TCM Acupuncture and Massage

Chapter 71 Diseases of the ENT (1)
白内障

An overview of the disease

([-]) Relevant knowledge

Cataract is the clouding of the lens in the eye from transparent to opaque, which prevents light from entering the eye and affects vision.The initial turbidity has little effect on vision, and then gradually aggravates, significantly affecting vision and even blindness.With the extension of life expectancy in the world, cataract patients will continue to increase.Cataract is the leading cause of blindness in the world. About 2 million people in the world are blind due to cataract, and another 1 million cataract patients need surgery to restore vision. In most African and Asian countries, cataracts are at least half of the blind.According to the results of our survey, cataract is also the most important eye disease that causes blindness in our country.

([-]) Etiology and pathogenesis

Medically it is called cataract.The human eye is like a camera, the crystalline lens is like the lens of the camera, and the retina in the fundus of the human eye is like the film.Cataracts are like the lens of a camera becoming cloudy. It is difficult for light to reach the retina and it is difficult to obtain a good image.On the basis of systemic aging and the decline of crystal metabolism, genetics, ultraviolet rays, systemic diseases, nutritional status and other factors may form the disease.

([-]) Clinical manifestations

Some elderly people usually need to wear reading glasses to read books and newspapers, but suddenly, they find that they can see clearly without wearing reading glasses. In fact, this is not a good sign, it is one of the early symptoms of cataracts.

Common symptoms are gradual blurring of vision, sometimes perceived halos around lights and colors of objects that are not bright enough.If you drive at night, you will feel uncomfortable or irritated by the glare of the headlights of the oncoming cars.In general, however, the course of the symptoms develops rather slowly and depends on where the lens is cloudiest and how it develops.

([-]) Diagnosis

根据临床表现及相应的眼底检查，可以很容易诊断本病。本病与年老有关。50～60岁老年性白内障的发病率为60～70％，70岁以上的达80％，80岁以上的老年人几乎达100％。

([-]) Treatment

There are many eyedrops for cataract on the market, but it is not clear whether they are effective or not.Surgery is the only proven way to treat cataracts most effectively, with a success rate approaching [-] percent.In the past, cataracts had to be fully matured to be operated on. The opacity in the lens and the capsular bag were removed together, and thick convex lens lenses were worn to correct vision after surgery.Now, we choose a microsurgical method, remove the turbidity in the lens under the microscope, keep the capsular bag, and implant the artificial lens, so that the postoperative vision can be restored quickly.In recent years, phacoemulsification has been developed on the basis of the latter.

([-]) Prevention

1. Eight countermeasures
(1) Wear sunglasses: Sunglasses can block ultraviolet rays and prevent it from damaging the eyes, mainly the lens, thereby reducing the occurrence of cataracts.When choosing sunglasses, the lenses must have UV protection. Elderly people with decreased vision after the age of 60, such as wearing yellow-brown sunglasses, can help prevent further loss of vision and the occurrence of cataracts.

(2) Drink plenty of water: When the human body is dehydrated, the normal metabolism of fluid in the body is disordered, and some abnormal chemical substances will be produced, which will damage the lens and lead to cataracts. For patients with existing cataracts, dehydration can aggravate the condition .Therefore, you should add more water.

(3) Take more vitamins: the content of vitamin C in human eyes is about 30 times higher than that in blood.With age, the nutrient absorption function and metabolism function gradually decline, the lens is malnourished, and the vitamin C content drops significantly, which will cause lens degeneration over time, leading to cataracts.Taking 100-200 mg of vitamin C per day can prevent cataracts.

(4) Less salt: Control the daily salt amount at 3 to 5 grams, which can play a better preventive role.

(5) Appropriate use of aspirin: Appropriate use of aspirin can also slow down the progress of cataract, and it should be controlled at 0.1-1.0 mg/day per kilogram of body weight. However, this drug is more irritating to the gastric mucosa, so it should be Take after meals.

(6) Smoking less: It is well known that long-term smoking can lead to lung cancer, but few people know that smoking can also cause cataracts.Studies have shown that the occurrence of cataracts in long-term smokers is also significantly higher than that of non-smokers.It is more pronounced in pipe smokers.

(7) Prevention of illness in early pregnancy: Mothers should beware of colds, fever, rubella, urticaria, etc. during pregnancy, especially within the first 3 months of pregnancy.The physical and mental health of pregnant women within three months of pregnancy can reduce the occurrence of congenital cataracts.

(8) Control blood sugar: If blood sugar control is unstable in diabetic patients, it is easy to cause eye diseases, such as cataracts, fundus hemorrhage, glaucoma, etc.Therefore, blood sugar should be controlled within the ideal range.

2. The Four Rules
(1) Pay attention to eye protection to prevent mechanical and radiation damage to the eyes, and educate children not to fight with sharp objects or play with dangerous toys.

(2) Use the eyes without feeling tired, and pay attention to the correct eye posture, distance, and whether the light source is sufficient.Every time you use your eyes for an hour or so, let your eyes relax, such as closing your eyes and resting your mind, walking around, looking at the sky or far away, etc., so that your eyes can get a rest.Try not to work in a dark environment for a long time.

(3) Insist on regular eye massage, and you can do eye exercises for eye acupoint massage.Through massage, it can accelerate the blood circulation of the eyes, improve the immunity of the eyeballs, and delay the development of crystal turbidity.

(4) Keep your mind at ease.It is necessary to avoid excessive emotional agitation, maintain a comfortable mood, ensure smooth circulation of Qi and blood throughout the body, and improve the body's ability to resist diseases.

[-]. Point massage

([-]) Acupuncture therapy

1. Select acupoints Jingming, Chengqi, Sibai, Taiyang, Tongziliao, Sizhukong, Yuyao, Yangbai, Cuanzhu, Fengchi, Hegu, Guangming.

2. Positioning
Jingming—the depression slightly above the inner canthus corner of the eye.

Chengqi—Look straight down the pupil, between the eyeball and the infraorbital rim.

Sibai - look straight down the pupil, in the depression of the infraorbital foramen.

The sun—the midpoint between the tip of the brow and the outer canthus of the eyes, in the depression one inch backward.

Pupil Liao—next to the outer canthus of the eye, at the outer edge of the orbit.

Sizhukong - face, brow depression.

Fish waist - look straight up with the pupils straight up and in the eyebrows.

Yangbai—Look straight up with pupils, 1 cun above eyebrows.

Cuanzhu—in the center of the brow, at the supraorbital notch.

Fengchi - the nape, under the occipital bone, the depression between the sternocleidomastoid muscle and the upper end of the trapezius muscle.

Hegu—the back of the hand, at the midpoint of the radial border of the second metacarpal bone.

Bright—outside of the calf, 5 cun above the tip of the lateral malleolus, on the front edge of the fibula.

([-]) Self-massage
1. Wipe the eyes with the fingers of both hands starting from the Yintang point, from the upper and lower eye sockets and eyeballs to the temples, and press harder on the Yintang and the sun, and the operation lasts for 5 minutes.

2. Rub the eyeballs Gently rub the eyeballs with the fingers of both hands for 1 minute.

3. Acupuncture Points are pressed on the above-mentioned points, taking the degree of soreness as the degree, and each point is 1 minute.

4. Use the thumbs of both hands of Fengchi to tap the Fengchi points on both sides, taking the degree of soreness as the degree, and operate for 1 minute.

rhinitis
An overview of the disease

Rhinitis refers to inflammation of the nasal mucosa and submucosal tissues.The manifestations of rhinitis are various.From the pathological changes of the nasal mucosa, there are rhinitis sicca and atrophic rhinitis.From the severity of the onset and the length of the course of the disease, it can be divided into acute rhinitis and chronic rhinitis.In addition, there are some rhinitis, although the onset is slow and the course of the disease lasts for a long time, but there are specific causes of the disease, so they have specific names, such as allergic rhinitis (that is, allergic rhinitis), drug-induced rhinitis, etc.The characteristics of various rhinitis are briefly introduced as follows:
([-]) Acute rhinitis

Acute rhinitis refers to acute infectious diseases of nasal mucosa and submucosa, commonly known as "cold" and "cold", often accompanied by inflammation of the upper respiratory tract of the pharynx, larynx and trachea.The condition usually improves gradually after 7 to 14 days.Those with strong resistance can heal themselves without treatment.This disease is popular, and is often related to seasons, environment and climate change, and is generally the most prosperous in spring, autumn and winter, when the climate changes.

1. Etiology and pathogenesis The disease is often caused by virus infection. The common pathogenic viruses are rhinovirus, adenovirus, influenza virus, parainfluenza virus, coronavirus, etc. Among them, rhinovirus and coronavirus infection are the main causes of the disease.When the body's resistance decreases due to systemic and local factors, the defense function of the nasal mucosa is destroyed, and the virus invades and causes the disease.

(1) Incentives

① Systemic factors: Most of them have a history of cold exposure, excessive smoking and alcohol, overwork, vitamin deficiency, endocrine disorders and other systemic chronic diseases.

② Local factors: chronic nasal diseases and adjacent infection lesions, such as chronic tonsillitis, chronic suppurative sinusitis, deviated nasal septum, etc.

2. Clinical manifestations At the beginning of acute rhinitis, the nasal cavity is dry and painful because of nasal mucosal vasoconstriction and mucosal ischemia.Half a day or one day later, the blood vessels in the nasal mucosa begin to dilate, and the secretion of the glands increases, leading to nasal congestion and a large amount of clear water nasal discharge. At this time, it is often accompanied by symptoms such as fever, headache, sore limbs, and loss of appetite.Examination showed congestion of nasal mucosa, red and swollen turbinates, and mucus secretions remained in the nasal passages.In the later stage, leukocytes exudate in large quantities, and the mucosal epithelium sheds and oozes out. These exudates accumulate on the mucosal surface, forming purulent secretions.The whole process takes about 1-7 days to fully recover.However, if the rest is not good and the treatment is not timely, it may aggravate the condition and cause complications.

3. Integrative traditional Chinese and Western medicine can be used to treat acute rhinitis.

(1) Whole body treatment: drinking plenty of water, soaking feet in hot water, hot bath, etc.The diet is light, digestible and nutritious.Those with severe symptoms should stay in bed.Early sweating therapy can relieve symptoms and shorten the course of the disease. It can be taken hot with ginger, brown sugar, and scallion decoction.Antipyretic analgesics and Chinese patent medicines can also be used to relieve symptoms.In addition, if there is a bacterial infection or suspected complications, antibiotics should be used for treatment.

(2) Local treatment: vasoconstrictors such as 1% (0.5% for children) ephedrine saline nasal drops can be used to reduce swelling of the mucous membranes and reduce nasal congestion and smooth drainage.

In addition, the correct method of blowing the nose should be adopted: squeeze one side of the nose tightly and gently blow out the nasal mucus from the opposite nasal cavity; or inhale the nasal mucus into the pharynx and then spit it out.

4. Prevention
(1) When a cold is prevalent, take two large walnuts, take the meat, cut into fine pieces, add some sugar, brew with boiling water, cover, and simmer for 5 minutes.Take walnuts and soup while hot, 2-3 times a day.

(2) The residence is always open, so that the living room receives more sunlight and maintains air circulation.

(3) Strengthen exercise, carry out outdoor sports appropriately, enhance physical fitness and make righteousness abundant, so as to resist the invasion of external evils.

(4) When the disease is prevalent, children are prohibited from going to shopping malls, theaters, parks and other public places.

(5) When the disease is prevalent, you must wear a mask when you go out.Eating more green onions, garlic, ginger, etc. has a preventive effect.

(6) Remove the lesions of the upper respiratory tract, and actively treat sinusitis, tonsillitis, chronic pharyngitis and other diseases.

(7) During the epidemic of colds, the bedroom can be disinfected by paraffin fumigation.

([-]) Chronic rhinitis

Chronic rhinitis is a chronic inflammation of the mucosa and submucosa of the nasal cavity.Relatively early chronic rhinitis often manifests as chronic congestion and swelling of the nasal mucosa. If chronic simple rhinitis develops into the hyperplasia and hypertrophy of the nasal mucosa and turbinate bone, it is called chronic hypertrophic rhinitis.

1. Chronic simple rhinitis is a common frequently-occurring disease, developed from acute rhinitis.Reversible inflammation of the nasal mucosa is associated with bacterial secondary infection, incomplete treatment, and recurrent attacks.

(1) Etiology and pathogenesis: Chronic rhinitis can develop from repeated episodes of acute rhinitis or incomplete treatment, or long-term stimulation or deformity of adjacent chronic inflammation, resulting in poor ventilation or drainage obstruction in the nose.

(2) Clinical manifestations

① Nasal congestion: It is characterized by intermittent, generally alleviated during the day, during labor or exercise, and aggravated at night, when sitting still or cold; and alternately, when lying on the side, the nasal cavity in the lower side is blocked, and the nasal cavity in the upper side is well ventilated. On the other side, nasal congestion appeared in the nasal cavity on the lower side.

②Much tears: often mucus, and purulent ones are more common after secondary infection.In addition, there are symptoms such as hyposmia, headache, dizziness, closed nasal sound when speaking, and throat discomfort when nasal mucus flows backward into the throat, and excessive "phlegm".

(3) Treatment principles

①Etiological treatment: Find out the systemic and local etiology and treat it in time; protect the environment, improve working conditions, and eliminate occupational pathogenic factors; exercise and improve resistance are active treatment methods.

②Local treatment: Nasal drops of vasoconstrictors can be used, or block therapy, or rinse the nasal cavity with warm saline, etc.

(End of this chapter)