Acupuncture-based treatments on cervical spondylosis of vertebral artery type

Cervical spondylosis of vertebral artery type is one of the chief patterns of cervical spondylosis.It is often described as neck pain accompanied with radiating pain and neurologic symptoms,such as sudden dizziness,blurred vision,tinnitus,nausea,vomiting,memory loss,and sudden fainting.The incidence of cervical spondylosis increases and patients with cervical spondylosis become progressively younger.Acupuncture in the cervical spondylosis of vertebral artery type treatment has a local positive reaction“Liuhe point”,in order to dredge the local Qi and blood.More and more evidences into the effectiveness and safety of cervical spine acupuncture for cervical spondylosis,specific neck pain,cervical radiculopathy,etc.This article summarizes the recent literature on acupuncture and acupuncture combined with other therapies for cervical spondylosis of vertebral artery type treatment and provides a comprehensive review from the perspectives of acupuncture therapy,warm needle moxibustion therapy,electroacupuncture,and acupuncture combined with other therapies,in order to provide reference and reference for clinical treatment.

Acupuncture of different stimulation for the treatment of neck type cervical spondylosis:a randomised controlled trial

Objective:To observe the difference in clinical efficacy of acupuncture with strong and weak stimulation in treating neck type cervical spondylosis.Methods:64 patients with neck type cervical spondylosis were randomly divided into strong stimulation group and weak stimulation group,with 32 cases in each group.The acupoints selected are Jingjiaji 5-7(cervical acupoints EX-B2 C5-C7),Tianzhu(BL10)on both sides,Houxi(SI3)on both sides,Hegu(LI4)on both sides,Geshu(BL17)on both sides,and Ashi.In the strong stimulation group,deep needling with 0.25 mm×40 mm milli-needle was performed,with a mild reinforcing-reducing method.The twisting angle was 90°-180°,the frequency was 60-90 times/min,and the needles were applied for 1 min at each point.Keep the needle for 30 minutes,twisting was performed every 10 min during the retention period.Change hands once.In the weak stimulation group,shallow acupuncture with a 0.18 mm×40 mm milli-needle was performed,with a mild reinforcing-reducing method,with a twisting angle of 60°-90°,a frequency of 30-60 times/min,and acupuncture for 10 seconds at each acupoint.Keep the needle for 30 minutes,and no needle during the retention period.Patients in both groups were treated once every 1 to 2 days,3 times a week for 2 weeks,and followed up for 1 month after all treatments.The two groups of patients were compared before and after treatment and during follow-up.The McGill pain questionnaire score and the cervical spine dysfunction index score were compared to determine the clinical efficacy.Statistical analysis was performed using SPSS 22.0 statistical software.Results:1 case drop-out in the strong stimulation group and 1 case in the weak stimulation group.The total effective rate of the strong stimulation group was 90.32%,the total effective rate of the weak stimulation group was 83.87%,and the total effective rate of the strong stimulation group was higher than that of the weak stimulation group(P<0.05).The total scores of the short-form McGill pain questionnaire,the VAS score,and the cervical spine dysfunction index scores of the two groups of patients were significantly lower than those of this group before treatment,and the difference was statistically significant(P<0.05).The total scores of the short-form McGill pain questionnaire,visual analogue scale score,and cervical spine dysfunction index scores of the strong stimulation group after treatment and follow-up were significantly lower than those of the weak stimulation group(P<0.05).Conclusion:Acupuncture with strong and weak stimulation can effectively treat patients with cervical spondylosis,and deep acupuncture with filiform needles and strong stimulation have better effect.

MULTI-CENTER RANDOMIZED CONTROLLED TRIALS OF COMBINED TREATMENT OF VERTEBRAL ARTERY TYPE CERVICAL SPONDYLOSIS WITH ACUPUNCTURE AND MASSAGE

Objective.To evaluate the clinical value of synthetical therapy of acupuncture and massage for treating vertebral artery type cervical spondylosis （VACS）. Methods： In the present study, triple-center, single-blind, randomized and control methods were adopted. Qualified subjects were randomly assigned to three groups： acupuncture-massage （acu-mas） group, acupuncture group, and massage group （60 subjects in each group）. Bilateral Fengchi （风池 GB 20）, Jiaji （夹脊 EX-B 2, C4-7） and Baihui （百会 GV 20） ware punctured in combination with massage at the neck-shoulder and back region. The treatment was conducted once daily, 14 times altogether. Results. After treatment, of the 60 cases in each of acu-mas, acupuncture and massage groups, 28, 11 and 13 were cured, 13, 20 and 17 markedly effective, 12, 14 and 16 effective, and 7, 15 and 14 ineffective, with the total effective rates being 88.3%, 75.0% and 76.7% respectively. The therapeutic effect of acu-mas group was significantly superior to that of simple acupuncture and massage groups （P〈 0.05）. The scores of clinical symptoms and signs in 3 groups all declined significantly after treatment （ P〈 0.01 ）, and the score of symptoms of acu-mas was markedly lower than those of acupuncture and massage groups （P〈 0.05）. No significant differences were found among 3 groups in the score of clinical signs and between acupuncture and massage groups in the score of clinical symptoms （P〉0.05）. The time for producing therapeutic effects in acu-mas group was significantly shorter than those of acupuncture and massage groups （P〈0.01, 0.05）, meanng a faster of aou-mas group in producing clinical effect. No adverse events ware found in all the 3 groups. Conclusion： Acupuncture and massage are effective and safe in the treatment of VACS, and the therapeutic effect of acupuncture combined with massage is superior to that of simple acupuncture and simple massage therapy.

CLINICAL OBSERVATION ON TREATMENT OF NERVE-ROOT TYPE CERVICAL SPONDYLOSIS WITH ACUPUNCTURE, TRACTION PLUS SELF-EXERCISE OF QIGONG

Purpose: To observe the therapeutic effect of acupuncture combined with traction and Qigong exercise for treatment of nerve root type cervical spondylosis. Methods: A total of 130 nerve root type cervical spondylosis patients were randomly divided into acupuncture + traction + Qigong exercise (ATQE) group (n=59), acupuncture + Qigong exercise (AQE) group (n=40) and traction + Qigong exercise (TQE) group (n=31). Main acupoints used were Fengchi (GB 20) and cervical Jiaji (EX B 2) on the affected side. Results: After one month’s treatment, in ATQE, AQE and TQE groups, 43 (72.88%), 18 (45.00%) and 12 (45.16%) had remarkable amelioration, 14 (23.72%), 14 (35.00%) and 10 (32.26%) were effective, and 2 (3.39%), 8 (20.00%) and 7 (22.58%) had no apparent changes with the total effective rates being 96.61%, 80.00% and 77.41% respectively. The therapeutic effect of ATQE group was significantly superior to that of AQE and TQE groups (P<0.01).

OBSERVATION ON THE THERAPEUTIC EFFECT OF ACPUNCTURE COMBINED WITH MASSAGE FOR CERVICAL SPONDYLOSIS OF VERTEBRAL ARTERIAL TYPE BY USING TRANCRANIAL DOPPLYER ULTRASONOGRAPHY

To observe the effect of acupuncture combined with massage on blood flow velocity of the vertebro-basilar artery in cervical spondylosis of vertebral arterial type （CSVAT） patients. Methods： In the present study, methods of evidence-based medicine, triple-centers, single-blindness, randomization and control were used. A total of 100 cases of CSVAT patients were randomized into acupuncture plus massage （acu-massage） group （n = 38）, acupuncture group （n = 32） and massage group （n = 30）. Acupoints used were Fengchi （风池, GB 20）, cervical Jiaji （颈夹脊 EX-B 2）, Baihui （百会 GV 20）, and the methods of massage used were kneading-rolling, adhesion-separating and acupoint-digital pressing, topical digital pressing and rubbing, traction-extending and mild palm-rubbing. The treatment was conducted once daily, with 7 sessions being a therapeutic course and continuously for 2 courses. Changes of peak velocity （Vp）, end-diastolic velocity （Vd）, mean velocity （Vm） of blood flow of the vertebral artery （VA） and basilar artery （BA）, etc were detected before and after the treatment by using transcranial Doppler （TCD） ultrasonography. Resuits： After the treatment, the abnormally low Vp of both VA and BA in acu-massage, acupuncture and massage groups, Vm of VA in acu-massage and acupuncture groups, Vm of BA in acu-massage and massage groups, and Vd of VA and BA in the 3 groups all increased significantly in comparison with their own pretreatment（ P 〈 0.05, 0.01）, and the therapeutic effects of acu-massage group in the 3 indexes were significantly superior to those of acupuncture group and/or massage group （P 〈0.05, 0.01 ）. The abnormally increased Vp of VA in acu-massage and acupuncture groups, Vm of VA in the 3 groups, and Vd of VA in acu-massage and massage groups decreased obviously after the treatment in comparison with their own pretreatment （P 〈 0.05, 0.01）, and the therapeutic effects of acu-massage group were significantly superior to those of acupuncture and/or massage group in the 3 indexes of VA （P〈0.05, 0.01）. In addition, the abnormally increased Vp, Vm and Vd of BA in the 3 groups showed a similar tendency. No significant differences between acupuncture and massage groups in 3 indexes （ P 〉0.05）. Conclusion： The therapeutic effects of acupuncture plus massage is significantly superior to those of simple acupuncture and simple massage therapies in improving abnormal blood dynamics of vertebral and basilar arteries in CSVAT patients.

Efficacy observation on cervical spondylosis of nerve root type treated by the warm needling at Jiájǐ(夹脊EX-B 2) and tapping with plum-blossom needle

Objective To observe the clinical effect on cervical spondylosis of nerve root type treated by warm needling therapy at Jiáj （夹脊 EX-B 2） and plum-blossom needle therapy. Methods According to the random number table, 150 cases of cervical spondylosis of nerve root type were randomized into an acupuncture-moxibustion group （75 cases） and a control group （75 cases）. In the acupuncture-moxibustion group, the warm needling at EX-B 2 and tapping with plum-blossom needle were applied. EX-B 2 on the affected segments were selected and stimulated with warm needling technique for 20– 30 min. Afterward, the plum-blossom needle was used to tap the skin around the acupoints, for 3 min on each site. The treatment was given once every day. Seven treatments made one session. The interval between two sessions was 1 day. In the control group, the medication was used in combination with traction therapy. The intravenous drip with 5% glucose 250 mL and compound salvia miltiorrhiza injection 40 mL was used, once a day. In traction treatment, the patient was in a sitting position, neck anteflexion at 15°–30°, traction force at 10%–20% of the body mass, for 20–30 min in each time. The treatment was given once every day. The appointed person evaluated therapeutic effects after the three sessions of treatment in the two groups. Results The clinical curative rate was 49.3% （37/75） and the total effective rate was 94.7% （71/75） in the acupuncture-moxibustion group and those were 24.0% （18/75） and 81.3% （61/75） respectively in the control group. The total effective rate and clinical curative rate in the acupuncture-moxibustion group were superior to the control group （both P0.05）. In the comparison of the duration of treatment and effect in the cured patients between the two groups, the curative rate in the 1st session of treatment in the acupuncture-moxibustion group was higher than that in the control group （P0.05）. In the comparison of the 6-month follow-up visit in the cured patients between the two groups, the effect in the acupuncture-moxibustion group was much more stable （P0.05）. Conclusion The warm needling therapy at EX-B 2 and tapping therapy with plum-blossom needle achieve the significant effect on cervical spondylosis of nerve root type.

Efficacy observation on cervical spondylosis of vertebral artery type treated with warm needling and rehabilitation physiotherapy therapy

Objective To compare the differences in the efficacy on cervical spondylosis of the vertebral artery type （CSA） treated with the warm needling therapy combined with the rehabilitation physiotherapy, the simple warm needling therapy and the simple rehabilitation physiotherapy separately and observe the impacts of them on the vertebral basilar artery （VBA） in hemodynamics. Methods Ninety cases of CSA patients were randomized divided into an acupuncture plus rehabilitation group, a warm needling group and a rehabilitation group, 30 cases in each. In the acupuncture ＋ rehabilitation group, the warm needling therapy was used at Jiájǐ （夹脊 EX-B 2） from C3 to C7 in combination with the rehabilitation physiotherapy such as traction and magnetic therapy. In the warm needling group, the simple warm needling therapy was applied. In the rehabilitation group, the simple rehabilitation physiotherapy was adopted. The VBA hemodynamic parameters, Vp, Vd, Vm and PI values were detected under the transcranial Doppler and taken as the indexes for the efficacy assessment of the groups. The efficacy of each group was assessed in association with the clinical curative rate. Results After treatment, the VBA hemodynamic parameters, Vp, Vd, Vm and PI values were all remarkably improved as compared with those before treatment in the three groups （P〈0.01, P〈0.05）. The improvement of the indexes in the acupuncture plus rehabilitation group were more significant as compared with either of the other two groups （all P〈0.01）. The clinical curative rate was 70.0% （21/30） in the acupuncture plus rehabilitation group, which was superior to 53.3% （16/30） in the warm needling group and 53.3% （16/30） in the rehabilitation group （all P〈0.01）. Conclusion The warm needling in combination with the rehabilitation physiotherapy significantly improves in VBA hemodynamic parameters for CSA and its clinical efficacy is superior to either the simple warm needling or the rehabilitation physiotherapy. Hence, this combined therapy was highly deserved to be promoted in clinical practice.

Blood-letting puncture and cupping at Dong's unique extra points for 65 cases of neck type of cervical spondylosis

Objective To observe the clinical effect of blood-letting puncture and cupping at Chōngxiāo（冲霄 Extra） point of Dong＇s unique Extra-ordinary points in the treatment of neck type of cervical spondylosis.Methods Sixty-five patients of neck type of cervical spondylosis were selected and treated with blood-letting puncture and cupping at Chōngxiāo（冲霄 Extra） point once every two or three days,three times constituted one course and two successive courses were given,then the clinical effect was evaluated.Results The curative rate was 69.2%（45/65）,and the total effective rate was 92.3%（60/65）.Conclusion Blood-letting puncture and cupping at Dong＇s Chōngxiāo（冲霄 Extra） point can be used to treat neck type of cervical spondylosis with simple manipulation and obvious efficacy.

Wet Cupping Therapy Improves Local Blood Perfusion and Analgesic Effects in Patients with Nerve-Root Type Cervical Spondylosis

Objective： To observe wet cupping therapy（WCT） on local blood perfusion and analgesic effects in patients with nerve-root type cervical spondylosis（NT-CS）. Methods： Fifty-seven NT-CS patients were randomly divided into WCT group and Jiaji acupoint-acupuncture（JA） group according a random number table. WCT group（30 cases） was treated with WCT for 10 min, and JA group（27 cases） was treated with acupuncture for 10 min. The treatment efficacies were evaluated with a Visual Analogue Scale（VAS）. Blood perfusion at Dazhui（GV 14） and Jianjing（GB 21） acupoints（affected side） was observed with a laser speckle flowmetry, and its variations before and after treatment in both groups were compared as well. Results： In both groups, the VAS scores significantly decreased after the intervention（P〈0.01）, while the blood perfusion at the two acupoints significantly increased after intervention（P〈0.05）; however, the increasement magnitude caused by WCT was obvious compared with JA（P〈0.05）. Conclusion： WCT could improve analgesic effects in patients with NT-CS, which might be related to increasing local blood perfusion of acupunct points.

The filiform fire needling therapy for cervical spondylosis of vertebral artery type:120 cases report

Objective To verify the clinical efficacy of the filiform-fire needling therapy on cervical spondylosis of vertebral artery type（CSA）.Methods One hundred and twenty cases of CSA were treated with the filiform-fire needling therapy.The acupoints were Bǎihuì（百会 GV 20）,Fēngchí（风池 GB 20）,Nǎohù（脑户 GV 17）,Jìngbǎiláo（颈百劳 EX-HN 15）,etc.The needles were inserted rapidly and retained for 20 min.The treatment was given once a day.7 treatments made 1 session.The efficacy was assessed after 1 session of treatment.Results Eighty-eight cases were effective markedly,accounting for 73.3%.Twenty-seven cases were effective,accounting for 22.4%.Five cases were failed,accounting for 4.2%.The total effective rate was 95.8%.Conclusion The filiform-fire needling therapy achieves the significant efficacy on CSA.