▲Zhao Shifu, a famous traditional Chinese medicine doctor in Guangdong Province, chief physician of traditional Chinese medicine, former vice president of Zhanjiang Second Traditional Chinese Medicine Hospital, director of the Department of Orthopedics, director of Zhanjiang Institute of Orthopedics and Traumatology, has been engaged in clinical teaching and scientific research of traditional Chinese medicine for 50 years, founded the "Zhaoshi Balanced Chiropractic Method", and won the second prize of international medical techniques, the gold medal of well-known Chinese doctors, the honorary titles of "Star of National Medicine" and "Good Doctor of Southern Guangdong". He has presided over 12 scientific research projects, published 50 academic papers, participated in the editor-in-chief and published 3 books, and won 6 scientific research achievement awards.
The medical case is a record of the clinical practice of traditional Chinese medicine, which reflects the specific application of reason, law, prescription and medicine in the process of diagnosis and treatment, and is the manifestation of the thinking process of doctors in diagnosing and treating diseases. The cases of famous doctors in the past dynasties are treasures in the treasure house of traditional Chinese medicine. We launched the column "Talking about Medicine with Cases", in order to inherit the essence, inspire our generation, and make progress together.
【Basic Information】
Zhao Moumou, male, 68 years old, on February 12, 2023.
【Pathogenesis】The patient has a history of cervical spondylosis, upper thoracic vertebral coronary heart disease, frequent arrhythmia, lumbar intervertebral disc herniation, etc. One day ago, I had symptoms such as sore throat, chills and chills, muscle and joint soreness, fever of 38 °C at night, sweating, frequent cough and wheezing, cough with yellow purulent sputum, accompanied by chest pain, strong neck pain, chest and back pain, dry mouth and desire to drink, etc., so I came to our hospital for treatment. Symptoms include: sore throat, chills and cold, muscle and joint soreness all over the body, fever of 38 °C at night, sweating profusely, frequent cough and wheezing, cough with yellow purulent sputum, accompanied by chest pain, strong neck pain, chest and back pain, dry mouth and desire to drink, and two stools. Physical examination: characteristic chiropractic examination: cervical tenderness is obvious in cervical spine C3-C6, and left and right rotation and flexion and extension are slightly limited; The T3-T4 spinous processes of the upper thoracic vertebra are crooked, and the corresponding paravertebral myofascial palpation pain is keen; Lumbar L3-L5 spinous process tenderness, corresponding deep paravertebral tenderness. The tongue is slightly red, with sharp edge tooth marks, yellow and greasy, and the veins are floating. Ancillary examinations: blood routine: white blood cells and neutrophils are slightly high; Chest CT showed multiple nodules of unequal size in both lungs, and bilateral pneumonia. Past medical history: previous history of cervical spondylosis, upper thoracic vertebral coronary heart disease, frequent arrhythmias, lumbar intervertebral disc herniation, etc.
Western medicine diagnosis: 1. Pneumonia; 2. Cervical spondylosis; 3. Upper thoracic spine syndrome; 4. Lumbar intervertebral disc herniation. Traditional Chinese medicine diagnosis: pulmonary paralysis, spinal paralysis (wind and heat invade the lungs, phlegm and dampness obstruction). Treatment: Promote the lungs and relieve cough, clear away heat and detoxify, dispel dampness and stop paralysis. Manual therapy: Zhao's balance chiropractic method: 1. Cervical spine manipulation: (1) Muscle relaxation method: the patient is sitting or lying down, the operator's thumb is pressed and the muscle fibers are pushed and pressed from top to bottom, and the technique is combined with light, heavy and light to loosen the muscles and tendons, and the positive pain points on the 5 lines of the neck (the middle line of the spinous process and the left and right transverse processes and the 2 lines directly from the side opening) are used to relax the key tendon management techniques, so as to achieve the purpose of adjusting and straightening the mechanical balance of the muscles and muscles; (2) Pulling, stretching, and twisting and reshaping method: the patient is in a supine position, the chest and back are cushioned with a soft pillow, the surgeon supports the patient's lower jaw with one palm, and the other palm finger is placed on the headrest, and when the palmar fingers of both hands are pulled and stretched to a relative limit, let the patient relax, slowly rotate to the left side to the maximum when the force is wrenched, stop for 1-2 seconds and then return to the original neutral position, and operate once on the left and right; (3) Thumb point pushing method: the patient is in the prone position, the chest is cushioned with a soft pillow, the head is slightly lower at the front edge of the bed, and the neck is naturally relaxed, taking the left side of the C4 spinous process as an example, the left palm root of the surgeon is placed on the opposite side of the pain point, and the right thumb slowly pushes and rubs the tender point to restore the spinous process; (4) Thumb squeezing method: the patient is sitting, taking the C5 spinous process to the left as an example, the operator's right thumb is placed above the right side of the C5 spinous process, and the left thumb is placed above the left side of C6, after the two thumbs are pressed and relaxed myofascia, the two thumbs are pushed downward in the opposite direction to recover, so that the upper and lower intervertebral joints can be coordinated and balanced; (5) Fixed-point wrench method in the upper cervical spine: taking C2 and C3 left side tenderness as an example, the patient takes a sitting or supine position, the head and neck are slightly bent forward, the surgeon's hands are placed under the coordinated traction of the lower jaw and the back occipital, and the left side is rotated, and then the original neutral position is restored, and then the right side is rotated once, and then the original neutral position is returned; (6) Lower cervical spine unfixed rotation method: when the lower cervical vertebra C4, C5, C6 spinous processes are crooked and have multiple pain points, the patient sits, the surgeon holds the patient's head and jaw pillow back and forth with both palms and fingers and pulls upwards for 2-3 times, stops for 2-3 seconds in the middle to buffer, and then uses one hand to hold the lower jaw tightly, and the other hand is placed on the side of the lower neck, and both hands work together at the same time to exert upward force to rotate the side to promote the synchronous recovery of multiple deviated spinous processes. Do the same thing on the contralateral side once. The lower cervical spine orthopaedic chiropractic technique is mainly based on non-fixed point rotation side wrench, and then the aftermath technique ends the cervical spine treatment. 2. Thoracic spine manipulation: (1) When the upper thoracic vertebrae T2, T3 and T4 are curved, the left and right shoulder pushes the vertebral impact method to correct the lateral turn of the upper thoracic vertebrae and the staggered seams of the thoracic costal facet joints; (2) When the relationship between the anterior and posterior intervertebral joints of the upper thoracic spine changes, including thoracic hunchback, interspinous tenderness, etc., which affect the cardiopulmonary respiratory function, the upper thoracic spine should be rubbed and pushed to restore the chiropractic system; (3) Double-handed palm weight superimposed impact method: the surgeon overlaps the palm root and is close to the top of the thoracic vertebral spinous process, and the upper arms work together to press vertically to impact the T2-T6 deviated spinous process to restore it. 3. Lumbosacral technique: use shoulder push and waist pulling method and rotary compression method to correct the sacroiliac joint rotation and staggered sutures, relieve lumbar intervertebral disc herniation, lumbosacral and lumbar leg pain, and assist in chiropractic reduction. Prescription: Yuqing Lung Detoxification Detoxification Soup with flavor: 10g of Ephedra, 10g of cinnamon branch, 20g of raw gypsum, 10g of almond, 10g of skullcap, 10g of peach kernel, 10g of Huoxiang, 10g of ginger magnolia, 10g of Bupleurum chinensis, 10g of Pueraria lobata, 5g of Xinhui tangerine peel, 10g of Schisandra chinensis, 15g of dandelion, 12g of forsythia, 10g of honeysuckle, 10g of licorice. A total of 4 doses, 1 dose per day, soak in water for 20 minutes, simmer for 30 minutes, take out the liquid medicine, add water to decoction, mix the liquid twice, and take it warmly in the morning and evening.
【Follow-up process】
Second diagnosis: On February 17, 2023, the patient felt that his symptoms improved significantly after taking the medicine, and he had no fever on the second day, and his cough and asthma were relieved on the third day, with dilute yellow sputum, the amount was reduced compared with before, the sputum was easy to cough out, there was no sputum blood, and there was cough occasionally. He was treated again according to the characteristic chiropractic plan of the first diagnosis, and the symptoms and signs of the patient's cervical and thoracic spine were basically relieved. After taking five more doses, the follow-up patient basically recovered. After half a year of follow-up, the patient's symptoms did not recur, and he insisted on working eight-hour shifts, in addition, he was able to travel deeply with the group in Xinjiang, with full physical strength and good spirits.
【Language】
TCM treatment focuses on the cause and pathogenesis, and through overall regulation, the living environment of pathogens is eliminated, and the body's self-healing function is mobilized. In this case, the treatment of Qinglung Jiedu Tang is the integration and application of Zhang Zhongjing's related formulas, and the key to the formula is to accurately find the cause and pathogenesis, clarify the treatment rules, and formulate an effective treatment plan. At the same time, combined with Zhao's balanced chiropractic technique, the internal and external two-pronged approach not only dispels internal causes, but also solves external factors, taking into account the specimens.
Zhao's Balanced Chiropractic Three Eighteen Methods of Clinical Syndrome Differentiation and Treatment, through the overall chiropractic treatment methods such as manual tuning, upper and lower connection, anterior-posterior correlation, and left-right symmetry, etc., are flexible and adaptable, especially the selection of highly targeted balanced osteopathic chiropractic treatment techniques to alleviate myofascial lesions in the spinal area, adjust the staggered joints of the spine, relieve the problems of "bone misalignment" and "tendon groove", and effectively restore the overall balance of the spine, with remarkable clinical results.
(Prepared by Zhao Hui)
Zheng reiterates:
Due to the different constitutions and conditions of each person, the treatment plan in this case is only applicable to the patient's condition at that time. Without TCM syndrome differentiation diagnosis and treatment, the treatment plan in this case must not be completely copied. If necessary, readers should go to a regular hospital for diagnosis and treatment to avoid delaying their condition. ■
[Source: Zhanjiang Second Hospital of Traditional Chinese Medicine, Medical Guidance: Zhao Shifu Chief TCM Physician]