Acupoint Injection and Acupoint Embedding
I. Overview of cervical spondylosis
1.Modern medical understanding
Cervical spondylosis refers to degenerative degeneration of cervical disc, cervical spine osteophytes and calcification of cervical ligament, which stimulate or compress the adjacent nerve roots, spinal cord, blood vessels and sympathetic nerves, and the corresponding clinical symptoms and signs appear, mainly manifested by pain and numbness in the neck, shoulder and arm, cervical straightness, restricted movement, vertigo and weakness of both lower limbs.
Western medicine classifies cervical spondylosis into five types: cervical type, nerve root type, spinal cord type, vertebral artery type, and sympathetic type. If two or more types are combined at the same time, it is a mixed type.
2.Chinese medicine understanding
Cervical spondylosis belongs to the category of “paralysis” and “vertigo” in Chinese medicine. The occurrence of cervical spondylosis is mostly due to the deficiency of kidney energy and the lack of consolidation of Wei Yang, which leads to the entry of wind, cold and dampness, resulting in the blockage of the meridians in the neck and the lack of smooth flow of Qi and blood. Clinically, it is often divided into five types: wind-cold-damp obstruction, qi stagnation and blood stasis, phlegm-damp obstruction, liver-kidney deficiency, and qi-blood deficiency.
3.Diagnostic points: fractal diagnosis
(1) Cervical type.
Etiology: mostly due to degenerative changes of intervertebral discs causing local muscle spasm in the cervical spine
Main symptoms: neck straightening, pain, or painful stiffness of the entire shoulder and back.
Head nodding, head tilting and head turning activities are limited; symptoms of dizziness may also occur.
Auxiliary examination: the physiological curvature of the cervical spine is straightened or disappeared on X-ray.
(2) Nerve root type.
Etiology: mainly due to the compression and stimulation of spinal nerve roots caused by the posterior and lateral protrusion of cervical discs or adhesions and scar contracture of nerve roots, mostly seen in the 4-7 cervical spine
Main symptoms: early symptoms of neck pain and stiffness of the neck.
radiating pain or numbness in the upper extremity, this pain and numbness radiates along the course of the compressed nerve root and the area of innervation, sometimes there is a clear relationship between the appearance and relief of symptoms and the position and posture of the patient’s neck
The affected upper extremity feels heavy, has reduced grip strength, and sometimes appears to hold objects falling down.
Ancillary examinations: X-rays show narrowing or hyperplasia of the lesioned intervertebral space, and bone spurs protruding into the intervertebral foramen are seen on oblique films. CT, MRI and other examinations can be done selectively if necessary.
(3) Spinal cord type.
Etiology: cervical spine hyperplasia, narrowing of the anterior and posterior diameter of the spinal canal causing spinal cord compression or spinal cord ischemia caused by compression of the arteries or veins innervating the spinal cord
Main symptoms: weakness, heaviness and numbness of both lower limbs, relieved at rest and aggravated by stress and exertion. Tendon reflexes of the extremities are hyperactive and Babinski reflexes are positive.
MRI shows that the spinal cord is compressed with wave-like indentation, and in severe cases, the spinal cord becomes thin.
(4) Vertebral artery type.
Causes: formation of vertebral spurs, compression or irritation of the vertebral artery, resulting in narrowing and distortion of the blood vessels and inadequate blood supply to the vertebrobasilar artery syndrome.
Main symptoms: Episodic vertigo, associated with change in the position of the neck. Sometimes it is accompanied by nausea, vomiting, tinnitus or hearing loss.
Auxiliary examination: X-ray film shows hyperplasia of the hook vertebral joint and narrow intervertebral foramen; vertebral arteriogram shows tortuosity, thinning and compression of the vertebral artery.
(5) Sympathetic type.
Etiology: sympathetic nerve compression
Main symptoms: headache or migraine, sometimes accompanied by nausea and vomiting, neck and shoulder pain, blurred eye vision, sweating, panic, stomach and epigastric discomfort, etc.
Auxiliary examination: no specific performance.
Acupoint injection
1, definition: also known as water injection, is the selection of certain Chinese and Western drugs injected into the relevant points of the body to prevent and treat diseases. Acupoint injection is a treatment method developed on the basis of the combination of acupuncture therapy and modern medical closure therapy, based on the meridian theory and the principle of drug therapy.
Action characteristics: acupuncture action, pharmacology, physicochemical stimulation of drugs, temporal effect
2.Actions.
(1) Pain-relieving effect
A large number of clinical data and experimental results confirm that acupoint injection, like acupuncture, can excite a variety of receptors and produce acupuncture signals, which reach the spinal cord and brain through different pathways and produce evoked potentials, which can have a significant inhibitory effect. Because the local stimulation signal enters the center, it can excite the activity of many neurons and release a variety of neuromediators, among which are 5-hydroxytryptamine and endogenous morphine substances with analgesic effect, and the release of these substances plays a pain-relieving role.
(2) Defense effect
Acupoint injection can strengthen the body and prevent disease, mainly because its acupuncture can stimulate the body’s defense mechanism related. Immunity is a series of protective responses generated by the body to recognize and remove foreign antigenic substances and its own deformed substances in order to maintain the relative constancy of the external environment of the body.
(3) Adjustment effect
Acupoint injection has different degrees of adjustment effects on the digestive, respiratory, circulatory and urinary systems of the body. For example, the adjustment effect on the digestive system is mainly manifested in the release of gastrointestinal smooth muscle spasm, adjustment of digestive juice secretion, adjustment of gastrointestinal peristalsis, etc. The adjustment effect is bidirectional, when the function is hyperactive, the function is relieved by acupoint injection; when the function is low, the function is enhanced by acupoint injection.
3.Commonly used drugs and their effects.
(1) Vitamin preparations: vitamin B12, vitamin D2 calcium fructosylate injection
Pharmacological effects: Vitamin B12 is necessary for cell division and maintaining the integrity of nerve tissue myelin sheath, participating in the synthesis of nuclear proteins, the conversion of methyl groups, maintaining the activity of -SH group, promoting the recycling of tetrahydrofolate, thus promoting the synthesis of nerve myelin lipids. Calcium ions are necessary for maintaining normal function of nerve, muscle and bone, involved in regulating the secretion and storage of neurotransmitters, maintaining normal excitability within the neuromusculature, and also promoting the absorption of vitamin B12. It is commonly used in cervical spondylosis of nerve root type, spinal cord type and cervical type.
(2) Chinese herbal preparations: Danshen and Angelica needles
Danshen needle and angelica needle have the effect of activating blood circulation and dispelling blood stasis, and the drug can be administered by injection through the meridian point system of Chinese medicine, which can enhance the effect of the drug and “pass through without pain”. They are commonly used for cervical spondylosis of vertebral artery type and sympathetic type. Among them, the qi stagnation and blood stasis type uses Dan Shen needle; the cold and damp type or qi and blood deficiency type uses Angelica needle.
Modern medical research: local medication can promote blood circulation, dilate peripheral blood vessels, improve peripheral blood distribution, repair damaged biofilm, thereby reducing tissue damage, rebuilding the stability of the tissue internal environment, alleviating blood circulation disorders, with anti-inflammatory and analgesic effects, and improve blood supply to the brain.
4.Commonly used points and their methods of operation.
(1) commonly used acupoints.
cervical type: ayurvedic point, new set, tianzong
vertebral artery type, sympathetic type: Fengchi, Xinshe
Nerve root type, spinal cord type: the corresponding spinal points of the diseased cervical segments
(2) Operation method.
The patient takes a sitting position, takes 2-4 points each time, the skin is routinely disinfected, takes a 5ml syringe and extracts about 2ml of injection fluid, stabs the point obliquely about 10-15mm, slowly lifts and inserts until there is a feeling of needles, aspirates the syringe without returning blood, injects the medicinal fluid (0,2-0,4ml of medicinal fluid per point) and once every other day, 3 times a course of treatment.
Third, acupuncture points buried wire.
1, concept.
Point buried wire is buried in the acupuncture points, the use of lamb’s intestine wire on the continuous stimulation of acupuncture points to treat disease a method.
2, role.
The sheep intestine thread buried in the acupuncture point is a heterogeneous protein that can induce a metabolic reaction in the body, sensitizing the lymphatic tissue, with antibodies, macrophages to destroy, decompose and liquefy the sheep intestine thread, so that it decomposes into peptides, amino acids, etc. Sheep intestinal thread in the body softening, decomposition, liquefaction and absorption, the physiological and biochemical stimulation of acupuncture points can be up to 20 days or longer, thus making up for the short acupuncture time, the effectiveness of the treatment is difficult to consolidate, easy to relapse and other shortcomings.
3, commonly used points and their methods of operation.
(1) Commonly used acupuncture points.
cervical type: ayurvedic point, new set, tianzong
vertebral artery type, sympathetic type: Fengchi, Xinshe
Nerve root type, spinal cord type: the corresponding spinal points of the diseased cervical segments
(2) Operation method.
The patient takes a sitting position and takes 2-4 points each time, the skin of the points is routinely disinfected, and a 00-gauge chrome lamb’s intestine thread (0.5-0.8 cm) is loaded into the front end of a sterilized No. 7 lumbar puncture needle (the tip of the needle core has been smoothed), and the needle is inserted obliquely into the acupuncture point, about 10-15 mm into each point. After lightly lifting and inserting the air, push the needle core while retreating the needle tube, so that the lamb’s intestine thread buried in the acupuncture point under the skin, the thread must not be exposed, sterilize the needle hole. 10 days once, 3 times a course of treatment. This method is mostly used for spinal cord type and vertebral artery type cervical spondylosis.