A preliminary investigation on the relationship between meridian tendon theory and cervical spondylosis
Author: Yang Xiaoqian1 Li Houchen1 Instructor: Tang Lixin2
1 Hainan Provincial Hospital of Traditional Chinese Medicine 2Dongzhimen Hospital, Beijing University of Traditional Chinese Medicine, Hainan Provincial Hospital of Traditional Chinese Medicine, Department of Acupuncture and Moxibustion Yang Xiaoqian
Abstract: The circulation of the twelve meridians and tendons is characterized by intersection and junction, and its symptoms are “pain in the limbs and tendon rotation when the disease passes”. As the circulation of the three Yang meridians of the hand and foot pass through the neck, they have a good stabilizing effect on the cervical spine, and if damaged, they can directly or indirectly lead to the development of cervical spondylosis. The junction of the three Yang meridians of the hands and feet, where they “meet at the joints”, is often the place where the cervical spine is prone to pain and lesions. The theory of meridians and tendons has an important significance in the diagnosis and treatment of cervical spondylosis, and the treatment rule of meridians and tendons “pain is the acupoint” can guide the treatment of cervical spondylosis.
The efficacy of acupuncture and moxibustion in the treatment of cervical spondylosis is certain, but the difference in treatment effect has always troubled practitioners. As stated in Su Wen – Yin Yang Ying Xiang Da Lun, “To treat a disease, one must seek the root cause”, establishing the cause of the disease is the first and necessary step in clinical treatment. In recent years, modern medicine has opened up new ideas for the etiological study of cervical spondylosis by paying attention to the cervical muscles and the progress of research on the biomechanics of the cervical spine, in addition to the common causes of cervical spondylosis. These two aspects are precisely related to the theory of meridians and tendons in Chinese medicine. According to Zhang Jiebin, “What is the reason for the existence of tendons in addition to the 12 meridians? The meridians are connected to the musculoskeletal system, which is the functional connection of the tendons associated with the meridians. In order to apply the theory of meridians and tendons to guide the treatment of cervical spondylosis in clinical practice, a preliminary discussion on the relationship between meridians and cervical spondylosis is now conducted.
1 Characteristics of the twelve meridians and tendons
1.1 Circulation characteristics
The distribution route of the twelve meridians is based on the meridians as the outline, and is basically the same as the distribution of the body surface circulation of the meridians with the same name, but in the opposite direction. Circulation is not completely subject to the meridians, although the circulation in the limbs body surface, thorax, abdominal cavity, but not into the viscera. And, in the body surface, some tendons beyond or less than the same name meridian circulation range. For example, the tendons of the foot sun “in the tongue”, “knotted in the shoulder”, “up knotted in the finish bone”; hand Yangming “around the scapula, holding the spine
1.2 Intersection and junction characteristics
There is no superficial flow relationship between the meridians, but there is intersection and connection: the twelve meridians intersect and merge through the process of circulation thus strengthening the connection between the meridians. For example, the tendons of the foot Yangming “merge with Shaoyang” and “merge with the Sun”; the tendons of the hand Shaoyang “merge with the hand Sun”. And more than one tendon is often gathered in the same place. For example, the tendons of the foot three yang, hand Yangming are knotted in (face cheek); hand three yang tendons knotted in the corner (side of the head). The six tendons of the hand are knotted at the wrist, elbow, shoulder and other parts. The knotting, gathering, intersection, and merging of the tendons are important contacts between the meridians and tendons, and are also places where problems of the meridians tendons tend to converge.
1.3 Disease characteristics
Twelve tendons are connected to the hundred bones, maintain the body, each position, due to cold, heat, wind, moisture and other evil attacks and bruises and injuries, twelve tendon disease symptoms are mostly manifested as the tendons through the tendons or movement-related disorders, mainly movement disorders and pain, such as relaxation, contracture, pain, tendons and shoulder not lifting and other unfavorable joint movement and limb wasting.
2 Relationship between cervical spondylosis and meridians
2.1 Stabilizing effect of the tendons on the cervical spine
The Shuowen Jiezi says: “tendons, the strength of the flesh; tendons, the origin of tendons, attached to the bone.” The meridian tendons include the skeletal muscles in modern medicine and the tendon sheaths, ligaments, fascia and other accessory tissues formed by the differentiation of connective tissues around the muscles, which travel in the neck equivalent to the parts distributed by the cervical extensor group, the anterior flexor group, the lateral cervical muscle group, ligaments and fascia [1]. The meridians play an important role in the stability and mobility of the cervical spine.
Normal human cervical spine stability consists of two major components: endogenous and exogenous [2]. Changes in the mechanical properties of the meridians can affect the exogenous stability of the cervical spine. The cervical muscles are an important component of the endogenous cervical meridians, and changes in the mechanical parameters of the cervical muscles are consistent with the traditional understanding of meridian pathology [1]. In terms of the impact on the endogenous stability of the cervical spine, on the one hand, the meridians allow the entire torso to maintain a certain shape and position through the constraint and coupling of the bones. The meridians have a cohesive function and “all tendons belong to the joints”, indicating that the meridians can restrain the movement of the joints; on the other hand, meridian pathology can affect the endogenous stability of the cervical spine by affecting the exogenous stability of the cervical spine. Thus, derangement of the meridians can lead to an imbalance in the internal and external forces of the cervical spine, leading to the development of cervical spondylosis.
2.2 Damage to the meridian tendons and the development of cervical spondylosis
The cervical meridians are the basis of the stability of the cervical spine. Damage to the cervical meridians leads to a decrease in the mechanical properties of the cervical muscles, which destabilizes the cervical spine exogenously and affects the normal position of the cervical joints, further aggravating the degeneration of the intervertebral discs and bony joints of the cervical spine and affecting the endogenous stability of the cervical spine [1].
The meridians that maintain the dynamic balance of the cervical spine are necessary to maintain the posture and curvature of the cervical spine. When the cervical tendons are damaged, abnormal manifestations such as relaxation, contracture, pain, tendon rotation and straightening will occur, leading to the occurrence of cervical cervical spondylosis on the one hand; on the other hand, the disordered tendons further affect the normal physiological curvature of the cervical spine, leading to endogenous instability of the cervical spine, aggravating the degenerative changes of the cervical spine and aggravating the occurrence and development of cervical spondylosis. As stated in Ling Shu Jing Tendon, “the tendons of the hand sun are sick …… around the scapula and lead to the neck”. From the theory of meridian tendons, injury to the meridian tendons of the neck is the main cause of cervical spondylosis, but it should not be overlooked that injury to the tendons of the distal extremities connected with the meridian tendons of the neck can also cause the occurrence of cervical spondylosis.
2.3 Meridians and symptoms related to the cervical spine
The symptoms of the twelve meridians and tendons can be summarized as follows: “When the disease passes through the limb pain and tendon rotation”. The tendons of the Hand Sanyang meridian go from the hand to the head, and the pathology of the cervical spine is involved in the pathology of the hand Sanyang meridian. The foot three Yang meridian tendons have a longer route, but they all pass through the neck, and the foot Sun meridian tendons are more than the range of their circulation, “from the armpit outside the Lian knot in the shoulder k”. The three Yang meridians of the hands and feet work together to link the bones of the neck and maintain the surrounding tissue structure. It maintains the normal functional activities of the neck, and when it becomes diseased, it causes discomfort in the neck, and pressure and pain points and tendon knots can be found on the meridian tendon circulation route.
Injuries to the meridian tendons are mostly manifested as “tendon urgency” in cervical spondylosis, such as “the spine is reflexed, the item tendon is urgent, the shoulder is not lifted …… cannot be shaken around” of the tendon of the foot sun, “the tendon of the foot Shaoyang “the little finger second finger branch turn tendons, …… on the lead lack of basin, breast, neck Wei tendons urgent.” In addition, the tendon of the hand sun’s tendon “neck tendon urgent, then the tendon impotence neck swelling, cold and heat in the neck”, the tendon of the hand shaoyang “branch turn tendon” and the tendon of the hand yangming “branch pain and turn tendon, shoulders do not lift, neck can not be seen left and right “. There are also pain-based injury manifestations, such as the tendons of the Sun of the hand “the disease of the small finger branch elbow in the sharp bone after the Lian pain, through the arm Yin, into the axilla, axillary pain, axillary posterior Lian pain, around the scapula leading to the neck and pain, should be in the ear pain leading to jaw” and so on.
2.4 Using pain as acupoint and treatment of cervical spondylosis
When discussing the treatment of the disease of the meridian tendons in the chapter of “Ling Shu – Jing Tendons”, it is repeatedly mentioned that “the treatment is to use the burnt needle to rob the acupuncture, to know as the number, and to use pain as the transmission”, saying that “using pain as the acupoint” is an important principle for the treatment of the disease of the meridian tendons. Yang Shanshan further elaborated: “The point of loss is also called the hole, that is, the tendon but from the tendon where the pain is, that is, the hole point, unnecessary to rely on the acupuncture points. The tendon is the capital of yin and yang gas, there is no space in it, not through the yin and yang gas up and down, but the evil into the coup attack tendons for disease, can not move acupuncture, so the disease resides in the painful place for acupuncture.” The tendons do not have the yin and yang and cross flow injection, can not circulate like the meridians, running qi and blood. If “the evil enters the couples”, then “the disease is caused by the knot”, and the tendons are injured, then the qi and blood are stagnant and do not pass, then the pain. The location of the disease is relatively fixed, unlike the transmission that occurs when the meridians are diseased, so treatment at the local level of the disease can achieve better results. The Spiritual Pivot – Wei Qi Disorder says: “There is no yin or yang in the tendons, no left or right, where the disease is waiting.” In the clinical treatment of the tendon disease, the principle of “pain as the loser” should be followed. Of course, the local pain acupuncture points are the most commonly used points in clinical practice, but the search for pain points at the distal end of the meridians of the diseased tendons should not be neglected, and the tendons should be treated as a whole, so that the overall balance of yin and yang in the body can be adjusted.
In summary, the causes and manifestations of cervical spondylosis are closely related to the meridian tendon theory, which can be used as a guide to open up new ideas for the treatment of cervical spondylosis. Specifically, we can follow the diagnostic and treatment rules of “pain as acupuncture point” as proposed in Ling Shu Jing Tendon, the treatment steps of “waiting for where the pain is” as stated in Ling Shu Wei Qi Disorder, and the treatment examination experience of “should be solved in the middle” as stated in Ling Shu Back Yu, and the treatment experience of “the pain should be solved in the middle” as stated in Ling Shu Wei Qi Disorder. “and the method of finding the foci of the disease as stated in Ling Shu Wei Qi, which is “first press and then apply it to the hand for a long time”. In conclusion, finding pressure points is an essential step in the treatment of cervical spondylosis, and modern medicine has confirmed that the appearance of pressure points is not accidental, but has certain diagnostic significance [3], and the program focusing on pressure points as treatment has achieved better results in clinical practice.
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