1. HYPERTENSION Lee Chong Leng 1

4. CONTENTS 1)Introduction5 - 16 2)Clinical Manifestations17 - 20 3)Essentials for Diagnosis21 4)Treatment with Tuina Therapy12- 42 5)Cautions43 6)Summary44 4

5. HYPERTENSION A very common disease, also called “primary hypertension” Marked by increasing blood pressure It can cause pathological changes of the heart, kidney and brain, etc Its occurrence often associates with age, occupation and family history 5

6. PRIMARY HYPERTENSION A major syndrome of frequent elevation of blood pressure Accounts for 80%-90% in clinical patients. Systolic pressure -- 140mmHg Diastolic pressure >= 90 mmHg 6

9. SECONDARY HYPERTENSION One of the syndromes occurring during the course of other diseases. It may be present or not, temporary or protracted Accounting for 10%-20% in clinical treatment 9

17. CLINICAL MANIFESTATIONS The clinical manifestations of hypertension varies greatly Some patients show no subjective symptoms and hypertension is often found by accident The common symptoms are vertigo, headache, red face and eyes, bitter taste in mouth, palpitation, constipation, reddish tongue and taut pulse 17

18. CLINICAL DIVISION Two types: 1.Slow progressive type 2.Rapid progressive type 18

19. SLOW PROGRESSIVE HYPERTENSION The symptoms include headache, dizziness, insomnia, memory failure, dysphoria, lassitude, on and so on The severity of the symptoms is irrelevant to the level of hypertension. The state of this type at the advanced stage is concerned with the pathological changes of the heart, brain and kidneys. 19

20. RAPID PROGRESSIVE HYPERTENSION It occurs suddenly and develop rapidly It commonly occurs among young people and those below 40 Pathological changes of the kidney and heart occur later Subject to cerebrovascular disease, heart failure and acute renal insufficiency 20

21. ESSENTIALS FOR DIAGNOSIS Hypertension is defined as systolic blood pressure >= 140mm Hg and diastolic blood pressure >= 90 mmHg without taking antihypertension drugs The patient who has a hypertension history and takes antihypertension drugs 21

22. TREATMENT WITH TUINA THERAPY Principle: Smoothing the liver to tranquilize mind, resolving phlegm and descending turbid Yin. 22

23. ACUPOINTS AND LOCATION Qiaogong, Yintang (EX-HN 3), Taiyang (EX-HN 5), Baihui (GV 20), Fengchi (GB 20), Jiaosun (SJ 20), Dazhui (GV 14), Guanyuan (CV 4), Qihai (CV 6), Shenshu (BL 23), Mingmen (GV 4), Yongquan (KI 1), head and face, neck and nape. 23

24. OPERATION The patient takes a sitting position Pushing and rubbing Qiaogong for about 1 minute Pushing from Yintang (EX-HN 3) to the hairline, along the eyebrows to Taiyang (EX-HN 5), and then around the eye socket from Yintang (EX-HN 3) to Jingming (BL 1) 24

25. 25 Qiaogong ( 桥弓 )

26. 26 Yintang ( 印堂 )

27. 27 Taiyang ( 太阳 )

28. 28 Jingming ( 睛明 )

29. OPERATION Rubbing the forehead from one side of Taiyang (EX-HN 5) to the other Using clean and dissipating manipulations to rub the Gallbladder meridian of foot-shaoyang Rubbing the forehead, face and Jiaosun, Jingming (BL 1) and Taiyang (EX-HN 5) about 3 minutes 29

30. 30 Jiaosun ( 角孙 )

31. OPERATION Grasping the vertex and, using just three fingers, rubbing Dazhui (GV 14) at neck and nape region Pressing and kneading Baihui (GV 20) and Fengchi (GB 20) Pushing from Fengfu (GV 16) down to Dazhui (GV 14) 31

32. 32 Dazhui ( 大椎 )

33. 33 Baihui ( 百会 )

34. 34 Fengchi ( 风池 )

35. 35 Fengfu ( 风府 )

36. OPERATION The same operation is performed on the bilateral courses of the bladder meridian about 4 minutes. Finally the operation is continued to the face with separate manipulation from the forehead to Yingxiang (LI 20) back and forth for about 3-5 minutes. 36

37. 37 Yingxiang ( 迎香 ) ， Cuanzhu ( 攒竹 )

38. OPERATION The patient takes a recumbent position Rubbing the abdomen clockwise and at the same time pressing the six Acupoints mentioned above for about 10 minutes 38

39. OPERATION Rubbing Shenshu (BL 23), Mingmen (GV 4) and the Governor vessel until it is warm in the local area Rubbing vertically Yongquan (KI 1) on the bottom of foot until it is warm 39

40. 40 Shenshu ( 肾俞 ) ， Dachangshu ( 大肠俞 )

41. 41 Mingmen ( 命门 )

42. 42 Yongquan ( 涌泉 )

43. CAUTIONS 1. Live a regular life: avoid overstrain do exercise under the instruction of the doctor abstain from greasy food and strong alcohol 2. Avoid emotional stimulation 43

44. SUMMARY Tuina therapy is suitable for treating slow progressive hypertension and can be used as the supplementary treatment for rapidly progressive hypertension. 44

45. 45 THANK YOU