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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. PC Leung 梁秉中 Institute of Chinese Medicine 中醫中藥研究所 The Chinese University of Hong Kong 香港中文大學. 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
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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 PC Leung 梁秉中 Institute of Chinese Medicine 中醫中藥研究所 The Chinese University of Hong Kong 香港中文大學
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 Origin of Massage 按摩的源起 按摩 改善血液循環 肌肉鬆弛 舒適 Massage Improved circulation Muscle relaxation Comfort
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
推拿,按摩是否力量、經驗、訓練便夠 Is Massage best done with strength, experience and training
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
疼痛的不同層次 Different Levels of Pain Perception • 反射反應 • 中樞層次 • - 大腦皮層 • - 位置感覺調節 • 門檻理論 • 大腦阻隔 • 環境、社會、心理學 • Reflex at spinal level • Central level - sensory cortex interpretation - proprioceptive inhibition • Gate theory - substantia gelationosa • Cortical inhibition • Environmental socio-psychological
Side circuits Substantia gelatinosa Mid-brain Endophines
Reflex is made more complicated Nocioceptive System Posterior horn side circuits Gate Theory Proprioceptive input Substantia gelatinosa Cortical inhibition Midbrain Outside influence-Psychosocial Genetics Behaviour Experience 心理 環境 社會 大腦阻隔 門檻理論 反射
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 Research
病人特徵 醫者特徵 病人醫者之溝通 疾病之性質 治療環境 Patient’s characteristics Healer’s characteristics Patient – Healer communication Nature of Illness Environmental setting 療效之多方面因素Factors Affecting Efficacy
病人特徵 Patients’ Characteristics • 知識形 • 迷信形 • 挑剔形 • 體面形 • Intellectual • Dull • Inquisitive • Official
醫者特徵 外貌 裝扮 誠信 Healer’s Characteristics Appearance Taste Confidence Honesty
溝通能力 語言 知能 關懷 誠懇 Communication Skill Language Intellectual Concern Openness
疾病之性質 急性(短暫) 慢性 老疾 能治/不治 Nature of illness Acute short duration Chronic long duration Very old problem Treatable/non treatable
治療環境 標準 專業 豪華 簡陋 Environmental Setting Standard Professional Luxurious Simple
技術重要還是多方面因素重要? Which is more important? Skill or Multiple Factors?
按摩師 技術 修養 儀態-裝扮-溝通能力 Technical skill General knowledge Communication skill - Pleasant look 基本需要的考慮Basic Considerations
文化傾向 治療環境 心理狀態 職業背景 病歷 Cultural background Treatment setting Psycho-social state Occupational state History of Illness 基本需要的考慮Other Considerations
按摩非按摩 按摩乃治療 按摩乃 朋友之道 安慰之道 啟發之道 引導自保,自療 Massage is not just massage Massage is removing illness Massage is making friends comforting friends inspiring friends Towards self protection self-treatment
深明此道者 將把按摩帶上更高層次 Once the practice becomes that divergent, Massage is substantially elevated
賽馬會盲人綜合服務中心 Jockey Club Multi-Service Centre for the Blind