3 cham cuu tri lieu

Dieu tri them C\lC bQ cac chung va benh 1.Gi8i thieu v~ chum va cuu Chum la dung kim charn vao huyet nharn rnuc dich phong va tri benh.. Ngoai charn kim, nay con nhieu phuong phap charn

ThS.BS Nguyen Manh Tri

ThS BS NGUYEN M~NH TRI

1 Mo ta duoc kY thudt Chdm va Cuu.

2 Trinh bay phuong phap chdm B6.

3 Trinh bay phuong phap chdm Ta.

4 Trinh bay phuong phap chdm CUu ai~u tri cac benh If Han - Nhiet

5 Nhdn thuc duce gia tri cua phuog phap chdm cuu trong viec phong

- tri benh va b6i duimg ndng cao sire khoe.

T hS BS N guyln Ma nh Tri

Sau khi eo mot chan doan theo Y hoc cd truyen, chung ta eo eo sd d€ lap ra mot phuon huyet diSu trio Bai nay giup ch cluing ta eo th€ chu dong chori huyet mot each linh hoat phu hQP vdi tirng hoan canh ma khong phai thuoc long nhieu cong tlnrc nghiern phuo g

V oi hinh anh Cay Nhan Sinh Bang Y, eo thS diSn dat pp chan doan theo y hoc cd truyen la giai dap nhtrng eau hoisau :

1.Tinh trang 12r~ : nguyen khi (nguyen am, nguyen dU011g)

2 Tinh trang 12 canh cay nrc tang phii, kinh nao benh

3 Tinh trang 5 la cay : nguyen nhan tu hanh nao trong ngii hanli

(5 eo nang phd bien) dac biet nguyen nhan tu han hay nhiet

Benh di~n ra la noi thuong man tinh tren eo dia suy ye'u ( hu)

hay ngoai cam dip tinh tren eodia con khoe manh (thuc).

4 Ch~n doan n guyen nhiin

11 ssuc oicn CRAM COO TRI Ll$U.

Tren eo Sd chan dean, chung ta eo muc dich tri lieu sau :

1 B6i dtiong nguyen khi :nguyen am, nguyen dU011g

2 Di~u chinh ngfi hanh ( dac biet la Thiiy - Hoa) cua kinb b?nh :

Hu thi bd, Thuc thi ta.

3 Dieu tri them C\lC bQ cac chung va benh

1.Gi8i thieu v~ chum va cuu

Chum la dung kim charn vao huyet nharn rnuc dich phong va tri benh

Kim eo th€ duce lam bang nhieu kim loai khac nhau nhu bac, vang, sat ma khong d. Kim eo nhieu loai : to, nho, dai, ngan khac nhau

Ngoai charn kim, nay con nhieu phuong phap charn khac nhu kich thich dien tai huyet, tac dong len huyet bang laser, bang bim huyet, go huyet, tac dong lien tuc bang chon chl, dan vien tu hay thuy charn

ThS.BS Nguy e n Manh T r i

Cuu la dung nhiet va hoi cua diroc thao thong kinh hoat lac duce d6t chay d~ tac dong Ie n huyet

C6 nhicu each ciiu : ctiu true tiep, ctru each girng, ciru each toi, ciru gian tiep bang dieu ngai ; dat v~t n6ng Ien huyet ; sa'y a'm huyet bang can cuu va den hong ngoai hay may s~y toe,

Sau day la mot phuong phap charn ciru vdi nhirng ky thuat don gian va hieu qua

2 Ky thuat cham cuu

- Thai dQcua ngiroi thay thudc: hoa nha, nghiern nic, an can, giai thich, hudng dftn tan tinh, 6n dinh tarn ly va tao niern tin noi nguoi benh

- Benh nhan nam hoac ngdi theo tu the' that tu nhie n thoai mai nhat

- Xac dinh dung huyet c~n cham ( phuong phap do thon, m6c giai ph~u, )

- Vo trung dung cu charn ciru va sat khufin d huyet c~n cham phai thuc hien nghiern chlnh d~ tranh viern nhiern tai hai

- Thuong dung loa ikim nho , nen charn cho cay kim dung vung la du

- f)i~u quan trong la phai diic khi nrc la cam giac kim cham mut chat tai ch6, benh nhan cam tha'y te r~n, ca ng, nang d ch6 charn, da noi cham irng hong,

- C6 th~ charn kim thang dung vdi mat da, hoac charn xien tuy theo vung da va eo day - mong khac nhau

- Charn nhanh, gon theo thu phap sau :

• Cam can kim doe theo ng6n tay cai va tro

• Co va barn manh 2 d~u ng6n tay vao kim nhu the tnrong cung

• B~ t manh hai ng6n tay v~ phia tnrdc d~ ph6ng kim nhu ban mui ten

- Dung dieu ngai to bang dieu thuoc la ma ha tren huyet, mudn a'm huyet thi dti xa, mudn n6ng huyet thi d~ g~n C6 th~ ctru each girng, chu y tranh d~ phong da C6 th~ dung may sa'y t6c, den hong ngoai va can ciru d~ cuu

ThS.BS N gu yln Manh Tri

C§n chu y phong tranh cac tai biSn eo th~ x a y ra khi cham ciru:

- V1Jl1gcham (shock) : eo th~ do benh nhan qua met, doi bung, hay qua SQ' hai, l~n d~u cham nhiSu kim va kich thich qua manh, Xir tri: binh tinh rut hSt kim, cho benh nhan nam nghi, day barn huyet Nhan Trung, Bach Hoi, Dung TuySn, Thap Tuyen,

- Chay mau, b~m tim: c~n trong khi cham cac huyet g~n mach mau, chirom nong noi b~m tim,

- Cong kim - gay kim: kh6ng dung kim bi cong, gi set, tranh thu thuat th6 bao qua manh Khi gay kim, neu than kim con 10 tren mat da thi binh tinh g~p ra, nSu than kim kh6ng con tren mat da thi danh dau, c6 dinh noi kim gay, goi tieu ph~u

- NhiSm trung: kh6ng cham noi vung da viem nhiem, 16 loet, can dam bao thu thuat v6 khu~n khi cham

- Phong: c~n chu y, c~n trong va ti mi khi CUu cho benh nhan, tranh d~ rot tan len da

3 Ky thua t ba ta

3.1 Chiim biJ

- Hirdng charn kim thuan chieu voi du'ong kinh

- Ve nhe kim thuan chieu d6ng h6 d6i vdi cac kinh ly tarn (tire dfty ngon tay cai v€ phia tnrdc, keo ngon tay tro lui lai )

Ve nhe kim nguoc chieu kim d6ng h6 d6i vdi cac kinh hudng tarn (tiic dfty ngon tay tro v€ phia tnrdc, kco ngon tay cai lui lai )

- Thoi gian hill kim la u

- Rut kim nhanh, bit 16charn

- Muon b6 am khi thi charn nhe cue duong vao kim dang charn am huyet d~ keo them dien tich am v€ do

Mucn b6 duong khi thl charn cue am vao kim dang charn dirong huyet d~ keo them dien tich duong v€ do

Kinh ly tarn

Ve thudn c hieu

Kinh hirdng tarn

Ve nguac chieu

M6i ngai ciiu eo tinh fim nong, ho vao duong huyet eo nghia la b6

ThS BS Nguyen Manh Tri

3.2 Chain la

- Hirdng charn kim nguoc chieu vdi duong kinh

- Ve kim nguoc chieu d6ng h6 d6i vdi cac kinh ly tarn

Ve kim thuan chieu kim d6ng h6 d6i vdi cac kinh hudng tarn

- Thai gian hru kim ngan

- Rut kim tu tu, kh6ng bit 16 cha m

- Dung cue am cua may dien charn dS tii am; dung cue duong dS

ta dirong

Kinh huong tarn Kinh ly tarn

Ve thudn chieu Ve nguac chieu

M6i ngai ciru c6 tinh ffm n6ng, khi ta ha cac am huyet chinh la lam cho n6 bot am (ta am)

4 Nghe thuut chum cuu:

Ky thuat charn ciru that ra rfft don gian: nhung cung mot ky thuat lai c6 nhirng k€t qua khac nhau d6i vdi nguoi charn va benh nhan khac nhau Sir khac nhau do d trong nghe thuat charn crru.

Nguoi thay charn cuu do h9C thirc ro rang va kinh nghiern day dan

se toa ra mot niern tu tin va gay niern tin Ion manh d6i vdi benh nhan Khi benh nhan tin tudng thl m6i mtii kim la mot qua tang vui mirng dS don nhan, con khi benh nhan chira tin nrdng thi rn6i mui kim la mot v~t nhon dam vao da thit ho c~n d~ khang lai

Mat khac, neu ngiroi nhac SI vdi cay dan "la mot" mdi c6 khuc nhac hay, thi ngiroi th~y charn ciru va benh nhan cling vay Trong khi cham ciru hay theo dei hop tac lang nghe dien bien cua nhirng trieu chirng mot each ky hrdng cho den khi ngiroi benh cam thffy d~ chiu do mdi la mot thii phap cao tay

ThS.BS N g yl n Manh Tri

C CHAM CUU TRJ BtNH THUQC HAN

1 CaA.M CUu VLEU TRl Hl1 HAN (Duong thuy suy)

1 Cham b6, ciru tm cac dirong thuy huyet cua kinh benh

Pht -+ Xich tracli

Tarn bao -+ Khuc tracli

£)~i tnrong -+ Nhj gian

Ti~u tnrong -+ tu» cdc

Ty -+ Am ldng tu y en

Can -+ Khac tu ye n

Bang quang -+ Thong cdc

2 Charn b6 cac du mo huyet, nguyen huyet cua kinh benh

11 CHAM CUu VLEU TRl THl/C HAN (am thuy vtfQng)

1 Ta charn, ciru n6ng, xoa n6ng cac am thuy huyet

Ph€ -+ Xich trach .

Dai tnrong -+ Nhi gian

Ti~u tnrong -+ tu« cdc

Bang quang -+ Thong cdc

2 Charn b6 cac du mQ huyet, nguyen huyet cua kinh benh

3 Ciru tm, xoa tm cac huyet nhay cam khac va Cs cac vung dau,

ThS.BS N guy e n Ma n h Tri

D CHAM CUU TRJ B~NH THUQC NHI~T

1 CHAM CUu TRJ HL1 NH1$T (Am Hoa suy)

1 Charn b 6 cac am ho a huyet cua kinh benh

PhS

Tarn

Tarn bao

Dai tnrong

Ti~u tnro g

Tarn tieu Ty

Th?n

Can

V i

Bang quang Bdrn

~ N g ut e'

~ Thi e u phi i

~ Lao c ung

~ Duan g kh e

~ Du a n g cdc

~ Chi ea u

~ D a i do

~ Nh ie n cd c

~ H a nli g i a n

~ Gi d i kh e

~ C o n [ o n

~ Du a n g phu

2 Charn b 6 cac du me) huyet, nguyen huyet cua kinh benh

11 CHAM CUu THl/C NH1$T (Duong Hoa vUQng)

1 Charn ta cac duong hoa huyet cua kinh benh

PhS

Tarn Tarn bao

B ;li tnrong

Ti~u tnrong Tarn tieu Ty

Th?n

Can Vi Bang quang Bdrn

~ N g u t e

~ Thi e u phu

~ Lao cung

~ Duang kh e

~ Du a n g cdc

~ Chi eau

~ Dai do

~ Nhien cdc

~ Hanli gian

~ Giai khe

~ C o n [on

2 Cha rnb 6 cac du me) huyet, nguyen huyet ciia kinh benh

3 Chuorn mat cac huyet vung dau n6ng

ThS.BS Nguy~n Ma nh Tri

KETLU!N

1 Benh chung xuflt hien thieri hmh van trang voi nhieu ten goi khac nhau Nhung cluing v~n eo nhirng cai chung Tnrdc bit cu benh nhan nao, benh gt thi cluing ta c~n :

1 Ch~n doan g6c rSNguyen am - Nguyen duong

2 Chan doan Tang phu Kinh benh

3 Ch~n doa n Han hay Nhiet

4 Chan doan Hu' hay Thuc

Tu do chung ta eo mot chan doan huong d~n cluing ta l~p phucng hudng dieu tri

2 Bai nay nhan manh den Han - Nhiet, Thiiy - Ho a VI phan IOn cac tnrong hop (khoang 80%) d~u do 2 nguyen nhan tren Nhtrng nguyen nhan khac se d~ c~p d bai sau

3 Bang phuong phap ch~n doan kha don gian, chung ta dff tun

duce m~ u s6 chung cua rit nhieu chirng benh khac nhau va d~ xuat ra cac phuong phap charn ciru va phuong duce gop phan tri duce nhieu chung benh tren

4. Qui luat "hoijc co hoijc khollg": Nhi~u th~y charn ciru charn

rtt nhieu kim len rit nhieu huyet; nguci thi charn nhorn huyet nay, nguoi thi charn nhorn huyet khac; ngtroi thi dung kim dai charn sau, nguoi dung kim ng~n cham can, nguoi dung dien charn, ngirci dung mai hoa cham ngiroi nao cung da t kSt qua rieng cua minh Va mot di~u rit

may man la h~u nhu kh6ng eo tai bien do tac dong len huyet (d6i khi eo tai bien do scj hai lam vung charn, do nhiern trung neu kh6ng v6 trung hay do th6 bao trong ky thuat) Co thS neu len qui luat tac dung cua

huyet hodc no dap ling, cam ling cho muc tieu di~u hoa dieu chinh eo

quan tang phii, hoac kh6ng eo tac dung nao ca VIno kh/ing cam ling.

5 Nguni thay charn ciru cting gi6'ng nhir nhirng ngirci di sari ban chim:

Hoac ho dung dan eo nhieu vien nho ban tdi con chim dang d~u treri canh S6 dan nho ca ng nhieu thi cang eo nhieu hy vong tning con chim Do la cham nhieu kim theo cac c6ng thirc, hoac dau dau charn diy vdi nhieu hy vong se g~p huyet cam ling

Hoac ho dung tirng vien dan bari tirng con chi m dang d~u tren canh Di~u thti vi la sir tinh toan ky va eo ky thuat chinh xac Do la cham ciru it kim ma d~ dang tning huyet cam irng

Hoac ho dung tirng vie n dan ban tirng con chim dang bay!