With the acceleration of people's life rhythm and the change of lifestyle, the incidence of cervical spondylosis is gradually increasing, and young people are developing, which makes young people begin to have symptoms of cervical spondylosis. If we don't pay attention to it and treat and control it in time, it will bring great harm to people, with long course of disease, slow curative effect and easy recurrence, which will seriously affect the normal work and quality of life of patients.
Keywords: cervical spondylosis; Chinese medicine; clinical care
1 the definition of cervical spondylosis
Cervical spondylosis, also known as cervical syndrome, is the general name of cervical osteoarthritis, hyperplastic cervicitis, cervical nerve root syndrome and cervical disc herniation, and it is a disease based on degenerative diseases. It is mainly due to long-term strain of cervical vertebra, hyperosteogeny, or disc herniation, ligament thickening, compression of cervical spinal cord, nerve root or vertebral artery, leading to a series of clinical syndromes of dysfunction. It is characterized by degeneration of cervical intervertebral disc itself and a series of secondary lesions, such as instability and looseness of vertebral body segments. Protrusion or prolapse of nucleus pulposus; Bone spur formation; Ligament hypertrophy and secondary spinal stenosis stimulate or compress adjacent nerve roots, spinal cord, vertebral artery and cervical sympathetic nerve, causing a series of symptoms and signs. Belonging to the category of arthralgia syndrome in traditional Chinese medicine.
2 Clinical manifestations of cervical spondylosis
The main manifestations are neck and shoulder pain, dizziness and headache, numbness of upper limbs, muscle atrophy, nausea, vomiting, severe spasm of lower limbs, difficulty in walking, and even blurred vision, tachycardia, dysphagia, quadriplegia, dysuria and paralysis. The clinical symptoms of cervical spondylosis are related to the lesion site, the degree of tissue involvement and individual differences.
3 Syndrome Differentiation and Classification of Cervical Spondylosis
Cervical spondylosis, cervical spondylotic radiculopathy, cervical spondylotic myelopathy, cervical spondylosis of vertebral artery type, sympathetic cervical spondylosis, cervical spondylosis of esophageal compression type.
4 Clinical nursing care of cervical spondylosis in traditional Chinese medicine
4. 1 Emotional nursing should know the patient's psychological state in detail, especially for patients with long-term illness or psychological fear. Only by letting them put down their ideological burdens and actively cooperate with the treatment can they achieve good therapeutic effects.
4.2 Diet and nursing should strengthen nutrition and properly eat soft-shelled turtle, pork loin and nuts such as walnuts and cashews. Adjust diet according to TCM syndrome types and TCM diet. Syndrome of qi stagnation and blood stasis: the symptoms are that the head and neck can't lean sideways, the tenderness refuses to press, or the pain is connected with the shoulder and back, or the pain is limited to the local area. The day is light and the night is heavy, and the pain is like acupuncture. The tongue has ecchymosis and blood stasis, and the pulse is tight or astringent. The treatment should promote blood circulation, dredge collaterals and relieve pain, and the diet is light and easy to digest. Fresh vegetables and fruits can also eat Tianqitian chicken soup, black fungus, Flammulina velutipes and steamed lean meat. Cold-dampness syndrome: eat warm and cold-dispelling food, lean meat, pig's trotters, mutton stewed with ginger, angelica and so on; Damp-heat syndrome: Symptoms include stiff neck joints or muscles, pain, thirst, dizziness, dizziness, heavy head, red tongue, yellow greasy fur, and slippery or thin pulse. Treatment should clear away heat and promote diuresis, dredge meridians, eat light food, such as coix seed and winter melon porridge, and prevent abdominal distension and constipation during bed rest to avoid aggravating pain. Cold-dampness arthralgia type: stiff neck joints or muscles, increased pain and cold pain, decreased heat pain, pale and fat tongue, white and greasy fur, tight or slow pulse, so it is appropriate to warm meridians to dispel cold, dispel dampness and dredge collaterals. Yin deficiency type: eating mung beans, lilies, adenophora adenophora, white fungus stewed with rock sugar or sea cucumber, white dove, soft-shelled turtle, beehive, etc. Nourish yin and kidney, strengthen tendons and bones. Phlegm and blood stasis hinder kidney deficiency, which is manifested as stiff and painful neck joints or muscles, unfavorable flexion and extension, weak waist and knees, pale tongue, white and greasy fur, thin or astringent pulse. Treatment should be tonifying kidney and resolving phlegm, promoting blood circulation and dredging collaterals, eating kelp, mussel and pig kidney.
4.3 Functional Exercise When the symptoms of various cervical spondylosis are basically relieved or in a chronic state, medical gymnastics can be started to further eliminate the symptoms and consolidate the curative effect. When the symptoms are acute, it is necessary to rest locally, and it is not appropriate to increase exercise stimulation. Exercise should be prohibited when there are obvious or progressive symptoms of spinal cord compression, especially when the cervical vertebra moves backward. The cervical rotation of vertebral artery type cervical spondylosis should be gentle and slow, and the amplitude should be properly controlled. The principle of exercise is gradual, and it is appropriate for patients to tolerate it.
4.3. 1 Rotate left and right to sit or stand. Hands akimbo, head turn left and right in turn. Move slowly. When rotating to the maximum, stay for 3 ~ 5 minutes. Muscles and ligaments are fully stretched and rotated left and right 10 times.
4.3.2 Raise the neck and shrink the neck to show the position. Shoulders naturally lift up, neck contracts down, stays for 3 ~ 5s, and then relaxes. Repeat 10 times.
4.3.3 Stand around the neck, relax the neck, breathe naturally, slowly turn the head, and repeat clockwise and anti-needle alternately 10 times. The patient stood with his hands akimbo, his head tilted to the left and then to the right. Be slow and don't overdo it. Repeat 20 times.
4.3.4 Move your neck back and forth, stand with your hands akimbo, bend your head forward as far as possible, and look down at the ground. Look up at the sky, lean back as far as possible and move slowly.
4.3.5 Gymnastics: Raise your hands horizontally, just like the clock points to 9: 00 at 15, and then raise your arms to 10 at 10, and do it continuously for 100 ~ 200 times. Pay attention to your whole body, and your arms are flapping up and down like the wings of a bird. Stick your arms back as far as possible and do a group every day.
4.4 Instructions: The decoction of traditional Chinese medicine should be taken at the temperature of 65438 0 dose /d, and taken orally twice with an interval of 4 ~ 6h. Avoid eating cold food during taking the medicine, and avoid getting cold in the outside, so as not to aggravate the condition, and observe the effect and adverse reactions after taking the medicine at any time.
4.5 Rehabilitation guidance
4.5. 1 Keep your neck and shoulders warm, avoid heavy objects on your head and neck, avoid excessive fatigue, and don't doze off or bend your head to play with your mobile phone while riding.
4.5.2 Diet should nourish liver, kidney, qi and blood, such as stewed chicken soup with astragalus root, Shenqi longan porridge, Shen Zao porridge, etc. Avoid eating cold fruits and vegetables, and Chinese medicine decoction should be taken warm.
4.5.3 Massage the painful parts of neck and shoulder, strengthen the exercise of neck and shoulder muscles, and do flexion, extension and rotation of head and upper limbs in spare time, which can not only relieve fatigue, but also make muscles developed and toughness enhanced, thus contributing to the stability of cervical spine and enhancing the adaptability of neck and shoulder to sudden changes in neck.
4.5.4 Establish a correct mentality, master scientific means to prevent and treat diseases, and cooperate with doctors to reduce recurrence.
4.5.5 Correct bad posture and habits, avoid sleeping on high pillows, don't turn your head and shrug your shoulders, and look positively when talking and reading. Keep your spine upright.
4.5.6 Thoroughly treat the soft tissue strain of neck, shoulder and back as soon as possible to prevent it from developing into cervical spondylosis.
4.5.7 Avoid contusion when working or walking, head and neck injury when braking suddenly, and avoid falling.
4.6 Self-treatment and prevention
4.6. 1 Shake upper limbs: relax shoulders, turn left shoulders and turn right shoulders. The number of times is generally 20.
4.6.2 Grasp the empty fingers: extend your arms horizontally forward, and bend and extend your fingers 50 times each.
4.6.3 Massage the ear: Pull the ear by hand, then massage and knead until the ear is hot.
4.6.4 Local massage: Find the tender points, induration points or muscle tension near the neck, big vertebrae and Fengchi point, and massage these parts. 4.6.5 Neck movement: Neck movement mainly includes head leaning forward, backward, left and right, and slowly rotating neck in four directions. Neck rotation can relieve neck pain in a short time.
4.6.6 Long-distance acupuncture: Find the tender points on the back of hand, the back of foot, the anterolateral part of small buttock and the lateral part of calf. Then press and knead.
4.6.7 Kneading ankle tendons: Kneading hamstring muscles with both hands.
preventive measure
4.6.8. 1 Ask the patient to lie flat on the low pillow and rest. When lying on your side, the neck and trunk are in a straight line to minimize neck movement.
4.6.8.2 gave up smoking and restricted alcohol to avoid cold and humidity. Avoid washing your hair before going to bed or taking a bath at midnight or early in the morning. Avoid falling asleep before the hair is dry, otherwise it will make moisture invade the neck and induce neck diseases. In addition, special attention should be paid to keeping the neck warm. A warm neck environment is very important to prevent the recurrence of cervical spondylosis.
4.6.8.3 can avoid head and neck fatigue and reduce irritation, which is conducive to the recovery of cervical spondylosis, maintain emotional stability, be positive, cheerful and optimistic, and treat cervical spondylosis correctly.
4.6.8.4 corrects bad posture in life. The bad posture of sitting, lying and watching TV in life is the main cause of chronic strain. When you need to keep your head down or your head up at work or other labor 1 ~ 2h, you must take time to exercise your neck moderately to relax your neck muscles and reduce the continuous muscle tension and cervical fatigue. Avoid neck hyperextension or hyperflexion.
4.6.8.5 chose the right pillow. People spend13 of their life in sleep, so it is very important to choose a suitable pillow for preventing cervical spondylosis. The pillow should not be too high or too low, and the height of the pillow should be perforated. Pay attention to the regulation of diet in daily life, and eat more foods that strengthen muscles and bones. For example, dark green vegetables, broccoli, milk and so on. Rich in vitamin D, it is helpful for bone nutrition. Foods such as garlic, onions, asparagus and eggs are rich in sulfur, which helps to repair and rebuild bones, cartilage and connective tissue.
5 conclusion
According to the principle of syndrome differentiation and treatment of traditional Chinese medicine, our department adopts physical therapy such as fumigation of traditional Chinese medicine, microwave, moxibustion across objects and He-Ne laser. Through the penetration of traditional Chinese medicine, it can achieve the functions of relaxing muscles and activating blood circulation, expelling wind and relieving pain, improving local blood circulation, accelerating tissue repair, and at the same time, carrying out emotional nursing, reasonably guiding diet, correctly exercising functions, relieving local muscle tension and improving local blood circulation of patients, which can significantly improve patients' clinical symptoms, persevere and strengthen bones and muscles.
References:
[1] Xia Zhiping. China's complete book of massage [M]. Shanghai; Shanghai University of Traditional Chinese Medicine Press, 2000.68.
[2] Luo Ping, Ma Jian, Yu Hao. The application of TCM syndrome differentiation diet in patients with cervical spondylosis [J]. chinese medicine guides, 2011.09 (33):164-165.
Model essay II on nursing of cervical spondylosis: Observation on nursing effect of comprehensive rehabilitation of cervical spondylosis Abstract: Objective: To explore and analyze the application of comprehensive nursing in comprehensive rehabilitation of cervical spondylosis and summarize its clinical value.
Methods: 65,438,000 patients with cervical spondylosis who came to our hospital from February 2002 to April 20, 2002 were analyzed retrospectively. Randomly divided into observation group and control group, 50 cases in each group. Patients in the control group were given routine symptomatic care, while patients in the observation group were given psychological and dietary care on the basis of routine care. To observe and compare the clinical efficacy of two nursing methods in the treatment of cervical spondylosis between the observation group and the control group.
Results: There was significant difference in curative effect between the observation group and the control group (P
Conclusion: Comprehensive nursing is helpful to improve the comfort of patients and promote their recovery as soon as possible, which is worthy of clinical reference and promotion.
Keywords: Clinical effect of comprehensive nursing care of cervical spondylosis
China Library Classification Number R47 Document Identification Number B1008-1879 (2012)12-0267-02.
Cervical spondylosis is a degenerative disease of cervical spine caused by strain, which is related to long-term neck flexion [1]. It mainly includes cervical osteoarthritis, cervical nerve root syndrome, hyperplastic cervicitis, cervical disc herniation and so on. In recent years, the prevalence of cervical spondylosis is on the rise [2]. Patients with severe cervical spondylosis may even compress nerve roots, causing acid paralysis or dizziness from arms to fingertips, and some cervical spondylosis may even compress the nerve center-spinal cord. Clinical research shows that the causes of cervical spondylosis are mostly caused by cervical strain, hyperosteogeny and ligament thickening, and some even caused by traffic accidents, which leads to the compression of cervical spinal cord, nerve roots and vertebral artery, thus causing various functional disorders [3]. Commonly used clinical treatments include traction, physical therapy and acupuncture. In order to make patients actively cooperate with clinical treatment and nursing, more effective nursing can not only reduce the risk of treatment, but also help to improve the quality of life of patients [4]. In order to explore and analyze the application of comprehensive nursing in the comprehensive rehabilitation of cervical spondylosis, this paper made a retrospective analysis of the patients with cervical spondylosis who came to our hospital from 20 12 to 20 12, and adopted comprehensive rehabilitation nursing measures, which achieved satisfactory clinical results. The report is as follows:
General data and methods of 1
1. 1 general information. From 20 12 to 20 10, there were 100 cases of cervical spondylosis with complete clinical data in our hospital, aged 38-63 years, with an average age of 53.4 years. Randomly divided into observation group and treatment group. 50 cases in the observation group, 33 males and 65,438 07 females, aged 38-63 years, with an average age of 53.6 years; 50 cases in the control group, 32 males and 65,438 08 females, aged from 39 to 62 years, with an average age of 53.2 years. There was no significant difference in sex, age and location of the disease between the two groups. 0.05), which is comparable.
1.2 treatment and nursing methods. In contrast, giving patients routine nursing measures mainly includes: paying attention to the patient's breathing, heart rate, blood pressure, pulse and so on. To observe whether the patient has complications and inducing factors. Assist patients to complete relevant examinations, and there are no relevant contraindications.
The observation group took comprehensive nursing measures on the basis of routine nursing, mainly including:
(1) Psychological nursing: Cervical spondylosis belongs to the category of psychosomatic diseases. The disease has a long course of disease, complicated symptoms, and many induced idleness, which is difficult to cure and causes serious psychological obstacles to patients. Therefore, it is necessary to carry out psychological care for patients, and psychological care should run through all the treatment and nursing operations of patients during hospitalization. The service attitude of medical staff is the first choice for patients. At the time of admission, patients are prone to psychological reactions such as nervousness, anxiety and fear due to physical discomfort and contact with strangers and the environment, which leads to the loss of their roles. Nursing staff should actively and enthusiastically accept patients and properly arrange patient beds. The ward environment, the staffing of doctors and nurses in charge, and matters needing attention during hospitalization were introduced in detail, so as to make them have a good first impression, comprehensively and carefully understand and evaluate the patient's illness, family situation and psychological anxiety, conduct targeted psychological counseling, explain the occurrence and development process of the disease, and cite cases that have been successfully cured, so as to relax and eliminate fear. At the same time, coordinate social support systems such as family members and units to avoid pressure from patients due to treatment costs. Building a harmonious nurse-patient relationship can enhance patients' sense of security and trust in nursing staff from all aspects, enable patients to treat diseases correctly, establish confidence in overcoming diseases, improve patients' compliance with treatment and nursing, and improve clinical treatment effect.
(2) Dietary care: A reasonable diet can ensure the body's nutritional supply, make the viscera function vigorous, enrich the qi and blood, and enhance the disease resistance. Instruct patients to eat a low-salt and low-cholesterol diet, which should be light and easy to digest, and do not eat fried foods and foods that cause bloating in dissolved oxygen meters. Eat less and eat more. Eat more fiber-rich foods and fruits.
(3) Rehabilitation instruction, which guides the patients with cervical spondylosis to carry out rehabilitation exercises, can make the corresponding neuromuscular muscles of the neck get regular traction and contribute to the recovery of the neck function. When you exercise neck muscle function, you should first do long-term contraction exercise to increase muscle strength, and then do neck exercise. When doing exercises, you should relax all over and step by step. After discharge, Tai Ji Chuan and other exercises can be properly carried out to harmonize qi and blood and cultivate one's morality.
(4) Strengthening publicity and education should actively educate and guide patients to understand cervical spondylosis, and educate patients to judge and describe their own pain, so as to understand the condition. By improving patients' understanding of cervical spondylosis, it is beneficial to improve patients' compliance in the treatment process.
1.3 evaluation criteria of curative effect. In order to evaluate the nursing effect, patients' satisfaction is divided into satisfaction, basic satisfaction and dissatisfaction, and the application effect of different nursing methods in patients with cervical spondylosis is evaluated accordingly.
1.4 statistical processing method. Statistical data were processed by SPSS 12.0 statistical software, and statistical data were tested by X2 test, P
Two results
The control group was satisfied with 15 cases, basically satisfied with 20 cases and dissatisfied with 15 cases, with a satisfaction rate of 70%. In the observation group, 20 cases were satisfied, 25 cases were basically satisfied and 5 cases were dissatisfied, with a satisfaction rate of 90%. After X2 test, there was a significant difference in nursing satisfaction between the observation group and the control group (P
To sum up, with the development of modern nursing science, nurses should pay more attention to it? People-oriented? Nursing concept [5]. Comprehensive nursing has become an important direction of current nursing work. This article through comprehensive nursing is conducive to improving the comfort of patients and promoting their recovery as soon as possible, which is worthy of clinical reference and promotion.
refer to
Ren Ke Mei. Observation on the effect of comprehensive nursing intervention on patients with cervical spondylosis [J]. ordinary care, 20 10/0,2 (8): 382-383.
[2] Shi Zizhen. Observation and analysis of the influence of comprehensive nursing care on patients undergoing cervical spondylosis surgery [J]. Contemporary Medicine of China.201.14 (18):119-120.
[3] Zhao Xiaoping, Song Yuping. Comprehensive nursing of cervical spondylosis of vertebral artery type [J]. hebei journal of traditional chinese medicine Journal, 20 10/0,8 (32):1249-1250.
[4] Jiang Shubo Rehabilitation guidance and nursing of cervical spondylosis [J]. Chinese and foreign women and children's health, 20 1 1, 7 (19): 332-333