Text|爻爻
Editor|Little Red Riding Hood
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With the development of the times, the continuous advancement of science and technology, the popularization of informatization, increasing the work pressure of modern people, changing life and rest habits, directly forming a variety of bad work and rest habits such as long working hours, increasing computer time, staying up late for a long time, poor sitting posture, etc., so that the age of onset of cervical spondylosis continues to become younger.
This kind of young cervical spine discomfort is more common in young and middle-aged people, such people mostly have head, shoulder, neck, arm pain and corresponding tender points, X-ray film has no obvious degenerative changes such as intervertebral space stenosis. Therefore, clinically, symptoms of cervical spondylosis and cannot be diagnosed as cervical spondylosis are classified as sub-health conditions with cervical spondylosis-related symptoms.
Sub-health state refers to non-disease and non-healthy state, is a class of secondary health state, is the state between health and disease is the "third state", "gray state", and repeated fatigue symptoms in the neck is also an external symptom of sub-health state.
Due to the organic lesions of the relevant structures of the cervical spine that are different from cervical spondylosis, cervical spine sub-health can alleviate and recover symptoms after timely medical intervention, adequate rest and habit change, and curb the development trend towards cervical spondylosis.
At present, the treatment of cervical sub-health in young and middle-aged people mostly relies on the relatively mature traditional Chinese and Western medicine treatment options for cervical spondylosis. Western medicine usually uses vasodilators, analgesics, vitamins and mechanical physiotherapy to relieve symptoms, although satisfactory treatment effects can be obtained, but the symptoms are repeated and difficult to cure.
Traditional Chinese medicine has unique advantages and good efficacy in both the treatment of cervical spondylosis and the regulation of sub-health status. In the treatment of cervical spondylosis, the characteristic therapies of traditional Chinese medicine are mainly reflected in acupuncture treatment.
In recent years, the research of acupuncture in the treatment of various types of cervical spondylosis has made great progress and satisfactory efficacy, and a variety of acupuncture and moxibustion ideas for the treatment of cervical spondylosis have been produced according to different differentiation methods, among which "Jin three needles" therapy as one of the many acupuncture treatment methods for cervical spondylosis has achieved positive efficacy in clinical practice.
In terms of regulating sub-health, TCM treatment is guided by the core ideas of "preventive treatment" and "holistic concept", and formulates different treatment plans according to the different constitutions of individuals, and has good feedback on efficacy in the results of many clinical scientific research and laboratory studies.
It will combine the two key elements of "cervical spine" and "sub-health", and integrate from the aspects of acupuncture and traditional Chinese medicine physique.
That is, acupuncture guided by the theory of traditional Chinese medicine constitution, supplemented by the "three needles of the neck" in the "Jin three needles" therapy to regulate the common stasis type constitution of cervical spine sub-health, and the agreement group of acupuncture for the treatment of cervical spondylosis were simply randomized controlled studies to compare the overall efficacy and recurrence before and after the experiment, explore the mechanism, provide a new method for the treatment of cervical sub-health, and make up for the gap in acupuncture treatment.
Cervical sub-health does not have serious degenerative changes in the structure of the cervical spine, mostly functional lesions, and non-surgical treatment can achieve better results. Western medicine treatment includes cervical traction, mechanical physiotherapy, drug treatment and other methods, traditional Chinese medicine treatment methods have diversity, acupuncture, tuina, traditional Chinese medicine, acupuncture, etc. have their own curative effects and advantages.
Advances in treatment in modern medicine
(1) Cervical traction
Cervical spine traction therapy is considered from the perspective of cervical spine structure and force, and uses external force to correct the dynamic and static balance of cervical spine at a certain traction angle.
Chen Yueming et al. proposed in the study of cervical spine traction that acute and chronic injuries of the cervical spine will lead to the imbalance of the cervical spine structure, which in turn aggravates the degenerative changes of cervical intervertebral discs and bones, and thus the abnormal structure stimulates the compression of accessory nerves and blood vessels to cause clinical symptoms of cervical spondylosis;
The use of traction first immobilizes the cervical spine, maintains the stability of the cervical spine, reduces local inflammation, relaxes muscles and relieves spasm;
Second, open the intervertebral space, increase the distance between the intervertebral foramen, reduce the pressure of the cervical intervertebral disc, accelerate the tissue recovery of intervertebral herniation, and relieve the compression of blood vessels and nerves; The third is to retract the incarcerated joint, restore the intervertebral stable structure, adjust the cervical spine sequence to normal, and play the role of immobilization, fixation, spasmolysm and reduction.
(ii) Physiotherapy
The purpose of physiotherapy treatment is to improve blood circulation in local soft tissues with the help of mechanical equipment, reduce the inflammatory stimulation of cervical disc appendages, and relieve muscle spasm. The commonly used physiotherapy methods are iontophoresis, high-frequency electrotherapy, ultra-short wave, short wave, paraffin wax therapy, hydrotherapy, infrared irradiation, etc.
He Yue'e et al. believe that cervical spondylosis, especially cervical spondylosis in young groups, can use a computerized intermediate frequency therapy instrument, because intermediate frequency electrotherapy is a kind of current without positive and negative electrodes, positive and negative exchange of fast, which is more stable under the action of current and is not easy to electrolyze, so it does not produce acid and alkali, and the skin irritation is small.
However, considering the dual limitations of each physiotherapy method in equipment and mechanism, appropriate alternating therapy should be used to ensure adequate rest of the neck to prevent repeated congestion and aggravate symptoms.
(iii) Drug therapy
Clinical Chinese and Western medicines are mostly used for symptomatic treatment, such as aspirin, ibuprofen, fenbid, phenylbutazone, voltaline and other non-retaining anti-inflammatory analgesics analgesia, vitamin B1 tablets, complex vitamins, metholamine tablets and other maintenance neuronutrition, cerebral blood insufficiency can also use nimodipine tablets, brain tablets, vitamin brain pathway tablets and other drugs.
There are also Park and other drugs that use hormones, dehydration or anti-inflammatory analgesia to inject local pain caused by cervical spine facet joints, which have been found to be beneficial to relieve neck pain and are more suitable for young people.
Acupuncture therapy
1. Acupuncture mechanism
As an advantageous disease in acupuncture treatment, cervical sub-health is more widely used in clinical practice than other treatment methods in terms of effectiveness, diversity, complementarity, safety and sustainability, and a large number of clinical and laboratory experiments can effectively prove the efficacy of acupuncture.
The first can not only improve neck and shoulder pain, but also improve the microcirculation of vertebral basilar artery, unblock meridians, eliminate local soft tissue inflammation, and relieve muscle spasm.
Huang Congyang et al. found that acupuncture can effectively improve the microcirculation of cervical capillaries, adjust vascular permeability, and improve tissue blood supply by acupuncture through acupuncture of cervical spinal acupuncture points, which confirms the effectiveness of acupuncture in adjusting the posterior circulation of the neck, and the persistence and accumulation of the acupuncture effect.
Liu Yue et al. also found that after acupuncture treatment, vertebral artery spasm was effectively reduced, blood flow speed decreased, thereby improving cerebral blood supply.
Zhou Wenwang combined warm acupuncture and traditional acupuncture supplementation, and selected Baihui, neck 3 to neck 5 spinal points and wind pool for acupuncture treatment, which also achieved the effect of improving blood supply and eliminating inflammation.
Second, acupuncture therapy can affect neurotransmitters and free radical metabolism. Zhong Weihong's experiments found that acupuncture of the neck and spinal points, in addition to the role of unclogging meridians and harmonizing qi and blood, can also improve the regulation of nerve and sympathetic humoral on this basis, restore the release of bradykinin, serotonin, acetylcholine and other chemicals, and coordinate and reduce clinical symptoms on the basis of neuro-endocrine.
The experiments of Yanbin and other net scholars also started from acupuncture to observe the changes of neurotransmitters in the neck clamping point, and obtained that acupuncture effectively improved blood circulation and nutrient metabolism of tissues around the neck, promoted the effective release of neurotransmitters, and alleviated clinical symptoms under synergistic effects.
Third, in recent years, abdominal acupuncture has described the mechanism of acupuncture in the treatment of diseases from a unique perspective, and also reflected its efficacy and advantages in the treatment of cervical spondylosis from a large number of clinical data.
Among them, the theoretical core of abdominal needle lies in the Shenque Buqi hypothesis, that is, the abdomen has a circulatory system that regulates the operation of qi and blood throughout the body with Shenque as the center, which is formed in the embryo with the regulation system of loosening the whole body qi and blood and macro-regulating the body, and the theoretical basis is derived from "the main bone of the kidney gives birth to the pulp, the kidney deficiency is not strong", "the main muscle limbs of the spleen, and the muscles and limbs of the spleen deficiency cannot be nourished".
The "Heaven and Earth Needle" (Zhong De, Guan Yuan) was selected to protect the spleen and kidneys, and then the corresponding acupuncture point Shangqu point on the abdominal hologram was combined with the following cyst to improve the blood supply to the brain, and the sliding flesh door slippery intervertebral joint jointly improved the qi and blood circulation of the neck and shoulders and reduced the clinical symptoms of cervical spondylosis.
2. Clinical application
Conventional acupuncture
The methods and acupuncture groups selected for the treatment of cervical spondylosis in the clinical application of acupuncture are different. Wang Taigang et al. took acupuncture to treat 126 cases of cervical spondylosis, with a total effective rate of 100%;
Li Hong's acupuncture of Houxi Cave treated 110 patients with cervical spondylosis according to the acupuncture of "Houxi Du Pulse Internal Canthus' Neck", with a total effective rate of 99.1%; Compared with conventional acupuncture, Jiang Zhenya et al. used pestle needle to treat cervical radiculopathy, and the effective rate of the treatment group was 93.3%;
Wang Yong selected the acupuncture group based on fixed asthma and large vertebral points, and used the three-needle prick method, and treated 44 cases of juvenile cervical spondylosis with the "Hegu thorn" on the shoulder well and the Yu point in the shoulder and the deep puncture method of neck 3 or neck 4, with a total effective rate of 100%.
Wang Jin et al. treated 108 cases of cervical spondylosis with shallow and deep stinging method, and the main acupoint was taken from the neck spinal point. Neck type with shoulder well (double), radiculopathy type with shoulder blade soreness with shoulder well, Tianzong, arm, with arm numbness with Quchi, Waiguan, Hegu, Houxi, vertebral artery type wind pool, Baihui, has achieved good curative effects.
Shang Xiukui et al. treated 80 patients with cervical spondylosis using "four-day acupoints", that is, four acupuncture points around the neck, namely Tianmu, Tianrong, Tianguang and Tianding, combined with the missing acupoints, and the symptoms of the treatment group improved better than those in the control group.
Zhou Yongtian, Sun Lijun applied a three-step method to treat 31 cases of adolescent cervical spondylosis, that is, first use needle puncture to release adhesions, then use single rotation reduction method or side wrench method to reset, and finally use points, according to the isological tendon manoeuvre to relax, the result is that the symptoms completely disappeared in 15 cases, the symptoms were significantly reduced in 14 cases, and there were no changes in 2 cases.
Electroacupuncture
Yu Jiangyan used electroacupuncture to clamp the spinal point and wind pool in the neck for treatment, believing that one-way needle can effectively improve the contracture of muscle fibers and relieve the traction of muscle fibers on vertebral arteries;
Pan Wenyu et al. called the acupuncture groups of Yintang, Shenting, Baihui, Shangxing, Brainhu, and Tianzhu (double) for electroacupuncture treatment, and found that the electroacupuncture treatment improved the blood circulation of brain tissue, accelerated the blood supply of vertebral basilar artery, promoted local tissue metabolism and absorption of inflammatory products, relieved flesh soreness, and alleviated symptoms caused by insufficient blood supply to vertebral basilar artery such as dizziness and headache;
In the study of Li Lanmin et al., using jade pillow, four Shencong, Fengchi, cervical spine clamp, shoulder well, and shoulder Yu as the acupuncture group, electroacupuncture was used to treat 120 cases of vertebral artery cervical spondylosis, and continuous waves were used after acupuncture to obtain gas, pulse frequency 30 times per minute, 15 times for 1 course of treatment, and the total effective rate was 95.0%.
Lv Yue took the solar meridian point as the main acupoint, and the acupoints were equipped with acupuncture points such as cervical spine clamping spine, large vertebrae, Tianzong, shoulder well, Quchi, Waiguan, Houxi, etc., and the climate of the needle was connected to the electric acupuncture using dense waves, the frequency was 150 times / min, the needle was left for 30 minutes, and the total effective rate for treating 40 patients with cervical spondylosis was 90%.
Moxibustion
Li Yanting et al. used scarless septum ginger pecking moxibustion for the treatment of 58 cases of cervical spondylosis, and selected Fengfu, Tianzhu, Da Vertebrae, Tao Dao and Ah Shi acupuncture points, with a total effective rate of 96.5%.
Zhuang Lixing used the pressure moxibustion Baihui point to treat cervicogenic vertigo, and selected the Baihui point of "Sanyang and Five Hui" to pass the moxa pressure moxibustion method, so that the warming effect of moxibustion fully expands capillaries and improves circulation, and waits until the increasing rate is 85.7%.
After Chang Jingling and other face acupuncture points such as wind pool, large vertebrae, neck clamp spine, A is acupoint, and outer pass, the medicinal liquid was applied to the large vertebrae, neck clamp spine, and A is acupoint, and at the same time put a moxibustion box to smoke.
The apparent efficacy of 68 patients treated with cervical spondylosis was 98.5%. He Guangwu ordered the treatment of 80 patients with cervical vertigo, and used neck clamp ridge temperature acupuncture as the experimental group to compare the electroacupuncture neck clamp spinal point treatment, and obtained a total effective rate of 95.2%, while the control group was only 84.2%.
3. Research on acupuncture and body tuning
The change of the pace of modern life, the continuous transformation of people's working lifestyle from simple physical work to mental work, thus bringing greater work pressure and fast-paced life, resulting in continuous changes in susceptible diseases, making modern clinical medical methods, methods and ideas need to be constantly updated.
As an emerging treatment idea, acupuncture and moxibustion is based on the overall concept of traditional Chinese medicine from the perspective of physique theory, and conducts in-depth research on the relationship between individual constitution and susceptibility to diseases.
Replace simple treatment with the idea of adjustment, expand the idea of acupuncture to treat diseases, and flexibly apply acupuncture, moxibustion, scraping, cupping and other methods in acupuncture to correct and dispel evil, and have the advantages of safety and non-toxic side effects over other drug treatments.
He Zhiqian et al. provided a basis for the feasibility of acupuncture and moxibustion to regulate physical constitution from a theoretical perspective in the research on acupuncture and the prevention of sub-health. Li Xueqing et al. discussed the relationship between physique and acupuncture from the perspective of "Lingshu", and believed that acupuncture can intervene in the physique through the meridian system.
4. Acupuncture for the treatment of cervical spondylosis
Wang Linlinxin classified and summarized the commonly used acupuncture points in the treatment of cervical spondylosis in ancient times and found that the effective acupuncture points were concentrated in the foot solar bladder meridian, foot less yang bile meridian, hand solar small intestine meridian and du vein:
Among the 131 acupuncture points retrieved for the treatment of cervical spondylosis, the most frequently used were Fengfu, Houxi and Fengchi, followed by Chengjing, Shoulder Well, Tianzhu, and 29 acupuncture points such as Shaohai, Da Shi, Shaoze and Tonggu.
At the same time, some scholars "summarized the acupuncture law of modern clinical treatment of radiculopathy, and found that the acupuncture point with the highest frequency of application was the neck clamp spinal point, followed by Quchi point, then Waiguan point, and the others were Fengchi, Hegu, Houxi, Shoulder Well, Da Vertebrae, Tianzong, Shoulder Cord, Ah Shi Acupoint, and Tianzhu.
When Cai Gengxi and other Min studied the acupuncture and moxibustion rules of cervical spondylosis, they believed that the commonly used treatment points were mostly from the Jingwaiqi Acupoint, the Foot Sun Bladder Meridian, the Foot Shaoyang Biliary Meridian, and the Hand Sun Small Intestinal Meridian, and the face points with the highest frequency of use were the neck clamp ridge, wind pool, Tianzhu, Ah Shi Acupoint, shoulder well, large vertebrae, neck bailao, houxi, big pole, shoulder outer Yu, etc.
Tuina therapy
Some scholars have proposed that Yingtuina has a variety of operation techniques such as point kneading, plucking, rotation reduction, etc., which can achieve "both muscles and bones", that is, the combination of tendons and rectification, which can not only improve the morphological function of local soft tissues, but also correct the displacement of bones and joints, restore the mechanical balance inside and outside the cervical spine, and is an effective method for treating cervical spondylosis in youth.
Wang Qingfu et al. found that chiropractic techniques can help improve the angular displacement of the cervical spine, the slippage of the main body and the depth of the cervical spine. Quan Xiaobin et al. treated 87 cases of cervical spine in adolescents, first using the plucking method to relax the neck muscles, and then applying the rotational rectification method to cure 82.76%, a total of 97.70%, which was better than the neck tie traction control group.
Li Zhigang and Kan used Tuina manipulation to treat 45 cases of juvenile cervical spondylosis, and selected a variety of methods such as point point, kneading, manual rectification, holding, stretching and pushing, and tendon straightening, with a total effective rate of 100%.
Traditional Chinese medicine therapy
Traditional Chinese medicine therapy mainly reflects the differentiation and classification of cervical spondylosis in traditional Chinese medicine, because the symptoms of the disease are more manifested, and the different symptoms are different dialectical angles, so each doctor has different dialectical diagnosis and treatment ideas, among which there are real diseases, and there are also false evidence, or virtual and real mixed evidence, and the disease location is mainly liver, spleen and kidney.
If vertebral artery cervical spondylosis is mainly characterized by vertigo, Hu Jun is identified as blood stasis obstruction, and treatment should use drugs that activate blood circulation and remove stasis; Wu Aimin Network believes that cervicogenic vertigo should pay attention to regulating the lifting and lowering of qi machines, and distinguishes as wind and evil obstruction, phlegm turbidity and medium obstruction, liver yang hyperactivity, and insufficient qi, respectively, use Sichuan iris tea to disperse, half-summer hemp white art soup, tianma hook vine drink, tonic and qi soup.
Other therapies
Wang Chunying treated 100 cases of cervical spondylosis with small needle knife, compared with 50 cases treated by acupuncture therapy, and the results were that 78 cases were cured in the small needle knife group, 21 cases were effective, and the total effective rate was 99%; Du Yuanshu et al. used acupuncture therapy to treat 57 cases of cervical vertigo, including 37 cases with complete disappearance of symptoms, 18 cases with one-time cure, and 18 cases with two to three cures.
Li Ziping used acupoint thread insertion method to treat 76 cases of vertebral artery cervical spondylosis with bilateral C3 to C5 chiropractic, with a total effective rate of 93.42%. Yinfeng Xinnet used danshen injection and dexamethasone injection to treat 302 cases of cervical spondylosis at acupuncture points such as the large vertebrae, with a total effective rate of 98.7%;
Fan Weixing took 4ml of 2% lidocaine and 10ml of triamcinolone acetate injection into Fengchi and Aji acupuncture to treat 36 cases of cervical vertigo, with a total effective rate of 94.4%.
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