Cervical spondylosis refers to a group of syndromes caused by degenerative changes in the bones, cartilage, and ligaments of the neck that involve the surrounding or adjacent spinal cord, nerve roots, blood vessels, and soft tissues.
I. The etiology of the disease is mainly due to the daily life, long time bad posture led to cervical degenerative lesions, stimulation or compression of the spinal cord, nerve roots or blood vessels caused by a series of clinical manifestations.
II. Clinical manifestations and diagnosis
1. Clinical manifestations
(1) Nerve root type: due to the stimulation of the nerves innervating the upper limbs, the shoulders and upper limbs are numb and painful, and the fingers are inactive, and can't complete the movements of chopsticks and fastening buttons well.
(2) Spinal cord type: in the early stage, the lower limbs are numb, inactive, difficult to walk, and the feet feel like "stepping on cotton", and in the later stage, it can develop into urinary and fecal disorders, and the upper limbs are numb and weak.
(3) Sympathetic type: dizziness, headache, blurred vision, panic, abnormal sweating, whimpering in the ears.
(4) Vertebral artery type: due to the irritation of the vertebral artery, resulting in insufficient blood supply to the brain, manifesting dizziness, headache, which can be suddenly aggravated by turning the head or even fainting (transient coma).
(5) Mixed type: two or more types exist at the same time.
2. Diagnosis Clinical manifestations and X-ray findings are consistent with cervical spondylosis, the diagnosis can be confirmed. However, if there are no clinical complaints and signs, but abnormalities appear on the X-ray film, the disease should not be diagnosed.
Three, diagnosis and treatment
1. External evil paralysis obstruction type
Diagnosis of head, neck, shoulder, back and limb pain, pain in a fixed place, like heat and evil cold, neck stiffness, activity is limited, the back of the neck can be touched to the stripes and pressure points, upper limbs heavy and weak, accompanied by symptoms such as head sinking, chest tightness, dullness and so on. The tongue is normal or dull, obese or with teeth marks, and the pulse is sluggish or slippery.
The treatment is to dispel wind and dispersing cold, and to remove paralysis by relaxing the meridians and collaterals.
The formula of remission soup plus and minus: qiangwu, roasted astragalus 15g, wind, angelica, red and white peony, turmeric 12g, roasted licorice, ginger 6g, sumac 10g.
Added subtractions, if the pain is severe, the cold evil is more prevalent, add the system of Chuanwu, appendicia, Xin Xin, Gui Zhi; if the dampness of the predominantly victorious, can be added Haitongpi, Siegesteria, Lutong.
2. Phlegm-dampness obstruction type
Identification of head and neck pain, shoulder and arm pain and discomfort, heavy limbs, accompanied by a heavy head and brain swelling, chest and epigastric fullness, less food and more sleep. The moss is white and greasy, and the pulse is dull and smooth.
The treatment is to dry dampness and dissolve phlegm, regulate qi and clear the channels.
Prescription refers to the fans of Poria Pill plus flavor: Poria, Dilong, Chenpi 12g each, Scutellaria, Schisandra, white mustard seed, gallbladder 10g each, Platycodon grandiflorus 6g, ginger and half-sia 9g.
Added subtractions if both see the stasis of blockage of the meridians, discretionary addition of panax notoginseng, Andrographis paniculata, Dilophylaxus; If both see the wind-cold, discretionary addition of Gui Zhi, Qiangwu, Lingxien, etc.; if both see the vertigo, addition of tianmu, atractylodes macrocephala, and also see the chest paralysis, add danshen, guaoshen, the chest paralysis, the chest is full of sleep. If there is also vertigo, add Tianma and Baijiu; if there is also chest paralysis, add Danshen, Guayu and Yu Jin.
3. Qi stagnation and blood stasis type
Identification of head, neck, shoulders and back and limbs numbness, tingling, pain in a fixed place, refusing to press, aggravated at night, accompanied by dizziness, blurred vision, insomnia and forgetfulness, vigilance and restlessness, chest tightness and chest pain, irritability, color of the face is not gorgeous. The tongue is purplish and dull, or with petechiae, and the pulse is mostly fine and stringy.
The treatment is to activate blood circulation, remove blood stasis and dredge the meridians.
The formula of Huayu Tong Tong is 18g of Angelica sinensis and Pueraria Mirifica, 30g of Salviae Miltiorrhizae, 21g of Corylus officinalis and 21g of Turbinariae, 9g of Mammillariae, 12g of Radix et Rhizoma Gastrodiae, 10g of Andrographis paniculata.
Additions and subtractions: if the patient has cold, add Gui Zhi (cinnamon branch), Cao Wu (Prepared Chuan Cao Wu) and Cinquillum officinale; if the patient has heat, add Fructus Bidentatae (Fructus Bidentatae) and Radix et Rhizoma Gastrodiae (Fructus Bidentatae); if there is deficiency of qi, add Astragali; if phlegm and dampness are present, add Radix Bidentatae (White mustard seed), If there is also chest paralysis, add Allium cepa, Yu Jin, Gua Puzu, half-sia.
4. Weakness of qi and blood type
Identification of head and neck pain and discomfort, numbness and numbness of the shoulders and arms, sleeplessness and dreaming, spontaneous sweating and night sweating, dizziness, palpitations and shortness of breath, less colorful, the symptoms of the female patients are aggravated after menstruation or menstrual disorders. The tongue is pale, the moss is thin and white, and the pulse is weak.
The treatment is to benefit qi and nourish blood, and to promote palsy.
The formula of Astragalus and Gui Zhi Wu Wu Tang Plus: 15g of Astragalus, 12g of each red and white peony, 10g of Gui Zhi, 6g of powdered deer horn (divided and swallowed), 15g of chickweed vine, 6g of ginger, and 4 jujubes.
Additions and subtractionsIf it is accompanied by rheumatism, add Wei Ling Xian, Turbinaria, Pueraria Mirifica, Qiang Wu, fried Cang Er Zi, etc.; if it is accompanied by stasis of blood, add Dilong, peach kernel, safflower, angelica tail, etc.; if it is accompanied by renal deficiency, add Epimedium, Cuscuta chinensis, dog's spine, etc.
5. Liver and kidney deficiency type
Identification of shoulder and neck discomfort, swelling and pain in the head, dizziness, tinnitus, can not turn around, accompanied by mental fatigue, forgetfulness, sleeplessness, lumbar and knee pain and weakness. The tongue is thin, reddish-red, with little or no moss, and the pulse is stringy.
The treatment is to benefit the essence and tonify the kidney, nourish Yin and calm the wind.
The formula Zuo Gui Wan is flavored with 15g each of Radix Rehmanniae Praeparata, Rhizoma Dioscoreae, Rhizoma Dioscoreae, Fructus Lycii, 12g each of Cornu Cervi Pantotrichum and Radix Paeoniae Alba, 10g each of Semen Cuscutae, 9g each of Radix Angelicae Sinensis and Radix et Rhizoma Glycyrrhizae, 24g each of Semen Aristolochiae,
Adding and subtracting if rheumatism is present at the same time, add Radix Rehmanniae Praeparata, Radix Aristolochiae Praeparatae, and Rhizoma Dioscoreae.
Four, adjuvant treatment
1. The adult medicine prescription six flavors of dihuang pill, ginseng nourishing pills, Jin Gui Kidney qi pills, Yunnan Baiyao, Bundai Pills, Yuan Hu pain tablets, chasing the wind through the bones of the pill, the great living Luo Dan.
2. prescription
(1) with Pueraria lobata, black beans, snake shedding, black sesame, ginseng, antler velvet, ripened earth, astragalus, walnuts, goji berries, licorice, white wine, each appropriate amount. Medicine immersed in wine within 1 month, serving 15ml, 2 times a day, 1 month for a course of treatment.
(2) with chuanxiong rhizome, thorn mustard, dahuric dahurica, qianghao, fengfeng, xinxing, mint, licorice, tea, each appropriate amount, add water and decocted into a thick paste, each serving 2g, 3 times a day; 2 months for a course of treatment.
(3) with white peony 240g, 90g, 90g, Pueraria Mirifica, peach kernel, safflower, frankincense, myrrh 60g, licorice 30g, the medicine is finely powdered water pan as a pill, each serving 3g. 3 times a day, 1 month for a course of treatment.
(4) Pueraria lobata 30g, scorpion 12g, centipede 2, snake, red peony, rhizoma ligustici, natural copper, perforated dragon, papaya 15g, deer with grass 30g, black fungus 15g, licorice 6g. all the medicines decocted in water, 1 day, morning and evening, 2 times to take.
(5) the whole scorpion 9g, centipede 2, deer containing grass 30g, snake, angelica, rhizoma ligustici, natural copper 15g. water decoction to take, 1 dose a day, 2 times, 10 days for a course of treatment. 2 ~ 3 courses of treatment cured.
3. Acupuncture and moxibustion prescription
(1) neck and shoulder pain hemp: large vertebrae, wind, wind pool, shoulder wells, shoulder calvary, quchi, hand Sanli, outside the Guan, Hegu and so on.
(2) headache: according to the different parts of the headache, take different points.
①For those with pain in the back of the head, the points chosen are: the back of the top, Tianzhu, Fengchi, Fengfu, Kunlun and the most obvious parts of the pain.
②For migraines, the acupoints to choose are: Fengchi, Taiyin, Rate Valley, Qushu, Cephalic Dimension and the painful parts.
③ For people with pain at the top of the head, the acupoints to choose are Baihui, Anterior Parietal, Tongtian, Xingmai and the painful part.
④ For those with pain in the front of the head, the acupoints of choice are: Shangxing, Touwei, Yintang, Hegu and the site of pain.
(3) Heart panic: Heart Yu, Shenmen, Tongli, Juque, Neiguan, Spleen Yu, and Foot Sanli, etc., all of which are slowly needled. If there is distraction and irritability, it can be combined with Taixi and Sanyinjiao; if there is shortness of breath and inability to lie down, it can be combined with Lung Yu and Shakuzawa; if there is abdominal distension and discomfort, it can be added with acupuncture in the middle epigastric region.
4. External treatment formula acupressure, large vertebrae point, shoulder well point, wind pool point, 2 to 3 times a day, 10 to 15 minutes each time.
Fifth, regulate
(1) Improve and adjust the sleep state. People spend 1/3 of their time in bed every day, and improper sleep posture will aggravate the pressure within the cervical disc, fatigue the ligaments and muscles around the cervical vertebrae, and induce cervical spondylosis. In order to maintain the normal physiological curve of the cervical spine during sleep, attention should be paid to children:
①The height of the pillow should be moderate. Pillow shape to the middle of the low, high at both ends of the Yuanbao-shaped good, this shape is the advantage of the neck can play a relative role in braking.
②Sleeping position should make the chest, waist to maintain a natural curvature, double hip, double knee flexion, so that the whole body muscle relaxation.
③Select a bed that maintains the balance of the spine, and a Simmons bed with a wooden base is preferred.
(2) Correct and change the bad position at work. Cervical spine degeneration and cervical spine long time in flexion or a particular position has a close relationship. Poor posture can lead to a series of symptoms caused by increased pressure in the intervertebral discs. There are a few suggestions for long time workers:
①Regularly change the position of the head and neck, reading and writing for 30 minutes after the neck should be active, look up and look away for half a minute, help to ease the tension of the neck muscles, but also to eliminate eye fatigue.
②Adjust the height and tilt of the desktop. Can make a desktop and desktop was 10 ° ~ 30 ° of the sloping work plate, work can reduce the cervical spine and cervical spine forward bending and cervical spine interspace pressure.