Chinese medicine treatment
Drugs can play an auxiliary symptomatic treatment role in the treatment of this disease, and the application of pain relievers, sedatives, vitamins (such as B1 and B12), vasodilators and herbal medicines can be chosen to have a certain effect on the relief of symptoms. In addition, while cervical spondylosis is treated by manipulation, patients can be treated by Chinese medicine with identification and typing, which can improve the efficacy, shorten the course of treatment and reduce the pain of patients. The common clinical types and empirical prescriptions are introduced as follows.
(A) Chinese medicine identification type: cold and dampness blocking ligament type
(This type is common in cervical spondylosis cervical type and nerve root type): headache or posterior occipital pain, neck stiffness, unfavorable turning, soreness, swelling, pain and numbness in one or both shoulders and fingers; or headache involving supreme back pain, cold and damp skin, fear of cold and like heat, soft tissue swelling nodules can be palpated next to the cervical spine. The tongue is light red, the coating is thin and white, and the pulse is thin and stringent. The treatment is to warm the meridians and invigorate the blood, dispel cold and dampness, and relieve pain.
Radix et Rhizoma Chuan Gui Zhi, Radix Qiang Wu, Radix Wei Ling Xian, Radix Gentiana Macrophylla, Radix Chuan Xiong, Radix Angelicae Sinensis, Radix Puerariae Sinensis, Radix Aconiti, Radix Shen Qu, Radix Paeoniae Alba.
In the formula, Qiang Wu, Ling Xian, Tian Ma and Gentiana Macrophylla, dispel cold and remove dampness to relieve pain; Chuan Xiong and Tian Ma treat headache. Gui Zhi, Chuan Xiong, Gui Wei, Red Peony and Gun Jia Zhu warm the meridians and activate blood circulation, and open the channels; Ge Gen relieves spasm, Shen Qu strengthens the spleen and stomach, and Licorice harmonizes the herbs.
(B) Chinese medicine identification category: Qi and blood deficiency with stasis type
(This type is commonly seen in vertebral artery type cervical spondylosis): dizziness, vertigo, blurred vision or pain in the eyes, weakness, poor nasal function, sore neck, or pain in both shoulders. The tongue is light red or light fat, with tooth marks on the sides. The coating is thin, white and moist. The pulse is sunken and weak. The treatment is to benefit Qi and nourish Blood, to awaken the brain and calm the mind, and to activate Blood circulation.
Radix Astragali, Radix Astragali, Radix Glycyrrhiza Uralensis, Radix Codonopsis Pilosulae, Rhizoma Atractylodis Macrocephalae, Radix Rehmanniae Praeparata, Radix Angelicae Sinensis, Radix Paeoniae Alba, Radix Rehmanniae Praeparata.
In this formula, roasted Astragalus, roasted licorice, Radix Codonopsis, fried Atractylodes, replenish Qi; Shu Di, Chuanxiong, Bai Shao, Angelicae Sinensis nourish Blood; Tian Ma, Chuanxiong, Chicken Blood Vine tranquilize the mind, invigorate Blood and open the channels, and Sha Ren regulate Qi and stomach to guide stagnation.
(C) Chinese medicine identification class: Qi and Yin deficiency with stasis type
(This type is common in vertebral artery type and sympathetic nerve type cervical spondylosis): recurrent episodes of vertigo, or even dozens of times a day, rotating vision even when lying in bed, accompanied by nausea, vomiting, weakness, walking instability, or palpitations, shortness of breath, irritability, dry throat and bitter mouth, poor sleep and dreaminess, etc. The tongue is red, with thin white or slightly yellow and dry coating, or the tongue is bare and without coating, with distended veins under the tongue. The pulse is sunken and counted, or stringed. Treatment is to benefit qi, nourish yin, calm the mind, and harmonize qi and blood.
Radix Angelicae Sinensis, Rhizoma Ligustici, Rhizoma Ligustici, Fructus Lycii, Radix Salviae Sinensis, Radix et Rhizoma Glycyrrhiza Uralensis, Radix Ziziphus Macrocephalae, Radix et Rhizoma Polygonatum, Radix Paeoniae Alba, Radix Salviae Miltiorrhizae, Radix et Rhizoma Dioscorea, Radix et Rhizoma Nightshade.
In this formula, roasted licorice, sage, white peony and wolfberry benefit qi and nourish yin; asparagus, chrysanthemum, fried jujube seed, fried cypress seed, roasted Yuanzhi and nightshade nourish the brain, nourish the mind and tranquilize the spirit; Chuanxiong, Dan Shen and Di Long activate blood circulation and relieve pain.
(D) Chinese medicine identification category: spleen and kidney Yang deficiency with stasis type
(This type is commonly seen in post-surgical sequelae of spinal cord cervical spondylosis or in those who have not been cured for a long time); incomplete paralysis of the limbs (rigid or soft paralysis), incontinence of urination and defecation, fear of cold and warmth, normal diet or poor appetite. The tongue is light red, the coating is thin and white or slightly greasy, and the pulse is sunken and thin and stringent, or sunken and weak. The treatment is to tonify the kidney and strengthen the spleen, warm the meridians and Yang, and strengthen the tendons and bones.
Radix Rehmanniae Praeparata, Jujube Peel, Gunned Dry Ginger, Turtle Board Gum, Deer Horns Gum, Gunned Jia Zhu, White Mustard Seed, Fried Eucommiae, Niubizi, Chinese Yam, Fried Shen Qu, White Peony, Chuan Gui Zhi, Cinnamon, Roasted Licorice.
In the formula, Shu Di, fried Eucommia and Niubizi nourish the kidney and nourish the blood; Deer horn gum and tortoise shell gum fill in the marrow, strengthen the tendons and bones; Date skin nourishes the liver and kidney, collects astringency and stops the loss of blood; Chuan Gui Zhi and Cinnamomum warm the meridians and Yang; Gun Ginger, Chinese yam, roasted licorice and fried Shen Qu strengthen the spleen and stomach, warm Yang and benefit Qi; White mustard seed dispels phlegm and disperse knots; Gun Jia Zhu softens the hardness and disperses knots, opens the meridians and activates the channels.
(V) Biochemical drug treatment
The treatment of cervical spondylosis by using bone peptide preparations such as bone peptide tablets and bone peptide injection extracted from pig limb bone or cow fetal bone, etc. Some clinical studies show that the total effective rate of oral bone peptide tablets for 3 weeks (2 tablets, tid) is 74%, 68%, 90% and 75% respectively for cervical spondylosis of nerve root type, spinal type, vertebral artery type and sympathetic nerve type.
Body acupuncture
(I) Acupuncture points
Main acupuncture points: 2 groups: 1, cervical 4-7; 2, mute 1-4, Fengchi, Tianzhu and Dazhi.
Supporting points: nerve root type plus shoulder well, scapular suture, quchi, hegu, houxi, pension; vertebral artery type plus Baihui, sijincong, sun, head wei, sanyinjiao, taixi, xingcheng; sympathetic type plus Baihui, sijincong, heart yu, liver yu, bile yu, tachong; spinal cord type plus foot sanli, sun, waiguan, commissioning, yanglingquan, ring jump.
Location of dumb 1 to 4: dumb 1, dumb 2 and dumb 4 are all located on the Governor’s Vessel; dumb 1 is between the spinous processes of the 2nd and 3rd cervical vertebrae (1 inch below the dumb door), dumb 2 is between the spinous processes of the 3rd and 4th cervical vertebrae, and dumb 4 is between the spinous processes of the 6th and 7th cervical vertebrae (1 inch above the great vertebrae). Mute 3 is open 05.inch (bilateral) next to mute 2.
Scapular suture point location: pressure pain point at the inner edge of the scapula.
(II) Treatment
The main points are selected 1 group at a time and can be used in rotation. The first group of points, generally taken from the neck 5 to 6, such as neck and shoulder pain numbness to the wrist and fingers, can be taken; the second group of points each time only selected dummy (1 to 4) in one point, the remaining points selected 1 to 2 points. The matching points according to the different types of symptoms, take 2 to 4 points.
Pinch point operation: take 28-30 gauge 1.5-2 inch milli-needle, stab at an angle of 75 degrees in the direction of the spine or 45 degrees next to the pinch point, until the tip of the needle has a sense of touch that retreats the needle 5 minutes. Use a combination of lifting and inserting with a small twist to promote needle conduction. If the pain is heavy, tightly lift and slowly insert, and if the limb is numb and cold, tightly insert and slowly lift. Generally, the method of flat tonic and flat diarrhea is used. Mute 1, 2, 4 points, are straight stabbing 1 to 2 inches, repeatedly lifting and inserting without twisting, mute 3 into the needle method as the pinch point. Requires accurate acupuncture points, light lifting and inserting 3 to 5 minutes after obtaining gas or pounding needles 2 to 3 minutes, requiring dumb 3 needle sense for the upper extremity touching the remaining points should reach the extremity touching the sensation. Needle sense is appropriate from weak to strong, gradually obtained, not pounding fierce stab. If the needle sense is not satisfactory, you can adjust the direction, such as the above needle sense is still not available, it is not necessary to force. Slowly out of the needle, out of the needle after rubbing the acupuncture hole for a moment. Dazhi point, fast into the needle, slowly send the needle to 1.5 inches deep. When the needle tip is slightly upward, the tip of the needle is slightly downward after obtaining qi, and then the thumb and index finger hold the needle handle for rapid small twisting, so that the patient has a soreness and numbness down the Governor’s vein, and then changed to top-down rhythmic twisting (i.e., thumb up, index finger down twisting the needle), running the needle for half a minute. Retreat the needle to the subcutaneous, and then point the needle tip to the affected side, lifting and twisting for 1 minute, so that the soreness and numbness reaches the shoulder and arm, without leaving the needle. Fengchi needle into the direction of the tip of the nose about 1.5 inches, so that the needle sense to the head and neck radiation, the Tianzhu point slightly to the spine oblique stab, the needle sense to the neck is appropriate to disperse, both with the method of flat supplementation and flat diarrhea. Supporting points, the needle into the qi also use the method of flat tonic and flat diarrhea, which, scapular suture point into the needle 3 to 5 minutes, there is localized soreness is appropriate; pension point point to take the palm of the hand towards the chest, the needle tip stabbed in the direction of Neiguan, the needle sense to the shoulder, elbow, wrist radiation. The above acupuncture points, except for those who do not retain needles, are retained for 20 minutes. Daily or every other day, 10-12 times for a course of treatment, the course of treatment interval of 3-5 days.
(C) Evaluation of efficacy
Criteria for differentiation of efficacy: clinically cured: symptoms completely disappeared, cervical mobility was normal, but cervical X-ray showed no significant improvement in degenerative lesions; effective: clinical symptoms significantly reduced, slight discomfort in the neck after exertion, the rest as above; effective: clinical symptoms reduced, can do light work, the rest as above; ineffective: symptoms and signs were not improved.
A total of 1991 cases were treated. Among them, 1741 cases were evaluated according to the above criteria, 778 cases were clinically cured (44.7%), 566 cases were effective (29.6%), 401 cases were effective (23.1%), and 46 cases were invalid (2.6%), with a total effective rate of 97.4%.
In the other 250 cases, the improvement rate of neck and shoulder pain was 91.6%, and the effective rate of finger numbness and neck and shoulder joint movement disorder were 89.5% and 94.2%, respectively. From the overall treatment, the best effect of acupuncture was seen with the nerve root type, while the worst was seen with the spinal cord type.
Electroacupuncture
(I) Acupuncture points
Main acupuncture point: pinch neck 2-7.
Supporting points: Pension, Tianzhu, Dazhi, Kidney, Large Intestine, Quchi, Waiguan, Hegu, Yanglingquan, and Chichibian.
(II) Treatment
For the main acupoint, select the corresponding pinch point according to the site of hyperplasia. For matching points, take 4-5 points at a time. The main point is pierced with a 2-inch milli-needle at a 45-degree angle toward the spine, and the needle is carried until the needle sensation is conducted, and the supporting points are entered to obtain qi. Then turn on the electroacupuncture instrument, negative pole connected to the main point, positive pole connected to the matching points, continuous wave, frequency 120-250 times / min, the current strength to the patient’s comfort, generally at 1 to 1.5 mA. Once a day, 30 minutes each time, 15 times as a course of treatment, the course of treatment interval of 4 to 5 days.
(III) Evaluation of therapeutic effect
A total of 168 cases were treated, partly with Chinese and Western drugs, with an overall effective rate of 93.3 to 96.4%.
Cupping
(I) acupuncture points
Main acupuncture points: 2 groups: 1, A-Yi point or Dazhi; 2, Da Loom and Fengmen.
Supporting points: Tianzong, Shoulder well, Shoulderzhen.
Location of the A-Yi points: pressure and pain points in the neck.
(II) Treatment
The first group of main acupuncture points is the stabbing cupping method, and the second group is the bamboo cupping method. One group at a time, can be used alternately. If only the main points are not effective, change or add 1 to 2 matching points.
Stabbing cupping method operation: can be first beryllium needle stabbing, straight into the straight out, deep to the periosteum, a small amount of blood out of the needle (usually no more than 5 ml), but also skin needles local percussion to the skin slightly bleeding. After acupuncture, add fire pot and keep the pot for 15 minutes, after removing the pot, make local massage and rotational movement of the head, once every 3-5 days, 3 times for a course of treatment. Treatment interval of 1 week.
Bamboo jar method: bamboo jars of different sizes are boiled in a pot of boiling water for 2 to 3 minutes, removed and shaken out of the water, then quickly placed on the acupuncture point so that the skin is sucked, 7 to 10 minutes after removal, to the extent that petechiae or congestion. Daily or every other day, 10 times as a course of treatment. The treatment interval is 3 to 5 days.
Preparation of medicinal solution: 10 g each of mugwort, eucommia, antiphlogistic, ephedra, papaya, Sichuan pepper, perforated sorrel, earthworm, qiangwu, atractylodes, solanum, sumac, safflower, peach kernel, penetrating herb, millennium health, haitongpi, 5 g each of frankincense and myrrh, cloth bag with water decoction.
(III) Evaluation of therapeutic effect
A total of 300 cases were treated, and the results were 54 cases clinically cured, 215 cases with significant effect and effective, and 31 cases with ineffective, with an overall effective rate of 86.7%.
Acupoint injection
(I) Acupuncture points
Main acupoints: Xin She, A-Yi, Dazhi, Tian Zong.
Supporting points: nerve root type plus Tian Ding, vertebral artery type and sympathetic type plus Feng Chi.
Location of the new set point: directly below the Fengchi point, 1.5 inches below the posterior hairline.
Location of the A-Yi point: pressure and pain point in the neck.
(II) Treatment
Medicinal solution: mixed injection (2 ml of Salvia injection + 5-10 ml of 10% glucose injection); wild papaya injection, compound Salvia injection.
Choose 1 point at a time for the main acupuncture point and 1 matching point according to the symptoms. The ayurvedic points are mostly around the cervical vertebrae and should be carefully searched for; if striated or nodular pain points can be found, it is better. Before injecting the solution, the needle should be slightly lifted and inserted so that the feeling of qi is obvious, and the Tian Ding point should be made to reach the diseased arm and fingers, and then slowly injected with 1 ml of any of the above mentioned solutions per point (2 ml of solution can be injected into the A-Yi point). 1 every other day, 12 times for a course of treatment.
(iii) Evaluation of efficacy
A total of 489 cases were treated, 184 cases were clinically cured, 247 cases were apparently effective, 45 cases were effective, and 13 cases were ineffective, with an overall efficiency of 97.3%. If cervical spondylosis is divided into 3 phases, phase 1 is the cervical spine instability phase, phase 2 is the bone flab stimulation phase, phase 3 is the bone flab compression phase, with the best effect of acupoint injection in phases 1 and 2.
Pick treatment
(I) acupuncture point
Main acupuncture point: AYI acupuncture point.
Location of the A-Ye point: i.e., the reaction point. It is mostly found on the neck and back, and is a party ginseng flower-like lesion change. They are usually round or oval, bean or peanut grain size, with neat edges, slightly darker than normal skin on the sides, and weakly reflective. It is more common in the large vertebrae and cervical vertebrae hyperplasia areas.
(II) Treatment
Select 3 to 4 ayurvedic points each time. After routine disinfection and local anesthesia with 2% procaine, a fine trigeminal needle is used to first break the epidermis and then to pick off the superficial skin fibrils. When picking the fibrils, the tip of the needle should be flat against the skin, slide it forward parallel to the skin, and then gently lift the needle upward to break the fibrils and pick them clean. When picking the next time, cut off the head of the fiber filaments exposed outside the epidermis from the previous picking. Pick once every 5 days, 5 times for a course of treatment. Note that when picking the treatment point each time, one of the points must be on the cervical vertebrae.
(III) Evaluation of curative effect
A total of 560 cases were treated, resulting in 504 cases of clinical healing, 38 cases of significant effect, 18 cases of effective, with an overall efficiency of 100%.
Cupping plus acupuncture point injection. Buried wire therapy
(A) acupuncture points
Main acupuncture point: cervical pinch point.
Supporting acupoints: Fengchi, Tianzong, Shuangjing, Shoulder Yi, Hegu, Waiguan, Zhongzhu.
(II) Treatment method
First take the main acupuncture point, and after acupuncture has obtained qi, cupping is performed using the rack fire method or suction method, usually taking 1 to 2 pairs of pinch points each time. Another 2 to 3 pairs of acupuncture points are selected, and after obtaining qi, apply a flat tonic and flat diarrhea technique. Retain the cupping time to the extent that the local skin is red and purple. Retain the needle for 15 minutes. The following day, 2 pairs of pinched spine points can be crossed and injected with vitamin B12 250 mcg/1 mL (0.5 mL per point) and angelica parasitic injection 2 mL (1 mL per point), respectively. The above method was applied once a day, alternately, for two months as a course of treatment. The treatment interval is 1 month.
(III) Evaluation of curative effect
The above method was used to treat 312 cases, resulting in 62 cases of clinical recovery, 235 cases of significant effect, 32 cases of effective, and 3 cases of ineffective. The total effective rate was 93.1%. The follow-up period was from 6 months to 4 years for 60 cases, and only 1 case of recurrence.
Buried wire therapy acupuncture points; Dazhi Quchi Waiguan A-Yi point
Laser irradiation of acupuncture points
(I) Acupuncture points
Main acupuncture point: AYi point.
Supporting points: Fengchi, shoulder yi, hegu, quchi, shoulder Liao.
Location of the A-Yi acupuncture point: the focal area of the lesion is the pinch point.
(II) Treatment
The main acupuncture point must be taken, and the supporting points are added as appropriate. The following two methods of irradiation can be used.
1, helium-neon laser irradiation: helium-neon laser irradiator with an output power of 25 mW, irradiation distance of 100 cm, spot diameter of 2 cm, direct irradiation of the A-Yi point, and matching points are irradiated with the end of the fiber close to the skin. The A-Ye point can also be irradiated by connecting special acupuncture needles with fiber optics to pierce vertically 3 to 5 cm until there is a strong feeling of distension and numbness. A-Yi point irradiation, each time 10 to 15 minutes; matching point irradiation 5 minutes.
2, carbon dioxide laser irradiation: with carbon dioxide therapy machine, irradiation at a distance of 25-30 cm from the acupuncture point area, spot diameter 4 cm, scattered focus vertical irradiation of each point for 15-20 minutes, to have a warm feeling.
All of the above methods once a day, 10 times as a course of treatment, the course of 5 to 7 days.
(III) Evaluation of therapeutic effect
The above method treated a total of 282 cases, resulting in 111 cases cured, 112 cases with significant effect, 44 cases effective, and 15 cases invalid, with an overall efficiency of 94.7%.
Non-surgical treatment of cervical spondylosis
The treatment methods of cervical spondylosis can be divided into two categories: non-surgical treatment and surgical treatment. At present, for the treatment of cervical spondylosis, most medical experts advocate non-surgical treatment, and only a few cases require surgical treatment. Non-surgical treatment is a combination of Chinese and Western medicine, and one or two to three of these methods can be selected and implemented at the same time according to different situations. They are introduced as follows.
Manual massage and tui-na therapy
This is the main method of treatment of cervical spondylosis in Chinese medicine, and is also a more effective treatment measure for cervical spondylosis. Its therapeutic effect is to relieve the tension and spasm of the neck and shoulder muscles, restore the cervical spine activities, release the nerve roots and soft tissue adhesions to relieve the symptoms, spinal cord type cervical spondylosis generally prohibits gravity massage and reset, otherwise it is very easy to aggravate the symptoms, and may even lead to paraplegia, even if the early symptoms are not obvious, surgery is generally recommended.
Cervical spine traction therapy
This is a more effective and widely used treatment method for cervical spondylosis, which is applicable to all types of cervical spondylosis except spinal cord type, and is more effective for early cases.
Physiotherapy
In the treatment of cervical spondylosis, physiotherapy can play a variety of roles. It is generally believed that in the acute stage, the iontophoresis, ultrasound, ultraviolet light or intermittent current are feasible; after the pain is reduced, ultrasound, iontophoresis, induction electricity or other heat therapy are used.
Warm compress
This treatment can improve blood circulation, relieve muscle spasm, eliminate swelling to reduce symptoms, and help stabilize the affected vertebrae after manipulative treatment. This method can be used to apply hot towels and hot water bags locally externally, and it is best to use herbal fumigation formula for hot compresses. Warm compress treatment is not recommended for patients with severe pain symptoms in the acute stage.