颈椎病中英文对照PPT课件.ppt

颈椎病CervicalSpondylosis 颈椎病CervicalSpondylosis 1 概念Concept2 解剖Dissect3 发病因素Pathogenicfactors4 分型Classification6 中医认识TheunderstandinginTCM7 治疗Treatment 概念Concept 颈椎病 又称为颈椎综合症 是颈椎及周围的软组织 如椎间盘 黄韧带 脊髓鞘膜等发生病理改变 导致颈神经根 颈脊髓 椎动脉及交感神经受到压迫或刺激 从而产生的各种临床症状 Cervicalspondylosisreferstopathogenicchangeofthecervicalvertebraeandsofttissuessurroundingthemsuchasintervertebraldisks yellowligaments duramaterandsoon resultinginthenerveroot spinalcord thevertebralarteryandthesympatheticnerveispressedorprovoked andoccuringaseriesofsymptoms 解剖Dissect 解剖Dissect 解剖Dissect 发病因素Pathogenicfactors 年龄Age 慢性劳损Overstrain 外伤Trauma 职业Job 颈椎病分型Classification 颈型Necktypecervicalspondylosis神经根型Cervicalspondyloticradiculopathy脊髓型Cervicalspondyloticmyelopathy椎动脉型Vertebralarterytypeofcervicalspondylosis交感型Sympatheticcervicalspondylosis混合型Mixedtypeofcervicalspondylosis 颈型Necktypecervicalspondylosis 以颈部酸 痛 麻 僵为主要临床表现或颈项部压迫感的颈椎病 症状集中在颈部 转动不灵活 Mainclinicalmanifestations aciddistention pain numbnessandstiffintheneck 颈椎曲度改变Thecervicalcurvaturechange 髓核突出压迫颈神经根Compressionofthenerveroot 神经根型Cervicalspondyloticradiculopathy 1 多见于30岁以上者Morecommoninpeopleover30yearsold2 起病缓慢 病程长 反复发作 Slowonset longcourseofdisease recurrentseizures 3 颈肩部疼痛 下颈椎病变可向前臂放射 Neckandshoulderpain somecanradiatetotheforwardarm 脊髓型Cervicalspondyloticmyelopathy 以颈脊髓受损为主要临床表现的颈椎病 主要表现为走路不稳 四肢麻木 大小便困难等 Mainclinicalmanifestations Cervicalspinalcordinjury suchasunsteadywalk numbnessoflimbs micturitionanddefecationdifficulties 椎动脉型Vertebralarterytypeofcervicalspondylosis 以椎基底动脉供血不足为主要临床表现的颈椎病 主要表现为头痛 头晕 黑朦等症状 与颈部旋转有关 Mainclinicalmanifestations vertebralbasilararteryinsufficiencysuchasheadache dizzinessandamaurosis relatetotheneckrotation 交感型sympatheticcervicalspondylosis 以头颈 上肢的交感神经功能异常为主要临床表现的颈椎病 主要表现为头晕 眼花 耳鸣 手麻 心动过速 心前区疼痛等一系列症状 X线片有失稳或退变 椎动脉造影阴性 Mainclinicalmanifestations neck upperlimbsympatheticnervousdysfunction suchasdizziness tinnitus numbnessofhand heartbeattachycardia precordialpain X ray degenerationofcervicalvertebra Vertebralarteryangiographynegative 混合型Mixedtypeofcervicalspondylosis 具备以上两种或两种以上的表现者 即可确诊 Withtwoormorethantwokindsofperformanceabove 中医认识TheunderstandinginTCM 本病属于中医的 痹证 项强 眩晕 颈肩痛 等范畴 内经 中提到 风 寒 湿三气杂至合而为痹也 CervicalSpondylosisbelongsto ArthralgiaDisease Stiffneck Dizziness Neckandshoulderpain inTCM ThePlainQuestionsays Thecombinationofthreekindsofevils wind coldandwet whichleadtoarthralgiadisease 治疗Treatment 1 针灸Acupunctureandmoxibustion2 拔罐Cupping3 中频Intermediatefrequencytherapyapparatus4 超声Ultrasound5 TDPSpecificelectromagneticspectrum6 牵引Traction 针灸Acupunctureandmoxibustion 处方 以局部取穴为主Prescription Selectpointsonthelocalasmainpoints主穴 大椎天柱后溪颈夹脊阿是穴Mainpoints Jiajiintheneck EX Dazhui DU 14 Tianzhu BL 10 Houxi SI 3 Ashipoints 辩证加减Modificationwithvarioussyndromes 风寒痹阻 加风门 风府祛风通络Obstructionbythewindandcold addFengmen BL 12 Fengfu DU 16 todispelwindandremoveobstructioninthecollaterals劳伤血瘀 膈俞 合谷 太冲活血化瘀 通络止痛Overstrainandbloodstasis addGeshu BL 17 Hegu LI 4 Taichong LR 3 topromotebloodcirculationtoremovebloodstasis肝肾亏虚 肝俞 肾俞 足三里补益肝肾 生血养筋Deficiencyoftheliverandkidney addGanshu BL 18 Shenshu BL 23 Zusanli ST 36 toinvigoratetheliverandkidney 针刺作用ThefunctionofAcupuncture 1 针刺可以改善腰椎间盘局部的血液循环 促进新陈代谢 Improvelocalbloodcirculationofthelumbarintervertebraldisc promotetheprocessofmetabolism 2 消除神经根的炎症 水肿 松解粘连 改善突出物与神经根的关系 Eliminationinflammation edemaofnerveroot lysisofadhesions improvetherelationshipbetweenhighlightandnerveroot 拔罐Cupping 作用 疏通气血 消除瘀滞 温通经络 祛湿驱风 散寒活血 舒筋止痛Function Promotingbloodcirculationtoremovebloodstasis expellingwindandcold removingobstructioninthecollateralstorelievepain 机制Mechanism 1 机械性刺激作用 治疗时 由于罐内形成负压 可使局部毛细血管充血 红细胞破裂形成自身溶血现象 表皮呈现淤血 由于类组胺物质产生 刺激各器官增强其功能活动 提高机体抵抗力 负压的机械刺激通过反射途径传达到中枢神经系统 调节神经活动 1 Mechanicalstimulation Duringthetreatment duetotheformationofnegative pressureinthecup canmakelocalcapillarycongestion erythroidburst formingautoimmunehemolyticphenomenon theepidermispresentscongestion Duetoclassofhistaminesubstanceproduce stimulationofvariousorganstostrengthenitsfunction improvethebodyresistance Negativepressuremechanicalstimulationbyreflexpathwaystothecentralnervoussystem modulateneuralactivity 2 温热作用 使局部血管扩张 促进局部血液循环 改善新陈代谢和组织营养状态 使血管和细胞的通透性增强 加强了网状内皮系统的吞噬功能 有利于炎症的吸收 2 Thermaleffects Makethelocalexpansionofbloodvessels promotebloodcirculation improvetheprocessofmetabolismandtissuenutritionstate sothatenhancesthepermeabilityofthebloodvesselsandcells enhancedthephagocyticfunctionofthereticuloendothelialsystem isconducivetotheabsorptionofinflammation 中频Intermediatefrequencytherapyapparatus ElectricalstimulationoftheIntermediatefrequencytoimprovethelocalbloodcirculation sothattomitigateedemabetweentheorganizationofnervefibres reducedtissuetension eliminateorreducethelesionareaofischemiaandanoxia eliminatesomevasoactivesubstancessuchas5 serotonin bradykinin histamine substancePwhichinducedpain achievetheanalgesiceffect 中频电刺激后改善了局部血液循环 使组织内神经纤维间水肿减轻 组织张力减低 病灶区缺血缺氧状态消除或减轻 使体内一些血管活性物质如5 羟色胺 缓激肽 组胺 P物质等致痛物质得以消除 从而起到了止痛作用 超声Ultrasound 1 机械作用 软化组织 增强渗透 提高代谢 促进血液循环 刺激神经系统和细胞功能 1 Mechanicalstimulation Softtissue enhancepenetration improvemetabolism promotebloodcirculation stimulatethenervoussystemandcellfunction 2 温热作用 增强血液循环 加强代谢 改善局部组织营养 增强酶的活力 降低肌肉和结缔组织张力 缓解痉挛 减轻疼痛 同时又可降低感觉神经兴奋性 起到镇痛作用 2 Thermaleffects Improvebloodcirculation strengthenthemetabolism improvelocaltissuenutrition enhanceenzymeactivity reducedmuscleandconnectivetissuetension relievespasmandpain butalsocanreducethesensorynerveexcitability achievetheanalgesiceffect TDPSpecificelectromagneticspectrum 1 热作用 红外线被人体吸收后转变成热能 通过热传导作用而使深层以至全身加热 1 Thermaleffects Infraredabsorptionbyhumanbodyisconvertedintoheatenergy throughaheatconductioneffectandmakedeeptissueevensystemicheating 2 解痉镇痛 提高痛阈和耐痛阈 2 Antispasmodicandanalgesic Increasedpainthresholdandpaintolerancethreshold 3 治疗关节挛缩 热可以提高挛缩关节及周围组织的弹性 3 Treatmentofarticularcontracture Heatcanimprovetheelasticityofthecontractureofthejointsandthesurroundingtissues 4 免疫作用 红外线可以扩张血管 改善血液循环 提高一切自身防御机制的活性 从而有非特异性消炎作用 4 Immunefunction Infraredcandilatebloodvessels improvebloodcirculation improvetheactivityofalldefensemechanisms thushavethenonspecificanti inflammatoryeffect 牵引Traction 1 使椎间隙和椎间孔增大 改变神经根与压迫物之间的位置关系 减轻或解除神经根等组织的刺激或压迫 Enlargethevertebraandintervertebralforamen changesthepositionrelationshipbetweenthenerverootandcompression reduceorrelievetheirritationorcompressionofthenerveroot 2 牵开小关节间隙 解除滑膜嵌顿 纠正椎体的侧倾 旋转 滑脱及后关节的错位 Pulltheclearanceofthesmalljoints relievingsynovialincarceration correctionrotation slippageandjointdislocationofthevertebral 3 局部制动 减少活动所造成的刺激和摩擦 有利于神经根 脊髓 关节囊 肌肉等的水肿和炎症的吸收 Localbraking reducedirritationandfrictioncausedbyactivity whichisconducivetotheedemaandinflammatoryabsorptionofthenerveroot spinalcord jointcapsule muscleandsoon 4 降低椎间盘内压或椎间盘内产生的负压 缓冲椎间盘向四周的压力 有利于膨出的髓核还纳 Reducingintradiscalpressureornegativ