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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月一、课程建设的既定目标v建设推拿学科系列推拿临床双语查房教 学课程。 二、课程建设的内容v1. 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。v2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。 二、课程建设的内容v(1 ) 用双语(英语)对腰椎间盘突出症的
2、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；v(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；v(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。二、课程建设的内容v(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；v(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；v(6) 依照剧本，拍摄颈椎病的临床双语查房 教学资料片。三、课程建设的意义v 该课程
3、建设凸现了我校在推拿教学方面 的特色和领先其它中医院校的优势。四、建设中采取的措施v1. 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。v2. 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。四、建设中采取的措施v 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
4、 定片工作。五、目前完成情况v(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；v(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；v(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。五、目前完成情况v(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
5、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；v(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Example of case historyvName: Mr. Peng, Sex: male, Age: 45vChief Complaint(C.C.): Waist pain with numbness in the right limb for a monthvHistory of present illness (HPT):The patient has a history of long-ter
6、m and repeated lumbago 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 press
7、ure is increased 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
8、 X- ray showed that 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.Example of case historyvPast History: Denied any history of kidney and bladder problems. vExamination:Neck flexion
9、test (Lindnerssign)(+),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 lat
10、eral curvature of 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 sideThe tongue looks dark
11、 with ecchymoses on it.The pulse is taut and uneven.Example of case historyvDiagnosis in Traditional Chinese Medicine:Yaotuitong (The stasis of Blood and Qi)vDiagnosis in Westen Medicine:Lumbar Disc HernationvTherapeutic Principle:Relaxing muscles and tendons,activating meridians and promoting the f
12、low of Qi and blood.Example of case historyvTuina treatmentv1. Manipulations vRolling, pressing, digital-pressing, kneading, and obliquely pulling etc.v2. Location of Pointsv Ashi Point, Shenshu (UB 23), Dachangshu (UB 25), Yaoyangguan (Du 3), Zhibian (UB 54),Huantiao (GB .30), Yinmen (UB 37), Weizh
13、ong (UB 40),Chengshan (UB 57), Yanglingquan (GB 34) and Jiexi(st 4o).v3. Operationv1) Rolling the two sides of the lumbar vertebrae, the hip muscles andvthe points of Shenshu (UB 23), Yaoyangguan (Du 3), Dachangshu (UB 25), Zhibian (UB 54)and Huantiao (GB 30).v2) Palm-kneading and digital pressing t
14、o the points of Chengfu (UB 36),vYinmen (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.v3) Pressing-kneading to the Ashi point on the sides of the lumbar vertebrae for 2-3 minutes. v4) Obliquely pulling manipu
15、lation on lumbar vertebral region.v5) Stretching and rotating his knee(s) and hip(s) to help move the lumbar vertebrae 35 times.Example of case historyv4. Course of Treatment: vThe patient recievcs treatment once every other day, ten times of treatment make one course.The interval between every two
16、courses is 3-5 days.vDoctors advice:vKeep the lumbar warm.vModerate exercise. SignatureLumbar Disk Herniation Ward round in EnglishvResidents Round (the last night)v住院医师查房（前一天晚上） vResident: Good evening, Mary , Im Dr， Zhu in charge of the ward. v住院医生：晚上好。玛丽 ,我是朱医生，主管这间病房。vPatient: Hello, Dr. Zhu.v病人：晚上好，朱医生。 vResident: This is Dr. Shi. Can you take the history now?v住院医生：这是史医生。请您现在询问病史吧？ vIntern: Yes. How do you feel now?v
