| Objective:The purpose of the study was to compare the clinical efficacy of extracorporeal shock wave therapy(ESWT)?acupotomy therapy and acupuncture therapy in the treatment of CSA under the guidance of the theory of aponeurotic,and to provide effective,safe and simple treatment for CSA.Methods:A total of 96 patients with CSA diagnosed by the outpatient of Orthopaedics,Shanxi Provincial Hospital of Traditional Chinese Medicine were collected and divided into 3groups randomly.And the three groups were treated with Extracorporeal Shock Wave Therapy(ESWT)?acupotomy therapy and acupuncture therapy therapyin vitro,respectively.Treatment was conducted on the premise that baseline data levels of patients in all three groups were roughly the same.Before ?after the treatment and 1 month later,the score was recorded by the Evaluation Scale for Cervical vertigo?Chinese medicine symptom integral(deficiency of Qi and blood)and Hemodynamic indexes(including the diameter ?peak systolic velocity? resistance index of bilateral vertebral arteries).The clinical symptoms such as vertigo and Hemodynamic indexes were compared?evaluated by parallel controlledl means in each group before and after the treatment while among the three groups were by group control means.Results:1.A total of 96 patients were included,and included 2 patients in the ESWT group who lost follow-up,2 patients in the acupotomy therapy group who lost follow-up.A total of 93 patients were included in the result analysis.2.it's comparable between The general conditions(gender,age,course of disease)?the Chinese medicine symptom integral(CSA--deficiency of Qi and blood)?the Evaluation Scale for cervical vertigo?and the Hemodynamic indexes of the three groups(P>0.05).3.Evaluation Scale for cervical vertigo:Comparison in the group:Comparison of scores before treatment,the scores of after treatment ?1 month of follow-up in each group were significantly higher and the difference was statistically significant(P<0.05).Comparison among the three groups:After the treatment and at 1 month of follow-up,there was no significant difference in the scores of the ESWT therapy and the acupotomy therapy(P>0.05).The score of the ESWT and the acupotomy therapy were higher than the acupuncture therapy,and the difference was statistically significant(P<0.05).4.Chinese medicine symptom integral:Comparison in the group:Comparison of scores before treatment,the scores of after treatment ? 1 month of follow-up in each group were significantly lower and the difference was statistically significant(P<0.05).Comparison among the three groups:After the treatment and at 1 month of follow-up,there was no significant difference among the three groups(P>0.05).5.Hemodynamic indexes:5.1 The diameter of bilateral vertebral arteries:Comparison in the group:Comparison of the diameter of bilateral vertebral arteries before the treatment,the diameter of the after treatment ?1 month of follow-up in the ESWT and the acupotomy therapy were significantly higher and the difference was statistically significant(P < 0.05),there was no significant difference among the the acupuncture therapy.(P>0.05).Comparison among the three groups:After the treatment and at 1 month of follow-up,there was no significant difference between the ESWT and the acupotomy therapy(P>0.05),and both of them were batter then the acupuncture therapy(P<0.05).5.2 The peak systolic velocity of vertebral arteries:Comparison in the group:Comparison of scores before treatment,the peak systolic velocity of vertebral arteries of after treatment ?1 month of follow-up in each group were significantly higher and the difference was statistically significant(P<0.05).Comparison among the three groups:After the treatment and at 1 month of follow-up,there was no significant difference among the three groups(P>0.05).5.3 The resistent index of vertebral arteries:Comparison in the group:Comparison of scores before treatment,the resistent index of vertebral arteries of after treatment ?1 month of follow-up in the ESWT and the acupotomy therapy were significantly higher and the difference was statistically significant(P<0.05).Comparison of scores before treatment,the resistent index of vertebral arteries of after treatment in the acupuncture therapy were lower and the difference was statistically significant(P<0.05),the resistent index of 1 month of follow-up was no significant difference(P>0.05).Comparison among the three groups:After the treatment,the resistent index of the left vertebral arteries of after the treatment by the acupotomy therapy were lower than the ESWT and the acupuncture therapy,and the difference was statistically significant(P<0.05).There was no significant difference between the ESWT and the acupuncture therapy.There was no significant difference among the three groups about the resistent index of the right vertebral arteries(P>0.05).At 1 month of follow-up,There was no significant difference among the three groups(P>0.05).6.Comparison of clinical efficacy:The total effective rate of the ESWT was 90%,the total effective rate of the acupotomy therapy was 87.10%,and the total effective rate of the acupuncture therapy was 65.63%.Comparison of the total effective rate after treatment,there was no significant difference between the ESWT and the acupotomy therapy(P>0.05),both the ESWT and the acupotomy therapy were higher than the acupuncture therapy,and the difference was statistically significant(P<0.05).7.Safety evaluation:Blood pressure,pulse,respiration,heart rate and other basic vital signs were monitored before and during treatment.2 patients in th ESWT fell off during treatment because of pharyngeal discomfortd,which was manifested as pharyngeal itching,cough.And the symptoms disappeard when treatment was stopped in time.3patient in the acupotomy therapy experienced faintng during acupuncture treatment,and the symptoms include palpitation,dizziness,palpitation,fatigue,nausea and cold sweat,One patient developed syncope.After the treatment stopped in time and given warm water?psychotherapy,the symptoms of patients was improved.1 patient was fell off because of personal reasons.No serious adverse reactions occurred in the acupuncture therapy.Conclusion:Under the guidance of the theory of aponeurotic,extracorporeal shock wave therapy(ESWT)?acupotomy therapy can effectively improve the symptoms and functions ?scores of the Chinese medicine symptom integral(deficiency of Qi and blood)?Hemodynamic indexes(including the diameter?peak systolic velocity? resistance index of bilateral vertebral arteries)of patients with vertebral artery type of cervical spondylosis(CSA).The acupuncture therapy has no obvious effect on changing Hemodynamic indexes.The long-term curative effect of the ESWT?the acupotomy therapy is effective.ESWT can be used as the preferred choice for the treatment of CSA because it is safe?convenient,and it's no trauma. |
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