葛根汤加减联合针刺颈夹脊穴治疗椎动脉型颈椎病临床观察OA

Objective:To observe the clinical efficacy of acupuncture at cervical Jiaji(EX-B2)points combined with Modified Pueraria Decoction on vertebral artery type cervical spondylosis.Methods:A total of 110 patients with vertebral artery type cervical spondylosis treated in the Department of Traditional Chinese Medicine at the Southern District of Henan Provincial Chest Hospital between January 2022 and October 2024 were selected and divided into the acupuncture group and the combined acupuncture-medication group using the random number table,with 55 cases in each group.Both groups received conventional massage and cervical traction therapy,along with Flunarizine Hydrochloride Capsules.The acupuncture group additionally received acupuncture at cervical Jiaji points,while the com-bined acupuncture-medication group further received acupuncture at cervical Jiaji points combined with Modified Pueraria Decoction.The peak systolic velocity(Vs),end diastolic velocity(Vd),and mean velocity(Vm)of the vertebral artery(VA)and basilar artery(BA),as well as the levels of myeloid differentiation factor 88(MyD88),Toll-like receptor-4(TLR-4),tumor necrosis factor-alpha(TNF-α),interleukin-1β(IL-1β),IL-6,and nitric oxide(NO),were observed before and after treatment.TCM syndrome scores,verti-go scores,and the incidence of adverse reactions before and after treatment were also evaluated in the two groups.Results:After treat-ment,the Vs,Vd,and Vm of VA and BA in both groups were higher than those before treatment,and the above indicators of the com-bined acupuncture-medication group were higher than those of the control group,with statistically significant differences(P<0.05).The levels of TLR-4 and MyD88 in both groups were lower than those before treatment,and the above levels of the combined acupunc-ture-medication group were lower than those of the control group,with statistically significant differences(P<0.05).The levels of TNF-α,IL-1β,IL-6,and NO in both groups were lower after treatment than before,and the above levels of the combined acupuncture-medication group were lower than those of the control group,with statistically significant differences(P<0.05).The TCM syndrome scores in both groups were lower than those before treatment,and the combined acupuncture-medication group had lower scores than those of the acupuncture group,with statistically significant differences(P<0.05).The vertigo scores in both groups were higher than those before treatment,and the combined acupuncture-medication group had higher scores than those of the acupuncture group,with sta-tistically significant differences(P<0.05).The incidence of adverse reactions was7.27％in the acupuncture group and12.73％in the combined group,with no statistically significant difference between the two groups(P>0.05).Conclusion:Acupuncture at cervical Jiaji points combined with Modified Pueraria Decoction can regulate the TLR-4/MyD88 signaling pathway,improve hemodynamics,and alleviate symptoms in patients with vertebral artery type cervical spondylosis.