| Objective1.Through a systematic review and meta-analysis of electroacupuncture combined with cupping and cupping for cervical vertebrae-related disease s,evaluation of the improvement of indicators of cervical vertebrae rela ted diseases by electroacupuncture combined with cupping and cupping.Pro vide evidence-based evidence for treatment of cervical vertebrae related diseases by electroacupuncture combined with cupping and cupping2.We conducted a randomized controlled trial,using non-steroidal anti-inflammatory drugs as a positive control group,to evaluate the safety and efficacy of electroacupuncture combined with pricking cupping and electroacupuncture for chronic neck pain.Method1.Literature research:The Cochrane evaluation system was used to evaluate the efficacy and s afety of electroacupuncture combined with pricking cupping therapy for ce rvical spondylosis.Computer search CNKI,VIP,Wanfang,Pubmed,Chinese b iomedical literature database CMB,The effect of Randomized controlled tr ials of electroacupuncture combined with puncture and cupping were includ ed in a meta analysis..2.Clinical research(1)Recruitment target:All recruited patients were from the acupuncture clinic of the Dade Ro ad General Hospital of the Second Clinical Medical College of Guangzhou U niversity of Traditional Chinese Medicine.(2)Trail designA random clinical design was used to avoid selectivity bias.According to the ratio of 1:1:1,follow the randomization operation,excel was use d to design the random number table number and grouping result,and make the card,seal it with opaque envelope,and order the serial number of th e random group of envelopes.Subjects were treated according to the card grouping according to the random number of the envelopes they received.B lind evaluators and data statisticians to avoid risk of bias in patient d ata assessment and statistics.(3)InterventionsElectroacupuncture combined with pricking cupping group:Electroacupuncture treatment:Acupoints:electroacupuncture points:Jingbailao,jingjiaji,Jianzhongs hu,Jianjing;.1 Needles;Huatuo brand electronic acupuncture instrument(SDZ-V type),0.3x25nun needle,vonfrey EVF3 tester,Aner iodine skin disinfectant,ste rile cotton swab,95%alcohol,disposable sterile needle(Specifications 0.7x30TW.LB),several glass cups(models:No.1,No.2,No.3,No.4,No.5),hemostats,medieal absorbent cotton,etc.2 Position and environment:the patient sit on a chair when aceived ac upuncture3 Operation method:the patient takes the sitting position,the acupun cture point and the finger of the needle are routinely disinfected,take the acupuncture points above the two sides,and use a needle to puncture the acupuncture point.The depth of the acupuncture is determined accordi ng to the body position and fatness of the subject.To the extent that th e patient feels sour,hemp,swelling,pain,etc.,then leave the needle,and then add the electro-acupuncture device to the two acupuncture points and give the corresponding electrical stimulation.The output current sh ould beIlnA when acupuncture,sparse wave;measure the patient's pain t hreshold and VAS score,and score the relevant scale.The above treatment was performed 3 times a week,the treatment interval was more than 24 ho urs,10 times was a course of treatment,and a total of 10 treatments wer e performed.Pricking cupping treatment:Each time 2-3 acupoints are selected,the patient takes a prone positi on or a prone position,and after disinfecting the selected skin and surr ounding area with iodine,use a disposable syringe needle to quickly punc ture 3-5 times in the tender area.(Deep 1-2un),quickly add glass cuppin g(the type of cupping is selected according to the skin area of the lick ing),5-10ml of bleeding,leave the cup on the neck for 3-5min,and wipe the surface of the skin with a sterile cotton ball after taking the cup.And press until the skin of the spurs does not bleed again.Local punctur e cupping was performed twice a week and was scheduled to be applied at t he first and third treatments per week.Note:Pay attention to local warm th after cupping,avoid contact with cold water on the day of treatment a nd directly blow air to the air conditioner.Electro-acupuncture grouP:Acupoints selection and electroacupuncture operation combined with cup ping group,only electroacupuncture operation.The above treatment was pe rforrmed 3 times a week,the treatment interval was greater than 24 hours,10 times was a course of treatment,and a total of 10 treatments were pe rformed.Control groupOral non-steroidal anti-inflammatory drugs,the usage and dosage are p rescribed according to the doctor' s prescription,and the treatment time is no more than 21 days.CourseThe above electroacupuncture treatment is 3 times a week,local punctu re and cupping is treated twice a week,and is scheduled to be applied at the first and third treatments per week.The treatment interval is great er than 24 hours,and the electroacupuncture combined with the pricking c upping is used.For 1 time,10 times for 1 course of treatment,a total o f 10 treatments.The medication is prescribed according to the doctor' s p rescription and is not used for more than 21 days.Grouping,study time and evaluation pointsThe patients with chronic neck pain were randomly divided into three g roups:electroacupuncture combined with pricking and cupping treatment gr oup,electroacupuncture group and drug control group.The electroacupunct ure group and the needle canister group were treated 10 times,and the dr ug group did not exceed 21 days.The evaluation was performed as an evalu ation point before treatment,5 times,10 times,and 1 month of follow-up,and a total of 4 evaluations were performed.Observation indexDemographic data:name,gender,age,duration of illness,medical hist ory,marriage history,etc.Curative observationa Cumulative assessment indicators:1)Northwick Park Neck Pain Scale(NPQ),evaluation time:0,5,10,follow?up follow-up January evaluation,a total of 4 times.b Immediate effect evaluation indicators:2)vonfrey EVF3 pain threshold tester,3)VAS visual simulation score,evaluation t ime point:pain threshold score and VAS score 1 min before treatment,1 m in after treatment,4 times.Secondary evaluation indicators,4)SF-36 Sy mptom Checklist,5)13 Beck Depression Self-Assessment Questionnaire(BD I),evaluation time:0,5,10,follow-up follow-up January evaluation,a total of 4 Times.6)Safety indicatorsAdverse reaction record:The adverse reaction of the drug was evaluate d by the SER adverse reaction scale,and the acupuncture adverse reaction was recorded every time the patient' s appearance was recorded.7)Efficacy evaluationAccording to the NPQ score,the decrease of?4 points before treatmen t is considered to be effective,and the decrease of less than 4 points i s invalid.At the same time,the NPQ,PPT,Beck SF-36 and VAS scores at e ach time point are compared and analyzed.8)Statistical analysis1 Statistical analysis will be carried out using SPSS17.0 statistical analysis software;2 all statistical tests use two-sided test,the differ ence between the tests is statistically significant P value is less than or equal to 0.05;3 measurement data will be measured by meanąstandard deviation Statistical description,the count data is statistically descr ibed using the frequency(composition ratio).The comparison between the repeated measurement data sets was performed by one-way repeated measures analysis of variance,and the comparison between groups was performed by two-way repeated measures analysis of variance or multivariate analysis of variance.4 NPQ efficacy analysis at 10 treatments using card room ana lysis and inter-groupcorrection;Result:1.System Overview:At the beginning,243 related articles were examined.After reading th e title,43 articles were obtained.After reading the abstract and the fu 11 text,the self-control was excluded,and 29 articles were included.By reading the full text,one article that did not meet the inclusion crite ria was excluded,and the duplicated papers were excluded.2 articles.Fi nally,13 articles were included.According to Cochrane's Revman 5.3 soft ware quality evaluation,the quality of the 13 articles included was not high.In the random method,the included literatures were all randomized controlled studies,but most of them did not indicate which method was us ed;All the literatures are not stated.All the literatures are not menti oned in the evaluation of the blind method.Incomplete reporting of the d ata is not mentioned in all the literature.13 papers evaluated the effic acy of electroacupuncture combined with pricking and cupping in the treat ment of cervical spondylosis.There are 3 articles compared with hand nee dies,4 articles compared with pricking cupping,1 case compared with pri eking,and 7 compared with electroacupuncture.Literature.Among the subj ects studied,there were 1476 patients,including 613 males and 863 femal e patients.In the course of disease,there were 6 literatures with a dis ease duration of more than 3 months.Three articles did not describe the length of the disease.Two articles included The shorter course of diseas e is the acute phase.In terms of outcome measures,the efficacy indicato rs were standardized treatments,while in the scale or objective indicato rs,only one paper used the McGill score,and only one paper in the pain mentioned the VAS score.The meta-analysis of the efficacy showed that th e test group was superior to the control group,and the difference was st atistically significant(OR?3.34,95%CI=-2.28,4.88,Z=6.20,P<0.00001).According to the GRADEpro online evaluation tool,the quality of the met a-analysis of electroacupuncture combined with cupping and cupping for ce rvical spondylosis was in a low quality.3.Clinical research1)NPQ evaluation indexComparison between groups:The overall comparison showed that the difference was statistically si gnificant(P=9.194,P=0.000),and the differences between the two groups were statistically significant(P=0.04,0.000).The difference between th e electroacupuncture group and the drug group was statistically significa nt(P=0.035).When treated 5 times,the difference between the needle group,the ele ctroacupuncture group and the drug group was statistically significant(P=0.003,0.01).There was no significant difference between the acupunctur e group and the electroacupuncture group(P>0.05).When treated 10 times,the difference between the needle group and the drug group was statistically significant(P=0.000).There was no signifi cant difference between the needle group and the electroacupuncture group(P>0.05).The difference between the electroacupuncture group and the dr ug group was statistically significant.Meaning(P=0.007).At 1 month follow-up,there were significant differences between the a cupuncture group and the electroacupuncture group and the drug group(P=0.001,0.000).The difference between the electroacupuncture group and the drug group was statistically significant(P=0.045).Comparison within the group:The scores of the treatment time points of the acupuncture group,the electroacupuncture group and the drug group were all lower than those bef ore treatment.The trend of the three groups of NPQ scores was statistica lly significant(P=0.000,0.002,0.026).There were significant differences between the acupuncture group treat ed 5,10 times and 1 month follow-up and the pre-treatment scores(P=0.000).There was no significant difference between the treatments of 5 treat ments and 10 treatments and 1 month follow-up(P>0.05);There were significant differences between the electroacupuncture grou p 5 and 10 times and the pre-treatment scores(P=0.018,0.001).There wer e no significant differences in the treatments after 5 treatments and 10 months follow-up(P>0.05).;There was a statistically significant difference between the drug grou p and the pre-treatment scores(P=0.002).There were no significant diffe rences between the 5 treatments,the treatment,the treatment,and the fo llow-up January(P>0.05)).2)PPT scoreComparison between groups:The overall comparison showed that the difference was statistically si gnificant(F=25.809,P=0.000),and the differences between the two groups were statistically significant(P=0.000,0.000).The difference between the electroacupuncture group and the drug group was statistically signifi cant(P=0.027).When treated 5 times,the difference between the needle group and the electroacupuncture group and the drug group was statistically significant(P=0.021,0.000),and the difference between the electroacupuncture grou p and the drug group was statistically significant(P=0.045).When treated 10 times,the difference between the needle group and the electroacupuncture group and the drug group was statistically significan t(P=0.006,0.000).The difference between the electroacupuncture group a nd the drug group was statistically significant(P=0.041).At 1 month follow-up,there were significant differences between the a cupuncture group and the electroacupuncture group and the drug group(P=0.006,0.000).There was no significant difference between the electroacupu ncture group and the drug group(P>0.05).Comparison within the group:The scores of the treatment time points of the acupuncture group,the electroacupuncture group and the drug group were lower than those before treatment.The trend of the three groups of PPT scores was statistically significant(P=0.000,0.000,0.047).There were significant differences between the acupuncture group treat ed 5,10 times and 1 month follow-up and the pre-treatment scores(P=0.000,).There were no significant differences between the treatments of 5 tr eatments and treatments 10 times and follow-up January.(P>0.05);There were significant differences in the electroacupuncture group bet ween 5 and 10 treatments and 1 month follow-up and pre-treatment scores(P=0.002,0.000,0.007).There were no differences between the treatments of 5 treatments and treatments 10 times and follow-up months.Significan ce(P>0.05),the difference between the treatment of 10 times and the fol low-up of January was statistically significant(P=0.025);There was a statistically significant difference between the drug grou p and the pre-treatment scores in the treatment group(P=0.000).There wa s no significant difference between the 5 treatments and the pre-treatmen t,10 treatments,and 1 month follow-up(P>0.05).3)BDI scoreComparison between groups:The overall comparison showed that the difference was statistically si gnificant(F=5.144,P=0.008),and the difference between the two groups was statistically significant(P=0.002),which was different from the ele ctroacupuncture group.There was no statistical significance(P>0.05).Th e difference between the electroacupuncture group and the drug group was statistically significant(P=0.0038).There were significant differences between the acupuncture group and t he electroacupuncture group and the drug group(P=0.001,0.014).There wa s no significant difference between the needle group and the electroacupu ncture group(P>0.05).There were significant differences between the acupuncture group and t he electroacupuncture group and the drug group(P=0.005,0.013).There wa s no significant difference between the needle group and the electroacupu ncture group(P=0.041).At 1 month follow-up,there was a statistically significant difference between the acupuncture group and the drug group(P=0.024).There was no significant difference between the needle group and the electroacupunctu re group(P>0.05).There was no significant difference between the electr oacupuncture group and the drug group.Significance(P>0.05).Comparison within the group:The scores of the treatment time points of the acupuncture group,the electroacupuncture group and the drug group were lower than those before treatment.The trend of the three groups of NPQ scores was statistically significant(P=0.000,0.000,0.001).There were significant differences between the acupuncture group treat ed 5,10 times and 1 month follow-up and the pre-treatment scores(P=0.000,0.000,0.000).There was a statistically significant difference betwee n the 5 treatments and the 10 treatments(P=0.034).There was no signific ant difference in the follow-up 1 month,5 treatments and 10 treatments(P>0.05).There were significant differences between the electroacupuncture grou p 5 and 10 times and the follow-up 1 month and the pre-treatment scores(P=0.000,0.000,0.000).The difference between the treatment 5 times and the treatment 10 times was statistically significant(P=0.000).There wa s no significant difference in the follow-up of 1 month and 5 times and 10 times(P>0.005).The difference between the drug group and the pre-treatment scores was statistically significant(P=0.001,0.002),and the treatment was 5 time s and the treatment was 10 times(P=0.001).There was no significant diff erence between the two groups(P>0.05).There was no significant differen ce between the follow-up 1 month and the treatment 5 times and 10 times(P>0.05).4)SF-36 score1)Physiological functionThere was no statistical significance between the three groups.(F=0.215,P=0.807):Comparison within the group:There was no statistically significant eh ange in the trend of the cup&elc group,the EA group,and the drug group(P>0.05).2)Physiological functionsThere was no significant difference between the cup&elc group and the EA group(P>0.05),the difference between the cup&elc group and drug grop u was statistically significant(P=0.000,0.007).Comparison within the grouP:The trend of the three group was statisti cally significant,Fcup&elc grour=26.365,P=0·000;FEA FEA group=8.245,P=0·000;Fdrug grop=3.275,P=0.026.3)PainComparison between groups:There were significant differences between the cup&elc group,the EA group and the drug group(P=0.000,0.005).There was significant difference between the cup&elc group and the EA group(P=0.038).Comparison within the group:The trend of the three group was statisti cally significant,Fcup&elc group=13.749,P=0.000;FEA group=5.046,P=0.003;F dr ug group=4.277,P=0.019.4)General health.Comparison between groups:There were significant differences between the cup&elc group and the EA group and the drug group(P=0.033,0.000).T here was no significant difference between the EA group and the drug grou p(P>0.05).Comparison within the group:The change trend of the cup&elc group and the electroacupuncture group were statistically significant.The Fcupelc group=10.086,P=0.000;the FEA group?4.337,P=0.036,the drug group transformation trend was not statistically significant.(P>0.05)5)Vitality:There were significant differences between the cup&elc group and the E A group and the drug group(P=0.000,0.006).There was no significant dif ference between the EA group and the drug group(P>0.05).Comparison within the group:The trend of the threegroup was statistic ally significant,Fcup&elc group=16.908,P=0.000;FEA group=4.093,P=0.010;Fdrug grwp=3.409,P=0.022.6)Social functions:Comparison between groups:There was no significant difference between the cup&elc group and the EA group(P>0.05).The difference between the t wo groups and the drug group was statistically significant(P=0.000,0.006).Comparison within the grouP:the change trend of the cup&elc group and the EA group were statistically significant(Fcup&elc group=26.402,P=0.000:F EA group=17.03,P=0.000),and the drug group showed no change trend(P>0.05)7)Emotional functions:Comparison between groups:There was no significant difference between the cup&elc group and the EA group(P>0.05).There was significant differ ence between the two groups and the drug group(P=0.000,0.004).Comparison within the group:The trend of the three group was statisti cally significant,Fcup&elc group=26.402,P=0.000;FEA group=17.03,P=0.000;Fdrug group=13.86,P=0.014.8)Mental health:Comparison between groups:When treatment 5 times,there was no statist ically significant difference between cup7elc group and the EA group(P>0.05).To the drug group,the cup&elc group and the EA group both have stati stically significantly(P=0.000,0.002),there was no significant differen ce between the he cup&elc group and the EA group at 1 month follow-up(P>0.05),which both are better than the drug group(P=0.004,0.017).Comparison within the group:The trend of the threegroup was statistic ally significant,Fcup&elc group=15.81,P=0.000;FEA group=12.50,P=0.000;Fdrug group=4.835,P=0.014)5)VASComparison between groups:When treated 5 times,To the drug group,the cup&elc group and the EA g roup both have statistically significance(P=0.019,0.000).The difference between the EA group and the drug group was statistically significant(P=0.001).When treated 10 times,the difference between the cup&elc group and th e electroacupuncture group and the drug group was statistically significa nt(P=0.001,0.000).The difference between the EA group and the drug grou p was statistically significant(P=0.000).At 1 month follow-up,there was a statistically significant difference between the cup&elc group and the EA group and the drug group(P=0.000,0.000).There was a statistically significant difference between the elec troacupuncture group and the drug group(P=0.006).According to the above trends,the cup&elc group is superior to the EA group and the drug group in reducing the VAS score,and the EA group is s uperior to the drug group.Comparison within the group:The trend of the three groups of VAS scores was statistically signific ant(P=0.000,0.000,0·000).In the cup&ele group,there were significant differences between the tr eated 5,10 times and 1 month follow-up and the pre-treatment scores(P=0.000,0.000,0.000).The difference between the treatments of 5 treatments and the treatments was 10 times.Significance(P=0.000,0.000),there was no significant difference between 10 treatments and 1 month follow-up(P>0.05).In the EA group,there were significant differences between the 5 and 10 times and the follow-up 1 month and the pre-treatment scores(P=0.000,0.000,0.000).The difference between the treatment 5 times and the treat ment 10 times was statistically significant(P=0.000).There was no signi ficant difference between the treatment of 10 times and the follow-up of January(P>0.005);In the drug group,there were statistically significant differences bet ween the 10 times and the follow-up 1 month to the pre-treatment scores(P=0.001,0.002).The treatment was 5 times and the treatment was 10 times(P=0.001).Follow-up was performed.There was no significant difference b etween the two treatments and the treatment(P0.05).(6)NPQ efficacy scoreThe difference between the three groups was statistically significant(P=0.023).Further analysis showed that the difference between the cup&el c group and the drug group was statistically significant(P<0.05),there was no significant difference between cup&elc group and EA group(P>0.05).There was no significant difference between the EA group and the drug gr oup(P>0.05).7)Safety evaluationAll the three groups had adverse events,all of which were mild,6 cas es in the needle group and 4 cases in the electroacupuncture group.The t otal incidence was 20%.Among them,4 cases caused by puncture in the loc al hematoma of the needle group,cupping blisters In 2 cases,2 cases of local muscle soreness in the electroacupuncture group,3 cases of nausea in the drug group,2 cases of abdominal pain,and 2 cases of palpitation,all of the above side effects were mild,and no intervention measures we re taken for treatment,and they improved themselves without leaving any problems.conclusion(1)An evidence-based medical study on the treatment of cervical verte brae-related diseases by electroacupuncture combined with cupping and cup ping shows that electroacupuncture combined with puncture and cupping can better improve the symptoms of cervical-related diseases compared with e lectroacupuncture,but this study The articles in the article are include d in the low quality,and most of them only evaluate the efficacy,and th e lack of psychological status and quality of life evaluation requires mo re evidence-based medical evidence to support;(2)In this clinical study,electroacupuncture combined with Pricking therapy,electroacupuncture therapy and drug treatment can effectively improve the scores of chronic NPQ,PPT,VAS,BDI and SF-36.To the effect,on the outcome of 10 evaluations of NQP treatment,the cup&elc group was equivalent to the EA group,which was superior to the drug group.The EA group was equivalent to the drug group.The overall analysis of the NPQ,PPT,BDI,and VAS indicators,cup&elc was better than EA group,The EA group can improve the NPQ,PPT,VAS,BDI score loetter than the drug group.SF-36,EA group,the cup&elc group could better improved the pain,general health,vitality,wihle two groups were better than drug in physiological function,vitality,and emotional function mental health.The drug group can improve the mental health,physiological functions,vitality,and emotional functions.This study shows that electroacupuncture combined with pricking therapy can improve the pain and depression and quality of life of patients with chronic neck pain compared with single electroacupuncture or drug therapy. |
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