Cervical Radiculopathy Clinical Trial
Official title:
Effectiveness of a Compound Traditional Chinese Herbal Medicine, Qishe Pill, on Cervical Radiculopathy: a Randomized, Double-blind, Placebo-controlled, Multicentre Trial
Radiculopathy generally presents with pain, numbness, or weakness in a dermatomal distribution. Cervical radiculopathy results from impingement on a nerve root by either spondylotic narrowing of the neural foramen or a lateral intervertebral disc herniation. Specifically, it should be the goal of the treating physician to relieve pain, improve function, and prevent recurrence. Various studies have shown that nonoperative management of cervical radiculopathy leaves a substantial minority of patients with persistently troublesome symptoms. Pharmacologic agents treat the underlying condition and provide symptomatic relief. The various classes of medications used to treat radiculopathy include steroids, nonsteroidal antiinflammatory drugs (NSAIDs), muscle relaxants, narcotics, and antidepressants. Herbal medicines have been used for centuries in China. In China, many patients with cervical disc disease are increasingly turning to herbal medicines to alleviate their symptoms and reduce the side effects of medications. The goal of this study is to determine the efficacy and efficacy of an herbal medicine, Qishe Pill, to treat cervical radiculopathy.
Cervical radiculopathy is a distinct consideration in the evaluation of any patients who
have neck pain and may be defined simply as an abnormality of a nerve root, which originates
in the cervical spine. The initial approach to the management of cervical spondylopathy
radiculopathy is nearly the same that the nonspecific neck or back pain can be found in most
of patients. Conservative treatments include non-steroidal anti-inflammatory drugs (NSAIDs),
narcotics, muscle relaxants, physical therapy and transcutaneous electrical nerve
stimulation (TENS). The main objectives of conservative treatments are to relieve pain,
improve function and improve health-related quality of life.However, these treatments for
cervical radiculopathy are limited by their modest effectiveness. Surgical treatment for
cervical disc disease is indicated when symptoms are refractory to conservative treatments
and neurological symptoms are progressive. In terms of pharmacotherapy, there generally is
no randomized, placebo-controlled trial available comparing the standard nonsurgical
treatments. Therefore, care plans should be designed principally based on accumulated
experience, the services available locally, and the respective preferences of patients.
Treatment plans are developed to alleviate pain, improve function, and prevent recurrences.
As a complementary and alternative medicine (CAM), herbal medicines have the potential to
avoid the adverse effects of medications and surgery.In the basic theory of traditional
Chinese medicine (TCM), the obstruction of Qi flow and blood circulation in the neck area
caused by some pathogenic factors, such as "Feng"(wind), "Han"(cold), "Shi"(dampness),
invading the neck, induces cervical degenerative disc diseases which are the cause of
cervical radiculopathy. According to the four traditional methods of diagnosis -
observation, listening, interrogation, and pulse-taking, on patients, TCM doctors can
analyze the certain pathogenic factors which cause neck pain. And then they will prescribe
herbal formulae based on the effect and the main indications of Chinese medicine. Natural
substances, including herbal medicines, have being used to promote healing and alleviate
neck pain in western countries. Previous studies have demonstrated that some active
substances in herbal medicine can promote Qi flow and blood circulation to alleviate pain.
A number of studies on the effects of the Chinese herbal medicine on cervical radiculopathy
have been proposed, but useful empirical research is insufficiency. For chronic neck pain
with or without radicular symptoms, there is low quality evidence that herbal is more
effective than placebo for pain relief, which is measured at the end of the treatment.
However, the size of the studies was small and the effect was measured in the short-term.
Further research is very likely to change both the effect size and our confidence in the
results. There is a need for trials with adequate numbers of participants that address
long-term efficacy or effectiveness of herbal medicine compared to placebo.
Qishe Pill is composed of processed Radix Astragali, Muscone, Szechuan Lovage Rhizome, Radix
Stephaniae Tetrandrae, Ovientvine, Calculus Bovis Artifactus. Using a well-designed clinical
trial, we will survey the effectiveness of concurrent use of this remedy in relieving neck
pain. Therefore, the present study is to examine effectiveness and safety of Qishe Pill, a
compound traditional Chinese herbal medicine, on neck pain in cervical spondylotic
radiculopathy in a randomized, double-blind, placebo-controlled trial. Results of this study
will provide evidence regarding the value of the Qishe Pill as an intervention to alleviate
neck pain caused by cervical radiculopathy.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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