Effectiveness Of Jingubingju Tuina Combined With Acupuncture Mainly For Cervical Spondylotic Radiculopathy:A Real-world Study

Objective:Through RWS methods,to explore the degree of pain,related symptoms and changes of anxiety and depression in patients treated by "Jingubingju" Tuina combined with whether have conventional acupuncture therapy or not in the treatment of CSR.We test it at the end of treatment and during follow-up period,so as to it can prove that"Jingubingju" Tuina could achieve better clinical efficacy and improve patients’ quality of life with CSR.Methods:The sample size calculated by PASS 11 software is 90 cases,which were half and half in two groups by RWS methods.The non-exposed group received just conventional acupuncture,while the exposure group was treated with "Jingubingju" Tuina in addition.The time of treatment were counted according to the patients’ real conditions,and the follow-up period was calculated according to the patients’ real treatment conditions of discharge from hospital or the time of the last outpatient visit(more than one week since the stop of treatment).The primary outcome indexes(Tanaka Yasuhisa Cervical Spondylosis Symptom Scale 20-point,NDI and NRS)and secondary outcome indexes(SF-36,HAMA and HAMD)were measured before hospitalization/the first clinic,discharge from hospital/the last clinic,and during the follow-up period(follow-up nodes were 4th,8th and 12th weeks after treatment finished).The scales can reflect the changes in symptoms,quality of life and anxiety and depression.Results:1.Before treatment,as for general data between groups,the baseline was comparable(P>0.05).2.Tanaka Yasuhisa Cervical Spondylosis Symptom Scale 20-point:Compared within groups,the scores were both higher after treatment(P<0.05);the exposed group was better(P<0.05)at the end of treatment compared between groups.As for the period of follow-up,it’s no significant difference(P>0.05).3.NDI:Compared within groups,it showed that scores were lower than before treatment(P<0.05);NDI scores were lower(P<0.05)in the exposed group at the end of treatment compared between groups.At the third follow-up,the NDI score of the exposed group was also lower(P<0.05).4.NRS:Compared within groups,the scores after treatment were lower(P<0.05);the exposed group’NRS scores were lower(P<0.05)which were compared between the two groups at the end of treatment.No significant difference between groups(P>0.05)at the period of follow-up.5.SF-36:The differences of scores were quite significant in statistics(P<0.05)after treatment;Compared between two groups,except SF and MH,the scores of other dimensions of SF-36 in the exposed group were better at the end of treatment(P<0.05).There was a statistically significant difference between groups in RP at the third follow-up(P<0.05).6.HAMA:Compared within two groups,the HAMA scores were lower after the treatment(P<0.05);The score of HAMA in the exposed group was lower at the end of treatment(P<0.05).No significant difference during follow-up in two groups(P>0.05).7.HAMD:Compared within two groups,the scores were lower after the treatment(P<0.05);The score of HAMD in the exposed group was lower after finishing the treatment(P<0.05).No significant difference during follow-up between two groups(P>0.05).Conclusions:Through this real-world study,it is concluded that "Jingubingju" Tuina combined with conventional acupuncture can effectively relieve pain,improve symptoms,the mood of anxiety or depression,quality of life,and no adverse events occur in the treatment of CSR.Therefore,it can be considered that "Jingubingju" Tuina combined with conventional acupuncture in the treatment of CSR is effective and safe,and it is worth recommending for clinical application.