Clinical trial of Guige Shujing Decoction combined with acupuncture in the treatment of cervical spondylotic radiculopathy with coldness-blood stasis obstructing meridians / 国际中医中药杂志

ABSTRACT

Objective:To explore the clinical effect of Guige Shujing Decoction combined with acupuncture in the treatment of cervical spondylotic radiculopathy with coldness-blood stasis obstructing meridians.Methods:A total of 86 patients with coldness-blood stasis obstructing meridians of cervical spondylotic radiculopathy, who met the inclusion criteria from May 2019 to May 2021, were divided into two groups, with 43 cases in each group, according to the random number table method. The control group was treated with routine basic treatment and acupuncture, and the observation group was treated with routine basic treatment, acupuncture and Guige Shujing Decoction. Both groups were treated for 4 weeks and followed up for 6 months. The scores of TCM syndromes were performed before and after treatment, Clinical Assessment Scale for Cervical Spondylosis (CASCS) was used to evaluate cervical spine function, Visual Analogue Score (VAS) was used to evaluate the degree of pain, Neck Disability Index (NDI) was used to evaluate cervical spine function, and ELISA was used to detect levels of hypersensitive C-reactive protein (hs-CRP), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α). The adverse reactions were observed during treatment and the recurrence rate was recorded during follow-up.Results:The total effective rate of the observation group was 95.35% (41/43), and that of the control group was 81.40% (35/43), the difference between the two groups was statistically significant ( χ2=4.07, P=0.043). After treatment, the scores and total scores of shoulder and neck pain, upper limb numbness, neck stiffness, head tenderness and heaviness in the observation group were significantly lower than those in the control group ( t values were 10.66, 12.89, 9.12, 12.27 and 8.75, respectively, P<0.001). After treatment, the CASCS score in the observation group was significantly higher than that of the control group ( t=2.64, P=0.010). After treatment, the VAS and NDI scores in the observation group were significantly lower than those in the control group ( t values were 5.62 and 7.00, respectively, P<0.001). After treatment, the levels of serum hs-CRP, IL-1β and TNF-α in the observation group were significantly lower than those in the control group ( t values were 6.65, 7.52 and 5.08, respectively, P<0.001). There was no significant difference in the incidence of adverse reactions between the two groups during treatment ( χ2=0.73, P=0.393). After 6 months of follow-up, the recurrence rate in the observation group was 2.44% (1/41) and that in the control group was 17.14% (6/35). There was a statistically significant difference in the recurrence rate between the two groups ( χ2=3.89, P=0.048). Conclusion:The Guige Shujing Decoction combined with acupuncture therapy can inhibit the neurogenic inflammatory reaction of patients with coldness-blood stasis obstructing meridians of cervical spondylotic radiculopathy, reduce pain, improve cervical spine function, reduce recurrence rate and improve curative effect.