? Principles and methods of acupuncture and moxibustion in treating scapulohumeral periarthritis
Periarthritis of shoulder:
At this early stage, severe pain is the main symptom, and functional activities are acceptable. In the later stage, shoulder dysfunction was the main cause, but the pain was relieved.
At the beginning of the disease, one or both shoulders are sore, which can radiate to the neck and the whole upper limb. The day is light and the night is heavy, the affected limb is afraid of cold, and finger hemp is swollen. The shoulder joint is stiff in different degrees, and the movements such as arm lifting, forward extension, external rotation and backward extension are limited. If the disease persists for a long time, it often leads to shoulder muscle atrophy due to cold and dampness stagnation and qi and blood stagnation, but the pain is relieved.
If the disease is mainly caused by pain at Zhongfu point in front of the shoulder, and the pain is aggravated after stretching, it belongs to Taiyin meridian syndrome; The main symptoms are pain in the lateral shoulder and shoulder epiphysis, and the tenderness and abduction of deltoid muscle are aggravated, which belongs to Yangming shaoyang meridian syndrome; Pain in shoulder, back, shoulder acupuncture and shoulder Shu is the main symptom, and the pain is aggravated when the shoulder is adducted, which belongs to the syndrome of sun meridian.
Principle:
Scapulohumeral periarthritis is multiple pains in the shoulders and arms, with limited motor function. Its pathological mechanism is blood stasis and edema in the lesion area, compression and stretching of peripheral pain nerves. Inflammatory blood stasis increases the concentration of local metabolites, which directly acts on pain nerves, thus causing severe pain. Inflammatory exudation leads to inflammation diffusion, involving adjacent tissues, and connective tissue hyperplasia and adhesion in the later stage, which makes joint movement disorder.
Application can regulate vascular function, improve blood circulation, accelerate the decomposition and transport of pathological metabolites in inflammatory stasis area, or inactivate them. It can also reduce the permeability of blood vessels in the inflammatory area, reduce inflammatory exudation, inhibit the diffusion of inflammation, accelerate the absorption of inflammatory exudate, reduce swelling and reduce its pulling effect on peripheral nerves. Acupuncture can activate endogenous morphine-like substances in the body and play a strong analgesic role. In the recovery period of scapulohumeral periarthritis, it can obviously promote tissue repair, inhibit excessive proliferation of connective tissue, reduce adhesion and alleviate dysfunction. Therefore, acupuncture plays a significant and reliable role in every pathological stage of scapulohumeral periarthritis.
Periarthritis of shoulder joint, referred to as "scapulohumeral periarthritis", refers to the clinical syndrome of severe shoulder pain, limited shoulder movement and rigidity. Belonging to the category of "shoulder arthralgia" in traditional Chinese medicine. According to its pathogenesis, clinical manifestations, onset age and other characteristics, Chinese medicine is called "shoulder leakage", "shoulder coagulation", "scapulohumeral periarthritis" and "fifty shoulders" respectively. Women are taller than men.
The occurrence of this disease is related to chronic strain, and the patient may have a history of external injury. The main pathology is chronic degenerative changes, mostly secondary to tenosynovitis, supraspinatus tendinitis or subacromial bursitis. Some patients are related to infectious diseases or endocrine function. Traditional Chinese medicine believes that the lesion of this disease is located in the meridians and tendons of the shoulder. People in their fifties are not healthy enough, and the camp and health are gradually weakening. If they feel local cold, or tired and depressed, or are used to lying on their side, they will oppress the tendons and veins for a long time, which will lead to stagnation of qi and blood and become shoulder arthralgia. Shoulder pain lasts for a long time, local qi and blood flow is not smooth, qi and blood stagnate, which leads to swelling and adhesion of the affected area, and finally the joints are stiff and the shoulders and arms cannot move.
Of:
1, basic
Treatment principles: relaxing tendons and activating collaterals, promoting qi and blood circulation, acupuncture and diarrhea.
Prescription: local acupoint selection of shoulder joint is the main method.
Ashi point in front of shoulder, Ashi point in front of shoulder, popliteal shoulder and Zhong Ping point in Yanglingquan (lower 1 inch).
Fang Yi: Taking the shoulder, the front of the shoulder and the chastity of the shoulder locally is called "three needles on the shoulder". Combined with local Ashi point, acupuncture plus moxibustion can dispel wind and cold, dredge meridians, and dredge meridians; Taking Yangling Spring far along the meridians can relax muscles and activate collaterals, dredge meridians and relieve pain; Zhong Ping Point is a newly discovered experience point in modern times. Matching points far and near can dispel evil, relax tendons and activate collaterals, harmonize qi and blood, and stop the pain.
Addition and subtraction: Taiyin Meridian plus Chize and Yinling Spring; Yangming Shaoyang Meridian plus Shousanli and Waiguan; After the sun passes the certificate, it is added to Houxi, Daxie and Kunlun; Pain lies in Yangming and Taiyang Meridian.
Operation: Grasp the angle and direction of acupuncture before and after the shoulder, and avoid oblique needling and deep needling inward; Yangling Spring deeply penetrates or penetrates into Yinling Spring; A powerful * * * can be used to penetrate mountains; Local chills and chills can be supplemented by moxibustion; You can also add cupping behind the shoulder needle and move cupping in parallel; The rest of the acupoints were acupuncture according to routine. Whenever acupuncture is performed at the distal acupoints, the patient's shoulders will move.
2. Other acupuncture therapies
(1) awn needle: take the shoulder and abdomen to pierce the polar spring, the shoulder and the chastity to pierce the polar spring, and the mouth to pierce the mountain. If you can't lift your shoulder, you can puncture it in many directions to lift your shoulder. When the mouth pierces the mountain, the patient can move the affected limb while moving the needle, and the movement should be slow to fast, and the force should not be too strong to avoid causing pain.
(2) Collateral puncture and cupping: For those with obvious swelling and pain in the shoulder and superficial blood stasis, you can tap the affected area with a skin needle with moderate strength, so that the local skin oozes blood slightly, and then cupping is added; If the blood stasis is deep, a small amount of bleeding can be caused by pricking 2 ~ 3 needles with triangular needles, and then cupping can be added to make the blood stasis exhausted and the evil force dredge the collaterals. Twice a week.
(3) Ear acupuncture: Take the shoulder, shoulder joint, clavicle, Shenmen, corresponding points, etc. Choose 3 ~ 4 points at a time, the fine needle is strong, and leave the needle; You can also press with seeds.
(4) Electroacupuncture: Take shoulder carbuncle, shoulder epiphysis, shoulder front, Tianzong, Quchi, Waiguan, etc. Select 3 ~ 5 acupoints at a time, and connect the electroacupuncture instrument. The intensity of continuous wave in the early stage and intermittent wave in the later stage is * * * 10 ~ 15 minutes.
(5) Acupoint injection: Inject injections such as Angelica sinensis, Ligusticum Chuanxiong, Rhizoma Corydalis and Carthami Flos. Or glucose injection and shoulder acupoint injection, each point is 0.5ml. If the tenderness point is extensive, you can choose 2 ~ 3 places with the most obvious tenderness for injection.
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Periarthritis of shoulder,