Spinal cord injuries occur in more than 130,000 patients each year, placing a heavy burden and emotional toll on society and families alike. Spinal cord injury does not only affect the physical activity of the patient, but also affects the function of the internal organs of the patient. It is important to monitor the regulation and treatment of each organ function of the patient while treating spinal cord injury.
What are the hazards of spinal cord injury to organ function?
1, the impact of spinal cord injury on the circulatory system.
In addition to the primary injury caused by violence, patients with spinal cord injury will also experience secondary injuries such as microcirculatory disorders and tissue edema in their pathophysiological process. The spinal cord microcirculatory disorders caused by spinal cord injury mainly include: microvascular injury, microthrombosis, microvascular spasm, blood-spinal cord barrier damage and intimal injury and other changes.
2, the impact of spinal cord injury on the digestive system
Studies have shown that about 1/3 of patients with spinal cord injury will have symptoms of gastrointestinal dysfunction such as constipation, abdominal distension, and incontinence. Acute complete spinal cord injury at the thoracic 6 level can be followed by progressive increase in abdominal distension and difficulty in defecation. Structural damage to the intestinal mucosa leads to increased permeability and storage of stool in the intestine, and bacterial overgrowth is the pathological mechanism of endotoxemia and intestinal bacterial translocation after acute spinal cord injury. The parasympathetic nerves that innervate the GI tract are mainly the vagus nerve and pelvic nerve, with the vagus nerve originating from the dorsal nucleus of the vagus nerve and the pelvic nerve originating from the lateral horn of the S2-S4 segment. The stomach, small intestine, cecum, appendix, ascending colon and transverse colon are innervated by the preganglionic fibers of the vagus nerve, and the part of the transverse colon below the right third is innervated by the pelvic nerve. The sympathetic nerve slows down gastrointestinal motility, hypotonia, and sphincter contraction, while the parasympathetic nerve has the opposite effect. Intestinal receptors are transmitted to the center via two main pathways: via sympathetic nerves to the posterior roots of the spinal nerves and then to the spinal cord; and via the vagus nerve to the central nervous system (mainly the solitary nucleus).
The level and degree of spinal cord injury is the main cause of gastrointestinal dysfunction. With injury in the plane above T12, spinal cord center-mediated peristalsis exists and stool stimulation of the intestinal wall can still be transmitted to the intestinal spinal center below the plane of injury (S2-S4), but stool is retained due to spasm of the external anal sphincter, called reflex bowel; with injury in the plane below L1, spinal cord center-mediated peristalsis is lost. Even if the intestine is filled with stool and the intestinal wall is stimulated, it cannot trigger defecation activity, which is called antireflective bowel.
3, the impact of spinal cord injury on the urinary system
Gao Weixing et al. reported that the rate of urinary tract infection in patients with spinal cord injury during the Tangshan earthquake was 82.0%. The most common complication of spinal cord injury reported by several scholars at home and abroad is urinary tract infection. A large sample survey in China found that 967 cases of spinal cord injury patients had 293 hospital infections, with an infection rate of 30.30%, with the urinary tract leading the infection sites, accounting for 73.38%, respiratory tract infection 12.63%, gastrointestinal tract infection 9.56%, and other infections accounted for 4.44%, while the hospital infection rate of non-spinal cord injury patients was 4.86% during the same period. The infection rate of patients with spinal cord injury was significantly higher than the average infection rate of the whole hospital. Urinary tract pathogens were mainly C-bacteria, Escherichia coli accounted for 53.85%, and green pus accounted for 11.54%. Lower respiratory tract infections are mainly Pseudomonas aeruginosa followed by Staphylococcus.
4, the impact of spinal cord injury on the respiratory system
Jiao Xinxu et al. reported that cervical spinal cord injury accounted for 61.8 percent of patients with spinal cord injury. The phrenic nerve, diaphragm and intercostal muscles are lost in those with damage to cervical segments 1 to 4, and they are unable to breathe deeply and cough. In patients with injuries to segments below cervical 5, there is no damage to phrenic neurons and respiratory insufficiency does not occur, but there are multiple causes of secondary neuronal damage that can indirectly lead to respiratory insufficiency. Patients with cervical medullary injury have weak intercostal muscles and abdominal muscles, poor tracheal smooth muscle activity, loss of cough reflex, and failure to expel tracheal secretions in a timely manner, affecting respiratory function. According to some scholars, 54% of spinal cord patients with respiratory tract infection had cervical segment injury, 29.73% had thoracic segment injury, and 16.22% had lumbar segment injury. After spinal cord injury, damage to distal organs was observed at different times as punctate hemorrhage, mainly in the lungs (100%), bladder hemorrhage (20%), and gastrointestinal hemorrhage (5%), with pulmonary hemorrhage being the most common and most abrupt hill, with the most severe from 48h to 72h after injury. Pulmonary hemorrhage has scattered dotted, dotted flake, large flake, single call multi-lobe different, chewing the lower lobe of both lungs is more common. Pathological examination confirmed pulmonary hemorrhage and pulmonary edema. The reduced ability of the lungs to expel sputum after spinal cord injury directly leads to recurrent lung infections that are extremely difficult to cure, and even with better antibiotics it is only a momentary control, but difficult to cure pneumonia at the root. Once the pneumonia is repeated, it will be very likely to produce drug-resistant bacteria, then only to replace the higher-grade antibiotics to control the lung infection is possible.
5, spinal cord injury on the nervous system
Spinal cord injury at the level of chest 6 or above can cause abnormal autonomic reflexes, with autonomic hyperreflexia or autonomic dysreflexia as the main manifestation, mainly characterized by paroxysmal sudden increase in blood pressure.
How to treat pulmonary infections complicated by spinal cord injury?
According to my clinical experience, the use of antibiotics is only one aspect of the treatment of pulmonary infections, and it is crucial to actively treat spinal cord injury, improve neurological function, and restore the patient’s normal pulmonary sputum excretion capacity. Most of the bacterial infections and fungal infections enter from the mouth, so good oral care is necessary to prevent the aggravation of lung infections; fourth, we must turn and pat the back more often to help the patient to shoot out the deep phlegm. The spinal cord injury patient’s own ability to excrete sputum is very weak, without outside help, it is difficult for him to excrete sputum from the deep part of the lung itself.
What stages of spinal cord injury affect lung function?
Breathing is divided into an expiratory phase and an inspiratory phase. During normal breathing, inspiration is an active process that includes the contraction of the innervation of the individual nerves from the diaphragm (cervical medullary stages 3-5), the innervation of the intercostal nerves from the pectoralis major (cervical 7-thoracic 1), pectoralis minor (cervical 7-thoracic 1) and the intercostal muscles (thoracic 1-12). During normal respiration, expiration is a passive process, except for coughing, sneezing or elimination of endocrine secretions that require active contraction of the expiratory muscles, which are generally passive. The abdominal muscles (thoracic 5 – lumbar 1) and the internal intercostal muscles (thoracic 1 – 12) are the main muscles that act on expiration.
Spinal cord injury above cervical 5 designed the main inspiratory muscles (diaphragm), in addition to the oblique muscles (cervical 5/6 innervated) and sternocleidomastoid muscles (cervical 2-3 innervated), which partially or completely limit inspiration, causing varying degrees of impairment of inspiration-related lung function indicators VS,FEV1, FVC, MVV, and PEF. Most patients with cervical and thoracic marrow injuries have a combination of ventilation dysfunction and reduced sputum excretion, which makes it impossible to remove secretions from the lungs, thus predisposing them to pneumonia.
Q: How to improve lung function after spinal cord injury?
1.Use transcranial magnetic stimulation therapy as early as possible.
Stimulation of the cervical and thoracic spine can improve expiratory and inspiratory functions and can promote sputum excretion.
2.Use acupuncture or medium frequency electrical stimulation
3. Use ultrashort wave to promote the expulsion of mucous phlegm.
4. Chinese medicine acupoint patching.
What are the prescriptions of herbal patches for respiratory tract infections.
1. Self-heating acupuncture point paste for cough and asthma in children to stop cough and dissolve phlegm. It is 95% effective
1g of thorny mustard, 1g of raw semen, 1g of almond, 1g of aster, 1g of winter flower, 0.5g of sage, 0.5g of dahurica dahurica, 0.5g of baiqian, 0.5g of chenpi, 0.5g of mulberry bark, 0.5g of baicalin, 0.5g of schisandra, 0.5g of schisandra, 0.5g of pseudostellaria, 0.5g of ginger juice, 0.5g of ginger juice. research ingredients.
Heat generation agent by weight percentage of iron powder 50%, activated carbon 12%, inorganic salt 13%, vermiculite 9%, water 16%. A total of paste made to apply to gauze, can be applied to acupuncture points.
2.Treatment of tonsillitis with Chinese herbal paste
Huanglian 10-20g, Scutellaria 10-20g, Phellodendron 10-20g, Gypsum 5-30g, Beehive 5-30g, Cinnamon 5-30g, Gardenia 10-20g, Bile South 10-20g, Rhubarb 10-20g, Cornus officinalis 5-30g, Alum 5-30g, Fritillaria 5-30g, Golden Buckwheat 5-30g. grind the powder. Take 5g of the mixed powder, add 1g of sodium benzoate and 3ml of edible vinegar. mix into a paste and apply on gauze to the Yongquan points on both sides. Usually 1-2 hours of medication can reduce fever, with remarkable curative effect.
3, treatment of pediatric pneumonia, bronchitis, phlegm saliva yong lung, gas rebellion and wheezing cough actual evidence. Use with caution in cases of spleen deficiency and diarrhea. Effective 100%
2-3g of Dracaena scoparia is sautéed and ground on the patch and put it on the dankness or lung points, 1-2 hours to remove, once a day, basically 3 days to cure.
4.Treatment of pediatric cough and asthma paste. It can stop cough and resolve phlegm, detoxify and clear heat. Efficiency up to 98%
1-5g of ephedra, 1-5g of pseudostellaria, 1-5g of white mustard seed, 1-5g of scape seed, 1-3g of saponaria, 1-5g of Chuanbei mother, 0.5-2.5g of light powder (gram replaced with 1-5g of clamshell powder), grinded and heated with honey to make a paste. Make a medicine paste.
Acupuncture points can be selected from bilateral Yongquan points, double flying lung acupuncture points, Tanzhong points. Or Yongquan acupoint, Tanzhong acupoint, Dazhi acupoint. Once a day.
5.Treatment of children’s cough, bronchitis herbal paste, efficiency 100%
Ephedra 10-20%, Semen 5-15%, Bayberry 5-15%, Almond 5-15%, Scutellaria 5-15%, Panax quinquefolium 10-20%, Ice chips 3-10%, powdered, with glycerin 3-10%, vinegar 10-30%. Make a paste to make a medicine patch. Apply to the point of tiantu, once a day.
6.Pediatric lung protection patch. Warming the meridians and channels, relieving qi and dissolving drinks, relieving cough and eliminating phlegm, and regulating the lung health of children. It can effectively prevent pediatric asthma, pneumonia, bronchitis, rhinitis, recurrent respiratory tract infections, various chronic coughs and allergic coughs, etc.
White Mustard Seed 0.2-0.7g, Hossein 0.3-1g, Yanhuo 0.6-1.4g, Sheng Gansui 0.3-1g, Ephedra 0.6-1.3g, Dried Ginger Powder 1-2g. grind the powder and mix with vinegar to make a paste to apply on the acupuncture points for backup. Acupuncture points: Dazhi, bilateral Lung Yu, Zhiyang, Tiandu, Tanzhong.
Each time 2-5h. 2-3 times a week, 4 weeks as a course of treatment. The efficiency is more than 87%.
7.Treatment of pediatric cough and cough external compress for cough caused by cold, acute and chronic bronchitis.
3-5g of Hosin, 2-4g of Dasaponin, 2-4g of Alum, 4-6g of Petunia. grind and mix, add 2-4g of ginger juice to moisten, add 3-5g of petroleum jelly, 1-3g of lanolin to make a paste. Apply topically on both Yongquan points before surgery for 6-12h and then remove. 3 days is a course of treatment, use two courses of treatment continuously.
8.Pediatric asthma patch
Gardenia 20-25g, peach kernel 20-25g, almond 20-25g, white pepper 10-15g, glutinous rice 5-10g. grind and make a paste with egg white and put it on the heart of the feet (male left and female right).
9.External ointment for the treatment of pneumonia in infants and young children
Specific gravity of the drug: 19.05% of Nantuan Vine, 4.17% of Ephedra, 4.17% of Angelica dahurica, 1.39% of Chen Pi, 1.39% of gypsum, ground and sieved. Mix with wood ginger seed oil 0.22%, tung seed oil 69.56% to make a paste. Stir for 1 hour at about 60 degrees, apply on gauze and set aside. Apply on selected acupuncture points following the meridians and change daily.
10.Treat cough, phlegm and wheezing caused by acute and chronic bronchitis and pneumonia in children and adults. Stops cough, dispels phlegm, calms asthma, and unblocks meridians. Fast-acting, cure rate of 98% or more, no side effects.
No.1 patch: Tooth soap 70-100g, cinnamon 4-8g, Semen 4-8g, tiannanxing 3-7g, ice chips 2-6g, date palm honey in appropriate amount
No. 2 paste: ephedra 20-40g, licorice 10-30g, gypsum 10-30g, almonds 30-50g, date palm honey in appropriate amount.
When making, the important powder is ground into powder, and the drug is mixed into a paste with date palm honey and applied on the patch, each patch contains 0.8-1.4g of drug.
No.1 paste is applied to Tanzhong point, No.2 paste is applied to Shenqu point, change once in 2 days, 4 days is a course of treatment.
11.Treatment of pediatric asthma, with an efficiency of 96.7%
Roasted ephedra 5-7g, almond 8-10g, white fruit 8-10g, cicada molasses 5-7g, dilong 5-7g, cinnamon stick 5-7g, fried soursop 8-10g, Qingxia 5-7g, grinded and added with ice chips 2-4g, mixed with petroleum jelly to form a paste and applied to both sides of the fixed asthma points.
12.Treating children’s cough and asthma with external paste
Perilla frutescens 1-3g, lycopodium 1-3g, ginger hemp 0.5-1.5g, licorice 0.5-1.5g, almond 1-3g, wild maidenhair 0.5-1.5g, grinded and mixed with peony seed oil 0.5-1.5g to form a paste and apply on gauze, and paste on both Yongquan points every night and remove the next day. 5 days is a course of treatment.
13.Chinese herbal paste for the treatment of pediatric respiratory diseases. For pneumonia and asthma, the efficiency is over 95%.
Peach kernel 60g, almond 5g, gardenia 5g, white pepper 6g, glutinous rice 6g, male clove 5g, cinnamon 50g, ephedra 5g, caryophyllum 30g, ice chips 10g, grind and spare.
When using 8-13g dipped in 75% alcohol, when the alcohol is not dry, the mud will be applied to the navel, bilateral Yongquan points, external gauze, tape fixed, 24 hours to change the medicine once, 3-6 days for a course of treatment.
14.Treating cough and asthma in children
2g of Tianhuancai, 2g of Zhuru, 1.5g of Ginger, 2g of Huangjingzi, 2g of Almond, 3g of Qianrihong root, 3g of Water Centipede, 2g of Dried Ginger. grinded and mixed with sesame oil to form a paste, applied on gauze at bedtime on both Yongquan points and removed in the morning, 3-5 days as a course of treatment. Used for the prevention of cold and cough, can be g 3 days stick once, all year round movement.
15.Treating pediatric pneumonia and wind-heat cough and wheeze, with 100% efficiency.
Chai Hu 8-9g, Ephedra 5g, bitter ginseng 5-6g, fishy grass 5g, double bark 4-5g grinded powder, mixed with honey into a paste and applied to the medicine paste.
The paste is applied to the navel and replaced once every 24 hours for 3-5 days as a course of treatment.
16.Chinese herbal patches for treating chronic cough in children, with 99% efficiency.
Bupleurum album 0.5-1.5g, Radix radix 5-10g, Senna 8-12g, Salvia 1-5g, Silphium 5-9g, Radix Xuanxian 1-5g, Radix Paeonia 1-3g, Hibiscus 3-8g, Radix Chuanbei 3-8g, Flos Chrysanthemi 3-8g, Zelenia 1-3g, Lily 5-10g, Pores 1-5g, Seaweed 2-7g.
Mix the powder and add sesame oil 18-25g at 50-60 degrees to make a paste and apply to the medicine paste and stick it on the navel.
17.Treating children’s wind-heat cough. It is 99% effective.
5g of bamboo, 3g of peppermint, 6g of fat sea, 5g of Qian Hu, 3g of honeysuckle, 7g of rhizome, 3g of orris, 8g of forsythia, 10g of loquat leaf, 3g of Yang Jin Hua, 5g of mulberry bark, 7g of bamboo leaf, 2g of stone wormwood, 3g of dirong. One patch a day.
18. Herbal paste for the treatment of pediatric pneumonia. Stop cough, resolve phlegm and calm asthma, and the wet rhotic sound in the lungs can be gradually reduced. The total efficiency reaches 95%.
White mustard seed 6-10g, Angelica dahurica 18-22g, Chen Pi 18-22g, Plantago ovata 8-12g, Cicada septica 8-12g. grind powder, make a paste with flour and apply on the ointment, paste on the lung acupoint, dazhi and fixed asthma points.