颈椎病中英文对照课件

颈颈 椎椎 病病Cervical Spondylosis 颈 椎 病Cervical Spondylosis 1颈颈 椎椎 病病 Cervical Spondylosis 1、概念、概念 Concept2、解剖、解剖 Dissect 3、发病因素、发病因素 Pathogenicfactors 4、分型、分型 Classification 6、中医认识、中医认识 The understanding in TCM 7、治疗、治疗 Treatment颈 椎 病 Cervical Spondylosis 12概念概念 Concept 颈椎病，又称为颈椎颈椎病，又称为颈椎综合症，是颈椎及周综合症，是颈椎及周围的软组织，如椎间围的软组织，如椎间盘、黄韧带、脊髓鞘盘、黄韧带、脊髓鞘膜等发生病理改变，膜等发生病理改变，导致颈神经根、颈脊导致颈神经根、颈脊髓、椎动脉及交感神髓、椎动脉及交感神经受到压迫或刺激，经受到压迫或刺激，从而产生的各种临床从而产生的各种临床症状。症状。Cervical spondylosis refers to pathogenic change of the cervical vertebrae and soft tissues surrounding them such as intervertebral disks,yellow ligaments,duramater and so on,resulting in the nerve root,spinal cord,the vertebral artery and the sympathetic nerve is pressed or provoked,and occuring a series of symptoms.概念 Concept 颈椎病，又称为颈椎综合3解剖解剖Dissect解剖4解剖解剖Dissect解剖5解剖解剖Dissect解剖6发病因素发病因素 Pathogenicfactors年龄年龄 Age慢性劳损慢性劳损 Overstrain外伤外伤 Trauma职业职业 Job发病因素 Pathogenicfactors年龄 7颈椎病分型颈椎病分型 Classificationn颈型颈型 Neck type cervical spondylosisn神经根型神经根型Cervical spondylotic radiculopathyn脊髓型脊髓型 Cervical spondylotic myelopathyn椎动脉型椎动脉型 Vertebral artery type of cervical spondylosisn交感型交感型 Sympathetic cervical spondylosisn混合型混合型 Mixed type of cervical spondylosis颈椎病分型 Classification颈型 8颈型颈型 Neck type cervical spondylosis 以颈部酸、痛、麻、僵为主要以颈部酸、痛、麻、僵为主要临床表现或颈项部压迫感的颈临床表现或颈项部压迫感的颈椎病，症状集中在颈部，转动椎病，症状集中在颈部，转动不灵活。不灵活。Main clinical manifestations:acid distention、pain、numbness and stiff in the neck.颈椎曲度改变The cervical curvature change颈型 Neck type cervical spondy9髓核突出压迫颈神经髓核突出压迫颈神经根根Compression of the nerve root神经根型神经根型Cervical spondylotic radiculopathy n1.多见于多见于30岁以上者岁以上者nMore common in people over 30 years oldn2.起病缓慢、病程长，反复起病缓慢、病程长，反复发作。发作。nSlow onset,long course of disease,recurrent seizures.n3.颈肩部疼痛，下颈椎病变颈肩部疼痛，下颈椎病变可向前臂放射。可向前臂放射。Neck and shoulder pain,some can radiate to the forward arm 髓核突出压迫颈神经根神经根型Cervical spondyl10脊髓型脊髓型Cervical spondylotic myelopathy 以颈脊髓受损为主要临床表现的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、颈椎病。主要表现为走路不稳、四肢麻木、大小便困难等。四肢麻木、大小便困难等。Main clinical manifestations:Cervical spinal cord injury，such as unsteady walk,numbness of limbs,micturition and defecation difficulties脊髓型Cervical spondylotic myelop11椎动脉型椎动脉型Vertebral artery type of cervical spondylosis 以椎基底动脉供血不足为以椎基底动脉供血不足为主要临床表现的颈椎病。主要临床表现的颈椎病。主要表现为头痛，头晕，主要表现为头痛，头晕，黑朦等症状，与颈部旋转黑朦等症状，与颈部旋转有关。有关。Main clinical manifestations:vertebral basilar artery insufficiencysuch as headache,dizziness and amaurosis,relate to the neck rotation.椎动脉型Vertebral artery type of c12交感型交感型sympathetic cervical spondylosis 以头颈、上肢的交感神经功能异常为主要临床表现的颈椎以头颈、上肢的交感神经功能异常为主要临床表现的颈椎病。主要病。主要表现为头晕、眼花、耳鸣、手麻、心动过速、心表现为头晕、眼花、耳鸣、手麻、心动过速、心前区疼痛等一系列症状。前区疼痛等一系列症状。X线片有失稳或退变，椎动脉造线片有失稳或退变，椎动脉造影阴性。影阴性。Main clinical manifestations:neck,upper limb sympathetic nervous dysfunction,such as dizziness,tinnitus,numbness of hand,heartbeat tachycardia,precordial pain.X-ray:degeneration of cervical vertebra.Vertebral artery angiography negative.交感型sympathetic cervical spondy13混合型混合型Mixed type of cervical spondylosis 具备以上两种或两种以上具备以上两种或两种以上的表现者，即可确诊。的表现者，即可确诊。With two or more than two kinds of performance above.混合型Mixed type of cervical spon14中医认识中医认识 The understanding in TCM 本病属于中医的本病属于中医的“痹证痹证”、“项强项强”、“眩晕眩晕”、“颈肩痛颈肩痛”等范畴，内经中提到等范畴，内经中提到“风、寒、湿风、寒、湿三气杂至合而为痹也。三气杂至合而为痹也。”Cervical Spondylosis belongs to“Arthralgia Disease”、“Stiff neck”、“Dizziness”、“Neck and shoulder pain”in TCM.The Plain Question says:“The combination of three kinds of evils:wind、cold and wet，which lead to arthralgia disease.”中医认识 The understanding in TCM 15治疗 Treatment1、针灸、针灸 Acupuncture and moxibustion 2、拔罐、拔罐 Cupping 3、中频、中频 Intermediate frequency therapy apparatus 4、超声、超声 Ultrasound 5、TDP Specific electromagnetic spectrum 6、牵引、牵引 Traction 治疗 Treatment1、针灸 16针灸Acupuncture and moxibustion处方：处方：以局部取穴为主以局部取穴为主Prescription:Select points on the local as main points主穴：主穴：大椎大椎 天柱天柱 后溪后溪 颈夹脊颈夹脊 阿是阿是穴穴Main points:Jiaji in the neck(EX)、Dazhui（DU-14）、）、Tianzhu(BL-10)、Houxi(SI-3)、Ashipoints针灸Acupuncture and moxibustion17辩证加减辩证加减 Modification with various syndromes风寒痹阻：风寒痹阻：加风门、风府祛风通络加风门、风府祛风通络Obstruction by the wind and cold:add Fengmen(BL-12)、Fengfu(DU-16)to dispel wind and remove obstruction in the collaterals劳伤血瘀：劳伤血瘀：膈俞、合谷、太冲活血化瘀、通络止痛膈俞、合谷、太冲活血化瘀、通络止痛Overstrain and blood stasis:add Geshu(BL-17)、Hegu(LI-4)、Taichong(LR-3)to promote blood circulation to remove blood stasis 肝肾亏虚：肝肾亏虚：肝俞、肾俞、足三里补益肝肾、生血养筋肝俞、肾俞、足三里补益肝肾、生血养筋 Deficiency of the liver and kidney:add Ganshu(BL-18)、Shenshu(BL-23)、Zusanli(ST-36)to invigorate the liver and kidney辩证加减 Modification with variou18针刺作用针刺作用The function of Acupuncture1 1、针刺可以改善腰椎间盘局部的血针刺可以改善腰椎间盘局部的血液循环、促进新陈代谢液循环、促进新陈代谢;Improve local blood circulation of the lumbar intervertebral disc,promote the process of metabolism.2 2、消除神经根的炎症、水肿，松解、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粘连，改善突出物与神经根的关系。系。Elimination inflammation、edema of nerve root,lysis of adhesions,improve the relationship between highlight and nerve root.针刺作用The function of Acupunctu19拔罐Cuppingn作用：疏通气血，消除瘀滞，作用：疏通气血，消除瘀滞，温通经络，祛湿驱风，散寒活温通经络，祛湿驱风，散寒活血，舒筋止痛血，舒筋止痛nFunction:Promoting blood circulation to remove blood stasis,expelling wind and cold,removing obstruction in the collaterals to relieve pain.拔罐Cupping作用：疏通气血，消除瘀滞，温通经络，祛湿驱20机制机制 Mechanism1、机械性刺激作用、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、Mechanical stimulation：During the treatment,due to the formation of negative-pressure in the cup,can make local capillary congestion,erythroid burst-forming autoimmune hemolytic phenomenon,the epidermis presents congestion.Due to class of histamine substance produce,stimulation of various organs to strengthen its function,improve the body resistance.Negative pressure mechanical stimulation by reflex pathways to the central nervous system,modulate neural activity.机制 Mechanism1、机械性刺激作用：治疗时，由于罐212、温热作用、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、Thermal effects：Make the local expansion of blood vessels,promote blood circulation,improve the process of metabolism and tissue nutrition state,so that enhances the permeability of the blood vessels and cells,enhanced the phagocytic function of the reticuloendothelial system,is conducive to the absorption of inflammation.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22中频Intermediate frequency therapy apparatus Electrical stimulation of the Intermediate frequency to improve the local blood circulation,so that to mitigate edema between the organization of nerve fibres,reduced tissue tension,eliminate or reduce the lesion area of ischemia and anoxia,eliminate some vasoactive substances such as 5-serotonin,bradykinin,histamine,substance P which induced pain,achieve the analgesic effect.中频电刺激后改善了局部血中频电刺激后改善了局部血液循环，使组织内神经纤维间液循环，使组织内神经纤维间水肿减轻，组织张力减低，病水肿减轻，组织张力减低，病灶区缺血缺氧状态消除或减轻，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使体内一些血管活性物质如5羟色胺、缓激肽、组胺、羟色胺、缓激肽、组胺、P物质等致痛物质得以消除，物质等致痛物质得以消除，从而起到了止痛作用。从而起到了止痛作用。中频Intermediate frequency ther23超声 Ultrasound 1、机械作用、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、Mechanical stimulation：Soft tissue,enhance penetration,improve metabolism,promote blood circulation,stimulate the nervous system and cell function.2、温热作用、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、Thermal effects：Improve blood circulation,strengthen the metabolism,improve local tissue nutrition,enhance enzyme activity,reduced muscle and connective tissue tension,relieve spasm and pain,but also can reduce the sensory nerve excitability,achieve the analgesic effect.超声 Ultrasound 1、机械作用：软化24TDP Specific electromagnetic spectrum 1、热作用、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、Thermal effects：Infrared absorption by human body is converted into heat energy,through a heat conduction effect and make deep tissue even systemic heating.2、解痉镇痛、解痉镇痛：提高痛阈和耐痛阈。2、Antispasmodic and analgesic：Increased pain threshold and pain tolerance threshold.TDP Specific electromagnetic 253、治疗关节挛缩、治疗关节挛缩：热可以提高挛缩关节及周围组织的弹性。3、Treatment of articular contracture：Heat can improve the elasticity of the contracture of the joints and the surrounding tissues.4、免疫作用、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、Immune function：Infrared can dilate blood vessels,improve blood circulation,improve the activity of all defense mechanisms,thus have the nonspecific anti-inflammatory effect.3、治疗关节挛缩：热可以提高挛缩关节及周围组织的弹性。26牵引 Traction 1、使椎间隙和椎间孔增大，改变神经根与压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。等组织的刺激或压迫。Enlarge the vertebra and intervertebral foramen,changes the position relationship between the nerve root and compression,reduce or relieve the irritation or compression of the nerve root.2、牵开小关节间隙，解除滑膜嵌顿，纠正椎牵开小关节间隙，解除滑膜嵌顿，纠正椎体的侧倾、旋转、滑脱及后关节的错位。体的侧倾、旋转、滑脱及后关节的错位。Pull the clearance of the small joints,relieving synovial incarceration,correction rotation,slippage and joint dislocation of the vertebral.牵引 Traction 1、使椎间隙和椎间孔增大，改变神273、局部制动，减少活动所造成的刺激和摩擦，有利于神经局部制动，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。根、脊髓、关节囊、肌肉等的水肿和炎症的吸收。Local braking,reduced irritation and friction caused by activity,which is conducive to the edema and inflammatory absorption of the nerve root,spinal cord,joint capsule,muscle and so on.4、降低椎间盘内压或椎间盘内产生的负压，缓冲椎间盘向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。四周的压力，有利于膨出的髓核还纳。Reducing intradiscal pressure or negative pressure generated by the intervertebral disc,buffer the surounding pressure of the intervertebral disc,which is in favor of restore of the eventration of the nucleus pulposus.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285、缓解腰肌痉挛和关节囊、韧带及神经根的粘连，从而使椎间盘内压减少，有、缓解腰肌痉挛和关节囊、韧带及神经根的粘连，从而使椎间盘内压减少，有利于腰椎平衡的恢复，增强腰椎的稳定性。利于腰椎平衡的恢复，增强腰椎的稳定性。Alleviate neck muscle spasm and joint capsule,ligament and nerve root adhesion,thereby allowing the intradiscal pressure reduction,beneficial to the balance of cervical vertebra recovery,enhance the stability of cervical spine.6、牵引时绷紧的后纵韧带可将突出的椎间盘还原，并可使皱折的黄韧带复平，、牵引时绷紧的后纵韧带可将突出的椎间盘还原，并可使皱折的黄韧带复平，减轻其对脊髓的压迫。减轻其对脊髓的压迫。Prolapse of lumbar intervertebral disc can be reduced by the taut posterior longitudinal ligament during the traction,and can make the wrinkles ligamentum flavum tension,reduce the spinal cord compression.7、缓解软组织的紧张和回缩，预防和矫正腰椎畸形的发生。、缓解软组织的紧张和回缩，预防和矫正腰椎畸形的发生。Remission tension and retraction of the soft tissue,prevention and correction of cervical spine malformation.5、缓解腰肌痉挛和关节囊、韧带及神经根的粘连，从而使椎间盘内2930写在最后写在最后成功的基础在于好的学习习惯成功的基础在于好的学习习惯The foundation of success lies in good habits30写在最后成功的基础在于好的学习习惯谢谢大家荣幸这一路，与你同行ItS An Honor To Walk With You All The Way讲师：XXXXXX XX年XX月XX日 谢谢大家讲师：XXXXXX 31