How is the doctrine of body mass applied in the clinical treatment of Tui Na?

With the continuous improvement of modern technology and medical treatment, individualized treatment has become more and more important to the medical profession, and therefore more attention has been paid to the human state and the connection between human beings and diseases under the influence of natural and social environment, i.e., the internal causes of diseases – the doctrine of constitution, in order to achieve better treatment results. Physique refers to the comprehensive and relatively stable characteristics of morphological structure, physiological function and psychological state of an individual in the course of life, based on inheritance and acquisition. Modern medical genetic research has shown that physical differences play an extremely important role in the development and treatment of diseases. Thousands of years ago, Chinese medicine emphasized the importance of innate endowments and endowments in the onset of disease and disease regression in the Nei Jing. The importance of endowments and endowments in the treatment. In the Nei Jing, “form” and “quality” were used to represent the “endowment” (Qian Jin Yao Fang) and “qi” (Qi). Later on, there are such terms as “endowment” (Qian Jin Yao Fang), “qi qi” (Liang Fang for Women), and “endowment” (Xiao Zi Zhan Zi Zu Wei Lun Fang). The physical characteristics of individuals and different groups, the law of differences, the law of formation and variation of physical constitution, the types of physical constitution and the method of classification, the law of occurrence and development of physical constitution and diseases, the diagnosis, identification and treatment of physical constitution and diseases, the law of medication, physical constitution and preventive health care, etc. are all discussed. It is also believed that the formation of physical constitution is closely related to innate endowment, acquired factors including geography and climate, living environment, living and eating structure, gender and age, social environment and psychological factors. The theory is widely used in clinical diagnosis and treatment, and has been continuously enriched and improved. Physique typing is an important issue in the clinical application of physique theory. Differences in physical constitution have an important impact on the occurrence, development and evolution of diseases. Such differences exist objectively in non-disease states as well. Since the beginning of Nei Jing, there have been many different types of typing of physique, and the basis of typing varies. Commonly, according to the prevalence of yin and yang, they are classified as yin and yang calm, yang Sheng, yang Sheng; or according to the small clinical pathology of Chinese medicine, they are classified as normal, yin deficiency, yang deficiency, phlegm-damp, damp-heat, qi deficiency, blood stasis; or according to the five elements (Ling Shu? Yin and Yang twenty-five people”), divided into wood, fire, earth, gold, water. Different types of constitution determine the special susceptibility of different individuals to certain causes and diseases and the tendency of pathological processes. What kind of people are susceptible to evil, what kind of evil they are exposed to, and what nature of disease occurs after exposure to evil, depends to a considerable extent on the constitution. In addition, the physical constitution is also the key to the prognosis of the disease, where the physical constitution is strong, strong resistance to evil, short course of the disease, good prognosis; where the physical constitution is weak, weak resistance to disease, evil is easy to take advantage of the internal deficiency, the disease is more difficult to cure; as “Su Wen? As stated in the “Commentary on Heat Diseases”, “three days for those who are refined, five days for those who are middle-aged, and seven days for those who are not refined”. In the clinical practice of Tui Na, the doctrine of physical constitution has an important guiding significance for the prevention and treatment of Tui Na diseases, which is mainly reflected in the aspects of prevention and pathogenesis, disease regression, identification and treatment, etc., and has its own uniqueness. At the same time, Tui Na is a Chinese medicine discipline that focuses on clinical operation and treatment. Therefore, the reasonable and effective use of body constitution theory in the treatment process can reflect the advanced and advantageous nature of Tui Na treatment and play an increasingly important role in clinical treatment. However, from the perspective of the doctrine of constitution, the constitution plays an important role in the formation of evidence, and the characteristics of the constitution influence the type of evidence, therefore, some people propose “treating by constitution”, which treats the differences in constitution according to the factors affecting the constitution. In Chinese medicine, it is emphasized that “the individual is the basis for the disease, and the physical constitution and the treatment are closely linked in the clinical evidence of Chinese medicine with the disease as the link. In addition to the main factors such as physical strength, physical fatness, age, gender, etc., the four seasons of climate change, geographical environment, also have an important impact on the human physique, so from the relationship between the physique and the treatment rules for discussion, should also be “according to the time to suit”, “according to the location to suit Therefore, when discussing the relationship between physical constitution and treatment rules, we should also “adapt to the time” and “adapt to the place. In response to these, there are different applications in the clinical treatment of Tui Na, as reflected in the operation of the techniques. For example, for those who are young and strong, fat, full of blood, solid bones, thick and black skin, the techniques can be fast and strong, in order to penetrate deep, activate blood circulation, remove blood stasis, and relax tendons and channels; when making adjustments, the adjustment can be slightly larger and stronger. Aging, weak and thin, blood deficiency, loose bones, thin skin color white manipulation should be gentle and slow, can not be tired of the already weak qi and blood tendons, and at the same time to benefit the blood, tendons and veins; manipulation adjustment should be small, light strength. Another example, the woman newly born, long illness loss, children’s flesh brittle, not full of vital energy, the technique should also be gentle superficial. Clinically, for the treatment of diarrhea in infants and children, we can lightly knead the central epigastric region, Tianshu, the foot three li, lightly massage the abdomen and pinch the Huatuo spine; while for diarrhea in adults, we can press the kneading method to increase the intensity of acupoint stimulation, increase the penetration of the abdomen and rub the hot back acupoints. The physiological activities of the human body, which affect the physique, are closely related to the changes in the natural environment, so the priority of massage treatment must also vary from time to time. Ling Shu? The beginning of the end” said: “Spring qi in the hair, summer qi in the skin, autumn qi in the flesh, winter qi in the tendons and bones.” In other words, in the spring and summer, Yang Qi develops, human qi and blood tend to be on the surface of the body, and the disease and evil are mostly superficial; in the autumn and winter, Yin Qi gradually wins, human qi and blood are hidden inside, and the disease and evil are mostly deep, therefore, it is advisable to treat lightly and shallowly in the spring and summer, and heavily and deeply in the autumn and winter. In addition, for those who have different physiques due to regional differences, attention should be paid to “local adaptation”. In addition to manipulative treatment, Tui Na clinical practice also emphasizes gongfu training. In order to consolidate and extend the clinical treatment effect, and at the same time play the role of disease prevention and health care, the medical staff of Tui Na instructs patients to carry out gongfu training according to the clinical medical needs of Tui Na. Health care is called health care, regimen, etc. in ancient times. Distinguishing the physique also plays an important role in health care and disease prevention. The strength of the physique determines the strength of the body’s ability to resist disease and prevent evil. By distinguishing the physique of the body, we can predict to a certain extent its susceptibility to certain disease-causing factors, so that we can adopt the corresponding gongfu training in a targeted manner to prevent disease before it happens. In conclusion, in the clinical treatment of Tui Na, we should pay full attention to and make use of physical factors. In order to improve the clinical efficacy, we should emphasize both the evidence-based treatment and the quality-based treatment, and combine the two organically. With the widespread application and in-depth research of the body quality theory in various departments, it will certainly promote the greater development of the concept of human-oriented treatment.