上海中医药大学课程建设项目参考PPT

1、1,上海中医药大学课程建设项目,推拿学科系列双语教学课程建设（三）中期汇报 李征宇 针灸推拿学院 2008年11月,2,一、课程建设的既定目标,建设推拿学科系列推拿临床双语查房教学课程,3,二、课程建设的内容,1. 在以往推拿学科系列双语(英语)教学课程建设（一）、（二）的基础上，继续开展推拿学科系列双语(英语)教学课程（三）推拿临床双语(英语)查房教学课程的建设，使推拿学科系列的双语教学更显系统化和连续性。 2从临床实际运用和学生能力培养视角出发，选择推拿临床的常见病腰椎间盘突出症和颈椎病为典型病例进行双语教学，起到以点带面的效果,4,二、课程建设的内容,1 ) 用双语(英语)对腰椎间盘突出

2、症的病史、症状、体征、影像学检查、诊断、鉴别诊断、推拿治疗、调护、国内外研究进展等进行临床查房教学，并着重强调该病临床病史的双语书写； (2) 编写腰椎间盘突出症的临床双语查房教学资料片的双语拍摄剧本； (3) 依照剧本，拍摄腰椎间盘突出症的临床双语查房教学资料片,5,二、课程建设的内容,4) 用双语对颈椎病的病史、症状、体征、影像学检查、诊断、鉴别诊断、推拿治疗、调护、国内外研究进展等进行临床查房教学，并着重强调该病临床病史的双语书写； (5) 编写颈椎病的临床双语查房教学资料片的双语拍摄剧本； (6) 依照剧本，拍摄颈椎病的临床双语查房教学资料片,6,三、课程建设的意义,该课程建设凸现了我

3、校在推拿教学方面的特色和领先其它中医院校的优势,7,四、建设中采取的措施,1. 前期的准备工作 主要是相关文献的回顾，查阅和分析有关的双语教学文件，着重了解临床双语查房教学课程的性质及重要性、并制定合适的课时数。 2. 双语剧本编写工作 在前期准备的基础上，参阅了大量的国内相关的书籍和一些国外资料，通过教研室教师反复共同讨论，对腰椎间盘突出症和颈椎病的内容经行了反复推敲，紧扣临床双语查房教学特点，编写推拿双语查房剧本，并反复修改,8,四、建设中采取的措施,3拍摄工作 积极与拍摄人员商讨拍摄事宜、准备工作及其拍摄细节等问题；同时组织参拍人员并进行培训工作及英语台词记忆；参与最后定片工作,9,五、

4、目前完成情况,1 ) 已对2003级针灸推拿专业（七年制外向型）及部分其他七年制专业学生完成了用双语(英语)对腰椎间盘突出症的病史、症状、体征、影像学检查、诊断、鉴别诊断、推拿治疗、调护、国内外研究进展等进行临床查房教学工作，并也完成了该病临床病史的英语书写样本； (2) 已完成了编写腰椎间盘突出症的临床双语查房教学资料片的双语拍摄剧本； (3) 依照剧本，已完成了腰椎间盘突出症的临床双语查房教学资料片的拍摄,10,五、目前完成情况,4) 已对2003级针灸推拿专业（七年制外向型）及部分其他七年制专业学生完成了用双语(英语)对颈椎病的病史、症状、体征、影像学检查、诊断、鉴别诊断、推拿治疗、调护

5、、国内外研究进展等进行临床查房教学工作，并也完成了该病临床病史的英语书写样本； (5) 已完成了编写颈椎病的临床双语查房教学资料片的双语拍摄剧本,11,Example of case history,Name: Mr. Peng, Sex: male, Age: 45 Chief Complaint(C.C.): Waist pain with numbness in the right limb for a month History of present illness (HPT):The patient has a history of long-term and repeated lu

6、mbago for ten years.About one month ago,he sprained his lumbus because of carrying heavythings, after that he was unable to sit up or turn over on bed. Then the stabbing pain is gradually felt radiating to the right limb, and the radiating pain becomes worse when the abdominal pressure is increased

7、during coughing or sneezing.The patient cannot stand and walk for a relatively long time. The stabbing pain in the lumbaus which occurs at a fixed location. He likes to lie on the normal side,and the affected lower limb is often bent.He consulted the doctor in a local clinic and the X-ray showed tha

8、t the disc problem was between L5 and S1,and he took some pain-killing pills.Then the symptoms has alleveited a little.Now he comes to our hospital for an examination,12,Example of case history,Past History: Denied any history of kidney and bladder problems. Examination: Neck flexion test (Lindnerss

9、ign)(+),Supine-position-abdomen-straighten-test(+), Straight leg-raising test :left 80,right 30,Bragrads test(+),Patellar reflex: left and right+,Achilles reflex: left +, right+,Hypoesthesia of the dorsum of the right foot and the posterior and lateral parts of the right leg. The lateral curvature o

10、f the lumbar vertebral column decreased .Tenderness and percussion pain in the lumbar between L5 and S1 which radiates to the sole through the lower extremity of the right side and marked tenderness in the distributing areas of the sciatic nerve of the right side.The tongue looks dark with ecchymose

11、s on it.The pulse is taut and uneven,13,Example of case history,Diagnosis in Traditional Chinese Medicine:Yaotuitong (The stasis of Blood and Qi) Diagnosis in Westen Medicine:Lumbar Disc Hernation Therapeutic Principle:Relaxing muscles and tendons,activating meridians and promoting the flow of Qi an

12、d blood,14,Example of case history,Tuina treatment 1. Manipulations Rolling, pressing, digital-pressing, kneading, and obliquely pulling etc. 2. Location of Points Ashi Point, Shenshu (UB 23), Dachangshu (UB 25), Yaoyangguan (Du 3), Zhibian (UB 54),Huantiao (GB .30), Yinmen (UB 37), Weizhong (UB 40)

13、,Chengshan (UB 57), Yanglingquan (GB 34) and Jiexi(st 4o). 3. Operation 1) Rolling the two sides of the lumbar vertebrae, the hip muscles and the points of Shenshu (UB 23), Yaoyangguan (Du 3), Dachangshu (UB 25), Zhibian (UB 54)and Huantiao (GB 30). 2) Palm-kneading and digital pressing to the point

14、s of Chengfu (UB 36), Yinmen (UB 37), Weizhong (UB 40), Chengshan (UB 57),Yanglingquan (GB 34), Feiyang (UB 58) and Juegu (GB 39)in the affected limb for 2 or 3 times. 3) Pressing-kneading to the Ashi point on the sides of the lumbar vertebrae for 2-3 minutes. 4) Obliquely pulling manipulation on lu

15、mbar vertebral region. 5) Stretching and rotating his knee(s) and hip(s) to help move the lumbar vertebrae 35 times,15,Example of case history,4. Course of Treatment: The patient recievcs treatment once every other day, ten times of treatment make one course.The interval between every two courses is

16、 3-5 days. Doctors advice: Keep the lumbar warm. Moderate exercise. Signature,16,Lumbar Disk HerniationWard round in English,Residents Round (the last night) 住院医师查房（前一天晚上） Resident: Good evening, Mary , Im Dr， Zhu in charge of the ward. 住院医生：晚上好。玛丽 ,我是朱医生，主管这间病房。 Patient: Hello, Dr. Zhu. 病人：晚上好，朱医生。

17、 Resident: This is Dr. Shi. Can you take the history now? 住院医生：这是史医生。请您现在询问病史吧？ Intern: Yes. How do you feel now? 实习医生：好的。玛丽，你现在感觉怎么样？ Patient: I am fine except for some pain. 病人：除了一些地方疼，其它感觉良好。 Intern: Oh, how long have you been like this? 实习医师：疼痛多长时间了？ Patient: About 1 year off and on. 病人：大概一年了。疼痛

18、一直是反复性的，时好时坏。 Intern: Can you describe the pain? 实习医师：你能把疼痛的情况描述一下吗,17,CERVICAL SPONDYLOPATHY Ward round in English,Directors Round 主任查房 Visiting physician: As a rule, the director comes to our ward to make a ward round. Professor Wang, weve received a new case with a one-month history of soreness a

19、nd numbness in the left upper extremity and decrease of hand strength. There are some troubles in diagnosis and treatment for him. 主治医生：作为常规，主任来病房查房。王教授，我们收了一个新病例左上肢酸痛麻木、握力减退一月。在为他诊断和治疗方时遇到了问题。 Director: Ok. Well have a look at this new patient. 主任医师：让我们去看看病人。 Visiting physician: Dr. Shi, Please rep

20、ort the case briefly to the director. 主治医生：史医生，请向主任简短报告病例。 Intern: OK. This is a 50-year-old male, who was admitted to our hospital in Jun. 2nd, 2008 because of recurrent attacks of pain in the neck and shoulder for six year, soreness and numbness in the left upper extremity and decrease of hand str

21、ength for one month and getting worse for one week. He also has a pain in his left chest. He is a cadre in Beijing University who needs long terms of deskwork. The patient had no obvious trauma history recently and no spinal disease previously. No special for other histories. The blood, urine routine analysis, the ECG and electrolyte analysis are all normal. Upon physical examination, stiffness of the neck muscle and tenderness around spinous process in C5-C7 were