analyzes the concept and development process of the disease from the perspective of modern medicine,focusing on the pathogenesis and relative diagnostic criteria of the disease.In addition,a large amount of literature is used to systematically summarize the progress of modern medical research on CEH.It is recognized that there are still many problems in the pathogenesis and clinical diagnosis and treatment of CEH.Tuina has certain clinical advantages in the treatment of this disease,but there is no high-level evidence to confirm its clinical mechanism.Clinical Research1.A study of the correlation between CEH and the state of the suboccipital deltoid group based on DTIObjective:To analyze the correlation between the incidence of CEH and the status of suboccipital deltoid group based on DTI.Methods:60 patients with CEH and 60 healthy volunteers were divided into the observation group and the control group.Then collected the data of MR and DTI(FA?ADC)of all the people,to establish a clinical data database and statistical analysis of the data through SPSS statistics software.Results:the difference between the patients with CEH and the healthy volunteers was found from the naked eye,so as the differenc between the affected side and the healthy side of patients with CEH.The muscle fiber bundles in the patients with CEH were thinner and disorder then the other people.The difference of FA value and ADC value at the same side of the suboccipital deltoid group between observation group and the control group was statistically significant(P<0.05).There was a statistically significant difference between the musculi rectus capitis posterior and the tmusculi obliquus capitis superior,but there was no significant difference between the obliquus capitis inferior from the FA value and ADC value of them.Conclusion: The water molecular diffusion of the suboccipital deltoid group is more abnormal in the patients with CEH than the healthy side and healthy volunteers,suggesting that the incidence of CEH is related to the status of the suboccipital deltoid group.2.Clinical study on treatment of CEH by Tuina on the suboccipital deltoid groupObjective:To observe the effects of two different treatments of tuina and needle knife in the treatment of CEH,and to explore the mechanism of them based on DTI.Methods:60 cases of CEH were divided into 30 cases of Tuina therapy group and 30 cases of Needle knife therapy group by using the randomized controlled study.After 4 weeks of treatment,data were collected from DTI,VAS,clinical efficacy,frequency of treatment and efficacy,follow-up of headache attacks,patient compliance and safety.Results: On the overall efficacy determination,the effective rate of the treatment group was 93.33% and the control group was 90%.There was a difference in the contrast of the DTI of the suboccipital deltoid group before and after the treatment of CEH.And the value of FA was higher than that before treatment,but the value of ADC was decreased.The VAS scores of the two groups were difference after the treatment,and the control group was better than the treatment group.The number and times of treatment in the control group were shorter than those in the treatment group.Follow up showed that the number of pain in the treatment group was significantly less than that in the control group in six months.Safety monitoring showed that there was no obvious adverse reaction in two groups after treatment,but some patients in the control group had mental tension in the early stage of treatment.Conclusion:Tuina therapy and Needle knife therapy have a definite effect on the treatment of CEH with the treatment of the suboccipital deltoid group.Tuina therapy is superior to Needle knife therapy in the overall efficacy,long-term efficacy and safety,while Needle knife therapy has the advantages of quick effect and good analgesic effect in the short term.3.A summary of the clinical experience of Professor Li Huadong in the treatment of Cervical diseaseFrist to analysis the Professor Li Huadong viewpoint of the pathogenesis of Cervicogenic disease,and then summarize his clinical thought and methods about such diseases.Then through the analysis of typical cases of the Cervical vertigo and CEH,to provides a reference for the clinical diagnosis and treatment in the future.