醫學博士的太極養生體驗
Practical self-care principles from the combined
perspectives of Western medicine and Tai Chi
李政欣
勒星頓中文學校
December 8, 2013
何謂養生?
• 古人云：善養生者，上養神智、中養形態、下養筋骨。
• 通過各種生活型態的調適, 颐養生命、增强體質、預防疾病，
以期儘量延長無(或少)病痛的時間, 並保持充分的心智與體
能, 而能完成各人生命中需要負擔的責任, 及希望達成的目
標.
Common chronic conditions as we age• Musculoskeletal: osteoarthritis, gout, loss of muscle mass
• Hormonal/metabolic: diabetes (type II), high cholesterol
• Neurological: dementia, Parkinson’s disease, stroke, poor
vision, hearing impairment, balance problem
• Cardiovascular: heart attack, hypertension, heart failure,
irregular heat beats, atherosclerosis
• Cancers: colon, lung, prostate, breast, …etc
• Lungs: chronic obstructive pulmonary disease, asthma
• Urinary: incontinence, urgency
• General: deconditioning, medication side effects, weight loss,
falls
Risk factors for cardiovascular diseases•
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•
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High blood pressure
High blood cholesterol
Diabetes
Smoking
Being overweight
Being physically inactive
Having a family history of early heart disease
Age (55 or older for women)
Uncontrolled stress
癌變的過程
Source: http://www.medicinenet.com/
Early detectionCancer Screening 癌症篩檢
1. 乳癌- 乳房攝影檢查：45-69歲婦女、40-44歲二等親曾有乳癌家族史
之婦女，每2年1次。
2. 子宮頸癌- 抹片檢查：30歲以上婦女，每年1次，建議婦女們每3年至
少接受1次。
3.大腸癌- 糞便潛血檢查：50至未滿75歲民眾，每2年1次。大腸鏡:每10
年1次
4. 口腔黏膜檢查：30歲以上有嚼檳榔（含已戒檳榔）或吸菸者、18至未
滿30歲有嚼檳榔（含已戒檳榔）原住民，每2年1次。
5. 肝癌篩檢: 每6個月提供B肝帶原和慢性肝炎患者1次腹部超音波和甲型
胎兒蛋白檢查，可以降低37％的肝癌死亡率。
Scientific bases for self repair, healing and
renewal:
• DNA repair: defects
associated with accelerated
aging and increased risks of
cancer
• Adult stem cells
• Immune surveillance
Werner syndrome: a premature aging
disorder caused by a genetic defect in
DNA repair and replication
How to prevent chronic conditions for a long,
healthy, medically uncomplicated life• Healthy eating habits
• Weight management
• Physical exercise
• Stress reduction
• Psychosocial support
• A good night’s sleep
-Donald Levy, MD, Director of Osher Clinical Center for Complementary and
Integrative Medical Therapies at Brigham and Women’s Hospital, quoted from The
Harvard Medical School Guide to Tai Chi
Healthy eating habits:
• Balanced nutrition
• Predominantly plant based, with high fiber content: choose
whole grains and beans over processed white grains
• Wide variety
• Unprocessed food
• Moderation: sugar, salt, red meat (saturated animal fat),
cholesterol, alcohol, portion
• Food safety: additives, preservatives, residual pesticides and
herbicides, pollution (bio-concentration)
• Slowing the pace of eating
維持適當的體重
Body Mass Index (BMI) Cutoff for Asians
BMI Cutoff
<18.5
Weight Status Comments
Underweight
Being underweight also puts you at risk for developing many health
problems. Discuss with your healthcare provider about how to
reach a healthy weight.
Your weight is within normal range. You can continue to keep a
18.5 - 23.9
24 - 26.9
>27
Healthy weight
healthy weight through physical activity and healthy eating. Keep
range
up with the good work!
Overweight
Being overweight can put you at risk for developing many chronic
diseases. Discuss with your healthcare professional on how to
achieve a healthy weight.
Obese
Obesity increases risks for developing many chronic diseases such
as heart disease and diabetes, and decreases overall quality of life.
Discuss with your healthcare provider about how to achieve a
healthy weight!
Wildman RP et al. Appropriate body mass index and waist circumference cutoffs for categorization of
overweight and central adiposity among Chinese adults. American Journal of Clinical Nutrition 2004;
80:1129.
Appropriate body-mass index for Asian populations and its implications for policy and intervention
strategies. Lancet 2004; 363:157-63
Source: 加斯林美國亞裔糖尿病研進會(AADI)
http://aadi.joslin.org/content/bmi-calculator
維持適當的腰圍
Target Waist Circumference for Asians and Asian
Americans
Sometimes even when your BMI is within normal range, having
too much fat around the abdomen (Apple shape body) will still
put you at risk for heart disease and diabetes. Below are the
target goals for waist circumference measurements.
Men
Women
Equals or less than 90cm (35.5 in)
Equals or less than 80cm (31.5 in)
Source: 加斯林美國亞裔糖尿病研進會(AADI)
http://aadi.joslin.org/content/bmi-calculator
Stress reduction• Stress: Body’s reaction to a challenge or threat
• Fight-or-flight response: activation of the sympathetic nervous
system
- Blood pressure rises
- Breathing becomes more rapid
- Heart rate (pulse) rises
- Muscles become tense
- Digestive system slows down
- Immune system goes down
- Heightened state of alertness
Medical conditions associated with chronic stress
Between 60% and 90% of all physician visits are for stress-related
complaints.
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arrhythmias, hypertension, increased risk of heart attack and
stroke
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asthma
-
irritable bowel syndrome, ulcers
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back pain, fatigue, headaches
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suppression of the immune system,
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increased vulnerability to anxiety and depression, infertility,
and hastening the aging process, …etc
Relaxation response (I)•
a physical state of deep rest that changes the physical and emotional
responses to stress (e.g., decreases in heart rate, blood pressure, rate
of breathing, and muscle tension).
•
Can be elicited by two essential steps:
- Repetition of a word, sound, phrase, prayer, or muscular
activity.
- Passive disregard of everyday thoughts that inevitably
come to mind and the return to your repetition.
from Benson Henry Institute for Mind Body Medicine at MGH
Relaxation response (II)•
Mind-body approaches that elicit the RR include: various forms of meditation,
repetitive prayer, yoga, tai chi, breathing exercises, progressive muscle
relaxation, biofeedback, guided imagery and Qi Gong.
•
Physiological effects of the RR: decreased oxygen consumption, decreased
carbon dioxide elimination, reduced blood pressure, heart and respiration
rate, …etc.
Dusek et al, Genomic Counter-Stress Changes Induced by the Relaxation Response, PLoS ONE 2008
RR practice enhanced expression of genes associated with energy metabolism, mitochondrial
function, insulin secretion and telomere maintenance, and reduced expression of genes linked
to inflammatory response and stress-related pathways.
-Dusek et al, PLoS ONE 2008; Bhasin et al, PLoS ONE 2013
Physical exercise• Moderate intensity:
• 道家養生: 內丹: 靜功 (氣功); 動功 (內家拳: 太極拳, 八卦拳, 形意拳)
• “Medicinal exercise”: 五禽戲, 八段錦,
• Other mind body exercises: Yoga, Pilates, …etc.
• 平甩功
Physical exercise- my Tai Chi regimen
Daily (~40 min, outdoors)
• 簡易氣功
• 太極熱身功
• 簡易太極32式
• 24式太極
Weekly (3-4 hr, indoors)
• Basic exercise: stance work, waist
turning, deep stretching
• Meditation
• 簡易太極32式
• 24式太極
• 太極刀
• 太極刀
• 楊式太極85式
• 推手
• 五禽戲, ...
Health benefits of Tai Chi• Improve your balance and bones: flexibility, agility (一舉動, 周身俱要輕靈)
• Ease your aches and pains: posture (虛領頂劲, 鬆肩, 含胸拔背; 立身中正而安舒),
heightened body awareness, low impact
• Strengthen your heart: aerobic, lower blood pressure
• Deepen and enrich your breathing: 氣宜鼓盪, deep abdominal breathing
• Sharpen your mind:神宜內斂, improve cognitive functions, learn new skills,
coordination
• Enhance psychological well being and sleep quality: stress reduction (meditation in
motion), relaxation (神舒體靜), psychosocial support
• Motivation and techniques to remain physically active for life
from The Harvard Medical School Guide to Tai Chi, by Peter M. Wayne PhD with Mark L Fuerst
A few more thoughts• Keep yourself well hydrated.
• Kegel exercise: 提肛
• Allergy
• Prevention of falls and injuries
Acknowledgment
Additional information sources-
• 薛霖統先生
• http://www.humanmedia.org/
wellbeing/
• 黃修忻博士(Cecilia Wong,
PhD)
• http://www.massgeneral.org/b
hi/
• 盧植生先生
• Anson Rathbone