The Effect Of Huoxue Tongdu Decoction Combined With Moxibustion On Postoperative Early Axial Symptoms For Cervical Spondylotic Myelopathy

Objective:To observe the clinical efficacy of huoxue tongdu decoction combined with moxibustion in the treatment of early axial symptoms after posterior cervical decompression for cervical spondylotic myelopathy.Method:From September 2017 to December 2018,56 patients with cervical spondylotic myelopathy who were admitted to the department of spinal orhopedics of fuzhou second hospital for expansive open-door cervical laminoplasty with miniplate fixation were selected.During the postoperative follow-up,they were diagnosed with postoperative early axial symptoms,met the criteria,voluntarily participated in the study and signed the informed consent.The patients were divided into 2 groups with 28 cases in each group.The control group and the experimental group adopted the same routine basic treatment methods,including daily life health guidance and neck muscle isometric contraction function exercise.On the basis of basic treatment,the experimental group was treated with huoxue tongdu decoction combined with moxibustion at cervical jiaji point for 4 weeks.The control group was treated with celecoxib capsules for 4 weeks.The Numerical Rating Scales?NRS?,Neck Disability Index?NDI?and Tsuji values were recorded on the first day before treatment and the last day after treatment,respectively.Changes in the modified JOA score?mJOA?,recurrence of axial symptoms,curvature of the lower cervical spine(C_2-7 Cobb Angle),and distance of the C_2-7 Sagittal vertical axis(C_2-7 SVA)were recorded at the follow-up of 1month after the end of the treatment course.Meanwhile,adverse reaction events in the treatment process were statistically evaluated,and SPSS20.0 software was used for statistical analysis to compare the differences between the two groups.Results:A total of 52 patients were fully followed up in this study.1.Baseline data?including general data,operative factors and differences in postoperative early axial symptoms?,NRS,NDI,Tsuji values,mJOA scores,C2-7 Cobb Angle,and C2-7 SVA were collected before treatment,and the differences were not statistically significant?P>0.05?and were comparable.2.The scores of NRS,NDI and Tsuji in both groups after and before treatment were significantly improved compared with those before treatment,with statistically significant differences?P<0.01?.3.There was no significant difference in NRS between the two groups after treatment?P>0.05?.4.Comparison of NDI and Tsuji scores between the two groups after treatment showed statistically significant differences?P<0.05?,and recurrence rates of axial symptoms in the two groups were followed up for 1 month after the end of the treatment course,which was lower in the experimental group than in the control group,with statistically significant differences?P<0.05?.5.mJOA score,C_2-7 Cobb Angle and C_2-7 SVA between the two groups were followed up one month after the end of the treatment course,and the differences were not statistically significant?P>0.05?.Conclusion:Huoxue tongdu decoction combined with moxibustion at cervical jiaji point can effectively improve the severity of early axial symptoms after expansive open-door cervical laminoplasty with miniplate fixation for cervical spondylotic myelopathy,reduce the incidence of recurrence,raise the satisfaction of patients for surgical effect,and improve the quality of life.Its short-term efficacy is positive and worthy of clinical application.