Literature Reviews And Clinical Retrospetive Study Of The Treament For Cervical Spondylotic Radiculopathy

BackgroundWith the development of society, cervical disease has been one of the most common disease in orthopedics. Cervical spondylotic radiculopathy(CSR) accounting for 70.2% of cervical disease, the majority of CSR were treated conservatively. And the treatment various. Literatures show that CSR treatments is various including traction, medication, massage, acupuncture, physiotherapy and so on. and multi-treatments show its advance but this type of treatment a large siege use in patients increased medical expenses. As people continued in-depth knowledge of the disease, treatment has also been improved, but not yet developed a standardized treatment. Therefore, patients pay for medical expenses large, bur did not get good rehabilitation. How to enhance the clinical efficacy, get rid of a large siege use of treatments became an urgent matter. Recent years, with the continuous development of evidence-based medicine, evidence-based medicine became modern clinical medicine standardized model. So we try to Establish an evidence-based treament strategy for clinic pratice.ObjectivesThrough evidence-based literature review and retrosprtive study of CSR patients case, investigating the current treament situation of integrated of Chinese and Western, we aim to establish programs to provide evidence-based integrated Traditional Chinese and Western Medicine treament strateties.MethodsResearch literature:systematic review and assessment through the literature (including ancient TCM and modern literature), including high-quality Chinese and Western medicine of randomized controlled trials, high-quality Chinese and Western medicine of Meta-analysis or clinical treatment guidelines. Retrospective study cases were from Guangdong hospital of TCM between January 2007 and December 2009, all of them should meet the CSR diagnosis standard and the inclusion criteria of CSR research. The retrospective survey summarize clinical experience and treatment strategies status, the general condition of patients, inducing factors, the extent of disease, treatment options, the average length of stay in hospital, and the efficacy of such treatment using excel, and spss statistical software analysis.ResultCSR cause and pathogenesis of TCM regards to Cold Wind exogenous pathogens invasion, disharmony between QI and bloodand, Deficiency of Zang and Fu, tendonitis, meridians disease, muscles and bones strain; And the treatment of herbal is a dialectical use of expelling Wind and removing Dampness herbal, invigorate the circulation of blood herbal, reinforce insufficiency herbal, dispelling internal Coldherbal, eliminating dampness and eliminating phlegm herbal. Traction, massage, acupuncture are respected and clinical literature most commonly used method, there is a lot of evidence that combined use of acupuncture, massage, traction for CSR are better than other treatments; As to the use of Chinese herbal, current literatures had no enough evidence. these clinical research methodology itself is not in high quality:the sample size is small and there is no meta-analysis can be used. supplemented by missionary, preventive care, drug treatment, treatment options need further refinement, the starting point in the adjuvant therapy on the need to More evidence to support; there are insufficent care in preventing recurrence of disease and health education can not keep up. we must further explore the "Disease preventing modal" to develop effective prevention and treatment. the treatment strategy model "Basic therapy,+adjuvant therapy+preventive health care" medical model should be advocated.ConclusionThe result of TCM treaments is lack of evidence, of which research is low quality RCT, it is difficult to draw firm evidence. Future reports of trials should improve reporting of the concealment of allocation, blinding of outcome assessor, adverse events and Standards of reporting for TCM interventions, Both short and long term follow-up are needed. Since this study is only preliminary retrospective analysis, retrospective review of cases only a single hospital results and different regions of different treatment methods used.So to carry out multi-center retrospective study will be better understanding of the treament strategies Status. The current study results show that the integrated treatment of traction, massage, acupuncture and other complementary therapies is the most effective treatment modalities of Cervical spondylotic radiculopathy. further to finalize the treatment plan, including the use of various treatments and treatment methods used time, and the entire treatment process in the time between the starting point of different treatment methods such as these uncertainties, the need for different professions, as well as the professional experts to consult an expert method; Finally, Prospective study should be conduct to estimate the determined treatment strategies, in order to evaluate the implementation of treatment programs, efficacy, economics effect.