怎样把按摩效应推上更具治疗意义的层次.ppt

世界盲人聯盟亞太區第七屆按摩研討會 The 7th WBU Asia Pacific Regional Seminar on Massage 怎樣把按摩效應推上更具治療意義的層次 How to Up-grade Massage to a High Efficacy Level 勞累,損傷? 肌肉疼痛 關節退化 ? 肌肉疼痛 筋肌懶閒 ? 肌肉疼痛 筋肌缺血 ? 肌肉疼痛 Overuse, Sprain ?Muscle pain Joint Degeneration ?Muscle Pain Under use/disuse? Muscle Pain Ischaemia? Muscle pain 黃帝內經 (黃帝岐伯按摩卷) 素問?血氣形志篇 「形數驚恐，經絡不通 病生於不仁，治之以按摩」 素問?卒痛論 「寒氣客於背俞之脈澀， 脈澀則血虛，血虛則痛， 其俞注於心，故相引而痛， 按之則熱氣至，熱氣至則痛 止矣。」 Huangdi Naijing (Chapter on Massage) Massage to harmonise, meridians Massage to improve circulation thence pain control 按摩同樣出現於 印度傳統醫學 埃及／羅馬／希臘史冊 Massage was described in Ayurveda Egyptian / Roman / Greek Medical Classics 按摩無分中西，目的一樣 手法細則不同 中醫推拿依照經絡、穴道指示。 西醫按摩依照解剖學基礎實施。 Aim of Massage, whether Western or Chinese are the Same However Chinese Massage depends on understanding of the meridians and Acu-points Western Massage depends on anatomical knowledge 總的來說中西，還是相同的地方多On the Whole, similarities are more than differences 請看身體各部的一些示範 Please look at some demonstration of different regions of the body 中醫按摩與Maitland manupulation Chinese Massage and Maitland manupulation 頸部 Neck 背部　Back 肩膀　Upper limb 肩膀　Upper limb 上臂　Upper limb 下肢　Lower limb 下膝　Knee 病人需要，靈活變通 Satisfy patient’s need, Flexibility 現代醫學分析療效，除針對病理解救 仍需注意心理、社會環境、文化背景 Modern Analysis of Treatment Efficacy shows the importance of Psychology, Social Environment and Cultural Background 疼痛的理解 Pain Perception Different Levels of Pain Perception Reflex at spinal level Central level - sensory cortex interpretation - proprioceptive inhibition Gate theory - substantia gelationosa Cortical inhibition Environmental socio-psychological 藥物有安慰劑效應 按摩也有安慰劑效應嗎？ Placebo Effect of Drugs Does Massage Possess Placebo Effects? 安慰劑　?　恥笑對象 Placebo ? Focus of Ridicule 但安慰劑有10 - 30％療效 But Placebo ?10 - 30% Efficacy 為何不善用安慰劑作用？ Why not make full use of Placebo? 實際療效 或 實際療效 ? 安慰劑作用 Genuine Efficacy OR Genuine Efficacy + Placebo Effect 安慰劑作用之研究 Placebo Effect Re