Acupuncture for pain
There is almost no part of the human body where pain does not occur, and the causes of pain are quite complex, and the causes of pain in some organs or tissues have not yet been fully understood. Today, we are just talking about our own experience in treating pain in the acupuncture clinic for more than 30 years, and we will refer to them together.
A, in the treatment of pain in acupuncture, should always follow the principle of identification of the internal organs and meridians and evidence: the development of pain, the period of clinical manifestations are intricate, but the causes, Chinese medicine believes that the main organs, meridian dysfunction. We use acupuncture to treat pain, that is, according to the theory of internal organs and meridians to diagnose the condition, to distinguish the nature of pain is cold, is hot, is deficient, is real, is table, is inside. It is important to distinguish whether the pain is cold, hot, deficient, real, superficial, or internal, or whether it is a mixture of cold and heat, deficiency and reality, and whether the disease has invaded the internal organs or the meridians. On the basis of clear identification, acupuncture and moxibustion are prescribed accordingly, either with acupuncture or moxibustion, or with both acupuncture and moxibustion, either with tonicity or diarrhea, or with both tonicity and diarrhea. In order to open the meridians and regulate the qi and blood, the yin and yang tend to be relatively balanced, and the pain is relieved or disappears. When talking about the importance of meridians and internal organs, Yu Jiayan once said: “If you do not know the internal organs and meridians, you will be wrong if you open your mouth. Especially for acupuncture treatment of pain, meridian identification is more important.
Clinical application.
(A) the application of the eight principles of identification in the treatment of pain
1. Cold pain: Generally caused by external wind and cold, over-eating cold and chilly, or endowed with insufficient yang energy and internal yin and cold. Solid cold pain: periarthritis, pain around the shoulder with cold sensation, restricted movement of the shoulder joint, pain aggravated at night, pale tongue, white or white greasy coating. Treatment: Warming the meridians and dispersing cold, clearing the channels and relieving pain. Acupuncture points: shoulder k, shoulder chastity, shoulder front, Tianzong, Houxi. Take the points on the same side of the lesion and use the warming and tonic technique to moxibustion the shoulder k, shoulder zhen and shoulder front with the needle shank and keep the needle for 30 minutes. 10 times as a course of treatment. Hypochondriac pain Gastroparesis with cool pain in the epigastrium, preferring warmth and pressure, preferring to eat hot drinks, thin stool, light tongue, thin coating, weak pulse. Treatment: Warming the stomach and dispersing cold, tonifying the middle energy. Acupuncture points: Zhonggui, Shen Que, Foot Sanli (double), Sanyinjiao, (double) with warming and tonifying techniques, Shen Que with moxibustion, Foot Sanli (double), Sanyinjiao, with warm acupuncture. The needles are left in place for 30 minutes. Treat once every other day. 10 times for a course of treatment.
2. Heat pain: usually caused by external wind-heat, excessive consumption of spicy food, or insufficient endowment of yin energy, resulting in internal heat. Knee swelling and pain: redness and swelling of one or both knee joints, pain, restricted movement, thirst, cold drinks, red tongue, yellow or greasy coating, slippery pulse. Treatment: Clearing heat and detoxifying the toxin, relieving dampness and subduing swelling. Acupuncture points: Double knee eyes, Yanglingquan, Zhizhong, Neiting, Manxi. Use the diarrhea method, stabbing quickly without leaving the needle. The treatment is carried out at the eyes of both knees and at the middle of the committee. The plum blossom needle is tapped and cupping is added, and the cupping is left for 5-10 minutes. 10 times as a course of treatment. Chinese herbs: Gui Zhi 10g, Bai Shao 10g, Sheng Shi Fa 30g, Zhi Mu 12g, Niu Knee 15g.
3. Deficiency pain: Pain generally caused by congenital endowment deficiency and gradual decline of qi and blood in old age. Proliferative knee arthritis: Proliferative degeneration of the knee joint with chills, soreness and weakness, difficulty walking, dark red or dark blue tongue, weak pulse. Treatment: Tonify the liver and kidney, strengthen the tendons and bones. Acupuncture points: (Group 1) Double knee eyes, Yanglingquan, Guizhong, Knee Pass (partial) Double knee eyes, Yanglingquan with warm acupuncture, 30 minutes. (Group 2) Kidney Yu, Sanjiao Yu and Taixi, both taken bilaterally, Kidney Yu and Sanjiao Yu, with warm acupuncture, once every other day. 10 times as a course of treatment. Chinese herbal medicine: Dulvus and Herba Tang Dulvus 15g, Mulberry 12, Qin Jiu 12g, Fanfeng 9g, Chuanxiong 9g, Shengdi 12g, Angelica 12g, Hossein 3g, Poria 15g, Gui Zhi 10g, Eucommia 15g, Niubizi 15g, Ginseng 15g.
4.Solid pain: Generally, the disease is superficial, and the disease is located in the meridians and does not enter the organs. Wind-cold headache. Headache, either left or right, or headache at the top of the head, or posterior headache, running clear snot, snorting, light tongue, thin coating, floating and tight pulse. Treatment: Dispersing wind and cold, relieving pain by circulation.
(II) Application of meridian identification in the treatment of pain
1, Frozen shoulder: for pain mainly in front of the shoulder, add Taiyuan, an infusion point of the five Yu points of the Lung meridian, on the basis of local acupuncture points; for pain mainly in the shoulder o, add Sanma, an infusion point of the Hand Yangming Large Intestine meridian; for pain mainly in the back of the shoulder, add Houxi, an infusion point of the Hand Sun meridian.
2. Headache: for Yang Ming headache, on the basis of local acupuncture points, add Hegu for wind-cold type and Erzhang for wind-heat type; for Shao Yang headache, on the basis of local acupuncture points, add Waiguan for wind-cold type and Liquid Gate for wind-heat type; for Zhe Yin headache, on the basis of local acupuncture points, add Taichong; for Sun headache, on the basis of local acupuncture points, add Kunlun.
(3) Application of blood pricking therapy in the treatment of pain
Blood pricking therapy is an ancient treatment method with special efficacy. After continuous practice and summary by generations of physicians, it is believed that blood pricking therapy has the following effects.
1, the heat and detoxification, reduce swelling and disperse nodules: stabbing the blood can make the evil heat, fire and poison with the blood out and can be cathartic, so as to have the effect of clearing heat and detoxification of fire, fire and heat congestion into heat and poison, fire down the enthusiasm of the poison since the solution. Therefore, pricking and releasing blood is mostly used to treat heat-related sores and swellings. Herpes zoster case Li, female, 28 years old, doctor. Pregnant for 7 months came to our department on April 28, 2011 complaining of: scintillating heat-like pain in the lower back for 3 days. Investigation: there were band-like blisters of different sizes in the third thoracic vertebra and about 5 cm left of the second lumbar vertebra. The patient was worried about the effect of medication on the fetus and requested acupuncture treatment. The patient’s low back pain was immediately relieved after disinfection with 75% alcohol and bleeding with a plum blossom needle, plus cupping of a large fire pot, which was left for 10 minutes. The next day, the patient returned to the clinic and complained that the pain had basically disappeared. On examination of the affected area, the herpes was all crusted and partially exfoliated. The affected area was treated with skin three needles for two times.
2, dredge the meridians, eliminate the stagnation: the meridians are the channels for running qi and blood, pricking the meridians and releasing blood can transmit the induction of needles to the relevant meridians and internal organs to regulate, promote the operation of qi and blood, dredge the meridians and eliminate the stagnation, improve the function of internal organs, and gradually balance yin and yang. The case of frozen shoulder: Li, a 48-year-old male, came to our department on March 12, 2011, with right shoulder pain for 1 week, cupping twice at home, but no obvious effect. The right shoulder joint movement was unrestricted, and pressure pain at the shoulder acupuncture point was obvious. After disinfection of the shoulder acupuncture point, the patient was cupped with a large fire cupping jar and left for 10 minutes. The shoulder pain was obviously relieved and the patient marveled at why your doctor’s fire cupping was so effective.
In clinical practice, I have learned that blood pricking therapy has the effect of unblocking the meridians. The effect of eliminating stagnation is faster and better than that of oral and static drops of Salvia. The mechanism that we follow is that if you pass, it does not hurt, and if it hurts, it does not pass. The purpose of using blood pricking is to achieve the purpose of no pain.
Modern experimental research proves that blood pricking has the effect of lowering infected leukocytes, neutrophils and raising lymphocytes. Blood pricking therapy has the effect of dilating blood vessels, increasing blood flow, improving the elasticity of blood vessels and tissue hypoxia, and it has a good adjustment effect on nerves and muscles. Blood pricking therapy has a good antipyretic effect through its effect on the body temperature center.
In clinical practice, I apply blood pricking therapy to treat diseases, mostly with focal areas, combined with meridian identification with distal acupuncture point pricking treatment, to achieve more satisfactory results. Blood pricking at the focal area has the effect of unblocking local meridians and adjusting the whole body’s qi and blood. Stabbing blood at distal points according to the meridians can unblock the meridians and adjust the function of the internal organs, and the combination of the two has good effects. Example: Herpes zoster – routine disinfection of the lesion site, bleeding from inside-out percussion with plum blossom needle, bleeding from Dazhi percussion, plus cupping with large fire cupping. Acute tonsillitis – quick stabbing and bleeding in the red and swollen tonsils, less business point stabbing and bleeding.
Technique: speed should be fast and bleeding should rather be more than less. According to the specific circumstances of the patient, good constitution, vigorous qi and blood, new disease, actual evidence, yang evidence, hot evidence, the bleeding volume is relatively appropriate. The bleeding volume should be relatively small for old, weak, young children, long illness, and deficiency.
(iv) Application of specific points in the treatment of pain.
1, cholecystitis – Yanglingquan, a joint point of the foot Shaoyang gallbladder meridian
2, stomach cramps – Foot San Li, a point of the Foot Yang Ming Stomach meridian
3. Low back pain – the joint point of the foot sun bladder meridian
(v) Balancing acupuncture in the treatment of pain.
Balanced acupuncture has 38 acupuncture points, which are easy to use, easy to operate, no need to identify the evidence, and the characteristics of taking the right point.
Shoulder pain – acupuncture point: shoulder pain acupuncture point: lumbar pain acupuncture point: lumbar pain acupuncture point: hip pain acupuncture point: hip pain acupuncture point
knee pain-access points: knee pain points.
(vi) Application of empirical points in the treatment of pain
1.Pi San acupuncture for pain points-have better pain relief effect.
2.Warm acupuncture – has a better pain relief effect on cold type pain.
3.Puncture point with blood and jar for chronic pain.
4.Auricular acupuncture – treatment of painful neck and shoulder muscle strain.
(7) Treatment of pain should be acupuncture and moxibustion should be applied to the disease.
Generally speaking, acute pain to a single treatment is appropriate, chronic disease to comprehensive treatment is better.
1, acute pain, the pillow point: the pillow point, the back of the hand two or three fingers metacarpophalangeal joint line after the midpoint 0.5 inch straight stab 0.3-0.5 inch,. Stay on the needle for 30-40 minutes. The course of the disease within 3 days, a needle a point once cured. Acute lumbar sprain Acupuncture point: back of the hand, lumbar pain point, two points on the back of the hand, two or three metacarpals and four or five metacarpals, 0.3-0.5 inch straight stab, 30-40 minutes. The course of the disease within 3 days, a needle and a point once cured.
2, chronic pain low back pain (proliferative, degenerative) knee joint proliferative arthritis, etc. On the combined application of acupuncture, moxibustion, blood pricking, fire cupping, ear acupuncture, drugs, etc..
We never use multiple acupuncture points and needles when one acupuncture point can be cured at one time, and we never use simple and single methods to mislead patients when multiple acupuncture points and needles are needed for joint application. Available points can not be used, we are determined not to use, must be used points, should be a point no less.
(H) treatment of low back and leg pain and upper extremity pain to pay attention to the application of Huatuo pinch points
1, lower limb pain: in the identification of points based on the addition of waist 4-5 Huatuo pinch ridge points.
2. Upper extremity pain: Add 1-3 Huatuo pinch points to the chest on the basis of identifying points.
3. In the treatment of cancer pain, acupuncture and moxibustion should be applied in combination with Chinese medicine and western medicine: In years of clinical observation, it is found that acupuncture has an irreplaceable role in reducing pain, relieving spasm and eliminating spasm. However, for pain caused by yin deficiency in long-standing diseases, the combined application of acupuncture and Chinese medicine is more effective than acupuncture alone. For pain caused by cancer, the combined application of acupuncture, Chinese herbal medicine and western medicine is more effective than simple acupuncture before the primary lesion is controlled.