| Objective: To observe the difference between the efficacy of acupuncture combined with joint mobilization and simple joint mobilization,explore the curative effect of acupuncture therapy,clarify the synergistic effect of acupuncture combined with joint mobilization in the treatment of cervicogenic headache(CEH),so as to seek an efficient clinical treatment plan and enrich the treatment means.Methods: Sixty patients with CEH who met the inclusion criteria from April 2018 to April2019 were randomly divided into a joint mobilization group(n=30)and an acupuncture combined with joint mobilization group(n=30).The joint mobilization group received simple joint mobilization treatment,while the acupuncture combined with joint mobilization group received the mobilization plus acupuncture treatment.The two groups of patients were treated for 2 weeks according to each group's protocol.During the trial,both groups of patients would be tested by the visual analogue scale(VAS),neck disability index(NDI),and passive range of motion(PROM)at the beginning,and after 2 weeks.The medical statistics software was used to analyze the differences in VAS,NDI and PROM values at different times between two groups.3 months later,the self-reported value of NDI was collected by phone,and the efficacy of the two groups were analyzed.Results: A total of 60 subjects diagnosed with CEH that met the inclusion criteria were included in this study.30 subjects were divided into the joint mobilization group and the other30 subjects were into the acupuncture combined with joint mobilization group,of which 1case was dropped(withdrew due to self-request)and 29 cases were completed.The baseline of the general data of the two groups were compared before treatment which showed that there was no significant difference between the two groups,including the values of VAS,NDI and PROM(P>0.05).Therefore,it can be concluded that the two groups of patients were comparable.After two weeks' treatment,it showed that:(1)the values of VAS,NDI and PROM all improved(P<0.05)in each group;(2)With the respect to VAS,NDI and PROM,the acupuncture combined with joint mobilization group improved significantly(P<0.05)than joint mobilization group;(3)The correlation analysis of efficacy and course of disease in the joint mobilization group showed that the improvement of PROM,VAS and NDI were significantly correlated with course of disease(P<0.05);The correlation analysis of efficacy and course of disease in the acupuncture combined with joint mobilization group showed that the improvement of VAS,NDI and PROM were not significantly correlated with course of disease(P>0.05);(4)Dividing the subjects into < 6 months and ? 6 months in accordance to course of disease,the VAS,NDI and PROM were compared between two groups accordingly.With subjects ?6 months,acupuncture combined with joint mobilization group showed more significant efficacy(P<0.05)in PROM and NDI than joint mobilization group,while there showed no significant efficacy(P>0.05)in VAS between two groups;With subjects <6months,there showed no significant difference(P>0.05)between two groups;(5)There was no significant difference in NDI between two groups(P>0.05)3 months later.Conclusion:(1)In the short-term efficacy,acupuncture combined with joint mobilization can improve the mobility,pain and function in patients with CEH,and the therapeutic effect is more obvious than that of joint mobilization.With the respect to long-term efficacy,there was no significant difference in the improvement of NDI.(2)The therapeutic effect of jointmobilization is related to the course of disease,and will be affected by the length of the course of disease,while acupuncture combined with joint mobilization shows significant therapeutic effect regardless of the length of the course of disease;(3)Acupuncture combined with joint mobilization has a more obvious therapeutic advantage for patients with CEH ?6months,and does not show the same significant therapeutic advantage for patients with CEH<6 months. |
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