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.

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.

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.

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.

Sandwich教学法在中医骨伤科专科护士实践的应用

目的探讨Sandwich教学法在中医骨伤专科护士实践的应用效果。方法选择40名中医骨伤科专科护士学员为研究对象,采用随机数字表法平均分为Sandwich教学法带教组(实验组)和授课为基础的教学法(LBL)带教组(对照组)。培训结束后比较两组学员理论考核、中医个案护理考核和操作考核的成绩,并调查学员对教学效果的评价。结果实验组的理论考核、中医个案护理考核以及操作考核成绩均高于对照组,差异有统计学意义(P<0.05)。与LBL教学法相比,绝大多数学员认为,应用Sandwich教学法能提高辨证施护能力、解决问题能力、思维开放能力、临床管理能力以及人际沟通能力。结论Sandwich教学法在中医骨伤科专科护士的实践教学中效果较好,值得进一步推广应用。

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.

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.

传统手法结合距下关节镜复位与经跗骨窦入路治疗SandersⅡ型跟骨骨折的疗效比较

【目的】探讨中医传统手法结合距下关节镜复位与经跗骨窦入路治疗SandersⅡ型跟骨骨折的临床疗效。【方法】将80例SandersⅡ型跟骨骨折患者随机分为对照组和研究组,每组各40例。对照组给予跗骨窦切开复位钢板内固定治疗,研究组给予中医传统手法结合距下关节镜复位螺钉内固定治疗。比较2组患者的手术情况(包括术中出血量及手术时间)、术后疼痛程度视觉模拟量表(VAS)评分、骨折愈合时间、并发症发生情况的差异以及手术前后足部功能美国足踝外科学会(AOFAS)踝-后足评分、Böhler角、Gissane角的变化情况。【结果】(1)研究组的术中出血量较对照组明显减少,术后疼痛程度VAS评分较对照组明显降低,手术时间及术后骨折愈合时间较对照组明显缩短,差异均有统计学意义(P<0.05或P<0.01)。(2)术后3、6、9个月,2组患者的AOFAS踝-后足评分均较术前明显提高(P<0.05),且研究组患者术后3个月和12个月的AOFAS踝-后足评分均明显高于对照组,差异均有统计学意义(P<0.05或P<0.01)。(3)术后3、6、12个月,2组患者的Böhler角、Gissane角均较术前明显增大(P<0.05),且均逐步恢复至正常范围内;组间比较,研究组术后3、6、12个月对Böhler角的改善作用均明显优于对照组(P<0.05),而2组患者术后各时间段的Gissane角比较,差异均无统计学意义(P>0.05)。(4)研究组的并发症发生率为7.50%(3/40),明显低于对照组的27.50%(11/40),差异有统计学意义(P<0.05)。【结论】针对SandersⅡ型跟骨骨折患者,采用中医传统手法结合距下关节镜螺钉内固定及跗骨窦切口进行治疗,均有良好的效果,但相对于后者,前者更微创,可有效缩短手术时间及骨折愈合时间,降低并发症发生率,患者术后疼痛程度更轻,医疗体验更优。中医传统手法结合距下关节镜螺钉内固定治疗SandersⅡ型跟骨骨折符合当前微创的潮流,也是将中医传统手法与现代微创技术相结合的尝试。

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。

中医筋骨理论中筋与骨的关系内涵探讨

中医骨伤科学具有鲜明的特色,其中筋骨理论对指导临床具有重大的意义。筋骨理论是中医骨伤科学的经典理论,但筋骨理论散在记载于各经典中,筋与骨内涵关系尚未有系统的阐述,尤其是生理、病理、治疗原则上的关系均为零散阐述。本文综合文献认为筋骨理论筋与骨内涵关系主要表现在:生理上相辅相成,体现为筋骨和合、骨正筋柔、筋强骨壮、筋骨互用等;病理上相互影响,体现为筋弛骨痿、筋滞骨错、骨错筋挪、骨断筋离等;治疗上同辨同治,体现为:理筋正骨、筋骨并重、筋骨平衡、调衡筋骨、根源同治等。骨伤临床实践遵循筋骨理论的指导原则,无论内治或外治,均需要辨病辨证结合,同时“辨骨、辨筋”相结合。

腰椎间盘突出症上海中医骨伤流派临床诊疗专家共识

腰椎间盘突出症(lumbar disc herniation,LDH)是临床常见病、多发病,严重影响患者的正常生活[1]。LDH发病率很高,全世界范围内有2%~3%的普通人群受其影响,且以25~60岁人群多发[2]。目前LDH的治疗大体分为手术治疗与非手术治疗,均有较好的疗效,但前者适应证严格、费用高、术后恢复期长,相比之下,非手术治疗创伤小、安全性高,患者接受度高。

《“十四五”中医药发展规划》背景下中医骨伤科学专业研究生的培养方案研究

《“十四五”中医药发展规划》公布,明确提出在新时期将全力助推中医药事业振兴发展。在此背景下,我国对高素质中医药人才的需求日益增加。中医骨伤科学是传统中医药的重要组成部分,但在当前中医骨伤科学专业研究生的培养方案下,培养出的研究生对中医传统治疗方法掌握较少、专业素质较弱,很难满足新时代对中医骨伤科学优秀人才的需求。文章对新时代背景下,对中医骨伤科学专业研究生的培养方案进行探索,以期提高研究生专业能力,培养出高素质中医药人才。

黄河文化视域下的中医骨伤流派研究

黄河流经不同地域,形成了各具特色的地域文化及中医药文化。黄河流域中医骨伤流派是中医学重要组成部分,千年来植根于黄河文化的沃土,结合当地地域特色,形成了各具特色的学术流派,推动了黄河流域骨伤科学的发展。通过文献资料研究黄河文化视域下各骨伤流派的历史渊源、特色及其对地方医学的贡献,探究黄河文化与学术流派的传承与发展,加深对黄河流域中医骨伤流派的认识,对推动中医骨伤科学发展,促进中医药传承与创新具有重要意义。

中医骨伤科学课程思政教学模式探析

以习近平新时代中国特色社会主义思想为指导,为贯彻落实党的二十大、全国教育大会、全国高校思想政治工作会议精神,全国高校要加强课程思政建设,将课程思政教育融入专业课程之中。中医骨伤科学是中医临床医学的一门重要学科,中医骨伤科学开展课程思政具有重要意义。通过探讨中医骨伤科学开展课程思政的教学模式,为提升中医骨伤科人才培养质量提供可行的教育教学方法。

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。

中医正骨学古今教学特点刍议

中医正骨学是一门技术性学科,在古今都占有着重要的医疗地位。文章针对中医正骨学的古代和现代教学特点进行讨论,并根据发展的实际情况分析教学模式的变化特点,以便更好地保持我国中医药治疗的特色和优势,使中医正骨学保持学科特色、发挥学科优势,充分利用现代科学技术,走在科技的前线,与现代高新技术相结合,促进其教学发展。

“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。

独活寄生汤治疗痹症研究进展

独活寄生汤是唐代著名医家孙思邈《备急千金要方》中治疗风寒湿痹的经典名方,其临床应用广泛且疗效较好。药理学研究已证实独活寄生汤不仅可以抗炎镇痛、调节免疫、干预氧化应激、促进骨代谢,在抗阿尔茨海默病、抗肿瘤、扩张血管,改善循环等方面也具有明显疗效。古代医家多用该方治疗痹证日久,肝肾两虚,气血不足,正虚邪实者。现代医家已将该方广泛用于治疗类风湿性关节炎、膝骨关节炎、腰椎间盘突出症、骨质疏松、骨折、腰背痛、神经根型颈椎病等骨伤科疾病。同时有研究表明,独活寄生汤联合针灸、手法、艾灸、中药熏洗等,疗效更为显著。随着现代医学技术和中西医结合的发展,后世医家的不断探究,独活寄生汤治疗痹症的地位和发展进程不断受到认可和推进。多项实验研究已证实,独活寄生汤的药理作用和治疗痹症的临床效果。现从药理作用及该方在痹症中的临床应用对近十年独活寄生汤相关37篇文献进行梳理,研究探讨独活寄生汤的应用,为临床应用提供更为科学的参考。

立德树人目标导向下《中医骨伤科学》课程思政教学的建设与优化

推进《中医骨伤科学》课程思政建设,要积极挖掘《中医骨伤科学》课程中蕴含的德育资源,寻找将思想政治教育融进《中医骨伤科学》课程中的契合点、结合点。《中医骨伤科学》是一门二级临床学科,是中医药文化的重要组成部分。文章将挖掘、整理《中医骨伤科学》中存在的思政元素,并将思政元素与《中医骨伤科学》有机融合。通过课程思政的建设,可以更好地培养医学生的“大医精诚”精神,引导学生们对中国传统文化的了解和热爱,激发他们对中医的兴趣和传承。主要从以下方面开展课程思政建设:提高《中医骨伤科学》教师的政治素质与人文素养;建立《中医骨伤科学》思政教育的课程教学方案;调整《中医骨伤科学》的评价体系;把握时代脉搏,不断改进和创新实施课程思政教学与专业融合。