20 years of dedicated research on "lingshu"

The 2018-12-14 health

Vertigo is a common disease. It was first translated into Chinese by French doctor Meniere in 1861, so it has the name of Meniere's syndrome and Meniere's disease, and has been used till now. Led by professor fan binghua from the third affiliated hospital of zhejiang university of traditional Chinese medicine, the team of national famous traditional Chinese medicine inheritance studios found that the disease was described in huangdi neijing · lingshu jing more than 2,000 years ago. "Ling shu · wei qi" records: "on the empty is dizzy"; "Linshu · sea theory" said: "if the sea of marrow is insufficient, the brain turns to tinnitus"; "Lingshu · oral inquiry" thinks: "lack of qi, the brain is dissatisfied with it, the ears for the bitter sound, the head for the bitter tilt, the eyes for the dazzle. These three verses show that vertigo is associated with "upper deficiency", "insufficient medullary sea" and "insufficient qi".

According to anatomical studies, intracranial tissue is mainly supplied by two blood vessels, one is the internal carotid artery which mainly supplies the brain, the other is the vertebrobasilar artery which supplies the cerebellum and medulla oblongata. In the case of decreased blood volume of vertebrobasilar artery, professor fan binghua proposed the hypothesis that whether labyrinth ischemia would also lead to unstable walking, dizziness, head weight, head swelling, headache, blurred vision and other symptoms. The team since 1999, after 20 years, more than 2000 patients with vertigo (minimum age 26 years old, biggest 83 years old) with vertebral basilar artery transcranial doppler (TCD) combined with the vertebral artery CT angiography three-dimensional reconstruction (3 d - CTA), to carry out the job is vertigo of vascular pathology study, found that the coincidence rate reaches 90%, and there are 335 species of vertebral basilar artery pathological change form.

Vertebrobasilar artery

There are 32 morphological changes

The results showed that there were 32 morphological changes in the morphological changes of vertebrobasilar artery. The details are as follows:

1. The initial segment of vertebral artery (V1 segment) refers to the part of vertebral artery ascending along the medial scalenus anterior muscle after it divides from the subclavian artery and penetrates into the 6th cervical transverse foramen. There were 6 types of abnormal vertebral artery perforation, vertebral artery perforation, vertebral artery tortuosity, vertebral artery hemangioma, calcification of vascular wall, and vertebral artery origin.

2. The internal segment of vertebral artery foramen (V2) refers to the part of vertebral artery passing through the transverse foramen of cervical vertebra and ascending to the part passing through the intervertebral foramen of the 1st cervical vertebra (atlas). There were 6 types of vascular calcification, including slender diameter of vertebral artery, absence of vertebral artery, local compression of vertebral artery, traction of vertebral artery by fibrous band, structural variation of transverse foramen of vertebral artery, and so on.

3. Vertebral artery atlantooccipital segment (V3 segment) refers to that after the vertebral artery penetrates the transverse atlas foramen, the vertebral artery notch (vertebral artery groove) of the atlas circulates inward, and penetrates the part between the occipital tuberosity and mastoid process medial to the occipital foramen magnum. There are 9 types of vertebral artery, including slender diameter, spasm of vertebral artery, absence of vertebral artery, abnormal perforation of vertebral artery, distortion of vertebral artery, abnormal structure of atlas transverse foramen, formation of loop loop of vertebral artery and vein, limited stenosis of vertebral artery, and double-branch deformity of vertebral artery.

4. Vertebral artery intracranial segment (V4 segment) refers to the part of both vertebral arteries ascending from the perforation of the occipital foramen to the anterior segment of basilar artery anastomosis. Vertebral artery vascular slender, vertebral artery vasospasm, vertebral artery intermittent enhancement, vertebral artery is absent, not ahead of cerebellar artery after separation, vertebral artery vascular adhesion, vertebral artery did not match, limitation of vertebral artery stenosis, vertebral artery hemangioma, vertebral artery hemangioma with calcification, vertebral artery calcification 11 types.

According to the statistics of the incidence rate of each physiological segment in the morphological and pathological changes of vertebrobasilar artery, the initial segment (V1) accounted for about 15%, the foramen segment (V2) accounted for about 20%, the atlantooccipital segment (V3) accounted for about 5%, and the intracranial segment (V4) variation accounted for about 60%.

"1 + 2" diagnosis method

The coincidence rate of massage validation was over 95%

Professor fan binghua's research team formed a simple and clear "1+2" diagnosis method based on the rules of morphological and pathological changes of vertebral artery and the rules of clinical symptoms. The diagnosis method is divided into two parts: the main symptom and the secondary symptom. Advocate disease lasts 7 days above with giddy namely, or giddy repeatedly attack (necessary symptom). Secondary symptom sees thing namely blurred, or dazzling, eye bilges; Tinnitus, or earplugs, hearing loss; Atlas occipital pain, or acid, swelling, paresthesia; Nausea or vomiting. When diagnosing, accord with giddy advocate disease, accord with 2 in secondary disease and above, can make clear diagnosis. After dual examination by vertebrobasilar doppler examination and three-dimensional reconstruction technology of vertebrovascular CT angiography (3d-cta), the efficacy was verified by massage, and the diagnostic coincidence rate was more than 95%.

Three-part massage

The main manipulation was the lesion side

The research team based on vertebral basilar artery various physiological period of vascular morphology characteristics and law of pathological changes, combined with meridian courses of traditional Chinese medicine and acupuncture effect, explore the start (V1) open source flow method, the hole section (V2) balance compensation method, atlas pillow (V3) spasmolysis unobstructed, targeted for three parts to massage therapy. Because the technique of intracranial segment (V4 segment) could not be reached, atlantooccipital segment (V3 segment) was included in the treatment.

1. Open source and flow increasing method: 1 inch was taken from the cervical arm point and the upper clavicle socket and the basin point (see the 1974 edition of Shanghai college of traditional Chinese medicine, acupuncture and moxibustion), corresponding to the pathological changes in the initial segment (V1) of the vertebral artery. Manipulation was mainly performed on the lesion side, and the meditative method was performed inward and downward, limited to the patient's tolerance. The operation of this site can release the surrounding soft tissue, relieve the compression or stimulation on the initial segment of vertebral artery, and play a role of "open source flow enhancement".

2. Compensation and balance method: two cervical segments (C1~C6) cervical jiaji acupoints were taken, which were located at the facet joint of the cervical spine, close to the transverse foramen of the cervical spine, corresponding to the pathological changes in the internal segment of the vertebral artery (V2). Manipulation is mainly on the lesion side, with the contralateral side as the auxiliary. The left hand pushes the right side, and the right hand pushes the left side, so that the action force is applied to the facet joint, which is limited by the patient's tolerance. This operation can relieve the stimulation of facet joint on vertebral artery, and complement both sides, improve the blood supply of vertebral artery, and play a role of "balance compensation".

3. Spasmolysis unobstructed method: fengchi point (located in the suboccipital triangle, the upper depression of sternocleidomastoid and trapezius) was taken to correspond to the pathological changes of vertebral artery atlantooccipital segment and intracranial segment blood vessels (V3 and V4 segments). With the ulnar side of the thumb, push the left hand to the right and the right hand to the left, and make the manipulation force apply to the atlantooccipital joint, so as to relieve the compression or stimulation of the atlantooccipital fascia and vertebral occipital muscle on the blood vessels and play the role of "spasmolysis and patency". Massage for 5 ~ 7 minutes for each part.

The manipulation was mainly on the lesion side, and the intensity was appropriate to the patient's perception of obvious acid distension at fengchi point, and the one-finger zen partial frontal push was used to push along the atlantooccipital joint toward the spine. This acupoint is the intersection point of foot shaoyang and yangwei veins. Yangwei veins are zyang veins, which are conducive to the rise of Yang qi, while the rise of bile qi is conducive to the injection of qi and blood into the head, so as to dredge the meridians and collaterals, harmonize qi and blood, improve eyesight, remove dizziness and stop dizziness. The key technique of this department is to directly release the spasm of surrounding soft tissue, promote the absorption of inflammatory substances, remove the stimulation to the vertebral artery, relieve the spasm, so as to achieve the effect of "spasmolysis unobstructed".