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

Abstract

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.

The efficacy of acupuncture therapies in cervical spondylotic radiculopathy: A network meta-analysis

“…Only one study reported the adverse reactions, which occurred in Fu's Subcutaneous Needling group of 3 patients with local bleeding after the treatment. Regarding the primary outcome measures, 27 studies reported the VAS scores [ 16 , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] ], 9 studies reported the NDI scores [ 18 , 21 , 23 , 26 , 32 , 34 , 35 , 40 , 44 ], and 6 studies reported the TY scores [ 21 , 27 , 33 , 36 , 41 , 43 ]. As for the diagnostic criteria, 18 studies adopted the “Standard for diagnosis and efficacy evaluation of Chinese Medicine syndromes and diseases” [ 17 ], 7 studies adopted the “Summary of the Second Symposium on Cervical Spondylosis” [ 45 ], 1 adopted “The experts consensus on the classification, diagnosis and non-surgical treatment of cervical spondylosis(2018)” [ 46 ], we found the diagnostic criteria involved have high similarity between each other after reading and comparison.…”

“…Among the 28 studies involved, 27 studies [ 16 , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] ] evaluated the VAS scores as an outcome measure. the meta-analysis forest plot shows that the curative effect of Acupoint catgut-embedding was better than Conventional acupuncture (SMD = 2.68, 95 % CI [−3.27, −1.69], Z = 5.28, P < 0.00001, I 2 = 89 %, 3RCTs), Needle Knife superior to Conventional acupuncture (SMD = 2.83, 95 % CI [−4.14, −1.52], Z = 4.24, P < 0.0001, I 2 = 95 %, 5RCTs), while Warm needle was better than Conventional acupuncture (SMD = 1.32, 95 % CI [−1.79, −0.84], Z = 5.46, P < 0.00001, I 2 = 64 %, 3RCTs).…”

“…Consequently, it is vital to enhance the soft tissue tension surrounding the cervical spine and restore its physiological curvature to alleviate pain and symptoms of nerve root compression. As a complementary and alternative therapy, several clinical trials [ 16 , [51] , [52] , [53] ] have demonstrated superiority of acupuncture in relieving pain in patients with CSR. Because there are different types of acupuncture therapy, each with different effects on symptom relief, this study conducted a Network Meta-analysis to determine the most suitable acupuncture intervention for CSR.…”

“…According to the “Huangdi Neijing,” “bi syndrome” is mostly caused by liver and kidney deficiencies, as well as external factors like “wind, cold, and wet three qi,” trauma, and strain. Based on the manuscripts analyzed in this study, it was found that Fire needle and Warm needle treatments were commonly used for the syndrome types associated with wind, cold, and wet, thanks to their unique thermal effects [ 16 , 23 , 28 , 29 , 32 , 38 , 39 ]. The “Jiaji” acupoints, located between the Bladder Meridian of Foot-Taiyang and the Governor Vessel meridians, are often selected for Acupoint catgut-embedding treatment [ 18 , 25 , 42 ], this helps regulate the qi, blood, Yin, and Yang of the viscera, primarily targeting liver and kidney deficiencies and other types of internal deficiencies.…”

“…One form of Chinese medicine therapy is acupuncture, which is believed to alleviate pain by stimulating acupoints and activating the nerve-endocrine-immune system [ 13 , 14 ]. Studies have indicated that acupuncture therapy can potentially accelerate the central nervous system to produce endogenous opioid peptides and activate related receptors, and then reduce the concentration of pain-related substances ET-1, SP while increasing the levels of CGRP, β-EP substances involved in pain relief [ 15 , 16 ]. However, there are various types of acupuncture therapies available, such as Conventional acupuncture, moxibustion, Needle Knife, Fire needle, and Fu's Subcutaneous Needling, among others.…”