内医大中医推拿学课件：扳法

扳法

PullingManipulation概念Concept用双手在治疗关节的两端做相反方向用力扳动肢体的手法，称为扳法。Amanipulationpeformedwithbothhandspullingthetwoarticularendsofthelimbswithforceinoppositedirections.分类Classification

颈部扳法

PullingoftheNeck颈椎斜扳法

Obliquely-pullingoftheCervicalVertebrae颈椎定位斜扳法

Obliquely-pullingafterlocalizingcervicalvertebrae胸背部扳法PullingofChestandBack扩胸牵伸扳法Chest-ExpansionPulling胸椎对抗复位法Counter-reductionofThoracicVertebrae腰部扳法PullingoftheWaist一、腰椎斜扳法

Obliquely-PullingoftheLumbarVertebrae单腿腰椎后伸扳法

Pullingoflumbarvertebraewithbackwardextensionofoneleg侧卧位腰椎斜扳法Obliquely-pullingofthelumbarvertebraewiththepatientinalateralposition双腿腰椎后伸扳法

Pullingoflumbarvertebraewithbackwardextensionoftwo-legs坐位腰椎斜扳法

Obliquely-pullingoflumbarvertebraewiththepatientinasittingposition二、腰椎旋转复位法RotatingReductionofLumbarVertebrae肩关节扳法PullingofShoulderJoints前屈、后伸扳肩法Shoulder-pullingofForward-flexionandBackwardExtension外展扳肩法Shoulder-pullinginAbductingManner外展扳肩法Shoulder-pullinginAbductingManner注意事项

Precaution扳法动作在起势时，要稳妥、缓和，而在扳动的瞬间，则必须动作果断而快速，且用力刚强，两手配和要协调。Pullingatthebeginningshouldbesteadyandmoderate,whileatthemomentofpulling,resoluteandrapid,andfirmforceandcoordinationbetweenthetwohandsareneeded.扳动的幅度不得超越正常的生理活动范围；扳动的方向，无论是多运动轴关节或单运动轴关节，在每次扳动时，只能选择一个运动轴所限定的方向施术。Therangeofpullingshouldnotbebeyondthelimitofnormalphysiologicalmovements.Asforthedirectionofpulling,onlythedirectionofonemovingaxiscanbechoseninthepulling,inthecaseofjointsofmulti-movingaxesorasinglemovingaxis.在施用扳法时，往往受术关节会发生弹响声，这表明扳动的应力传递到位，手法复位成功。但在临床上，不一定每个人每次都会有此反应，只要扳动的方向与幅度正确，就会有效。故不必每次都以出现声响为手法成功的标准，更不能盲目地以扩大扳动幅度来追求弹响声。否则，往往会因过度的牵拉而造成关节、韧带的损伤。

Inaddition,inthecourseofpulling,thereisusuallyacrackintheoperatedjoint,whichmeansthestressbypullinghasreachedtherequiredpositionandsuccessofthereductionhassucceeded.Butclinicallyitisnotnecessaryforeveryonetohavesuchacrackineverypulling.Theoperatingiseffectivesolongasthedirectionandrangeareright.Forthisreason,there’snoneedforeachpullingtohavesuchacrackstandard,stilllesstoconcentrateoncracksbyblindlyenlargingthepullingrange.Otherwiseanover-pullingwouldresultininjuriesofjointsandligaments.临床在施用扳法时，往往先用其他手法在关节周围操作，待痉挛的肌肉放松、挛缩的韧带、筋腱软化以及痛势缓解后，再用本法整治患病关节。这样不但可提高扳法的成功率，而且术者也可以少受痛苦，并避免手法造成的损伤。Beforetheclinicalpulling,othermanipulationsareusuallyoperatedaroundtheaffectedjoints.Thismanipulationisappliedtoitonlywhenspasmodicmusclesarerelaxedandcontractedligamentsandtendonssoftened,andthepainremitted.Inthiswaynotonlythesuccessrateofpullingcanbeincreasedbutthedoctorsaveshisefforts,thepatienthaslesspain,andpullinginjuriesareavoided.功效

Effect具有整复关节紊乱及半脱位、松解粘连、滑利关节、矫正畸形、恢复关节运动机能等功效。Ithasthefunctionofrestitutingarticulardisturbanceandsemiluxation,releasing

adhesion,lubricating

joints,correctingdeformityandrenewingarticular-movingability.临床应用

ClinicalApplication本法适用于全