Friday, November 19, 2010

Treatment of Coronary heart disease (ischemic heart disease)

Modern medicine cholesterol coronary heart disease is due to lipid deposition in the coronary artery wall intima, the endothelial cells, smooth muscle cells, connective tissue proliferation and platelet aggregation and atherosclerotic plaque formation, causing stenosis or occlusion, or by coronary artery intimal smooth muscle contraction caused by the strong coronary artery spasm, leading to myocardial ischemic changes. Blood cholesterol, high blood pressure and smoking are occurring major risk factor for this disease.

The main basis for the diagnosis of coronary heart disease with acute or chronic myocardial ischemia reflect a variety of clinical symptoms or laboratory findings, and the pathogenesis of atherosclerosis and related to age, hypertension, elevated blood lipids and other factors as a secondary basis. ECG clinical examination remains the primary method of myocardial ischemia, angina patients may have ECG S-T segment depression, myocardial infarction patients may have dynamic ECG S-T segment and T wave changes and pathological features of Q wave . When necessary, can be used for ECG stress test, such as the double secondary staircase test, test and pedal pedal test. There are other tests coronary heart vectorcardiogram methods, echocardiography, cardiac function graph, dynamic electrocardiogram. Because coronary angiography is invasive examination, and with some risk, although it is a valuable diagnostic tool, it is not yet as a general method for early diagnosis of coronary heart disease and widely used.

Coronary heart disease treatment principle is to try to improve coronary circulation and neuropsychological status. Vasodilator antianginal with active treatment of various diseases can aggravate angina, patients from the spirit of life and all aspects of work and diet guidance and care.

Coronary heart disease in Chinese medicine are mostly "Chest", "really sad", "Jue heartache" and other areas. Description of the symptoms as early as the fifth century BC "via" in there records, Wei Zhiwei "heart disease", "really sick." Mainly by Qi stagnation, blood stasis is not General Erzhi pain. The invasion of six exogenous pathogenic cold, so cold coagulation vein wall, Juji closing argument; food accidentally, cream beam Atsumi, metamict phlegm, phlegm violations, occupied the area Qing Kuang; or phlegm burning network, fire is on yan ; yin and yang of body fluid or blood deficiency, blood deficiency, resulting in slow, can lead into stasis disease. Impassioned internal injuries, qi stagnation, blood stasis in the chest, will also cause chest pain Chest.

The Features of Coronary heart disease (ischemic heart disease)

Coronary heart disease is called "coronary heart disease", also known as "ischemic heart disease." Cardiac blood supply mainly responsible for the occurrence of atherosclerotic coronary artery, causing stenosis, or blockage of blood supply to the heart, rather then completely cut off, leading to nutritional deficiency is caused by myocardial necrosis, resulting in a severe clinical symptoms. Stenosis caused by other reasons, such as coronary artery spasm, also can produce similar clinical manifestations and therefore its total known ischemic heart disease.

The main clinical manifestations of coronary heart disease are angina pectoris, myocardial infarction, arrhythmia, heart failure. Typical angina pain showed the central part of the chest or 1 / 3 can be left shoulder, left arm radiation; its atypical cases may be pain in the lower sternum, upper abdomen, left chest, etc.. The nature of pain to pressure, heaviness, Jinshu feeling, burning sensation based, and the chief complaint of chest tightness were more non-rare. Most of the time pain in the attack last 2-3 minutes, usually less than half an hour. Often a result of strenuous exercise, stairs, weight or emotional excitement, joy, anger, excessive and cold, after eating, and so induced. Frequently there is a sudden heart attack, severe, frequent, prolonged duration of angina than the original, the original can not make it ease the commonly used drugs, pain accompanied by sweating, pale purple, heart rate bradycardia or arrhythmia, cardiac insufficiency and so on.

Keshan disease

Keshan disease is a kind of cardiomyopathy based systemic endemic disease, found in 1953 in Keshan County in Heilongjiang Province, hence the name. The disease in Heilongjiang, Jilin, Hebei, Shaanxi, Gansu Province and Inner Mongolia Autonomous Region is also popular in many villages.

Jihuan under the onset of the disease, the length of the course and the presence or absence of symptoms, divided into acute type, TB type (slow type) and latent. The clinical presentation often chest tightness, heart palpitations discomfort, nausea, frequent vomiting, shortness of breath, swelling and other symptoms, fraudulent claims can have acute cardiogenic syncope and convulsions. As early as the food and vomit mucus, bile was after, it is often referred to in the civil and the disease as a "spit yellow water disease." Medical examination often shows dark complexion, limbs Jueleng, weak pulse, low body temperature, blood pressure, heart weight sector is increased and low heart sounds weak, apex a systolic murmur grade I-II, when diastolic gallop law. Department of arrhythmia and more premature ventricular contractions, ventricular tachycardia or atrioventricular block. Lungs may have dry, moist rales, hepatomegaly is also visible.

Etiology of this disease still unknown, it seems with the soil (including food) in the abnormal levels of certain elements. Also a cause of infection.

Diagnosis is based on the disease, there are a variety of myocarditis signs of myocardial damage after one, but can be other causes other than heart attack. In non-endemic areas of Keshan disease endemic areas should consider the possibility of this disease.

Treatment of this disease is mainly symptomatic treatment. Such as anti-shock, anti-heart failure, anti-arrhythmia and the application of vitamin C, while the rest was a quiet first.

Keshan disease in medicine is not specifically discussed. According to the sudden onset of the disease characteristics and clinical symptoms of typhoid fever are often considered as insidious, Shao Yu containment in the Haner, heart yang weak spleen yang is not up to the limbs, fraudulent claims directly in the heart of pathogenic cold, hair loss yang violence as syncope, seizures, heart palpitations. It can also refer to "heart palpitations" and "Mind of labor" for theory of governance, bad storm into the heart yang, timid strain, timid evil volts and so on.

Tuberculous peritonitis

Mycobacterium tuberculosis peritonitis caused by chronic diffuse peritoneal infection. To children, young adults often. Women slightly more than men, as 1.2-2.0:1.

[Etiology and Pathogenesis]
Most of tuberculous peritonitis secondary to tuberculosis of other organs change. Route of transmission of the disease can be spread directly or intra-abdominal tuberculosis from hematogenous spread. The former is more common, such as intestinal tuberculosis, mesenteric lymph nodes of nuclear, tubal tuberculosis, the disease can be directly based primary lesions. More women than men, probably because of retrograde pelvic tuberculosis infection.

[Clinical manifestations]
The clinical manifestations of tuberculous peritonitis with the primary tumor, infection routes, pathological type and body reactivity vary, different priorities onset of the disease. Most moderate onset, but the number of acute onset Zheyi not fresh. Onset, the main symptoms are fatigue, fever, abdominal distension and abdominal pain, have chills, fever are sudden onset. Cases began to light was insidious condition.
First, the general performance of fever and night sweats, the most common, accounting for about 67-95%, medium-hot type to hot and mostly low heat, sweating severe late anemia, weight loss, edema, glossitis, angular cheilitis and vitamin A malnutrition, lack of psychosis performance. In women of childbearing age, menopausal infertility are more common.
Second, about two-thirds of the patients with abdominal pain can occur in different degrees of abdominal pain, mostly persistent pain or dull pain, pain and more at Cullen, lower abdomen, sometimes in the whole abdomen.
Third, the majority of patients with abdominal distention and bloating sense of ascites can be symptoms of tuberculosis peritonitis associated with or caused by intestinal dysfunction. About one-third of patients, there may be ascites.
Fourth, a sense of flexibility and a sense of abdominal wall flexibility is due to mild irritation or chronic peritoneal inflammation was caused.
V. adhesion abdominal mass in patients with type and type of cheese often palpable abdominal mass, usually located in the lower abdomen.
Six other patients, there may be some diarrhea.

[Laboratory examinations]
First, the blood picture, erythrocyte sedimentation rate and tuberculin test. White blood cell count were normal or slightly higher, a few low. Acute abdominal spread of tuberculosis or cheese type of white blood cell count can be increased in patients, erythrocyte sedimentation rate can be as simple indicators of disease activity, disease activity in this period is generally faster, lesions tend to rest gradually to normal. Tuberculin test was strongly positive in the diagnosis of the disease has helped, but in miliary tuberculosis or critically ill patients but can be negative.
Second, check the ascites ascites was straw yellow exudate.
Third, gastrointestinal X-ray diagnosis of the disease secondary value.
Fourth, extensive adhesions laparoscopy with peritoneal examination is contraindicated.

Chronic cholecystitis

Chronic cholecystitis is gallbladder disease clinically the most common one. Clinical manifestations of abdominal discomfort or dull pain, often exacerbated in the post-eating greasy food, but also have nausea, bloating and belching. If the cystic duct or common bile duct is blocked by stones or thick bile, or Oudi's sphincter spasm, often at the onset of biliary colic after a meal. Signs of right upper quadrant tenderness, positive Murphy's sign. Water when the gallbladder, and a large palpable gallbladder. Generally do not heat or only low heat.

Modern medicine that this disease occurs on the basis of cholelithiasis, and often the sequelae of acute cholecystitis. The main cause of bacterial infections and cholesterol metabolism disorders.

The diagnostic criteria for chronic cholecystitis and biliary colic and cholelithiasis history of dyspepsia symptoms. Duodenal drainage and help the diagnosis of gallbladder imaging.

Modern medicine for the disease mainly low-fat diet, oral treatment of choleretic drugs and other methods; acute attack, use of antimicrobial drugs, and recurrent biliary colic, cholecystectomy general, better effect.

Chronic cholecystitis mostly in clinical medicine, "hypochondriac pain" category. That liver qi stagnation, lost in the catharsis, bile lost pass down, not General pain, disharmony of liver and is belching, poor appetite, abdominal bloating nausea. If the heat Accumulation spleen, liver and spleen fumigation that catharsis liver and spleen dysfunction, and was in the abdominal or Xie pain, poor appetite, mouth waiting.

Saturday, July 31, 2010

Oral ulcers or low immunity related

  Over the past that the incidence of oral ulcers of unknown cause. Now found that the incidence of oral ulcers, in particular, is a recurring event, and their weakened immune function or long-term low has a direct relationship.
  Oral ulcers often occur in cold, pharyngitis, diarrhea or other diseases and chronic after the process, such as occurred in the use of hormones, antibiotics, immunosuppressants when. Patterns of life disorders, eating poorly, indigestion, stress, chronic constipation, late at night less sleep, over exertion, etc. occurs, their decreased immunity, may cause mouth ulcers. So often in the clinical use of vitamin B or vitamin therapy not see results, no significant effect for treatment with antibiotics, ulcer coating powder Ye can not be cured and that these therapies can not prevent repeated occurrence of oral ulcers.
  Oral ulcer treatment should be taken to enhance immune function measures. At the same time, should be avoided may lead to lower self-immunity factor, to prevention and treatment of oral ulcers from the root.

Wednesday, July 28, 2010

Pelvic examination should do what?

  (1) secretion samples for direct smear vaginal, cervical secretions, or urethral discharge, or peritoneal fluid (via the posterior vaginal fornix, abdominal, or laparoscopic access), so direct thin smear, after drying Methylene blue or Gram stain. Where PMN double within the gram-negative bacteria to see who was infected with gonorrhea. Because cervical gonococcal detection rate of only 67%, so other than gonorrhea smear-negative and can not be there, but positive smear is very specific. Microscopic examination of Chlamydia trachomatis monoclonal antibody fluorescein dye can be used, where the observed fluorescence microscope flashing dots of a star as the positive.
  (2) the pathogens isolated from patients Ibid, immediately or in the 30s will be inoculated in the Thayer-Martin medium, 35 ℃ incubator training set 48h, in order to identify bacteria glycolysis. The new determination of the relative speed of Chlamydia enzyme instead of the traditional detection methods chlamydia, can also be used on mammalian cell culture for Chlamydia trachomatis antigen detection, the legal systems of enzyme-linked immunosorbent assay. The average sensitivity of 89.5%, and 98.4% specificity.
  Bacterial culture can also be other strains of aerobic and anaerobic bacteria, and as the basis for selection of antibiotics.
  (3) the posterior fornix fornix puncture after puncture of gynecologic acute abdomen is the most common and valuable diagnostic methods. Through the puncture, and the resulting nest abdominal contents or the contents of the uterus rectum, such as the normal peritoneal fluid, blood (fresh, stale, coagulation wire, etc.), purulent secretions or pus, so diagnosis can be further defined, Microscopic examination of biopsy material and culture are essential.
  (4) is mainly B-type ultrasonic inspection or gray-scale ultrasound scanning, photo films, the technology for identification from the fallopian tube, ovarian and bowel adhesion formation with the mass or abscess, 85% of accuracy. However, pelvic inflammatory disease with mild or moderate degree of difficulty in B mode ultrasound images showed features.
  (5) laparoscopy, if not diffuse peritonitis is still generally good, laparoscopy or suspected PID in PID and other acute abdomen to patients, laparoscopy was not only the diagnosis and differential diagnosis can also pelvic inflammatory disease extent preliminary determination.
  (6) examination of male partners of women that contribute to the diagnosis of pelvic inflammatory disease. Desirability of their male partners to make a direct smear of urethral discharge Gonococcus staining or culture, if found positive, it is the strongest evidence, especially in the asymptomatic or the symptoms of mild to severe. Or more of the white blood cells can be found. If PID patients of all men with untreated, regardless of whether they had symptoms of urethritis, then obviously the reduction of recurrence is very significant.

Thursday, July 22, 2010

What the elderly dizzy examination

  What is the reason for the elderly dizziness? Expert, dizziness is a lot of people will have experienced symptoms. Common cause of dizziness older anemia, hypertension, cervical spondylosis, cerebral arteriosclerosis. What are the specific reasons for the elderly dizziness, the following will give you details.
  What is the reason the elderly dizziness
  1, high blood lipid
  Slow blood flow, brain insufficiency, occurs easily fatigue, dizziness, fatigue and other symptoms. The main diet is usually irrational, a large number of patients to eat high-fat, cholesterol, without love of sports.
  2, anemia
  If the elderly dizziness, weakness, pale performance, should go to the hospital to check to see if anemia.
  Three, high blood pressure
  In addition to dizziness in patients with hypertension but also often accompanied by Touzhang, palpitation, irritability, tinnitus, insomnia and discomfort.
  4, cervical spondylosis
  Constant neck tight, flexibility is limited, occasional pain, numb fingers, cold, a heavy feeling. Cervical vertebral artery compression of cervical hyperplasia, resulting in inadequate cerebral blood supply is the main reason for the disease dizziness.
  5, heart disease
  Early coronary heart disease, the symptoms are still mild, some people may not have chest tightness, palpitations, shortness of breath and other notable not only headache, dizziness, limb weakness, the spirit of hard concentration, such as tinnitus or amnesia. Dizziness occurred at this time due mainly to coronary atherosclerosis occurred, thinner lumen to narrow, making the heart ischemia and hypoxia. The cardiac insufficiency, can result in insufficient blood supply, causing dizziness.
  6, cerebral arteriosclerosis disease
  Conscious patients with dizziness, and frequent insomnia, tinnitus, mood swings, forgetfulness, limbs numb. Cerebral arteriosclerosis smaller diameter of the cerebral blood vessels, brain blood flow decreased, resulting in cerebral circulation, not getting enough oxygen, causing dizziness.
  Experts advise elderly with symptoms of dizziness, the alert over the disease more promptly to the hospital so bungled condition.

Wednesday, July 21, 2010

Hemorrhoids Self-Care patients pay attention to

  Whether it is outpatient surgery, or hospital treatment, hemorrhoids patients should pay attention to self nursed back to health, to cope with treatment, should mainly pay attention to the following aspects:
  (1) to maintain smooth stool: Hemorrhoid surgery generally be within 24 hours after the first bowel movement. Defecation is prohibited during the period, there should be more water and eat the role of beverages, such as Runchang honey, fruit juice and vegetable juice, it can promote urination and avoid constipation. Anal surgical injury as the skin, causing sphincter spasm, so before the first bowel movement oral Maren Runchang Pills, Sanguisorba Huaijiao, fruit pieces such as intestines medication guide. If severe constipation, can be paraffin oil enema, hip bath with warm water before they make anal sphincter relaxation, defecation can be caused by anal ease the pain. ~ Like about the first bowel movement is often accompanied by a small amount of blood, stool Department of wounds caused by friction, is normal, do not panic. After defecation should cultivate the habit of waking in the morning every day, then dressing after the hip bath. To prevent dry stool, should eat a diet high in fiber and contain high-fat oils, should not rely on laxative bowel movement a day, if constipation, can be oral Maren Runchang pill before going to sleep, Sanguisorba Huaijiao, Niuhuangjiedu pill or fruit guide piece, until softened stool immediately after the withdrawal.
  (2) after using Bath: Bath is a clean anus and promote wound healing and inflammation of the simple and effective method. After every time they have to be hip bath, hip bath with hot smoked the first time, when the water temperature is moderate, then placed in the anus perineal wash basin hip bath for 20 minutes or so. Hip bath can warm salt water, medicine Qudu soup or 1:5000 potassium permanganate solution and so on.
  (3) Dressing: hemorrhoids after injection of indomethacin may be, chlorhexidine hemorrhoids suppository, erythromycin suppository, Ma Ying Long Hemorrhoids Suppository filling in the anus and other drugs can. Open wounds in addition to the suppository, the obligated Vaseline gauze, medicine Shengji Yuhong Ointment Pink gauze and other packing gauze or anus with their protection within the wound to facilitate wound drainage.
  (4) after activities: Generally speaking large surgical wound, and wounds have not healed completely during the walk should be minimal, so that the wound edges to avoid the formation of edema due to the friction force to extend the healing time. 3 months after wound around a long time not riding a bike, to prevent the healing of wounds caused by friction and excessive bleeding.