Spinal cord injury is due to trauma, disease and congenital factors, resulting in partial or total impairment of sensory and motor functions below the plane of nerve injury, accompanied by bladder and rectal dysfunction, causing patients to lose some or all of their working ability, ability to live and ability to take care of themselves, and it is one of the main targets of rehabilitation treatment. According to the symptoms of Chinese medicine, spinal cord injury is categorized as “impotence” and “retention of urine”. Chinese medicine believes that this disease mainly damages the three veins of the kidney, the governor, and the belt, and the injury will lead to stagnation, and stagnation of the meridians will result in the poor functioning of qi and blood, and the loss of the muscles and bones to be moistened, which will paralyze the limbs and make them unsympathetic. If the blood and qi do not run smoothly, the bladder will not have the right to vaporize, and the urine will either be retention of urine or overflow from the urine. Diagnostic Criteria 1. Symptoms: mainly muscle motor control disorder and difficulty in action, bowel control disorder, sensory disorder. Some patients have abnormal pain and phantom pain. Patients with high spinal cord injury may have difficulty in breathing, and patients with fractures, dislocations, pressure sores and other complications may have corresponding symptoms. 2.Signs: the main manifestations are weakening or loss of muscle strength, abnormal muscle tone (hypotonia, hypertonia, spasticity), abnormal tendon reflexes (no reflexes, weak reflexes, hyperreflexia), pathological reflexes (Hoffman’s sign and Babinski’s sign), abnormal skin sensation (no sensation, hypoesthesia, hypersensitive sensation), skin breakage or pressure ulcers, and so on. high level spinal cord injury can have breathing dyskinesia and Autonomic hyperreflexia. 3, clinical classification (1) traumatic ① cervical spinal cord injury: flexion-type rotational dislocation or fracture dislocation is the most common, the best part of C5-6, hyperextension type injury is most common in the elderly, accounting for cervical spine injuries of about 30, gluttony is seen in the C4-5, belongs to the stability of the injury. ② Thoracolumbar spinal cord injury: mostly located in T12-L1, resulting in complete dysfunction of the spinal cord, conus or cauda equina. ③ Open injury: open wound at the site of spinal cord injury, less common. ④ whiplash injury: most often seen in the upper body in high-speed movement suddenly stationary, resulting in the head due to inertia continue to move forward, Zhao into the spinal cord injury. x-ray is often no positive signs, spinal cord injury position incomplete. (2) non-traumatic ① vascular: arteritis, spinal thrombophlebitis, arteriovenous malformation. ② Infectious: Guillain-Barré syndrome, transverse myelitis, anterior horn of the spinal cord gray matter, etc. ③ Degenerative: remember muscle atrophy, amyotrophic lateral sclerosis, spinal cord cavernous disease, etc. Tumor: primary tumors, such as cerebral (spinal) meningioma, glioma, neurofibroma, multiple spinal cord tumors, etc.; secondary tumors, such as spinal cord tumors secondary to lung cancer, prostate cancer and so on. Clinical syndromes: Typical transverse injuries are paraplegia and quadriplegia according to the level of injury. However, some incomplete injuries have special manifestations, including: (1) Central bundle syndrome: common in cervical spinal cord vascular injury. Nerve involvement and dysfunction in the upper limbs is finally reduced to the lower limbs, where the patient may be able to walk, but the upper limbs are partially or completely paralyzed. (2) Half-cut syndrome: common in knife or gunshot wounds, loss of proprioception and movement in the limb on the same side of the injury, and loss of para-temperature sensation. (3) anterior fascicular syndrome: anterior spinal cord injury, loss of motor and temperature and pain sensation below the plane of injury, while proprioception exists. (4) Posterior fascicular syndrome: injury to the posterior part of the spinal cord, with loss of proprioception below the plane of injury, but loss of motion and temperature and pain sensation. (5) Spinal cord cone syndrome: mainly spinal cord sacral segment cone injury, which can cause loss of bladder, bowel and lower extremity reflexes. Occasionally, sacral segment reflexes can be preserved. (6) Cauda equina syndrome: injury to the lumbosacral nerve roots within the spinal canal can cause loss of bladder, bowel, and lower extremity reflexes, which manifests itself as a characteristic of peripheral nerve injury (delayed paralysis). (7) Spinal cord shock: a temporary and reversible loss of physiologic function of the spinal cord or cauda equina, seen in patients with only simple compression fractures and even negative imaging. There is no mechanical compression of the spinal cord or anatomical damage. Patients with this type may have hyperreflexia but no muscle spasms. Identification criteria 1, meridian stasis: muscle flaccidity of the injured limb, impotence, numbness, inability to pass stools, yellowish tongue coating, thin and astringent pulse. Deficiency of liver and kidney: muscle atrophy of injured limbs, contracture and stiffness, numbness, dizziness, tinnitus, soreness and weakness of waist and knees, incontinence of bowel movement, red tongue with little moss, fine stringy pulse. Therapeutic principles and selection of acupoints 1, this disease to dredge the dong chi, facilitate the two stools as the basic principle of treatment. 2, in the selection of points can be based on the “kidney main bone marrow”, “the Governor of the Governor’s Vessel of the body of the Yang”, as well as the specifics of the injury site for the selection of points, the selection of basic principles of points are as follows: ① identification of the meridian selection: according to the injury site circulation over, select the corresponding meridian points, due to Spinal cord injury is closely related to the dushi meridian and bladder meridian, so the first choice of dushi meridian, bladder meridian or spine points. ② with the symptom selection points: according to the paralyzed limbs of the nerve and muscle damage performance selection points, such as axillary nerve to take the extreme spring, etc.; radial nerve to take the Quchi, hand Sanli, etc.; median nerve to take the Quze, arm, etc.; sciatic nerve to take the ring jump, etc.; peroneal nerve to take the Commission of the sun, etc.; paralyzed lateral muscle group to take the Yang meridian points, paralyzed medial muscle group to take the yin meridian points. For urinary dysfunction, take points such as subs, chibian, shui dao, zhongji, etc. For bowel dysfunction, take points such as changqiang, tianshu, guilai. Nerve damage, usunoxnqwi, so the preferred points are the Directing Vessel, the Bladder Meridian or the Clamping Spine Points, ③ Localized selection of acupuncture points: usually in the upper and lower vertebrae of the plane of injury each selected acupuncture points, and combined with localized Clamping Spine Points, Directing Vessel Points, and Bladder Meridian Points. Efficacy assessment criteria (Chinese medicine industry standard of the People’s Republic of China) 1. Cure: normal limb movement, muscle fullness, normal neurological and laboratory tests. 2.Improved: limb impotence improved, symptoms improved, nervous system and laboratory examination basically normal. 3.Not cured: limb impotence and weakness without improvement. Therapeutic effect analysis 1, factors affecting the efficacy of acupuncture ① Condition: different degrees of spinal cord injury will have an impact on the efficacy of treatment, the condition of the less severe for incomplete spinal cord injury, acupuncture efficacy is good, faster recovery, fewer sequelae; complete spinal cord injury paraplegic patients, acupuncture treatment can alleviate the symptoms of the course of treatment is long, the efficacy of the treatment is poor, can be restored to part of the function, and often leave serious sequelae. Adhering to the treatment and combining with functional exercise can delay muscle atrophy and consolidate the effect of treatment. ② Acupuncture: this disease is induced by internal and external causes are mostly false evidence, acupuncture techniques should be light, more complementary method, be careful with laxative, electroacupuncture treatment of this disease stimulation should be moderate, to the patient tolerance at the same time, it is appropriate to choose a low-frequency small-amplitude stimulation, so as to avoid depletion of the patient’s positive qi. ③ The patient’s body state: the body is strong, have strong perseverance and desire to recover, in the acupuncture treatment at the same time and can adhere to the functional exercise, the efficacy is better; on the contrary, the body is weak, lack of perseverance and confidence, often can not adhere to the treatment, and the functional exercise is less active, the efficacy is poorer. ④Treatment timing: acupuncture can significantly reduce and delay the early pathological damage, reduce the occurrence of irreversible changes, and promote the repair of damaged spinal cord nerves. Therefore, the earlier the intervention time of acupuncture treatment, the more conducive to the recovery of the condition, the faster the effect, and can reduce the complications, reduce the sequelae; longer course of the disease, the intervention of the timing of the later, often can not be quick effect, and the course of treatment should be prolonged. 2, the link and mechanism of acupuncture treatment Spinal cord injury is a common serious injury disease, spinal cord injury vascular and neurobiochemical mechanisms are the two major mechanisms of secondary spinal cord injury, the two exist at the same time and interact with each other, ultimately resulting in microcirculation disorders of the spinal cord, as well as spinal cord necrosis of the liquefaction of neural tissues. According to the above mechanism, the clinical treatment of this disease mostly adopts electroacupuncture, and its links and mechanisms can be summarized as follows: ①Neuroprotective effect: studies have shown that the use of electroacupuncture treatment in the early stage of acute spinal cord injury can play an important role in the inhibition of apoptosis and neuronal protection in the early stage of spinal cord injury by down-regulating the expression of Fas, cysteine and aspartic acid protease. ②Promote the regeneration of damaged neural tissue: electroacupuncture can generate a strong electric field in the spinal cord, prevent Ca ions from flowing inward by antagonizing the endogenous injury current, stabilize the membrane structure, increase the activity of mitochondrial enzymes, block secondary lesions in the spinal cord, and protect the degeneration of spinal cord nerve axons, thus promoting the regeneration of nerve axons. Some studies have also shown that electroacupuncture may promote the metabolic process of the cells of the injured spinal cord tissues by promoting the metabolic process of the cells, causing the adenylate cyclase activity of the cell membrane to rise, so that the ATP generation of CAMP increases, and at the same time of enhancing the cellular metabolism, initiating the synthesis and secretion process of the proteins such as neurotrophic factors and cell growth factors, thus promoting the survival and differentiation of the transplanted neural stem cells in the spinal cord as well as promoting the survival of injured neurons and their axonal regeneration and reconstruction. This will promote the survival and differentiation of transplanted neural stem cells in the spinal cord, as well as promote the survival of damaged neurons and their axon regeneration, rebuild the neural pathway and restore the function of the spinal cord. ③Improve spinal microcirculation: stimulation of the ducal vein or spine pinch points by electroacupuncture can regulate the spinal cord vegetative nerves, improve the blood circulation and nutrient metabolism of the local tissues, promote the flow of the cerebrospinal fluid, reduce the spinal cord injury site of adhesion and edema and hematoma compression, and stimulate the spinal cord segment above and below the lesion to achieve the effect of pain relief through the masking effect, the central interfering effect of analgesia and the release of encephalphalogens to reduce the scarring. ④Regulation of bladder function: spinal cord injury is often accompanied by abnormal urinary function, from the urodynamic classification of the pathology because of the urethral muscle without reflexes, spasticity of the external urethral sphincter, urethral muscle reflex hyperactivity, or complications of internal and external sphincter spasticity, such as synergistic dysregulation of spasms. Under the premise of retaining catheterization to empty the bladder, acupuncture can effectively improve the function of bladder forcing muscle, relieve the spasm of external urethral sphincter, and synergize the function of internal and external sphincters so as to gradually achieve voluntary urination. Spinal cord injury plane and functional prognosis is closely related, in general, the higher the plane of injury, the worse its functional recovery, the higher its life dependence, spinal cord damage once the vital signs are stabilized can start the recovery period of acupuncture and rehabilitation, such as the patient is not able to take care of themselves, then the nursing care should be to ensure that the patient turn over every two hours, and do a good job of the whole body cleaning work, urine and feces and perineal care to avoid Local dampness, avoid urinary infection, and prevent pressure sores. Strengthen the passive and active movement of the whole body joints, carry out the corresponding rehabilitation training, and actively encourage the patients to build up confidence and actively carry out active rehabilitation exercise.