Objective Based on meridian sinew theory, to observe the clinical efficacy of heat-sensitive moxibustion combined with acupuncture in the treatment of cervical spondylotic radiculopathy (CSR).

Methods 80 CSR patients were randomly divided into an observation group and a control group using a random number table method, with 40 patients in each group. The observation group received acupuncture at points selected based on meridian sinew differentiation, Ashi points, and related meridian sinew knots, while receiving heat-sensitive moxibustion treatment. The control group received acupuncture treatment at the cervical Jiaji points and Ashi points. The clinical efficacy of two groups of patients, including traditional Chinese medicine (TCM) syndrome scores, visual analogue scale (VAS) scores, neck disability index (NDI), were compared before and after treatment. Serum inflammatory factors including interleukin (IL)-1β, IL-6, and tumor necrosis factor - α (TNF - α), muscle tone indicators, and local skin temperature changes were also measured.

Results After treatment, the total effective rate of the observation group was 95.0%, which was better than the control group's 80.0% (P＜0.05); The scores of TCM syndrome, VAS, NDI, serum IL-1 β, IL-6, TNF - α, skin temperature of neck and shoulder , and muscle tone levels were significantly improved in both groups (P＜0.05), with greater improvements in the observation group (P＜0.01).

Conclusions Under the guidance of meridian sinew theory, heat-sensitive moxibustion combined with acupuncture can effectively alleviate pain and improve cervical spine function in the treatment of CSR. Its mechanism may be related to the inhibition of inflammatory responses around nerve roots, reduction of muscle tone, and improvement of local microcirculation, and its efficacy is superior to that of traditional acupuncture therapy.