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1、颈 椎 病 Cervical Spondylosis,颈 椎 病 Cervical Spondylosis,1、概念 Concept 2、解剖 Dissect 3、发病因素 Pathogenicfactors 4、分型 Classification 6、中医认识 The understanding in TCM 7、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。,Cervical spondylosis refers to p
2、athogenic 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.,解剖 Dissect
3、,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 Neck type cervical spondylosis 神经根型Cervical spondylotic radiculopathy 脊髓型 Cervical spondylotic myelopathy 椎动脉型 Vertebral artery type of cervical spondylosis 交感型 Sympathetic cervical spondylo
4、sis 混合型 Mixed type of cervical spondylosis,颈型 Neck type cervical spondylosis,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。 Main clinical manifestations: acid distention、pain、numbness and stiff in the neck.,颈椎曲度改变 The cervical curvature change,髓核突出压迫颈神经根 Compression of the nerve root,神经根型Cervical spond
5、ylotic radiculopathy,1.多见于30岁以上者 More common in people over 30 years old 2.起病缓慢、病程长，反复发作。 Slow onset, long course of disease, recurrent seizures. 3.颈肩部疼痛，下颈椎病变可向前臂放射。 Neck and shoulder pain, some can radiate to the forward arm,脊髓型Cervical spondylotic myelopathy,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
6、等。 Main clinical manifestations: Cervical spinal cord injury，such as unsteady walk, numbness of limbs, micturition and defecation difficulties,椎动脉型Vertebral artery type of cervical spondylosis,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。,Main clinical manifestations: vertebral basilar artery insu
7、fficiency such as headache, dizziness and amaurosis, relate to the neck rotation.,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。 Main clinical manifestations: neck, upper limb sympathetic nervous dysfunction, such as dizziness, tin
8、nitus, numbness of hand, heartbeat tachycardia, precordial pain. X-ray: degeneration of cervical vertebra. Vertebral artery angiography negative.,混合型Mixed type of cervical spondylosis,具备以上两种或两种以上的表现者，即可确诊。 With two or more than two kinds of performance above.,中医认识 The understanding in TCM,本病属于中医的“痹证
9、”、“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。” 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.”,治疗 Treatment,1、针灸 Acupunct
10、ure and moxibustion 2、拔罐 Cupping 3、中频 Intermediate frequency therapy apparatus 4、超声 Ultrasound 5、TDP Specific electromagnetic spectrum 6、牵引 Traction,针灸 Acupuncture and moxibustion,处方：以局部取穴为主 Prescription: Select points on the local as main points 主穴：大椎 天柱 后溪 颈夹脊 阿是穴 Main points: Jiaji in the neck(EX
11、)、Dazhui（DU-14）、Tianzhu(BL- 10)、 Houxi(SI-3)、Ashipoints,辩证加减 Modification with various syndromes,风寒痹阻：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：膈俞、合谷、太冲活血化瘀、通络止痛 Overstrain and blood stasis: add Geshu(B
12、L-17)、Hegu(LI-4)、Taichong(LR-3) to promote blood circulation to remove blood stasis 肝肾亏虚：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,针刺作用 The function of Acupuncture,1、针刺可以改善腰椎间盘局部的血液循环、促进新陈代谢; Improve lo
13、cal blood circulation of the lumbar intervertebral disc, promote the process of metabolism. 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。 Elimination inflammation、 edema of nerve root , lysis of adhesions, improve the relationship between highlight and nerve root.,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 Funct
14、ion:Promoting blood circulation to remove blood stasis, expelling wind and cold,removing obstruction in the collaterals to relieve pain.,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、Mechanical stimulation：During t
15、he 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,
16、improve the body resistance. Negative pressure mechanical stimulation by reflex pathways to the central nervous system, modulate neural activity.,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、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 cel
