中医整脊科技术操作规范标准(5)

Introdution

International still mistaken cervical and lumbar traction technology is a patent of western medical; seriously affect Traditional Chinese Medicine (TCM) propagation and overseas development.

On 2013, Professor Yizong Wei was invited by New York University Occupational Health to give a lecture. Professor Wei's lecture together with TCM chiropractic treatment technique was submitted to National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) and approval as continuing education programs of the school and entered the America medical system.

New release in National Occupational Classification listed TCM Chiropractic as TCM profession. TCM chiropractic theories and diagnostic technique will be popularized nationally. In order to follow this development trend, standardization of the therapy technique, that will ensure the quality of health care and the discipline of healthy development.

TCM Chiropractic is a Traditional Chinese Medicine specialist aims to restore or improve the Cervical and lumbar curvature in order to treat spinal strain. Using spinal correction technique, curvature drag and tune technique as the major clinical skills. Research in standardizes both treatment methods will ensure the quality of the medical care, that is also the foundation of this subject development.

Currently, In clinical application, there are ten spinal correction techniques which are: \jí Sōng shū fǎ\(Spinal press and relax technique),\shū duān zhuǎn fǎ\

(Atlantoaxial joint turning technique), \Qiān jǐng zhé dǐng fǎ\\xuán zhǐfǎ\(Cervical rotate and pull technique), \xiōngguò shēn fǎ\(Chest hyperextension technique), \yāo xuánzhuǎn fǎ\(Thoracolumbar rotation technique), \technique), \(hand drags and hold pelvic technique), Most of them inherited from Traditional Chinese medicine technique. For example, \shū duān zhuǎn fǎ\( Atlantoaxial joint turning technique ) origins from 《Zhū bìngyuán hòu lùn》\yāo xuánzhuǎn fǎ\ Thoracolumbar rotation technique ) and \rotation technique ) origins from Tang Dynasty 《Bèi jí qiānjīn yào fāng》\formulation\shēn yā pén fǎ\hnique ) origins from Yuan Dynasty 《Huíhui yàofāng》(AD1368), \( Lumbosacral side pull technique ), \ ( hand drags and hold pelvic technique ), origins from Ching Dynasty 《Zhōngguó jiēgǔ túshuō》(AD1807).

In Curvature drag and tune technique, \cloth bag ) and \s from Yuan Dynasty 《Yǒng lèi qián fāng》(AD 1331) , \from Yuan Dynasty 《Shì yī dé xiào fāng》 (AD 1345). (Annex 1)

All above treatment techniques inherit from the clinical application from over a thousand years ago till now and go through the animal test, dynamic observation by X-Ray and clinical study, initially we are clear about all Indications, contraindications and operation Procedure. In the 12th Five Year Plan 《Treatment Guidelines》 study, after more than 60 national expert?s

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confirmation, it becomes the major treatment techniques in 《TCM common chiropractic treatment guidelines.》, it has been incorporated in the 《Guidelines》 the Appendix (Annex 2). Three years after the release of 《Guidelines》, it was welcome by clinicians. According to the press 《TCM common chiropractic treatment guidelines.》 circulation of 20,000 copies and no medical accident ever reported.

Further to enhance the advantage of TCM Chiropractic, study is made on the developing major technical standard, that will increase the scientific value of these technique, Improve the clinical efficacy and face international competition, Lay the foundation for the spread of Traditional Chinese medicine to the world, Also inherit and carry forward Chinese medicine, Promote the importance of the Chinese traditional culture.

From 2009 corresponding unit undertake the State Administration of Traditional Chinese Medicine to develop 25 cases for the \atment guidelines”. In 2015 provide revision on another 15 cases, completed all tasks on time. The Unit has 8 senior professional titles running the spinal health professional committee of the world, there are 22 countries, more than 500 members, of which more than 400 senior experts, recently sending experts to participate in the GRADE courses organized by the World Union, the team has the power to develop international standards.

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TCM Spinal Orthopedic Operation Norms

1 Spinal Orthopedic Manipulations 1.1 Hinge Joint Relaxing Manipulation 1.1.1 Indications

Spinal injuries that require sinew and curvature rectifying. 1.1.2 Contraindications 1.1.2.1 Spinal tuberculosis 1.1.2.2 Spinal tumor 1.1.2.3 Spinal myelitis 1.1.2.4 Severe osteoporosis

1.1.2.5 Lumbar pressing being inappropriate for slipped lumbar disc 1.1.3 Cautions 1.1.3.1 Press slowly.

1.1.3.2 Apply different degrees of strength according to patient?s physique and increase the strength gradually.

1.1.3.3 The strength of percussion on the hinge joint should be appropriate without causing pain. 1.1.4 Manipulation Methods

[Method 1] Ask the patient to lie flat on the stomach. Using the thumb pulp of both hands, the practitioner presses the vertebral plate of both sides perpendicularly from DU 14 (dà zhuī, 大椎) downwards. Repeat this procedure for 3 to 5 times. Then, ask the patient to lie on the side and bend the spine. The practitioner clenches a fist and percusses the cervicothoracic joint, thoracolumbar joint and lumbosacral joint by the muscle of hypothenar.

[Method 2] Also called as ?Hyperextension with foot pedaling?, this method is indicated for youth and people with a good physique, but not for the old and those with a weak physique. Ask the patient to lie on the stomach. The practitioner stands on the couch and lifts and pulls one leg of the patient as hyperextension. Then, the practitioner uses one foot to step on the vertebrae one by one from DU 14 downwards.

1.2 Atlantoaxial Holding and Rotating Manipulation 1.2.1 Indications Atlantoaxial dislocation 1.2.2 Contraindications

1.2.2.1 Congenital Deformity of Atlantoaxial Joint

1.2.2.2 Trauma-induced atlantoaxial dislocation at the acute stage 1.2.3 Cautions

1.2.3.1 Do not hold the head for more than 1min, or the swallowing activity will be affected. 1.2.3.2 Apply persistent but not sudden strength for holding the head. 1.2.3.3 It is inappropriate to rotate the head for more than 10°.

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1.2.4 Manipulation Methods

Ask the patient to sit upright and the practitioner stands at the rear side. The practitioner puts the thumb and index finger of one hand on both sides of the atlantoaxial joint, approximately at the place of GB 20 (fēng chí, 风池) of both sides. Meanwhile, use the elbow of another hand to support patient?s lower jaw. With a little strength of both hands, lift patient?s head upwards lightly and rotate it to the protruded side for no more than 10° and for a short moment. Then lower the head. Every time of lifting and rotating should not be more than 1min and repeat this procedure for 3 to 5 times. Do such a procedure in the opposite direction and reduction is indicated if the patient feels emptiness at the protruded side without tenderness.

1.3 Neck Pulling and Process Pressing Manipulation 1.3.1 Indications

Cervical disorders due to reduced, disappeared or reversed cervical vertebral curvature. 1.3.2 Contraindications

1.3.2.1 Acute stage of any cervical disorders 1.3.2.2 Tuberculosis of cervical vertebra 1.3.2.3 Tumor of cervical vertebra 1.3.2.4 Myelitis of cervical vertebra 1.3.2.5 Increased cervical vertebral curvature 1.3.3 Cautions

1.3.3.1 Apply this manipulation after relaxing the sinews.

1.3.3.2 Be careful to apply it for acute slipped cervical disc and stenosis of cervical vertebral canal.

1.3.4 Manipulation Methods

[Method 1] Ask the patient to lie on the back and the practitioner relaxes the sinews of the neck. Afterwards, the practitioner holds the patient?s occipital region and pulls it with the palm of both hands for 1 to 3min. Then, put the pulp of four fingers on the neck back and pull, knead and press the cervical vertebral process repeatedly from the 7th cervical vertebra upwards for about 20min.

[Method 2] Ask the patient to rotate the neck greatly. The practitioner pulls the occipital region by one hand, supports the chin by the forearm of another hand, and presses the opposite shoulder joint by the foot. Exert reciprocal strength by the two hands, aiming to pulling the 6th and 7th vertebrae away from the thoracic vertebra.

1.4 Neck Rotating and Lifting Manipulation 1.4.1 Indications

Cervical disorders due to deviated cervical vertebral process 1.4.2 Contraindications

1.4.2.1 Unclear diagnosis without excluding congenital deformity and osteopathy by X-ray scan 1.4.2.2 Patients above 60 years old and below 16 years old complicated with spinal osteoporosis 1.4.2.3 Severe cardiopathy and hyperthyroidism

1.4.2.4 Slipped vertebral disc compressing dural sac for more than a half 1.4.2.5 After surgery of cervical vertebrae

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