Traditional Chinese Medicine Tang Yong Chong Qing Orthopaedics - - PowerPoint PPT Presentation

Traditional Chinese Medicine

Tang Yong Chong Qing Orthopaedics Hospital of TCM, China

contents

n Philosophy of Chinese medicine n Therapy methods: n acupuncture n moxibustion n Tui na……

Philosophy of Chinese medicine

qIt is based on the world view of Taoism qTerms originated from Taoism are used in Chinese medicine.

qQi (Chi) q yin and yang q the five elements

QI

qQi? ( original qi, qi of channels, qi of heart…….) qBasic meaning is “air” → invisible and important thing qIn Taoism: qSubstance, invisible, crucial in nature

lao tzu Taoism

QI

universe

“道生仪(original qi,)，仪生二， 二生三，三生万物。”

Qi in TCM

n substance which is invisible and has high

energy

n Qi of channels n Original qi (like genetic material )

n Function of certain substances

n Heart qi

Yin and Yang(methodology)

n primary meaning

n Yang-the place where the sun shines n Yin- the place where sun can not shine

n abstractive meaning

n Yang-bright, warm, daytime, movement, qi(steam),

upward……

n Yin-dark, cold, stillness, night, water( liquid),

downward ……

philosophy concept of yin and yang

n Things in the universe had the contradict yin

side and yang side. Yin and yang in TCM

n The relationship of them is opposite and

mutually restrained ; interdependent ; in a wane-wax balance ; transform to other side

yang qi, spirit, surface, fever, flushed skin,fast pulse Warm, acrid Fast, heavy Yin qi, body, inside Cold, dark skin, slow pulse Cool, bitter Slow, soft yang yin A human symptoms herbs Tui na manipulates

treatment

• Healthy

imbalance - Disease :yang excessive, yang deficiency …… balance

diagnose

Yin and yang state of the body

the five elements

n The five elements refer to the wood, fire,

earth, metal, water

n originally- the basic living condition of

human being

n Later -- philosophy term , the attribute of

the material word

The five element of the world

Wood fire earth metal water Season spring summer late summur autumn winter Climate wind heat dampness dryness cold Color blue red yellow white black Taste sour bitter sweet pungent salty Zang liver heart spleen lung kidney Orifice eye tongue mouth nose ears Tissue tendons blood vessels muscles skin bones Emotion anger joy pensiveness grief fear metal earth fire water wood

lung spleen liver kidney heart stomach small intestine bladder gallbladder tendon

Blood vessels

muscles skin bone eye tongue mouth nose ear large intestine

water metal wood fire earth

The five elements in TCM

body

System of wood

n Liver is the master of this system. n The taste of sour, the color of blue , the

emotion of anger, the eyes, the sinews, and the nails, belonged to this system.

liver Gall bladder sinew eye sour anger blue nail

Treatment method of TCM

n Tui na n accupuncture n moxibustion n Cupping therapy n scraping n Chinese herbal therapy n Food therapy

Inner-therapy Exo-therapy manipulates on the acupoints or the routes of the channels

cupping therapy

get rid of damp and cold in the channels and get qi and blood flow used to treat common cold, headache, the pain of side chest, back, waist and legs, etc.

scraping

Can regulate the yin and yang in balance, get blood and qi flow fleuntly in the channels , and get rid of wind , cold and heat in the channels Often used to treat common cold, sunstroke, pain of the shoulder, back, legs, and used at the beginning of infectious diseases. Little articles with smooth fringe

accupuncture

n Channels n how it is used in treatment

The channels

channel system

Major channels Twelve regular channels Connect to Connecting channels

• utside

Inside:viscera pathways that carry qi, blood, and fluids around the body Eight irregular channels (Ren, Do…) The fourteen channels

The heart channel Twelve regular channels qHave fixed routs qDeeper part is associated with an organ qThere are acupoints on the superfacial part qAcupoints: qi of organ communicate with the surface of the body

History

n more than 3000 years n Initially, crude needles, made from sharpened

stones, animal bones, or bamboo, were used

n About 200B.C. <the yellow empiror’s internal

classic>, the part of <spirital axis>, described acupuncture systematicaly

n around 600 A.D. ,introduced to Kereo, Japan,

and south east Asia

n around the beginning of 17th century, n introduced to Europe

n According to WHO, the following disease could

be useful :

n Pain (chronic, surgical, arthritic, malignant, headache,

backache).

n Organic

Lesions (cardiovascular, respiratory, genitourinary system, skin,).

n Neurological (peripheral & central). n Substance abuse (drugs, nicotine, food & alcohol). n Gynecological disorders n Psychiatric (depression & anxiety)

Caution

v the patient has a hemophilic condition. v the patient is pregnant v the patient has a severe psychotic condition or

has recently taken drugs or alcohol.

v at the point where the skin has infection, ulcer,

• r scar, it is unfit to have acupuncture.

Types

n common acupuncture n Combined with cupping therapy and

moxibustion

n Electric acupuncture n auricular acupuncture

In treatment

n First, distinguish the pattern of the disease

n To know disease is on the surface or in the

• rgans, is deficiency or excessive, is cold or

warm

n To choose proper acupoints and

manipulations

n Needles. n Angle of inserting n De qi

n a special feeling of sour, numb, swell and tight,

but not pain

Manipulates

n to make de qi occure or to get certain treatment

effects( such as reinforce deficient or decanta excessiveness)

n raising and thrusting n twirling n Rotation n plucking n Scraping n trembling

Moxibustion

n often used to relieve pain, to stop hiccup,

to improve the founction of immune system, to help the recovery from

• peration, stroke, etc.

n In health care

Types

n over moxibustion n burning moxibustion n indirect moxibustion

The dose of moxibustion

n the skin of the acupoin became red n or until the lip become red

Choice of over moxibustion and burning moxibustion

n Over moxibostion

n non-invasive n patient feel very comfortable n effect is modarate

n burning moxibustion

n convenient and time saving n has a long lasting effect n hurt to skin

n Example: (from li guan rong, a professor of

medical college of Sichuan university)

n Professor li used moxi-stick to stimulate the

point of Dazhu( BL11) to treat patients with cervical spondylopathy. There are 124 cases, with the efficiency rate of 91.95%. it was

• bserved that, when the patient have a warmth

feeling passing on from the shoulder, to the elbow and wrist soon after the moxibustion was applied, there would be a good therapy effect.

n A case:

n Mrs.xu, female, 53 year’s old. She

suffered repeated attack of shoulder-neck pains for four years. X-ray examination showed a cervical spondylopathy. The condition did not improved after western medicine, herbal therapy, and other physical therapy. Apply over moxibustion

• n the point of Dazhu. After 15 min , a

warmth felt passing on from shoulder to elbow, and the pain relieved. After another twice moxibustion therapy, the pains

• disappeared. In a 12 year’s follow up, the

disease did not reoccure.

Moxibustion used in healthcare

n Over moxibustion is often used in

• healthcare. This method is non-invasive,

simple and have a good effect. It has been a main healthcare method since Tang dynasty.

some important healthcare acupoints

n Zhusanli : the most important acupoint of healthcare n Moxibustion on this point can reinforce the founction

• f spleen and stomach, enrich the qi of our body and

warm kidney to make our body healthy

n can promote the activities of immune system n can regulate the level of suger in blood and the blood

pressure to normal…

n Guanyuan: (3 Cun under the bellybutton) n the point of “original qi”, where male hide

essence and female hide blood.

n can warm and smooth the channels, enrich yang

and kidney, get yin and yang in balance.

n Modern science showed, it can regulate the

function of hypothalamus-pituitary-gonadal axis， promote cellular immune function, and can cut down fat in the blood，prevent artherosclerosis.

Tuina

n a kind of massage which was directed by the

theory of TCM.

n to stimulate the points and channels so as to correct

the imbalance of yin and yang

n “where

there is stuck, there is pain ” , get qi and blood flow fluently in the channels.

n used in internal medicine, orthopaesics, health

care, rehabilitation, etc.

n safe,

no side effects, effective and cheap. patient will not get nervous.

basic manipulatons in tuina

n For the manipulations of tuina, there are

four requirments , they are: “softness”, “steadiness”, “persistence” ， “deepness” .

n Softness: it means in the process, the

patient should not get painful, but feel relaxed and comfortable. This is the basic requirement of the manipulations. Only the practitioner has a high technique, that his manipulations can be felt soft but not weak.

n Steadiness: It means the rhythm and the

force of the manipulations should be even, can’t be sometimes faster or sometimes harder to obtain a stronger stimulation.

n Persistence: It means, only the

manipulation persisted for a certain period

• f time, the stimulation accumulated to a

certain mount, and an effect can be get.

n Deepness. It means, the stimulation of the

manipulation should get deep into the body or pass through the channels, and a feeling of sour, swelling, warm, numb is

• get. Deepness is the proof of the effect of

this practice.

Basic Manipulations

n Push n Na n Press n Mo n roll n Vibrate n Beat n stretch n Pull n Rotate

Caution

n 1. locomotion organ with tuberculosis or infection

with pus.

n 2. unknown acute spinal injury or spinal cord injury n 3. skin with pathologic changes or injuries, bruise n 4. the part which is bleeding or with blood disease n 5. women who is pregnant or has menses (tuina

can’t be applied to the abdomen and lumbosacral part and certain acupoints)

n 6. patient who is hungry or too full or is extrimely

tired ( patient may get faint in the process.)

Scapulohumeral Periarthritis （shoulder pain）

n It is caused by the soft tissue injury or

degeneration of the shoulder joint. it mainly has the symptoms of pain in the shoulder region and limited movements of the shoulder joint. it is also called a “ fifties shoulder” because it often

• ccurs in people about fifty years old. In TCM, it

is caused by shoulder strain and the pathogenic factors of wind, coldness or dampness.

n The aim is : n 1. to relieve the pain. n 2. to promote the blood circulation of the

shoulder joint.

n 3. tripping adhesion of the joint, to recover

the movement of it

n the main acupoints used: n the manipulations used: roll, push, pressure, na,

rotate, vibrate, pull, etc.

manipulations

n 1. begin with soft manipulations, to relieve

the tension of the muscle .

n 2.to relaxe muscles and tendons and to

dredge the channels

n 3. to strip adhesion, to recover the

movement of the joint

n 4.to dredge the tendons and muscles,

used as the ending manipulations.

exercise

n 1、climb the wall n 2、do circular movement of the shoulder

joint

n 3、back ward extend of the arms n 4、outward rotation of the arms.

roll

Action: bent the fingers as if hold an egg naturally. Roll the little finger side

• f the hand back

back and forth through the rotate of the forearm.

n Key of the action: relax the shoulder. The

elbow bent about 120°. The rolling of the hand is produced by the rhythmic rotate of the forearm. The wrist is relaxed and have the largest bend and extend movement. The action should be done steadily , softly, and smoothly.

back

Push

Action: With certain vertical pressure, push the finger, palm, hukou, fist, or elbow in a certain direction and rhythmicly.

n Key of the action: relax the shoulder,

elbow , arm and wrist. The force is produced by the forearm. The action should be done steadily, softly, in rhythm and slowly.

back

Dazhu Dazhu back

Mo

Action: rub the fingers or palm circularly with pressure.

back

Key of the action: relax the shoulder, elbow , and wrist, the palm is flat. The force is produced by the forearm. There are strength stored in the fingers and palm. The movement should be done steadily , softly, and smoothly.

Vibrate

back

press or hold by the finger or palm, vibrate fast and in rhythm with little width.

Action: Press or hold by the fingers or palm, vibrate fast and in rhythm. Key of the action: concentrate the mind in the manipulation and the movement is evenness.

Na

Action: Use the fingers and palm , hold the deeper tissue, knead and raise it with a gliding movement rhythmicly.

Key of the action: relax the shoulder, elbow , arm and wrist. There are strength stored in the fingers and palm. The movement should be done evenly, smoothly, and slowly.

back

Press

Action: Press thum, palm, fist,

• r the elbow to

the deeper tissue with some rotating.

n Key of the action: relax the shoulder,

elbow , arm and wrist. There are strength stored in the fingers and palm. The movement should be done slowly and softly, the rotating is in rhythm.

back

Beat

Action: Beat with finger, palm or fist in rhythm.

n Key of the action: relax the shoulder,

elbow , and wrist. The movement should be done steadily and briefly.

back

strech

Action: Hold the two ends of a joint and stretch it just beyond the limit.

n Key of the action: relax the shoulder, there

are strength stored in the fingers and palm. The force is produced by the waist and

• arms. The action should be done briefly,

the strength and range of it should be controlled carefully.

back

Pull

back

Action: hold one or two end of a joint and pull. Key of the action: relax the shoulder, there are strength stored in the fingers and palm. The force is produced by the waist and arms. The action should be slowly, the strength and range of it should be controlled carefully.

Rotate

back

Hold one or two end of a joint and make the joint have a circular movement. Key of the action: relax the shoulder, there are strength stored in the palm and wrist. The force is produced by the arm. The action should be slowly, the range of it should be controlled carefully.