| 1 Research purposeNeck type of cervical spondylosis(NTCS)is a cervical spondylosis mainly characterized by cervical muscle strain or degeneration,with pain,limited mobility and stiffness as the main clinical symptoms.It is the initial stage of other types of cervical spondylosis,which will progress to other types of cervical spondylosis if it is not treated in time and effectively.Therefore,timely treatment of cervical spondylosis is of great significance to prevent it from aggravating into other types of cervical spondylosis.Studies have confirmed the definite efficacy of acupotomology in the treatment of NTCS,but there are few reports on the treatment of NTCS with acupotomology by reducing soft tissue tension and increasing neck temperature.So this study observed the curative effect of acupotomology in the treatment of NTCS by comparing it with comfort acupotomology,and preliminaryexplored the relevant mechanism of it by reducing soft tissue tension from the warming effect.2 Research methodsIn this topic,60 subjects who met the diagnostic criteria of NTCS were selected from the outpatient department of the Chinese Medical Hall of Beijing University of Traditional Chinese Medicine.The subjects were divided into treatment group(n=30)and control group(n=30)according to the principle of single blind randomization by using a random number table method.The treatment period of the two groups was 1 time/week,3 times.Finally,56 subjects completed all treatments,including 2 cases of shedding in the treatment group and 2 cases of shedding in the control group.VAS score and NPQ score were measured before treatment,one week after treatment and at the 1-month follow-up.To evaluate the clinical efficacy of acupotomology in the treatment of NTCS,the changes of VAS and NPQ scores before and after treatment were compared between the two groups.By observing the changes of neck soft tissue tension,neck temperature and the range of motion of cervical vertebra before and after treatment in the two groups,the related mechanism of acupotomology reducing soft tissue tension and improving skin temperature in the treatment of NTCS was discussed.3 Research results3.1 Baseline information:There were insignificant differences in general information,such as age,gender,disease course,as well as VAS score,NPQ score,range of motion of cervical spine,neck temperature and muscle tension of cervical soft tissue between the two groups before treatment,which were comparable.3.2 Clinical efficacy:Based on the symptom improvement rate of VAS score the total effective rate of the treatment group is 100%and of the control group is 75%.The specific distribution of marked effect in the treatment group:2 cases were cured,13 cases showed obvious effect,13 cases were effective.And in the control group:2 cases showed obvious effect,19 cases were effective and 7 cases were ineffective.The curative effect of the treatment group was better than that of the control group(P<0.05);During the follow-up,the total effective rate of the treatment group was 93%(1 case was cured,13 cases were markedly effective,12 cases were effective and 2 cases were ineffective),while the total effective rate of the control group was 64%(18 cases were effective and 10 cases were ineffective),with significant difference between the two groups(P<0.05).3.3 Comparison of VAS scores between the two groups:In both groups,the VAS scores after treatment were significantly lower than those before treatment(P<0.05).The mean VAS scores of the treatment group after treatment and at the 1month follow-up were significantly lower than those of the control group(P<0.05).3.4 Comparison of NPQ scores between the two groups:In both groups,the NPQ scores after treatment were significantly lower than those before treatment(P<0.05).The NPQ scores of the treatment group after treatment and at the 1-month follow-up were significantly lower than those of the control group(P<0.05).3.5 Comparison of soft tissue tension between the two groups:After the treatment,the tension of each part to be tested was significantly reduced in both groups;the soft tissue tension at left C4-5,C6-7,and bilateral levator scapulae after treatment and at the 1-month follow-up were significantly lower than those of the control group(P<0.05).3.6 Comparison of the neck temperature between the two groups:In treatment group,the temperature of the bilateral C4-5,C6-7,and levator scapularis increased significantly after treatment(P<0.05),and there was no significant difference in the sternocleidomastoid(P>0.05).In control group,only the temperature of the left C4-5 increased significantly after treatment(P<0.05),and the other parts showed no significant difference(P>0.05).The temperature of all parts in treatment group was significantly higher than that in control group(P<0.05).At the 1-month follow-up,the temperature of bilateral C4-5,C6-7 and levator scapulae in the treatment group were significantly higher than those in the control group(P<0.05),but there was no significant difference in sternocleidomastoid muscle temperature(P>0.05).3.7 Comparison of range of motion of cervical vertebra between two groups:In treatment group,the range of flexion,extension and lateral flexion of cervical spine increased significantly after treatment(P<0.05),and there was no significant difference in rotational activity(P>0.05).In control group,the range of lateral flexion of cervical spine increased significantly after treatment(P<0.05)and there was no significant difference in the range of flexion,extension and rotational(P>0.05).After the treatment,the range of motion of the treatment group in extension and flexion was greater than the control group(P<0.05).At the 1-month follow-up,the the range of motion of the treatment group in flexion,extension and left flexion was greater than the control group(P<0.05),there was also no significant difference in rotational activity(P>0.05).4 Research conclusion4.1 Acupotomy can effectively reduce the symptoms of cervical pain,improve cervical activity and improve the quality of life of patients,and the clinical effect is obviously better than that of comfort needle knife therapy.4.2 The analgesic and sliding joint of acupuncture knife may be closely related to the effect of warming after the needle knife reduces the tension of local soft tissue.Therefore,Acupotomy can significantly relieve neck pain,improve the range of motion of cervical and other clinical symptoms by reducing soft tissue tension,and its mechanism may be related to the promotion of local skin temperature after acupotomy reduces soft tissue tension,so as to play a warming effect. |
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