《小儿推拿秘诀》对中医推拿学的贡献

明代医家周于蕃辑录、整理的《小儿推拿秘诀》,系统地总结和阐释了明代以前的推拿手法和经验,确定了手臂等推拿部位与脏腑的联系,首次提出推拿渐进适应原则,确立了先后次序以及手法的分类及适应症,对发展小儿推拿术起到了十分重要的作用。

试论经筋理论对推拿治疗腰椎间盘突出症的指导意义

在推拿治疗腰椎间盘突出症的理论与临床研究中,多从传统经络腧穴理论或现代生物力学理论寻找理论依据或突破口,而关于经筋理论对推拿治疗本病的指导却少有涉及与研究。事实上民间尤其是部分少数民族地区却广泛流传着应用经筋理论通过寻找并弹拨经筋结聚处的方法来治疗各种疼痛性疾病的经验。基于此,文章从经筋理论基本概念、经筋理论对腰椎间盘突出症病因病机的认识以及指导如何选取推拿操作部位、如何运用推拿手法等几个方面,就经筋理论对推拿治疗本病的指导意义这一问题进行了探讨。

Observation on therapeutic effect of acupuncture at abdomen acupoints plus tuina for lumbar intervertebral disc herniation

Objective: To observe the clinical efficacy of acupuncture at abdomen acupoints plus tuina for lumbar intervertebral disc herniation (LIDH). Methods: A total of 70 patients with LIDH were randomized into an observation group and a control group, with 35 cases in each group. The observation group was treated with acupuncture at abdomen acupoints plus tuina, while the control group was treated only with tuina treatment. The clinical efficacy was observed after one course of treatment. Results: The cure rate and the total effective rate of the observation group were 83.3% and 96.7%, respectively. The cure rate and the total effective rate of the control group were 39.4% and 78.8%, respectively. There were significant differences in the cured rate and the total effective rate between the two groups (both P<0.05). There was no significant differenee in Japanese Orthopedic Association (JOA) score between the two groups before treatment (P>0.05). After treatment, the JOA scores of both groups in creased sign ifica ntly, and the in tra-group differe nces were statistically sign ifica nt (both P<0.05);the JOA score of the observation group was significantly higher than that of the control group (P<0.05). Conclusion: Acupuncture at abdomen acupoints plus tuina has a better therapeutic effect than tuina alone in the treatment of LIDH.

Therapeutic observation on tuina at head and abdomen for headache due to phlegm turbidity

Objective:To observe the clinical efficacy of tuina at head and abdomen for headache due to phlegm turbidity.Methods:A total of 56 patients with headache due to phlegm turbidity were randomized into a tuina group and a Chinese medicine group by the random number table,with 28 cases in each group.The tuina group was treated mainly with tuina at the head and abdomen,while the Chinese medicine group was treated with oral administration of Ban Xia Bai Zhu Tian Ma Tang(Pinellio,Atractylodes Mocrocepholo and Gastrodio Decoction).The course of treatment was 30 d.The scores of headache index,traditional Chinese medicine syndrome scale,and the therapeutic efficacy were observed.Results:There were 2 dropouts in each group during treatment.The total effective rate was 92.3%in the tuina group,significantly higher than 76.9%in the Chinese medicine group(P<0.05).The scores of headache index and traditional Chinese medicine syndrome scale in both groups decreased after treatment(both P<0.05),and scores in the tuina group were lower than those in the Chinese medicine group(both P<0.05).Conclusion:Tuina mainly at head and abdomen is effective in treating headache due to phlegm turbidity,and has a better effect than Ban Xia Bai Zhu Tian Ma Tang(Pinellia,Atractylodes Macrocephalo and Gastrodio Decoction).

Tuina for primary insomnia： a meta-analysis

Objective： To systematically evaluate the therapeutic efficacy of tuina therapy for primary insomnia. Methods： Nine Chinese and English databases were searched from the inception to May 2017 to identify randomized controlled trials （RCTs） studying tuina therapy for insomnia. The enrolled articles were all RCTs with tuina as the monotherapy or major therapy in the experiment group, with clear diagnostic criteria for primary insomnia well recognized worldwide or in China, and Pittsburgh sleep quality index （PSQI） as one of the outcome measures. Two researchers evaluated the risk of bias and quality of the enrolled studies by following Cochrane Handbook version 5.1.0. The meta-analysis was performed by RevMan version 5.3. Results： Eleven studies were included with a total of I 076 participants. The Western medication adopted in the control groups were benzodiazepine receptor agonists. The studies were all assessed as high risk of bias for blinding since blinding method was unable to be performed due to the specificity of tuina therapy; no study reported the support of fund or potential interest conflict, so they were all rated unclear for selective reporting. The meta-analysis showed that compared with other traditional Chinese medicine therapies, tuina worked more effectively in reducing the PSQI score （MD=-4.11〈O, 95% confidence interval （CI） -6.01 to -2.22, P〈0.O001）; compared with oral administration of Western medication, tuina showed more significant efficacy in reducing the PSQI score （MD=-3.42〈0, 95%CI -5.19 to -1.66, P〈0.O001）. Subgroup analysis showed that head tuina alone showed no significant difference compared with oral administration of Western medication regarding the change of PSQI score （MD=-4.19〈O, 95%CI -8.87 to 0.50, P〉0.05）; a combination of head and back tuina could more effectively reduce the PSOJ score compared with oral administration of Western medication （MD=-2.08〈O, 95%CI -3.09 to -1.06, P〈0.O001）. Conclusion： Tuina can produce more significant efficacy in treating primary insomnia compared with other traditional Chinese medicine therapies and oral administration of Western medication, especially the combination of head and back tuina.