Clinical Exploration Of Acupuncture Treatment Of Cervical Spondylosis Based On Neck Anatomy

[Objective]To explore the clinical efficacy of the acupuncture protocol used based on cervical anatomy for cervical type cervical spondylopathy so as to provide a reference basis for the selection of precise acupoints and acupuncture manipulation in the treatment of cervical type cervical spondylopathy.[Method]30 patients who met the inclusion criteria were selected.The target muscles and needle points were determined by two means,the inspection of the position of head,neck and shoulders and palpation of the positive tender points on the target muscles Target muscles include posterior rectus major,inferior oblique,sternocleidomastoid,splenius capitis and superior trapezius(1-5 muscles were selected according to inspection and palpation).This study used the acupuncture technique,whereby the needle can beremoved immediately once the abnormal tension of the target muscle has been relieved after the twitching of the target muscle.Treatment was performed on alternate days,with 6 treatments regarded as one course of treatment.Patients who met the recovery standard prior to 6 treatments were discharged earlier and a follow-up was conducted for all patients one month after the end of treatment.Northwick park questionnaire(NPQ),Short-form McGill pain questionnaire-2(SF-MPQ-2),Neck disability index(NDI)and Clinical assessment scale for cervical spondylosis(CASCS)were used before the first treatment,before the third treatment,before the sixth treatment,two days after the last treatmentand one month posttreatment(follow-up).SF-MPQ-2 and CASCS were used after the first treatment,after the third treatment and after the sixth treatment.SPSS 22.0 was used for data analysis,with P<0.05 indicating the difference in results to be statistically significant and modern medical records cloud platform(V2.1)was used to analyse the selection rule of the target muscle through association rule learning and complex network analysis.[Results]1.Evaluation of NPQ scores:The NPQ score decreased after treatment,and the follow-up score remained lower than before,the difference was statistically significant(P<0.05).This proves that the acupuncture protocol can improve the NPQ score and maintain the therapeutic efficacy for one month.2.Evaluation of SF-MPQ-2 scores:The SF-MPQ-2 score decreased after treatment,and the follow-up score remained lower than before,the difference was statistically significant(P<0.05).This proves that the acupuncture protocol can improve the SF-MPQ-2 score and maintain the therapeutic efficacy for one month.3.Evaluation of NDI scores:The NDI score decreased after treatment,and the follow-up score remained lower than before,the difference was statistically significant(P<0.05).This proves that the acupuncture protocol can improve the NDI score and maintain the therapeutic efficacy for one month.4.Evaluation of CASCS scores:The CASCS score increased after treatment,and the follow-up score remained higher than before,the difference was statistically significant(P<0.05).This proves that the acupuncture protocol can improve the CASCS score and maintain the therapeutic efficacy for one month.5.Evaluation of SF-MPQ-2 and CASCS scores before and after the first treatment:Comparison of the scores of SF-MPQ-2 and CASCS before and after the first third and sixth treatment was done.The scores of SF-MPQ-2 before three treatments were higher than those after three treatments,and the scores of CASCS before three treatments were lower than those after three treatments,the difference was statistically significant(P<0.05).Thus proving that the acupuncture protocol can improve SF-MPQ-2 and CASCS scores before and after the first,third and sixth treatment,which indirectly proves that the protocol has good immediate efficacy.6.Through the complex network analysis,the core muscle combination comprises of the left posterior rectus major,the right posterior rectus major,the left inferior oblique and the left superior trapezius.That is to say,the main muscles treated are posterior rectus major,inferior oblique and superior trapezius.7.Through association rule learning,muscle combinations used more commonly and with higher association were as follows:left inferior oblique and right posterior rectus major(43 times),right posterior rectus major and left inferior oblique(43 times),left superior trapezius and left posterior rectus major(34 times),left posterior rectus major and left superior trapezius major(34 times),left posterior rectus major and right inferior oblique(28 times),right inferior oblique and left posterior rectus major(28 times).Hence in general,the posterior rectus major and inferior oblique are relatively on two sides,and the posterior rectus major and superior trapezius are mostly on the same side.8.Evaluation of Clinical efficacy:30 cases of clinical observation were completed.The results were as follows:23 cases were cured,5 cases were significantly effective,1 case was effective,and 1 case was ineffective.The total effective rate was 96.7%and the ineffective rate was 3.3%.The follow-up results showed that the total effective rate was 80.0%and the ineffective rate was 20.0%.[Conclusion]1.The acupuncture protocol can effectively improve the patients' pain scores(NPQ and SF-MPQ-2)and cervical dysfunction scores(NDI and CASCS).2.The acupuncture protocol has good immediate efficacy,and the curative efficacy can be maintained for one month according to the follow-up results.3.In this protocol,the main muscles treated are posterior rectus major,inferior oblique and superior trapezius,followed by sternocleidomastoid muscle and splenius capitis muscle,in which the posterior rectus and superior trapezius were mostly treated on the same side.4.The acupuncture protocol adopts the combination of inspection and palpation to improve the precision of the pionts selection,and the acupuncture technique is safe,easy to operate,has minimal pain which is worth popularizing and using in clinical practice.