Tuina is promising for the treatment of pediatric tics

【Overview】

Tourette-Tourette syndrome is a common psychological, behavioral, and neuropsychiatric syndrome in childhood characterized by chronic, fluctuating, multiple muscle twitches, or accompanied by involuntary laryngeal abnormalities and obscenity. Boys are more common, with a male-to-female ratio of about 3:1, and it is more likely to occur between the ages of 2 and 12. A few resolve spontaneously to puberty, and some gradually worsen into adults.

Modern medicine is not very clear about its causes and mechanisms. It is believed to be related to genetics, central nervous system structure, dysfunction and diseases (such as epilepsy), as well as psychiatric and metabolic disorders.

In Chinese medicine, "twitching" is referred to as "convulsions", "fistulas", "tendons and flesh", and "vibration"; "dirty words" are related to abnormal mental consciousness. This condition is similar to the "slow convulsive wind", "slow spleen wind" and "abnormal transient" in Chinese medicine.

【Etiology】

Modern Chinese medicine has more treatment for this disease and less summary. In the process of continuous exploration.

1. Tics and wind The disease is characterized by long-term recurrent local tics. Tics are manifestations of hepatic wind. "Pediatric Pharmacy Certificate ZhiZhi Zhi Zhi Zhi The "Su Qing Zhen Zhi Da Theory" says that "all winds and dizziness belong to the liver", that is, head shaking, limb vibration, and shaking are liver wind. There are sharp and slow alarms, and the key to distinguishing between strong and weak twitches lies in weakness. The disease is similar to slow convulsions, but is dominated by local tics.

Second, tics and liver and kidney liver and kidney cohabitation under the focus, sperm and blood homology. If congenital insufficiency, or acquired disorders, resulting in insufficient sperm and blood, liver body and vein loss; or children lack of care, temperament, impatience, liver qi depression knot can not be stretched, depressed and fire, burning camp yin. Due to the loss of liver and muscles, there are frequent facial twitches such as blinking, frowning, grinning, shrugging of the nose, and neck, as well as limb twitching symptoms such as swinging arms, shaking hands, clenching fists, kicking legs, and stomping feet. And most of them are induced or aggravated by emotional agitation, which fully indicates that it is liver and kidney yin deficiency, muscle and vein loss.

Third, the disease and the heart and spleen This disease twitching is involuntary, and weak, similar to slow convulsions. The heart is the ruler of the monarch, the Lord God. That is, the coordination of functions and movements between the various organs and parts of the human body is commanded by the heart. God's lack of master is the root cause of unconscious action. Slow wind blame spleen. The "Juvenile Evidence and Treatment Criterion : Slow Alarm" describes "Muke spleen soil, stomach as the intestines of the spleen, wind in the stomach, fistula gradually growing, its fistula symptoms, both shoulders slightly shrugged, both hands drooping, and constantly shaking" is similar to the symptoms of this disease. Because of its convulsions and weakness, it should be blamed on spleen deficiency.

Fourth, abnormal sounding between the larynx and profanity and phlegm: the throat constantly emits strange sounds as the characteristics of the disease. The laryngeal sound in Traditional Chinese medicine is mostly caused by sputum turbidity. Sputum clouding on the mongqing trick and phlegm obsessive mind trick constitute another key pathogen of this disease. The phlegm of Chinese medicine comes from the spleen, that is, "the spleen is the source of phlegm." "Another example of the association of the disease with the spleen."

In summary, this disease is the evidence of this false standard.

The standard is hyperphotose, wind movement, phlegm, and is characterized by frequent convulsions and foul language.

This deficiency is caused by liver and kidney yin deficiency, insufficient qi and blood, and timidity.

【Diagnosis】

1. Diagnosis

1. Criteria: Chinese Mental Illness Classification Scheme and Diagnostic Criteria (ccmd-2-r) adopted at the Quanzhou Conference in 1994.

(1) The disease is before the age of 21, and most of them are between the ages of 2 and 15.

(2) It is mainly manifested as a variety of tic movements and one or more involuntary vocalizations, both of which appear at certain times during the course of the disease, but do not necessarily exist at the same time.

(3) Tic symptoms occur repeatedly many times a day, almost every day, but the intensity of symptoms changes within weeks or months, and can be restrained for several minutes to hours, the course of the disease lasts at least 1 year, and the symptoms are relieved for more than 2 months in the same year.

(4) Involuntary twitching and vocalization, which cannot be explained by other diseases.

2. Laboratory examination: magnetic resonance imaging (MRI) and cerebral blood flow imaging (spect examination) can assist in diagnosis. The volume of the basal nucleus on both sides of the skull can be found to be asymmetrical, and the average volume of the bilateral caudal nucleus and bean-like nucleus is reduced by normal. Skull spect examination reveals areas of reduced perfusion of localized blood flow in the temporal lobe, frontal lobe, and basal nucleus. Patients have reduced local blood perfusion at the lesion site during tic seizures and increased seizures, which are similar to the spect image characteristics of patients with epilepsy, but whether they have the same pathological basis as epilepsy need to be further studied.

Some patients may have mild EEG abnormalities, but there is no specificity, mainly slow wave or spike wave increase, no epileptic computer wave, and the dynamic electroencephalogram (aeeg) abnormality rate can reach 50%. Cranial CT is more than normal.

2. Differential diagnosis

The disease is similar to the name of the child's hyperactivity syndrome, can occur together, easy to confuse The disease is characterized by local (a group and multiple groups of muscle groups) involuntary tics and laryngeal involuntary vocalization, and its twitching is diverse, fluctuating and long-term. Children's hyperactivity syndrome has no convulsions, and generally does not have abnormal laryngeal vocalizations, but is manifested as difficulty in entering static, hyperactivity, hyperactivity, and impulsivity.

【Treatment】

1. Governing the law

Stop (local) convulsions, stop the profanity language as a method of curing the symptoms, can be achieved by calming the liver and extinguishing the wind, nourishing the yin and the yang, calming the mind, seeing the shock, and opening up the phlegm. Toning yin and yang, reconciling qi and blood as the cure can be achieved by nourishing the liver and kidneys, nourishing the heart and spleen, etc.

Empirical evidence, hot evidence, and yang hyperactivity are mainly fang 1, supplemented by fang 2; false evidence, cold evidence, and qingyang non-rising are mainly fang 2, supplemented by fang 1.

Second, the basic party

Prescription 1

compose

Heart and liver tongqing (3~5 minutes)

Four major techniques of head (within 1 minute of opening the Heavenly Gate; 1 to 2 minutes of Tuikan Palace; 2 to 3 minutes of kneading or transporting the sun; 3 kneading of the high bones of the back of the ear and 1 pinch 50 to 60 times)

Head three vibration press (thumb finger abdomen or palm root vibration press Baihui, each vibration 5 to 8 seconds, pause for a moment, re-vibration, a total operation of about 1 minute; two hand food, middle and nameless three fingers placed together in the upper orbit of the two eyes, 3 kneading 1 vibration, 2 to 3 minutes; two palms opposite the two temples, symmetrically squeezed to the center; the back palm is placed on the forehead, the other palm is placed in the back pillow is also symmetrically squeezed to the center; each squeeze is pressed for 3 to 5 seconds, vibration is 1 time, operation 2 to 3 minutes, the name vibration is pressed to the head of the four sides)

Triple yin intercourse operation (the thumb ends of both hands are placed in the triple yin intercourse, first point 10 times, then press the thumb finger abdomen vibration for 30 to 40 seconds, and then rub up and down to make it hot)

Prescription 2

Spleen Tonic (3~5 minutes)

Kidney Meridian (3~5 minutes)

Kneading 2 horses (2~3 minutes)

Rub Nailao Palace (1~2 minutes)

Pinching (3 to 20 times)

Dantian operation (rub the lower abdomen with three fingers or full palm for about 1 minute; knead for 2 to 3 minutes; relax and re-vibrate for about 1 minute per vibration; rub horizontally to make it hot)

3. Dialectical Arguments

(1) Yin and void wind movement

Symptoms: frequent blinking, facial muscle twitching, head swinging, unfavorable throat, frequent throat clearing, emaciation, hot flashes, night sweats, five upset fever, dizziness, strabismus, hearing loss, tongue redness and less moss, fine pulses, red fingerprints.

Treatment: Nourish yin and yang to stop spasms

Prescription: Party 1 with Party 2. Add the water bottom fishing moon (30 to 40 times, nourishing yin and clearing the heat and submerged yang), point saving bamboo (10 to 20 times, calming and calming the spirit), point four white (10 times, stop facial muscle spasm and frequent blinking), push bridge arch (left and right 5 to 8 times, flat liver latent yang reverse), push down the tianzhu bone (make local flushing, flat liver reverse), take Taixi (10 times, nourish kidney yin), Mo Yongquan (20 laps, ignite the fire to return to the yuan).

(2) The heart and liver are on fire

Symptoms: restless limbs, instantaneous eyes, teeth grinding in sleep, nose and scratching ears, red face, upset and irritable, frequent stuttering, night crying, mouth and tongue sores, thirst and drinking, tongue red drop, strong pulse string number, fingerprint purple.

Treatment: clear the heart and remove troubles, calm the liver and calm

Prescription: Mainly party 1. Jia Da Ma crossed the Tianhe River (the second finger of the food alternately slapped from the bottom up to the forearm palm side flushing, clear the heart to remove the trouble), push rubbing the heart Yu (push the heart Yu down with the thumb finger abdomen, so that the local fever, can clear the heart fire), pinch Jingwei (two thumbs a pinch Jingning, a pinch Wei Ling, at the same time pinch 10 times, stop the shock and stop the convulsions), pinch the mountain root green tendon (10 times, the mountain root green tendon is the characteristic of liver wind, pinch can calm the liver and extinguish the wind), sweep the head side (1 to 2 minutes, both can dispel the wind, but also wake up the brain), push the abdominal yin and yang (20 to 30 times, Can drain the gas machine, divergent fire), pinch Tai Chong (10 times, clear diarrhea liver fire).

(3) Two deficiencies in the heart and spleen

Symptoms: limb movement, numbness, convulsions and weakness, constant shock, dizziness, forgetfulness, poor academic performance, lack of concentration, easy to wake up in sleep, salivation, no color, less food, loose stools, light tongue, thin white moss, weak pulses, fingerprint floating.

Treatment: Nourish the heart and spleen, calm the spirit and settle the mind

Prescription: Mainly party 2, matching party 1. Add three levels (1 to 3 minutes, for the temperature as a supplement), kneading the external work (about 1 minute, for the temperature is liter), pinching the inner pass (3 kneading 1 pinch for 1 minute, calming the mind and calming the mind effectively), taking the wind pool and taking the shoulder well (each taking about 1 minute, can lift the qi machine, improve the blood supply to the head and neck), take the blood sea (10 times, can nourish the blood and dispel the wind, stop convulsions), rub the foot three miles (2 to 3 minutes, replenish the spleen and stomach qi), dim sum Yu (10 times, invigorate the yang qi in the chest), vibrate and rub the body (3 rub 1 vibrate for 1 minute, open the chest and smooth the qi, invigorate the heart and yang).

(4) Phlegm obsession

Symptoms: convulsions, trance, strange cries in the throat, salivation, throat discomfort, dizziness, chest tightness, nausea, constant vomiting, mossy, slippery pulse, fingerprint stagnation.

Treatment: Open sputum opening

Prescription: Party 1 with Party 2. Add the bagua within the transport (2 to 3 minutes, smooth the phlegm), rub the palm of the small horizontal stripe (about 1 minute, which should be the phlegm point), pinch the plate door (10 times) and knead the small horizontal stripe (10 times) can clear the heat and purify the phlegm, open up the trick and wake up the spirit; wasp out of the hole method (5 to 10 times, can open the phlegm to fix the alarm), knead the middle and paramalarial milk root (three-finger kneading method for 1 to 2 minutes, dissolve phlegm and loosen the knots, wide chest and rational qi).

Fourth, symptomatic treatment

Facial convulsions are mainly in pinching people and carrying pulp; upper limb convulsions are pinched in the valley and quchi; lower limb convulsions are pinched by hundred worms, Chengshan and Weizhong (the above acupuncture points are the experience acupuncture points of ancient and modern treatment of convulsions, and each acupuncture point is about 10 times). Poor coordination of movements, frequent convulsions can be added to the ten Xuan (5 times) and adjust the five viscera (5 times), the two methods in the child's ten fingers operation, can coordinate the five viscera, regulate the mind; blink frequently add the eyes, dispel the wind, stop spasmodic click to save bamboo (one hand in the food of the two fingers pressed separately, 10 times), take the eye Ming (thumb, the second finger of the index finger pressed on the eye, and at the same time to the middle of the hard to take it) and the dot silk bamboo empty (10 times); nose twitch plus can pass the nose, stop the nasal twitch of the point Yingxiang (10 times), Zhenshan root (10 times) Scratching the ear more than or ear twitching is longer than the point horn sun (10 times), vibrating wind (10 times); shaking the shoulder and taking the shoulder well (1-2 minutes, dispelling the wind) and the pinching of the old dragon (10 times) to stop the convulsions (10 times), pinching the five knuckles (10 times); the lower limb swing is more than a little calf nose (10 times, dredging the qi and blood, stopping the wind), taking the Achilles tendon (that is, taking The Taixi and Kunlun, about 1 minute, can relieve spasm, extinguish the wind) The inter-laryngeal sound plus the three lines after the neck (the middle line and the left and right side open 1.5 inch line, loosen the bladder meridian, help improve the supply of qi and blood in the head), take the shoulder well (about 1 minute, relieve the spasm of the larynx muscles), press the three concaves (vibrate the celestial process 10 times, press the missing basin at the same time with both hands, stay for a few seconds to the maximum tolerance, let go, press again, operate 6 to 8 times, sharpen the throat, scatter stasis, relieve laryngeal spasm).

[Precautions]

First, this disease is a dominant disease of pediatric massage, but the treatment time is very long, often several months or years. According to the characteristics of the convulsions of this disease as chronic and volatile, it can be used as a key massage of fang 1 during its frequent attacks, and in normal times, it can be mainly used as fang 2, which can be taught to parents for home health massage. Symptomatic addition and subtraction for each part of the twitching pinch, cheng pulp, hegu, qu chi, hundred worms, chengshan and wei zhong points, such as frequent twitching, should be forced deeply, pinch about 10 times, such as the usual conditioning, it is appropriate to use the pinch kneading method, every 3 kneading 1 pinch, the strength of the pinch can be appropriately lighter.

Second, for profanity, or stuttering children, you can use the method of changing the language environment for conditioning. For example, let them learn another dialect or foreign language, insist on reading the text aloud every day, etc.

III. Persist in comprehensive prevention and control. If the diet should be light, eat more vegetables and coarse grains, avoid greasy, fried, spicy and easy to allergy foods, eating habits should be regular, rationalized, not forced to eat. Psychological regulation is very important, to eliminate the psychological and spiritual burden of children, so that they can establish self-confidence, not fear, not inferiority. To avoid colds and strengthen physical fitness.

Fourth, my own experience, with traditional Chinese medicine effect is better. Chinese medicine is best processed into pills or powders, which is conducive to long-term use!

The article is transferred from Professor Liao Pindong's pediatric tuina blog