| ObjectiveThis thesis aims to summarize professor(wangjianmin)'s clinical experiences and academic thoughts on the treatment of cervical spondylosis of vertebral artery type(CS-VA) by three-step balanced physical therapy(TSBPT) in the Second Chinese Medicine Hospital of Jiangsu Province(SCMHJP).Based on the comparison of clinical curative effect, transcranial doppler(TCD) findings, function markings and symptoms before and after treatment, to compare TSBPT with the traditional manipulation therapy, this thesis has come to a conclusion that the treatment methods of Prof. Wang are indeed feasible.MethodsProf. Wang has treated 76 cases of patients with CS-VA in the manipulation department of SCMHJP during the period from August 2012 to December 2014. The 76 cases of the patients were randomly divided into two groups of 38, one was treatment group, and another was control group.The treatment group was treated by Prof. Wang's TSBPT (tendon-soothing, bone-setting and dialectical therapy). The main objection of tendon-soothing was relaxation therapy of soft tissues by a series of skills such as rolling manipulation, pressing manipulation, rubbing reduction, grasping manipulation, traction manipulation, sweeping manipulation, wiping manipulation, scrubbing manipulation, palm-rubbing technique, etc. The regular positions and acupoints of tendon-soothing were neck, shoulder blade, back of the head, two sides of head, Wind Pond(GB20), Great Axle(BL11), Central Shoulder Transport(SI15), Outer Shoulder Transport(SI14), Shoulder Well(GB21), Celestial Gathering(SI11), Bingfeng (SI12), Temple, Ophryon, Living Acupoint, etc.The bone-setting was to select directedly the spinal rotation massage mainly according to the patient's specific condition and test results. The main skills of spinal rotation massage Prof. Wang most frequently applied were rotary location pulling after stretching cervical vertebra, obliquely-pulling after rotating cervical vertebrae, and cervical short lever technique. The main position of spinal rotation massage was cervical vertebrae.Based on the specific symptoms of patients, the dialectical therapy focused on the syndrome differentiation and specific treatment methods of different disease types. The main skills of dialectical treatment Prof. Wang most frequently applied were scrubbing manipulation and rubbing reduction. The main therapic positions of this method were the small of the back and some specific acupoints such as Pishu(BL20), Stomach Transport(BL21), Rich and Prosperous (ST40), Tsusanli (ST36), Shenshu(BL23), Vitaport(DU4), Taichong (LV3), Interline (LV2), etc.The control group was treated by traditional manipulation therapy, viz., tendon-soothing, according to the massage textbook, Yu Dafang's Science of Tuina. The main therapic skills were pressing manipulation, rubbing reduction, rolling manipulation, grasping manipulation, traction manipulation. The treatment positions of this method were neck, upper back, Wind Pond(GB20), Celestial Tripod (LI17), Supraclavicular Fossa(ST12), Central Shoulder Transport(SI15), Outer Shoulder Transport(SI 14), Shoulder Well(GB21), etc.Course of TreatmentBoth the treatment and control group were carried out two therapic course (10 times per course,30 minutes each time, one time every other day). When the treatment of the 76 cases of patients had been completed, the SPSS 13.0 software was applied for statistical comparisons of the two groups in clinical curative effect, transcranial doppler(TCD) findings, function markings and symptoms. Finally, the results of statistical analysis were obtained.Results1.The curative effect comparison of both groups indicated that the treatment group was significantly higher than another group. Among the treatment group(38 cases),10 cases were cured,28 cases were effective, the total effective rate was 100%. And meanwhile among the control group(38 cases),6 cases were cured,27 cases were effective,5 cases were invalid, the total effective rate was 86.8%. The significant difference between the two groups (P<0.05) manifested a statistical significance.2. The TCD findings comparison of both groups before and after treatment.A. The comparison of blood flow velocity (Vm) and pulsatile index(PI) in left vertebral artery between the treatment and control group before and after treatment. The comparison of above indexes between two groups before treatment (P>0.05) manifested that there was a statistical significance. In each group, the differences of above indexes between before and after treatment (P<0.05) showed a statistical significance. The differences of above indexes between two groups after treatment (P<0.05) assured a statistical significance.B. The comparison of blood flow velocity (Vm) and pulsatile index(PI) in right vertebral artery between the treatment and control group before and after treatment. The comparison of above indexes between two groups before treatment (P>0.05) manifested that there was a statistical significance. In each group, the differences of above indexes between before and after treatment (P<0.05) showed a statistical significance. The differences of above indexes between two groups after treatment (P<0.05) assured a statistical significance.C. The comparison of blood flow velocity (Vm) and pulsatile index(PI) in Vertebrobasilar artery between the treatment and control group before and after treatment. The comparison of above indexes between two groups before treatment (P>0.05) manifested that there was a statistical significance. In each group, the differences of above indexes between before and after treatment(P<0.05)showed a statistical significance. The differences of above indexes between two groups after treatment (P<0.05) assured a statistical significance.3. The comparison of symptoms and function markings between the treatment and control group before and after treatment. There is no significant differences in comparison of symptoms and function markings between the treatment and control group before treatment (P>0.05). In each group, the differences of above indexes between before and after treatment (P<0.05) showed a statistical significance. The comparison of symptoms and function markings between the treatment and control group after treatment (P<0.05) manifested that there was a statistical significance. The comparison of improvement index between the treatment and control group (P<0.05) also showed a statistical significance.ConclusionThe TSBPT has more advantages in treatment of CS-VA in comparison with the traditional manipulation therapy.CreativeIn the course of this study, Prof. Wang considered that the pathogeny of CS-VA was mainly the damage of body's balance system, which referred mainly to cervical biomechanical balance of modern medical and Yin-Yang balance of Chinese Medicine. In order to restore the body's balance system, so he initiated to apply TSBPT in the treatment of CS-VA. It is the TSBPT to carry out three steps in the treatment of CS-VA.The first step is tendon-soothing which aims to restore the dynamic balance of cervical spine through soft tissue relaxing, which needs to be applied a series skills, such as rolling manipulation, pressing manipulation, rubbing manipulation, etc. The second step is bone-setting, which aims to restore the static balance of cervical spine through cervical vertebra adjusting, which needs to be applied modern spinal rotation massage. The third step is dialectical therapy which aims to restore the Yin-Yang balance of Chinese Medicine. Now in the treatment of CS-VA, many a massage doctor applies tendon-soothing and bone-setting, individual doctors apply even dialectical therapy, however, almost no doctor can effectively combine the three skills, it is no other than Prof. Wang who able to flexibly apply the TSBPT in clinic daily and widely applied in clinical practice.Prof. Wang considers that the TSBPT is an effective method not only in the treatment of CS-VA, but also in the treatment of other spinal diseases such as degenerative changes of lumbar spine, lumbar disc herniation, ankylosing spondylitis. The TSBPT applied to clinical treatment, the same therapeutic effects can be achieved in the treatment of spine related diseases such as cervical vertebra related headache, insomnia, thoracic obstruction, and in the treatment of thoracic vertebra related diseases such as asthma, stomachache, diarrhoea, constipation, and in the treatment of lumbar related diseases such as frequent micturition, asynodia, menoxenia, algomenorrhea, etc. Prof. Wang's TSBPT are worth studying and popularizing for our young doctors. |
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