Needle knife therapy
1. Body position: prone position. Underbelly pillow when necessary.
2. Body surface signs: the position of the hump's highest point, to grasp the following signs:
(1) the seventh cervical spine process is the lower part of the neck, the most prominent point at the junction of the thoracic vertebra and cervical vertebra, and the number of this process is up and down.
2. The highest point of the two iliac crest line for the fourth lumbar spine process.
(3) both sides of the subscapular Angle line level the 7th thoracic spine process. The superior Angle of the scapula is connected by the spinous process of the 3rd thoracic vertebra.
(4) with the finger along the 12th rib to the spine touch, and the intersection of the spine for the 11th thoracic vertebra.
(5) refer to the neck, chest, lumbar spine anterolateral X-ray assisted localization.
(1) fixed point for correction of spinal deformity:
The first acupotomy was performed at the highest point of the hump, with a total of 9 points in the upper and lower vertebrae between spines and transverse processes.
The second needle operation was performed at 6-9-12 at the highest point of the hump, between the spine and the transverse process.
The third acupotomy was performed at the lower segment of the first acupotomy, the superior spinal ligament, the interspinous, intertransverse interarticular capsule, the erector spinal muscle, and the multifissure muscle, at 6-9-12.
The fourth needling operation was performed at the upper segment of the second needling operation, interspinous intertransverse intercostal joints, cyclotron muscles, etc., at 6-9-12.
And so on. When the spine of the hump section of all acupotomology released, can start again from the highest point, set at 6-9-12, continue treatment, until the cure.
(2) correction of contracture point of soft tissue outside the spine:
A. Abdominal point: rectus sheath, subcostal arch and pubic symphysis, all selected its pain point.
B. Thoracic point: the point of tenderness at the junction of sternum and costal cartilage.
C. Lumbar fascia tenderness point: 12 subcostal and iliac bone wing tenderness point.
D. Other soft tissue contracture points: such as abdominal, external oblique, lower serratus, etc.
4. Routine skin disinfection, gloves, sterile cloth, needle knife operation.
5. Needle knife operation:
(1) interspinous point: knife edge line parallel to the longitudinal axis of the spine, needle knife body and skin vertical penetration. After the acupotomy reached the interspinous ligament, the line of the knife edge was rotated 90°, and the bone surface of the upper margin of the lower spinous process was cut and peeled several times.
(2) the point between the transverse process: knife edge line and the body of the longitudinal axis parallel. The acupotomy body and the skin surface penetrate vertically, reaching the transverse protrusion bone surface. Adjust the needle knife to the lower margin of the transverse process, turn the knife edge line 90°, cut and peel the intertransverse process ligament and intertransverse process muscle along the lower margin of the transverse process, until the knife becomes loose.
(3) rib transverse node: the spinous process to lower side open 2-2.5 cm, to the line of the mouth parallel to the longitudinal axis of the spine into the bone surface into the joint space, longitudinal cut until there is a sense of relaxation.
(4) rib arch under point: in the rectus sheath blade line parallel to the longitudinal axis in the body, the needle knife body and the leather face perpendicular to Pierce the skin, the blade close to the edge of the ribs, fumble, taking a sample hard toughening fascia tissue is reached before the rectus sheath, adjust the blade line parallel to the rib arch, cut open along the edge of rib arch bone surface rectus sheath knife, vertical and horizontal spin off again, have a loose feeling.
(5) anterior sheath of rectus abdominis pubic symphysis point: the line of the knife edge is parallel to the longitudinal axis of the body, and the needle knife body and the skin surface are vertically penetrated to the upper edge bone surface of the pubic symphysis. The line of the knife edge was rotated 90° to make it parallel to the bone surface of the upper margin of the pubic symphysis. Incision and dissection were performed along the bone in front of the anterior sheath of rectus abdominis.
6 sternum and costal cartilage junction tenderness point: edge line and the longitudinal axis of the sternum parallel, needle knife body and skin surface vertical, piercing subcutaneous, direct to the bone surface, the junction of the costal cartilage and sternum incision and dissection, depth is not more than 0.5cm.
(7) lumbar dorsal fascia 12 costal edge point: the knife edge line is perpendicular to the lower edge of the rib (about 15° ~ 30° Angle with the lower segment of the spine), the needle knife body and the skin surface are punctured vertically to the surface of the 12th rib. Adjust the needle knife to the bone surface of the lower rib edge 12, turn the knife edge line so that it is parallel to the lower rib edge, cut and peel along the bone surface of the lower rib edge until there is a sense of looseness under the knife.
8 lumbar fascia iliac ridge edge point: knife line and the body vertical axis parallel, needle knife body and skin vertical, piercing the iliac ridge bone surface. Adjust the blade to the bone surface of the upper edge of the iliac crest, turn the line of the blade so that it is parallel to the bone surface of the upper edge of the iliac crest, cut and peel until loosening is felt under the knife.
Never put off till tomorrow what you can. The acupotomy was covered with sterile dressing and fixed.
Client supine, two doctors against traction. One person inserted two hands under the patient's bilateral armpits to support the back, pulled the side of the thoracorib, and pressed double forearms on the patient's bilateral shoulders. The other person holds the patient's upper ankles with both hands and holds the patient under traction for 1 minute against traction.
Next, pull bosom rib to press shoulder doctor to do not move, the doctor that holds ankle-bone instead is fixed before iliac superior spine, two people instantaneous at the same time press 3 ~ 5 times can. After returning to the ward, pelvic traction was performed in supine position. In addition to traction, upper thoracic lesions can walk on the ground. For thoracolumbar junction and lumbar section, do not get out of bed for 3 weeks.
Chen yanping doctor acupotomy treatment of common diseases :(1) a variety of soft tissue adhesion, contracture, scar and caused by the limbs of the trunk of the body of some stubborn pain; (2) partial bone spurs (or hyperosteogeny); (3) bursitis (4) sequelae caused by injury of limbs and trunk; (5) early myositis ossificans (including calcification of muscular ligaments); (6) various tenosynovitis; (7) cumulative injuries of muscles and ligaments; (8) traumatic muscle spasm and muscle tension (non-brain-derived); (9) sequelae of surgical injury; (10) sequelae of pathological injuries; (11) malunion of shaft fractures. Comprehensive disease, especially good at acupotomology treatment of various cervical and lumbar diseases; Periarthritis of shoulder. Osteoarthritis of the knee; Apoplectic sequelae; Tennis elbow and other acute and chronic soft tissue pain and facial paralysis, facial muscle spasm; Gastritis; Insomnia; Asthma; Urticaria and other difficult diseases.
For the technique of needle knife and whether application of anesthetic, the doctor of traditional Chinese medicine, western medicine and traditional Chinese and western medicine combined with education background of physicians have their own understanding, to talk about my opinions below: needle knife therapy in clinic, I insisted on no anesthesia or drugs such as hormones, first is to avoid drug damage to the patients, especially the joints, joints, tendons, ligaments and other drug easily cause brittle harden, causes the sequela of similar closed; Secondly, the use of drugs is not easy to get the patient's cooperation, resulting in acupotomology efficacy greatly discounted. The last point is that acupotomology can hardly stimulate the meridians of the human body after the use of drugs, thus affecting the role of acupotomology in dredge the meridians. Most of the acupotomology books require the acupotomology clinician to release the acupotomology accurately to the anatomical site or even the very dangerous place, such as the spinal canal. Once the operation is wrong, the consequences are the most serious. The reason is that acupotomology doctors are overconfident (mostly doctors born in western medicine) and pursue the treatment of loosening the yellow ligament, circumferential occipital muscle and spinal canal, while ignoring that acupotomology is the product of integrated Chinese and western medicine. Small acupotomy is a small therapeutic instrument that integrates acupuncture needle and scalpel, so it can play the role of needle and knife separately in clinical practice, or play the comprehensive effect of acupotomy jointly.