NUMERICAL INVESTIGATION OF EFFECT OF ROLLING MANIPULATION OF TRADITIONAL CHINESE MEDICAL MASSAGE ON BLOOD FLOW

The hemodynamic mechanism of rolling manipulation (RM) of traditional Chinese medical massage (TCMM) is investigated. An axisymmetrical nonlinear model and an arbitrary Lagrangian-Eulerian finite element method (ALE-FEM) with rezoning algorithm were introduced to study the viscous flow through an axisymmetrical rigid tube with axially moving stenosis to simulate the rolling manipulation. Flow rate and wall shear stress were obtained by solving complete Navier-Stokes equations numerically. The numerical results show that the stenosis moving frequency, namely the frequency of rolling manipulation, has great effect on the disturbance of flow and the wall shear stress. The stenosis coefficient, which characterizes the severity of the stenosis, another adjustable parameter in rolling manipulation, also shows the significant effect on flow rate and wall shear stress. These numerical results may provide some data that can be taken into consideration when massage is used in clinic.

Traditional Chinese spinal orthopedic manipulation

Traditional Chinese spinal orthopedic manipulation(TCSOM)is an external therapeutic method of traumatology and orthopedics of traditional Chinese medicine to treat trauma and set bone.The doctor exerts his force through thumb or bilateral upper extremities on the spine or acupoints of the patient,applying various manipulatory techniques according to the conditions.Correcting the abnormal position or state of the spine serve as the most important theoretical foundation for TCSOM to treat spinal disorders and spinogenic disorders.This paper presented the definition and function of the TCSOM,with a special focus on how to make a preliminary diagnosis of spinal segments disorders,and the indications of TCSOM in different spinal segments.

An exploration of the origin and flow of the development of traditional Chinese medicine orthopedic and chiropractic massage

Traditional Chinese medicine(TCM)chiropractic massage is a kind of orthopedic therapy that corrects the abnormal anatomical position of bone or joint and corrects the dislocation of joint by manipulation so that the bone is soft and the Qi and blood are reconciled(Qi:The intangible,high-mobility nutritive substance that maintains vital activities).Manipulation treatment is the first of the four major orthopedic diseases.At the same time,TCM chiropractic massage is also an essential part of TCM.TCM orthopedic chiropractic practice originated from the struggle between humanity and nature,sprouted from the Warring States period to the two Han Dynasty,formed in the Sui,Tang,and Song Dynasties,matured in the Ming and Qing Dynasties,and flourished in the modern era.In more than 2,000 years of development,many practical techniques have been produced,which have profoundly influenced the inheritance and development of modern techniques,making the TCM orthopedic chiropractic massage in the contemporary era form the characteristics of“tendon and bone”and“point-line-face combination”.At present,the development of TCM chiropractic massage is facing the great challenges of modern medicine and modern advanced science and technology such as American chiropractic and the limitations of its development.Therefore,in the future,the development direction of Chinese medicine orthopedic chiropractic massage should be“hybrid to treat”.In the face of modern medicine,we should take its essence to its dross,eclectic,organically integrate its advantages into itself,enrich its theoretical framework,and strengthen the construction of disciplines and departments to enhance its competitiveness.It is believed that Chinese medicine orthopedic chiropractic massage can have better development in the future and can make more contributions to the health of the world’s people.

Traditional Chinese medicine ointment combined with tuina therapy in treatment of pain and swelling after total knee arthroplasty

BACKGROUND The most effective treatment for knee joint pain is total knee arthroplasty(TKA),but the risk of pain and swelling in patients after surgery is high.Ice application,ankle pump exercise and non-steroidal anti-inflammatory painkillers are the primary clinical treatments after surgery.However,long-term use of nonsteroidal anti-inflammatory pain relievers can easily cause gastrointestinal damage.Traditional Chinese medicine(TCM)ointments and tuina therapy integrate TCM and manipulation,which effectively promotes the penetration of TCM into the skin lesions,improves local blood circulation and inflammatory reaction and has good long-term effects on patients.AIM To evaluate the efficacy of TCM ointment combined with tuina therapy in the treatment of pain and swelling after TKA.METHODS The randomized controlled clinical trial enrolled 80 patients who underwent TKA via the same procedure.The patients were randomly divided among the treatment group(n=40)and the control group(n=40).The control group was given an analgesia pump in addition to oral painkillers as the postoperative intervention.The treatment group received TCM ointment with tuina therapy in addition to the analgesia pump and oral painkillers in the postoperative period.The following variables were recorded 3 d before surgery and 3 d,7 d and 14 d after surgery:Visual analogue scale(VAS)score;skin temperature;circumferences at 15 cm above and below the patella;maximum active knee flexion angle;and the knee injury and Osteoarthritis Outcome score(KOOS).RESULTS After treatment,VAS was significantly lower in the treatment group than the control group at 7 d(t=7.536,P<0.001)and 14 d(t=8.563,P<0.001).The skin temperature of participants in the treatment group was significantly lower than that in the control group at 7 d(t=2.968,P=0.004)and 14 d(t=4.423,P<0.001).The circumference values of the two positions in the treatment group were lower than those in the control group at 7 d[t=2.315,P=0.023(above);t=2.121,P=0.037(below)]and 14 d[t=2.374,P=0.020(above);t=2.095,P=0.039(below)].After 14 d of treatment,the maximum active knee flexion angle and KOOS of the two groups were significantly improved but were significantly higher in the treatment group(P<0.05 for both).CONCLUSION TCM ointment and tuina therapy have significant advantages over standard care in the treatment of pain and swelling after TKA.This additional treatment may improve knee function but additional studies are needed to confirm our observations.

Traditional Chinese medicine manipulative reduction combined with percutaneous vertebroplasty for treating type Ⅲ Kummell's disease: A case report

BACKGROUND A patient with type Ⅲ Kummell’s disease had a ruptured posterior cortex of the fractured vertebral body, which caused spinal cord compression. An open surgery was considered the best choice of operation. However, the patient and her family refused open surgery and instead demanded a minimally invasive surgical treatment such as percutaneous vertebroplasty(PVP). After preoperative discussion, we finally adopted the novel therapy of traditional Chinese medicine manipulative reduction(TCMMR) combined with PVP.CASE SUMMARY A patient with type Ⅲ Kummell’s disease exhibiting bone block-induced spinal cord compression was admitted to our hospital. She suffered from a variety of medical disorders but refused open surgery, and instead asked for PVP surgery. TCMMR, in parallel with PVP, was used to restore the height of the compressed vertebral body and reduce the symptoms of spinal cord compression by the bone block in order to strengthen the vertebral body and prevent further collapse. The surgery was very successful. The height of the compressed vertebra was restored, and the symptom of spinal cord compression by bone block was reduced successfully via TCMMR. The fractured vertebra was solidified by the PVP. The pain visual analog score declined from preoperative 7 scores to postoperative 2 scores, and the Frankel spinal cord scale increased from preoperative D degree to postoperative E degree.CONCLUSION The new method has advantages in treating patients with type Ⅲ Kummell’s disease who cannot be treated with open surgery.

Operating procedures of traditional Chinese medicine breast massage

Traditional Chinese medicine breast massage,also known as breast Tuina or manual expression of breast milk,is a technique of using certain manipulations to act on specific positions or acupoints of the breast to promote blood and lymphatic circulation of breast and facilitate the discharge of stagnant milk.This technique is widely used in China to treat breastfeeding problems such as breast engorgement,mastitis,and postpartum hypogalactia.In this article,we introduce the definition and standardization process of breast massage,elaborate the operating procedures of breast massage in detail,and summarize and discuss the current situation of its clinical application,so as to provide a reference for its wide application and in‑depth research.

Effects of Chiropractic and Traditional Chinese Medicine in Treating Patients with Acute Postpartum Pubis Symphysis Pelvic Girdle Pain

[Objectives]To analyze and study the effects of chiropractic and traditional Chinese medicine on pain score and functional ambyiation category scale rating in patients with cervical spondylosis.[Methods]41 postpartum patients with acute pubic symphysis pelvic girdle pain were treated by Xiao Huoluodan Granules(orally taking one bag of Xiao Huoluodan Granules 20 g three times daily with 120-150 mL warm water after each meal),and combined with sacroiliac joint manipulation,muscle posture relaxation and muscle energy technique.[Results]After treatment,the pain score(VAS)was decreased and Holden walking function rating was improved(all P<0.001).[Conclusions]Chiropractic and traditional Chinese medicine therapy has a significant effect on the treatment of postpartum acute pubic symphysis pelvic girdle pain,and it can effectively relieve pain,improve postpartum quality of life and prevent postpartum complications.Due to its benefits,it is worthy of clinical promotion and application.

Effect of Chinese tuina massage therapy on resting state brain functional network of patients with chronic neck pain

Objective:Cervical disease,a type of chronic pain,can greatly impact quality of life.Traditional Chinese tuina,a form of therapeutic massage and manipulation,has been shown to be effective in relieving pain and other symptoms in patients with chronic neck pain.This study applied functional magnetic resonance imaging (fMRI) to explore the features of the resting state network of patients with chronic neck pain caused by cervical radiculopathy,and how tuina affects the causality between intrinsic brain networks.Methods:Using Granger causality analysis,effective connectivity of brain networks of 10 patients with chronic neck pain was compared with 10 healthy control subjects.Resting state fMRI data were using magnetic resonance scanning.Cervical spondylosis symptom scores were evaluated before and after 4 weeks of tuina therapy.Independent component analysis was applied to extract the specific networks related to sensation,execution,and cognition,including sensorimotor network (SMN),visual network (VN),auditory network (AN),anterior and posterior default mode network (aDMN,pDMN),left frontoparietal network and right frontoparietal network.Results:Compared with the control group,data from the treatment group revealed two major findings:before tuina therapy,SMN had a profound influence on aDMN and AN greatly affected pDMN;however,after 4 weeks of tuina therapy,aDMN and SMN showed reversed causality.Conclusion:Chronic neck pain caused by cervical radiculopathy may influence the DMN,which plays an important role in emotion,cognition,and memory,by stimulating the sensory afferent network.Tuina not only significantly relieves pain and discomfort,but also reverses the causality between aDMN and SMN.

Immediate effects of scalp acupuncture with twirling reinforcing manipulation on hemiplegia following acute ischemic stroke: a hidden association study

Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.

Reduction in nerve root compression by the nucleus pulposus after Feng's Spinal Manipulation

Ninety-four patients with lumbar intervertebral disc herniation were enrolled in this study. Of these, 48 were treated with Feng＇s Spinal Manipulation, hot fomentation, and bed rest （treatment group）. The remaining 46 patients were treated with hot fomentation and bed rest only （control group）. After 3 weeks of treatment, clinical parameters including the angle of straight-leg raising, visual analogue scale pain score, and Japanese Orthopaedic Association score for low back pain were improved. The treatment group had significantly better improvement in scores than the control group. Magnetic resonance myelography three-dimensional reconstruction imaging of the vertebral canal demonstrated that filling of the compressed nerve root sleeve with cerebrospinal fluid increased significantly in the treatment group. The diameter of the nerve root sleeve was significantly larger in the treatment group than in the control group. However, the sagittal diameter index of the herniated nucleus pulposus and the angle between the nerve root sleeve and the thecal sac did not change significantly in either the treatment or control groups. The effectiveness of Feng＇s Spinal Manipulation for the treatment of symptoms associated with lumbar intervertebral disc herniation may be attributable to the relief of nerve root compression, without affecting the herniated nucleus pulposus or changing the morphology or position of the nerve root.

Mining the rules of acupoint selection and manipulation scheme of massage in reducing or substituting drug treatment of simple obesity based on association rules and entropy cluster analysis

Based on the data mining of clinical literature,we analyzed the characteristics of Acupoint Selection and manipulation in the clinical treatment of“simple obesity”,in order to optimize the compatibility of clinical acupoints,simplify the manipulation,and summarize the core prescription of Massage in the treatment of simple obesity.Methods:First we search and screen the clinical literature of Chinese Massage therapy for“simple obesity”by scholars at home and abroad.Then we analyze the Acupoint Selection and manipulation rules of Chinese Massage therapy for“simple obesity”by using data mining technology and traditional Chinese Medicine Inheritance assistant system.Finally we obtain the optimal new prescription based on complex system entropy clustering and unsupervised entropy hierarchical clustering analysis.Results:Fifty-seven prescriptions meeting the inclusion criteria were selected,including TIANSHU(ST25)(36),ZHONGWAN(RN12)(32),GUANYUAN(RN4)(30),ZUSANLI(ST36)(27),QIHAI(RN6)(23),“Stomach Meridians”(10),“Spleen Meridians”(8),Renmai(7),Abdomen(36),Umbilicus(8),Pressing(33),Holding(27),Pressing(26),and get 4 core Prescriptions like ST25-RN12-Renmai-Stomach Meridians-Abdominal Rub-Rubbing-Pushing thumb-Rubbing-Palm Pushing-Thumb Point Acupuncture-Palm Vibration and 4 new prescription of Massage manipulation for the treatment of simple obesity.Conclusion:The results of clinical diagnosis and treatment data are mined and analyzed by traditional Chinese medicine inheritance assistant system.The acupoint compatibility,manipulation rules and core prescriptions obtained can provide statistical basis and references for clinical Massage manipulation in the treatment of simple obesity.

On English translation of infant Tuina points in traditional Chinese medicine

1 Introduction In recent years, several international standardized traditional Chinese medicine （TCM） nomenclatures have been published, including the major ones A Proposed Standard International Acupuncture Nomenclature by World Health Organization （WHO） in 1991, International Standard Terminologies on Traditional Medicine in the Western Pacific Region by WHO in the Western Pacific Region （WPRO） in 2007 and International Standard Chinese-English Basic Nomenclature of Chinese Medicinet31 by the World Federation of Chinese Medicine Societies （WFCMS） in 2007. However, an English translation of points applied in infant Tuina therapy is neither contained in any of these standardized nomenclatures,

基于筋骨理论对青少年颈痛的临床新思考

青少年颈痛症状类似于成人颈椎病,但其病理改变并不完全符合颈椎椎间盘退变。因此,应积极探索更符合其临床特点的病因学和病理学理论,实现临床对青少年颈痛的有效诊断与治疗。在石氏伤科百年治伤临床经验和最新科学研究认识的基础上,探讨青少年颈痛的诊断名称和基于“筋骨合和”理论的病因病机,并针对颈部“筋出槽、骨错缝”核心病机建立“四以相和”的诊治策略。

以小儿推拿学课程为示范的中医药院校课程思政探索

以小儿推拿学课程为示范,进行中医药院校课程思政的探索与实践,以寻求专业知识与思想政治教育的有机融合,培养具有优秀品质与德行的中医药专业人才。以2019级针灸推拿学专业学生为研究对象,在授课中深入挖掘课程中蕴含的思政元素并与专业知识相结合,结课后通过问卷调查及成绩考核评价课程思政效果。通过课程的学习,学生建立了专业认同感及医者的大爱精神和专业素养,并将医者人文精神运用到日常诊疗过程中。专业知识与思政元素的有机融合,对学生综合能力的提升有显著帮助。

基于“筋、节、骨、髓”分型探讨神经根型颈椎病的手法治疗

神经根型颈椎病(CSR)是一种由于颈椎间盘和椎间关节退变引起的疾病,主要表现为颈部、肩部及上肢神经支配区域的疼痛、感觉异常和运动障碍。传统中医的筋骨辨证在治疗该病时存在概念不清、辨证分型不一等问题。岐黄学者林定坤教授在筋骨辨证的基础上,结合现代解剖学提出了颈椎“筋”“节”“骨”“髓”4大分型。该文通过总结林定坤教授对CSR筋骨辨证学术思想,总结手法治疗该病的作用靶点,提出基于筋劳、节错、骨变和髓损等4种病损分型,采用理筋、调节、护髓和治骨4种手法治疗,以期完善骨伤科手法治疗CSR的辨证施治体系,为临床提供参考。

“乎井术”针刺疗法治疗慢性非萎缩性胃炎临床研究

目的:观察长桑君脉法“乎井术”针刺疗法对缓解慢性非萎缩性胃炎临床症状的临床疗效。方法:回顾分析2020年6月—2022年10月到广州中医药大学顺德医院顺峰山门诊和三门诊就诊,且治疗方案采用了长桑君脉法“乎井术”针刺疗法的慢性非萎缩性胃炎患者资料。比较患者治疗前后的中医证候积分,并统计临床疗效、症状缓解时间及不良反应。结果:治疗后患者腹痛、腹胀、胸胁胀痛、烧心、呃逆、恶心等中医证候积分均降低(P<0.05)。临床治疗总有效率91.71%。不良反应发生率0.55%。治疗后患者各不适症状均在2~4 min左右可得到缓解。结论:“乎井术”针刺治疗能迅速缓解患者临床症状,解除患者痛苦,操作简便,安全有效。

中医传统特色外治疗法在糖尿病周围神经病变患者中的应用进展研究

糖尿病周围神经病变(Diabetic Peripheral Neuropathy, DPN)广泛存在于糖尿病患者群体中,患者通常存在下肢麻木疼痛等感觉异常。DPN患者临床症状诸多,严重影响生活质量。临床针对DPN患者治疗方式多采用口服药物治疗为主,其临床应用效果具有一定局限性。中医传统特色外治法的出现为DPN治疗领域工作开展提供新思路,诸多特色外治疗法应用方式及功效均存在差异。该文主要从DPN发病机制及临床症状、中医对DPN的认识及中医传统特色外治疗法技术优势3个方面探究DPN及外治疗法临床应用意义,并从膏摩疗法、推拿疗法及针刺疗法3个维度探究外治法应用效果。以此为DPN患者治疗提供重要技术参考,满足DPN患者群体个性化治疗需求,凸显传统中医在治疗DPN领域中的价值。

中医骨伤手法联合桂枝新加汤治疗神经根型颈椎病的临床研究

目的 探讨中医骨伤手法结合桂枝新加汤治疗神经根型颈椎病(CSR)的效果及对炎症介质、疼痛及颈椎功能的影响。方法 前瞻性选取2022年2月至2023年2月林州市中医院收治的60例CSR患者为研究对象,按随机数表法分为观察组和对照组各30例,对照组患者采取中医骨伤手法,观察组患者采取中医骨伤手法联合桂枝新加汤治疗,均连续治疗两个疗程(一个疗程15 d)。比较两组患者的中医疗效,以及治疗前后的中医证候积分、视觉模拟评分法(VAS)、炎症介质[白介素-6 (IL-6)、白三烯B4 (LTB4)、肿瘤坏死因子(TNF-α)、白三烯C4 (LTC4)]水平、颈椎功能障碍指数(NDI)、生活质量简表(SF-36)评分和椎动脉血流速度(左右侧椎动脉血流量、血流速度),同时比较两组患者治疗期间的不良反应情况。结果 观察组患者的治疗总有效率为90.00%,明显高于对照组的66.67%,差异有统计学意义(P<0.05);治疗后,两组患者的中医证候评分和VAS分值均呈降低趋势,且治疗一个疗程后、两个疗程后,观察组患者的中医证候评分和VAS分值明显低于对照组,差异均有统计学意义(P<0.05);治疗后,两组患者的血清LTB4、LTC4、IL-6、TNF-α水平均呈降低趋势,左侧、右侧椎动脉血流速度、血流量均呈升高趋势,且治疗一个疗程后、两个疗程后,观察组患者的血清LTB4、LTC4、IL-6、TNF-α水平明显低于对照组,左侧、右侧椎动脉血流速度、血流量明显高于对照组,差异均有统计学意义(P<0.05);治疗后,两组患者的NDI分值均降低,SF-36分值均升高,且治疗两个疗程后,观察组患者的NDI分值低于对照组,SF-36分值高于对照组,差异均有统计学意义(P<0.05);观察组患者治疗期间的不良反应总发生率为13.33%,对照组为10.00%,差异无统计学意义(P>0.05)。结论 中医骨伤手法联合桂枝新加汤治疗CSR患者效果可靠,其可增加抗炎效果、调节椎动脉血流,从而减轻疼痛程度,改善临床症状,促进颈椎功能好转,且不良反应少。

中医推拿㨰法的上肢关节运动角度特征分析

目的 研究推拿医生㨰法操作中肩、肘、腕关节的运动学及关节协调性变化。方法 应用Vicon三维运动捕捉系统采集10名初学组和10名熟练组推拿医生㨰法操作的运动学数据,比较两组在推拿㨰法操作中肩、肘、腕关节的运动模式差异。结果 初学组与熟练组㨰法操作时,肘关节活动角度无显著差异(P>0.05),其主要差异为腕关节屈伸和肩关节内收外展角度不同,熟练组较初学组㨰法操作时肩关节内收外展活动角度显著更小(P<0.05),熟练组腕关节掌屈最大角度显著大于初学组(P<0.05)。结论 㨰法的运动学特征主要为腕关节屈伸,肘关节和肩关节旋转,㨰法操作主要是前臂旋转与腕关节屈伸的复合运动,熟练组的“沉肩”操作要领掌握更好。

名老中医手法治疗神经根型颈椎病经验述要

神经根型颈椎病(CSR)属中医学项痹、颈项痛、项肩痛等范畴,当代名老中医手法治疗该病经验丰富、疗效显著。本文通过梳理国家级、省级、市级名老中医手法治疗CSR相关文献,总结名老中医对CSR的病因病机认识,分析其以手法治疗CSR时遵循的原则,提炼其特色手法操作,为传承发展名老中医手法治疗CSR学术思想奠定基础。参考文献34篇。