TCM Acupuncture and Massage

Chapter 60 Nervous system diseases (2)
2. Home care for common headaches

(1) Headache caused by general fatigue: take a hot bath to relieve fatigue.After washing your hair in winter, dry your hair carefully with a hair dryer, and then apply heat to the back of your head.

(2) Headaches caused by menopause: massage the forehead to the back of the head with the palm of your hand, or press the Sanyinjiao point 3 inches above the medial malleolus with your fingers, which also has excellent curative effect.

(3) Hypertensive headache: Massage the Adam's apple and lateral cervical muscles with two fingers, and at the same time press the Renying acupoint on the arterial pulse on both sides of the Adam's apple.

(4) Headache caused by cold and fever: While scalding feet with hot water, apply cold towels or ice packs to the forehead and the back of the head to relieve the pain.

(5) Headache caused by toothache: If the headache is caused by toothache on the upper teeth, apply an ice pack to the central protrusion of the zygomatic bone, and also apply it to the Xiaguan point on the lower edge of the zygomatic arch.If it is caused by lower tooth pain, cold compress on the lower jaw and acupressure on the Jacar point in front of the mandibular angle will also have an excellent effect.

(6) Headache accompanied by eye fatigue and eye pain: put a cold towel or ice pack on the upper part of the eyelids and forehead, and apply cold compresses for 5 to 10 minutes.Applying cold packs to the eyes and massaging them with light pressure can also have a good analgesic effect.

[-]. Point massage

([-]) Acupuncture therapy

1. Take acupuncture points
Main points: Baihui, Fengchi, Taiyang.

Acupoint selection by division: for forehead pain, take Yangbai, Yintang, Cuanzhu, Hegu, and Sungu; for migraine, take Taiyang, Shugu, Sidu, Waiguan, Zulinqi; for back headache, take Houxi, Jinmen, and Shugu; Take Neiguan, Taichong, and Yongquan for pain on the top of the head.Acupoint combination: add Hegu and Lieque for those who feel exogenous evils; add Sanyinjiao and Taichong for those with hyperactivity of liver yang; add Zhongwan and Fenglong for those with moderate obstruction of phlegm; add Qihai and Zusanli for qi deficiency; add Sanyinjiao and spleen for blood deficiency Yu.

2. Positioning
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.

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

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.Cuanzhu—the face, with sunken brows.

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.

Valley - dorsum of the foot, the depression in front of the junction of the 2nd and 3rd metatarsal bones.Rate Valley—the head, the tip of the ear is 1.5 inches straight up to the human hairline.

Sidu - dorsal side of the forearm, on the line connecting Yangchi and the tip of the elbow, 5 cun below the tip of the elbow, between the ulna and the radius.

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.

Zulinqi—outside of the dorsum of the foot, behind the fourth metatarsophalangeal joint, in the depression on the outside of the extensor toe minor tendon.

Houxi—on the ulnar side of the palm, with a slightly clenched fist, on the far side behind the 5th metacarpophalangeal joint at the red and white border of the head of the transverse palmar crease.

Jinmen—On the outside of the foot, directly below the front edge of the lateral malleolus, at the lower edge of the cuboid bone.Bundle bone—outside of the foot, behind the fifth metatarsophalangeal joint, at the junction of red and white flesh.Neiguan—on the palm side of the forearm, on the connecting line between Quze and Daling, 5 cun above the transverse crease of the wrist, between the palmar longus tendon and the flexor carpi radialis tendon.

Taichong—on the dorsal side of the foot, in the depression behind the first metatarsal space.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 1/2 and middle 3/1 of the line connecting the head of the 3nd and 1rd toe seams and the heel.Lie Que—Cross the mouth of a tiger with both hands, and the tip of the index finger reaches the place.Sanyinjiao—3 cun above the tip of the medial malleolus, on the posterior border of the medial tibia.

Zhongwan—on the front midline, 4 cun above the middle of the navel.

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.

Sea of ​​Qi—lower abdomen, on the front midline, 1.5 cun below the middle of the navel.

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.

Pishu—back, below the spinous process of the 11th thoracic vertebra, 1.5 cun laterally.

([-]) Self-massage
1. Use two middle finger pulps to start from the Yintang between the eyebrows, and apply along the upper edge of the eyebrows to the temples. The starting point is slightly heavier, and the force is gradually reduced when the application is performed 9 times.

2. Use two middle fingers to rub the eyebrow arch, starting from Yintang, along the upper edge of the brow, and gently rub outwards respectively, rubbing on Cuanzhu, Sizhukong, Tongziilio and temples, repeat 9 times.

3. Press Yuyao with both middle fingers on the Yuyao point 9 times.

4. To wipe the eyeballs, start from the Jingming point with the index fingers of both hands.Apply through the pupils to the temples, repeat 18 times, and the movements should be gentle. If there is redness and swelling, apply 18 more times.

5. Press the acupoints on the head and face, start from Yintang with the middle finger, press Jingming and Yingxiang respectively, and fit in Renzhong.Then press the ground bins separately to fit into the Chengjiang acupoint.Then press Renying and Yanche acupoints.Finally, use the middle finger to press upwards to the temple along the sequence of Yifeng, Tinghui, Tinggong and Ermen points.Press each point above and repeat 3 times.

6. Press the three meridians, start from Yintang with two middle fingers, press up to Baihui point on the top of the head along the Du meridian; then start from Yangbai point on the two eyebrows, press along the bladder meridian to Luoque point; then press on Baihui and Yintang , Yangbai and other acupoints were pressed more heavily, repeated 8 times.This method has obvious analgesic effect.

7. Wiping Use the tips of the index, middle and ring fingers of both hands to rub against the forehead in a semi-circular way. When wiping, start from one point and gradually move backward until the top of the head.

8. Dry comb the ten fingers slightly apart, bend each finger, and use the fingertips to comb the hair quickly and rhythmically from the front hairline to the top of the head.

9. Hook Fengchi Point on the forehead with one hand, slightly bend the middle finger of the other hand and touch Fengchi point forcefully, until there is a feeling of soreness and swelling on the forehead.Click on one side, switch to the other side.

10. Palm knocking Hold a hollow fist in your hand, and knock up and down on the top of your head and forehead with the back of your hand. The technique should be brisk.

11. Flick the ten fingers apart, and use the fingertips to quickly flick up and down on the scalp for 1 to 2 minutes.

insomnia
An overview of the disease

([-]) Relevant knowledge

Insomnia, also known as insomnia, is a class of diseases characterized by the inability to obtain normal sleep due to mental disorders or restlessness.Mild cases manifest as difficulty in falling asleep, or sleep soundly but not soundly, sometimes waking up while sleeping, or unable to sleep again after waking up; severe cases are insomnia all night.

Insomnia is one of the common clinical diseases. Although it is not a critical disease, it often hinders people's normal life, work, study and health, and can aggravate or induce palpitations, chest obstruction, dizziness, headache, stroke and other diseases.Obstinate insomnia brings long-term pain to patients, and even forms dependence on sleeping pills, and long-term use of sleeping pills can cause iatrogenic diseases.Traditional Chinese medicine and acupuncture can often significantly improve sleep conditions by adjusting the functions of the body's viscera, qi and blood without causing drug dependence or iatrogenic diseases, so they are welcomed by patients.

([-]) Etiology and pathogenesis

Insomnia is located in the heart, due to lack of nourishment or restlessness of the mind.It is due to the imbalance of yin and yang in the heart, gallbladder, spleen and kidney, and the imbalance of qi and blood, resulting in lack of nourishment of the mind or restlessness.It is closely related to the following factors.

1. Excessive worry, work and rest imbalance lead to damage to the heart and spleen, and then insufficient Qi and blood to support the mind, eventually leading to insomnia.

2. Panic or sexual labor damages the kidneys, resulting in disharmony between the heart and the kidneys, and the heart fire is blazing alone, leading to restlessness and insomnia.

3. Weakness of the body leads to timidity and timidity, leading to insomnia.

4. Emotional depression makes the liver lose its balance, liver yang disturbs the mind, and insomnia occurs.

5. Improper diet or stagnant food, resulting in disharmony of stomach qi and insomnia.As stated in "Su Wen·Ni Tiao Lun" "If the stomach is not in harmony, you will feel restless when lying down".

([-]) Forms and manifestations of sleep disorders

1. Short sleep time Going to bed late and getting up early, the daily sleep time is only 5-6 hours or even less, and it usually occurs in the elderly.

2. Difficulty in falling asleep. After going to bed, I can't fall asleep for a long time, and I toss and turn all night.

3. Premature awakening type wakes up early and cannot sleep again.

4. Difficulty maintaining sleep, poor quality and frequent dreams, intermittent sleep, being awakened by a small sound, etc.

([-]) Diagnosis

1. Difficulty falling asleep or waking up easily after waking up in mild cases, unable to fall asleep for more than 3 weeks after waking up, and difficulty sleeping all night in severe cases.

2. Often accompanied by headache, dizziness, palpitations, forgetfulness, fatigue, restlessness, dreaminess, etc.

3. No other organic diseases that hinder sleep have been found through various system and laboratory inspections.

([-]) Treatment

The principle of treatment is mainly to replenish deficiency and relieve excess, and adjust yin and yang.Those who are deficient should replenish essence and produce marrow, nourish kidney yin, nourish qi and blood, regulate spleen and kidney; those who are deficient should dry dampness and eliminate phlegm, clear liver and relieve fire, and calm down.However, the occurrence of this disease is mostly those with yin deficiency and yang hyperactivity, and the treatment should be to clear fire, nourish yin and subdue yang.

1. Living arrangements should develop a living habit of regular daily life, planned work and study, a combination of work and rest, and relaxation.

2. Drug treatment can be appropriately selected sedative hypnotic drugs for treatment, but it is easy to cause dependence and should not be taken for a long time.

3. Medical Physical Therapy Physical exercise and appropriate physical labor have a good effect on improving the physical condition of patients.Qigong, Tai Chi, yoga and other folk fitness techniques are beneficial to the relief of symptoms and can be used.

4. For music therapy, music with a softer melody can be used, which has a good adjustment effect on the whole body, and can be carried out in conjunction with the above treatments.

([-]) Prevention

The cause of this disease is a mental disorder, so special attention should be paid to mental regulation, so as to control emotions, relieve worry and anxiety, and maintain a comfortable mind.The sleeping environment should be quiet, and avoid drinking strong tea, coffee and excessive excitement before going to bed.Pay attention to the orderly work and rest.Appropriate participation in sports activities can promote the effect of treating insomnia, improving physical fitness and improving work and study efficiency.

[-]. Point massage

([-]) Acupuncture therapy

1. Select acupoints from Baihui, Sishencong, Yintang, Taiyang, Xinshu, Pishu, Shenshu, Guanyuan, Qihai, Neiguan, Shenmen, Zusanli, Fenglong, Sanyinjiao, Taixi.

2. Locate Baihui—on the front and rear midlines, 5 inches into the front hairline.

Sishencong - 1 inch on each side of Baihui, front, back, left, and right sides, with a total of 4 points.

Yintang - the midpoint of the line connecting the two eyebrows.

The sun—the midpoint of the line connecting the brow tip and the outer canthus, 1 inch backward.

Xinshu—on the back, below the spinous process of the fifth thoracic vertebra, 5 cun laterally.

Pishu—back, below the spinous process of the 11th thoracic vertebra, 1.5 cun laterally.

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

Guanyuan—lower abdomen, on the front midline, 3 cun below the middle of the navel.

Sea of ​​Qi—lower abdomen, on the front midline, 1.5 cun below the middle of the navel.

Neiguan—inner forearm, 2 cun above the transverse wrist crease, between the palmar longus tendon and the flexor carpi radialis tendon.

Shenmen—wrist, on the transverse wrist crease, in the radial depression of the flexor carpi ulnaris tendon.

Zusanli - 3 inches below the calf's nose, a finger across from the front edge of the tibia.

Fenglong—8 inches above the lateral malleolus, two fingers apart from the front edge of the tibia.

Sanyinjiao—3 cun above the medial malleolus, on the posterior border of the medial tibia.

Taixi—the midpoint of the line between the tip of the medial malleolus and the Achilles tendon.

([-]) Self-massage
1. Push and wipe the forehead Use four fingers on the forehead to push from the upper, middle and lower edge of Yintang point to the sun, and press appropriately on Yintang and the sun.Then push up from Yintang point to Shenting point.Finally, close your eyes and press Jingming, and use the wiping method to operate on the upper and lower eye sockets.A total of 5 to 10 minutes of operation.

2. To adjust the head, first press the Baihui and Sishencong points respectively, taking the degree of soreness as the degree.Then use the finger tapping method, sweeping method, and grasping method to operate on the whole head.A total of 5 to 10 minutes of operation.

3. Take Fengchi Use the thumbs of both hands to lift the Fengchi acupoints on both sides respectively, so that the degree of local soreness is obvious.

4. Hold the Jianjing Points on both sides of the Jianjing with two hands, and the degree of local soreness is obvious.

5. Acupuncture Press the above-mentioned acupoints until there is a feeling of soreness and swelling locally.

6. Stretch both hands back to wipe Shenshu, rub the Shenshu points on both sides, and use local diathermy as the degree.

Facial paralysis
An overview of the disease

([-]) Relevant knowledge

The full name of facial paralysis is idiopathic facial paralysis, also called for short facial neuritis or Bell's palsy.The onset is often caused by facial cold or local viral infection. The clinical manifestations are facial muscle movement disorders, crooked mouth and eyes, incomplete eyelid closure, shallow nasolabial folds, and disappearance of forehead lines.The disease is mostly due to sleeping and lying in the wind, and it appears after feeling the wind and cold. The onset is rapid, and there are no symptoms such as hemiplegia and confusion.

([-]) Etiology and pathology

The etiology of facial neuritis is not fully elucidated.Because the bony facial nerve canal can only accommodate the passage of the facial nerve, once the facial nerve ischemia or edema occurs, it will inevitably lead to compression of the facial nerve.The triggering factors may be local neurotrophic vasospasm caused by wind chill, viral infection (such as herpes zoster) and autonomic instability, leading to ischemic edema of nerves, which can also be used as a sign of Guillain-Barre syndrome.The early pathological changes of facial neuritis are nerve edema and demyelination, and severe cases may have axonal degeneration.

([-]) Clinical manifestations

1. It can occur at any age, and it is slightly more male.The onset is usually acute, and symptoms can reach a peak within hours or 1 to 3 days.

2. At the beginning of the disease, it may be accompanied by pain in the retroauricular mastoid area, inner ear or mandibular angle on the affected side.The facial expression muscles on one side are completely paralyzed, the forehead lines disappear, the forehead cannot be wrinkled, the eye fissure becomes larger, the eye fissure cannot be closed or is incompletely closed, the eyeball of the paralyzed side turns upward and outward when the eyes are closed, and the white sclera is exposed, which is called Bell's sign The nasolabial fold on the affected side becomes shallow, the corner of the mouth droops, and the corner of the mouth is tilted to the healthy side when showing teeth; paralysis of the orbicularis muscle causes air leakage when blowing and whistling; paralysis of the buccinator muscle makes it easy for food to stay between the teeth and cheeks of the diseased side .Idiopathic facial neuritis is mostly unilateral, occasionally bilateral, mostly Guillain-Barre syndrome.

3. Because some nerve fibers in the facial nerve innervate the taste sensation in the front 2/3 of the tongue.Therefore, some patients may experience loss of taste in the anterior 2/3 of the ipsilateral tongue.In addition, there may also be hyperacusis, pain behind the ear on the affected side, hypoesthesia in the auricle and external auditory canal, and herpes in the external auditory canal or tympanic membrane.

4. The prognosis can be judged clinically based on experience and EMG: ① Incomplete facial paralysis can begin to recover within 1 to 3 weeks after onset, and is expected to recover significantly and gradually recover within 1 to 2 months; young patients have a good prognosis ; Mild facial paralysis no matter whether it is treated or not, the recovery rate can reach more than 92%; ②The prognosis is better for those with a history of cold exposure; , angina pectoris, or those with a history of myocardial infarction in the past have a poor prognosis; ④ If denervation potentials appear in the facial nerve 10 days after the illness, the recovery time will be prolonged, with an average of 3 months.In patients with complete facial paralysis, it is helpful to check the facial nerve conduction velocity within 1 week after the disease. If the amplitude of the M wave of the evoked action potential on the affected side is 30% or more of that on the healthy side, it is expected to recover within 2 months; if 10 ~30% of patients need 2-8 months to recover, and there may be complications; if only 10% or less, it takes 6-12 months to recover, and it is often accompanied by complications such as hemifacial spasm and joint movement .

([-]) Diagnosis and Differential Diagnosis
Facial paralysis can be divided into central facial paralysis and peripheral facial paralysis according to the site of disease.Among them, the cause of central facial paralysis is on the opposite side, and only the lower 2/3 of the facial expression muscles are paralyzed (below the eye cleft); while the peripheral facial paralysis is on the same side, and all the facial expression muscles on the same side of the face are paralyzed.What is discussed here is peripheral facial paralysis, which is generally easy to identify based on clinical manifestations.

The disease needs to be differentiated from the following diseases:
1. Guillain-Barre syndrome may have peripheral facial paralysis, mostly bilateral, accompanied by symmetrical limb paralysis and cerebrospinal fluid protein-cell separation.

2. Otitis media, labyrinthitis, mastoiditis and other concurrent otogenous facial paralysis, as well as mumps, tumor, mandibular suppurative lymphadenitis, etc., usually have special symptoms and medical history of the primary disease.

3. Peripheral facial paralysis caused by tumors or meningitis in the posterior fossa usually has a slow onset, and there are primary diseases and other manifestations of cranial nerve damage.

(End of this chapter)