Clinical control study of traditional Chinese medicine hot compress combined with traction in the treatment of cervical spondylotic radiculopathy: Study protocol

Effects of TCM external scalding therapy on spleen-stomach deficiency cold stomachache and inflammatory indexes

OBJECTIVE

To determine the efficacy and safety of traditional Chinese medicine (TCM) external scalding therapy on spleen-stomach deficiency cold stomachache.

METHODS

The medical records of 98 patients with spleen-stomach deficiency cold stomachache treated in the Affiliated Hospital of Jiangnan University from January 2019 to January 2020 were collected and analyzed retrospectively. Among them, 52 patients treated with western medicine were assigned to the control group, while the other 46 patients treated additionally with TCM external scalding therapy were assigned to the observation group. The two groups were compared in terms of serum gastrin (GAS), inflammatory factors and visual analogue scale (VAS) score, adverse reaction rate and symptom remission time.

RESULTS

After treatment, the observation group showed a significantly lower GAS level than the control group (P<0.05), along with significantly lower serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) than the control group (all P<0.05). The observation group demonstrated significantly lower VAS score than the control group (P<0.05). The observation group experienced notably shorter remission time of dull epigastric pain, epigastric distension, fatigue and belching and acid reflux than the control group (all P<0.05), and a significantly lower incidence of adverse reactions was found in the observation group than that in the control group (P<0.05). Multivariate analysis revealed that history of alcoholism and treatment method were independent risk factors affecting patient outcomes (all P<0.05).

CONCLUSION

TCM external scalding therapy has shown effectiveness in treating spleen-stomach deficiency cold stomachache. It alleviates stomachache symptoms and also reduces the occurrence of adverse reactions and inflammation, holding great potential for widespread adoption in clinical practice.

Clinical Study on the Treatment of Non-isotropic Cervical Spondylosis by Neck Pain Granules Combined with Tuina

BACKGROUND

Cervical spondylotic radiculopathy is a common form of cervical spondylosis caused by degeneration of the cervical spine. Currently, non-surgical treatment is the preferred treatment method, and Chinese medicine is widely used.

OBJECTIVE

To investigate the effect of radiculopathy spondylosis by tuina spinning and lifting technique.

METHODS

Experimental Design: We conducted a 12-week, open-label, analyst-blinded, randomized clinical trial (2 weeks of intervention plus 10 weeks of observational follow-up). A total of 25 patients with radiculopathy were collected, and data was analyzed during the treatment and recovery period.

INTERVENTIONS

Neck pain granules group: a package of oral neck pain granules after meals, three times a day, treatment for 2 weeks; neck pain granules combined with massage lifting technique, treatment group: use, massage lifting technique treatment, once every two days, normal take neck pain granules, treatment for 2 weeks. All cases were followed up for 2.5 months. Main Monitoring Indicators: Visual Analog Scale, Neck Dysfunction Index score, and Tanaka jiu (Tanaka Yasuhisa Cervical Spondylosis Symptom Scale) were recorded on time, and statistical statistics were made.

RESULT

The scores of VAS and NDI were significantly more effective in the neck pain granules combined with the tuina group than in the neck pain granules group, while the Tanaka Yasuhisa Cervical Spondylosis Symptom Scale was not significantly different between the two groups.

CONCLUSION

The treatment effect of neck pain granules combined with tuina was significantly better than that of traditional Chinese medicine alone.

Clinical study of Chinese medicine holographic scraping combined with hot ironing in improving early diabetic retinopathy

OBJECTIVES

To investigate the clinical effect of holographic scraping combined with Chinese medicine hot ironing on the improvement of early diabetic retinopathy (DR).

METHODS

The clinical data of 120 inpatients with diabetes mellitus were retrospectively analyzed. All patients had early retinopathy. According to different treatment methods, the patients were segmented into a scraping group (accepted holographic scrapping), an ironing group (accepted Chinese medicine hot ironing), and a combined treatment group (accepted holographic scraping combined with Chinese medicine hot ironing). The traditional Chinese medicine (TCM) symptom scores, efficacy in TCM symptom relief and fundus symptom relief, quality of life, blood glucose index level, and safety were compared among the three groups.

RESULTS

Compared with the scraping group and the ironing group, the TCM symptom scores of the combined treatment group on the 3rd day, 7th day, and 14th day of treatment were decreased; The total effective rates in TCM symptom relief and fundus symptom relief were increased; The scores of four dimensions in QoL of patients increased (all P<0.05); and Fasting blood glucose (FBG), 2 h postprandial blood glucose, and glycosylated hemoglobin were decreased (all P<0.05). There was no significant difference in the distribution of DR grade (I, II, and III) in the combined treatment group compared with the scraping group and ironing group (all P>0.05). The resistance index of the combined group after treatment was lower than that before treatment and lower than that of the hot ironing group and scraping group (all P<0.05).

CONCLUSIONS

The application of holographic scraping combined with Chinese medicine hot ironing in the treatment of early DR could alleviate the symptoms of blurred vision and dry eyes. Early intervention for retinopathy with both methods can reduce the disability rate and improve the quality of life of patients, which has a better effect than simple therapy.

A Protocol for a Single-Centered, Pragmatic, Randomized, Controlled, Parallel Trial Comparing Comprehensive Nonsurgical Therapy Options for Individuals with Lumbar Spinal Stenosis

Aim

Lumbar spinal stenosis (LSS) is a long-term degenerative disease. Considering the risks and advantages of the patient's age range and the characteristics of the condition, non-surgical treatment is recommended. To determine the best first-line non-surgical therapy for LSS, few studies have examined different non-surgical therapies. Therefore, the main objective of this study is to determine whether the selection of comprehensive Chinese medicine (CM) treatment for LSS is more successful than non-surgical conservative treatment.

Patients and Methods

In this two-armed, parallel, single-centered, pragmatic randomized controlled study, 94 LSS participants will be randomized to receive 24 sessions of comprehensive CM therapy or conservative treatment for 3 months, with follow-up assessments at 6, 9, 12, and 15 months. The primary outcome will be based on the success rate of the Zurich Claudication Questionnaire (ZCQ) for the most clinical important difference (MCID) at 3 and 15 months. Secondary outcomes include Numerical Rating Scale (NRS) scores for back and leg pain, ZCQ scores, Oswestry Disability Index scores for lumbar dysfunction, and Short-Form 12 scores for health-related quality of life at 3, 6, 9, 12, and 15 months. Adverse events and incidences of surgery will be reported anytime during the trial and follow-up.

Conclusion

This protocol examines the comparative efficacy of comprehensive CM therapy compared with conventional care through a pragmatic randomized controlled trial to present data to facilitate clinical or policy decision-making. The outcomes will make it easier to decide which patient-centered treatments to prioritize for LSS.

Changes of Endothelin-1 and Calcitonin Gene-Related Peptide Concentrations in Patients with Cervical Radiculopathy after Wrist-Ankle Acupuncture-Moxibustion and Hot Compression with Chinese Herbal Medicine

Objective

This study aimed at investigating the effects of wrist-ankle acupuncture-moxibustion and hot compression with Chinese herbal medicine on pain symptoms, endothelin-1 (ET-1), and calcitonin gene-related peptide (CGRP) concentrations of patients with cervical radiculopathy (CR).

Methods

A total of 82 patients with CR were randomly divided into the study group and control group, with 41 cases in each group. The control group was treated with standard treatment. In addition to standard treatment, the study group was additionally treated with wrist-ankle acupuncture-moxibustion and hot compression with Chinese herbal medicine. The ET-1 and CGRP concentrations in the plasma were measured by the radioimmunoassay method.

Results

The total response rate in the study group and the control group was 97.55% and 82.93%, respectively. The study group showed lower scores of the visual analogue scale (VAS), Northwick Park Neck Pain Questionnaire (NPQ), McGill Pain Questionnaire (MPQ), numbness intensity assessment, and neck disability index (NDI) but higher scores of the Short Form-36 (SF-36) health survey questionnaire than the control group after treatment. Besides, the study group exhibited reduced ET-1 and substance P (SP) concentrations concomitant with increased CGRP and β-endorphin (β-EP) concentrations compared with the control group.

Conclusion

Wrist-ankle acupuncture-moxibustion and hot compression with Chinese herbal medicine could effectively alleviate the pain of CR patients, affect ET-1 and CGRP concentrations, promote the recovery of cervical function, and improve the quality of life.

Effect of Tongluozhitong Prescription-Assisted Intra-Articular Injection of Sodium Hyaluronate on VAS Score and Knee Lysholm Score in Patients with Knee Osteoarthritis

Knee osteoarthritis (KOA) has become one of the leading causes of workforce loss in the middle-aged and elderly population and a global public health problem second only to cardiovascular disease, so we need to find more effective treatments for this disease. In this study, we selected 120 patients with KOA admitted to our hospital from June 2018 to December 2020 and divided them into treatment group 1, treatment group 2, and joint group according to the random number table method, with 40 patients in each group. Treatment group 1 was treated with Tongluozhitong prescription dip-soaking therapy, treatment 2 group was treated with intra-articular injection of sodium hyaluronate, and the joint group was treated with a combination of both modalities for 4 weeks in all three groups. Clinical efficacy, visual analogue scale (VAS), Lysholm knee score (LKS), activity of daily living score (ADL), the levels of bone metabolic markers such as cartilage oligomeric matrix protein (COMP), type II collagen degradation maker (CTX-II), and matrix metalloproteinase-3 (MMP-3), and the levels of inflammatory mediators such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and hypersensitive C-reactive protein (hs-CRP) were used as observations to compare and analyze the therapeutic effects of the three treatment regimens in KOA patients. The results showed that the clinical excellence rates of the joint group, treatment group 1, and treatment group 2 were 72.50%, 50.00%, and 90.00%, respectively, with statistically significant differences between any two comparisons. After treatment, VAS scores, serum COMP, CTX-II, MMP-3, IL-1β, TNF-α, and hs-CRP levels decreased in all three groups, and the levels of each index were as follows: joint group < treatment group 1 < treatment group 2, and the difference between any two comparisons was statistically significant. The LKS score and ADL score increased in all three groups, and the levels of each index were as follows: joint group > treatment group 1 > treatment group 2, with statistically significant differences in any two groups compared. None of the patients in the three groups experienced any significant adverse effects during treatment. This suggests that the dip-soaking therapy of Tongluozhitong prescription is more advantageous than intra-articular sodium hyaluronate injection treatment in suppressing the level of serum bone metabolic markers and inflammatory mediators, reducing pathological joint damage, relieving symptoms of pain, alleviating degenerative joint symptoms, and improving knee function in KOA patients. The combination of the two in KOA patients can significantly improve the efficacy and has a good safety profile.