ThS.BS Nguyen Manh Tri ThS BS NGUYEN M~NH TRI Mo ta duoc kY thudt Chdm va Cuu Trinh bay phuong phap chdm B6 Trinh bay phuong phap chdm Ta Trinh bay phuong phap chdm CUu ai~u tri cac benh If Han - Nhiet Nhdn thuc duce gia tri cua phuog phap chdm cuu viec phong - tri benh va b6i duimg ndng cao sire khoe ThS.BS Nguyln Manh Tri Sau eo mot chan doan theo Y hoc cd truyen, d€ lap mot phuong chung ta eo eo sd huyet diSu trio Bai giup cho 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 phuong A Ml)C etcn CHAM CUU NHAC 14-1 PmidNG pIlAp CHAN DoAN 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 ho i sau : Tinh trang 12 r~ : nguyen ( nguyen am, nguyen dU011g) Tinh trang 12 canh cay nrc tang phii, kinh nao benh Tinh trang la cay : nguyen nhan tu hanh nao ngii hanli (5 eo nang phd bien) dac biet nguyen nhan tu han hay nhiet Benh di~n la noi thuong man tinh tren eo dia suy ye'u ( hu) hay ngoai cam dip tinh tren eo dia khoe manh (thuc) Ch~n doan nguyen nhiin 11.ssuc oicn CRAM COO TRI Ll$U Tren eo Sd chan dean, chung ta eo muc dich tri lieu sau : B6i dtiong nguyen : nguyen am, nguyen dU011g Di~u chinh ngfi hanh ( dac biet la Thiiy - Hoa) cua kinb b?nh : Hu thi bd, Thuc thi Dieu tri them C\lC bQ cac chung va benh ta B KY THU~ T CHAM CUU 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 nhu bac, vang, sat ma khong d Kim eo nhieu loai : to, nho, dai, ngan khac Ngoai charn kim, 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 Nguyen Manh Tri 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 Ky thuat cham cuu - Thai dQ cua 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 na m hoac ngdi theo tu the' that tu nhie n thoai mai nhat - Xac dinh dung huyet c~n cham ( phuong phap 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 i kim nho , nen charn cho cay kim dung vung la du - f)i~u quan la phai diic 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 theo vung da va eo day - mong khac - Charn nhanh, gon theo thu phap sau : • • Cam can kim doe theo ng6n tay cai va tro Co va barn manh 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 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 guyln Manh Tri C§n chu y phong tranh cac tai biSn eo th~ xay cham ciru: - V1Jl1g cham (shock) : eo th~ 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 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 10 tren mat da thi binh tinh g~p ra, nSu than kim kh6ng 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 cham - Phong: c~n chu y, c~n va ti mi CUu cho benh nhan, tranh d~ rot tan len da 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 - Muon b6 am huyet d~ keo them Mucn b6 duong huyet d~ keo them 16 charn thi charn nhe cue duong vao kim dang charn am dien tich am v€ thl charn cue am vao kim dang charn dirong dien tich duong v€ Kinh ly tarn Ve thudn chieu Kinh hirdng tarn Ve nguac chieu M6i ngai ciiu eo tinh fim nong, ho vao duong huyet eo nghia la b6 duong 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 Ve thudn chieu Kinh ly tarn Ve nguac chieu M6i ngai ciru c6 tinh ffm n6ng, ta cac am huyet chinh la lam cho n6 bot am (ta am) Nghe thuut chum cuu: Ky thuat charn ciru that rfft don gian: nhung cung mot ky thuat lai c6 nhirng k€t qua khac d6i vdi nguoi charn va benh nhan khac Sir khac d nghe thuat charn crru Nguoi thay charn cuu h9C thirc ro rang va kinh nghiern day dan se toa 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, 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 cham ciru hay theo dei hop tac lang nghe dien bien cua nhirng trieu chirng mot each ky hrdng cho den ngiroi benh cam thffy d~ chiu mdi la mot thii phap cao tay ThS.BS N guyln Manh Tri C CHAM CUU TRJ BtNH THUQC HAN CaA.M CUu VLEU TRl Hl1 HAN (Duong thuy suy) Cham b6, ciru tm cac Pht Tarn Tarn bao £)~i tnrong Ti~u tnrong Tarn tieu Ty Th~n Can Vi Bang quang £)Cfm dirong thuy huyet cua kinh benh -+ Xich tracli -+ hai -+ Khuc tracli -+ Nhj gian -+ tu» cdc -+ Djch m/in -+ Am ldng tuyen -+ Amcoc -+ Khac tuyen -+ NQi dinh -+ Thong cdc -+ Hi?p khe tus« Charn b6 cac du mo huyet, nguyen huyet cua kinh benh 11 CHAM CUu VLEU TRl THl/C HAN (am thuy vtfQng) Ta charn, ciru n6ng, xoa n6ng cac am thuy huyet -+ Xich trach Ph€ -+ Thie'u hai Tarn -+ Khuc trach Tarn bao -+ Nhi gian Dai tnrong -+ Ti~u tnrong tu« cdc -+ Tarn tieu Djch m/in -+ Am ldng tuy~n Ty -+ Amcoc Th~n -+ Can Khuc tuyen -+ NQi dinn Vi -+ Bang quang Thong cdc -+ £)Cfm Hiep khe Charn b6 cac du mQ huyet, nguyen huyet cua kinh benh Ciru tm, xoa tm cac huyet nhay cam khac va Cs cac vung dau, eo cirng lanh ThS.BS Nguyen Manh Tri D CHAM CUU TRJ B~NH THUQC NHI~T CHAM CUu TRJ HL1 NH1$T (Am Hoa suy) Charn b6 cac am ho a huyet cua kinh benh PhS ~ Ngute' Tarn Tarn bao Dai tnrong Ti~u tnrong Tarn tieu ~ ~ Thieu phii Lao cung ~ Duang khe ~ Duang cdc Th?n Can Chi eau Dai ~ Nhien cdc ~ Hanli gian Vi ~ Gidi khe Bang quang Bdrn ~ Con [on ~ Duang phu Ty ~ ~ Charn b6 cac du me) huyet, nguyen huyet cua kinh benh 11 CHAM CUu THl/C NH1$T (Duong Hoa vUQng) Charn cac duong hoa huyet cua kinh benh PhS ~ Ngu te Tarn ~ Thieu phu Tarn bao ~ Lao cung BC;li tnrong ~ Duang khe Ti~u tnrong ~ Duang cdc Tarn tieu ~ Chi eau Ty ~ Dai ~ Nhien cdc Th?n ~ Hanli gian Can ~ Giai khe Vi ~ Con [on Bang quang ~ Duang phu Bdrn ta Cha rn b6 cac du me) huyet, nguyen huyet ciia kinh benh Chuorn mat cac huyet vung dau n6ng ThS.BS Nguy~n Manh Tri KETLU!N Benh chung xuflt hien thieri hmh van trang voi nhieu ten goi khac Nhung cluing v~n eo nhirng cai chung Tnrdc bit cu benh nhan nao, benh gt thi cluing ta c~n : Ch~n doan g6c rS Nguyen am - Nguyen duong Chan doan Tang phu Kinh benh Ch~n doa n Han hay Nhiet Chan doan Hu' hay Thuc Tu chung ta eo mot chan doan huong d~n cluing ta l~p phucng hudng dieu tri Bai nhan manh den Han - Nhiet, Thiiy - Ho a VI phan IOn cac tnrong hop (khoang 80%) d~u nguyen nhan tren Nhtrng nguyen nhan khac se d~ c~p d bai sau Bang phuong phap ch~n doan kha don gian, chung ta dff tun duce m~ u s6 chung cua rit nhieu chirng benh khac va d~ xuat cac phuong phap charn ciru va phuong duce gop phan tri duce nhieu chung benh tren 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 tac dong len huyet (d6i eo tai bien scj hai lam vung charn, nhiern trung neu kh6ng v6 trung hay th6 bao 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 VI no kh/ing cam ling Nguni thay charn ciru cting gi6'ng nhir nhirng ngirci di sari ban chim: Hoac ho dung dan eo nhieu vien nho ban tdi chim dang d~u treri canh S6 dan nho ca ng nhieu thi cang eo nhieu hy vong tning 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 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 chim dang bay!