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【医学ppt课件】 第七节、脏腑兼病

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医学ppt课件 脏腑兼病第七节
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单击此处编辑母版标题样 式 单击此处编辑母版副标题样式 *1 第七节、脏腑兼病第七节、脏腑兼病 成都中医药大学 严石林 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 第七节、脏腑兼病辨证 u概念:两个 或两个以上的 脏腑病证并见 者,称为脏腑 兼病。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 一、心肾不交证 u1、概念:指心与肾的阴液亏虚,阳气偏亢,以心烦、失 眠、梦遗、耳鸣、腰酸为主要表现的证候。 u2、临床表现: u 心阴虚,心火旺: u 心烦失眠,惊悸健忘。 u 肾阴亏虚: u 头晕耳鸣,健忘,梦遗,腰膝酸软。 u 阴虚内热见症: u 口咽干燥,五心烦热,潮热盗汗,便结尿黄。 u 舌脉:舌红少苔或无苔,脉细数。 u3、审证要点:心烦、失眠、梦遗、耳鸣、腰酸与阴虚症 状共见为主。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 二、心肾阳虚证 u1、概念:指心与肾的阳气虚衰,失于温煦,以心 悸、水肿为主要表现的虚寒证候。 u2、临床表现: u 心阳虚见症: u 心悸怔忡,胸闷气短,唇甲青紫。 u 肾阳虚见症: u 腰膝酸冷,肢体浮肿,小便不利。 u 虚寒见症:畏寒肢冷,神疲乏力。 u 舌脉:舌质淡紫,苔白滑,脉弱。 u3、审证要点:心悸、水肿与虚寒症状共见为主。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 三、心肺气虚证 u1、概念:指心肺两脏气虚,以咳喘、心悸、胸闷为主要 表现的虚弱证候。 u2、临床表现: u 心气虚见症: u 心悸怔忡,动则尤甚。 u 肺气虚见症: u 胸闷,咳嗽,气短而喘,吐痰清稀,自汗。 u 气虚见症: u 声低懒言,神疲乏力,面色淡白。 u 舌脉: u 舌淡白苔白,或唇舌淡紫,脉沉弱或结或代。 u3、审证要点:咳喘、心悸、胸闷与气虚症状共见为主。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 四、心脾气血虚证 u1、概念:指脾虚气弱,心血不足,心神失养,以心悸、 神疲、头晕、食少、腹胀、便溏为主要表现的虚弱证候, 又称心脾两虚证。 u2、临床表现: u 心血虚见症: u 心悸怔忡,失眠多梦,头晕健忘。 u 脾气虚弱见症: u 食欲不振,腹胀,便溏。 u 脾不统血见症: u 皮下紫斑,女子月经量少色淡,淋漓不尽。 u 气血两虚见症:神疲乏力,面色萎黄。 u 舌脉:舌质淡嫩,脉细弱。 u3、审证要点:心悸、神疲、头晕、食少、腹胀、便溏。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 五、 心肝血虚证 u1、概念:指血液亏少,心肝失养,以心悸、多梦、眩晕 、肢麻、经少与血虚症状为主要表现的证候。 u2、临床表现: u 心血虚见症: u 心悸心慌,失眠多梦健忘。 u 肝血虚见症: u 头晕目眩,视物模糊,爪甲不荣,肢体麻木, u 震颤,女子月经量少色淡,经闭。 u 血虚见症:面白无华。 u 舌脉:舌质淡白,脉细。 u3、审证要点:心悸、多梦、眩晕、肢麻、经少与血虚症 状共见为主。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 六、脾肺气虚证 u1、概念:指脾肺两脏气虚,以咳嗽、气喘、咯痰、食少 、腹胀、便溏为主要表现的虚弱证候。 u2、临床表现: u 脾气虚见症: u 食欲不振,食少,腹胀便溏。 u 肺气虚见症: u 久咳不止,气短而喘,声抵懒言, u 吐痰清稀,面浮肢肿。 u 气虚见症: u 声低懒言,神疲乏力,面白无华。 u 舌脉:舌质淡,苔白滑,脉弱。 u3、审证要点:咳嗽、气喘、咯痰、食少、腹胀、便溏与 气虚症状共见为主。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 七、肺肾气虚证 u1、概念:指肺肾气虚,摄纳无权,以久病咳喘、呼多吸 少、动则尤甚为主要表现的虚弱证候。又称肾不纳气证。 u2、临床表现: u 肺气虚见症: u 咳喘无力,气短而喘,吐痰清稀,声低乏力,自汗。 u 肾气虚见症: u 呼多吸少,动则喘息尤甚,耳鸣, u 腰膝酸软,尿随咳出。 u 气虚见症: 少气懒言,神疲乏力,困倦嗜卧。 u 舌脉:舌淡紫,脉弱。 u3、审证要点:久病咳喘、呼多吸少、动则尤甚与气虚症 状共见为主。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 八、肺肾阴虚证 u1、概念:指肺肾阴液亏虚,虚火内扰,以干咳、少痰、 腰酸、遗精为主要表现的虚热证候。 u2、临床表现: u 肺阴虚见症: u 咳嗽痰少,痰中带血,声音嘶哑。 u 肾阴虚见症: u 腰膝酸软,男子遗精,女子月经不调。 u 阴虚内热见症: u 口燥咽干,形体消瘦,骨蒸潮热,盗汗颧红。 u 舌 脉:舌红少苔,脉细数。 u3、审证要点:干咳、少痰、腰酸、遗精与虚热症状共见 主要。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 九、肝火犯肺证 u1、概念:指肝火炽盛,上逆犯肺,肺失清肃,以胸胁灼 痛、急躁、咳嗽痰黄或咳血为主要表现的实热证候。又称 木火刑金证。 u2、临床表现: u 肝经实火见症: u 胸胁灼痛,急躁易怒,头胀头晕, u 面红目赤,口苦口干。 u 肺热见症: u 咳嗽阵作,甚则咳血,痰黄稠黏。 u 舌脉:舌质红,苔薄黄,脉象弦数。 u3、审证要点:胸胁灼痛、急躁、咳嗽痰黄或咳血与实热 症状共见为主。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 十、肝胆湿热证 u1、概念:指湿热内蕴,肝胆疏泄失常,以身目发黄、胁 肋胀痛及湿热症状为主要表现的证候。以阴痒、带下黄臭 为主要表现者,称肝经湿热(下注)证。 u2、病因:感受湿热之邪;嗜食肥甘、湿热内生; u 脾胃失运,湿浊内生,反侮肝胆。 u3、临床表现: u 主症:身目发黄,胁肋胀痛,胁下痞块。 u 兼症:厌油腻,纳呆,泛恶欲呕,腹胀,口干口苦, 发热或寒热往来,阴部潮湿、瘙痒、湿疹,阴器肿痛,带 下色黄秽臭,小便黄赤,大便不调。 u 舌脉:舌红苔黄腻,脉弦滑数。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. u4、证候分析: u 肝胆失疏:胁肋灼热胀痛,口苦咽干, u 寒热往来,身目发黄,胁下痞块。 u 脾胃失运:厌油腻,纳呆,泛恶欲呕,腹胀, 。 u 湿热下注:阴部潮湿、瘙痒、湿疹,阴器肿痛 ,带下色黄秽臭,小便黄赤,大便不调。 u 湿热舌脉:舌红苔黄腻,脉弦数或滑数。 u5、审证要点:身目发黄、胁肋胀痛或阴部瘙痒、 带下色黄与湿热症状共见为主。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. u6、鉴别诊断: 肝胆湿热与脾胃湿热 u 共同点:共见发黄,纳呆,腹胀,便溏,恶心,呕吐 ,舌红,苔黄等症。 u 不同点: 肝胆湿热 脾胃湿热 u 症状: 胸胁胀痛 脘腹痞闷 u 往来寒热 纳呆呕恶 u 阴部瘙痒 大便不爽 u 阴器肿痛 肢体困重 u 带下色黄臭秽 u 脉象: 弦数 濡数 u 病机: 肝失疏泄 纳运升降失常 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 十一、肝胃不和证 u1、概念:指肝气郁结,胃失和降,以脘胁胀痛、暧气、 吞酸、情绪抑郁为主要表现的证候。又称肝气犯胃,肝肾 气滞证。 u2、临床表现: u 肝气郁滞见症: u 胁肋胀痛,窜痛,情绪抑郁,烦躁, u 易怒,善太息。 u 胃气上逆见症: u 胃脘胀满疼痛,呃逆嗳气, u 吞酸嘈杂,不欲饮食。 u 舌脉:舌苔薄白或薄黄,脉弦。 u3、审证要点:脘胁胀痛、暧气、吞酸、情绪抑郁为主。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 十二、肝郁脾虚证 u1、概念:指肝失疏泄,脾失健运,以胸胁胀痛、情绪郁 郁、腹胀、便溏为主要表现的证候。又称肝脾不调证。 u2、临床表现: u 肝气郁结见症: u 胸胁胀满窜痛,善太息, u 情志抑郁,急躁易怒。 u 脾失健运见症: u 食少腹胀,肠鸣矢气,便溏不爽 u 腹痛欲泻,泻后痛减,大便溏结不调。 u 舌脉:舌苔白,脉弦或缓。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. u3、审证要点:胸胁胀痛、情绪郁郁、腹胀、便溏 为主。 u4、鉴别诊断:肝胃不和,肝郁脾虚。 u 共同点:均有胸胁胀满疼痛,情志抑郁,急 躁易怒。 u 不同点: u 肝胃不和兼胃失和降,常见胃脘胀痛,呃逆 嗳气。 u 肝郁脾虚兼脾失健运,常见食少,腹胀,便 溏。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 十二、肝肾阴虚证 u1、概念:指肝肾阴液亏虚,虚热内扰,以腰酸胁痛、眩 晕、耳鸣、遗精为主要表现的证候。又名肝肾虚火证。 u属下焦病证。 u2、临床表现: u 肝阴虚见症: u 胁痛,头晕目眩,失眠多梦。 u 肾阴虚见症: u 耳鸣健忘,腰膝酸软,男子遗精,女子月经量少。 u 阴虚内热见症: u 口燥咽干,五心烦热,盗汗颧红。 u 舌脉:舌红少苔,脉细而数。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. u3、审证要点:腰酸胁痛、眩晕、耳鸣、遗精与虚热症状 共见为主。 u4、鉴别诊断:心肾不交,肺肾阴虚,肝肾阴虚。 u 共同点:均有肾阴虚证,同见腰膝酸软,耳鸣遗精, 阴虚内热的表现。 u 不同点: u 心肾不交兼心阴亏虚,常见心悸,心烦,失眠多梦等 症。 u 肺肾阴虚兼肺阴亏虚,常见干咳无痰,痰少难咯等症 。 u 肝肾阴虚兼肝阴亏损,常见胁痛,目涩,眩晕等症。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 十三、脾肾阳虚证 u1、概念:指脾肾阳气亏虚,虚寒内生,以久泻久痢、水 肿、腰腹冷痛为主要表现的虚寒证候。 u2、临床表现: u(1)腹泻为主: u 久泄,久痢,五更泄泻,完谷不化,粪质清冷。 u(2)水肿为主: u 全身水肿,小便不利,甚则腹胀如鼓。 u(3)虚寒见症: u 面色 白,畏寒肢冷,腰膝、下腹冷痛。 u(4)舌脉: u 舌质淡胖,舌苔白滑,脉沉迟无力, Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. u3、审证要点:久泻久痢、水肿、腰腹冷痛与虚寒 症状共见为主。 u4、鉴别诊断:脾肾阳虚,心肾阳虚。 u 共同点:均有肾阴虚,同见腰膝酸冷,水肿 ,小便不利,畏寒肢冷,舌淡胖,苔白滑等症。 u 不同点: u 脾肾阳虚兼脾阳虚衰,常见食少,腹胀,便 溏,完谷不化等症。 u 心肾阳虚兼心阳虚损。常见心悸怔忡,胸闷 气短,面唇紫暗等症。
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