META Analysis Of Filiform Needle Combined With Traditional Chinese Medicine In The Treatment Of Cervical Spondylosis

Purpose:Based on a meta-analysis of the literature on the treatment of cervical spondylosis with needle thread and traditional Chinese medicine,differences in the efficacy of acupuncture,TCM,and the combination of acupuncture and medicine were evaluated,and the idea of selecting acupuncture points and formulation medication bases was explored,which would provide more reliable information and an evidence-based medical basis for the clinical treatment of cervical spondylosis with a combination of acupuncture and medicine,and lay the foundation for establishing a scientific and effective system for prevention and treatment of cervical spondylosis.Materials and methods: Through the CNKI retrieval,the Wanfang database,and the Cochrane Library,we searched all published randomized controlled trials(RCT)articles in Chinese and English on needlepoint cervical spondylosis and Chinese medicine during 11 years from January 2010 to December 2020.Articles were screened against inclusion and exclusion criteria,and system quality was assessed using the Revman Manger 5.3 statistical software provided by the Cochrane Collaborative Network.Based on the cloud platform of ancient and modern medical records,the rules for meridians,acupuncture points,and prescriptions were explored using methods of correlation analysis,group analysis,and related information on meridians,acupuncture points,acupuncture,moxibustion,Chinese medicine,prescriptions and other information statistically.Results : 1.Meta-analysis results In this study,the inclusion and exclusion criteria were strictly implemented.A total of 29 articles are included,including 29 Chinese articles,and a total of 2568 topics.There were a total of 1,300 cases in the treatment group and 1,268 cases in the control group.The treatment group was treated with a combination of acupuncture and medication,while the control group was treated with Chinese medicine or mono acupuncture.Overall clinical efficacy: The treatment group with combined therapy was superior to the control group with acupuncture alone in improving the clinical symptoms of cervical spondylosis [OR and 95%Cl value were 4.51[3.32,6.13],P < 0.00001(< 0.05)],with statistical difference.Overall clinical efficacy: The treatment group with combined treatment outperformed the control group with individual Chinese medicine in improving the clinical symptoms of cervical spondylosis [OR value and 95% Cl were 5.26 [2.97,9.29],P <0.00001(<0.05)],with statistic of difference.Overall vas score: The treatment group with combined therapy was superior to the control group with single acupuncture in overall vas score [MD =-1.64,95%Cl is [-2.13,-1.16],Z=6.65,P < 0.00001(< 0.05)],with statistical difference.Overall cascs scores: The treatment group with combined therapy was superior to the control group with single acupuncture in overall cascs scores [MD=10.58,95%Cl is [6.61,14.54],Z=5.23,P < 0.00001(< 0.05)],with statistical difference.2.Meridian law analysis results The meridian tropism of acupoints for the treatment of cervical spondylosis by filiform needling was the most in the governor vessel,followed by the Sanjiao meridian of Hand-Shaoyang,followed by the large intestine meridian of Hand-Yangming,small intestine meridian of Hand-Taiyang,bladder meridian of Foot-Taiyang and gallbladder meridian of Foot-Shaoyang.3.Result of acupoint rule analysis The core acupoints in the database of acupuncture and moxibustion for the prevention and treatment of cervical spondylosis included: Jiaji(EX-B2),Fengchi(GB 20),Dazhui(GV 14),Baihui(GV 20)and Tianzhu(ST 25).Commonly used formulations included Sanyinjiao(SP 6)-Dazhui(GV 14),Sanyinjiao(SP 6)-Baihui(GB 20),Jianjing(GB 41)-Fengchi(GB 20),Waiguan(SP 6)--Hegu(LI)4),and Dazhui(GV 14)-Taixi(KI 3).4.Drug law analysis results The core drugs in the database for the comprehensive prevention and treatment of cervical spondylosis by traditional Chinese medicine include: Radix Angelicae Sinensis,Herba speranskiae tuberculatae,Radix Aconiti Kusnezoffii,Caulis Spatholobi,and Rhizoma Ligustici Chuanxiong.Common combinations include "Radix Paeoniae Alba-Rhizoma Ligustici Chuanxiong","Rhizoma Ligustici Chuanxiong-Radix Paeoniae Alba","Radix Astragali-Radix Angelicae Sinensis","Radix Astragali-Radix Glycyrrhizae",and "Semen Persicae-Flos Carthami".The commonly used drugs were classified into: rheumatism-eliminating drugs,deficiency-reinforcing drugs,blood-activating and stasis-resolving drugs,exterior-relieving drugs,and diuretic and dampness-infiltrating drugs.The meridian tropism of the drugs for the comprehensive prevention and treatment of cervical spondylosis by traditional Chinese medicine was mostly liver meridian,followed by heart meridian and spleen meridian,followed by lung meridian and kidney meridian.Conclusion: 1.During the period from 2010 to 2020,there were 234 articles concerning the treatment of cervical spondylosis with the combination of acupuncture and medicine,but only 29 articles with high quality adopted randomized controlled trials.The scientific design of clinical trials is an important problem that must be solved in TCM research.2.Cervical spondylosis refers to the symmetrical distinction between meridians and collaterals,in which the yang meridian is predominant,and the choice of acupuncture point along the meridian reflects the characteristics of "intersecting meridians,indicators of access".3.Partial acupoint selection for treatment of cervical spondylosis shows the characteristics of local predominance and distal predominance.4.Different acupuncture and moxibustion interventions in the treatment of cervical spondylosis will lead to different deqi effects and different final treatment effects.The deep acupuncture had a better analgesic effect than the shallow acupuncture.The therapeutic effect of applying special reinforcing-reducing manipulation after acupuncture was better than that of neutral reinforcing-reducing manipulation.5.The analysis of medication regularity of Chinese medicinals for the treatment of cervical spondylosis indicated that for external use,Chinese medicinals are mainly for percutaneous dispelling of wind and promoting blood circulation,and for internal use,Chinese medicinals are mainly for nourishing liver and kidney.