Second, the shape of the needle knife, structure and the difference with the acupuncture needle. The shape determines the function.
1, diameter.
Commonly used work-type needle knife for 0.8-1mm, tissue stimulation, with a certain amount of hardness and toughness, easy to implement a variety of internal needle knife techniques, and acupuncture needles for 0.16-0.3mm.
2.Tip.
The tip of the needle knife is a flat blade, not only can stimulate the tissue, but also can cut the tissue, while the tip of the acupuncture needle is a cone-shaped “tip”, only can stimulate the tissue.
3, needle handle and directional.
The needle knife’s handle is gourd-shaped, which means “hanging pot to help the world”, and the direction of the handle is the same as the direction of the blade, so the direction of the handle is the direction of the blade in the body when the needle knife is operated, while the acupuncture needle does not have this characteristic.
Three, the needle knife and the concept of needle knife medicine
Acupuncture knife.
Any medical device that is pierced into the human body by needling and can play the role of scalpel treatment in the human body is collectively called needle knife.
Acupuncture medicine: is based on the traditional Chinese medicine yin and Yang balance, the overall concept, the theory of diagnosis and treatment and the theory of acupuncture and moxibustion meridians, and as a macroscopic guide, but also absorbed the latest achievements of modern medical anatomy, pathology, surgery, biomechanics, imaging and clinical medicine, and as a microscopic positioning qualitative diagnosis and treatment basis, the formation of a new independent medical discipline. It takes chronic soft tissue injury, osteophytes and crest-related diseases as the main research object, and takes the closed minimally invasive release of acupuncture and the corresponding manipulation to adjust the mechanical balance as the main treatment means, which is an emerging medical edge discipline combining Chinese and Western medicine.
Fourth, the principle of acupuncture treatment.
Needle knife has the dual role of “needle” and “knife”. Needle” role of the use of Chinese medicine “pain is not pass, pass is not pain” principle. And what does the “knife” target? It is the scar, contracture, adhesions of the lesion tissue.
Two concepts should be mentioned here: dynamic balance and dynamic imbalance. The human body is in “dynamic equilibrium” when its organs are moving freely within the limits of normal life activities and within the amount and degree of specific time and space, and the opposite is called “dynamic imbalance”. The soft tissues of the human body include muscles, ligaments and other non-bony tissues, which are important structures for maintaining the dynamic balance of the human body. The dynamic activities of the human body require the participation of different parts of the soft tissues to complete. The soft tissues are the first to bear the brunt of all external injuries (sudden, cumulative, invasive, etc.).
Soft tissue injury leads to small blood vessel rupture and bleeding, small vessel obstruction, “stasis”, soft tissue ischemia, muscle fiber contracture, decreased elasticity, fracture, thickening, glassy changes, and finally adhesions, contractures, scars, and blockages. These new pathological factors may lead to imbalance in the dynamic balance of the body, joint displacement, nerve or vascular compression or irritation, and then to new diseases. By removing these pathological changes, the dynamic balance of the body is restored, the nerve or blood vessel compression or irritation is released, and the displaced joint is reset with the manipulation, thus relieving the patient of pain.
The six components of acupuncture medicine are: acupuncture medicine pathophysiology, acupuncture medicine imaging, acupuncture medicine manual science, acupuncture medicine diagnosis, acupuncture medicine treatment, acupuncture medicine nursing.
Fifth, the indications and contraindications of acupuncture treatment, the interval of treatment, precautions.
At present, the most recognized diseases with the most advantages and the most certain efficacy of acupuncture treatment are all kinds of pain caused by chronic soft tissue injury: headache, facial pain, cervical spondylosis, frozen shoulder, tenosynovitis, arm numbness, chest and back pain, low back pain (such as lumbar muscle strain, lumbar intervertebral disc herniation, ankylosing crestitis), bone and joint pain (such as traumatic arthritis, middle-aged and old-aged hyperplastic arthritis), trauma, post-surgical residual pain ( bruises, contusions, sports injuries, training injuries, post-surgical scar pain, contractures, incision pain), post-disease pain, rheumatoid rheumatism, gouty arthritis, femoral head necrosis (through the release of periprosthetic soft tissues to improve periprosthetic and femoral head blood circulation to achieve pain control symptoms and improve function.)
Contraindications to acupuncture treatment.
Firstly, tumor, tuberculosis, eosinophilic granuloma are excluded, and then the following 7 areas.
1, all serious visceral diseases of the attack period.
2, the application site has skin infection muscle necrosis.
3.The administration site has redness, swelling and burning or abscess in the deep part.
4.If there are important neurovascular or important organs at the site of surgery and cannot be avoided during surgery.
5.Patients with hemophilia or other bleeding tendencies.
6.People who are extremely weak, and then perform the needle knife surgery after their body has recovered.
7.People with high blood pressure and emotional stress.
In one of the above 7 cases, although there are indications for acupuncture treatment, acupuncture surgery should not be performed. Needle knife treatment is usually effective 1-2 times, 3-5 times cure. For systemic extensive soft tissue damage, ankylosing crepitis, femoral head necrosis, rheumatoid arthritis and other disorders, 10-20 or more treatments are required. Regarding the number of days between acupuncture sessions, this is what I do in the clinic: in general, it is done every 5-7 days. In addition, depending on the patient’s physical condition, age, the presence of underlying diseases, the size of the lesion, the number of sites, and the patient’s tolerance.
If the patient is young, in good health, with extensive lesions and good tolerance, and needs more than 10 treatments, in order to shorten the course of the disease, it can be done every 1-3 days depending on the situation and different parts of the body. For example, if the patient has damage to the neck and shoulder, waist, back and arms, I can do the neck today, the waist tomorrow or the day after, and then the back the day after. On the contrary, if the patient is old, in poor health, and has underlying diseases, even if the lesion is small in extent, the treatment should be done at long intervals and in small amounts several times. Needle knife treatment instructs patients not to get water in the eye of the needle within 3 days, during treatment, pay attention to rest, do not strenuous activity.
Sixth, the safety of needle knife treatment, needle knife operation is a “blind” surgery?
Some people say that the safety of needle knife operation under the blind, will hurt the important neurovascular cause medical accidents, well, the following I will say, we how to carry out needle knife operation.
We divide the parts of the human body into safe areas: the area has no important blood vessels and nerves and is deeply blocked by bone, which will not injure internal organs.
Relatively safe area: this area has important neurovascular and internal organs but with some avoidance measures, it can not be injured.
Dangerous area: there are important neurovascular and internal organs in this area, which cannot be avoided.
We operate generally in the safe area and the relatively safe area, the dangerous area is less after all. Therefore, most parts of the human body can be operated with a needle knife.
The diameter of the needle knife is only 0.8-1mm, so the positioning must be accurate, we positioned on the body surface and to operate in deep tissue, we are required to master the human body surface positioning, fine anatomy, three-dimensional anatomy, in different positions of operation and require mastery of dynamic anatomy, to touch the deep tissue, especially bone and require us to have a sensitive sense of touch, needle knife into different tissues of the human body requires We have a sensitive sense of needle under the hands. Some people say, we are “touching the stone to cross the river”, good, bone, bony mark is our “stone”, is our reference, only needle knife touch the bone surface to ensure safety, in order to carry out the next operation. But you do not know where the stones in the river are, and where the “stones” of the human body are, after studying so much anatomy you are clear. This is part of the theory of closed needle knife surgery, one of the four major theories of needle knife medicine. Therefore, closed-needle surgery is a blind surgery, but definitely not a blind surgery, and it is safe under the standard operation.