1、中医与影像医学 在骨肌病变中的作用,Empirical Science: early acupuncture,History of TCM,Although modern medicine is established in Asia, traditional medicine also plays a big role in peoples healthcare and is gaining in popularity in other countries too.Traditional medicine a system of ancient medical practice that d
2、iffers in substance, methodology and philosophy to modern medicine plays an important role in health maintenance for the peoples of Asia.Millions of patients around the world use TCM or a related practice. In Hong Kong and mainland China, approximately 60% of the population has consulted traditional
3、 medicine practitioners at least once.,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。,TCM is descriptive and phenomenological it typically diagnoses patients using concepts based on the relatio
4、nship between signs and symptoms, obtained through questioning, listening, palpation, visual inspection and smelling. In contrast, Western-style, modern medicine has mainly used single biomarkers to describe disease states, for example diagnosing type 2 diabetes by measuring glucose levels. But ther
5、e is a growing realization in the West that single biomarkers are not enough.,All systems go Jan van dr Greef is a principal scientist at the Netherlands Organization for Applied Scientific Research (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
6、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。,All systems go Jan van der Greef is a principal scientist at the Netherlands Organization for Applied Scientific Research (TNO),Traditional Chinese Medicine,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
7、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,Western Medicine,The concepts of Asias traditional medicines might sound alien to Western ears, but some of them are starting to evolve to fit scientific investigation.,The advantages and disadvantages of the two systems
8、(TCM and Western Medicine) are the premise of the integration The gaps of the two systems are closing The two systems cannot replace each other, but instead they will fill each other out.,TCM: holistic, but the lack of analytical methods Western Medicine: multiple analytic methods, but the lack of o
9、verview.,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,Imaging and TCM syndrome differentiation of cervical spondylosis,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,Imaging and TCM syndrome differentiation of cervical spondy
10、losis,intervertebral space,intervertebral foramen,X-ray of cervical disease,cervical curvature,facet joint,position of odontoid,X-ray of cervical disease,Diameters from spinous process to midline,Forward and backward angle/horizontal angle of vertebral body,CT of cervical disease,disc herniation,spi
11、nal stenosis,CT of cervical disease,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.,Imaging and TCM syndrome differentiation of prolapse of lumbar disc,Imaging and TCM syndrome differentiation of prolapse of lumbar disc,hyperosteogeny,hypertrophy of facet joints,disc-space narrowing,Lumber Disc H
12、erniation,Lumber Disc Herniation,摘要,Cerebral metabolic changes in men after chiropractic spinal manipulation for neck pain.,Ogura T, Tashiro M, Masud M, et al. Altern Ther Health Med. 2011;17(6):12-7.,Objective: The aim of the present study was to investigate the effects of CSM on brain responses in
13、 terms of cerebral glucose metabolic changes measured by 18F fluorodeoxyglucose positron emission tomography (FDG-PET). Methods: Twelve male volunteers were recruited. Brain PET scanning was performed twice on each participant, at resting and after CSM. Results: Increased glucose metabolism was obse
14、rved in the inferior prefrontal cortex, anterior cingulated cortex, and middle temporal gyrus, and decreased glucose metabolism was found in the cerebellar vermis and visual association cortex, in the treatment condition (P .001).,Ogura T, Tashiro M, Masud M, et al. Cerebral metabolic changes in men
15、 after chiropractic spinal manipulation for neck pain. Altern Ther Health Med. 2011;17(6):12-7.,X-ray and efficacy of TCM treatment of cervical disease,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.,intervertebral foramen,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, 201
16、1.,X-ray and efficacy of TCM treatment of cervical disease,facet joint,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.,position of odontoid,Male patient, 60y, changes in cervical physiological curvature after cervical massage therapy,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.,CT and
17、efficacy of TCM treatment of cervical disease,CT and efficacy of TCM treatment of cervical disease,Changes of cervical spinal curvature,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.,Before Treatment,After Treatment,Male patient, 60y, changes in odontoid process position after cervical mass
18、age therapy,CT and efficacy of TCM treatment of cervical disease,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.,The distance difference between odontoid process and both sides of block,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.,1.150.65,0.380.43,Before Treatment,After Treatment
19、,CT and efficacy of TCM treatment of cervical disease,Male patient, 61y, changes in intervertebral foramen after cervical massage therapy.,CT and efficacy of TCM treatment of cervical disease,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,Anteroposterior diameter of the intervertebral for
20、amen,CT and efficacy of TCM treatment of cervical disease,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,MRI and cervical massage therapy,Quesnele JJ, Triano JJ, Noseworthy MD, et al. Changes in vertebral artery blood flow following various head positions and cervical spine manipulation.
21、J Manipulative Physiol Ther. 2014 Jan;37(1):22-31.,MRI and cervical massage therapy,objective The study was to investigate the cerebrovascular hemodynamic response of cervical spine positions including rotation and cervical spine manipulation in vivo using magnetic resonance imaging technology on th
22、e vertebral artery(VA). Methods 4 randomized clinical tasks Ten healthy male participants Physiologic measures of VA blood flow and velocity at the C1-2 spinal level,Quesnele JJ, Triano JJ, Noseworthy MD, et al. Changes in vertebral artery blood flow following various head positions and cervical spi
23、ne manipulation. J Manipulative Physiol Ther. 2014 Jan;37(1):22-31.,Quesnele JJ, Triano JJ, Noseworthy MD, et al. Changes in vertebral artery blood flow following various head positions and cervical spine manipulation. J Manipulative Physiol Ther. 2014 Jan;37(1):22-31.,MRI and cervical massage thera
24、py,MRI and efficacy of TCM treatment of chronic lower back pain,Cramer GD, Cambron J, Cantu JA, et al. Magnetic resonance imaging zygapophyseal joint space changes (gapping) in low back pain patients following spinal manipulation and side-posture positioning: a randomized controlled mechanisms trial
25、 with blinding. J Manipulative Physiol Ther. 2013 May;36(4):203-17.,MRI/ Befor treatment Massage Therapy MRI/ After treatment,Cramer GD, Cambron J, Cantu JA, et al. Magnetic resonance imaging zygapophyseal joint space changes (gapping) in low back pain patients following spinal manipulation and side
26、-posture positioning: a randomized controlled mechanisms trial with blinding. J Manipulative Physiol Ther. 2013 May;36(4):203-17.,Cramer GD, Cambron J, Cantu JA, et al. Magnetic resonance imaging zygapophyseal joint space changes (gapping) in low back pain patients following spinal manipulation and
27、side-posture positioning: a randomized controlled mechanisms trial with blinding. J Manipulative Physiol Ther. 2013 May;36(4):203-17.,MRI and efficacy of TCM treatment of chronic lower back pain,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
28、。,Thanks for Your Attention,Acknowledge that some of the great contribution from Dr. Zhan Songhua, Dr. Liu Qiong et al,Kong LJ, Fang M, Zhan HS, et al. Tuina-focused integrative chinese medical therapies for inpatients with low back pain: a systematic review and meta-analysis. Evid Based Complement
29、Alternat Med. 2012: 578305. 詹红生,牛守国,吴健康,等.仰卧位拔伸整复手法治疗神经根型颈椎病的随机、对照、多中心临床研究.中国骨伤, 2006, 19(5): 257- 260.,Efficacy of traditional Chinese medicine treatment with spinal disorders has been approved,The preliminary evidence from current studies suggests that TICMT might be effective complementary and al
30、ternative treatments for in-patients with LBP.,Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2012, Article ID 578305, 14 pages doi:10.1155/2012/578305,Imaging Technology,庄园, 詹松华, 谭文莉, 等. 腰椎间盘突出症推拿治疗前后影像学特征比较.2014.,Comparison of various diameters before a
31、nd after massage therapy for 30 cases of lumbar disc herniation,Lumber Disc Herniation,CT and efficacy of TCM treatment of prolapse of lumbar intervertebral disc,庄园, 詹松华, 谭文莉, 等. 腰椎间盘突出症推拿治疗前后影像学特征比较.2014.,Comparison of lumbar vertebrae radian before and after massage therapy for 30 cases of lumbar disc herniation,庄园, 詹松华, 谭文莉, 等. 腰椎间盘突出症推拿治疗前后影像学特征比较.2014.,
