[转]提高针灸临床诊断水平的重要性及其方法的思考

1、转提高针灸临床诊断水平的重要性及其方法的思考objective to improve the clinical diagnostic level of acupuncture and its methodsthere are many factors influencing the curative effect of acupuncture the author thinks there are 3 main aspects: first, whether the diagnosis is correct; two, whether the treatment is appropriate:

2、 three, it is related to the functional state of the patient the study on compatibility of acupuncture point selection, operation time, operation method and the pa.tient，s functional status is discussed a lot, now the author raise the clinical diagnosis level of acupuncture slightly to express1 clin

3、ical diagnosis of acupunctureonly a short while ago, acupuncture is considered as simple, convenient and cheap, safe and effective therapy in the country, z，small needle curezz is almost known to all. the seriousness, complexity, limitation and danger of acupuncture treatment have been neglected. so

4、me people learn simple acupuncture techniques and then take care of them they give treatment or autonomy to the cause, pathogenesis, diagnosis, differential diagnosis and prognosis of the disease some people opened abroad at present, there are many foreign students come to study china acupuncture, m

5、any of whom do not have medical background or low educated personnel, that after a short training graduation clinic, making clinical acupuncture practitioners quality level uneven in quality therefore, in some countries, the status of doctors has not acknowledged that some western countries in weste

6、rn medicine practitioners do not understand western diagnostic grounds, requiring patients by western diagnostic checks, and then can be recommended for the treatment of 1 with acupuncture i do not deny the positive side, the popularity of acupuncture education brings in domestic and abroad, however

7、, acupuncture as a normal medical treatment, should be serious and its scientific nature, especially practitioners domestic acupuncture regular hospital should have the quality and cultivation of medical moral good, and constantly improve the level of medical technology.in clinical practice, the wor

8、k of acupuncturist has its particularity. first, because there is no inside and outside, women, children, facial features and other professional restrictions, the treatment involved a department of general hospital patients, comprehensive treatment of the object, causing difficulties for the in-dept

9、h study of various professional acupuncturists; secondly, the heavy task of treatment many patients seek acupuncture treatment before, more or less have received western medicine or traditional chinese medicine treatment, because some diseases have little effect, they hope to be placed in acupunctur

10、e treatment. doctors need daily hands-on treatment of a large number of patients, in the face of economic problems and busy tasks and treatment in recent years, increasingly simplified treatment process, some doctors, often become doctors and assistants, students flow form, to comprehensively grasp

11、the diagnosis and treatment of patients some doctors are getting acupuncture and western medicine diagnosis began in the diagnosis of traditional chinese medicine acupuncture treatment, will not essential some training courses and foreign students, because of the lack of solid basic knowledge of tra

12、ditional chinese medicine and western medicine, only with rote in the teacher behind, keen to learn the secret of acupuncture acupoints and other simple tricks over time, acupuncture will inevitably lead to heavy treatment, light diagnosis, and the tendency to simplify acupuncture treatmentthe autho

13、r believes that to maintain sustainable development in acupuncture, it is not easy for an acupuncturist to become a high level physician. to improve the level of acupuncture treatment, diagnosis and treatment are necessary.correct diagnosis and accurate evaluation of the condition are the premise of

14、 reasonable treatment in clinical, we should pay full attention to the training of diagnostic awareness otherwise, in the near future, the weight of acupuncture medicine will probably be greatly reduced, and the rest is probably just a simplified acupuncture therapy.2 importance of tcm diagnosisthe

15、process of tcm diagnosis, which is collected by the four diagnostic information of patients condition, then analyze and identify under the guidance of tcm theory, the comprehensive judgment process of disease and syndrome types among them, the identification of disease is the overall nature of the d

16、isease and pathogenesis of the whole process of understanding of the disease, syndrome differentiation is a disease in the course of development of a specific understanding of pathogenesis features because the pathological mechanism of the patient visits period is more specific from the disease diff

17、erentiation, therefore, syndrome differentiation has become an important basis for clinical treatment of chinese medicine.some people think that acupuncture treatment is different from traditional chinese medicine treatment, and there is no need for dialectical treatment the author believes that thi

18、s view does not conform to the guiding ideology of traditional chinese medicine the concept of holism and the treatment of syndrome differentiation are the basic characteristics of traditional chinese medicine although the word syndrome differentiation and treatment" as a special term in chines

19、e medicine appeared later, this academic thought has been guiding the clinical practice of tcm for thousands of years acupuncture is an important part of traditional chinese medicine, and its clinical behavior can not be separated from the guidance of tcm theory. it is only in the specific methods o

20、f differentiation that it should stress its own characteristics in fact, in addition to a small number of clinical acupuncture meridian sinew disease, most symptoms of acupuncture prescription, reinforcing and reducing methods of use, stimulation method selection, stimulation quantity and so on, all

21、 need to make choices in a premise of differentiation diagnosis, that is to say, the treatment measures are appropriate or not, depends largely on the the doctor certified diagnostic accuracy. at this point, the earliest ancient medical book "huangdi nei jing has been put forward in our country

22、. such as "lingshu > root knot" said: "with a needle to know that regulating yin and yang, regulating yin and yang, qi is light, and shape and gas, make god inside i work in the flat gas industry chaos pulse, working under the vast gas crisis ” "the twelve original" lings

23、hu > nine said: "where the needle, false is false, full of relief, in addition to chen wan, evil wins are false" "who will use the needle, first pulse gas, as the play easy, but also can cure it is obvious that the ancients paid more attention to the treatment of acupuncturein the

24、long term clinical practice, physicians of the past dynasties created many kinds of dialectical methods, each of which has its own characteristics and guides the diagnosis and treatment of various branches of tcm in the clinical diagnosis method of acupuncture and moxibustion, commonly used eight pr

25、incipal syndromes, syndrome differentiation of viscera, meridian differentiation and syndrome differentiation of qi and blood comprehensive dialectical method, especially the meridians, has an important guiding significance for the diagnosis and treatment of clinical acupuncture lingshu > meridia

26、ns long ago pointed out: "the meridians, so can i, at all, adjust the actual situation, not unreasonable, that attaches great importance to the theory of meridians however, the current clinical acupuncture point of view, we should admit, for the study of physiological function and meridian diff

27、erentiation diagnosis of meridian, yet to be perfect, there are still many problems to be solved, has not been well established and developed to adapt to the clinical diagnosis system of modern acupuncture and moxibustion,the current textbook of acupuncture and moxibustion is obviously not enough fo

28、r this discussion. many diagnostic and diagnostic contents are similar to those of internal medicine and other subjects it has not been able to highlight the characteristics of acupuncture and to a great extent divorced from the clinical practice of acupuncture and moxibustion, 2. zhou enhua 3 retri

29、eved clinical literature mainly acupuncture from 2001 to 2003, which involves the meridian syndrome differentiation articles account for a small proportion, indicating that the current clinical acupuncture meridians do not pay attention to the phenomenon is more serious, there is a blind pursuit of

30、western standards tendency, we should pay enough attention to thei have been in the national advanced acupuncture class, many times to listen to the famous acupuncture expert wang juyi teacher lectures, and with the clinic, deep feeling mr. wang believes that the specific points, experience points c

31、an cure all diseases the same kind of disease the acupoints can be varied, but the same point and can treat a variety of diseases, which requires differentiation, especially the meridians must learn, otherwise it will become ''carpenter needle teacher wang at first before acupuncture treatme

32、nt, tcm, especially on the surface of meridians and acupoints examination, through trial, digestion, circulation, according to the law, the children understand the meridian changes, looking for disease objective indications, on this basis, combined with clinical symptom analysis, and identify the cr

33、ux of the meridians and meridians of the specimens of the actual situation according to priorities, the mutual influence and function of viscera meridian theory, choose the most need to adjust the meridians, acupoints and treatment of the disease last because teacher wang's diagnosis of syndrome

34、 differentiation is careful, the compatibility of acupoints is accurate, so it can get good clinical effect though few acupoints are used in addition, the famous chinese medicine acupuncture expert guan zunhui teachers clinical treatment, but also attaches great importance to dialectical diagnosis,

35、under the premise of a clear dialectical, decided to choose acupuncture prescription, guiding the application of acupuncture techniques the teachers clinical trial disease, focusing on palpation, stressed at god, cha gas, the concept of color after years of clinical practice, the meridians are studi

36、ed deeply, summed up the meridian syndrome differentiation as the key link, twelve by the symptoms as the weft, pay attention to this differentiation, pay attention to skin, by a set of dialectical method of reinforcement theory in clinical application. in the meridian differentiation at the same ti

37、me, closely combined with the viscera differentiation, eight categories of syndrome differentiation, qi and blood syndrome differentiation and other dialectical methods, a comprehensive and detailed understanding of the disease, reflecting the integrity and flexibility of syndrome differentiation tr

38、eatment the teacher，s clinical syndrome differentiation is clear, and the selection of acupoints is few and the technique is unique4-5 has set a good example for us. how to improve the clinical diagnostic level of acupuncture and how to improve the quality of acupuncture treatment, wang juyi, teache

39、r, tube compliance teacher and many other famous acupuncture experts can give us good experience from one aspect their experience tells us that the senior acupuncturist needs to have a solid theoretical foundation of the system of traditional chinese medicine, spirit of clinical practice skills and

40、study days and months multiplying diligently exploration, diagnosis and treatment are indispensable, not a simple impetuous on the other hand, in addition to chinese traditional diagnostic methods, anomaly detection means we can also introduce the modern science and technology on meridians and acupo

41、ints were explored in this regard, many scholars have carried out active exploration 6,worthy of further attention.3 importance of clinical combination of traditional chinese medicine and western medicinetraditional chinese medicine and western medicine are both studies of human life phenomena in na

42、ture,it's just a matter of observing things from angles and ways of studying them the overall concept of tcm as the premise of the study, western medicine on reductionism as the basis of the study of traditional chinese medicine; focusing on the macro system, pay attention to the micro local chi

43、nese focus on western medicine; western medicine clinical experience, focus on the analysis of experiments, the 2 methods have advantages and limitations especially in modern times, western medicine, with the support of modern science and technology, has developed rapidly. in the face of this situat

44、ion, where will chinese medicine develop? a person with breadth of vision sound can be heard without end arguments each one airs his own views among them, in terms of tcm diagnostic methods, there are many thinkers, 7. the author believes that the two aspects including differentiation of disease and

45、 syndrome of tcm diagnosis should be complete, but the modern trend is that chinese medicine clinical treatment based on syndrome differentiation, and for disease research has not been in-depth, the original concept of tcm has been far from meeting the needs of today，s clinical development furthermo

46、re, both the tcm disease or syndrome, is under the guidance of tcm, starting from the overall concept, through the combination of all, from the analysis of dysfunctional angle between human organs and organs, the diagnosis, the diagnosis itself inevitably lack of physiological and pathological chang

47、es of specific anatomical entity objective therefore, the medical imaging and laboratory examination methods produced by modern science and technology are difficult to serve the theory of tcm in order to improve the diagnosis method of tcm, it is necessary to start with the theoretical framework of

48、tcm we hope that the modern acupuncture science which can reflect the theoretical viewpoint of tcm and utilize modern scienee and technology can be completed in no time at this stage, the clinical practice is the combination of traditional chinese medical diagnosis and western medicine diagnosis, wh

49、ich can make up for the deficiency of microscopic diagnosis of tcm of course, the study of tcm diseases and the methods of tcm diagnosis can not be stopped. western medicine should not be replaced by western medicine instead of traditional chinese medicine, but should be improved and developed. in m

50、any years of clinical practice, i recognize that it is very necessary for acupuncturist to learn basic methods of western medical diagnosis on the basis of learning and mastering the knowledge of traditional chinese medicine here is a typical case of the authot's experience.the patient, female,

51、was 65 years old. the main reason is that the lower right leg is numb for 1 weeks, and the left side of the mouth and eyes are skewed for 13 hours, and the right limb is weak for 4 hours. the department of traditional chinese medicine is closed past hypertension, history of cervical spondylosis admi

52、ssiondiagnosis: western medicine: cerebral infarction, hypertensive disease, iii cervical vertebra disease; traditional chinese medicine: stroke (meridian), liver wind phlegm type after admission to improve blood circulation, protect brain cells, expand blood vessels, lower blood pressure, tradition

53、al chinese medicine, such as weathering phlegm treatment, the patient，s right limb movements improved, but the left facial paralysis is still serious please consult the acupuncture department to assist in the treatment of facial paralysis consultation examination: left ear and mastoid tenderness, le

54、ft facial expression in peripheral facial paralysis, right upper limb muscle strength grade v - share, left upper limb muscle strength grade v, did not elicit bila teral pathological reflex head mr i showed that there were multiple cerebral infarction in bilateral basal ganglia, coronal region and p

55、arietal cortex. the abnormal signals in the left mastoid were considered as inflammatory changes. a history of ear disease, left ear hearing loss for a long time, has not been checked and treated, recently ear pain. according to symptom, sign and auxiliary examination,consider the facial paralysis w

56、ith cerebral infarction can not be explained, and may be related to ear disease department of ent consultation, examination by specialist and temporal bone ct confirmed that cholesteatoma was secondary to peripheral facial paralysis because of the conservative treatment can not solve the problem, ca

57、rry out surgical treatment the postoperative recovery was good and the symptoms of facial paralysis improved. the similar situation is not uncommon in clinical practice, the author in the ward, outpatient work has also seen a patient with a right waist and abdomen pain by acupuncture treatment, were

58、 diagnosed as abdominal aortic aneurysm; the other patients received acupuncture treatment for left oculomotor nerve palsy, found after intracranial aneurysm; and because of right flank pain treated withacupuncture after treatment, diagnosed with thoracic tumor; because of low back pain with acupunc

59、ture treatment, found for cancer and bone metastasis in this way, these cases were combined with western medical diagnosis before they were diagnosed and appropriate treatment measures were taken. "acupuncture clinical misdiagnosed chinese acupuncture" magazine in 2004 the third period published '"analysis of 4 cases with the author's personal experience to warn you, the first diagnosis responsibility put forward higher requirements on the acupuncturist, to a comprehensive and detailed history collection and analysis of the disease, as far as p