Acupuncture treatment of depressive neurosis
Depression neurosis is mainly characterized by emotional depression, completely or almost completely lose interest in people or things around, or can not get interest from ordinary activities, but its severity does not meet the diagnostic criteria for major depression.
The incidence of the disease accounts for 5% -10% of psychiatric outpatients.
The pathogenesis of the disease has not been clarified.
In addition to psychological treatment, western medicine mainly uses antidepressants, but these drugs have many adverse reactions, are highly addictive and have many contraindications.
Depressive neurosis belongs to the category of “depression” in Chinese medicine.
The cause is emotional trauma, leading to qi stagnation, blood stasis, phlegm, etc. The pathological changes are related to heart, liver and spleen.
The treatment of this disease is more important than dispelling the liver and regulating the air, and acupuncture at Baihui, Yintang, Siguan (Taichong, Hegu) is used. Acupuncture is combined with deep breathing and air-conduction.
In the prescription, Taichong is the original point of the liver meridian. The main subject is “the chest is full,… must not be too restful all day long.” It cooperates with Guwei Siguan acupoint, which has the effect of relieving the liver and regulating gas;Judingding has the effect of relieving the liver and rejuvenating the spirit; Yintang cooperates with Baihui to reconcile the nerves and guides the air, and has the effect of strengthening the function of relieving the liver and rejuvenating Qi;
Diagnostic criteria 1. Western medicine standards are based on the diagnostic criteria for the second edition of the Chinese Mental Illness Classification and Diagnostic Standards (CCMD-2-R) adopted by the Chinese Psychiatric Committee in 1994: (1) meet the diagnostic criteria for neurosis.
(2) The main clinical manifestations are persistent mild to moderate depression, accompanied by at least three of the following symptoms: ① decreased interest but not lost; pessimistic disappointment about the future, but not despair; conscious fatigue or weaknessLoss of spirit; ④ self-evaluation declines, but willing to accept encouragement and praise; ⑤ not willing to communicate with people, but good passive contact, willing to accept sympathy and support; ⑥ want to die, but have serious concerns; seriously ill, But actively seek treatment, hoping to cure it.
(3) None of the following symptoms: ① obvious psychomotor depression; awakening early and symptoms of morning and evening light; ③ severe guilt or self-incrimination; ④ continuous loss of appetite and significant weight loss (non-main axisDue to physical illness); ⑤ more than one attempted suicide; ⑥ cannot take care of themselves; hallucinations or delusions; 缺 impaired consciousness.
(4) The course of the disease is at least 2 years, and the mood is low for most of the entire course of the disease. If the interval is normal, the maximum time is not more than 2 months at a time.
Second, the standard of traditional Chinese medicine refers to the Standard for Diagnosis and Efficacy of TCM Diseases and Syndromes issued by the State Administration of Traditional Chinese Medicine in 1995.
(1) TCM diagnosis: depression.
The disease is caused by discomfort and stagnation of the air. Depression, restlessness, or irritability and crying are the main symptoms.
(2) Syndrome classification of traditional Chinese medicine: ① Liver qi stagnation syndrome: mental depression, chest bloating, or belching, belching frequently, good and too breathy, irregular menstruation.
The tongue coating is thin and white, and the pulse strings.
② Stagnation of Qi and Stagnation: Irritability, irritability, chest tightness, bloating, headache, red eyes, bitter mouth, yellow urine.
Red tongue, yellow fur, and number of pulse strings.
③Demonstration of melancholia and sorrow: uneasy, distressed, easy to wake up with dreams, crying with sorrow and sadness.
The tip of the tongue is red, the moss is thin and white, and the pulse strings are thin.
④ Heart and Spleen Deficiency Syndrome: Thoughtfulness, confusion, chest tightness, palpitations, insomnia and forgetfulness, chlorosis, dizziness, fatigue, spontaneous sweating, and bad mood.
The tongue is pale, the moss is thin and white, and the pulse string is thin or thin.
⑤ Yin deficiency and fire prosperous syndrome: chronic illness, irritability, irritability, irritability, irritability, dizziness, palpitations, redness, hot hands, feet, dry mouth, or night sweats.
Red tongue, thin moss, thin or thin pulse strings.
Indication 1 is depressive neurosis; 2) It meets the diagnostic criteria of “Long Qi Stagnation Syndrome” and “Qi Hua Huo Syndrome” of TCM “depression”; 3) Patients are awake and have no mental disorders, which can be combined with acupuncture treatment.
Contraindications 1. Patients with epilepsy and severe cardiovascular and cerebrovascular, liver, kidney, and hematopoietic system diseases; 2. Pregnant women and patients with blood syndrome; 3. Patients with skin or auricle damage and infection.
Technical operation method 1: The equipment is prepared to adopt 0 in accordance with national production standards.
35 × 25mm milli-needle II, detailed operation steps (1) Patient position: supine.
(2) Disinfection: ① Acupuncture point disinfection: use 0.
A cotton ball with 5% -1% iodophor or 75% medicinal alcohol is wiped from the center by a circular extension at the operation site.
② Acupuncture point disinfection: use containing 0.
5% -1% iodophor or a cotton ball containing 75% medical alcohol strictly disinfects the entire auricle more than 2 times.
③ Disinfection of the surgeon: The doctor’s hands can be washed with soap and water, and then wiped with a cotton ball containing 75% medical alcohol.
(3) Acupuncture and acupoints: Hegu on both sides, Taichong on both sides, Baihui, Yintang.
(4) Acupuncture process: ① Acupuncture the Siguan acupoint first.
When the needle is inserted, the needle point is perpendicular to the acupoint skin, and the needle is quickly inserted. After the needle point passes through the skin, the needle is slowly inserted inward to a depth of about 0.
5 inches, with the degree of gain, you can use the gentle lifting and inserting needle method. ② After acupuncture, the needle tip is at an angle of 20 ° with the scalp, and it penetrates quickly under the scalp. After passing through the skin, the needle point enters the needle about 0 along the vein.
5 inches, with the degree of gaining energy, can be gently lifted and inserted.
③ Then acupuncture the acupoint, pinch the local skin, and pierce the skin quickly. After passing through the skin, the needle point pierces into the nose toward the root of the nose about 0.
5 inches, with the degree of gaining energy, can be gently lifted and inserted.
④ Retain the needle after acupuncture, and cooperate with the air-conducting method: that is, the patient with the prescription closed his eyes, his lips lightly closed, and slowly and deeply breathing with the nose until the needle is released. The total needle retention time is 30 minutes.
⑤ Needle withdrawal: Perform needle withdrawal in the order of needle insertion. Note that after removing the needle at each acupoint, use a clean cotton swab to insert it for more than 30 seconds, or take the point without bleeding as the degree.
⑥ Implant the ear needle after the needle is taken out: After strictly disinfecting the auricle, take the reconstructed auricle on the liver and heart points, replace the pin ear acupuncture needle, and fix the disinfected auricle with the left hand.Gently pierce the auricle and fix it with adhesive tape. Leave the needle for 3 days. Use the left and right acupoints alternately.
Third, the treatment time and course of treatment twice a week, 12 weeks is a course of treatment.
Fourth, the key technology transfer (1) Accurate acupuncture.
(2) Pay attention to acupuncture reservations.
(3) Cooperate with air-conducting method.
(4) Acupuncture needles are used to consolidate the curative effect.
(5) Pay attention to continue to consolidate treatment after the course of treatment.
V. Precautions (1) After the patient has sweated heavily, this therapy should not be used when mortality, so as to avoid the phenomenon of dizziness.
(2) Do not use this therapy for patients with epilepsy or severe cardiovascular and cerebrovascular, liver, kidney, and hematopoietic diseases.
(3) Pay attention to prevent bleeding after needle injection.
(4) Once the auricle is infected, it will cause serious consequences. Therefore, the entire auricle must be disinfected before the ear acupuncture needle is buried, and the surgeon must also disinfect the hands before the operation.
6. Possible accidents and treatment plans (1) Needle dizziness: Patients who have needle dizziness can usually be relieved after a short break. In severe cases, first aid measures should be given. At the beginning, the following methods can be used: acupressure or acupunctureGongshuigou, Zhongchong, Sulu, Neiguan and Zusanli; or Baihui, Qihai, Guanyuan.
However, if the symptoms persist without remission, necessary first aid measures need to be taken.
(2) Convulsions: Acupuncture patients must be asked if they have a history of convulsions.
Those who do have a history of this disease should be carefully observed.
In case of convulsions, remove all needles immediately and take first aid measures.
If the condition is not immediately controlled, the patient should be promptly referred to the emergency center.
(3) Stagnant Needle: Once stagnation occurs, the patient is required to relax.
If the needle is twisted too much in a single direction, you can twist the needle in the opposite direction to eliminate the stagnation of the needle. If the local muscle contraction causes the stagnation of the needle, you can extend the needle retention time slightly, and then twist the needle out, orPress gradually near the acupuncture point, or stab another needle nearby to distract the patient’s attention; if the patient’s position changes, the original position should be restored and the needle slowly lifted out.
(4) Broken needle: If a broken needle occurs, please keep the patient calm and do not move to prevent the broken needle from closing to the deep part of the tissue.
If the broken part of the needle is still exposed outside the body, the needle can be lifted out with tweezers.
If the broken end is level with the skin, you can gently insert it around the pinhole to expose the broken needle to the outside. Hold the forceps to lift the needle out.
If the broken needle is completely subcutaneous, the patient should be restored to its original position. Generally, the broken end can be exposed outside.
If unsuccessful, surgical removal is required.
Adverse reactions / events (1) Those who are not skilled in needle insertion may cause acupuncture pain.
(2) If the needle is not stopped after the needle is taken out, local bleeding may occur.