TCM Acupuncture and Massage

Chapter 47 Cardiovascular and Cerebrovascular System Diseases (5)
(3) Drink milk regularly: scientific research has confirmed that there is a special ingredient in milk that can protect the brain blood vessels.Animal experiments have shown that milk can effectively reduce the risk of stroke induced in rats with high blood pressure.Recent scientific studies have shown that calcium in milk has the effect of lowering blood pressure. For this reason, experts suggest that both young people and middle-aged and elderly people should insist on drinking milk every day, so as to effectively prevent stroke.

(4) Drink green tea regularly: Medical experts believe that one of the pathological factors leading to stroke is the production of harmful active enzymes in the body, which can promote a harmful substance called lipid peroxide, which can reduce the elasticity of blood vessel walls.The antioxidant substances in tea such as vitamin E and tannic acid can effectively enhance the elasticity of blood vessel walls, so drinking green tea regularly can prevent stroke.

(5) Take cod liver oil: Cod liver oil is rich in a special fatty acid, which has the function of resisting platelet aggregation and reducing total cholesterol and blood consistency, and has a good preventive and therapeutic effect on stroke.However, any drug varies from person to person, and cod liver oil must be taken under the guidance of a doctor to prevent overdose and lead to some adverse consequences.

5. Physical exercise
Prevention Practice has proved that physical exercise can help prevent stroke.

(1) Physical exercise can enhance physical fitness, improve disease resistance, and delay aging.

(2) Physical exercise can enhance heart function, improve blood vessel elasticity, promote blood circulation throughout the body, and increase blood flow in the brain.

(3) Physical exercise can lower blood pressure, dilate blood vessels, accelerate blood flow, and reduce blood viscosity and platelet aggregation, thereby reducing thrombus formation.

(4) Physical exercise can promote lipid metabolism and increase the content of high-density lipoprotein in the blood, thereby preventing arteriosclerosis.Long-term exercise can reduce body weight and prevent obesity.

Therefore, physical exercise is an important measure to prevent stroke.

([-]) Rehabilitation

Partial recovery is common, but complete recovery is rare.After a stroke, four things can happen:
1. When a stroke occurs, severely damaged cells die and never recover.

2. Partially damaged brain cells due to brain swelling recover and work again after the swelling subsides.This procedure usually occurs in the first few weeks after a stroke.

3. Other brain cells not affected by the stroke gradually take over the function of the dead cells.However, the occurrence of this situation is limited.

4. The patient learns and adapts to a new way of life, and overcomes the function lost after the stroke.Most recovery occurs within the first six months after a stroke.Then it stagnates and fades away.

Therefore, patients should not have unrealistic hopes.The most important thing is that despite the stroke, the patient should still have a sense of satisfaction, independence and self-satisfaction in life.

([-]) Treatment

1. Transient ischemic attack (TIA) should be based on the principles of improving blood supply, preventing recurrence, and preventing cerebral infarction.

(1) Etiological treatment: For those with a clear etiology, treatment should be targeted at the etiology as much as possible, such as hypertension, diabetes, hyperlipidemia, etc.

(2) Preventive drug treatment: including anti-platelet aggregation (long-term use of aspirin) and improvement of microcirculation (intravenous ligustrazine or Danshen injection, etc.).

(3) Cerebral protection therapy: Calcium ion antagonists, such as nimodipine and siberine, can be used.

2. Ischemic stroke

(1) Cerebral thrombosis

① General treatment: bed rest, oxygen inhalation if necessary.

② Restoration of blood supply to the brain: mainly includes thrombolysis (should be carried out within 6 hours of onset, in China, intravenous infusion of urokinase is generally used, and the coagulation situation should be closely observed during this period), anticoagulation (rapid avoidance of coagulation or aspirin and other drugs can be used), Volume expansion (low right intravenous infusion can be used), vasodilator (you can use Nimoton or Danshen, Ligustrazine and other drugs).

③Brain protection: It can prevent reperfusion injury, and use it as soon as possible can prolong the time in the penumbra and provide a basis for restoring blood supply.Including calcium ion antagonists (Nimotop orally), oxygen free radical scavengers (vitamin C or E intravenously or orally), and hypothermia (27-35°C, generally use ice compresses on the head, even if there is no fever) and other measures.

④ Traditional Chinese medicine preparations: including Xingnao Kaiqiao (Angong Niuhuang Pills orally or related preparations Qingkailing, Xingnao Jingjing infusion) and promoting blood circulation and removing blood stasis (drugs such as Danshen, Xueshuantong, and Ligustrazine can be used).

⑤ Prevention and treatment of cerebral edema: If necessary, rapid intravenous infusion of mannitol can be used.

⑥ Nerve cell nutrient: the curative effect is uncertain and expensive, so it is not necessary.Energy mixture, cerebrolysin, citicoline and other drugs can be used.

⑦ Control blood pressure (lower blood pressure should be considered above 180/110 in the acute phase), control blood sugar, maintain water and electrolyte balance, and prevent infection and other complications.

⑧Traditional Chinese medicine and acupuncture should be involved as soon as possible to promote recovery.

(2) cerebral embolism
① Similar to cerebral thrombosis, but special attention should be paid to maintaining cardiac function.In addition, since cerebral infarction is likely to cause hemorrhagic infarction, anticoagulation, thrombolysis, platelet aggregation inhibition and volume expansion should be used cautiously, and it is best not to use them.

② Actively treat the primary disease, prevent the cause, and prevent recurrence. 3. Hemorrhagic stroke (1) Cerebral hemorrhage: Generally, hemostatic drugs are not used in the treatment.Because in hemorrhagic stroke not caused by a disorder of the coagulation mechanism, hemostatic drugs have no effect on the normal coagulation mechanism.However, it should be used when the coagulation mechanism is abnormal or combined with gastrointestinal bleeding.

① Keep quiet, rest in bed, reduce visits, and closely observe vital signs.

② Maintain water and electrolyte balance and ensure nutrition: supplement sodium, potassium and sugar.

③ Control cerebral edema and reduce intracranial pressure: Cerebral edema reaches its peak about 48 hours after the onset, maintains for 3 to 5 days, then gradually subsides, and lasts for 2 to 3 weeks.Drugs such as mannitol, diuretics and albumin can be used.

④Control of high blood pressure: Generally, no antihypertensive drugs are needed within 180/105.Generally, drugs such as captopril and betaloc can be used.

⑤ Actively prevent infection, ulcer and other complications.

⑥ Surgical treatment: It should be carried out within 6 to 24 hours after the onset of the disease.Generally, it is used when the intracranial pressure is high and the amount of bleeding is large.

(2) Subarachnoid hemorrhage: The principle should be to stop bleeding, prevent spasm, eliminate the cause, and prevent recurrence.

① General treatment: absolute bed rest for more than 4 weeks, ECG monitoring, and avoid all factors that may cause blood pressure to increase.

② Hemostasis: mainly to prevent further bleeding.Drugs such as hemostatic aromatic acid can be used.

③ Dehydration: mannitol, furosemide, albumin, etc. can be used.

④ Prevention of cerebral vasospasm: Nimodipine can be taken orally.

⑤ Eliminate the cause of the disease.

([-]) Knowledge about TCM

Chinese medicine believes that stroke is due to the disorder of Qi and blood, which produces wind, fire, phlegm, and blood stasis, resulting in blockage of the cerebral arteries or blood spillage outside the cerebral arteries.Clinically, the main symptoms are sudden fainting, hemiplegia, crooked mouth and tongue, astringent or silent speech, and numbness in one side of the body.According to the damage of the brain and whether there is a coma or not, it is divided into the middle meridian and the middle viscera, and the middle viscera is different from closed disease and dementia.

1. According to the damage of the brain and whether there is coma or not, it is divided into the middle meridian and the middle viscera (1) The middle meridian: it is part of the body or one side is numb, or one side is weak, or the tongue is crooked.

(2) Classics of Chinese Medicine: The main symptoms are hemiplegia, crooked tongue, tongue force or reluctance to speak, and numbness in one side of the body.

(3) Zhongjingluo: the collective name of Zhongluo and Zhongjing, it is a person who is unconscious and comatose.

(4) Zhongfu: The main symptoms are hemiplegia, crooked tongue, tongue force or silence, partial body numbness, trance or confusion.

(5) Internal viscera: there must be dizziness or faintness, and symptoms such as hemiplegia, crooked tongue, strong tongue and difficulty in speaking or not speaking.

(6) Middle viscera: the collective name of the middle viscera and the middle viscera. 2. According to the clinical manifestations, there are differences between closed syndrome and out syndrome in the middle viscera (1) closed syndrome: sudden fainting, unconsciousness, or unconsciousness, loss of speech, hemiplegia, trismus, phlegm in the throat, and closed bowel movements Resistance, thick and greasy fur, stringy pulse.

(2) De-symptoms: sudden fainting, unconsciousness, or unconsciousness, loss of speech, eyes and mouth opening, hand peeing, pale complexion, and cold limbs.

[-]. Point massage

([-]) Acupuncture therapy

1. Take acupuncture points
(1) Acupuncture can be performed according to the specific symptoms for the meridian of stroke.

(2) Acupoints can be selected for the middle viscera according to the difference between closed syndrome and off syndrome.

(3) In addition, some acupoints for expelling wind can be selected for prevention.

① Skewed mouth and eyes: take Yifeng, Hegu, Dicang, Jiache, Chengjiang, Xiaguan, Sibai, Taiyang, Yangbai, and Yintang.

②Upper limb paralysis: take shoulder skull, Quchi, Shousanli, Waiguan, Yangxi, Hegu.

③Paralysis of the lower limbs: take Huantiao, Yanglingquan, Zusanli, Weizhong, Chengfu, Fengshi, Xuanzhong, Kunlun.

④Language barrier: Take Yamen, Lianquan, Tongli, Zhaohai.

⑤ closed disease: take Renzhong, Fengfu, Fengchi, Baihui, Neiguan, Hegu, Zusanli, Fenglong, Taixi, Laogong, Yongquan.

⑥ Detoxification: Take Renzhong, Baihui, Yongquan, Guanyuan, Shenque, Shenshu, and Mingmen.

⑦ Prevention: Take Baihui, Fengchi, Neiguan, Hegu, Zusanli, Fenglong, Taixi, Taichong.

2. Positioning
Yifeng—behind the earlobe, the depression between the mastoid process and the angle of the mandible.

Hegu—the back of the hand, between the 1st and 2nd metacarpal bones, at the midpoint of the radial side of the 2nd metacarpal bone.

Dicang—outside the corners of the face, facing the pupils upwards.

Cheekcar—cheek. About one transverse finger (middle finger) above the front and upper part of the mandibular angle. When chewing, the masseter muscle protrudes and presses the depression.

Chengjiang—the face, the central depression of the chin-labial groove.

Xiaguan—in front of the ears on the face, in the depression formed by the zygomatic arch and the mandibular notch.

Sibai - directly below the pupil of the face, in the depression of the infraorbital foramen.

Taiyang—temporal part, between the brow tip and the outer canthus of the eyes, the depression about one finger behind.

Yangbai—forehead, directly above the pupils, 1 cun above the eyebrows.

Yintang—forehead, between the brows.

Shoulder skull - the shoulder, on the deltoid muscle, when the arm is abducted or extended forward, the depression anteriorly and inferiorly to the acromion.

Quchi—outside of the transverse cubital crease, the midpoint of the line connecting Chize and the lateral epicondyle of the humerus when the elbow is flexed.

Shousanli—on the radial side of the back of the forearm, on the line connecting Yangxi and Quchi points, 2 cun below the elbow crease.

Waiguan—dorsal side of the forearm, on the line connecting Yangchi and the tip of the elbow, 2 cun above the transverse crease on the dorsum of the wrist, between the ulna and the radius.

Yangxi—on the radial side of the transverse crease on the dorsum of the wrist, in the depression between the extensor hallucis brevis and extensor hallucis longus tendons when the thumb is turned up.

Circumference—the lateral part of the femur is lying on the side and the femur is flexed, at the junction of the outer 1/3 and middle 1/3 of the line connecting the most convex point of the greater trochanter and the sacral hiatus.

Yanglingquan—on the outer side of the calf, in the depression anteriorly and inferiorly to the head of the fibula.

Zusanli - anterolateral side of the calf, 3 cun below the calf's nose, one finger (middle finger) away from the front edge of the tibia.

Weizhong—the midpoint of the popliteal crease, between the biceps femoris and semitendinosus tendons.

Supporting support—the back of the thigh, the midpoint of the horizontal crease under the buttocks.

Fengshi—on the midline of the outer part of the thigh, 7 inches above the rouge crease, or at the tip of the middle finger when the hand is upright and down.

Xuanzhong—outside of the calf, 3 cun above the tip of the lateral malleolus, on the front edge of the fibula.

Kunlun—the back of the lateral malleolus on the dorsum of the foot, the depression between the tip of the lateral malleolus and the Achilles tendon.

Dumb door—neck, 0.5 cun straight above the middle of the posterior hairline, below the spinous process of the first cervical vertebra.

Lianquan—neck, on the anterior midline, above the throat, in the depression on the upper edge of the hyoid bone.

Tongli—on the palm side of the forearm, 1 cun above the transverse carpal crease on the radial side of the flexor carpi ulnaris tendon.

Zhaohai—on the inner side of the foot, in the depression below the tip of the medial malleolus.

Human center - face, at the intersection of the upper 1/3 and middle 1/3 of the human center groove.

Fengfu—Neck, 1 cun straight above the center of the posterior hairline, directly below the external occipital eminence, in the depression between the trapezius muscles on both sides.

Fengchi—Neck, under the occipital bone, level with Fengfu, the depression between the sternocleidomastoid muscle and the upper end of the trapezius muscle.

Baihui—on the head, 5 inches straight above the center of the front hairline, or the midpoint of the line connecting the two ear tips.

Neiguan—on the palm side of the forearm, on the connecting line between Quze and Daling, 2 cun above the transverse crease of the wrist, between the palmar longus tendon and the flexor carpi radialis tendon.

Fenglong—anterior lateral side of calf, 8 cun above the tip of lateral malleolus, two transverse fingers (middle finger) beside the front edge of tibia.

Taixi - behind the medial malleolus on the inside of the foot, the depression between the tip of the medial malleolus and the Achilles tendon.

Laogong—palm, between the 2nd and 3rd metacarpal bones, on the 3rd metacarpal bone, at the tip of the middle finger when making a fist and flexing fingers.

Yongquan—the bottom of the foot, the depression in the front of the foot when the foot is rolled, approximately at the intersection of the front 2/3 and middle 1/3 of the line connecting the head of the 1nd and 3rd toe seams and the heel.Guanyuan—lower abdomen, on the front midline, 3 cun below the middle of the navel.

Shenque—the middle of the abdomen, the center of the navel.

Shenshu—waist, below the spinous process of the second lumbar vertebra, 2 cun laterally.

Mingmen—waist, on the posterior midline, in the depression under the spinous process of the second lumbar vertebra.

Taichong—on the dorsal side of the foot, in the depression behind the first metatarsal space.

([-]) Self-massage
1. Pushing the head Use five fingers to push from Yintang, Taiyang, along the Governor Vessel, Bladder Meridian and Gallbladder Meridian to Dazhui and Fengchi respectively, and the operation is about 5 minutes.

2. Massage and knead the upper limbs Use the massage and kneading method for the upper limbs on the healthy side along the line of the Hand-Yangming Large Intestine Meridian for about 10 minutes.

3. Press and knead the lower limbs and use the upper limbs on the healthy side to massage and knead along the line of the Hand-Yangming Large Intestine Meridian for about 10 minutes.

4. Pat the whole body Pat the head, upper limbs and lower limbs with empty palms for about 5 minutes.

(End of this chapter)