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tqscspbuhct · Posted: Sun 14:03, 27 Feb 2011 Post subject: 针推并用治

针推并用治疗胸椎小关节紊乱症临床观察
头置于医者右肩。医者上身略前俯，右膝顶住患者胸椎棘突侧偏部位(或明显压痛点)，嘱患者缓慢深呼吸，当患者呼期末了时，术者双手用力往后下方压，右膝同时往前上方顶推，此时可闻及关节复位响声。此法多适用于胸椎中、上段小关节紊乱。2．2．2双掌重叠推压法：患者俯卧，两上肢置于身旁，胸部垫软枕，术者站在患者侧方，一手掌根部按住患椎棘突高凸出，另一只手掌在叠压，均匀用力贴紧后，嘱患者作深呼吸，待呼气之末时，沿棘突方向向前下方瞬间用力推压之，可有椎体滑动复位的感觉或闻及复位时的声响。此法多适用于胸椎中、下段小关节紊乱。2．2．3双掌交叉按压法：患者俯卧，胸部垫软枕，术者站于患侧，两上肢伸直并互相紧贴，两手掌根分别置于脊柱两旁，横突上双手手指方向相反，嘱患者缓慢深呼吸，医者的手掌随着患者胸壁的呼吸运动而起伏，乘其呼气末期肌肉放松时，顺势加大掌根按压力量，向外下方短促冲击推按，并沿脊柱由上至下按压，如闻及清脆的小关节弹响声，即是复位成功。此方法胸椎上、中、下段小关节紊乱均适用。2．2．4推压旋转脊柱法：患者正坐方凳上，脱去上衣，使脊背露出，一助手固定患者双下肢，以防转动．术者站于其患侧，以一手拇指抵住其患侧偏突的棘突，既有推压之力，又有拨动棘突之力；而以另一上肢从患者腋下绕过，再以手掌按压患者颈部，先将患者脊柱逐渐前屈曲及向对侧侧屈至紧张限制位，然后屈曲位和缓地小度转动患者躯体，逐渐将身体向患侧侧屈至最大幅度，再以突发有控制的力量旋转突破脊柱运动的弹性限制范围，同时推压棘突之拇指用力压拨，常可听到“咯噔”的响声而复位．此方法多常限于男性患者使用。2．2．5牵引推压复位法：患者俯卧床上，其双手抓住床头，助手用双手握住患者双踝上方，缓慢用力向下牵引，待患者肌肉放松，脊柱间隙增大时，术者立于患者身旁，用两手拇指找到棘突侧偏的部位，定好用力方向，待助手将脊柱间隙牵开时，再用力下按，将侧偏棘突向脊中线推送，就可复位。此方法多适用于患者身体强壮，肌肉痉挛难以放松，采用其他方法难于收效者。3疗效观察3．1疗效标准治愈：胸椎侧偏棘突复位，背痛消失，功能恢复正常，随访l周无复发；好转：胸椎侧偏棘突有所改善，疼痛减轻，功能未完全恢复；无效：治疗前后体征、症状无变化。3．2治疗结果本组以针推并用治疗96例，按上述疗效标准判定，治愈83例，占86．46％，好转l2例，占12．5％，无效l例，占1．04％。治疗最少1次，最多7次，多数患者经治疗l一2次即可治愈。4讨论胸椎小关节紊乱多见于从事体力劳动的青壮年，女多于男，多数患者有肩背部慢性劳损或外伤史，其发病与长时间处于某种不良体位或由于提、搬、举姿势不当，或上肢用力不协调而扭伤，是椎体单个或多个发生轻微的变位而造成后小关节紊乱，出现背部深、浅肌群反射性肌紧张和疼痛，或合并肌肉损伤出现背痛，其治疗以解除滑膜嵌顿，使失稳的小关节恢复正常的解剖位置为原则，而关节周围尤其是深层软组织的充分放松是纠正错位的前提。我们采用针刺敏感点、夹脊穴，局部揉按的方法，可改善血液循环，有效松解受累关节，尤其是深层韧带、肌肉等软组织，促进韧带、关节束等病损的修复，为正骨手法复位创造有利的条件，而正骨手法可通过改变胸廓症状的运动，增宽关节间隙，恢复关节损伤后炎症的吸收，解除对神经组织的机械的压迫和炎症刺激。复位后可在背部采用揉、提、散、拍、打等手法整理。针推并用治疗能散结通络、理气活血、剥离粘连、缓急解痉、使筋脉疏通，疼痛消除。发病后治疗越早，疗效越好，常能收到立竿见影的效果。应注意的是：诊断须准确，应排除因骨折、肿瘤、结核等引起的胸背痛，以免加重病情或产生不良后果。
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ghdhair100 · Posted: Mon 5:18, 28 Feb 2011 Post subject:

String Quartet
Choosing A String Quartet If you are arranging a special event then a string quartet can add an extra something to your day. When it comes to arranging any type of event there are loads of different music choices that you can go for. The type of event that you are putting together will probably affect the type of music set up that you want. For example at a teenager's birthday you'll probably want a DJ where as for a wedding you may want something a little different. For a really beautiful and classy musical accompaniment at a wedding then you could go for a string quartet. If you decide that you would like a string quartet for your big day then you'll still have more decisions to make. There are lots of bands that offer to play as a string quartet at your wedding or event so you'll need to decide which band you want to use. These have different styles and different music set lists, so have a browse through and see what bands are available and who plays the type of music that you would like. Even then you'll need to decide exactly when you would like them to play. For example if you have a string quartet for your wedding you could have them playing the wedding march as the bride arrives, or you could have them playing to greet your guests at the reception. You could even have them doing a turn during the dinner for your guests to enjoy. This is all down to personal preference and is something that you'll need to discuss with the band you are using for your event. Don't forget that they'll have played at weddings and events before so they will be able to give you advice on what works and what doesn't and so hopefully help make your decision a bit easier. If you think that a string quartet may suit the event that you have coming up then why not start looking online at the different bands that are available in your local area. If you search online you should find details of plenty of bands, they'll have details on the songs they play and the services that they offer so you should have no problem in deciding on the band you would like to play at your event.
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