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.
Friday, November 19, 2010
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.
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.
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.
[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.
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.
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