1, etiology of the general theory of traumatic paraplegia is the human spine in different violent injuries to the spinal cord and the cauda equina and the two kinds of neural tissue mixed injury of the clinical manifestations, the etiology of its two kinds: 1 the spine and spinal cord caused by the factors of open injuries most of the wartime weapons kill or other pathologic factors of the implementation of the surgical injuries; 2 closed spinal fracture or dislocation caused by the spinal cord injuries often occurs in the operation of industrial and mining and traffic accidents and sports and other traumatic injuries. and traffic accidents, as well as sports and other traumatic injuries. The spinal cord and the cauda equina; due to the nature and degree of injury are different so often produce shock, contusion, extrusion, pull or cut off and other different degrees of damage, paraplegia is the result of serious damage to the nerve tissue “spinal cord”. Fractures or dislocations of cervical vertebrae often cause paraplegia (i.e. quadriplegia), and fractures or dislocations of vertebrae below the thoracic vertebrae cause paraplegia of both lower limbs, which often result in different degrees of disability and a series of early or late complications. However, if patients can be accurately diagnosed at an early stage and master the principles of timely and correct treatment by combining traditional Chinese and Western medicines, many of them may regain a considerable amount of their labor ability and ability to take care of themselves, and can prolong their lives completely. Moreover, it can completely prolong the patient’s vitality and reduce the early mortality. Five common clinical manifestations of spinal cord or cauda equina injury: (1) spinal cord shock: mainly nerve tissue cells have not suffered serious damage, but only after a strong shock, the arterial and venous blood vessels of different sizes produce a slight damage to the blood circulation disorders caused by the same time, but also often appear incomplete loss of motor, sensory nerve function or visceral paralysis phenomenon, generally in a short period of time can be quickly restored! Generally, all normal neurophysiological functions can be quickly recovered within a short period of time. Spinal cord shock is a natural phenomenon inevitably occurring in all kinds of spinal cord injury symptoms. (2) Simple spinal cord injury: often occurs in the tenth thoracic vertebra above a certain part of the vertebral fracture or dislocation, because the spinal column was injured by the nature of different, so the spinal cord will form the concertina, contusion, pulling, extrusion, and other degrees of damage, the common clinical level of injury below the level of the trunk and limbs of the sensory and motor functions are immediately lost, and may lose the control of urinary and fecal self-care ability, the muscles also began to occur flaccid paralysis. The muscles also begin to undergo flaccid paralysis. It is clinically found that, in the course of Western medical treatment, after surgical restoration and fixation, the spinal cord at the injury site is severely attacked by cold due to excessive fluid infusion, which will lead to cold condensation and stagnation of qi, so that after a few weeks, the muscles below the level of the spinal cord injury begin to change from relaxation to spasm, and tendon reflexes become hyperactive from disappearance, and there are also some patients with different degrees of severe pain in the deep sensory nerves, but there is no restoration of the function of sensory nerves on the surface of the body. The theoretical basis of Chinese medicine is to treat all injuries with warm and hot medicine, remembering cold, so similar sequelae will not occur. (3) Simple cauda equina injury: mainly occurs in the second lumbar vertebrae below the fracture or dislocation, the cauda equina nerve tissue such as severe compression, contusion, fracture, the same loss of limb sensory and motor nerve function below the level of the injury, due to the nature of the injury and the degree of the loss of urine and feces control ability is also the same to varying degrees of loss, due to the cauda equina belongs to the tail end of the spinal cord nerve tissue, so the injury and the surrounding nerve tissue is also the same as the loss of sensory and motor nerve functions. Because the cauda equina belongs to the tail end of the spinal cord nerve tissue, it can be easily repaired or regenerated after the injury and the surrounding nerve tissue, but the loss is serious and can still lead to permanent paralysis if the correct treatment principle is lost. (4) Mixed injury of spinal cord and cauda equina: mainly due to fracture or dislocation from below 11th thoracic vertebrae to above 1st lumbar vertebrae, the degree of spinal cord injury is also different in clinical observation: 1 if the spinal cord and nerve roots are not completely injured, there will be some sensory or motor nerve function below the level of injury. 2 the spinal cord and the nerve roots are all contused and severed, and all the nerve function is lost completely. Since the degree of injury to the spinal cord varies, the clinical manifestations also vary. However, no matter which part of the spinal cord is injured, the early symptoms are basically the same, but due to the different medications used in the clinical treatment of Chinese medicine and Western medicine, the clinical efficacy and recovery level of paraplegic patients are very different. (5) Visceral injury: spinal fracture or dislocation injury not only makes the spinal cord and other tissues around the local injury, but also for the injury of local neighboring organs and remote organs can cause different degrees of injury, for example: lung injury produces respiratory disorders; spleen, stomach and qi injury of dietary disorders; bladder, intestinal injury secretion disorders and vascular injuries such as blood circulation disorders, etc., these organ injuries can be recovered with traditional Chinese medicine treatment. These organs can be restored with traditional Chinese medicine treatment in case of minor damage, but in case of serious damage, it is necessary to continue the rehabilitation treatment with traditional Chinese medicine to improve the quality of the patient’s vitality after the rescue treatment with western medicine surgery. In the process of clinical treatment of traumatic paraplegia, if we can implement the principle of orthopedic treatment which combines Chinese and western medicine in diagnosis, restoration, medication and functional exercise, we can realize the breakthrough features of fast recovery from early complications, high regeneration cure rate after spinal cord cell injury and less after-effects, and the unique physical therapy of Chinese medicine can completely replace the microcirculation of various tissues of the human body which cannot be realized by the western medical practice, surgery and western medicine so far. The microcirculation function of strengthening cell metabolism after injury. 2, Western medicine in the treatment of paraplegia in the clinical main work (1) Western diagnosis: first observe the patient’s mental consciousness is awake, in the case of the casualty did not shock, in particular, to check in detail the internal organs with or without injury or limbs and other parts of the combined injury, a comprehensive and systematic detailed examination of the record is important in order to compare the progress of the restoration of the treatment in the future. X-ray examination: if the patient has shock by various rescue measures after treatment recovery should be done in a timely manner after the X-ray examination, to show the site of spinal injury and vertebral fracture and dislocation of the type of judgment and analysis of spinal cord injuries, the implementation of planned rehabilitation and manipulation of treatment undoubtedly play an indispensable and important role in supporting the implementation of the special circumstances of the X-ray film shows inconsistent with the clinical performance, the reason is that the patient is injured through the However, in special cases, the radiographs are not consistent with the clinical findings, because the patient’s injuries are often reset or repositioned by themselves during the process of moving and transporting, which requires careful questioning and manipulation to analyze the damage to the nerve tissues in order to implement the planned and correct treatment. (2) Western medicine surgical repositioning and fixation treatment principle: in the treatment of paraplegia, in order to release the spinal cord due to fracture or dislocation of the spinal cord to form the pulling, squeezing, contusion, cut off the decompression, the implementation of manipulation traction repositioning or surgical repositioning and internal fixation is an indispensable and important link. Closed spinal cord injury: whether the paraplegic patients with closed spinal cord injury should be treated with surgical repositioning, it must be decided according to the results of X-ray examination in the clinic. If the vertebral body is just a general stability fracture or dislocation of different degrees, it is appropriate to adopt the conservative method of traction and repositioning, and try to avoid re-injury caused by surgical repositioning of the muscle tissues or a large amount of loss of qi and blood, which would reduce the recovery ability of the patient. If the X-ray film shows that the spinal cord and cauda equina are squeezed by the bone fragments, the decompression of removing the bone fragments needs to be carried out immediately, and if the bone fragments removed due to decompression are too much and too big, the implantation of fusion plate is needed to strengthen the physiological function of the spinal trunk. Therefore, in clinical treatment, the best treatment plan should be chosen according to different injuries to minimize unnecessary re-injury. (3) Western medicine urinary treatment: all paraplegic patients in the early post-injury period, due to spinal cord injury shock bladder sphincter lost nerve innervation ability, so the phenomenon of urinary retention, so in the clinic first of all to deal with a timely work is urinary catheterization, the patient should be admitted to the hospital in aseptic conditions in a timely manner will be with air bladder double-lumen catheter or ordinary indwelling catheter inserted into the lower part of the bladder for the indwelling catheterization, and closely watch out for the obstruction of catheters during the treatment. During the treatment period, close attention should be paid to the occurrence of catheter obstruction, and if necessary, the bladder can be rinsed with 200 ml of sterile saline or 30% boric acid water, but in order to avoid the adverse consequences of urethral infection caused by long-term indwelling urinary catheter, the catheter should be discharged at an early stage when other comorbidities have been recovered, and early manipulation should be adopted to cooperate with or train the patients to urinate on their own. 3, Chinese medicine in paraplegia clinical drug integrated treatment Clinical practice has proved that: Chinese medicine has successfully made up for the manipulation and western medicine so far failed to achieve the human body organs and tissues, spinal cord nerve tissue, bone tissue, muscle tissue and other cell physiological metabolism of the microcirculation function, but also can rapidly improve the human body’s various tissues of the damage itself to the repair capacity. Chinese medicine firstly breaks through to fill the blank that western medical circles still have not realized the treatment of various comorbidities of paraplegia with oral medication. (1) Chinese medicine treatment of vertebral fracture: in order to restore the physiological function of the human spine after being injured in time and decompression of the spinal cord at the same time, so under a clear diagnosis according to the different nature of the vertebral fracture or subluxation, carry out the correct surgery or traction will push the body to reset and fixation, however, if you want to make paraplegic patients to recover rapidly and then walk again at the level of the standard of healing, so fight for the healing of vertebral fracture time is particularly important, the authors based on the According to the orthopedic academic theory of Chinese medicine, the authors use the physical function of oral Chinese medicine to promote the blood circulation of the injured local area, strengthen the metabolism of the bone tissue cells, early formation of bone scab, rapid healing of the fracture end, accelerate the healing time of the fracture, improve the quality of the fracture healing, and lay a strong foundation for the paraplegic patient’s early sitting up and walking again. (2) Chinese medicine replenishes blood and generates fluids: at present, in the treatment of paraplegia, surgical dissection for the patient’s injury of vertebral body reset and internal fixation has become the conventional therapy of western medicine, although the human body’s injury of the spine has been fixed in time and efficiently, but due to the loss of one thing and the other, it brings to the patient’s muscular tissues and vascular damage as well as loss of blood and qi can not be ignored, and it brings to the patient’s restoration of health and its influence is also very serious, and blood and fluids are the material to maintain the life of human body. Fluid is the maintenance of human life material metabolic raw materials, easy to lose and difficult to become. Clinical evidence: Western medicine postoperative blood transfusion to supplement the bleeding caused by surgery or open injury and Chinese medicine to Chinese medicine to replenish blood efficacy comparison is completely different, because Western medicine can only transfuse tangible blood, but can not be input to the blood in the intangible qi, so the patient’s immunity is still low and not easy to recover. The authors based on the ancient saying that see blood Hugh treatment of blood, must first adjust its gas, because the tangible blood can not be born quickly, the invisible gas when the emergency solid theoretical principles to guide the practice. Therefore, the use of traditional Chinese medicine to replenish qi, blood and fluids for the metabolism of all tissues and cells of paraplegic patients to supplement the nutrients contained in the diet is the biggest key issue in the treatment of paraplegia in the clinic. (3) Chinese medicine to replenish qi: Chinese medicine philosopher cloud: limb weakness, slight speech, pulse to weak, face impotence white are all called qi deficiency, this phrase explains “qi” in the body of the physiological mystery. However, the human body in the burst of extrusion, fall, hit the injury, clinical operators only pay attention to the patient’s tangible tissue damage, but ignored the dirty gas damage to the patient’s physical health brought about by the serious harm, the author of paraplegia clinical treatment observation found that the blood and fluid is the human body all the tissues and cells metabolism of the material base material; gas is the human body organs skills vitality and limb cellular vitality of the original driving force. The driving force, if the yuan qi damage, even if the nerve conduction function is normal, people’s limbs are still weak, the physiological function of human organs will still be reduced not easy to recover, so whether it is pathological factors or traumatic factors caused by qi must be highly valued, the clinical evidence: the use of traditional Chinese medicine unique therapeutic effect, both to restore the physiological respiratory function of the lungs can be supplemented with the damage of the dirty qi (i.e., yuan qi), and can enhance the body digestion, absorption, secretion, and the ability of the body to digest, absorption, and secretion of the blood and fluids. It can enhance the physiological qi function of the digestive, absorptive and secretory organs of the human body, and improve the metabolic cycle of all the tissues and cells of the human body by taking sufficient nutrients from the diet and medicines of the internal organs and organs. In addition, qi replenishment with traditional Chinese medicine still has significant curative effect on restoring the muscle strength of patients below the level of spinal cord injury. (4) Chinese medicine treatment of spinal cord injury: how to regenerate the tissue cells after spinal cord injury is still under research and exploration in the international medical community, but this major problem of clinical medicine has never been answered by the correct treatment. The author’s clinical practice of treating paraplegia with traditional Chinese medicine has produced a new understanding and experience. Any tissue of human body itself has strong cell regeneration and metabolism, but there must be a very rich supply of nutrients in order to renew the cell metabolism, why is it not easy to regenerate the cells of the tissue after spinal cord injury, the author’s research results proved that, it is because of the destruction of blood vessels that deliver blood and oxygen to the spinal cord tissues and the obstruction of the circulation, so the spinal cord nerve tissue is lost. The authors’ research results proved that it is because the blood vessels carrying blood and oxygen to the spinal cord tissue are destroyed, and the blood circulation is blocked, so the physiological metabolic function of the spinal cord nerve tissue is lost. Clinical practice found that: after spinal cord injury, if timely use of traditional Chinese medicine physical function to quickly repair the damaged blood vessels physiological function, so that the damaged spinal cord tissue to get enough blood and oxygen, while using traditional Chinese medicine to mediate to improve the physiological function of the spinal cord, strengthen the spinal cord from the blood to absorb the extraction of myelin cells myelination, after a series of traditional Chinese medicine comprehensive treatment and repair of spinal cord neural tissues of different injuries, along with the regeneration and healing of cells, most of the nerve conduction function. After a series of comprehensive treatment and repair, the nerve tissues of different damaged spinal cord can be restored with the regeneration and healing of the cells, and most of the conduction functions can be restored. (5) Chinese medicine treatment of respiratory disorders: respiratory disorders make the early serious comorbidity of traumatic paraplegia, the cause of which is lung tissue injury after the chest is crushed by bursting and crashed, due to the factors of rupture and bleeding of the lung tissue caused by severe pain, which brings great physiological dysfunction of lung respiration, so the authors in the clinic, in addition to the use of the main treatment for the spinal cord injury, but also timely and concurrently with the use of ginseng-su drink or Xiao Chaihu Tang plus subtractions to Promote blood circulation, move qi, dispel phlegm and remove respiratory secretions and blood stasis in the lungs, and try not to use a large number of antimicrobial infusions to treat respiratory obstacles, because the medicinal solution is too cold, it is very easy to make the injured spinal cord or other tissues of the accumulation of fluid and oedema, which results in the stasis of blood stasis of cold and stagnation of qi and impede the regeneration of the spinal cord, and it is more likely to bring the patient with the serious after-effects of the long-term spasticity and pain that are difficult to recover from limbs below the level of the injury and are beyond salvage. (6) Chinese medicine treatment for constipation: paraplegic patients with spinal cord injury are affected by internal injuries or bed-ridden and lack of movement, and the production of constipation in the stool is one of the most common clinical symptoms, and it is also one of the diseases that can be easily treated in the paraplegic clinic. If the patient is unable to pass stools and has abdominal distension and no exhaustion, there is gas stagnation, which can be treated with Jiawei Chengqi Tang, and if the patient has abdominal pain and hardness and no distension and constipation, which can be treated with Four Substances Soup plus or minus, all of them will be effective immediately. Loss of urinary function of bladder and defecation function of intestines is transformed according to the recovery of the function of spinal cord or visceral qi, if the injured nerve tissues can not be repaired, so it is difficult to restore the function of the injured organs. Therefore, it is extremely important to rapidly repair all the comorbidities of traumatic paraplegia with traditional Chinese medicine in clinical practice. (7) Prevention and treatment of decubitus ulcers with traditional Chinese medicine: paraplegic patients suffer from early loss of motor and sensory nerve function, damage to local peripheral blood vessels, obstacles to blood circulation, as well as open spinal cord injuries or large amounts of bleeding caused by surgery and other injuries, so that the immune function of the patient’s body decreases, so that the skin’s tolerance to compression is reduced, and if the patient lies still in one position for a long period of time, the skin can be damaged in the bulge of the body after 4 to 6 hours. Decubitus ulcers can occur in the elevated parts of the body soon after 4 to 6 hours of lying in one position for a longer period of time. This is especially true if you are lying on a hard bed and cannot turn over technically. Therefore, in order to prevent the occurrence of bedsores must do a good job of all the meticulous care is particularly important, the current sponge pad and air cushion is more ideal appliances, but also need to be every two hours around the clock carefully will be the patient to turn over once. If nursing negligence bedsore development will be quite rapid, small bedsore as long as the focus on the local no longer under pressure, the external application of muscle blood cream can be cured, the larger bedsore is paraplegic patients late fatal one of the important factors, according to Chinese medicine surgical theory, rotting meat not go new meat is not born of the ancient not easy to principle, so must be used in traditional Chinese medicine to remove the dead muscle, take a lot of drugs to replenish the blood in order to timely recovery of the patient’s physical quality, and then use the blood of the drug to recover the patient’s Physical quality, and then use the drugs for natural healing, but the sores must be strictly noted when changing the medicine, not to use cool liquid cleaning, so as not to prevent the sores from being cooled to prevent the growth of muscle healing, in the case of the patient does not appear to have a high fever, do not use a large number of antimicrobial agents to anti-inflammatory or rehydration, so that the patient’s blood increased vigorously in the fluid, the coagulability of the blood decreases, the granulation of the tissues is difficult to form, sores are quite difficult to heal! Clinical time has proved that traditional Chinese medicine internal and external therapies are the most effective way to treat bedsores. (8) Functional exercise: after the spinal cord and cauda equina tissue is injured, after the correct manipulation of the vertebral body reset and fixed and the treatment of drugs for 5-7 weeks, the injured spinal cord nerve tissue initially produces the healing changes of the myeloid bud tissue, in order to restore the paraplegic patient to lose the nerve function below the level of injury to prevent the limb joints from stiffness and deformity, it is important to do the limb passive functional exercise in time at an early stage, but the manipulation should not be too violent, and it is required to reach the normal level. It is very important to do passive functional exercise of the limbs in early and timely manner, but the manipulation should not be too violent, and it is required to reach the normal functional range as the standard. In the drug treatment effect of general spinal fracture or dislocation 5 ~ 7 weeks can also be achieved solid fusion, so we should encourage the patient to turn over and sit up early exercise, if the patient has reached the ability to sit up, the knee joint to splinting, began to help axillary cane for lower limb walking exercise, until the release of the device to help the double crutches or help cane can walk. Strengthening functional exercise is both the basis for testing the regeneration of the spinal cord and the restoration of the innervation function. Therefore, restoration of all human functions is an important and indispensable process in paraplegia clinic. For the therapeutic rehabilitation of every traumatic paraplegic patient, timely, correct and rapid treatment must be carried out under the combination of many aspects, i.e., to achieve the highest rehabilitation standard of early complications and to avoid the occurrence of complete complications. “The biggest hope of paraplegic patients is to be able to walk again, so fighting for the time of treatment and recovery is the most important, and it is of great significance to relieve the patients from the thought of lifelong disability at an early date.” At present, paraplegic rehabilitation centers have been established all over the world, but most of them are mainly based on western medical rehabilitation treatment, although some of them can not be solved by traditional Chinese medicine, but they still have not realized the main treatment problems that traditional Chinese medicine can solve, such as medication to promote the regeneration of the spinal cord and other comorbidities such as the manipulation and western medicine can not be realized, so it is very difficult for paraplegic patients to reach the self-care of their own lives or to restore a certain degree of labor ability. Therefore, in order to improve the highest level of treatment and rehabilitation of traumatic paraplegia, it is very necessary to give full play to the respective advantages of Chinese and Western medicine, and then, in clinical practice, Chinese and Western medicine should be thoroughly combined to form a complete paraplegic medical system in both thought and action.