内科常见病症的中医药照顾课件2.ppt

1、内科常见病症的内科常见病症的中医药照顾中医药照顾 感冒，俗称伤风，是感触风邪或时行病毒，引起肺卫功能失调，出现鼻塞流涕、喷嚏、头痛、恶寒、发热、全身不适等主要临床表现的一种外感病。起病急，临床以鼻塞、流涕、喷嚏、头痛、咳嗽、恶寒、发热、全身不适为主要表现。症状表现常呈多样化，以鼻、咽部痒、干燥、不适为早期症状，继而喷嚏、鼻塞、流涕等，轻者易于痊愈，重者高热、咳嗽、胸痛。l风邪犯表的临床症状。如鼻、咽部痒而不适，鼻塞、流涕、喷嚏、声重而嘶，头痛，恶风，恶寒等。l邪从口鼻而入，病程较短，一般为3-7天，普通感冒一般不传变。l一年四季均可发病，以冬、春季节为多。应与温病早期相鉴别。应与温病早期相鉴别

2、。v中药治疗：如风寒证可用荆防败毒散；如风热证可用银翘散；如暑湿证可用新加香薷饮。针灸治疗：均用泻法其它疗法：板蓝根冲剂、藿香正气丸汤药不宜久煎；药应温热服，服后避风覆被取汗，或吃热汤以助药力，以遍体微汗为宜，切忌大汗淋漓；汗出后应注意避风保暖，以防复感。注意休息，饮食进流质或半流质为宜。药后得汗为病邪外达之象，无汗是邪尚未祛。汗出后身凉脉静为病邪得解。v主要预防药物有贯众、大青叶、藿香、金银花等；v加强锻炼，适当进行室外活动，提高抗病能力；v注意防寒保暖，及时增减衣被，避免淋雨受凉及过度疲劳；v醋熏蒸法：室内消毒，可用食醋熏蒸。咳嗽是由六淫外邪侵袭肺系，或脏腑功能失调，内伤及肺，肺气不清，失

3、于宣肃所成，临床以咳嗽、咯痰为主要表现。有声无痰为咳，有痰无声为嗽。一般痰声多并见，难以截然分开，故以咳嗽并称。咳嗽、咯痰是本证的主要表现。外感引起的咳嗽、咯痰大多伴有发热、头痛、恶寒等，起病较急，病程较短；内伤所致的咳嗽，一般无外感症状，起病慢，病程长，常伴有脏腑功能失调的证候。咳逆有声，或伴咽痒咯痰；外感咳嗽，起病急，可伴有寒热等表证；内伤咳嗽每因外感反复发作，病程较长，咳而伴喘；急性期，周围血白细胞总数和中性粒细胞增高；听诊可闻及两肺野呼吸音增粗，或伴散在的干湿性啰音；肺部X线摄片检查正常或肺纹理增粗。v中药治疗：中药治疗：如三拗汤合止嗽散、桑菊饮、桑杏汤、二陈汤合三子养亲汤、清金化痰汤

4、、沙参麦冬汤v针灸治疗：针灸治疗：均用泻法、平补平泻法v其它疗法：其它疗法：桑叶、枇杷叶各12克，水煎服。注意四时气候变化，随时增减衣被，防寒保暖，避免外邪侵袭。锻炼身体，增强体质，适当进行耐寒锻炼。改善生活环境，清除烟尘和有害气体。戒烟，忌食辛辣油腻之品。眩晕是由于风、火、痰、瘀、虚引起清窃失养，临床上以头晕、眼花为主症的一类病症。眩即眼花，晕即头晕，两者常同时出现，故统称为眩晕。轻者仅眼花，头重脚轻，或摇晃浮沉感，闭目即止；重则如坐车船，视物旋转，甚则仆倒。或兼目涩耳鸣，少寐健忘，腰膝酸软；或兼恶心呕吐，面色苍白，汗出肢冷等。发作期间舌苔多为白腻或黄腻，缓解期苔薄白，舌质红或有瘀斑、瘀点，

5、脉象多弦表现为弦滑、弦细、弦涩等。v头晕目眩，视物旋转，轻者闭目即止，重者如坐车船，甚则仆倒。可伴有恶心、呕吐，眼球震颤，耳鸣耳聋，汗出，面色苍白等。v慢性起病，逐渐加重，或反复发作。v其它各项检查：如查血红蛋白、红细胞计数等。本病应与中风、厥证、痫病相鉴别。本病应与中风、厥证、痫病相鉴别。l中药治疗：如天麻钩藤饮、龙胆泻肝汤、半夏白术天麻汤、归脾汤、左归丸等；l针灸治疗：虚证，针宜补法，可灸；实证，针宜泻法，不灸。l居室保持安静、舒适、避免噪声、光线柔和；l患者应保持充足的睡眠，注意劳逸结合；l眩晕反复发作应卧床休息，闭目养神，少作或不做旋转、弯腰的动作。l对重症病人应密切观察并及时处理。l

6、患者应保持心情愉悦，饮食应清淡易消化为宜，积极治疗有关疾病。如眩晕反复发作，有加重趋势，并兼头胀而痛，心烦易怒，口齿不清，肢麻震颤者，有发生中风的可能，应急送上级医院抢救。胃痛，又称胃脘痛，是由外感邪气、内伤饮食情志、脏腑功能失调等导致气机郁滞，胃失所养，以上腹胃脘部疼痛为主症的病症。l胃痛的部位在心下胃脘，以胀痛、刺痛、隐痛常见。l胃痛可为持续性，也可为发作性，可无压痛，或压痛并不明显，无反跳痛。l常因寒暖失宜、饮食失调、情志不舒等诱因而发作或加重，并常伴有食欲不振、恶心呕吐、吞酸嘈杂等症状。l胃脘部疼痛，常伴有食欲不振、痞闷或胀满，恶心呕吐，吞酸嘈杂等；l发病常与情志不遂、饮食不节、劳累、

7、受寒等因素有关；l起病或急或缓，常有反复发作的病史；l其它辅助检查。应与真心痛相鉴别。应与真心痛相鉴别。l中药治疗：如用良附丸、保和丸、柴胡疏肝散、丹栀逍遥散、清中汤、黄芪健中汤、失笑散合丹参饮。l针灸治疗：实证者针用泻法，寒证加灸；虚证者针用补法；指压至阳穴法。l其它疗法：安中散、百合、丹参等。重视精神与饮食方面的调摄，保持精神愉快，性格开朗，劳逸结合，切忌暴饮暴食，或饥饱无常，饮食以少食多餐，清淡易消化为原则，可减轻胃痛和减少胃痛发作。胃痛伴有呕血、黑便者，应转诊上级医院治疗。头痛是指由于外感与内伤，致使脉络绌急或失养，清窍不利所引起的病人自觉头部疼痛为特征的一种常见病症。头痛也是一个常见

8、症状，可发生在多种急慢性疾病中，有时也是某些相关疾病加重或恶化的先兆。v患者自觉头部疼痛是共同的临床表现；v外感头痛表现为突然发作，其痛如破，痛无休止；v内伤疼痛则缓慢而病，痛势绵绵，时痛时止，长久不愈，其痛多以空痛、隐痛、昏痛，遇劳或情志刺激而发作与加重为主。l以头痛为主症，有突然而作，其痛如破而无休止者；也有反复发作，久治不愈，时痛时止者；l头痛每次发作可持续数分钟、数小时、数天或数周不等。本病应与类中风、真头痛相鉴别。本病应与类中风、真头痛相鉴别。l中药治疗：如川芎茶调散、芎芷石膏汤、天麻钩藤饮、大补元煎、八珍汤等；l针灸治疗：风湿头痛、肝阳头痛、痰浊头痛针宜泻法；血虚头痛针宜补法；瘀血

9、头痛针宜补泻兼施。l其它疗法l急性发作期应适当休息，不宜食用炸烤辛辣的厚味食物，控制烟酒。l采取疏导劝慰以稳定情绪；l缓解期应注意情志、饮食及寒暖等的调护，以防复发。头痛剧烈，伴烦躁、恶心、呕吐者应转诊治疗。0B3E6I9LdOgRjVmYp!t&w-z1C4G7JaMePhTkWnZr$u*x+A2E5H8KcNfQiUlXo#s%v)y0B3F6I9LdOgSjVmYq!t&w-z1D4G7JbMePhTkWoZr$u(x+A2E5H9KcNfRiUlXp#s&v)y0C3F6IaLdPgSjVnYq!t*w-z1D4G8JbMeQhTkWoZr%u(x+B2E5H9KcOfRiUmXp#

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22、TlWoZr%u(y+B2E6H9KcOfRjUmXp!s&v)z0C4F7IaMdPgSkVnYq$t*x-A1D5G8JbNeQiTlWo#r%u(y+B3E6H9LcOfRjUmYp!s&w)z0C4F7JaMdPhSkVnZq$u*x-A2D5G8K8KbNfQiTlXo#r%v(y0B3E6I9LcOgRjVmYp!t&w)z1C4F7JaMePhSkWnZq$u*x+A2D5H8KbNfQiUlXo#s%v(y0B3F6I9LdOgRjVmYq!t&w-z1C4G7JbMePhTkWnZr$u(x+A2E5H8KcNfRiUlXp#s%v)y0B3F6IaLdOgSjVmYq!t*

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24、9L9LdOgRjVmYq!t&w-z1C4G7JaMePhTkWnZr$u*x+A2E5H8KcNfQiUlXp#s%v)y0B3F6IaLdOgSjVmYq!t*w-z1D4G7JbMeQhTkWoZr$u(x+B2E5H9KcNfRiUlXp#s&v)y0C3F6IaLdPgSjVnYq!t*w-A1D4G8JbMeQhTlWoZr%u(x+B2E6H9KcOfRiUmXp!s&v)z0C3F7IaMdPgSkVnYq$t*w-A1D1D5G8JbNeQiTlWo#r%u(y+B2E6H9LcOfRjUmXp!s&w)z0C4F7IaMdPhSkVnZq$t*x-A2D5G8KbNeQi

25、TlXo#r%v(y+B3E6I9LcOgRjUmYp!t&w)z1C4F7JaMdPhSkWnZq$u*x-A2D5H8KbNfQiTlXo#s%v(y0B3E6I9LdOgRjVmYp!t&w-z1C4G7JaMePhTkWnZr$u*x+A2E5H8KcNfQiUlXo#s%v)y0B3F6I9LdOgSjVmYq!t&w-z1D4G7JbMePhTkWoZr$u(x+A2E5H9KcNfRiUlXp#s&v)y0C3F6IaLdPgSjVnYqYq!t*w-A1D4G8JbMeQhTlWoZr%u(x+B2E5H9KcOfRiUmXp#s&v)z0C3F7IaLdPgSkVnYq$t*w-A1