中医与影像医学在骨肌病变中的作用课件

中医与影像医学 在骨肌病变中的作用 EmpiricalScience earlyacupuncture HistoryofTCM AlthoughmodernmedicineisestablishedinAsia traditionalmedicinealsoplaysabigroleinpeople shealthcare andisgaininginpopularityinothercountriestoo Traditionalmedicine asystemofancientmedicalpracticethatdiffersinsubstance methodologyandphilosophytomodernmedicine playsanimportantroleinhealthmaintenanceforthepeoplesofAsia MillionsofpatientsaroundtheworlduseTCMorarelatedpractice InHongKongandmainlandChina approximately60 ofthepopulationhasconsultedtraditionalmedicinepractitionersatleastonce 尽管现代医学已经立足于亚洲 但传统医学仍扮演着重要角色 甚至在其他国家也越来越受到人们的欢迎 古代传统医学体系和医疗实践中使用的与现代医学不同的药物 方法和理念在亚洲各国人民的健康维护中起着重要作用 数以百万计的世界各地患者使用传统中医或相关实践 在香港和中国大陆 大约60 的人至少有一次传统中医咨询 TCMisdescriptiveandphenomenological ittypicallydiagnosespatientsusingconceptsbasedontherelationshipbetweensignsandsymptoms obtainedthroughquestioning listening palpation visualinspectionandsmelling Incontrast Western style modernmedicinehasmainlyusedsinglebiomarkerstodescribediseasestates forexamplediagnosingtype2diabetesbymeasuringglucoselevels ButthereisagrowingrealizationintheWestthatsinglebiomarkersarenotenough AllsystemsgoJanvandrGreefisaprincipalscientistattheNetherlandsOrganizationforAppliedScientificResearch TNO 各种文化都有自己哲学科学 特别是在医学方面 二十世纪的西方似乎证明这一点 使得我们对生理学和生物化学的了解有了巨大的进步 中医重视现象的描述 它通常使用基于体征和症状之间关系的概念 通过询问患者 望 触 扣 听 甚至于闻气味来诊断 相比之下 西方现代医学主要采用单一的生物标志物来诊断疾病 例如测量血糖诊断糖尿病 但人们已日益认识到单一的指标是不够的 AllsystemsgoJanvanderGreefisaprincipalscientistattheNetherlandsOrganizationforAppliedScientificResearch TNO TraditionalChineseMedicine 中医从过去的2000年里观察获得了和医学有关的知识 进行了多种调查和并积累了临床经验在这漫长的时间里 其理论和治疗方法已经被反复使用和完善 但总体来讲还是一门经验科学 Philosophies哲学Personalized个性化Integration整体观 TCM WesternMedicine TheconceptsofAsia straditionalmedicinesmightsoundalientoWesternears butsomeofthemarestartingtoevolvetofitscientificinvestigation Theadvantagesanddisadvantagesofthetwosystems TCMandWesternMedicine arethepremiseoftheintegrationThegapsofthetwosystemsareclosingThetwosystemscannotreplaceeachother butinsteadtheywillfilleachotherout TCM holistic butthelackofanalyticalmethodsWesternMedicine multipleanalyticmethods butthelackofoverview 影像医学如何和中医合作 在传统中医里没有影像检查一说 所以影像医学对中医来讲完全是新的学科 利用现代医学技术来验证中医的各种征象和中医药的疗效是主要的结合点 放射科是重要的现代医学工具 可以用来验证各种中医的治疗方法 ImagingandTCMsyndromedifferentiationofcervicalspondylosis 陈木养 余洪希 王东坚等 颈椎病影像学征象与中医辨证分型的相关性研究 现代医院 2010 痹症型 眩晕型 ImagingandTCMsyndromedifferentiationofcervicalspondylosis intervertebralspace intervertebralforamen X rayofcervicaldisease cervicalcurvature facetjoint positionofodontoid X rayofcervicaldisease Diametersfromspinousprocesstomidline Forwardandbackwardangle horizontalangleofvertebralbody CTofcervicaldisease discherniation spinalstenosis CTofcervicaldisease 严福根 王健 腰椎间盘突出症3 0T磁共振影像与中医证型的相关性研究 浙江中医杂志 2013 ImagingandTCMsyndromedifferentiationofprolapseoflumbardisc ImagingandTCMsyndromedifferentiationofprolapseoflumbardisc hyperosteogeny hypertrophyoffacetjoints disc spacenarrowing LumberDiscHerniation LumberDiscHerniation 摘要 Cerebralmetabolicchangesinmenafterchiropracticspinalmanipulationforneckpain OguraT TashiroM MasudM etal AlternTherHealthMed 2011 17 6 12 7 Objective TheaimofthepresentstudywastoinvestigatetheeffectsofCSMonbrainresponsesintermsofcerebralglucosemetabolicchangesmeasuredby 18F fluorodeoxyglucosepositronemissiontomography FDG PET Methods Twelvemalevolunteerswererecruited BrainPETscanningwasperformedtwiceoneachparticipant atrestingandafterCSM Results Increasedglucosemetabolismwasobservedintheinferiorprefrontalcortex anteriorcingulatedcortex andmiddletemporalgyrus anddecreasedglucosemetabolismwasfoundinthecerebellarvermisandvisualassociationcortex inthetreatmentcondition P 001 OguraT TashiroM MasudM etal Cerebralmetabolicchangesinmenafterchiropracticspinalmanipulationforneckpain AlternTherHealthMed 2011 17 6 12 7 X rayandefficacyofTCMtreatmentofcervicaldisease 张明才 石印玉 陈东煜 等 矫正关节突关节 骨错缝 手法治疗神经根型颈椎病的有效性研究 上海中医药杂志 2011 intervertebralforamen 张明才 石印玉 陈东煜 等 矫正关节突关节 骨错缝 手法治疗神经根型颈椎病的有效性研究 上海中医药杂志 2011 X rayandefficacyofTCMtreatmentofcervicaldisease facetjoint 张明才 石印玉 王翔 等 手法矫正寰枢关节骨错缝的有效性研究 上海中医药杂志 2009 positionofodontoid Malepatient 60y changesincervicalphysiologicalcurvatureaftercervicalmassagetherapy 詹松华 赵喜 谭文莉 等 神经根型颈椎病推拿治疗的MSCT评价 中国医学计算机成像杂志 2012 CTandefficacyofTCMtreatmentofcervicaldisease CTandefficacyofTCMtreatmentofcervicaldisease Changesofcervicalspinalcurvature 詹松华 赵喜 谭文莉 等 神经根型颈椎病推拿治疗的MSCT评价 中国医学计算机成像杂志 2012 BeforeTreatment AfterTreatment Malepatient 60y changesinodontoidprocesspositionaftercervicalmassagetherapy CTandefficacyofTCMtreatmentofcervicaldisease 詹松华 赵喜 谭文莉 等 神经根型颈椎病推拿治疗的MSCT评价 中国医学计算机成像杂志 2012 Thedistancedifferencebetweenodontoidprocessandbothsidesofblock 詹松华 赵喜 谭文莉 等 神经根型颈椎病推拿治疗的MSCT评价 中国医学计算机成像杂志 2012 1 15 0 65 0 38 0 43 BeforeTreatment AfterTreatment CTandefficacyofTCMtreatmentofcervicaldisease Malepatient 61y changesinintervertebralforamenaftercervicalmassagetherapy CTandefficacyofTCMtreatmentofcervicaldisease 赵喜 谭文莉 杨烁慧 等 多层螺旋CT评价推拿治疗神经根型颈椎病椎间孔变化的价值 颈腰痛杂志 2011 Anteroposteriordiameteroftheintervertebralforamen CTandefficacyofTCMtreatmentofcervicaldisease 赵喜 谭文莉 杨烁慧 等 多层螺旋CT评价推拿治疗神经根型颈椎病椎间孔变化的价值 颈腰痛杂志 2011 MRIandcervicalmassagetherapy QuesneleJJ TrianoJJ NoseworthyMD etal Changesinvertebralarterybloodflowfollowingvariousheadpositionsandcervicalspinemanipulation JManipulativePhysiolTher 2014Jan 37 1 22 31 MRIandcervicalmassagetherapy objectiveThestudywastoinvestigatethecerebrovascularhemodynamicresponseofcervicalspinepositionsincludingrotationandcervicalspinemanipulationinvivousingmagneticresonanceimagingtechnologyonthevertebralartery VA Methods4randomizedclinicaltasksTenhealthymaleparticipantsPhysiologicmeasuresofVAbloodflowandvelocityattheC1 2spinallevel QuesneleJJ TrianoJJ NoseworthyMD etal Changesinvertebralarterybloodflowfollowingvariousheadpositionsandcervicalspinemanipulation JManipulativePhysiolTher 2014Jan 37 1 22 31 QuesneleJJ TrianoJJ NoseworthyMD etal Changesinvertebralarterybloodflowfollowingvariousheadpositionsandcervicalspinemanipulation JManipulativePhysiolTher 2014Jan 37 1 22 31 MRIandcervicalmassagetherapy MRIandefficacyofTCMtreatmentofchroniclowerbackpain CramerGD CambronJ CantuJA etal Magneticresonanceimagingzygapophysealjointspacechanges gapping inlowbackpainpatientsfollowingspinalmanipulationandside posturepositioning arandomizedcontrolledmechanismstrialwithblinding JManipulativePhysiolTher 2013May 36 4 203 17 MRI BefortreatmentMassageTherapyMRI Aftertreatment CramerGD CambronJ CantuJA etal Magneticresonanceimagingzygapophysealjointspacechanges gapping inlowbackpainpatientsfollowingspinalmanipulationandside posturepositioning arandomizedcontrolledmechanismstrialwithblinding JManipulativePhysiolTher 2013May 36 4 203 17 CramerGD CambronJ CantuJA etal Magneticresonanceimagingzygapophysealjointspacechanges gapping inlowbackpainpatientsfollowingspinalmanipulationandside posturepositioning arandomizedcontrolledmechanismstrialwithblinding JManipulativePhysiolTher 2013May 36 4 203 17 MRIandefficacyofTCMtreatmentofchroniclowerbackpain 小结 我们必须相信中医治疗的神奇作用我们也必须明白中医治疗仍有许多无法解释的现象现代影像技术在评估传统中医的疗效和征象方面有一定的作用传统中医和现代医学技术结合的时代已经到来 这是无法拒绝也无法抵抗的事实 ThanksforYourAttention AcknowledgethatsomeofthegreatcontributionfromDr ZhanSonghua Dr LiuQiongetal KongLJ FangM ZhanHS etal Tuina focusedintegrativechinesemedicaltherapiesforinpatientswithlowbackpain asystematicreviewandmeta analysis EvidBasedComplementAlternatMed 2012 578305 詹