Clinical Characteristics And Related Mechanisms Of Comprehensive Conservative Treatment Of Cervical Spondylosis With Traditional Chinese And Western Medicine

Objective: To observe the safety,effectiveness and reproducibility of conservative treatment of cervical spondylosis with traditional Chinese and Western medicine,analyze its function characteristics and related mechanisms,and establish a large database of cervical spondylosis patients.Methods: This trial was a multi-center clinical Real World Study.Patients with cervical spondylosis(radiculopathy type,vertebral artery type and mixed type)who are eligible for the study are treated conservatively with Chinese and Western medicine.Visits at 0,2,4,6,12,26,and 52 weeks to collect basic information of patients and Visual Analogue Scale,Neck Disability Index,Short Form 36-item Health Survey,Vertigo Syndrome Scale,and establish a large database of more than 1,000 patients with cervical spondylosis.Analyze and compare the effectiveness of drug therapy,drug internal therapy,drug external therapy,physical therapy,manual therapy,acupuncture therapy,external therapy(At least one of drug external therapy,manual therapy and acupuncture therapy)and exercise for cervical spondylosis.The stratified analysis of cervical spondylosis patients with different genders,ages,types,course,baseline pain degree and baseline vertigo level is performed to evaluate the effectiveness and prognosis of different groups of drug external therapy?exercises and drug internal therapy.Results:(1)Baseline data of 1014 cases showed 705 female cases(69.53%),the average age was 46.43±12.49 years old,male ?40 years old and female ?35 years old 761 cases(75.05%),Female ? 35 years old(five seven)536 cases(52.86%),765 cases of cervical spondylotic radiculopathy(75.44%),483 cases with a course of more than 1 year(47.60%),649 cases with moderate pain(64.00%),197 cases of vertebral artery type and mixed cervical spondylosis patients with mild vertigo(79.12%),993 patients with health education(97.93%),901 patients with external therapy(88.86%),695 patients with drug therapy(68.54%),658 patients with exercise(64.89%),634 patients with physical therapy(62.52%),594 patients with drug external therapy(58.58%),425 patients with manual therapy(41.91%),364 patients with acupuncture therapy(35.90%),245 patients with drug internal therapy(24.16%).There were 38 possible adverse events related to treatment.(2)Comparison before and after treatment suggests that drug therapy,drug internal therapy,drug external therapy,physical therapy,manual therapy,acupuncture therapy,external therapy and exercise for cervical spondylosis may have significant effectiveness of pain relief,neck function improvement,health recovery and vertigo symptoms reduction.(P<0.001)(3)Comparison between groups suggests that drug therapy for cervical spondylosis may have significant effectiveness of pain relief,neck function improvement,health recovery,Vitality recovery,Social Functioning recovery,Mental Health recovery and vertigo symptoms improvement.Drug internal therapy for cervical spondylosis may have a significant effectiveness of pain relief and vertigo symptoms reduction.Drug external therapy for cervical spondylosis may have significant effectiveness of pain relief,neck function improvement,health recovery,general health recovery,vitality recovery,social functioning recovery,role-emotional recovery and vertigo symptoms improvement.Physical therapy for cervical spondylosis may have significant effectiveness of mental health recovery.Acupuncture treatment of cervical spondylosis may have significant effectiveness of pain relief and mental health recovery.External treatment for cervical spondylosis may have significant effectiveness of neck function improvement,health recovery and general health recovery.Exercise for cervical spondylosis may have significant effectiveness of neck function improvement,health recovery,social function recovery,role-emotional recovery and mental health recovery.(P<0.05)(4)Stratified analysis suggests that drug external therapy may have significant effectiveness of pain relief 2 weeks later for women,female ? 35 years old or male ? 40 years old,course ? 1 year and mild pain;2 weeks later for radiculopathy type;2-6 weeks and 26-52 Weeks for mixed type;4 weeks later for course 3-6 months,moderate pain;4 weeks and 12 weeks later for severe pain;12 weeks later for course 0-3 months;26 weeks later for vertebral artery type;26 weeks later for female <35 years old or male <40 years old,course 6 months-1 year;52 weeks for men with cervical spondylosis.Drug external therapy may have significant effectiveness of neck function improvement 2 weeks later for women,female ? 35 years old or male ? 40 years old,course ? 1 year;2 weeks later for radiculopathy type;2-6 weeks and 52 weeks for female <35 Age or male <40 years old;4 weeks later for men,course 3-6 months,severe pain,moderate pain;4 weeks later for vertebral artery type;4 weeks and 12 weeks later for mixed type,6 weeks later for course 0-3 months;26 weeks later for mild pain;52 weeks for course 6 months to 1 year with cervical spondylosis.Drug external therapy may have significant effectiveness of health recovery 4 weeks later for women,course 0-3 months and 3-6 months,severe and moderate pain;4 weeks later for radiculopathy type;6 weeks later for man,course ?1 year;6 weeks later for vertebral artery type;12-26 weeks for course 6 months to 1 year with cervical spondylosis.Drug external therapy may have significant effectiveness of vertigo symptoms reduction 6 weeks later for man;12 weeks later for female ? 35 years old and male ? 40 years old;12-26 weeks for women,moderate pain;26 weeks later for mild baseline vertigo,course 0-3 months with cervical spondylosis.(P<0.05)Exercise may have significant effectiveness of neck function improvement 26-52 Weeks for radiculopathy type and moderate pain;2 weeks for course 6 months to 1 year and mild pain;4-12 weeks for 0-3 month;4-6 weeks for vertebral artery type;4 weeks for course 3-6 months and ?1 year with cervical spondylosis.Exercise may have significant effectiveness of health recovery 2-12 weeks for moderate pain;2-4 weeks for female ?35 years old and male ?40 years old,radiculopathy type,course 3-6 months;2 weeks for vertebral artery type,course 0-3 months and ?1 year with cervical spondylosis.Exercise may have significant effectiveness of vertigo symptoms reduction 2 weeks for 0-3 months;4 weeks for female ?35 years old and male ?40 years old with vertebral artery and mixed cervical spondylosis.(P<0.05)Drug internal therapy may have significant effectiveness of pain relief 2-26 weeks for severe pain;2 weeks for mild pain,12-52 weeks for female ? 35 years old and male ? 40 years old;26-52 weeks for mixed type;52 weeks for women,radiculopathy type,course 0-3 months,moderate pain with cervical spondylosis.Drug internal therapy may have significant effectiveness of neck function improvement 2 weeks for course 6 months to 1 year;12 weeks later for mixed type with cervical spondylosis.Drug internal therapy may have significant effectiveness of vertigo symptoms reduction 2-4 weeks and 12-26 weeks for moderate pain vertebral artery and mixed type,2-4 weeks and 12 weeks for women,2-4 weeks for female ? 35 years old and male ? 40 years old,2 weeks for mild vertigo,4-12 weeks for mixed type with cervical spondylosis.(P<0.05)Conclusion: Comprehensive conservative treatment of cervical spondylosis with traditional Chinese and Western medicine has the characteristics of good clinical effectiveness,less adverse events and recurrence,which can be applied and promoted.According to the research,the main conclusions may be as follows:(1)Cervical spondylosis is more common in women,female ? 35 years old and male ? 40 years old.Cervical spondylotic radiculopathy is the most common type.It often has a course of more than 1 year.It often shows moderate pain and mild vertigo.The treatment is followed by health education,external treatment,drug therapy,exercise,physical therapy,drug external therapy,manual therapy,acupuncture therapy,and drug internal therapy.(2)Different conservative treatments such as drug therapy,drug internal therapy,drug external therapy,physical therapy,manual therapy,acupuncture therapy,external therapy and exercise for cervical spondylosis may have significant effectiveness of pain relief,neck function improvement,health recovery and vertigo symptoms reduction.There are some differences in the clinical effectiveness and the prognosis of cervical spondylosis patients with different gender,age,type,course,baseline pain degree and vertigo level.(3)Cervical spondylotic radiculopathy is recommended to use drug external therapy,exercise,drug internal therapy;cervical spondylosis of vertebral artery is recommended to use drug external therapy,drug internal therapy,exercise,manual therapy,acupuncture therapy;Hybrid type of cervical spondylotic radiculopathy and vertebral artery type cervical spondylosis is recommended to use drug external therapy,drug internal therapy.(4)Drug external therapy may have significant effectiveness.Drug internal therapy and exercise can play a synergistic and complementary role.For patients who have limited economic conditions and can endure symptoms of cervical spondylosis during treatment,they can only choose drug external therapy.