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颈椎病CervicalSpondylosis.颈椎病CervicalSpondylosis1、概念Concept2、解剖Dissect3、发病因素Pathogenicfactors4、分型Classification6、中医认识TheunderstandinginTCM7、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。Cervicalspondylosisreferstopathogenicchangeofthecervicalvertebraeandsofttissuessurroundingthemsuchasintervertebraldisks,yellowligaments,duramaterandsoon,resultinginthenerveroot,spinalcord,thevertebralarteryandthesympatheticnerveispressedorprovoked,andoccuringaseriesofsymptoms..解剖Dissect.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Necktypecervicalspondylosis神经根型Cervicalspondyloticradiculopathy脊髓型Cervicalspondyloticmyelopathy椎动脉型Vertebralarterytypeofcervicalspondylosis交感型Sympatheticcervicalspondylosis混合型Mixedtypeofcervicalspondylosis.颈型Necktypecervicalspondylosis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。Mainclinicalmanifestations:aciddistention、pain、numbnessandstiffintheneck.颈椎曲度改变Thecervicalcurvaturechange.髓核突出压迫颈神经根Compressionofthenerveroot神经根型Cervicalspondyloticradiculopathy1.多见于30岁以上者Morecommoninpeopleover30yearsold2.起病缓慢、病程长，反复发作。Slowonset,longcourseofdisease,recurrentseizures.3.颈肩部疼痛，下颈椎病变可向前臂放射。Neckandshoulderpain,somecanradiatetotheforwardarm.脊髓型Cervicalspondyloticmyelopathy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、大小便困难等。Mainclinicalmanifestations:Cervicalspinalcordinjury，suchasunsteadywalk,numbnessoflimbs,micturitionanddefecationdifficulties.椎动脉型Vertebralarterytypeofcervicalspondylosis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。Mainclinicalmanifestations:vertebralbasilararteryinsufficiencysuchasheadache,dizzinessandamaurosis,relatetotheneckrotation..交感型sympatheticcervicalspondylosis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。Mainclinicalmanifestations:neck,upperlimbsympatheticnervousdysfunction,suchasdizziness,tinnitus,numbnessofhand,heartbeattachycardia,precordialpain.X-ray:degenerationofcervicalvertebra.Vertebralarteryangiographynegative..混合型Mixedtypeofcervicalspondylosis具备以上两种或两种以上的表现者，即可确诊。Withtwoormorethantwokindsofperformanceabove..中医认识TheunderstandinginTCM本病属于中医的“痹证”、“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。”CervicalSpondylosisbelongsto“ArthralgiaDisease”、“Stiffneck”、“Dizziness”、“Neckandshoulderpain”inTCM.ThePlainQuestionsays:“Thecombinationofthreekindsofevils:wind、coldandwet，whichleadtoarthralgiadisease.”.治疗Treatment1、针灸Acupunctureandmoxibustion2、拔罐Cupping3、中频Intermediatefrequencytherapyapparatus4、超声Ultrasound5、TDPSpecificelectromagneticspectrum6、牵引Traction.针灸Acupunctureandmoxibustion处方：以局部取穴为主Prescription:Selectpointsonthelocalasmainpoints主穴：大椎天柱后溪颈夹脊阿是穴Mainpoints:Jiajiintheneck(EX)、Dazhui（DU-14）、Tianzhu(BL-10)、Houxi(SI-3)、Ashipoints.辩证加减Modificationwithvarioussyndromes风寒痹阻：加风门、风府祛风通络Obstructionbythewindandcold:addFengmen(BL-12)、Fengfu(DU-16)todispelwindandremoveobstructioninthecollaterals劳伤血瘀：膈俞、合谷、太冲活血化瘀、通络止痛Overstrainandbloodstasis:addGeshu(BL-17)、Hegu(LI-4)、Taichong(LR-3)topromotebloodcirculationtoremovebloodstasis肝肾亏虚：肝俞、肾俞、足三里补益肝肾、生血养筋Deficiencyoftheliverandkidney:addGanshu(BL-18)、Shenshu(BL-23)、Zusanli(ST-36)toinvigoratetheliverandkidney.针刺作用ThefunctionofAcupuncture1、针刺可以改善腰椎间盘局部的血液循环、促进新陈代谢;Improvelocalbloodcirculationofthelumbarintervertebraldisc,promotetheprocessofmetabolism.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。Eliminationinflammation、edemaofnerveroot,lysisofadhesions,improvetherelationshipbetweenhighlightandnerveroot..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Function:Promotingbloodcirculationtoremovebloodstasis,expellingwindandcold,removingobstructioninthecollateralstorelievepain..机制Mechanism1、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、Mechanicalstimulation：Duringthetreatment,duetotheformationofnegative-pressureinthecup,canmakelocalcapillarycongestion,erythroidburst-formingautoimmunehemolyticphenomenon,theepidermispresentscongestion.Duetoclassofhistaminesubstanceproduce,stimulationofvariousorganstostrengthenitsfunction,improvethebodyresistance.Negativepressuremechanicalstimulationbyreflexpathwaystothecentralnervoussystem,modulateneuralactivity..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、Thermaleffects：Makethelocalexpansionofbloodvessels,promotebloodcirculation,improvetheprocessofmetabolismandtissuenutritionstate,sothatenhancesthepermeabilityofthebloodvesselsandcells,enhancedthephagocyticfunctionofthereticuloendothelialsystem,isconducivetotheabsorptionofinflammation..中频IntermediatefrequencytherapyapparatusElectricalstimulationoftheIntermediatefrequencytoimprovethelocalbloodcirculation,sothattomitigateedemabetweentheorganizationofnervefibres,reducedtissuetension,eliminateorreducethelesionareaofischemiaandanoxia,eliminatesomevasoactivesubstancessuchas5-serotonin,bradykinin,histamine,substancePwhichinducedpain,achievetheanalgesiceffect.中频电刺激后改善了局部血液循环，使组织内神经纤维间水肿减轻，组织张力减低，病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5—羟色胺、缓激肽、组胺、P物质等致痛物质得以消除，从而起到了止痛作用。.超声Ultrasound1、机械作用