Far Mako Punk Tur

 

FARMAKOPUNKTUR  

Also known as hydroacupunctrue, this is a needling therapy where injecting certain Chinese or Western medicines are injected into the acupoint 248 248 Introduction to Acupuncture and Moxibustion or special spot. spot. It has the double double effectiveness of acupuncture and medication. Instruments: Injectors of 1 ml, 2 ml, 5 ml, 10 ml and 20 ml or disposable syringes. Ordinary  points are injected with long pinheads of No. 5 for dentistry, points of the eye with No. 4  pinheads, and points of deep parts parts with long pinheads for blocking. Commonly used physic liquor: 0.20% – 2% 2% procaine hydrochloride, vitamins B1, B2, K3 and C, atropine, physiological saline, water for injection, various kinds of antibiotics, γaminobutyric acid, acetylglutamine, adenosine triphosphate, Danshen injection (Salviae Miltiorrhiza), Danggui injection (Angelicae Sinensis), Yuxingcao injection (Herba Houttuyniae) and Yemugua injection (Fructus Chaenomelis). Manipulation Preoperative preparation Sterilize the injectors and the local skin, and examine the liquor; never use those with ampules damaged, overdue or deteriorated. Check the name and dosage, make hypersensitive tests in advance for those which may cause an allergy like procaine or penicillin, and they should not be applied to patients with positive reaction. Injecting method Insert the needle quickly and push it slowly slowly to the desired depth, lifting and thrusting it till the arrival of qi, then pump back the wick-in-needle. If there is no back-streaming of blood, inject the liquor. Generally, push into the liquor at a moderate speed but slowly for the weak and patients with chronic diseases. And push quickly for patients with strong constitutions or acute diseases. If the liquor is too much, injection by layering from deep to superficial should  be employed. The dosage for injection to differ ent ent acupoints depends on the patient’s condition and constitution, the drug concentration and the acupoint area, mostly ranging from 0.3 ml to 1 ml, sometimes from 5 ml to 20 ml. The manipulation is applied once daily or once every other day 7 – 10 10 times as a course. Indications Acupoint injection is widely used in the clinic and is applicable to various systemic diseases,  but is more commonly used for pain and inflammatory diseases, such as trifacial neuralgia, sciatica, lobar pneumonia or acute appendicitis. During the injection, never use drugs with high concentration or too- strong stimulation. For some parts like the joint cavity and some  points like hegu (LI 4) of infants in particular, this method should should not be employed.

 

CHRONIC GASTRITIS Selection of points: Commonly used points —  points  —   ganshu (BL 18), weishu (BL 21) and zusanli (ST 36). Supplementary point  —   dannang (EX-LE6). Manipulation: Choose one of the injections  —   Huanqi (astragalus), vitamin B12 (50 mcg) or vitamin C injection  —   or use them alternately. Two pairs of points are selected each time and dannang (EX-LE6) may be added if there is complicated cholecystitis. A No. 5 pinhead for dentistry and a 5 ml injector are used to insert into ganshu (BL 18) 18) and weishu (BL 21) obliquely toward toward the spine, and perpendicularly perpendicularly into zusanli (ST 36) and dannang (EX-LE6) till the arrival of qi. Slightly Slightly lift and thrust the needle to cause a stronger sensation of needling before injecting the liquor. The manipulation is performed once every other day for three months as a course, at an interval of seven days  between courses. PEPTIC ULCER Selection of points: Commonly used points  —   zusanli (ST 36), zhongwan (RN 12), pishu (BL 20) and weishu (BL 21). Supplementary points  —   yanglingquan (GB 34) is added for abdominal distension, jianjing (GB 21) for for nausea and neiguan (PC 6) for vomiting. vomiting. Manipulation: Three or Four commonly used points are employed at each session. Vitamin B1 injection 100 mg (2 ml) and vitamin B12 injection 250 mcg (1 ml), mixed intensively with an 5 ml injector, is injected slowly into the selected points on the arrival of qi, 0.5 ml for each point, once a day, 10 times as a course, at an interval of 1 week. TRIGEMINAL NEURALGIA Selection of points: Commonly used point  —   ashi point (trigger point). Supplementary  points  —   yuyao (EX-HN4) and yangbai (GB 14) added for pain in branch I; sibai (ST 2), yingxiang (LI 20) and yifeng (SJ 17) for pain in branch II; dicang (ST 4), jiache (ST 6) and yingxiang (LI 20) for pain in branch III. Manipulation: Prepare 654-2 injection or water for injection. Commonly Commonly used points and two or three supplementary points on the affected side are employed at each session. Locate the ashi point, the trigger point which induces pain in the trigeminal nerve, and it is given an intradermal injection with 0.1 ml injection water using a No. 4 needle, which makes the local skin protrude in the form of a white heap (not (not subcutaneous injection). The other acupoints are punctured with a No. 5 needle from dentistry until the sensation of an electric shock or something else arises. Then lift the needle a little, push into 654-2 injection, 5 – 10 10 ml at each  point. The manipulation is applied once daily, or once every other day or twice a week for cases of infrequent seizures, 10 times as a course.

 

SCIATICA Selection of points: Commonly used points  —   huantiao (GB 30), yinmen (BL 37), yanglingquan (GB 34) and chengfu (BL 36). Supplementary points —  points —  dachangshu  dachangshu (BL 25), shenshu (BL 23), weizhong (BL 40) and kunlun (BL 60). Manipulation: Select one of the following injections: a 10% glucose injection (5 –  (5 – 10 10 ml for each point); vitamin B1 2 ml (100 mg) with a 0.5% procaine hydrochloride injection 10 ml (4 – 6 ml for each point). Commonly used points are taken as the main points, and one or two supplementary  points may ma y be added for a better bett er effect, all from f rom the t he affected aff ected side. s ide. For the first session, only huantiao (GB 30) is punctured deeply with a long needle, slightly lifting and thrusting until the sensation of an electric shock arises (be sure not to insert the needle forcefully or aimlessly, in case of injuring the nerve). Then withdraw the needle 1 – 2 fen, before injecting the liquor. The points are alternately selected, according to the most obvious tenderness. Huantiao (GB 30) must be employed for the first three or four sessions. The operation is applied once every day or every other day, at 10 – 15 15 sessions as a course. IMPOTENCE Selection of points: Commonly used points  —   yangweixue [consisting of five points: one  point at the upper one-third, middle one-third and lower one-third respectively; bilateral  points 1 cun to the one-third one-t hird of the middle along the line between shenque (RN 8) and qugu (RN 2)]. Supplementary points  —   three groups, namely (1) sanyinjiao (Sp 6) and shenshu (BL 23); (2) changqiang (DU 1); (3) ciliao (BL 32). Manipulation: The injections are 0.5% procaine, strychnine nitrate (2 mgL/1 ml) or 5% glucose 30 ml mixed with strychnine 1 ml. Commonly used points and one group of supplementary points are employed at each session. Five needles 2.5 cun long are inserted into five points successively, with thrusting, thrusting, lifting, twirling and rotating of the needles to induce a sensation radiating to the penis. The needles are retained for 20 min, with interrupted stimulations. Supplementary point injection. group is given strychnine injection; one pair ofpoints pointsareisgiven employed, with the The two first points used alternately. A No. 5 dental needle is inserted till the arrival of a needle sensation and then 0.5 ml strychnine is injected, twice per week. The second group is given 0.5% procaine. After the skin anaphylactic test, a No. 7 needle is inserted along changqiang (DU 1) and along the tailbone upward to the ischial rectal fossa, and then 20 ml procaine is injected (be sure not to inject it into the rectum), also twice per week. The third group is given the mixed injection, which is better to be prepared temporarily. t emporarily. With the patient in the prone sitting sit ting posture, locate ciliao (BL 32), insert a No. 5 needle to a depth of 1 cun, and inject 4 ml liquid, also twice per week. The three groups may be applied in turn, once a day, six times ti mes as a course. RADIATION REACTIONS Selection of points: zusanli (ST 36).

 

Manipulation: A fluorodexamethasone injection is given as physic physic liquor, and bilateral  points are employed at each session. 5 – 10 10 mg of fluorodexamethasone (5 mg/ml) is sucked into a 5 ml injector with a No. 5 pinhead for dentistry, which is inserted perpendicularly till the arrival of qi, and 2.5 – 5 mg is injected into each point. The treatment is performed once daily, at three sessions as a course. ACUTE APPENDICITIS Selection of points: Lanweixue (EX-LE7). Manipulation: Water for injection is taken as physic liquor, 10 – 20 20 ml at each session. Bilateral lanwei points (EX-LE7) are employed, employed, with the tenderness punctured w with ith a No. 5 needle for dentistry. For patients with strong constitutions and dull to needling, the needle  points are inserted obliquely upward (at an angle of 45° with the skin) with slow injection of 10 ml for each point within 5 min; for patients with weak constitutions and sensitive to needling, the needle points are inserted perpendicularly downward or obliquely downward with slow injection of 5 ml for each point. The treatment is applied once daily. URINARY CALCULI Selection of points: Commonly used points  —   shenshu (BL 23), guanyuan (RN 4) and yinlingquan (SP 9). Supplementary points  —   zusanli (ST 36), sanyinjiao (SP 6), yanglingquan (GB 34), daheng (SP 15), zhongji (RN 3) and huantiao (GB 30). Manipulation: A 10% glucose injection is taken as the physic liquor. Commonly used points are employed at each session, according to symptoms, Yanglingquan Yanglingquan (SP 9) and Huantiao (GB 30) are added for colic onset; sanyinjiao (SP 6), for dysuria and hematuria; zhongji (RN 3), for distension in the lower lower abdomen and interrupted urination; zusanli (ST 36), for dry vomiting and abdominal distension; and dasheng (SP 15), for abdominal pain around the umbilicus. Needle the points with slight lifting, thrusting, twirling and rotating till the arrival of qi, followed by injecting 2 – 8 ml of the liquor into each point. The treatment is applied once every day or every other day, at 30 sessions as a course. ACUTE TONSILLITIS Selection of points: Commonly used points —  points  —   hegu (LI 4), yifeng yifeng (SJ 17) 17) and zusanli (ST 36). Supplementary points  —   quchi (LI 11), xingjian (LV 2), zhaohai zhaohai (KI 6) and dazhui (DU 14). Manipulation: Select either physiological saline or vitamin B1 (50 mg/ml). Commonly used  points taken as the main points, which may be replaced by supplementary points if no satisfactory result is achieved. Two or three points are employed at each session, lateral to the head or face, and lateral or bilateral to the four limbs. 0.30 – 1.0 1.0 ml of liquor is injected into each point, depending on the thickness of the local muscles. Take a No. 5 pinhead for dentistry in injection, and push in the liquor on the arrival of qi. The treatment is applied once daily, or twice daily for severe cases.

 

CHRONIC FATIGUE SYNDROME Selection of points: Zusanli (ST 36). Manipulation: Bilateral points are employed. The patient is in the sitting or supine position. Both zusanli points (ST 36), after routine sterilization, are perpendicularly punctured to a depth of of 4 cm, lifting and thrusting appropriately till there is a sensation of soreness and distension, by astragalus injection, 2 mlaat eachinterval. point, once every other day, at 10 sessions as afollowed course. The next course begins after 5-day

SAFETY A safe injection, phlebotomy (drawing blood), lancet procedure or intravenous device insertion is one that: • does not harm the recipient; • does not expose the provider to any avoidable risk; • does not result in any waste that is dangerous for other people.  people.   Unsafe injections can result in transmission of a wide variety of pathogens, including viruses,  bacteria, fungi and parasites (2). They can also cause non-infectious adverse events such as abscesses and toxic reactions. Reuse of syringes or needles is common in many settings. It exposes patients to pathogens either directly (via contaminated equipment) or indirectly (via contaminated medication vials) (3, 4).The risks of unsafe injection practices have been well documented for the three primary bloodborne pathogens  –   human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV). Health workers should wear non-sterile, well-fitting latex or latex-free gloves when coming into contact with blood or blood products. To disinfect skin, use the following steps (27 – 29): 29): 1. Apply a 60 – 70% 70% alcohol-based solution (isopropyl alcohol or ethanol) on a single-use swab or cotton-wool ball. DO NOT use methanol or methyl-alcohol as these are not safe for human use. 2. Wipe the area from the centre of the injection site working outwards, without going over the same area. 3. Apply the solution for 30 seconds then allow it to dry completely. When giving medication: –  medication:  –  DO  DO NOT use a single loaded syringe to administer medication to several patients (i.e. ensure one needle, one syringe, one patient!);  –   DO NOT change the needle in order to reuse the syringe; –  syringe;  –  DO   DO NOT use the same mixing syringe to reconstitute several vials; –  vials; –  DO  DO NOT combine leftover medications for later use.

REFERENSI Ren Zhang. Introduction to Acupuncture and Moxibustion Volume 6. World Century Publishing Corporation. 2013 WHO best practices for injections and related procedures toolkit. WHO. 2010