therapeutic method
To treat hiccups, we should first treat the primary disease that causes hiccups, and then treat them symptomatically. Here are some simple and practical methods to block nerve reflex and stop burping. 1, distracting attention and eliminating tension and bad stimulation.
2. Take a deep breath first, then hold it for as long as possible, then exhale and repeat several times.
3. Drink boiled water, especially slightly hot boiled water, take a big sip and swallow several times.
4. Wash your hands, insert your index finger into your mouth and gently stimulate your throat.
5. Put the mixed gas into a plastic bag and inhale. The mixed gas contains 90% oxygen and 10% carbon dioxide.
6. Chew ginger slices.
7. Wash the raw leek, squeeze out the vegetable juice and take it orally.
8. Persimmon stalks (referring to the stalks of fresh persimmons or dried persimmons) are 20 tablets each time, decocted 100 ml, and taken orally twice, 50 ml each time. You can also add leek seeds and fry together as appropriate.
Drug treatment of intractable hiccups
The so-called intractable hiccup refers to those who last for weeks or even months and are ineffective in general treatment. According to the experience of various parts of our country, it is summarized as follows. You can choose one of them and often get good results.
(1) scopolamine. Intramuscular injection of scopolamine 0.3 ~ 0.4 mg every 6 ~ 12 hours, a total of 1 time, until hiccups stop.
(2) Norfloxacin alcohol. Norfloxacin alcohol 5 mg, taken orally, three times a day, usually takes effect in 2 ~ 3 days. After hiccups stop, take the medicine for 2 ~ 3 days to consolidate the curative effect.
(3) ephedrine. Intravenous injection of ephedrine 5 mg usually takes effect 15 seconds after injection.
(4) cinobufotalin. Intramuscular injection of cinobufotalin 2 ~ 4 ml, 2 ~ 3 times a day. Generally, after taking 1 ~ 2 times, the hiccups are relieved, and the symptoms disappear completely after 3 ~ 4 days.
(5) Ritalin. Ritalin (20 mg) was injected intramuscularly, and repeated injection was performed after 2 hours.
(6) Antiepileptic drugs. Taking 100 mg of antiepileptic drugs and 5 mg of diazepam three times a day can control the seizure after two weeks.
(7) the method of swallowing cigarettes. Methods: Take a rectangular empty paper box with an opening at one end, light the scraps of paper with fire, put them into the paper box, and then release them to produce smoke. Immediately press the open end of the carton tightly around the patient's lips, leave his nostrils, and tell him to eat food with his mouth open and swallow smoke, but avoid inhaling smoke. After swallowing 1 ~ 3 minutes, the hiccups stopped. Then, add and subtract Fu Xuandai Zhetang and Lilac Powder, daily 1 dose, divided into 2 ~ 3 doses, which can consolidate the curative effect.
traditional Chinese medicine
The main symptoms are that the stomach gas does not fall, and it rushes up to the throat, producing, um, repeated guttural sounds, short and frequent uncontrollable sounds, and no sound. Also known as "Feng" and "Fa". The location of the disease is mainly in the middle jiao, and the stomach qi moves against the diaphragm. Can be caused by improper diet, stomach loss and health; Or emotional disharmony, liver qi invading the stomach, or lack of healthy qi. Caused by qi and blood failure. Syndrome differentiation and treatment of hiccup should first distinguish between deficiency and excess, cold and heat. Common syndromes are: ① Hiccup due to stagnation of stomach cold. The symptoms are, um, dull and continuous voice, upset stomach, reduced fever, white tongue coating and slow pulse. Treat moderate and moderate temperature and dispel cold. Use clove powder. ② Hiccup caused by epigastritis of stomach fire. The symptoms are, er, loud voice, irritability, bad breath and cold drinks, red tongue with yellow fur and slippery pulse. The treatment should be clearing away heat and dredging fu-organs, and adding Xiaochengqi decoction. ③ Hiccup due to Qi-blocking and phlegm-blocking. Symptoms are excessive phlegm and saliva, uh, expectoration, fullness in the chest and hypochondrium, or nausea and anorexia, greasy tongue coating and slippery pulse. Fu Xuan Daihe Decoction is suitable for reducing qi, resolving phlegm and regulating stomach. ④ Hiccup due to deficiency of spleen and stomach yang. The symptoms are, um, deep voice, shortness of breath, pale face, cold limbs, pale tongue and weak pulse. Treating the middle warmer, well, it can be flavored with Lizhong decoction. ⑤ Hiccup caused by insufficient stomach yin. The symptoms are short and discontinuous voice, dry mouth, dry tongue, less food, red tongue with little coating and rapid pulse. It is advisable to nourish yin and stomach, and use Yiwei decoction to add flavor. This mild disease can heal itself without treatment. A few critically ill patients have hiccups in the late stage, which is a sign of decreased vitality and stomach gas failure, and the prognosis is poor.
burp
Pronunciation: e you
Explanation: The breath in the throat is opposite to the sound.
Source: Wang Kentang's standard of syndrome differentiation and treatment: "Hiccup, the so-called Cleisthenes."
Acupuncture is mainly used to treat stubborn pathological hiccups. The first modern report was published in 1957 [1]. Hiccup is one of the traditional indications of acupuncture and moxibustion, so the clinical data of acupuncture and moxibustion in the past 40 years are very rich. However, acupuncture became more and more mature in treating this disease after the 1980s. In the method of acupoint selection, through a lot of observation and application experience, including syndrome differentiation, disease differentiation and acupoint selection, a variety of effective acupoint prescriptions were screened and summarized. There are various methods of acupoint stimulation, including body acupuncture, acupuncture, pointer, ear acupuncture and eye acupuncture. They are all in use and the effect is satisfactory. In addition, many individual cases of severe intractable hiccups cured by acupuncture are also reported, which is also worthy of attention.
Of course, it must also be pointed out that there are few articles about the mechanism of acupuncture treatment of this disease.
Traditional therapy in China
acupuncture and moxibustion
(1) acupoint selection
Main point: Zhong Kui.
(2) treatment
Take the first acupuncture point in Zhong Kui as an example. It can be acupuncture. Acupuncture and Moxibustion: The patient lies on his back, relaxes his clothes and trousers, and after local disinfection, he uses No.28 0.5 ~ 1 inch fine needle to vertically enter the left and right Zhong Kui points at the same time, with a depth of about 0.2 mm, and then strengthens the stimulation by twisting. When inserting the needle, let the patient take a deep breath from the nose, and then do the maximum breath-holding action. Hold your breath continuously for 3 ~ 5 times during needle transportation. Once the hiccup stops, make the patient take a deep abdominal breath, keep the needle for 30 minutes, and give the needle every 5 minutes 1 time. Or electrify with electro-acupuncture instrument for 30 minutes, choose intermittent wave, and adopt the stimulation amount that patients can tolerate. Moxibustion: Suitable for severe hiccups. You can apply a little vaseline on Zhong Kui point, and then set an moxa cone the size of a wheat grain to light it, and it will be strong for 5 ~ 7 times in a row, 1 ~ 2 times a day. If the moxibustion scar oozes, it can be coated with gentian violet liquid medicine and covered with sterile gauze.
(3) Evaluation of curative effect
55 cases were treated by the above methods. Acupuncture treatment of 50 cases, 49 cases were cured, ineffective 1 case (caused by primary liver cancer), the effective rate was 98% [5]. Five patients with advanced liver cancer were treated with moxibustion. Results Only 1 case recurred after moxibustion, but moxibustion was still effective and the rest were effective [6].
Electroacupuncture
(1) acupoint selection
Key points: Swallowtail, Tianding and Zhongshan.
Matching points: Tiantu, Leque, Zusanli and Neiguan.
(2) treatment
Choose 1 point for each point, and choose 1 ~ 2 points for matching. At Kyubi no Youko point, use a 5-6-inch long needle, quickly insert the needle into the skin at an angle of 25 degrees, then lie down, pierce into Jianli or Xiawan point, and leave the needle for half an hour. If it is invalid, it will add thorns to the sky; Pierce the acupoint with a 2-inch filiform needle to a depth of about 0.2 ~ 0.3 inch, then turn the needle downward and pierce 1 ~ 15 inch along the posterior chest wall (pay special attention to safety when stabbing the tiantu point, and the needle tip should not be tilted to the left or right). After that, the electro-acupuncture instrument is connected, the negative pole is connected with pigeon tail, and the positive pole is connected with mutation. Using continuous wave, high frequency (3000 ~ 5000 times/min) and strong current (intensity suitable for patients) were applied first, and power was applied for 65438 0 minutes. Then adjust the current intensity and frequency to the extent that the patient feels comfortable, and continue to power on for half an hour. The zenith point can make the patient lie on his back. Take a 28-gauge 2-inch needle, first stab it straight into the acupoint for about 0.2 inch, and then pierce it in the direction of the sky map. When the filiform needle penetrates to a certain depth and touches the phrenic nerve (at this time, the patient may have reflex diaphragm contraction), then the electroacupuncture instrument (bilateral tripod) is connected. Stimulate 1 min with continuous wave, high pulse rate and strong current (which the patient can tolerate), and then adjust it to the low frequency and weak current that the patient feels comfortable. At Zhongshan point, the patient opens his mouth and takes a deep breath, and the needle tip pierces the acupoint 0.3 ~ 2 inches upward along the skin. Oblique stab both sides of the column point to the elbow with a depth of 0.2 ~ 0.5 inch. First strengthen the stimulation, and then electrify the needle according to the above method. In Neiguan and Zusanli, acupuncture was performed after hiccups stopped, and the above methods were used to tonify deficiency and stop diarrhea. All the above methods should be adhered to 15 minutes, 1 time every day, 3-5 times, and one course of treatment.
(3) Evaluation of curative effect
The above method was used to treat 129 cases, and the total effective rate was 88.3 ~ 97.4% [2 ~ 4].
needle
(1) acupoint selection
Key points: Yifeng and Tianding.
Matching points: Neiguan and Zusanli.
(2) treatment
Take only one main point at a time, and add points when the curative effect is not obvious. At a wind point, press it again with the thumb pulp at the depression behind the root of the earlobe until it hurts, or press it in the direction of the mandible, about 1 min. If it doesn't heal once, press it several times. Tianding point, thumb or middle finger pointing to abdomen, click this point (unilateral or bilateral) 1 ~ 3 minutes. Press the bamboo point again with two thumbs, and press the other four fingers close to the valley point continuously for 5 ~ 10 minutes from light to heavy, depending on the degree of acid swelling. At Zusanli, first inject 0.5 ml of atropine into the acupoint, and then press Neiguan point with the belly of your thumb, from light to heavy, until you feel pain and numbness in the acupoint area, and press for 5 ~ 10 minutes each time. Stubborn people can press it several times.
(3) Evaluation of curative effect
* * * 82 cases were observed, 79 cases were cured and 3 cases were ineffective. The total effective rate was 96.3%.
Auricular acupuncture
(1) acupoint selection
Key points: middle ear and stomach.
Matching points: liver, spleen, sympathetic, Shenmen, subcortical and adrenal.
(2) treatment
You must choose the main points, and add 2 ~ 3 points each time according to the symptoms. Take 0.5-inch needle shallow puncture and diarrhea in the ear, twist or wind the needle handle for half a minute, then pierce the stomach meridian point, lift the needle and insert it until it is angry, and fix the buried needle with adhesive tape. According to the symptoms, the needle was buried 1 ~ 2 days. Acupuncture of acupoints can be used. Leave the needle for 30 minutes after getting angry. Usually take both points.
(3) Evaluation of curative effect
* * * Treated 109 cases, the results showed that 107 cases were cured, 2 cases were ineffective, and the total effective rate was 98.2% [1 1 2].
Eye acupuncture
(1) acupoint selection
Main acupoints: upper jiao, middle jiao, gallbladder and stomach.
(2) treatment
After local disinfection, the patient closes his eyes, the operator presses the eyeball with his left hand to tighten the skin in the orbit, and holds the No.32 5-minute needle with his right hand. In the acupoint area 2 minutes away from the edge of the orbit, he gently inserted the needle along the skin. If there is a feeling of electric shock, ants jumping up and down, or feeling sour and numb, it means that acupuncture is holding your breath, and keep the needle 15 ~ 20 minutes. 65438+ 0 times a day, 2 times in severe cases.
(3) Evaluation of curative effect
* * * 30 patients with intractable hiccups (course of disease 3 ~ 10 days) were treated by the above methods, and all of them were cured. 26 cases were cured within 3 times [13].
Acupoint injection
(1) acupoint selection
Key points: Divide into two groups. Neiguan sky map1; 2. Zhongwan and Zusanli.
(2) treatment
Liquid medicine: atropine, 1% procaine injection, vitamin B 1, B6 injection. Select 1 (Vitamin B 1 is used with B6).
Take 1 min at one time and select alternately; You can also just take Neiguan or Zusanli. 0.5 ml 1% procaine was injected at each point; Take 2ml of vitamin B 1 and B6 injection respectively, and mix them evenly, 2ml for each point; Atropine only takes one acupoint at a time, and each acupoint is 0.5 mg. If it doesn't work after 3 hours, inject it into the other side of the hole. The rest drugs are 1 time per day.
(3) Evaluation of curative effect
* * * 38 cases were treated with/kloc-0, and the effective rate was 95.8 ~100% [14 ~16].
Body acupuncture plus ear acupuncture
(1) acupoint selection
Main acupoints: Shu Ge, middle ear (auricular point).
(2) treatment
The patient takes lateral position and Shu Ge points on both sides. The doctor used four 1 inch filigree needles to obliquely pierce the acupoints at about 1.5cm up, down, left and right, with the needle tips all pointing at the acupoints, and applied a small twist technique. At the same time, use a 0.5-inch millineedle on one side of the middle ear point until you feel pain. Leave it for 20 minutes, and then take out the needle. Every day 1 time.
(3) Evaluation of curative effect
Eight cases were treated with this therapy. After 1 ~ 2 times of treatment, they all recovered, and there was no recurrence after half a year's follow-up [17].
Acupuncture needle applied to body
(1) acupoint selection
Point: a sunken valley
(2) treatment
Let the patient lie on his back or take a sitting position, taking both sides. Use a 2-inch needle to insert the needle 1.5 inch towards the center of the foot, and twist it for 5 minutes. At the same time, ask the patient to take a deep breath and hold it for as long as possible, then exhale slowly and leave the needle for 30 minutes. Repeat this breath-holding action during the needle retention, and do the needle every 5 minutes. Every day 1 time,1time is a course of treatment.
(3) Evaluation of curative effect
After a course of treatment, 196 cases were cured and 4 cases were effective. The total effective rate was 100% [18].
Main references
[1] Lin Yingqiao. Acupuncture treatment of diaphragmatic spasm after abdominal operation. Fujian Traditional Chinese Medicine1957; 2(5):2 1。
[2] Long Anmin. Observation on therapeutic effect of acupuncture on 60 cases of hiccup. Hebei journal of traditional chinese medicine Journal1987; (3):30。
Zhu Fulin, et al. 30 cases of intractable hiccup treated by acupuncture. journal of traditional chinese medicine, Jiangsu1983; 4( 1):46。
[4] Chen Gaocai. 39 cases of air ventilation acupuncture hiccup. Jiangxi Traditional Chinese Medicine1986; (2):36。
[5] 50 cases of intractable hiccup were treated by Fei, et al. New Chinese Medicine1988; 20( 1):38。
Hua Yanling, et al. Five experiences in treating hiccups by moxibustion at Zhong Kui point. Shanghai Journal of Acupuncture1984; 3( 1): 18。
[7] Gu. 32 cases of hiccup treated by pressing Yifeng. Journal of traditional chinese medicine, Zhejiang1984; 19(4): 165。
Xia Jinling, wait. Treatment of hiccup with acupressure at Neiguan point and Zusanli injection. New Chinese Medicine1986; 18(9):3 1。
[9] Zhao Mengsheng. 20 cases of intractable hiccup treated by Diantianding. Jilin traditional Chinese medicine 1986, (4): 16.
[10] Gong. Acupoint acupressure for diaphragmatic spasm. Journal of traditional chinese medicine, Zhejiang1980; 15(5):20 1。
Liu Shulan. 47 cases of severe hiccup (diaphragmatic spasm) treated by auricular acupuncture. China Acupuncture1987; 7(2):46。
Nie et al. Observation on 62 cases of diaphragmatic spasm treated by auricular needle penetration and needle embedding. Henan Traditional Chinese Medicine1986; ( 1):34。
Pang wenqing 30 cases of intractable hiccup treated by eye acupuncture. Guangxi Traditional Chinese Medicine1989; 12(2):30。
[14] Gui Fanghu et al. 50 cases of intractable hiccup treated by atropine acupoint blocking, Journal of Integrated Traditional Chinese and Western Medicine1990; 3( 1):49。
[15] Yang Shukun. 48 cases of hiccups were treated by injecting vitamin B 1 and B6 into Neiguan point. Journal of Integrated Traditional Chinese and Western Medicine1988; 8(2): 1 1。
[16] End of blade closing. 40 cases of intractable hiccups treated by acupoint injection of procaine. Shanghai Journal of Acupuncture1988; 7( 1):2 1。
[17] Treating hiccups with four needles around white acupoints. China Acupuncture1997; 17( 1):24。
[18] Xu Shunzeng. 200 cases of intractable hiccup treated by acupoint pressing. China Acupuncture1997; 17(8):7。
First, syndrome differentiation
1, food stagnation
Main manifestations: loud wheezing, abdominal distension, anorexia, thick and greasy tongue coating, smooth and powerful pulse.
2. qi stagnation
Main manifestations: frequent hiccups, epigastric pain, fullness in chest and hypochondrium, thin tongue coating and strong pulse.
3, stomach cold
The main manifestations are: er, the voice is slow and powerful, and the temperature drops slightly, especially when it is cold, the stomach is uncomfortable, the tongue coating is white and moist, and the pulse is late.
Second, treatment.
The main treatment principle is to regulate the stomach and stop it. Alas, acupuncture and purgation should be used for those with food stagnation and qi stagnation. Acupuncture for patients with stomach cold is used to dispel stomach cold.
Prescription: Shu Ge, Zhongwan, Neiguan and Zusanli.
Accumulated food plus great deficiency; Qi stagnation is added halfway up the mountain, which is too impulsive; Patients with stomach cold add epigastric pain.
Cupping can also be used for treatment. Commonly used acupoints are: Shu Ge, Geguan, Ganshu, Zhongwan and Rugen.
The name of disease syndrome. Upsurge of stomach gas, er, er, an audible symptom. See the third volume of Rejuvenation of All Diseases. One is xx, hiccup. "Neijing" called Xu. Jin and Yuan Dynasties were often called cough. Also known as eating backwards, eating bad. Commonly known as fighting. Its sound is short, which is different from long sound. Hiccup is divided into cold and heat, heat, qi, phlegm, blood stasis and deficiency, and it is also divided into exogenous hiccup, internal injury hiccup, cough with yang syndrome and hiccup with yin syndrome. See each article for details. This syndrome can be seen in stomach, diaphragm spasm, nervous hiccup, and also in critical diseases.
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