Journal of Traditional Chinese Medicine ›› 2025, Vol. 45 ›› Issue (6): 1423-1434.DOI: 10.19852/j.cnki.jtcm.2025.06.020
• Guideline • Previous Articles Next Articles
FENG Tianxiao1, QIN Xiaokuan1, SUN Kai1, WANG Xu1, XIE Yanming2, GE Long3, SU Youxin4, WANG Peimin5, MA Yong6, ZHU Liguo1(
), WEI Xu1(
)
Received:2025-03-12
Accepted:2025-07-10
Online:2025-12-15
Published:2025-11-24
Contact:
Prof. WEI Xu, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China; Beijing Key Laboratory of Orthopedics of Traditional Chinese Medicine, Beijing 100102, China. weixu.007@163.com, Telephone: +86-10-84739223; +86-10-84739223;About author:Feng Tianxiao and Qin Xiaokuan are co-first authors and contributed equally to this work
Supported by:FENG Tianxiao, QIN Xiaokuan, SUN Kai, WANG Xu, XIE Yanming, GE Long, SU Youxin, WANG Peimin, MA Yong, ZHU Liguo, WEI Xu. Clinical practice guideline for Traditional Chinese Medicine: cervical radiculopathy[J]. Journal of Traditional Chinese Medicine, 2025, 45(6): 1423-1434.
| Item | Definition |
|---|---|
| Evidence quality | |
| High (A) | We are very confident that the true effect lies close to that of the estimate of the effect. |
| Moderate (B) | We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. |
| Low (C) | Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. |
| Very low (D) | We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. |
| Recommendation strength | |
| Strong (1) | When the desirable effects of an intervention clearly outweigh the undesirable effects, or clearly do not, guideline panels offer strong recommendations. |
| Weak (2) | when the trade-offs are less certain — either because of low quality evidence or because evidence suggests that desirable and undesirable effects are closely balanced — weak recommendations become mandatory. |
Table 1 Evidence quality grades and strength of recommendations
| Item | Definition |
|---|---|
| Evidence quality | |
| High (A) | We are very confident that the true effect lies close to that of the estimate of the effect. |
| Moderate (B) | We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. |
| Low (C) | Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. |
| Very low (D) | We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. |
| Recommendation strength | |
| Strong (1) | When the desirable effects of an intervention clearly outweigh the undesirable effects, or clearly do not, guideline panels offer strong recommendations. |
| Weak (2) | when the trade-offs are less certain — either because of low quality evidence or because evidence suggests that desirable and undesirable effects are closely balanced — weak recommendations become mandatory. |
Figure 2 Visual graphic of recommendations CR: cervical radiculopathy; TCM: Traditional Chinese Medicine; GPS: good practice statement; 1: strong; 2: weak; B: moderate; C: low; D: very low.
| TCM syndrome type | Primary symptom | Secondary symptom | Tongue and pulse |
|---|---|---|---|
| Syndrome of Qi stagnation and blood stasis | Experience tingling and numbness in the neck, shoulders, and affected limb; encounter fixed pain; exhibit aversion to pressure; heightened pain during nighttime. | Display a dark complexion; observe localized petechiae on the body. | Manifest a purple and dark tongue with petechiae; demonstrate a tense and rough pulse. |
| Syndrome of wind and cold obstructing collaterals | Report pain and numbness in the neck, shoulder, and affected limb, exacerbated by cold and alleviated by warmth. | Express a fear of cold and wind; note limbs feeling cold; experience sweating or lack thereof. | Present a pale tongue with thin white fur; exhibit a floating tight or slow pulse. |
| Syndrome of liver and kidney insufficiency | Describe dull pain and numbness in the neck, shoulder, and affected limb. | Complain of soreness and weakness in the waist and knees; note dryness of the eyes; report dizziness, tinnitus, insomnia, and dryness of the throat and mouth. | Show a thin and red tongue with little or no fur; demonstrate a tense thin pulse or thin rapid pulse. |
| Syndrome of Qi and blood depletion | Experience pain and numbness in the neck, shoulders, and affected limb; observe muscle atrophy in the hand. | Report dizziness; describe palpitations; note shortness of breath; present with a pale face; express alarm and restlessness; observe sunken nails without luster; report dry and itchy skin. | Display a pale tongue with little fur; manifest a thin weak pulse. |
Table 2 The TCM syndromes types of CR
| TCM syndrome type | Primary symptom | Secondary symptom | Tongue and pulse |
|---|---|---|---|
| Syndrome of Qi stagnation and blood stasis | Experience tingling and numbness in the neck, shoulders, and affected limb; encounter fixed pain; exhibit aversion to pressure; heightened pain during nighttime. | Display a dark complexion; observe localized petechiae on the body. | Manifest a purple and dark tongue with petechiae; demonstrate a tense and rough pulse. |
| Syndrome of wind and cold obstructing collaterals | Report pain and numbness in the neck, shoulder, and affected limb, exacerbated by cold and alleviated by warmth. | Express a fear of cold and wind; note limbs feeling cold; experience sweating or lack thereof. | Present a pale tongue with thin white fur; exhibit a floating tight or slow pulse. |
| Syndrome of liver and kidney insufficiency | Describe dull pain and numbness in the neck, shoulder, and affected limb. | Complain of soreness and weakness in the waist and knees; note dryness of the eyes; report dizziness, tinnitus, insomnia, and dryness of the throat and mouth. | Show a thin and red tongue with little or no fur; demonstrate a tense thin pulse or thin rapid pulse. |
| Syndrome of Qi and blood depletion | Experience pain and numbness in the neck, shoulders, and affected limb; observe muscle atrophy in the hand. | Report dizziness; describe palpitations; note shortness of breath; present with a pale face; express alarm and restlessness; observe sunken nails without luster; report dry and itchy skin. | Display a pale tongue with little fur; manifest a thin weak pulse. |
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