headache lee chong leng 1. contents 1)introduction6 - 76 - 7 2)clinical manifestations8 -16...
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HEADACHE
Lee Chong Leng
1
CONTENTS
1)
Introduction 6 - 7
2)
Clinical Manifestations 8 -16
3)
Essentials for Diagnosis 17 - 18
4)
Treatment with Tuina Therapy
19 - 64
5)
Cautions 65 - 665
HEADACHE
Pain in the upper part of the head due to pathological changes inside or outside the cranium
A commonly encountered subjective symptom and can be found in many different acute or chronic diseases
6
HEADACHE Four causes of headache
Intracranial pathologic changes
Extracranial pathologic changes
General diseases
Neurosis
If the headache is a secondary symptom caused by injury, wound or some other diseases, it will disappear after the main symptoms are eliminated.
7
CLINICAL MANIFESTATIONS
1. Wind cold 风寒头痛2. Wind heat 风热头痛3. Summer-heat 暑湿头痛4. Hyperactivity of liver yang 肝阳头痛5. Phlegm and turbid substance 痰浊
头痛6. Blood deficiency 血虚头痛7. Kidney deficiency 肾亏头痛8. Blood stasis 瘀血头痛
8
CLINICAL MANIFESTATIONS
1. Wind cold 风寒头痛 Involvement of the nape and
back, aversion to wind and cold, aching limbs and joints
Preference for wrapping the head, no thirst
Light and whitish tongue coating, floating or tense pulse
9
CLINICAL MANIFESTATIONS
2. Wind heat 风热头痛3. Distending headache, or even
splitting pain in the head
4. Aversion to wind, fever, reddish complexion and eyes, thirst and preference for drinking, reddish and sore throat, yellowish urine
5. Reddish tongue tip & light yellow coating, floating and rapid pulse10
CLINICAL MANIFESTATIONS
3. Summer-heat 暑湿头痛4. Binding pain
5. Abdominal distension, anorexia, lassitude, heaviness, and pain in the body, feverish body and spontaneous sweating, dysphoria, thirst
6. Greasy coating, soft and rapid pulse 11
CLINICAL MANIFESTATIONS
4. Hyperactivity of liver Yang 肝阳头痛 Headache and dizziness, especially
in both sides
Dysphoria, restless sleep, reddish complexion, dry and bitter taste, hypochondriac distension
Reddish tongue and light yellowish or scanty tongue coating, taut and strong or taut, thin and rapid pulse
12
CLINICAL MANIFESTATIONS
5. Phlegm and turbid substance 痰浊头痛
Marked by distension headache
Fullness sensation in the chest and diaphragm, anorexia, lassitude, profuse saliva and fluid, vomiting
Whitish and greasy tongue coating and slippery pulse
13
CLINICAL MANIFESTATIONS
6. Blood deficiency 血虚头痛 Headache, vertigo
Aggravation of pain after overstrain, languor, dark complexion, poor appetite, palpitation, short respiration
Light tongue, thin and limp or unsmooth pulse
14
CLINICAL MANIFESTATIONS
7. Kidney deficiency 肾亏头痛 Severe pain
languor, tinnitus and vertigo, amnesia and insomnia, weakness of waist and limbs, seminal emission and leukorrhagia
Headache due to Yang deficiency is marked by cold limbs, light and plump tongue, sink thin and limp pulse
Headache due to Yin deficiency is marked by dry mouth with scanty fluid, reddish tongue, thin and rapid pulse
15
CLINICAL MANIFESTATIONS
8. Blood stasis 瘀血头痛9. Repeated headache occurrence,
difficulty to heal
10.Fixed location, puncturing pain, or with a history of traumatic injury of the head
11.Purple and dark tongue and unsmooth pulse
16
ESSENTIALS FOR DIAGNOSIS
1. Headache, involving the forehead, tempus, vertex and occiput or the whole head, characterized by flicking pain, stabbing pain, distending pain, vertigo or vague pain. It may occur suddenly or recur frequently and linger. It may last for several minutes, hours days or weeks
2. History of sudden onset or repeated occurrence due to invasion of exogenous pathogenic factors or endogenous ones
17
ESSENTIALS FOR DIAGNOSIS
3. Take blood routine test, blood pressure test, cerebrospinal fluid test and EEG test as well as Doppler, cranial and cerebral CT and MRI test if possible, in order to rule out organic disease and decide diagnosis
18
TREATMENT WITH TUINA THERAPY
Principle:
Dredging meridians, prompting Qi and blood flow (疏经通络,行气活血)
19
TREATMENT WITH TUINA THERAPY
Acupoints and location:
Yintang (EX-HN 3), Touwei (ST 8), Taiyang ( EX-HN5),Yuyao (EX-HN 4), Cuanzhu (BL 2), Yangbai, Baihui (GV 20), Sishencong, Jianjing (GB 21), Fengchi (GB 20), the head, face, nape and neck regions
20
TREATMENT WITH TUINA THERAPY
Operation 1:(1)Patient - sitting position (back)(2)Use one-finger pushing method to push down through the neck, where the bladder meridian of foot-Taiyang runs, for about three minutes(3)Press Fengchi (GB 20), Fengfu (GV 16), Tianzhu (BL 10)(4)Grasp Fengchi (GB 20) and Jianjing (GB 21), 1 minute for each(5)Grasp along the neck where the bladder meridian of foot-Taiyang runs for 4-5 times
21
22
Fengchi ( 风池 )
23
Fengfu ( 风府 )
24
Tianzhu ( 天柱 )
25
Jianjing ( 肩井 )
TREATMENT WITH TUINA THERAPY
Operation 2:(1)Patient - sitting position (front and back)(2)Use one-finger pushing method to push from Yintang (EX-HN 3), the hairline up to Touwei (ST 8) and Taiyang (EX-HN5) for 3-4 times(3)Press Yintang (EX-HN 3), Yuyao (EX-HN 4), Taiyang (EX-HN 5) and Baihui (GV 20)(4)Grasp with five fingers from vertex to Fengchi (GB 20)(5)Grasp with three fingers the bladder meridian of foot-Taiyang down to Dazhui (GV 14) for 3-4 times
26
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Yintang ( 印堂 )
28
Touwei ( 头维 )
29
Taiyang ( 太阳 )
30
Yuyao ( 鱼腰 )
31
Baihui ( 百会 )
32
Dazhui ( 大椎 ) , Feishu (肺俞 )
MANIPULATIONSACCORDING TO
SYNDROME DIFFERENTIATION
33
(1) COLD AND WIND
Roll the neck and back for about 2-3 minutes
Press and rub Feishu (BL 13) and Fengmen (BL 12) Grasp both sides of Jianjing (GB 21)
Rub bladder meridian at both sides of the back until it is warm
34
35
Dazhui ( 大椎 ) , Feishu (肺俞 )
36
Fengmen ( 风门 )
(2) WIND AND HEAT
Press and rub Dazhui (GV 14), Feishu (BL 13), Fengmen (BL 12), one minute each
Grasp Jianjing (GB 21), Quchi (LI 11), shousanli (LI 10), Hegu (LI 4) until there is aching and distending feeling in the local area
Knock the back until it becomes warm
37
38
Quchi ( 曲池 )
39
Shousanli ( 手三里 )
40
Hegu ( 合谷 )
(3) SUMMER-HEAT
Press and rub Dazhui (GV 14) and Quchi (LI 11)
Grasp Jianjing (GB 21) and Hegu (LI 4)
Knock the bilateral courses of the bladder meridian until the skin turns red
Pinch Yintang (EX-HN 3) and neck until it turns red
41
(4) HYPERACTIVITY OF LIVER YANG
Push Qiaogong up and down for 20 times each
Clean and dissipate tempus where the gallbladder meridian runs
Press and rub Jiaosun (TE 20), Taichong (LR 3) and Xingjian (LR 2) for about 10 times
Rub Yongquan (KI 1) until it turns warm
42
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Qiaogong ( 桥弓 )
44
Jiaosun ( 角孙 )
45
Dadun ( 大敦 ) , Xingjian ( 行间 ) , Taichong ( 太冲 )
46
Yongquan ( 涌泉 )
(5) PHLEGM AND TURBID SUBSTANCE
Push and rub the abdomen, specially Zhongwan (CV 12), and Tianshu (ST 25) for 6-8 minutes
Press and rub Pishu (BL 20), Weishu (BL 21), Dachangshu (BL 25)
Rub the left back horizontally until it is warm
Press and rub Zusanli (ST 36), Fenglong (ST 40) and Neiguan (PC 6)
47
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Zhongwan ( 中脘 ) , Tianshu ( 天枢 ) , Qihai ( 气海 )
49
Geshu ( 膈俞 ) , Ganshu ( 肝俞 ) , Pishu ( 脾俞 ) , Shenshu ( 肾俞 )
50
Weishu ( 胃俞 )
51
Shenshu ( 肾俞 ) , Dachangshu (大肠俞 )
52
Zusanli ( 足三里 )
53
Fenglong ( 丰隆 )
54
Neiguan ( 内关 )
(6) BLOOD DEFICIENCY Rub the abdomen for 6-8
minutes, especially Qihai (CV 6), Zhongwan (CV 12) and Guanyuan (CV 4)
Rub the left back horizontally and the governor vessel vertically until it is warm
Press and rub Xinshu (BL 15), Geshu (BL 17), Zusanli (ST 36) and Sanyinjiao (SP6) until it is slightly aching and distending
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Zhongwan ( 中脘 ) , Tianshu ( 天枢 ) , Qihai ( 气海 )
57
Yingxiang ( 迎香 ) , Cuanzhu ( 攒竹 )
58
Xinshu ( 心俞 )
59
Geshu ( 膈俞 ) , Ganshu ( 肝俞 ) , Pishu ( 脾俞 ) , Shenshu ( 肾俞 )
60
Sanyinjiao ( 三阴交 )
(7) KIDNEY DEFICIENCY
Rub in circle the abdomen for 6-8 minutes, especially Qihai (CV 6) and Guanyuan (CV 4)
Rub the governor vessel horizontally
Press Shenshu (BL 23) and Mingmen (GV 4) and waist until warmth is felt
61
62
Shenshu ( 肾俞 ) , Dachangshu (大肠俞 )
63
Mingmen ( 命门 )
(8) BLOOD STASIS
Press and knead Taiyang (EX-HN 5), Cuanzhu (BL 2), forehead and tempus where the gallbladder runs
Rub the forehead and both sides or Taiyang (EX-HN 5) until it is warm
64
CAUTIONS1. Patients with headache due to
exogenous pathogenic factors must keep warm, avoiding wind and cold and taking sufficient rest
2. Patients with headache due to hyperactivity of liver Yang should frequently test blood pressure, pay attention to the undulation of blood pressure and its influence on the heart.
3. Patients with headache due to blood deficiency and kidneys deficiency should avoid excessive sexual intercourse
65
CAUTIONS
4. Stop smoking and drinking is helpful for healing different types of headache
5. Tuina therapy is not suitable for intracerebral diseases, such as cerebrovascular disease at the acute stage, cerebral contusion, and encephalic traumatic hematoma
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THANK YOU
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