Abstract
Objective
To explore the exploratory clinical effects of acupotomy combined with tuina in patients with insomnia accompanied by cervical spondylosis (CS).
Methods
This retrospective study included 107 patients diagnosed with insomnia and CS from January 2023 to November 2025. After 1:1 propensity score matching (PSM), 52 pairs (104 patients) were assigned to the control group (tuina alone) and experimental group (acupotomy plus tuina). Neck Disability Index (NDI), Visual Analog Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), and Insomnia Severity Index (ISI) were compared before and 3 weeks after treatment using analysis of covariance (ANCOVA). The Johnson–Neyman method was applied for further subgroup analysis of indicators with significant group-baseline interactions.
Results
Baseline characteristics were well balanced between groups after PSM (all P > 0.05). The experimental group showed significantly lower posttreatment PSQI and ISI scores than the control group (P < 0.001). Significant interactions were found in NDI and VAS (P < 0.05). JN analysis indicated the combined therapy was superior across all NDI levels, with greater improvement at higher baseline disability. For VAS, the advantage was significant only when baseline VAS > 3.98, and the effect increased with higher baseline pain. Both groups had no severe adverse events.
Conclusion
The combination of acupotomy and tuina may offer additional benefits over tuina alone in improving sleep quality, alleviating neck pain, and disability in patients with insomnia accompanied by CS. These findings are preliminary and require confirmation in prospective trials.
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