RU2366405C1 - Therapy of muscular scapulohumeral periarthrosis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to neurology and reflexotherapy. The method involves clinic, paraclinic examination of the patient, pain localisation, traditional oriental diagnostics and acupuncture treatment of acupuncture points. If pain is localised in superexternal region of anterior chest wall, anterexternal surface of humeral joint and in upper one-third of anterexternal surface of shoulder, acupuncture points involved are as follows: P7, C9, P2, P3, P4 in 1, 3, 4, 5, 6, 7 days and IG3, V62, V59, P2, P3, P4 in 2, 8 days. If pain is localised in upper one-third of posterexternal surface of shoulder, external surface of humeral joint, the following acupuncture points are treated: GI6, VB44, GI14, GI15, GI16 in 1, 3, 4, 5, 6, 7 days and V62, V59, GI14, GI15, GI16 in 2, 8 days. If pain is localised on posteromedial surface of shoulder girdle and posterocervical region, the acupuncture points are: TR5, IG1, IG9, IG10, IG14 in 1, 3, 4, 5, 6, 7 days and IG3, V59, IG9, IG10, IG14 in 2, 8 days.

EFFECT: method improves clinical effectiveness and prolongs remission owing to selection of acupuncture points considering pain localisation and injury levels in canal-meridian system.

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Description

The invention relates to medicine, namely to neurology and reflexology, and can be used in the complex treatment of shoulder-shoulder periarthrosis (PLP), in particular with the muscular form of PLP.

With all the variety of existing methods for treating PLP, this problem has not been completely resolved, the prevalence of PLP is not decreasing, and the disability of patients with PLP at working age remains significant.

There is a known method of treating PLP, which consists in applying electropuncture to the area of the affected joint and its projection point of the corresponding auricle (I.Z.Samosyuk, V.P. Lysenyuk. Acupuncture, Kiev, Moscow: "Ukrainian Encyclopedia", "Ast-press", 1994, p. 430-431).

A known method of treating PLP (E.S. Zaslavsky. Pain muscle syndromes in the shoulder girdle, arm and chest, Novokuznetsk, 1982, p. 58-60), which consists in acupuncture of the following acupuncture points: E36, TR5, MC6, RP9, P2, V15, P3, P4, GI4, GI5, GI6, C1, C2, IG9, IG10, IG13, IG14.

The disadvantage of these methods is the lack of effectiveness, high relapse rate after treatment.

A known method of treating PLP (Gavaa Luvsan, 76), which consists in picking out acupuncture points: TR5, TR9, IG3, IG5, GI4, GI10, GI11, P5, P7, VB38, TR14, TR15 and subsequent cauterization (Traditional and modern aspects of reflexology, M .: Nauka, 1990, p. 374) of local points.

The disadvantage of this method is that the points are not selected differentially, i.e. there is no choice of acupuncture points depending on the form of the course of PLP and the levels of damage in the channel-meridian system of the body. Thus, a sufficiently effective treatment is not provided.

The closest is the method according to patent No. 2273467, IPC A61H 39/06, A61H 39/08, publ. 04/10/2006, "A method for the treatment of shoulder-shoulder periarthrosis." The method relates to the treatment of PLP with localization of pain on the posteromedial surface of the joint, shoulder girdle and posterior cervical region. Thermal acupuncture of local points is carried out and the needles act in a harmonizing way on restorative points, symptomatic points, points of systemic action. On days 1, 2, 4, and 8, acupuncture points V64, IG4, IG6 are performed.

The disadvantage of this method is that the points are not selected differentially, i.e. there is no choice of acupuncture points depending on the form of the course of the PLP and the exact location of pain. Thus, a sufficiently effective treatment is not provided.

The objective of the invention is the creation of an effective method of treating a muscle variant of PLP with prolonged remission due to differentiated selection of points and rapid relief of pain.

The goal is achieved by a method of treating the muscular form of the shoulder-shoulder periarthrosis, including clinical, paraclinical examination of the patient with the determination of localization of pain and traditional eastern diagnosis with the determination of the state of meridians, as well as the effect of acupuncture on acupuncture points.

Acupuncture of points located on the conjugate meridians, points aligning the bioelectric parameters of the meridians, points of wonderful meridians and segmental-local points is carried out in a neutral harmonizing way.

When pains are localized in the upper outer region of the anterior chest wall, the anterior external surface of the shoulder joint and in the upper third of the anterior external surface of the shoulder, acupuncture points are acupuncture: P7, C9, P2, P3, P4 at 1, 3, 4, 5, 6, 7 days and points IG3, V62, V59, P2, P3, P4 in 2, 8 days.

When pain is localized in the upper third of the posterior external surface of the shoulder, the external surface of the shoulder joint, acupuncture points are acupuncture points: GI6, VB44, GI14, GI15, GI16 at 1, 3, 4, 5, 6, 7 days and points V62, V59, GI14, GI15 GI16 in 2, 8 days.

When pain is localized on the posteromedial surface of the joint, shoulder girdle and posterior cervical region, acupuncture points are acupuncture: TR5, IG1, IG9, IG10, IG14 at 1, 3, 4, 5, 6, 7 days and points IG3, V59, IG9, IG10, IG14 in 2, 8 days.

The novelty of the method lies in the fact that:

- Impact on point P7 - Lo - the point of the lung canal P, at the level of the conjugate canals of the lungs P and large intestine GI - distributes energy between the channels of the lungs P and large intestine GI.

- Impact on point GI6 - Lo - the point of the canal of the large intestine GI, at the level of the conjugate canals of the large intestine GI and lungs P - distributes energy between the channels of the large intestine GI and lungs P.

- The impact on the point TR5 - Lo - the channel point of the three TR heaters, at the level of the conjugate channels of the three TR heaters and the MC pericardium channel - distributes energy between the channels of the three TR heaters and the MC pericardium.

- The impact on the point C9 - the polarization point of the union of the top - bottom of the heart channel C and the kidney channel R - activates the tendon-muscle meridian of the heart channel C.

- The impact on the point VB44 - the polarization point of the union of the top - bottom channel of the gallbladder VB and the channel of the three heaters TR - activates the tendon-muscle meridian of the gallbladder channel VB.

- The impact on the point IG1 - the polarization point of the union of the top-bottom channel of the small intestine IG and the channel of the bladder V - activates the tendon-muscle meridian of the channel of the small intestine IG.

- Impact on the IG3 point - the point is the key of the wonderful DU-MAY meridian, which is responsible for the state of nutritional energy, improves metabolic processes in the body.

- Impact on point V62 - point key is a wonderful meridian YAN-JIAO-MAY allows you to adjust the transport of nutrient energy.

- Impact on point V59 - Ce point of the wonderful meridians DU-MAY and YAN-JIAO-MAY - dissipates excess energy, which leads to a decrease in pain.

- Impact on points: P2, P3, P4, GI14, GI15, GI16, IG9, IG10, IG14 - segmented-local points, improves innervation and tissue microcirculation in this segment.

- The impact is carried out in a neutral harmonizing way.

The set of essential features of the proposed method allows to increase the effectiveness of treatment due to the fact that:

- differentiation of the localization of pain in the muscular form of PLP was made taking into account the levels of damage in the canal-meridian system, which allows the selection of acupuncture points that clearly corresponds to the selective damage to certain muscle groups of the shoulder girdle;

- perform an additional effect on segmental-local points, which improves innervation and tissue microcirculation in this segment and leads to an improvement in the state of muscle fibers and normalizes muscle tone, which allows to reduce treatment time and increase the period of remission;

- the procedure for influencing points is optimal and provides an effect on most parts of the pathological process, affecting local changes in tissues and organs, on non-specific generalized positive reactions ("adaptation reactions"), normalizing nervous regulatory processes and eliminating pain.

The proposed method of treatment is as follows. After conducting a clinical and paraclinical examination, the patient undergoes a traditional eastern diagnosis, on the basis of the data obtained, acupuncture points are selected depending on the location of the pain and taking into account the levels of damage in the canal-meridian system of the body.

Simultaneously with the main acupuncture points: P7, C9, GI6, VB44, TR5, IG1, IG3, V62, V59, they act on segmental-local points: P2, P3, P4, GI14, GI15, GI16, IG9, IG10, IG14. Acupuncture is carried out in a neutral harmonizing way. The course of treatment is 8 sessions conducted daily. The duration of the procedure is 30 minutes.

Acupuncture was performed by exposing the points to a neutral harmonizing method in the following sequence:

With the localization of pain in the upper outer region of the anterior chest wall, the anterior external surface of the shoulder joint and in the upper third of the anterior external surface of the shoulder, acupuncture points are acupuncture:

On days 1, 3, 4, 5, 6, 7 - P7 - Lo - point of the lung channel P, C9 - polarization point of the union of the top-bottom of the heart channel C and the kidney channel R, P2, P3, P4 - segmental-local points.

On days 2 and 8 - IG3 - point key of the wonderful meridian DU-MAY, V62 - point key of the wonderful meridian YAN-JIAO-MAY, V59 - Ce point of the wonderful meridians DU-MAY and YAN-JIAO-MAY, P2, P3, P4 - segmental-local points.

With localization of pain in the upper third of the posterior external surface of the shoulder, the external surface of the shoulder joint, acupuncture points are acupuncture:

On days 1, 3, 4, 5, 6, 7 - GI6-Lo - point of the colon canal GI, VB44 - polarization point of the union of the top-bottom channel of the gallbladder VB and the channel of three heaters TR, GI14, GI15, GI16 segmented-local points.

On days 2 and 8, V62 is the key point of the wonderful YAN-JIAO-MAY meridian, V59 - Xie is the point of wonderful DU-MAY and YAN-JIAO-MAY meridians, GI14, GI15, GI16 are segment-local points.

With the localization of pain on the posteromedial surface of the joint, shoulder girdle and posterior cervical region, acupuncture points are acupuncture:

On days 1, 3, 4, 5, 6, 7 - TR5-Lo - point of the channel of three heaters TR, IG1 - point of polarization of the union of the top-bottom channel of the small intestine IG and the channel of the bladder V, IG9, IG10, IG14 - segmented local points.

On days 2, 8 - IG3 - point is the key of the wonderful meridian DU-MAY, V59-Се - point of the wonderful meridians DU-MAY and YAN-JIAO-MAY, IG9, IG10, IG14 - segment-local points.

Example 1

Patient L., 50 years old. He was admitted with complaints of acute pain in the upper outer region of the anterior chest wall, the anterior external surface of the shoulder joint and the upper third of the anterior external surface of the shoulder to the left. The mobility of the left shoulder joint is limited.

Vertebral neurological history - 10 years. This exacerbation within three months; about this exacerbation, he was treated in a polyclinic for 12 days, where magnetotherapy, electrophoresis with novocaine and drug therapy were carried out: anti-inflammatory drugs, medical and medical blockade with vitamin B12. As a result of the treatment, a slightly positive effect was noted.

Objectively: the condition is satisfactory. Elevation of the left shoulder girdle, restriction of active and passive movements in the left shoulder joint when moving back and up, marked pain on the anteroposterior surface of the shoulder joint and the upper third of the anteroposterior surface of the shoulder are noted. Tendon reflexes from the upper extremities are "living", D = S. Sensitivity is not broken, D = S. Eastern diagnostic data: expressed pain on the external course of the lung meridian R and moderate pain on the external course of the heart meridians C, small intestine IG, and bladder V are palpated; pulse diagnostics - increasing the strength and filling of the pulse at the points of the lung meridians R, heart C, small intestine IG and the bladder V. Electropuncture diagnostics by the Voll method revealed an increase in the UEF threshold (Voll unit) above 60 UEF in channels P, C, IG, V. (norm 45-55 UEF).

X-ray revealed arthrosis of the shoulder joint.

DS: Periarthrosis of the shoulder blade. Muscular form. Chronic recurrent progressive course. The period of exacerbation. Irritatively deficient stage, 3rd degree of clinical manifestations.

A course of acupuncture was carried out daily, 8 sessions on acupuncture points: P7, C9, P2, P3, P4 at 1, 3, 4, 5, 6, 7 days and IG3, V62, V59, P2, P3, P4 at 2, 8 days , in accordance with the proposed method. The duration of the procedure is 30 minutes.

After the 3rd session of acupuncture, the pain syndrome decreased significantly. After the course of treatment, the pain syndrome completely stopped. Pulse diagnostics: alignment of the strength and filling of the pulse wave at the diagnostic points of the meridians P, C, IG, V. Electropuncture diagnostics by the Voll method: UEF threshold within 45-55 UEF in the meridians P, C, IG, V. During follow-up observation during 1.5 years of manifestation of PLP was observed once and briefly for one day after severe physical exertion.

Thus, the proposed method allows for accurate determination of the localization of pain in the muscular variant of PLP, taking into account the levels of damage in the canal-meridian system, to make a reasonable and selective choice of acupuncture points that provide an impact on most parts of the pathological process, which increases the effectiveness of treatment and increases the period remission, eliminates pain.

Example 2

Patient P., 46 years old. Received complaints of paroxysmal pain in the upper third of the posterior surface of the shoulder, the outer surface of the shoulder joint and shoulder girdle on the left, intensifying with movement. The mobility of the left shoulder joint is severely limited.

Vertebroneurological history - 8 years. This exacerbation within two months; about this exacerbation, she was treated in a polyclinic for 14 days, where magnetotherapy, electrophoresis with novocaine and drug therapy were carried out: anti-inflammatory drugs, medical and medical blockade with vitamin B12. As a result of the treatment, a slightly positive short-term effect was noted.

Objectively: the condition is satisfactory. There is a restriction of active and passive movements in the left shoulder joint when moving back and up, when the arm is pulled to the side, severe soreness on the outer surface. Tendon reflexes from the upper extremities are "living", D = S. Sensitivity is not broken, D = S.

Eastern diagnostic data: expressed pain on the outward course of the large intestine meridian GI and moderate soreness on the outer course of the meridians of the gallbladder VB, bladder V are palpated; pulse diagnostics - increasing the strength and filling of the pulse at the points of the meridians of the large intestine GI, gallbladder VB and bladder V;

Electropuncture diagnostics by the Voll method revealed an increase in the UEF threshold (Voll unit) above 58 UEF in the channels GI, VB, V (norm 45-55 UEF).

X-ray revealed arthrosis of the shoulder joint.

DS: Periarthrosis of the shoulder blade. Muscular form. Chronic recurrent non-progressive course. Irritatively deficient stage, 3rd degree of clinical manifestations.

A course of acupuncture was carried out daily, 8 sessions on acupuncture points: GI6, VB44, GI14, GI15, GI16 at 1, 3, 4, 5, 6, 7 days and V62, V59, GI14, GI15, GI16 at 2, 8 days, at in accordance with the proposed method. The duration of the procedure is 30 minutes.

After the 3rd session of acupuncture, the pain syndrome decreased significantly. After the course of treatment, the pain syndrome completely stopped. Pulse diagnostics: alignment of the strength and filling of the pulse wave at the diagnostic points of the meridians GI, VB, V. Electropuncture diagnostics according to the Voll method: UEF threshold within 45-55 UEF in the meridians GI, VB, V. During follow-up observation for 1.5 years manifestations of PLP were observed once and briefly for one day after severe physical exertion.

Thus, the proposed method allows for accurate determination of the localization of pain in the muscular variant of PLP, taking into account the levels of damage in the canal-meridian system, to make a reasonable and selective choice of acupuncture points that provide an impact on most parts of the pathological process, which increases the effectiveness of treatment and increases the period remission, eliminates pain.

Example 3

Patient G., 48 years old. He was admitted with complaints of paroxysmal pain in the right shoulder joint with localization of pain on the posteromedial surface of the joint, shoulder girdle and posterior cervical region. Joint mobility is limited.

From the anamnesis: sick for 2 years; For this exacerbation, he was treated for 10 days in a clinic where electrophoresis with novocaine, magnetotherapy and drug therapy were carried out: anti-inflammatory drugs, medical and medical blockade with vitamin B12. As a result of the treatment, no effect was observed.

Objectively: the condition is satisfactory. Elevation of the right shoulder girdle, restriction of active and passive movements in the right shoulder joint during abduction and insertion of the arm behind the head, marked pain on the posteromedial surface of the joint, shoulder girdle and posterior cervical region on the right are noted. Tendon reflexes from the upper extremities are "living", D = S.

Sensitivity is not broken, D = S.

Oriental diagnostic data: palpation of pronounced tenderness along the outer course of the small intestine meridian IG and moderate tenderness along the outer course of the meridians of three TR heaters, bladder V; pulse diagnostics - increasing the strength and filling of the pulse at the points of the small intestine meridians IG, three TR heaters, and the bladder V. Electropuncture diagnostics by the Voll method revealed an increase in the UEF threshold (Voll unit) above 65 UEF in the IG-70 UEF, TR-65 channels UEF, V-68 UEF (norm 45-55 UEF).

X-ray revealed arthrosis of the shoulder joint.

DS: Periarthrosis of the shoulder blade. Muscular form. Chronic recurrent progressive course. The period of exacerbation. Irritatively deficient stage, 3rd degree of clinical manifestations.

A course of acupuncture was carried out daily, 8 sessions on acupuncture points: TR5, IG1, IG9, IG10, IG14, at 1, 3, 4, 5, 6, 7 days and points IG3, V59, IG9, IG10, IG14 at 2, 8 days , in accordance with the proposed method. The duration of the procedure is 30 minutes.

After the 3rd session of acupuncture, the pain syndrome decreased significantly. After the course of treatment, the pain syndrome completely stopped. Pulse diagnostics: alignment of the strength and filling of the pulse wave at the diagnostic points of the meridians IG, TR, V. Electropuncture diagnostics according to the Voll method: UEF threshold within the range of 45-55 UEF in the meridians IG-54 UEF, TR-50 UEF, V-45 UEF. During follow-up observation for 1.5 years, the manifestations of PLP were noted once and briefly for two days after hypothermia.

Thus, the proposed method allows for accurate determination of the localization of pain in the muscular variant of PLP, taking into account the levels of damage in the canal-meridian system, to make a reasonable and selective choice of acupuncture points that provide an impact on most parts of the pathological process, which increases the effectiveness of treatment and increases the period remission, eliminates pain.

Claims (1)

A method of treating the muscular form of the shoulder-shoulder periarthrosis (PLP), including clinical, paraclinical examination of the patient with localization of pain and traditional eastern diagnostics with the determination of the state of meridians and the impact of acupuncture points with acupuncture, characterized in that acupuncture points located on the conjugate meridians, points aligning the bioelectric parameters of meridians, points of wonderful meridians and segmental-local points with neutral harmonizing methods both, and with localization of pain in the upper outer region of the anterior chest wall, the anterior external surface of the shoulder joint and in the upper third of the anterior external surface of the shoulder, acupuncture points are acupuncture: P7, C9, P2, P3, P4 in 1, 3, 4, 5, 6, 7 days and points IG3, V62, V59, P2, P3, P4 in 2, 8 days; with localization of pain in the upper third of the posterior external surface of the shoulder, the external surface of the shoulder joint, acupuncture points are acupuncture: GI6, VB44, GI14, GI15, GI16 at 1, 3, 4, 5, 6, 7 days and points V62, V59, GI14, GI15 GI16 on days 2 and 8; when localizing pain on the posteromedial surface of the joint, shoulder girdle and posterior cervical region, acupuncture points are acupuncture: TR5, IG1, IG9, IG10, IG14 at 1, 3, 4, 5, 6, 7 days and points IG3, V59, IG9, IG10, IG14 in 2, 8 days.