Gender: male
Age: 18 years old
Chief complaint: blurred vision, myopia for more than 2 years, aggravated 1 month.
History: The patient's vision was blurred due to eye fatigue for two years, and he was afraid of being near and far away. In recent 1 month, his symptoms worsened, and his eyes were mushy and painful when he read more books, so he came to the acupuncture department of our hospital for treatment.
Physical examination: Vision examination: left eye 0.3, right eye 0.3, pale tongue, thin coating, thin pulse.
Diagnosis of traditional Chinese medicine: can be near and afraid of being far away.
Modern medical diagnosis: myopia.
Acupuncture treatment:
Treatment: dredging collaterals, improving eyesight and relieving pain.
Prescription: old-age care and light.
Treatment course: Take the upper acupoints for routine disinfection, and perform the method of flat reinforcing and purging. Hold the needle in your right hand and put it into the hole, wait for its breath, and twist it evenly before and after, without unidirectional twisting, with even finger force, with the frequency of 60~90 rpm, repeated operation 1 min, leaving the needle for 30 minutes, once a day, and 10 is 1 course of treatment.
Ask the patient to go home and massage the acupoints around the eyes, such as bright eyes, bamboo, yang white, weeping and four white, and ask the patient to pay attention to eye hygiene and look at the distant scenery to avoid eye fatigue. After treatment 1 course, the visual acuity recovered to 0.8 in the right eye and 0.8 in the left eye; After two courses of treatment, the binocular vision recovered to1.2; After persistent treatment 1 month, the visual acuity of both eyes recovered to 1.5. Follow-up for 3 months showed no recurrence of symptoms.
(editor's or author's) note/comment/remarks
Myopia refers to a kind of ametropia in which parallel light enters the eye without accommodation and focuses on the retina after being refracted by the refractive system. It is characterized by clear near vision and blurred far vision. At present, the incidence of myopia among young students is increasing year by year, which is mostly caused by teenagers' incorrect learning posture, eye fatigue caused by watching TV or computer for a long time, and the ciliary body is in a state of tension for a long time.
Traditional Chinese medicine recognized this disease earlier. In Ming Dynasty, Wang Kentang called it "near qu" in "Criterion of Syndrome Treatment and Seven Tips". In the Ming Dynasty, Fu Renyu's Examining Yao Letter and Lu Jiping's Notes on Clinical Diseases in Ophthalmology also called him nearsightedness and fear of distance.
There are many discussions on the etiology and pathogenesis of this disease in the medical books of Chinese medicine in the past dynasties: Chao Yuan Fang's Treatise on the Sources of Diseases in Sui Dynasty holds that the inability to see far is caused by "strain on viscera and deficiency of liver qi". Wang Haizang said: "You can't be farsighted, blame it for no fire, and the law should be used to replenish your heart." Examining Yao Letter not only follows the previous theory that Yang deficiency is far from enough, but also points out that myopia can be caused by "deficiency of liver meridian and kidney meridian disease", and mentions that "observing and receiving can lead to near vision" and "long-term eye injury can lead to near vision", which has a more comprehensive understanding.
"Jin Jian, a Medical Doctor, Essentials of Ophthalmology" points out: "Myopia is clear, farsightedness is faint, and insufficient sunshine is invaded by yin." "Lecture Notes on Ophthalmology of Modern Chinese Medicine" says that "the reason why the eyes can see everything is because the essence of the zang-fu organs is focused on the eyes" so that they can be full of light and see things normally.
In a word, myopia is mostly due to deficiency of heart yang or spleen deficiency and weak qi, and the eyes can't go farther; Or because of long-term blood injury, exhaustion of sight and gallbladder, deficiency of liver and kidney, the eyes are out of support, so that Guanghua can only see near instead of far.
In this case, the acupoints for the aged in the middle range are the acupoints of the hand-sun meridian, which is divided into two branches upward at the branch of the basin, one is the outer canthus of the eye, and the other is the oblique canthus of the eye (the zygomatic epiphysis), which is connected with the foot-sun meridian, just as the point for the aged in the book "Ode to All Diseases" is good at treating eye diseases; "Tongren Acupoint Acupuncture and Moxibustion Illustration" also includes: "The treatment of old-age care is unclear", so it is taken to regulate qi and promote blood circulation, relax tendons and dispel cold, dredge collaterals and relieve pain;
Guangming point, which means "bright, bright and bright", is the collateral point of the gallbladder meridian of foot shaoyang, which has the function of connecting qi and blood of liver and gallbladder, and can treat the diseases of both liver and gallbladder at the same time. The chapter of Lingshu Pulse Degree says that "the liver opens its eyes" and "the liver and qi pass through the eyes" show that the liver are closely related to the eyes, and the liver and gallbladder are both exterior and interior, and the gallbladder meridian follows. Myopia is due to the deficiency of Yang-qi, so acupuncture at this point can soothe the liver and relieve depression, so as to promote the stagnation of liver and gallbladder meridians, reconcile qi and blood, make people feel happy and restore their eyes. It has been highly praised by doctors since ancient times and is an important point for treating eye diseases.
The experimental study on the influence of acupuncture at Guangming point on eye circulation made by modern scholars shows that acupuncture at Guangming point can dilate the central retinal artery and increase the blood flow velocity, suggesting that it can increase the circulating blood volume of retina. It can be seen that whether from the perspective of traditional Chinese medicine or modern scientific research, acupuncture at Guangming point can stimulate menstrual qi, make eye qi and blood flow smoothly, and make eyes fully nourished. The two points are matched for the upper and lower diseases, and the points are selected from a long distance, which plays the role of improving eyesight and is commonly used for treating myopia by Cheng Lao.
In this case, the young patients were instructed to pay attention to eye hygiene, look at the distant scenery more, avoid excessive eye fatigue, and insist on massaging the points around the eyes, such as bright eyes, bamboo storage, yang white, weeping, four white eyes, swollen eyes and silk bamboo holes.
Among them, Jingming point can dredge collaterals and improve eyesight, and treat myopia, color blindness, optic atrophy and night blindness; Save bamboo points to treat myopia, tears, conjunctivitis and eyelid tremor; Yangbai point treats ametropia; Chengqi point treats myopia and astigmatism; Sibai points soothe the liver, benefit the gallbladder, dispel wind and improve eyesight, and treat red eyes, swelling and pain, and nebula; Treating ametropia, night blindness and keratitis with pupil; Silkworm bamboo cavity is used to treat unclear vision. It is found that long-term self-massage of the above points can increase the blood supply of the peripheral arteries, improve the blood supply obstacles, improve the blood circulation of the eyes, make the fundus tissues get sufficient nutrition, relieve the fatigue and spasm of the ciliary muscles, improve the nutritional status of the eye muscles, restore the adjustment ability of the ciliary muscles to the lens, and thus improve and restore the vision.
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