上海中醫(yī)藥大學(xué)課程建設(shè)項目

1、上海中醫(yī)藥大學(xué)課程建設(shè)項目,推拿學(xué)科系列雙語教學(xué)課程建設(shè)（三）中期匯報 李征宇 針灸推拿學(xué)院 2008年11月,一、課程建設(shè)的既定目標(biāo),建設(shè)推拿學(xué)科系列——推拿臨床雙

2、語查房教學(xué)課程。,二、課程建設(shè)的內(nèi)容,1. 在以往推拿學(xué)科系列雙語(英語)教學(xué)課程建設(shè)（一）、（二）的基礎(chǔ)上，繼續(xù)開展推拿學(xué)科系列雙語(英語)教學(xué)課程（三）――――推拿臨床雙語(英語)查房教學(xué)課程的建設(shè)，使推拿學(xué)科系列的雙語教學(xué)更顯系統(tǒng)化和連續(xù)性。2．從臨床實際運用和學(xué)生能力培養(yǎng)視角出發(fā)，選擇推拿臨床的常見病―――腰椎間盤突出癥和頸椎病為典型病例進行雙語教學(xué)，起到以點帶面的效果。,二、課程建設(shè)的內(nèi)容,(1 ) 用雙語(英語)對腰椎

3、間盤突出癥的病史、癥狀、體征、影像學(xué)檢查、診斷、鑒別診斷、推拿治療、調(diào)護、國內(nèi)外研究進展等進行臨床查房教學(xué)，并著重強調(diào)該病臨床病史的雙語書寫；(2) 編寫腰椎間盤突出癥的臨床雙語查房教學(xué)資料片的雙語拍攝劇本；(3) 依照劇本，拍攝腰椎間盤突出癥的臨床雙語查房教學(xué)資料片。,二、課程建設(shè)的內(nèi)容,(4) 用雙語對頸椎病的病史、癥狀、體征、影像學(xué)檢查、診斷、鑒別診斷、推拿治療、調(diào)護、國內(nèi)外研究進展等進行臨床查房教學(xué)，并著重強調(diào)該病臨床病史的

4、雙語書寫；(5) 編寫頸椎病的臨床雙語查房教學(xué)資料片的雙語拍攝劇本；(6) 依照劇本，拍攝頸椎病的臨床雙語查房教學(xué)資料片。,三、課程建設(shè)的意義,該課程建設(shè)凸現(xiàn)了我校在推拿教學(xué)方面的特色和領(lǐng)先其它中醫(yī)院校的優(yōu)勢。,四、建設(shè)中采取的措施,1. 前期的準(zhǔn)備工作 主要是相關(guān)文獻的回顧，查閱和分析有關(guān)的雙語教學(xué)文件，著重了解臨床雙語查房教學(xué)課程的性質(zhì)及重要性、并制定合適的課時數(shù)。2. 雙語劇本編寫工作

5、 在前期準(zhǔn)備的基礎(chǔ)上，參閱了大量的國內(nèi)相關(guān)的書籍和一些國外資料，通過教研室教師反復(fù)共同討論，對腰椎間盤突出癥和頸椎病的內(nèi)容經(jīng)行了反復(fù)推敲，緊扣臨床雙語查房教學(xué)特點，編寫推拿雙語查房劇本，并反復(fù)修改。,四、建設(shè)中采取的措施,3．拍攝工作 積極與拍攝人員商討拍攝事宜、準(zhǔn)備工作及其拍攝細節(jié)等問題；同時組織參拍人員并進行培訓(xùn)工作及英語臺詞記憶；參與最后定片工作。,五、目前完成情況,(1 ) 已對2003級針灸推拿專業(yè)（七

6、年制外向型）及部分其他七年制專業(yè)學(xué)生完成了用雙語(英語)對腰椎間盤突出癥的病史、癥狀、體征、影像學(xué)檢查、診斷、鑒別診斷、推拿治療、調(diào)護、國內(nèi)外研究進展等進行臨床查房教學(xué)工作，并也完成了該病臨床病史的英語書寫樣本；(2) 已完成了編寫腰椎間盤突出癥的臨床雙語查房教學(xué)資料片的雙語拍攝劇本；(3) 依照劇本，已完成了腰椎間盤突出癥的臨床雙語查房教學(xué)資料片的拍攝。,五、目前完成情況,(4) 已對2003級針灸推拿專業(yè)（七年制外向型）及部分其

7、他七年制專業(yè)學(xué)生完成了用雙語(英語)對頸椎病的病史、癥狀、體征、影像學(xué)檢查、診斷、鑒別診斷、推拿治療、調(diào)護、國內(nèi)外研究進展等進行臨床查房教學(xué)工作，，并也完成了該病臨床病史的英語書寫樣本；(5) 已完成了編寫頸椎病的臨床雙語查房教學(xué)資料片的雙語拍攝劇本,Example of case history,Name: Mr. Peng, Sex: male, Age: 45 Chief Complaint(C.

8、C.): Waist pain with numbness in the right limb for a month History of present illness (HPT):The patient has a history of long-term and repeated lumbago for ten years.About one month ago,he sprained his lumbus because

9、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 pressure is i

10、ncreased 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 lo

11、wer limb is often bent.He consulted the doctor in a local clinic and the 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

12、 to our hospital for an examination.,Example of case history,Past History: Denied any history of kidney and bladder problems. Examination: Neck flexion test (Lindner'ssign)(+),Supine-position-abdomen-straighte

13、n-test(+), Straight leg-raising test :left 80,right 30,Bragrad's test(+),Patellar reflex: left and right++,Achilles reflex: left ++, right+,Hypoesthesia of the dorsum of the right foot and the posterior and lateral

14、parts of the right leg. The lateral 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 s

15、ide and marked tenderness in the distributing areas of the sciatic nerve of the right side..The tongue looks dark with ecchymoses on it.The pulse is taut and uneven.,Example of case history,Diagnosis in Traditional Chine

16、se Medicine:Yaotuitong (The stasis of Blood and Qi)Diagnosis in Westen Medicine:Lumbar Disc Hernation Therapeutic Principle:Relaxing muscles and tendons,activating meridians and promoting the flow of Qi and blood.,Ex

17、ample of case history,Tuina treatment1. Manipulations Rolling, pressing, digital-pressing, kneading, and obliquely pulling etc.2. Location of Points Ashi Point, Shenshu (UB 23), Dachangshu (UB 25), Yaoyangguan (Du

18、 3), Zhibian (UB 54),Huantiao (GB .30), Yinmen (UB 37), Weizhong (UB 40),Chengshan (UB 57), Yanglingquan (GB 34) and Jiexi(st 4o).3. Operation1) Rolling the two sides of the lumbar vertebrae, the hip muscles and

19、the points of Shenshu (UB 23), Yaoyangguan (Du 3), Dachangshu (UB 25), Zhibian (UB 54)and Huantiao (GB 30).2) Palm-kneading and digital pressing to the points of Chengfu (UB 36),Yinmen (UB 37), Weizhong (UB 40), Chengs

20、han (UB 57),Yanglingquan (GB 34), Feiyang (UB 58) and Juegu (GB 39)in the affected limb for 2 or 3 times.3) Pressing-kneading to the Ashi point on the sides of the lumbar vertebrae for 2--3 minutes. 4) Obliquely pulli

21、ng manipulation on lumbar vertebral region.5) Stretching and rotating his knee(s) and hip(s) to help move the lumbar vertebrae 3—5 times.,Example of case history,4. Course of Treatment: The patient recievcs treatment

22、once every other day, ten times of treatment make one course.The interval between every two courses is 3--5 days.Doctor’s advice:Keep the lumbar warm.Moderate exercise. Signatu

23、re,Lumbar Disk HerniationWard round in English,Resident’s Round (the last night)住院醫(yī)師查房（前一天晚上）Resident: Good evening, Mary , I’m Dr， Zhu in charge of the ward. 住院醫(yī)生：晚上好。瑪麗 ,我是朱醫(yī)生，主管這間病房。Patient: Hello, Dr. Zhu.病人：晚上

24、好，朱醫(yī)生。Resident: This is Dr. Shi. Can you take the history now?住院醫(yī)生：這是史醫(yī)生。請您現(xiàn)在詢問病史吧？Intern: Yes. How do you feel now?實習(xí)醫(yī)生：好的?，旣?，你現(xiàn)在感覺怎么樣？Patient: I am fine except for some pain.病人：除了一些地方疼，其它感覺良好。Intern: Oh, how lon

25、g have you been like this?實習(xí)醫(yī)師：疼痛多長時間了？Patient: About 1 year off and on.病人：大概一年了。疼痛一直是反復(fù)性的，時好時壞。Intern: Can you describe the pain?實習(xí)醫(yī)師：你能把疼痛的情況描述一下嗎？,CERVICAL SPONDYLOPATHY Ward round in English,Director’s Round主任

26、查房Visiting physician: As a rule, the director comes to our ward to make a ward round. Professor Wang, we’ve received a new case with a one-month history of soreness and numbness in the left upper extremity and decrease

27、of hand strength. There are some troubles in diagnosis and treatment for him. 主治醫(yī)生：作為常規(guī)，主任來病房查房。王教授，我們收了一個新病例——左上肢酸痛麻木、握力減退一月。在為他診斷和治療方時遇到了問題。Director: Ok. We’ll have a look at this new patient. 主任醫(yī)師：讓我們?nèi)タ纯床∪恕isitin

28、g physician: Dr. Shi, Please report the case briefly to the director. 主治醫(yī)生：史醫(yī)生，請向主任簡短報告病例。Intern: OK. This is a 50-year-old male, who was admitted to our hospital in Jun. 2nd, 2008 because of recurrent attacks of pain

29、in the neck and shoulder for six year, soreness and numbness in the left upper extremity and decrease of hand strength for one month and getting worse for one week. He also has a pain in his left chest. He is a cadre in

30、Beijing University who needs long terms of deskwork. The patient had no obvious trauma history recently and no spinal disease previously. No special for other histories. The blood, urine routine analysis, the ECG and ele

31、ctrolyte analysis are all normal. Upon physical examination, stiffness of the neck muscle and tenderness around spinous process in C5-C7 were evident. The muscle force and tender reflex of left biceps brachii muscle were

32、 reduced. Stretching test of brachial plexus nerve and crushing test of intervertebral foramen were positive. Plain X-ray showed decrease of cervical curve, stenosis of intervertebral space of C5-C6 and hyperplasia of ve

33、rtebral edge. Upon spine MRI films a paramedian left C5-C6 disc herniation and radical compression are depicted. That's all for this case.,,,六、存在的問題和采取的措施,由于推拿臨床雙語(英語)查房教學(xué)課程的建設(shè)是一項全新的工作，對英語的水平要求較高，這就給我們的工作帶來了很大的困難。