To explore the efficacy and mechanism of acupuncture,moxibustion and tuina for the treatment of vertebral artery type cervical spondylosis.Methods：A total of 120 patients with vertebral artery type cervical spondylosis from April 2017 to December 2018 were randomly divided into a control group and an observation group by random number table method,with 60 cases in each group.The control group was treated with Jiaji(EX-B2）point on neck,while the observation group was treated with tuina on the basis of the control group.At the end of the treatment,the clinical efficacy of the 2 groups was observed,and the hemodynamic indexes such as time mean flow velocity(TMFV),peak systolic blood flow velocity(PSV),pulsatility index(PI),resistance index(RI）of the vertebral artery-basilar artery before and after treatment were observed.The neuron-specific enolase(NSE）and endothelin(ET）value of the 2 groups before and after treatment were extracted and analyzed.Results：(1）After treatment,the clinical symptoms and functional scores of the 2 groups were significantly improved(P<0.05),and the observation group was better than the control group(P<0.05).After treatment,the total effective rate of the control group was 76.67%,and that of the observation group was 91.67%.The treatment group was significantly better than that of the control group(P<0.05).(2）There was no significant difference in hemodynamic evaluation between the 2 groups before treatment(P>0.05); TMFV and PSV of vertebral artery-basilar artery in the 2 groups were significantly increased after treatment(P<0.05),while P I and RI of vertebral artery-basilar artery in the 2 groups were significantly decreased(P<0.05),and the hemodynamic indexes in the observation group were better than those in the control group(P<0.05);(3）After treatment,the levels of NSE and ET in both groups decreased significantly(P<0.05),and the observation group was better than the control group(P<0.05).Conclusion：Tuian combined with acupuncture and moxibustion can effectively improve the clinical symptoms of patients with vertebral artery type cervical spondylosis.Its mechanism is related to the decrease of NSE and ET levels and the change of hemodynamics.