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B y t
Bnh hc v iu tr ng y
Sch o to bc s y hc c truyn M s: .08.Z.32
Ch bin: PGS.TS. Phan Quan Ch Hiu
Nh xut bn y hc H Ni - 2007
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Ch o bin son:
V Khoa hc & o to, B Y t
Ch bin:
PGS.TS. Phan Quan Ch Hiu
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LI GII THIU
Thc hin mt s iu ca Lut Gio dc, B Gio dc v o to v B Y t ban hnh chng trnh khung o to Bc s y hc c truyn. B Y t t chc bin son ti liu dy - hc cc mn hc chuyn mn, c bn chuyn ngnh theo chng trnh trn nhm tng bc xy dng b ti liu dy hc chun v chuyn mn m bo cht lng o to nhn lc y t. Sch Bnh hc v iu tr ng y c bin son da trn chng trnh gio dc i hc ca Trng i hc Y Dc thnh ph H Ch Minh trn c s chng trnh khung c ph duyt. Sch c bin son da trn c s kin thc c bn, h thng; ni dung chnh xc, khoa hc, cp nht cc tin b khoa hc, k thut hin i v thc tin Vit Nam. Sch Bnh hc v iu tr ng y c bin son bi cc nh gio giu kinh nghim v tm huyt ca b mn Y hc c truyn ca Trng i hc Y Dc thnh ph H Ch Minh. Sch Bnh hc v iu tr ng y c Hi ng chuyn mn thm nh sch v ti liu dy - hc chuyn ngnh bc s y hc c truyn ca B Y t thm nh vo nm 2006. B Y t ban hnh l ti liu dy - hc t chun chuyn mn ca ngnh y t trong giai on 2006 - 2010. Trong qu trnh s dng sch phi c chnh l, b sung v cp nht. B Y t xin chn thnh cm n cc Nh gio, cc chuyn gia ca Trng i hc Y Dc thnh ph H Ch Minh dnh nhiu cng sc hon thnh cun sch, PGS.TS. Nguyn Nhc Kim v PGS.TS. Chu Quc Trng c v phn bin cun sch sm hon thnh kp thi phc v cho cng tc o to nhn lc y t. V ln u xut bn nn cn c khim khuyt, chng ti mong c kin ng gp ca ng nghip, cc bn sinh vin v cc c gi ln xut bn sau c hon thin hn.
V khoa hc v o to B Y t
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Mt s t ng ngha
m Khng a s nn i tin phn vng nt Li Tiu tin sn i tin phn to Tiu tin t Nn ma
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Li ni u
Bnh hc v iu tr ng y cp n ton b nhng bnh chng ca ng y hc, gip ngi sinh vin c c ci nhn va ton din, va c bn v l lun bnh hc v iu tr hc ng y. Nhn thc ny rt quan trng, to tin cn thit gip hc vin thun li hn khi hc tp tip theo nhng phn bnh hc v iu tr kt hp ng y v Ty y (c cp trong Bi ging iu tr kt hp). y cng l mc tiu cui cng ca qu trnh o to ngi thy thuc kt hp ng ty y. Bnh hc v iu tr ng y c trnh by theo hai chng ln. Chng th nht m t nhng bnh chng do ngoi nhn gy ra, bao gm:
Bnh hc v iu tr bnh ngoi cm Thng hn Bnh hc v iu tr bnh ngoi cm n bnh Bnh hc v iu tr bnh ngoi cm Lc dm
Chng th hai cp n nhng bnh chng do ni nhn v nguyn nhn khc gy ra. Nhm bnh l ny ch yu xut hin cc tng ph, bao gm
Bnh hc v iu tr bnh Ph - i trng Bnh hc v iu tr bnh T - V Bnh hc v iu tr bnh Thn - Bng quang Bnh hc v iu tr bnh Can - m Bnh hc v iu tr bnh Tm - Tm bo - Tiu trng - Tam tiu
Phn iu tr ca mi bnh chng u c phn tch c th trn c s l lun ng y (dc tnh ng y, hc thuyt kinh lc) v c lp li nhiu ln cc bn sinh vin d dng hc tp. tp trung gip sinh vin c c ci nhn va ton din, va c bn v l lun bnh hc v iu tr hc ng y, nn chng ti c gng tn trng kin, quan nim ca ngi xa v chuyn ti ton b nguyn bn l lun t cc ti liu kinh in. V th, s khng trnh khi nhng u t v hiu qu thc s ca nhng phng cch tr liu ca y hc c truyn trong mt s tnh hung lm sng (tnh trng try tim mch, hn m) cng nh tnh thc t ca mt s v thuc hin rt t c s dng. Cng vi l do nu trn m chng ti cha cp c th, chi tit v liu dng ca thuc cng nh chi tit k thut chm cu trong ti liu ny. Nhng phn rt quan trng nu trn s c cp nht c th, chi tit (liu lng thuc, k thut chm cu..) trong nhng ti liu v iu tr kt hp ng ty y.
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gip sinh vin phn tch c c th vai tr ca thuc v huyt trong tng phng php tr liu, chng ti c dnh thm phn cui ca quyn sch ny nhng cch k n thuc ng y, qua cc bn sinh vin c th d dng hiu c v tr, vai tr quan trng (theo th t Qun, Thn, T, S) ca tng v thuc, ca tng huyt s dng trong tr liu ca ng y hc. ng thi, quyn sch ny cng tp hp nhng im quan trng cn ghi nh, xp vo nhng c nh du, nhm gip sinh vin c th nhanh chng kim tra li nhng im mu cht, quan trng ca nhng ni dung hc tp. Tt c cc bi ging mn bnh hc v iu tr u c km theo phn cu hi trc nghim (t n tp) gip sinh vin t hc. Nhng bi ging l thuyt ny s c minh ha trn thc t ti cc c s thc tp y hc c truyn (C s 3-Bnh vin i hc Y Dc TP. H Ch Minh, Vin y dc hc dn tc TP. H Ch Minh, Bnh vin y hc dn tc TP. H Ch Minh...). Khoa y hc c truyn, i hc Y Dc TP. H Ch Minh rt mong c cc bn sinh vin tham kho k li gii thiu ca quyn sch ny trc khi tham gia vo qu trnh hc tp mn hc v rt mong c s ng gp kin ca cc bn sinh vin v cc ng nghip.
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Mc lc
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PGS.TS. Phan Quan Ch Hiu
Bi 1. Bnh hc ngoi cm 1. i cng 2. Phn loi bnh ngoi cm Cu hi n tp p n Bi 2. Bnh hc ngoi cm Thng hn 1. i cng 2. Bnh hc ngoi cm thng hn (lc kinh hnh chng) Cu hi n tp p n Bi 3. Bnh ngoi cm n bnh 1. i cng 2. Nguyn nhn gy bnh 3. Sinh bnh l ca ngoi cm n bnh 4. Nhng im khc nhau gia ngoi cm n bnh v ngoi cm thng hn 5. Bnh hc v iu tr Cu hi n tp p n Bi 4. Bnh ngoi cm Lc dm 1. i cng 2. Nhng chng bnh thng gp 3. Ph lc Cu hi n tp p n
9 9 10 17 20
21 21 25 42 45
46 46 47 47 48 49 63 67
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Cu hi n tp p n Bi 6. Bnh hc T V 1. i cng 2. Nhng hi chng bnh T V Cu hi n tp p n Bi 7. Bnh hc Thn Bng quang 1. i cng 2. Nhng bnh chng Thn - Bng quang Cu hi n tp p n Bi 8. Bnh hc Can - m 1. i cng 2. Nhng bnh chng tng Can - ph m Cu hi n tp p n Bi 9. Bnh hc Tm - Tiu trng PGS. TS. Nguyn Th Bay Tm bo - Tm tiu 1. i cng 2. Nhng bnh chng Tm - Tiu trng Cu hi n tp p n Bi 10. Cch k n thuc 1. Nhng phng cch k n thuc 2. Nhng ni dung quan trng trong cch k n thuc theo l lun ng y 3. S phi ng cc v thuc trong mt n thuc 4. S cm k trong khi dng thuc Cu hi n tp p n Ti liu tham kho
PGS.TS. Phan Quan Ch Hiu; ThS. BS. Ng Anh Dng PGS.TS. Phan Quan Ch Hiu PGS.TS. Phan Quan Ch Hiu
119 123 124 125 128 140 145 146 146 151 172 177 178 178 181 198 203 204 204 215 239 245 246 246 248 252 253 254 256 257
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Chng I
Bnh hc ngoi cm
Mc tiu
Sau khi hc tp, sinh vin PHI: 1. Trnh by c khi nim bnh ngoi cm v nhng phn loi bnh ngoi cm theo ng y. 2. Nu c nhng c im ring v phn bit c s khc nhau gia nhng loi ngoi cm: Lc dm, Thng hn, n bnh, Dch l. 3. Da vo tn bnh ng y, sinh vin s xc nh c loi ngoi t no gy bnh cng nh v tr bnh ca tt c cc loi bnh ngoi cm.
1. i Cng Theo Y hc c truyn (ng y), bnh ngoi cm l nhng bnh c nguyn nhn t s khng thch ng c ca c th vi nhng tc ng t nhng yu t ca mi trng bn ngoi (do kh hu, thi tit ca mi trng bn ngoi tr nn thi qu, tri thng, vt qu kh nng thch ng ca c th ngi bnh).
Theo quan nim ca ng y hc: c 6 loi kh hu, thi tit khc nhau
trong t nhin bao gm: Phong, Hn, Th, Thp, To, Ha. y l nhng tnh trng thi tit, kh hu hin din bnh thng trong nm v bin i theo qui lut chung ca t nhin. Chng c gi di tn chung l lc kh. Bnh thng, cc loi kh hu ny tht s cn thit cho s sng, cho sc kho; ch khi tri thng (tr nn thi qu hoc bt cp, hoc xut hin khng ng vi thi gian qui nh) chng mi c iu kin gy bnh. Khi y, lc kh c gi l lc dm hay lc t.
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Bnh ngoi cm pht sinh c lin quan cht ch vi thi tit. Nhng th
cht ca tng c nhn cng tham gia quan trng vo din tin ca bnh. Tnh trng ca c th (khe, yu) s phn ng vi nguyn nhn gy bnh rt khc nhau. Cho nn vi cng mt nguyn nhn gy bnh, bnh ngoi cm cng pht sinh nhiu dng khc nhau. V th, trong thc tin iu tr, ngi thy thuc ng y khi xt on v iu tr bnh ngoi cm lun lun phi xem xt mi tng quan gia sc mnh ca nguyn nhn gy bnh (c lc, ng y hc gi chung di danh t t kh) v sc chng , kh nng thch ng ca c th (chnh kh).
2. PHN LOI BNH NGOI CM Do lun c mi tng quan gia thay i ca mi trng bn ngoi v tnh trng chung ca c th m bnh ngoi cm c nu trong cc ti liu c rt a dng v phc tp. Ty theo quan im, kinh nghim ca tng tc gi m c mt cch bin chng v xp xp khc nhau. C th nhn thy 4 cch phn loi bnh ngoi cm. 10
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2.1. Ngoi cm lc dm 2.1.1. i cng Trong cc ti liu ng y, nhng bnh l ngoi cm thuc nhm ny thng c nhng c im:
Bnh ngoi cm lc dm c 3 mc
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Phong hn phm kinh Cn Tiu trng (on vai). Thng thy trong
au vai do vim gn c di gai.
Phong hn phm kinh Cn Bng quang (on lng). Thng thy trong
au thn kinh lin sn.
Bnh kinh Cn lun c triu chng au nhc xut hin km theo, trong
khi bnh kinh chnh khng bt buc phi c. Nhng bnh cnh thng gp trong nhm ny gm:
+ Hn tr Can mch. Triu chng chnh au nhiu vng bng di, au nh co tht, vn xon, cm gic lnh bng. au bng kinh, au bng di lan xung b sinh dc, vng bng di ni cc. iu tr phi n kinh, tn hn. + Phong hn phm kinh Bng quang (on lng v chi di). Thng thy trong vim thn kinh ta. + Phong hn phm kinh m (on lng v chi di). Thng thy trong vim thn kinh ta. + Phong hn phm kinh V (on u mt). Thng thy trong lit mt ngoi bin, au dy thn kinh mt. + Phong nhit phm chnh kinh: triu chng chnh au nhc ti ch, vng au nng . Chm lnh d chu. St cao, s nng. Nhng bnh cnh thng gp trong nhm ny gm:
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Phong nhit phm kinh Dng minh V v i trng (on u). Thng gp trong lit mt, au dy thn kinh mt. Phong nhit phm kinh V (on ngc). Thng gp trong vim tuyn v. Phong nhit phm kinh m (on hng sn). Thng gp trong au dy thn kinh lin sn, zona lin sn.
Ngoi t phm vo k kinh bt mch Triu chng chnh ty thuc vo k mch no b xm phm (tham kho thm bi K kinh bt mch - Sch Chm cu hc, cng tc gi). Thng gp trong nhm bnh chng ny:
Phong nhit phm mch i. Thng gp trong lit hai chi di do vim
ty cp.
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Nhit kt i trng
+ Triu chng chnh st cn, au bng, bng trng, chi nn, to bn hoc nhit kt bng lu + Thng gp trong to bn cp tnh ca nhng bnh c st cao. + Bnh cnh ny tng t nh H/C Dng minh trong cch bin lun theo Thng hn lun.
Nhit bc i trng
+ Triu chng chnh st, kht nc, au bng, rut si, tiu phn vng nt, hoc nhy nht, hu mn nng , mt , tay chn nng, li , ru vng. + Thng gp trong tt c nhng trng hp tiu chy nhim trng, vim d dy -rut cp, ng c thc n.
i trng hn kt
+ Bng au nhiu, chi nn, y trng, ming nht, to bn. Mt trng, mi nht, tay chn mt, li trng, t ru. Mch trm, huyn. + Thng gp trong tt c nhng trng hp b i tin.
V thp nhit
+ Triu chng chnh ming ng, kht nc m khng dm ung. St hoc c cm gic nng, st cn. au thng v, bun nn, nn ma, trng bng, tiu chy. Tay chn nng n, cm gic nng n ton thn. + Thng gp trong nhim trng rut, vim d dy rut cp.
V nhit ng thnh
+ Triu chng chnh ming kh kht, mi nt n, d i, si rut, chy mu nu rng, i tin b kt, tiu, sn . + Thng gp trong st pht ban, herpes.
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Ngoi t phm vo tng Tnh trng ny t c cp hn (so vi kinh lc v h thng ph) v bao gm:
Phong hn thc Ph
+ Triu chng chnh s lnh hoc s gi, ho mnh, n o, ho c m, m trong, h hp ngn, mi nght, chy nc mi. au u hoc u nng, au nhc lng v ton thn, au 2 b vai, au gy. + Thng gp trong cm cm, vim ng h hp trn do siu virus (giai on khi pht), hen ph qun.
To kh thng Ph
+ Triu chng chnh ming kh, kht nc. au ngc. Ho mnh n o. Ho gy au, ho khan, ho c m, mu. C hng kh, khan ting. + Thng gp trong giai on ton pht ca nhim trng ng h hp, vim phi thy, ph qun ph vim, vim hng cp.
Nhit nhp Tm bo
+ Triu chng chnh m sng, ni lm nhm, hn m, lm lm, vt v, st cao. Bnh cnh ny c cp trong cch bin lun theo n bnh di bnh cnh nhit nhp huyt phn. + Thng gp trong cc tnh trng nhim trng nhim c thn kinh, vim no mng no.
2.2. Ngoi cm thng hn 2.2.1. i cng Phng php bin gii bnh ngoi cm ny c Trng Trng Cnh tng hp v trnh by trong Thng hn lun v c nhng c im chnh sau y:
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Su bnh cnh lm sng nu trn c sp xp t ngoi vo trong, th hin su giai on bnh khc nhau ca bnh ngoi cm.
Din bin ca bnh c quy lut. Bnh cnh lm sng nu din bin t
ngoi vo trong l bnh t nh n nng v ngc li. 2.2.2. Nhng bnh chng ca Ngoi cm Thng hn Bao gm 6 bnh cnh chnh (tham kho thm bi Bnh hc Ngoi cm Thng hn, trang 14).
Hi chng Thi dng. Triu chng chnh mch ph; u c cng, au,
s lnh.
Hi chng Thiu dng. Triu chng chnh ming ng, hng kh, mt
hoa, hn nhit vng lai, khng mun n, tm phin, hay i (nn).
Hi chng Dng minh. Triu chng chnh st cao, kht nc, phin to. Hi chng Thi m. Triu chng chnh bng y au, i (nn) ma, tiu
chy, li nht, ru trng mng, mch tr hon.
Hi chng Thiu m. Triu chng chnh biu hin tng Tm v Thn. Hi chng Quyt m. Triu chng chnh chn tay quyt nghch.
2.3. n bnh (c th gi Ngoi cm n bnh) (tham kho thm bi Bnh hc Ngoi cm n bnh, trang 46) 2.3.1. i cng l nhng bnh ngoi cm c c im:
Khi pht bng bnh cnh nhit: st cao, kht nc. Din bin theo qui lut. Bnh cnh thng nng, cp ngay t u, li nhiu di ha, bin chng.
Dip Thin S, Ng Cc Thng tng hp v l gii nhng bnh chng ny trong cc sch n nhit bnh v n bnh iu bin. 16
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2.3.2. Nhng bnh chng ca Ngoi cm n bnh C 2 kiu bn lun v din bin ca n bnh
T trn xung (Ng Cc Thng): y l cch bin gii din bin bnh theo Tam tiu v c 3 giai on.
+ Nhit t Thng tiu (Tm Ph). + Nhit t Trung tiu (T V). + Nhit t H tiu (Can Thn).
T nng vo su (Dip Thin S): theo cch bin gii ny, din bin ca n bnh bao gm 4 giai on.
+ Nhit t V phn. + Nhit t Kh phn . + Nhit t Dinh phn. + Nhit t Huyt phn.
2.4. Dch l Dch l l nhng loi bnh c bit. Bnh khng ch do nguyn nhn lc dm tc ng vo v c nhng c im
CU HI N TP
A. CU HI 5 CHN 1 - CHN CU NG
1. Bnh danh no KHNG thuc nhm ngoi cm lc dm A. Hn t phm vo tn lc B. Hn tr Can mch C. Phong nhit phm kinh m D. Thi dng kinh chng E. Ngoi cm phong hn 17
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2. Bnh danh no KHNG thuc nhm ngoi cm lc dm A. Phong nhit phm mch i B. Dng minh kinh chng C. Phong nhit phm kinh V D. Ngoi cm phong hn E. Thp nhit i trng 3. Bnh danh no KHNG thuc nhm ngoi cm lc dm A. Thiu dng chng B. Hn t phm kinh Cn C. Phong hn phm kinh m D. Phong nhit phm vo mch Xung E. Nhit kt i trng 4. Bnh danh no KHNG thuc nhm ngoi cm lc dm A. Thiu m ha nhit B. Phong hn phm kinh i trng C. Phong hn phm kinh V D. Thp nhit phm vo mch Xung E. Ngoi cm phong nhit 5. Bnh danh no KHNG thuc nhm ngoi cm lc dm F. Phong nhit phm mch c G. Thp nhit i trng H. Quyt m hn quyt I. Thp nhit t J. Can m thp nhit 6. Nguyn nhn gy bnh ca Bng quang thp nhit A. Ngoi thp B. Ngoi nhit C. Ni thp D. Ni nhit E. Ngoi thp v ngoi nhit
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7. Nguyn nhn gy bnh ca To kh thng Ph A. Ngoi nhit B. Ngoi to C. Ni to D. Ni nhit E. Ngoi to v ngoi nhit 8. V tr bnh (ni tn thng) ca Thp nhit i trng A. Kinh chnh i trng B. Kinh Cn i trng C. Kinh bit i trng D. Ph i trng E. Bit lc i trng 9. V tr bnh (ni tn thng) ca Phong hn phm Ph A. Kinh chnh Ph B. Kinh Cn Ph C. Kinh Bit Ph D. Tng Ph E. Dinh phn 10. Bnh danh no KHNG thuc nhm bnh ngoi cm A. Bng quang h hn B. Can m thp nhit C. V nhit ng thnh D. Nhit nhp huyt phn E. Quyt m chng
B. CU HI TR LI NGN 1. C bao nhiu cch phn loi bnh chng ngoi cm? 2. c im chnh phn bit nhm bnh chng ngoi cm lc dm vi ngoi cm thng hn v ngoi cm n bnh? 3. c im chnh phn bit nhm ngoi cm thng hn v ngoi cm n bnh? 4. c im chnh phn bit nhm bnh dch l v ngoi cm n bnh?
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5. Tn gi ca nhng bnh chng ngoi cm thng hn? 6. Tn gi ca nhng bnh chng ngoi cm n bnh?
P N
A. CU HI 5 CHN 1 - CHN CU NG
STT 1 2 3 4 5 p n D B A A C STT 6 7 8 9 10 p n E B D D A
B. CU HI TR LI NGN 1. C 4 cch phn loi 2. Din bin c qui lut nhm ngoi cm thng hn v n bnh 3. Lun lun khi pht bng bnh cnh nhit nhm ngoi cm n bnh 4. Ly lan thnh dch v xy ra lc c thin tai, ch ha nhm dch l 5. Thi dng chng, Thiu dng chng, Dng minh chng, Thi m chng, Thiu m chng, Quyt m chng 6. Nhit Thng tiu, nhit Trung tiu, nhit H tiu.
Nhit V phn, nhit Kh phn, nhit Dinh phn, nhit Huyt phn
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Bi 2
Mc tiu
Sau khi hc xong, sinh vin PHI 1. nh ngha c bnh thng hn theo ng y. 2. Trnh by c qui lut truyn bin ca bnh thng hn. 3. Lit k c nhng triu chng chnh ca tng bnh cnh ca Lc kinh. 4. Lit k c tn, thnh phn cu to bi thuc chnh cho tng bnh cnh v phn tch c c s l lun ca bi thuc s dng.
1. i Cng 1.1. Tc gi Trng Trng Cnh cn c tn l Trng C, ngi Nit Dng, Nam Qun i ng Hn (nay l huyn Nam Dng, H Nam, Trung Quc). Sinh vo khong 142 - 210 thi Hn Linh (168 - 188), lm quan cho n i Vua Kin An (198 - 219) ng hc rng, ti cao, ni ting lim khit. ng c 2 thy thuc truyn ngh l H Ngung v sau l Trng B T. Dng h ng rt ng, hn 200 ngi, nhng ch trong hn 10 nm (thi Kin An) cht mt hn 2/3, trong 70% v thng hn. l ng c thc gic ng nghin cu, tm hiu v vit sch v bnh thng hn. 1.2. Tc phm Trng Trng Cnh c 2 tc phm: Kim qu yu lc v Thng hn lun (Thng hn tp bnh lun). Quyn Thng hn lun c ng c kt kinh nghim lm sng t i Hn tr v trc, da vo Ni kinh m bin son thnh.
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Thng hn lun nguyn bn tht lc. Hin nay ch cn li bn ca Vng Thc Ha (i Ty Tn) bin tp gm 10 quyn, 22 thin, 397 php v 113 phng; vn dng khong 80 v thuc vo iu tr (*) B sch gm c hai phn Phn bnh st ngoi cm vi su loi bnh cnh. Phn tp bnh: cp n hn 40 loi bnh ni, ngoi, ph, sn khoa. 1.3. c im chung
(*)Nguyn Trung Ha - Gio trnh Thng hn v n bnh hc - Hi YHDT Ty Ninh ti xut bn nm 1985 - Lu hnh ni b, trang 8 - 11
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Ni chung truyn v bin lun phi hp chung vi nhau v chu nh hng bi ba nhn t
Chnh kh thnh suy: chnh kh thnh, sc chng ca c th mnh, bnh t s khng truyn c vo trong. Ngc li, nu chnh kh suy h, bnh t s d dng truyn c vo su bn trong. Ngoi ra, nu bnh t vo trong, nhng khi chnh kh c phc hi, chng c t, s lm bnh t m chuyn dng, t nng chuyn sang nh. T kh thnh suy: t kh mnh l yu t thun li bnh chuyn vo trong, tr thnh nng. iu tr khng thch hp
C th tun t t Thi dng sang Thiu dng; tip n l Dng minh; tip n l Thi m; tip n l Thiu m v cui cng l Quyt m. Hoc cng c th chuyn ngay t kinh dng bt k no sang h thng kinh m. Thiu dng bn biu bn l chng
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Nguyn nhn: c th yu, dng kh thiu, chnh kh suy lm ngoi t trc tip phm vo tam m (H hn chng).
+ L chng chuyn ra biu chng: bnh tam m chuyn thnh tam dng; bnh bn trong chuyn dn ra bn ngoi; do chnh kh dn hi phc, bnh din tin tt. Th d: trc trng Thiu m c nn ma, tiu chy, sau thi gian iu tr ngng tiu chy v i tiu to kt, pht st, kht. l Thi m bnh nh dng kh trng v khi phc li nhng t vn cn, do bnh chuyn thnh Dng minh. + Tnh bnh: chng trng mt kinh cha gii khi hon ton li xut hin chng trng mt kinh khc; nguyn nhn do truyn bin.
Mt s nh ngha
+ Bnh chng thng hn c th n c xut hin mt kinh; cng c th hai, ba kinh cng bnh (hp bnh). + Bnh mt kinh cha khi; xut hin thm kinh khc bnh; c th t trc sau ong bnh).
- Bnh thng hn c nh ngha theo 2 cch: + Rng: l tn gi chung tt c bnh ngoi cm c st, do lc dm gy bnh. + Hp: l tn gi nhng bnh ngoi cm ch do phong hn t gy ra - Thng hn lun kho st nhng bnh ngoi cm m din tin bnh c qui lut theo 6 giai on Thi dng, Dng minh, Thiu dng, Thi m, Thiu m, Quyt m. - 6 giai on din bin bnh thng hn phn nh tng quan lc lng gia sc khng ca c th (chnh kh) v tc nhn gy bnh (t kh). - Nguyn tc iu tr chung bnh ngoi cm thng hn +Tam dng bnh: chnh kh mnh, t kh thnh, nguyn tc iu tr ch yu l khu t. +Tam m bnh: chnh kh suy, iu tr ch yu l ph chnh, nng tng trng v ty theo tnh trng ca bnh khu t.
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2. BNH HC NGOI CM THNG HN (LC KINH HNH CHNG) 2.1. Thi dng chng 2.1.1. Nhc li c s gii phu sinh l hc ng y ca h thng Thi dng Thi dng bao gm Tc Thi dng Bng quang kinh v Th Thi dng Tiu trng kinh. Quan h biu l vi Tc Thiu m Thn v Th Thiu m Tm. Tc Thi dng Bng quang kinh bt u t gc trong mt n trn, giao nh vo no, bit xung c n gip tch trong lng. on ngm ca ng kinh i n Thn v Bng quang, xung chn.
Thi dng kinh i ngoi biu, trong thuc ph Bng quang. Bng
quang c tc dng ch tng tn dch v kh ha, cng nng kh ha ny da vo s gip ca Thn kh v khng tch ri cng nng kh ha ca Tam tiu. Ngoi ra v kh tuy h tiu, nhng phi thng qua s gip ca trung tiu, m khai ph thng tiu. N phi da vo s tuyn pht ca Ph a i ton thn. Do cng nng ca Thi dng v Ph hp ng vi nhau ch biu (tham kho thm bi hc thuyt Tng tng). 2.1.2. Bnh l
Nguyn nhn: do phong hn ngoi nhp Bnh trnh: thi k u ca ngoi cm V tr: bnh biu Tnh cht: thuc dng, thuc biu Triu chng quan trng ca bnh giai on Thi dng
+ Mch ph (biu chng) + u c cng, au (vng do h thng kinh Thi dng chi phi) + S lnh (t biu, V kh b tn thng)
Do th cht khng ging nhau, cm t nng su khc nhau, bnh tnh nng nh khc nhau, nn Thi dng chng c phn lm hai loi
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2.1.2.1. Thi dng kinh chng Triu chng chung: s lnh, pht st, u c cng au, ru li trng mng, mch ph. Thi dng kinh chng bao gm hai nhm bnh
Trn y ch gii bi thuc ny nh sau: Qu chi tn n, thuc dng. Thc dc kh bnh, thuc m. Qu chi li c thm v tn ca Sinh khng, ng kh tng cu c th nh n iu ha dng kh ca chu thn. Thc dc li c v cam kh ca i to v Cam tho, c hai hp nhau ha, c th nh n t nhun cho m dch ton thn. Trng Trng Cnh dng chng i b dng cho m dng, b dng cho ci ngun ca m hi. Nh vy, n l loi dc cn bn thng t vy. Ngoi ra hp cho lng l h tr, tc l dng thy cc h tr cho m hi. V th sau khi ra m hi ngi bnh khng b tn thng nguyn kh.
Phn tch bi thuc Qu chi thang: (Php hn)
V thuc Qu chi i to Bch thc Gng sng Cam tho Dc l ng y Cay ngt, i nhit, hi c. Tr c lnh trm hn, gii biu Ngt n. B T ch kh, dng V, sinh tn dch. iu ha cc v thuc Chua ng, hi hn. Nhun gan, dng huyt, lim m Cay n. Tn hn, n trung. Thng mch Ngt, bnh. B T V, nhun ph, thanh nhit gii c, iu ha cc v thuc
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Gii biu
c hiu khu phong, gii biu c hiu khu phong, gii biu Tr cm, au u Tr cm, au cng gy
Nghinh hng
Huyt ti ch
Tr ngt mi
Triu chng: pht st, s lnh, khng m hi, u c cng au, mch ph
khn (biu thc chng).
Ung Ngang gii thch bi thuc nh sau: Ma hong kh bc tn n, l loi chuyn dc ca Ph kh, nay chy trong Thi dng n c th khai tu l hn t; Qu chi tn n c th dn t kh doanh phn t ra c biu; Hnh nhn kh cam tn hn m ging kh; Cam tho cam bnh pht tn m ha trung.
Phn tch bi thuc Ma hong thang: (Php hn)
V thuc Ma hong Qu chi Hnh nhn Cam tho Dc l ng y Cay ng, n. Khai thu l, lm ra m hi, li tiu tin Cay ngt, i nhit, hi c. Tr c lnh trm hn V ng, hn. Ging kh, tn hn. Cha ho Ngt, bnh. B T V, nhun Ph, thanh nhit gii c, iu ha cc v thuc
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c hiu khu phong, gii biu c hiu khu phong, gii biu tr cm, au u
2.1.2.2. Thi dng ph chng Do kh ca kinh v ph tng thng vi nhau, nn Thi dng biu chng khng gii c, bnh s theo kinh vo ph (Bng quang v Tiu trng). Giai on ny c gi l Thi dng ph chng
Pht st, c x chiu l c st cn, m hi, phin kht hoc kht mun
ung, ung vo th ma, nm su ngy khng i ng, li ro m kht, T DI VNG TIM N BNG DI RN Y M AU, tiu bt li. (Bnh Bng quang kh phn).
iu tr; thng dng hnh thy, ngoi s ni li. (Ng linh tn).
+ Bi Ng linh tn c tc dng cha chng Thi dng sc thy, ph kt kh hung cch. + Phn tch bi thuc Ng linh tn
V thuc Phc linh Tr linh Qu chi Trch t Bch trut Dc l ng y Ngt, nht, bnh. Li thy, thm thp, b T nh Tm Li niu, thm thp Cay ngt, i nhit hi c, n ha Bng quang, s tn ngoi t Ngt nht, mt. Thanh t thp nhit Bng quang Ngt ng, hi n Kin V, ha trung, to thp
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Ni quan
Thi dng bnh 6-7 ngy biu chng vn cn, mch vi m trm, ngi
pht cung bi c nhit h tiu, BNG DI PHI RN Y, TIU TIN T LI, TIU RA HUYT EN NHNH. (Bnh Bng quang huyt phn).
o nhn i hong
* Trng hp ny c th s dng cng thc huyt chm cu nh trng hp ca hi chng Thi dng sc thy.
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2.2. Dng minh chng 2.2.1. Nhc li c s gii phu sinh l hc ca h thng Dng minh H thng Dng minh bao gm Tc Dng minh V v Th Dng minh i trng. H thng ny c quan h biu l vi Tc Thi m T v Th Thi m Ph. H thng Dng minh chu nh hng bi kh To (t tri) v hnh Kim (t t).
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Kinh chng l ch nhit t bao ph ton thn. Ph chng l ch V trng to nhit, cu to.
2.2.2.1. Dng minh kinh chng
St cao, m hi, kht thch ung nc, tm phin, ru vng kh, mch
hng i.
Kha Vn B gii thch bi thuc Bch h thang nh sau: Thch cao v tn hn; tn c th gii nhit c nhc, hn c th thng ha V ph. Tnh ca hn l trm, ging; v tn c th chy ra ngoi; n ng vai Qun vi vai tr ni ngoi ca n. Tri mu kh nhun; kh dng t ha; nhun ng vai t nhun to kh; dng n dng vai Thn. Dng Cam tho, Cnh m iu ha trung cung, v li n c th t ha t trong Th. Th ng vai rung nng cy cy, c hai ha hon c ci hn trong hn dc, ha c ci kh trong kh dc
+ Phn tch bi thuc Bch h thang (Php thanh)
V thuc Sinh thch cao Tri mu Cam tho Cnh m Dc l ng y V ngt, cay, tnh hn. Vo 3 kinh Ph, V, Tam tiu. Thanh nhit, ging ha, tr phin, ch kht V ng, lnh. T Thn, t ha Ngt n. Ha trung b th. iu ha cc v thuc ch V, sinh tn
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St cao, tng vo chiu ti, xut hn lin min, to bn, bng y au, s
n, phin to, lm nhm, mch trm hu lc.
Y Tng Kim Gim chp: cc chng kt nhit trong m thnh mn, b, to, thc u dng i tha kh thang h. Mn l bng sn trng, y, cho nn dng Hu phc thng kh tit chng y. B l tc cng vng thng v, cho nn dng Ch thc ph kh kt. To l phn to trong rut kh qunh, cho nn dng Mang tiu nhun to lm mm cht rn. Thc l bng au, i tin b khng thng cho nn dng i hong cng tch t nhit. Nhng phi xt trong 4 chng , chng no nng hn dng c ci no nhiu ci no t cho va phi mi c th khi c.
+ Phn tch bi i tha kh thang (Php h)
V thuc i hong Mang tiu Ch thc Hu phc Dc l ng y ng, lnh. Vo T, V, i trng, Can, Tm bo. H tch tr trng v, t thc nhit huyt phn Mn, lnh. Vo i trng, Tam tiu. Thng i tin, nhuyn kin, tn kt. ng, hn. Vo T, V. Ph kt, tiu tch tr, ha m tr b. Cay, ng m vo T, V, i trng. Hnh kh, ha m tr nn ma.
DNG MINH CHNG - Ch chng (triu chng quan trng) ca Dng minh chng: st cao, kht nc d. - Bnh chng Dng minh bao gm Dng minh kinh chng (khi bnh cn ng kinh) v Dng minh ph chng (khi bnh xm phm ph). - Ch chng ca Dng minh kinh chng: st cao, kht d, mch hng i - Ch chng ca Dng minh ph chng: st cao, to bn - Thuc tiu biu trong iu tr Dng minh kinh chng: Bch h thang - Thuc tiu biu trong iu tr Dng minh ph chng: i tha kh thang
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2.3. Thiu dng chng 2.3.1. Nhc li c s gii phu sinh l hc ca h thng Thiu dng H thng Thiu dng bao gm Tc Thiu dng m v Th Thiu dng Tam tiu. Quan h biu l vi Tc Quyt m Can v Th Quyt m Tm bo. m da vo Can, tnh ch s tit, thch iu t, cho nn m ph iu ha th T V khng bnh. Tam tiu l ng vn hnh thy ha. Cng nng s tit ca m bnh thng th Tam tiu thng sng, thy ha thng ging bnh thng. Thiu dng gia Thi dng v Dng minh gi l bn biu bn l. 2.3.2. Bnh l Khi bnh vo n Thiu dng, chnh t nh nhau, tng ha b ut dn n m nhit ut chng. (Ming ng, hng kh, mt hoa).
Triu chng: ming ng, hng kh, mt hoa, hn nhit vng lai, khng
mun n, tm phin, hay i.
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2.4. Thi m chng 2.4.1. Nhc li c s gii phu sinh l hc ca h thng Thi m H thng Thi m bao gm Th Thi m Ph v Tc Thi m T. H thng Thi m c quan h biu l vi h thng Dng minh gm Th Dng minh i trng v Tc dng minh V
Nguyn nhn
+ Hn thp trc trng. + Tam dng bnh chuyn ti. + iu tr sai. + T dng h tn, ngoi t ni n.
c im ca Thi m bnh l T h, hn thp ni sinh. Thi m c quan h biu l vi Dng minh, nn trong qu trnh bnh l c nh hng qua li, c phn h thc. V th c cu: Thc tc Dng minh, H tc Thi m. 34
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Triu chng: bng y au, i ma, tiu chy, thch m, thch n, khng
kht, li nht, ru trng mng, mch tr hon.
THI M CHNG
- Ch chng (triu chng quan trng) ca Thi m chng bng y au, i ma, tiu chy, thch m, mch tr hon.. - Thuc tiu biu trong iu tr Thi m chng: L trung thang
2.5. Thiu m chng 2.5.1. Nhc li c s gii phu sinh l hc ca h thng Thiu m H thng Thiu m bao gm Th Thiu m Tm v Tc Thiu m Thn. H thng Thiu m c quan h biu l vi h thng Thi dng gm Th Thi dng Tiu trng v Tc Thi dng Bng quang. Tm Thn l gc m dng ca c th. Tm thuc Ha, ch huyt mch, ch thn, thng lnh hot ng sinh l ton thn. Thn thy ch tng tinh, tng thy, cha nguyn m, nguyn dng, l gc tin thin. Tm ha lm m 35
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Thn thy v Thn thy lm mt Tm ha. Tm Thn tng giao, thy ha k t duy tr s hot ng bnh thng ca c th. 2.5.2. Bnh l Bnh giai on nng, biu hin Tm Thn bt tc Nguyn nhn
Ngoi t trc trng ( ngi gi yu, hoc Thn kh suy) Truyn bin t ngoi vo trong (kinh khc truyn n).
Bnh cnh lm sng bao gm 2 th
Triu chng
+ Khng st, s lnh, mun ng, mun i nhng khng i c + Tm phin, kht, tiu trong, li nht, ru trng, mch vi
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Triu chng: tay chn lnh, khng s lnh, mt , ngi lm lm, tiu
trong, mch vi tuyt (triu chng ca Thiu m chn hn gi nhit).
Tr thot chng Chn dng h Cha chng Thn dng suy. Cp cu chng thot ca trng phong n - bKhai khiu nh thn, gii quyt nghch Bi nguyn - b Thn
Kh hi Quan nguyn
Triu chng: ming to, hng kh. Tm phin kh ng, bt rt, tiu
vng, li , mch t sc.
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b. m h thy nh
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THIU M CHNG
- Ch chng (triu chng quan trng) ca Thiu m chng: ri lon thc (tm phin hoc lm lm, l m), mch h. - Bnh chng Thiu m bao gm Thiu m ha nhit chng (tnh trng t nguy cp hn) v Thiu m ha hn chng (khi tnh trng bnh nguy cp hn). - Tnh trng tay chn lnh v mch vi (th hin tnh trng suy sp tun hon) l triu chng c bn phn bit gia Thiu m ha nhit chng v Thiu m ha hn chng - Thiu m ha nhit chng c th biu hin di 2 dng: m h nhit chng v m h thy nh - Tnh trng tiu li hay khng li l triu chng c bn phn bit gia m h nhit chng v m h thy nh - Thiu m ha hn chng c th biu hin di 2 dng: dng h hn chng v m thnh cch dng chng - Tnh trng c st hay khng st l triu chng c bn phn bit gia dng h hn chng (khng st, lnh t chi) v m thnh cch dng chng (st, lnh t chi) - Thuc tiu biu trong iu tr m h nhit chng ca Thiu m ha nhit: Hong lin a giao thang - Thuc tiu biu trong iu tr m h thy nh ca Thiu m ha nhit: o xch tn - Thuc tiu biu trong iu tr m thnh cch dng chng ca Thiu m ha hn: Thng mch t nghch tn - Thuc tiu biu trong iu tr dng h hn chng ca Thiu m ha hn: T nghch thang
2.6. Quyt m bnh chng 2.6.1. Nhc li c s gii phu sinh l hc ca h thng Quyt m H thng Quyt m bao gm Tc Quyt m Can v Th Quyt m Tm bo. H thng Quyt m c quan h biu l vi h thng Thiu dng gm Th Thiu dng Tam tiu v Tc Thiu dng m.
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Ngoi t trc trng Ngoi t truyn kinh t ngoi vo (nh Thi m, Thiu m...)
Chng trng ch yu ca giai on ny gm
Thng nhit h hn Quyt nhit thng phc: tay chn mp lnh xen ln pht st Quyt nghch: tay chn mp lnh Tiu chy, nn ma
Bnh giai on ny (giai on cui ca Thng hn bnh) thng phc tp. Php tr (nguyn tc tr liu) da vo cc im:
Chn tay mp lnh khng c cng h Tiu chy nng khng th cng phn biu
Mt cch tng qut th ty theo tng trng hp c th m gii quyt, nhng lun ch hi dng ng thi ch bo tn m dch. 2.6.2.1. Quyt m hn quyt
Triu chng: chn tay quyt lnh, khng st, s lnh, li nht, mch vi
hoc t sp tuyt.
iu tr: c th s dng
+ Hi dng cu nghch (T nghch thang). Xin tham kho thm phn Thiu m ha hn. + n thng huyt mch. (ng quy t nghch thang) + Phn tch bi ng quy t nghch thang: (Php b - n)
V thuc Cam tho Can khng ng quy Ph t ch Dc l ng y Ngt n. Ha trung b th. iu ha cc v thuc Cay n. n dng tn hn Cay, ngt, n. B huyt, hot huyt, nhun to, hot trng, iu huyt, thng kinh Cay, ngt, i nhit, c c B ha tr dng, hi dng cu nghch, trc phong hn thp t
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Triu chng: chn tay quyt lnh, st, kht, tiu vng , ru vng, mch
hot.
Triu chng: chn tay quyt lnh, tiu kht, i khng mun n, n vo
i ra di, tiu chy khng cm.
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QUYT M CHNG
- Ch chng (triu chng quan trng) ca Quyt m chng: tay chn quyt lnh (chng quyt), mch vi. - Bnh chng Quyt m bao gm Quyt m nhit quyt (tnh trng t nguy cp hn), Quyt m hn quyt (khi tnh trng bnh nguy cp hn) v Quyt m hi quyt - Tnh trng c st hay khng st l triu chng c bn phn bit gia Quyt m nhit quyt v Quyt m hn quyt - Triu chng quan trng chn on phn bit Quyt m hi quyt l nhm triu chng tiu ha: i ma (c th i ra giun), tiu chy khng cm. - Thuc tiu biu trong iu tr Quyt m hn quyt: T nghch thang v ng quy t nghch thang - Thuc tiu biu trong iu tr Quyt m nhit quyt: T nghch thang v Bch h thang - Thuc tiu biu trong iu tr Quyt m hi quyt: mai hon
Cu hi N TP
CU HI 5 CHN 1 CHN CU NG NHT
1. Bnh cnh Quyt m nhit quyt c xp vo A. Bnh ngoi cm lc dm B. Bnh ngoi cm thng hn C. Bnh ngoi cm n bnh D. Bnh do ni nhn E. Bnh do nguyn nhn khc 2. Triu chng ca Thi dng trng phong A. Pht st, m hi, s gi lnh, u c cng au B. Pht st, phin kht, tiu tiu kh, bng di y au C. Pht st, bt rt, bng di au, tiu tin t li D. Pht st, st v chiu, m hi, u c cng au E. Pht st, khng c m hi, u c cng au
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3. Bi thuc ch nh cho H/C Thi dng sc huyt A. Ma hong thang B. Qu chi thang C. Ma hnh thch cam thang D. Ng linh tn E. dng thang 4. Triu chng ca H/C Dng minh ph chng A. Pht st, m hi, s gi lnh, mch ph hon B. Pht st, m hi, s nng, kht nc, tm phin C. Pht st, m hi, cu to, bng y au, tm phin D. Pht st, khng m hi, mch ph khn E. Pht st, bt rt, bng di au, tiu tin t li 5. Php tr ca H/C Thi dng A. Hn B. Th C. H D. Ha E. Thanh 6. Triu chng ca H/C Thi m A. Bng y chng, au. Tin kh B. au thng v, cu to C. Ho, au ngc, khc m trng trong D. y bng, i ma, tiu chy E. au bng qun tht, i ma, tiu chy phn te vng 7. Bi thuc ch nh cho H/C Thi m A. L trung thang B. Ct cn cm lin thang C. i tha kh thang D. iu v tha kh thang E. T nghch thang
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8. Triu chng no KHNG c trong H/C Quyt m A. ng kinh, co git B. Trn nng, di lnh C. Tay chn mp lnh xen ln pht st D. Tay chn mp lnh E. Tiu chy, nn ma
CU HI NHN QU
1. Trong bi Ma hong thang cha chng Thi dng thng hn gm: Ma hong, Qu chi, Hnh nhn, Cam tho a. V Cam tho lm t bi v b. Cam tho c tc dng thanh nhit gii c A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 2. Trong phng huyt iu tr hai chng Thi dng sc thy v Thi dng sc huyt a. Ngi ta u chm b huyt Ni quan bi v b. Ni quan c tc dng ph kt kh A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 3. Trong bi thuc Hong lin thang cha HC Quyt m gm: Nhn sm, i to, Hong lin, Qu chi, Can khng, Bn h, Cam tho bc a. V Can khng lm t bi v b. Can khng c tc dng n trung tr nn ma A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu
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C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 4. Trong phng huyt hi dng cu nghch gm: Dng tuyn, Mnh mn, Quan nguyn, Thn khuyt cha Quyt m chng a. Ngi ta chm b huyt Mnh mn b Thn dng bi v b. Huyt ny c tc dng b mnh mn tng ha A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 5. a. Trong bi o xch tn (Tiu t) iu tr HC Thiu m ha nhit, Sinh a lm qun bi v: b. Sinh a tc dng dng m, nui Thn, dng huyt A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai
P N
CU HI 5 CHN 1
STT 1 2 3 4 5 6 7 8 p n B A E C D D A A
CU HI NHN QU
STT 1 2 3 4 5 p n D E C A A
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Bi 3
MC TIU
Sau khi hc tp, sinh vin PHI 1. nh ngha c bnh ngoi cm n bnh. 2. Trnh by c nguyn nhn v c ch sinh bnh ca ngoi cm n bnh. 3. Lit k c nhng triu chng chnh ca tng giai on ca ngoi cm n bnh. 4. Phn bit c s khc bit ch yu gia ngoi cm n bnh v ngoi cm thng hn. 5. Trnh by c nguyn tc iu tr v cch tr ca tng th lm sng. 6. Phn tch c c s l lun ng y ca vic iu tr n bnh.
Khi pht vi st cao Bnh cnh thin v nhit Din bin theo quy lut Bnh thng cp tnh, din tin nhanh, bnh cnh thng nng Nu bnh pht thnh dch th c gi l n dch.
Trong ti liu c, c nhng cch gi tn (cch phn chia) bnh ngoi cm n bnh khc nhau.
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+ Tn cm + Phc t
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3.3. Bnh cnh lm sng Mt cch tng qut, bnh V phn v Kh phn thuc bnh ca kh. Bnh Dinh phn v Huyt phn c xp vo nhm bnh ca huyt. Bnh V phn (ch biu, ch Ph v b mao) l bnh ca kh nhng c biu hin nh. Bnh kh phn (ch n nhit t vo su, vo l; nhng cha vo huyt) l bnh ca kh nhng biu hin nng, su. Bnh Dinh phn (t vo Tm, Tm bo) l bnh ca huyt nhng c biu hin nh, nng. Bnh Huyt phn (T vo Can huyt) l bnh ca huyt vi nhng triu chng nng, nghim trng hn.
Tn dch b thng nh hng n huyt l t vo Dinh phn. Huyt b tn thng tng i nhiu l t vo Huyt phn.
4. NHNG IM KHC NHAU GIA NGOI CM N BNH V NGOI CM THNG HN
STT 1 2 3 n bnh Kho st cc bnh ngoi cm c tnh cht nhit Khi pht ngay vi Nhit chng Din bin c quy lut, theo V, Kh, Dinh, Huyt v Tam tiu Thng hn Kho st tt c cc bnh ngoi cm Khi pht vi Phong, Hn, Th, Thp chng. Giai on sau mi xut hin Nhit chng Din bin c quy lut, theo Lc kinh
C IM CA N BNH
- n bnh l mt loi bnh Ngoi cm - Hai nguyn nhn gy bnh ca Ngoi cm n bnh: + Lc dm: ch yu Nhit t. + L kh - C 2 cch kho st din tin c qui lut ca Ngoi cm n bnh: din tin t ngoi vo trong (V, Kh, Dinh, Huyt) hoc din tin t trn xung (thng tiu, trung tiu, h tiu). - Nhng giai on din bin ca Ngoi cm n bnh phn nh tng quan lc lng gia sc khng ca c th (chnh kh) v tc nhn gy bnh (t kh).
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5. BNH HC V IU TR 5.1. Nhc li chc nng sinh l ca V, Kh, Dinh, Huyt V, Kh, Dinh, Huyt chu lu khp c th duy tr s sng bnh thng ca con ngi.
V c tc dng:
+ Bo v c th chng li tc nhn gy bnh t bn ngoi + n dng c nhc, sung nhun b phu + Qun l vic ng m l chn lng (quan h mt thit vi vic m hi).
Dinh (hm kinh doanh) c vai tr sinh huyt v dinh dng ton thn.
Dinh kh lu hnh bn trong mch.
5.2. Bnh hc v iu tr Ngoi cm n bnh 5.2.1. V phn chng y l n nhit thi k u. Bnh b mao v Ph. Giai on ny, bnh thng c 2 mc biu hin gm: t b mao v t Ph Triu chng chung ca bnh V phn: s gi lnh, pht st, kht khng nhiu, ho t m, hoc m kh khc, mch ph sc. 5.2.1.1. T b mao Triu chng: st, s gi lnh, mch ph sc, hoc c ho, au hng, kht. Php tr: thanh tn biu nhit (Ngn kiu tn).
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Bch hi i chy
Gii biu
c hiu khu phong, gii biu c hiu khu phong, gii biu Tr cm, au u au cng gy
5.2.1.2. T Ph Triu chng: ho t m, hoc m kh khc, au hng, hi s gi, s lnh, hi pht st. Php tr: tuyn Ph tn nhit (Tang cc m). 50
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Bch hi i chy
Gii biu
c hiu khu phong, gii biu c hiu khu phong, gii biu Tr cm, au u Tr cm, au cng gy
Tr ho Ngt mi
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V PHN CHNG
- Ch chng (triu chng quan trng) ca V phn chng: st, mch ph sc. - Bnh chng V phn bao gm 2 bnh cnh: t b mao (khi bnh cn phn nng) v t Ph (khi bnh xm phm chc nng tuyn ging ca Ph). - Triu chng quan trng ca bnh cnh T b mao: st, s gi, s lnh, mch ph sc - Triu chng quan trng ca bnh cnh t Ph: st, ho t m, m dnh kh khc - Thuc tiu biu trong iu tr bnh chng t b mao: Ngn kiu tn - Thuc tiu biu trong iu tr bnh chng t Ph: Tang cc m
5.2.2.1. Nhit Ph kinh Triu chng: st, phin kht, phin to, bt an, ho m c vng, kh khc. Kh suyn, ho ra mu, tiu , li , ru vng kh hoc nht, mch hot sc. Php tr: tuyn ging Ph nhit (Ma hnh cam thch thang).
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i chy
Gii biu
Tr ho Tr ho, kh th Ngt mi
Triu chng: tc ngc, pht st tng cn, thng bun phin, kh ng.
Mch sc, ru vng.
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Gii biu
i chy
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Khc tr Hp cc
H st
b. Trng nhit h l
Triu chng: t l nhiu ln, hu mn nng rt, mch sc, ming kht,
ru vng kh.
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V thuc Ct cn Hong lin Hong cm Nhn trn Kim ngn Mc thng Hoc hng Cam tho
Dc l ng y Ngt, cay, bnh. Vo T, V. Sinh tn ch kht, tr phin, thanh nhit. ng, hn. Vo Can, m. Thanh nhit, tr thp, thanh Tm, tr phin, gii c, thanh Can ha, ch huyt do nhit. ng, hn. Vo Tm, Ph, Can, m, i trng. Thanh nhit, t ha, lm li thp Ph, tr thp V trng. ng cay, tnh hi hn. Vo T, V, Can, m. Li thp nhit, thoi hong. Ngt, ng. Vo Ph, V, Tm, T, i trng. Thanh nhit gii c, thanh nhit V trng, thanh biu nhit. ng, lnh. Vo Tm, Tiu trng, Ph, Bng quang. Ging Tm ha, thanh li Tiu trng, thanh thp nhit Bng quang. Cay, m vo Ph, T, V. Tn th thp, iu ha T V, phng hng ha trc thp. Ngt bnh. Vo 12 kinh. B trung kh, ha hon, gii c.
KH PHN CHNG
- Ch chng (triu chng quan trng) ca Kh phn chng: st cao, phin to. - Bnh chng Kh phn bao gm 4 bnh cnh: nhit Ph kinh, Nhit ut hung cch, Nhit nhp V v Nhit kt trng ph. Bnh cnh Nhit kt trng ph c 2 th Trng to tin b v Trng nhit h l. - Triu chng quan trng ca bnh cnh nhit Ph kinh: ho nhiu, m kh khc. - Triu chng quan trng ca bnh cnh nhit ut hung cch: tc ngc, phin to - Triu chng quan trng ca bnh cnh nhit nhp V: st cao, kht d, mch hng i. - Triu chng quan trng ca bnh cnh nhit kt trng ph: st, ri lon i tin - To bn hay tiu chy, l l triu chng quan trng phn bit bnh cnh Trng to tin b vi Trng nhit h l ca nhit kt trng ph - Thuc tiu biu trong iu tr bnh chng nhit Ph kinh: Ma hnh cam thch thang - Thuc tiu biu trong iu tr bnh chng Nhit ut hung cch: Chi t s thang - Thuc tiu biu trong iu tr bnh chng Nhit nhp V: Bch h thang - Thuc tiu biu trong iu tr bnh chng Trng to tin b ca Nhit kt trng ph: iu v tha kh thang - Thuc tiu biu trong iu tr bnh chng Trng nhit h l ca Nhit kt trng ph: Ct cn cm lin thang
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5.2.3. Dinh phn chng Cn c xem nh giai on u ca n bnh Huyt phn. Bnh cnh xut hin Tm, Tm bo v triu chng ch yu gm huyt nhit v l m. Bnh xut hin Dinh phn c th do t V phn chuyn n, khng qua Kh phn, trc tip vo Huyt phn (Nghch truyn Tm bo); c th do t Kh phn chuyn n hoc cng c th l trc trng. n bnh Dinh phn biu hin 3 nhm bnh chng 5.2.3.3. Nhit thng dinh m (m h ni nhit)
V thuc Bt sng tru Huyn sm Mch mn Sinh a Kim ngn Thanh nhit c phn Dinh
Dc l ng y
ng, mn, hi hn. T m, ging ha, tr phin, nhun to Ngt, ng. Nhun Ph, sinh tn Hn, ngt, ng. Nui Thn, dng m, dng huyt Ngt, ng. Vo Ph, V, Tm, T, i trng. Thanh nhit gii c, thanh nhit V trng, thanh biu nhit. ng, hn. Vo Can, m. Thanh nhit, tr thp, thanh Tm, tr phin, gii c, thanh Can ha, ch huyt do nhit. ng, lnh. Vo m, i trng, Tam tiu. Thanh nhit, gii c, tn kt, gii cm tr phong nhit. Ngt, nht, hn. Thanh Tm ha, li niu, tr phin nhit ng, hi hn. Trc huyt (khng huyt khng dng)
Hong lin
Lin kiu
L tre an sm
Triu chng: l m ni nhm, tm phin li , ng vi khng tnh. Php tr: thanh tm khai khiu (Thanh cung thang).
+ Phn tch bi thuc: (Php b - thanh)
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V thuc Bt sng tru Huyn sm Mch mn Lin t tm Lin kiu Trc dip
Dc l ng y Thanh nhit c phn Dinh ng, mn, hi hn. T m, ging ha, tr phin, nhun to Ngt, ng. Nhun Ph, sinh tn V ng, tnh hn. Thanh Tm kh nhit. Cha tm phin, th huyt ng, lnh. Vo m, i trng, Tam tiu. Thanh nhit, gii c, tn kt, gii cm tr phong nhit. Ngt, nht, hn. Thanh Tm ha, li niu, tr phin nhit
5.2.3.3. Dinh v hp t
Php tr: lng thanh Dinh V (Ngn kiu tn b Kinh gii, u s, gia
Sinh a, n b, Huyn sm, i thanh dip).
+ Phn tch bi thuc: (Php b - thanh)
V thuc Lin kiu n b Kim ngn Sinh a Huyn sm Bc h Ct cnh Ngu bng t L tre Cam tho
Dc l ng y ng, lnh. Vo m, i trng, Tam tiu. Thanh nhit, gii c, tn kt, gii cm tr phong nhit. Cay ng, hi hn. Thanh huyt nhit, tn huyt. Cha nhit nhp doanh phn Ngt, ng. Vo Ph, V, Tm, T, i trng. Thanh nhit gii c, thanh nhit V trng, thanh biu nhit. Hn, ngt, ng. Nui Thn, dng m, dng huyt ng, mn, hi hn. T m, ging ha, tr phin, nhun to Cay, mt, vo Ph, Can. Pht tn phong nhit. ng, cay, hi m. Vo Ph. Kh m ch khi, tuyn Ph li hu hng, bi nung gii c. V cay, ng, tnh hn. Vo Ph, V. Tc dng tn phong nhit, tuyn Ph, thu chn Ngt, nht, hn. Thanh Tm ha, li niu, tr phin nhit Ngt bnh. Vo 12 kinh. B trung kh, ha gii c.
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Tc dng iu tr T m
i chy
Thanh nhit
Thanh nhit
Bch hi
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5.2.4. Huyt phn chng Giai on ny, nhit t vo su bn trong, ch yu Can Thn.
Bnh Thn ch yu l biu hin tnh trng hao huyt nng, gy thng
m hoc vong m. Nhit nhp vo Huyt phn bng 2 con ng
V thuc Bt sng tru Sinh a Bch thc n b Thanh nhit c phn Dinh
Dc l ng y
Hn, ngt, ng. Nui Thn, dng m, dng huyt ng, cht, chua. Nhun gan, dng huyt, lim m, li tiu Cay, ng, hi hn. Thanh huyt nhit, tn huyt. Cha nhit nhp doanh phn
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Ngoi cn: Hnh gian, Thiu ph, Ni quan, Thn mn, Thn du, Can du, Thi kh, Phi dng, Tam m giao.
Tn huyt Hnh gian Thiu ph Ni quan Thn mn Can du Thn du Thi kh Phi dng Tam m giao C s l lun Hunh ha huyt/Can Hunh ha huyt/Tm Giao hi huyt ca Tm bo v mch m duy c hiu vng ngc Du Th huyt/Tm Du huyt ca Can lng Bi du huyt/Thn Nguyn huyt/Thn Lc huyt/Thn Giao hi huyt ca 3 kinh m/chn Tc dng iu tr Bnh can Ging ha Cha chng hi hp, au ngc gy kh th, ngn ngc T Tm ha B Can huyt T m B Thn B Thn T m
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- Ch chng (triu chng quan trng) ca bnh Huyt phn: st cao, xut huyt, co git. - Bnh chng Dinh phn bao gm 4 bnh cnh: Huyt nhit vng hnh, Can nhit ng phong, Huyt nhit thng m v Vong m tht thy. - Triu chng quan trng ca bnh cnh Huyt nhit vng hnh: st cao, du xut huyt ngoi da v ni tng. - Triu chng quan trng ca bnh cnh Can nhit ng phong: st cao, co git tng cn. - Triu chng quan trng ca bnh cnh Huyt nhit thng m: st cao, ming li kh. - Triu chng quan trng ca bnh cnh Vong m tht thy: du mt nc nng n. - Thuc tiu biu trong iu tr bnh chng Huyt nhit vng hnh: T gic a hong thang - Thuc tiu biu trong iu tr bnh chng Can nhit ng phong: Linh dng cu ng thang - Thuc tiu biu trong iu tr bnh chng Huyt nhit thng m: Phc mch thang gia gim - Thuc tiu biu trong iu tr bnh chng Vong m tht thy: Tam gip phc mch thang.
CU HI N TP
CU HI 5 CHN 1 - CHN CU NG
1. Trong n bnh, nu mi mc bnh m pht ra ngay, bnh cnh s xut hin A. V phn B. Kh phn C. Dinh phn D. V phi hp vi Kh phn E. Huyt phn 2. Triu chng no KHNG c trong n bnh Kh phn A. St, s gi lnh B. St cao C. To bn D. Tiu chy E. au ngc, ho 63
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3. V tr xut hin triu chng ca n bnh V phn A. Hung cch B. Ph C. V D. Trng ph E. Tm bo 4. Bi thuc ch nh cho n bnh V phn A. Tang cc m B. Qu chi thang C. Ma hong thang D. Chi t s thang E. Ma hnh thch cam thang 5. V tr no KHNG xut hin triu chng ca n bnh Kh phn A. Hung cch B. V C. Trng ph D. Ph E. Tm bo 6. Triu chng quan trng trong chn on n bnh Dinh phn A. St cao B. Ho, au ngc C. Cu to D. L m, ni nhm E. Du xut huyt 7. Triu chng quan trng trong chn on n bnh Huyt phn A. Co git B. St cao C. Ngi mt mi D. Cu to bn E. L m, ni nhm
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8. Triu chng quan trng trong chn on n bnh Huyt phn A. L m, ni nhm B. St cao C. Cu to bn D. Du xut huyt E. Tiu chy khng cm c
CU HI NHN QU
1. Trong bi thuc Ngn kiu tn cha bnh t b mao gm: Lin kiu, Kim ngn, Bc h, Kinh gii, u s, Ct cnh, Ngu bng t, L tre, Cam tho. a. V Lin kiu lm qun, bi v b. Lin kiu c tc dng gii cm tr phong nhit A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 2. Trong bi thuc Tang cc m cha bnh t Ph gm: Tang dip, Cc hoa, Bc h, Lin kiu, Hnh nhn, Ct cnh, L cn, Cam tho. a. V Ct cnh lm thn, bi v b. Ct cnh c tc dng thanh nhit, ch khi, chng nn A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 3. Trong phng huyt cha chng Nhit ut hung cch gm: i chy, Khc tr, Hp cc, Ni quan, n trung. a. Ngi ta chm b huyt Ni quan cha chng ut hung cch, bi v b. Huyt ny c tc dng c hiu tr bnh vng hung cch A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu
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C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 4. Trong phng huyt cha chng to trong Nhit kt trng ph gm: Thin khu, Chi cu, Khc tr, Hp cc a. Ngi ta chm t huyt Thin khu, bi v b. Huyt ny l giao hi huyt ca V v i trng A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 5. Trong bi thuc Thanh cung thang cha bnh Nhit nhp tm bo gm: Bt sng tru, Huyn sm, Mch mn, Tm sen, Lin kiu, Trc dip. a. V Trc dip lm t, bi v b. Trc dip c tc dng thanh nhit, cha tm phin, th huyt A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 6. Trong phng huyt cha chng co git trong nhit huyt phn gm: Bch hi, Nhn trung, Thp tuyn. a. Ngi ta chm t huyt Thp tuyn, bi v b. Huyt ny l huyt c hiu cha chng t ngt trng phong A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai
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P N
CU HI 5 CHN 1 CHN CU NG
STT 1 2 3 4 5 6 7 8 p n A A B A E D A D
CU HI NHN QU
STT 1 2 3 4 5 6 p n A E D C C A
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Bi 4
Bnh ngoi cm lc dm
MC TIU
Sau khi hc tp, sinh vin PHI 4. nh ngha c bnh ngoi cm lc dm. 5. Lit k c nhng triu chng chnh ca tng bnh cnh thuc ngoi cm lc dm. 6. Trnh by c nguyn tc iu tr v cch tr ca tng bnh chng. 7. Lit k c tn, thnh phn cu to bi thuc chnh cho tng bnh cnh v phn tch c c s l lun ca bi thuc s dng.
Gy nn do ngoi nhn gm Phong, Hn, Th, Thp, To, Ha. Gy bnh t ngoi Kinh lc n cc ph tng su. Khng theo quy lut truyn bin no. Bnh danh lun bao gm
+ Tn tc nhn gy bnh + V tr (kinh lc, tng ph) ni b bnh
Bnh Ngoi cm lc dm c 3 mc
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+ Cng thc huyt s dng: s dng huyt ti ch v ln cn vng au, vi k thut n chm
2.1.2. Hn t phm vo kinh Cn y l nhng tnh trng m ngoi t tn cng cc b vo mt on l trnh ca kinh Cn. Triu chng chnh: au co rt, au km cm gic t b, nh kin b. C th km gim vn ng ti ch. V tr au ty thuc vo h kinh cn no b tn thng. Khng c biu hin ca cc triu chng ca tng ph tng ng. Nhng bnh cnh thng gp trong nhm ny gm: 2.1.2.1. Phong hn phm kinh cn i trng (on vai), thng thy trong vim quanh khp vai. 2.1.2.2. Phong hn phm kinh cn Tiu trng (on vai), thng thy trong vim quanh khp vai. 2.1.2.3. Phong hn phm cn kinh m (on vai gy), thng thy trong vo c cp.
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Php tr: hnh kh hot huyt (Hot lc ch thng thang). Tin lng
bnh tt.
iu tr bng chm cu: bt buc phi dng php Phn chm Thiu
chm. Cng thc huyt: p thng trn kinh Cn b tn thng. K thut chm cu: n chm t. Thi gian iu tr ko di cho n khi mt ht p thng. 2.1.3. Ngoi t phm vo chnh kinh Trong nhng sch ng y hc, nhng nguyn nhn thng thy nht nhm bnh l ny l phong, hn v nhit. Nhm bnh l ny biu hin nhng tnh trng ngoi t tn cng cc b vo mt on l trnh ca chnh kinh v n cc b phn nng ca c th c lin quan n ng kinh (bnh l xy ra trong trng hp ngoi t phm vo ton b kinh chnh thng c cp v bin lun theo Thng hn lun). Nhng bnh cnh thng gp trong nhm ny gm: 2.1.3.1. Hn tr Can mch a/ Bnh nguyn: do hn t xm nhp vo Can kinh b/ Bnh sinh: kinh Can, trong l trnh vng bn, vng quanh b phn sinh dc, qua bng di tn ra 2 bn chn. Hn t xm phm Can mch lm kinh kh ngng tr nn c biu hin au bng, sn kh. c/ Triu chng lm sng:
au nhiu vng bng di, au nh co tht, vn xon, cm gic lnh bng. au bng kinh, au bng di lan xung b sinh dc. Vng bng di
ni cc.
n kinh thang
C nhiu bi thuc cng tn n kinh thang c s dng tr nhng trng hp au bng kinh. Tuy nhin nhng bi thuc ny c xut x khc nhau v cc dc liu cu thnh cng khc nhau. Bi th 1 c xut x t Cc phng dng tr huyt hi h hn, kinh nguyt khng u. Bi th 2 xut x t Chng tr chun thng tr huyt hi b h lnh, lng kinh t, kh thng, huyt trng, bng au. Bi th 3 xut x t Thm th tn sinh dng cho ph n mch Nhm v Xung b h, ri lon kinh nguyt.
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Bi n kinh thang di y xut x t Kim qu yu lc. C tc dng tr i h, bng di lnh, kinh b hoc ra nh git, bui chiu pht st, lng bn tay nng.
+ Phn tch bi thuc: (Php hn)
V thuc Qu chi Sinh khng Nhn sm Mch mn Xuyn khung n b Bch thc A giao Bn h Ng th du ng quy Cam tho Dc l ng y Cay, ngt, i nhit, hi c. Tn hn n, cay. Tn hn. Hi dng thng mch Ngt, hi ng, n. i b nguyn kh, ch huyt sinh tn Ngt, ng, mt. Nhun Ph, sinh tn Cay, n. Hot huyt, ch thng, hnh kh, khu phong Cay, ng, hi hn. Thanh huyt nhit, tn huyt ng, chua, hi hn. Nhun gan, dng huyt, lim m, li tiu Ngt, bnh. T m, dng huyt. B Ph, nhun to Cay, n. H kh nghch, tiu m Cay, ng, n, hi c. Cha n khng tiu, nn ma, au bng, tiu chy Dng Can huyt Bnh, ngt. B T V, nhun Ph, thanh nhit, gii c, iu ha cc v thuc
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2.1.3.2. Phong hn phm kinh Bng quang (on lng v chi di). Thng thy trong vim thn kinh ta. 2.1.3.3. Phong hn phm kinh m (on lng v chi di). Thng thy trong vim thn kinh ta. 2.1.3.4. Phong hn phm kinh V (on u mt). Thng thy trong lit mt ngoi bin, au dy thn kinh mt.
Php tr: khu phong, tn hn, hnh kh hot huyt Bi thuc s dng: Hot lc ch thng thang.
+ Cng thc huyt s dng
Tn huyt Gip tch tng ng Hon khiu y trung Huyt ti ch Hp Th huyt/Bng quang Mt trong lc tng huyt i chung Lc ca Bng quang C s l lun Tc dng iu tr Thng kinh lc vng bnh tng ng H st Huyt c hiu iu tr bnh tht lng Huyt theo l lun ng kinh c hiu cha au lng Quang minh Lc ca m Huyt theo l lun ng kinh
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2.1.3.5. Phong nhit phm chnh kinh Triu chng chnh au nhc ti ch, vng au nng . Chm lnh d chu. St cao, s nng. Php tr l khu phong thanh nhit. Nhng bnh cnh thng gp trong nhm ny gm:
Phong nhit phm kinh V (on ngc). Thng gp trong vim tuyn
v. Bi thuc s dng gm B cng anh, Lin kiu, Thanh b, Bi mu, Lc gic tim, Thin hoa phn, ng quy (Tiu ung tn c m).
Phong nhit phm kinh kinh m (on hng sn). Thng gp trong
au dy thn kinh lin sn, zona lin sn. Bi thuc s dng gm Cam tho, Khng hot, Tin h, Ct cnh, Xch linh, Ch xc, Nhn sm, Xuyn khung, c hot, Si h (Nhn sm bi c tn). 2.1.4. Ngoi t phm vo k kinh bt mch Triu chng chnh ty thuc vo k mch no b xm phm (tham kho thm bi K kinh bt mch). Thng gp trong nhm bnh chng ny: 2.1.4.1. Phong nhit phm mch i Thng gp trong lit hai chi di do vim ty cp. 2.1.4.2. Phong nhit phm mch c Thng gp trong lit t chi do vim ty cp, vim mng no, un vn, bi no, vim no. 2.1.4.3. Thp nhit phm vo mch Xung Thng gp trong vim m o, vim phn ph, vim ng tiu thp ph n.
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2.2. Ngoi t phm phn biu y l nhng bnh cnh ngoi t xm phm vo phn ngoi ca c th (v phn). Thng gp trong bnh cnh cm cm hoc vim ng h hp trn v gm: 2.2.1. Ngoi cm phong hn Thng gp trong cc bnh cm cm, vim ph qun, hen ph qun, vim thanh qun... ca Ty y.
Php tr: s phong tn hn. C th dng php gii c khu phong hoc tn
n pht hn.
+ Phn tch bi thuc Qu chi thang.
V thuc Qu chi i to Bch thc Gng sng Cam tho Dc l ng y Cay ngt, i nhit, hi c. Tr c lnh trm hn, gii biu Ngt n. B T ch kh, dng V, sinh tn dch. iu ha cc v thuc Chua ng, hi hn. Nhun gan, dng huyt, lim m Cay n. Tn hn, n trung. Thng mch Ngt, bnh. B T V, nhun ph, thanh nhit gii c, iu ha cc v thuc
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Gii biu
c hiu khu phong, gii biu c hiu khu phong, gii biu Tr cm, au u Tr cm, au cng gy
Nghinh hng
Huyt ti ch
Tr ngt mi
Triu chng: st, s gi, mch ph sc, hoc c ho, au hng, kht. Php tr: thanh tn biu nhit (Ngn kiu tn).
+ Phn tch bi thuc: (Php hn)
V thuc Lin kiu Kim ngn Bc h Kinh gii u s Ct cnh Ngu bng t Dc l ng y ng, lnh. Vo m, i trng, Tam tiu. Thanh nhit, gii c, tn kt, gii cm tr phong nhit. Ngt, ng. Vo Ph, V, Tm, T, i trng. Thanh nhit gii c, thanh nhit V trng, thanh biu nhit. Cay mt. Vo Ph, Can. Pht tn phong nhit. V cay, n. Vo Ph, Can. Pht biu, kh phong, li yt hu. V ng, tnh hn. Vo Ph, V. Tc dng gii biu, tr phin ng cay hi m. Vo Ph. Kh m ch khi, tuyn Ph li hu hng, bi nung gii c. V cay, ng, tnh hn. Vo Ph, V. Tc dng tn phong nhit, tuyn Ph, thu chn
L tre (Trc dip) Ngt nht, hn. Thanh Tm ha, li niu, tr phin nhit Cam tho Ngt bnh. Vo 12 kinh. B trung kh, ha gii c.
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Bch hi i chy
Gii biu
c hiu khu phong, gii biu c hiu khu phong, gii biu Tr cm, au u
- Thng gp trong bnh cnh cm cm hoc vim ng h hp trn. - Triu chng quan trng ca ngoi t phm biu (gm V phn v Ph): du hiu c tnh cht ton thn: st, au nhc mnh my, triu chng b my h hp. - Thuc tiu biu trong iu tr ngoi cm phong hn: Qu chi thang, Ma hong thang. - Thuc tiu biu trong iu tr ngoi cm phong hn: Ngn kiu tn.
2.3. Ngoi t phm vo cc quan tit y l nhng bnh l au nhc cc khp xng. Triu chng chnh thay i ty theo loi ngoi nhn gy bnh v v tr ca khp b thng tn. Bnh thng c trnh by trong chng T chng. Theo T lun thin (T Vn) th 3 kh phong hn thp ln ln dn n, hp li m thnh chng t. Nu phong kh thng th sinh Hnh t. Nu hn kh thng th sinh Thng t. Nu thp kh thng th sinh Chc t. Ngi m dng thnh, nhit nu bn trong hoc 3 t lu tr lu ngy th sinh Nhit t. 2.3.1. Phong kh thng (Hnh t) Triu chng: mnh my au nhc, au nhiu khp, di chuyn, khng c nh ch no c. S gi, ru li trng, mch ph.
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Php tr: tn hn l chnh, khu phong tr thp l ph, hnh kh hot huyt.
+ Phn tch bi thuc
V thuc Qu chi Can khng Ph t ch Thin nin kin Uy linh tin d Thng trut Xuyn khung Ngu tt Dc l ng y n kinh, thng mch n trung, tn hn n thn ha, kh hn thp, gim au. Tr phong thp, mnh gn xng Kh phong thp, thng kinh lc, gim au. Li thy, thanh nhit, kin t. n trung ha m Hot huyt ch thng B Can, ch Thn
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2.3.3. Nhit t
c im l cc khp sng , nng, au, lm pht st, s gi, kht nc. Php tr: thanh nhit khu phong, ha thp. (Bch h qu chi thang)
+ Phn tch bi thuc
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V thuc Thch cao Qu chi Tri mu Hong b Thng trut Kim ngn Tang chi Phng k Ngnh m Cam tho
Dc l ng y Thanh Dng minh kinh nhit, tr nhit thnh, phin to. n kinh thng mch Thanh nhit lng huyt nhun to Thanh nhit gii c n trung ha m Thanh nhit gii c Tr phong thp, thng kinh lc Tr phong, hnh thy, t thp nhit n trung ha v Gii c, iu ha cc v thuc
- Thng gp trong bnh l au nhc cc khp xng. - Nguyn nhn gm 3 loi t kh: Phong (hnh t), Hn (thng t), Thp (chc t). Nhit t (nhit t) nu c 3 t kh (Phong, Hn, Thp) phi hp. - Triu chng quan trng ca Hnh t: au nhiu khp, di chuyn, khng c nh. - Triu chng quan trng ca Thng t: au d di mt khp c nh, khng lan, tri lnh au tng, chm nng au. - Triu chng quan trng ca Chc t: au mt ch c nh, au c tnh cch tr nng xung, co rt li, t b. - Triu chng quan trng ca Nhit t: cc khp sng , nng, au, pht st. - Thuc tiu biu iu tr cho Hnh t: Phng phong thang gia gim. - Thuc tiu biu iu tr cho Thng t gm Qu chi, d, Can khng, Ph t ch, Xuyn khung, Thin nin kin, Ngu tt, Uy linh tin. - Thuc tiu biu iu tr cho Chc t: d nhn thang gia gim. - Thuc tiu biu iu tr cho Nhit t: Bch h qu chi thang.
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2.4. Ngoi t lc dm phm tng ph 2.4.1. Nhit kt Bng quang (thp nhit Bng quang) a/ Nguyn nhn gy bnh: do ngoi t (thp nhit t) ut kt Bng quang. b/Triu chng lm sng: tiu vng, tiu mu, tiu gt. ng thi thp nhit t cng lm n tr gy bng di trng y, mt tiu m tiu khng ht, tiu c. Thng gi chung l chng lm lu. c/ Bnh cnh Ty y thng gp: vim bng quang cp, nhim trng niu thp. d/ Php tr: thanh nhit t ha, li thy thng lm e/ Phng dc: cc bi thuc c s dng gm Bt chnh tn, Lc nht tn.
Bi thuc Bt chnh tn
C 2 bi Bt chnh tn vi xut x khc nhau, cng thc khc nhau v tc dng iu tr gn ging nhau. Bi c xut x t Y phng hi hi (Hi Thng Y Tng Tm lnh) c cng thc gm Bin sc, C mch, Hot thch, Sn chi, Xa tin c dng tr tiu gt do nhit. Bi thuc di y c xut x t Ho t cc phng.
Tc dng iu tr: thanh nhit t ha, li thy thng lm. Ch tr: vim
bng quang, i but, i rt, i ra mu. Cn ch khi dng ung chung vi nc ng tm.
+ Phn tch bi thuc: (Php thanh)
V thuc Mc thng Bin sc C mch Hot thch Xa tin t Sn chi i hong Cam tho Ngt, hn vo 2 kinh V, Bng quang. Thanh nhit, li tiu Ngt, hn, khng c. Li tiu thanh Can phong nhit, thm Bng quang thp kh ng, hn. Thanh nhit t ha, li tiu cm mu ng, hn. H v trng tch tr. T huyt phn thc nhit, h huyt, ph trng h Ngt, bnh. B T V, nhun Ph, thanh nhit gii c, iu ha cc v thuc Dc l ng y ng, hn. Ging Tm ha, thanh Ph nhit, li tiu, thng huyt mch ng, bnh, khng c. Li tiu, thng lm, st trng
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Tc dng iu tr: thanh nhit t ha, li tiu. Ch tr: st cao, tiu tin
sp, tm phin, ming kht. Mnh nng, th t i l ra mu mi, b i au but.
+ Phn tch bi thuc: (Php thanh)
V thuc Hot thch Cam tho Dc l ng y Ngt, hn vo 2 kinh V, Bng quang. Thanh nhit, li tiu Ngt, bnh. B T V, nhun Ph, thanh nhit gii c, iu ha cc v thuc
y dng
2.4.2. Can m thp nhit a/ Bnh nguyn: do thp t, nhit t xm phm n Can v m. b/ Bnh sinh: thp nhit xm phm, nung nu Can, m lm ri lon chc nng ca Can m sinh ra cc chng trng:
Hn nhit vng lai: lc nng lc lnh. Ri lon tiu ha, ri lon i tin do m tham gia vo vic lm chn
nh thc n.
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2.4.3. Phong hn thc Ph a/ Nguyn nhn: cm phong hn t qua con ng da lng mi hng. b/ Bnh sinh
Sch nm t tng ph bnh hnh cho rng khi phong t trng phn
trn c th: au u, c gy, lng, ton thn.
Ph ch kh, ch h hp, hn t nhp ph lm Ph kh bt tuyn: kh th. Ph khai khiu ra mi, hn t nhp Ph gy nght mi. Ph bin ng vi khi sinh ho. m l cht bnh l do t m dch ca Ph khi b bnh m thnh, cm
phi hn t th m long. c/ Triu chng
au u hoc u nng, au nhc lng v ton thn, au 2 b vai, au gy. Ru li mng. Mch ph khn (nhanh, hu lc, cng).
d/ Bnh cnh Ty y thng gp: tnh trng cm cm. Vim ng h hp trn do siu vi. Giai on khi pht mt tnh trng nhim trng ng h hp. Cn hen ph qun do lnh. 83
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e/ Php tr: s phong, tn hn, tuyn ph, ha m. f/ Phng dc: T t ging kh thang (Cc phng)
+ Phn tch bi thuc: (Php hn)
V thuc T t Sinh khng Nhc qu Hu phc Trn b Tin h ng qui Bn h ch Cam tho Dc l ng y Cay, m vo T Ph. Pht tn phong hn, kin V, ch nn, ha m, ch khi, l kh, an thai (ht: c Thn, gii c, st trng) Cay, hi nng vo Ph, T, V. Pht tn phong hn, n V, ch nn, ch t, ha m, ch khi, li thy (v) Cay, ngt, i nhit vo Can Thn. B mnh mn ha, kin T. Tr dng, cu nghch. ng, cay, m vo T V, i trng. Hnh kh ha m, tr nn, n trung to thp Cay, m, vo V Ph. Hnh kh, bnh V, ha m, to thp ng, cay, hi lnh, vo T Ph. Pht tn phong nhit, h m, ging kh Ngt, cay, m vo Tm, Can, T. Dng huyt, hot huyt Cay, m vo T, V. Hnh kh, ha m, to thp, ging nghch, ch nn, ch khi Ngt, bnh vo 12 kinh. B trung kh, ha hon, gii c
Hi ca Th tc Thiu dng v Dng duy c hiu khu phong, gii biu mch Khu phong phn trn c th Lc ca kinh Ph. Tuyn thng Ph kh Hi ca Kh Lc ca V. Huyt c hiu tr m Tr cm, au u au cng gy Cha chng kh th, ngt mi Tc dng ha (hn) m ti Ph
2.4.4. Phong nhit phm Ph a/ Bnh nguyn: cm phi phong nhit t qua ng da lng, mi hng. b/ Bnh sinh
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Ph ch h hp: ho. Ph dch v tn dch kh ro do nhit (hng kh, kht nc, to bn, tiu sn). m l sn vt bnh l ca Ph: do nhit sinh m vng. Nhit bc Ph lc (ho ra mu). c/ Triu chng lm sng
Ngi bt rt. St hoc cm gic nng. S gi. To bn, tiu sn. au hng, au ngc. Ho khc m vng dy. Ho ra mu. H hp ngn.
Ngc nng, tc ngc.
Giai on ton pht mt nhim trng ng h hp. Vim hng cp. Vim phi thy. Ph qun, Ph vim. Lao phi. Vim mng phi. Hen Ph qun.
e/ Php tr: s phong thanh nhit, tuyn Ph, ha m. f/ Phng dc: Tang cc m (n bnh iu bin).
+ Phn tch bi thuc: (Php hn)
V thuc Tang dip Bc h Cc hoa Lin kiu Hnh nhn Ct cnh L cn Cam tho Dc l ng y Ngt, ng, hn vo Can, Ph, Thn. Pht tn phong nhit, thanh Can, minh mc, thanh Ph ch khi Cay, mt, vo Ph, Can. Pht tn phong nhit Ngt, ng, tnh hi hn, vo Ph, Can, Thn. Pht tn phong nhit, thanh Can minh mc, ging ha, gii c ng, lnh, vo m, i trng, Tam tiu. Thanh nhit, gii c, tn kt, gii cm tr phong nhit ng, m vo Ph, i trng. Thng Ph, bnh suyn, nhun trng, thng tin, n Ph ng, cay, hi m vo Ph, kh m ch khi, tuyn Ph li hu hng, bi nung gii c Ngt, hn, vo Ph V. Thanh nhit, sinh tn, li niu, thanh Ph nhit, ch khi, thanh nhit, ch nn Ngt, bnh, vo 12 kinh. B trung kh, ha gii c
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2.4.5. To kh thng Ph a/ Bnh nguyn: cm nhim to t qua ng mi hng v da lng. b/ Bnh sinh: to t l dng t c tnh cht lm thng tn m dch ca Ph, do khi Ph m b thng tn th Ph kh cng b thng tn theo. Ngoi ra m dch b kh cn cng gy nn st, nng, nhng nu st nng khng u th gi l n to, cn ngc li mt lnh th gi l lng to.
Ming kh, kht nc. St hoc cm gic nng (n to). S lnh hoc s
gi (lng to).
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e/ Php tr: thanh Ph nhun to. f/ Phng dc: Thanh to cu ph thang (Y mn php lut)
+ Phn tch bi thuc: (Php thanh)
V thuc Nhn sm Tang dip T b dip Thch cao M en Mch mn A giao Hnh nhn Cam tho Dc l ng y Ngt, hi ng, m, vo Ph, T. i b nguyn kh, ch huyt, sinh tn Ngt, ng, hn, vo Can, Ph. Pht tn phong nhit, thanh Can, minh mc, thanh Ph, ch khi ng, bnh, vo Ph, V. Thanh Ph ch khi, thanh V ch nn Ngt, cay, hn, vo Ph, V, Tam tiu. Thanh nhit, ging ha, tr phin, ch kht Ngt, bnh, vo T, Ph, Can, Thn. Nhun h, li niu, ch nn Ngt, hi ng, hi lnh vo Ph, V, Tm. H st, nhun Ph sinh tn Ngt, bnh, vo Ph, Can, Thn. T m, dng huyt, b Ph nhun to, ch huyt an thai ng, bnh, vo Ph, i trng. Thng Ph, bnh suyn, nhun trng, thng tin, n Ph Ngt, bnh, vo 12 kinh. B trung kh, ha hon, gii c
2.4.6. Nhit kt i trng a/ Nguyn nhn: cm nhim hn t truyn bin theo lc kinh ti Dng minh i trng v ha nhit, to. b/ Bnh sinh: nhit t c tnh cht tn kh v hao tn dch do s nh hng n chc nng truyn tng ca ph i trng cng nh hao tn m dch ca ph i trng. Nhit ut kt th tit ra ngoi lm tu l m ra, v m hi (C thng lun). Ngoi ra, i trng l kinh a kh a huyt nn xut hin st cao v nhp huyt phn: hn m, ni sng. c/ Triu chng lm sng
Ni sng, mt , st cn, au bng, bng trng, khng a s nn To bn hoc nhit kt bng lu. m hi, tiu t, , mt , au u,
tay chn nng.
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2.4.7. Nhit bc i trng a/ Nguyn nhn: cm nhim nhit t qua ng n ung. b/ Bnh sinh: tnh cht nhit t l tn kh v tiu hao tn dch ca i trng. Ngoi ra cn biu hin ca nhit trn lm sng nh bng si, rut au, hn m, ni sng (th lon bo ch h bch - Ch chn yu lun). Nhit t lm ri lon chc nng truyn tng phn (tiu chy). i trng nhiu kh huyt, nn khi b nhit xm nhp s xut hin st cao, ni sng. c/ Triu chng lm sng
Ni sng, st, kht nc, au bng, rut si Tiu phn vng nt, hoc nhy nht, hu mn nng , mt , tay chn
nng, li , ru vng. d/ Bnh cnh Ty y thng gp: tt c nhng trng hp tiu chy nhim trng. e/ Php tr: thanh nhit, li thp, ch t. f/ Phng dc: Ct cn cm lin thang
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St cao, lnh run, phin kht au nhiu quanh rn, mt rn (l cp hu trng), bng trng, rut si,
trung tin mi hi, phn nhy nht, c dnh nh bt cua, hoc i ra phn ln nhy mu, hoc ra mu ti
Lm ging, nn ma, tiu t, ngn, , v m hi, tay chn nng, pht ban Li , ru vng, nhy nht. Mch t sc, vi t.
d/ Bnh cnh Ty y thng gp
2.4.9. i trng hn kt a/ Nguyn nhn: cm nhim hn t qua con ng n ung. b/ Bnh sinh: tnh cht ca hn l lm cho kh t li khin cng nng truyn tng phn ca i trng b ngng tr. Ngoi ra trn lm sng cn c nhng biu hin ca Hn kh nh mt trng, s lnh, tay chn mt, da bng mt v nc tiu trong, trng, nhiu. 90
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Bng au nhiu, khng a s nn, y trng Ming nht nho, mt trng, mi nht, tay chn mt To bn, li trng, t ru. Mch trm, huyn.
d/ Bnh cnh Ty y thng gp: nhng trng hp b i tin chc nng e/ Php tr: cng trc hn tch. f/ Phng dc: Tam vt b cp hon (Kim qu yu lc)
+ Phn tch bi thuc (Php h)
V thuc B u ch Can khng i hong Dc l ng y Cay, nhit, c, vo V, i trng. Thng tin do hn tch Cay, m vo Tm, Ph, V, T, Thn, i trng. n trung, tn hn ng, lnh vo T, V, i trng, Can, Tm bo. H tch tr trng v, t thc nhit huyt phn
2.4.10. Hn thp khn T a/ Nguyn nhn: cm nhim hn thp t qua ng mi, da lng hoc ng n ung. b/ Bnh sinh: ngoi tnh cht hn t lm dng kh t li, thp t lm tr tr hot ng ca kh a n ngn tr cng nng hot ng ca T V. Bnh cnh lm sng cn mang nhng c im ca thp nh tnh cht nng n, trn dnh, y trng bng, thng (ch thp thng mn). Hn c tnh cht nht nho, trong sut (ch bnh thy dch) hoc co rt m ti (ch hn thu dn). Do Hn thp gy nn
V kh tr tr: bng chng, nn nc trong. T khng vn ha thy cc: chn n, nht ming, si bng, tiu chy
nc trong. T ch huyt nn y nc ming nht dnh.
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T khng vn ha thy thp: tiu t, tay chn nng n. T quan h vi Tm ch thn minh: l m, bun ng.
c/ Triu chng lm sng
Bun ng, thng xuyn mun ng, thch ung nc nng, bun nn. Phn nho, tiu chy phn lng, tay chn nng n, au thng v, au d
dy, trng. bng, n km, lm ging.
T t Bch ch Ct cnh Bch linh Bch trut i phc b Hu phc Trn b Bn h ch Cam tho
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2.4.11. T V thp nhit a/ Nguyn nhn: cm nhim thp nhit t qua ng mi da lng hoc ng n ung. b/ Bnh sinh: ngoi tnh cht ca th (nhit) t l lm hao kh, tn hao tn dch v thp t lm tr tr hot ng ca kh a n ngn tr hot ng cng nng ca T, V v lm hao tn tn dch ca V. Bnh cnh lm sng cn mang nhng c im nh: bng cng to g ku nh trng, si rut thuc nhit (ch bnh hu thnh, ch phc trng i). Bt rt, pht cung thuc Ha (ch tho cung vit) (ch chn yu i lun). Mu vng l mu ca Th thuc nhit (ngh xung chi/744, Linh Khu). Bng trng y thuc thp. Th (nhit), thp lm cho T, V:
V kh tr tr: trng bng, si bng, nn ra nc ng c. T khng vn ha thy cc: chn n, ming ng, tiu chy. T khng vn ha thy thp: tiu t, tay chn nng n. Tn dch hao tn: kh kht m khng ung nhiu. T, V c lc ni vi Tm ch thn minh nn c triu chng bt rt,
pht cung. c/ Triu chng lm sng:
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b/ Bnh sinh: nhit (ha) t phm V lm tiu hao tn dch, kh kht, l ming, tiu sn. ng thi nhit t lm bc huyt (chy mu rng ming). V lc vi Tm (Thn minh) nn gy bt rt, cung sng. c/ Triu chng lm sng
Ming kh kht, mi nt n. D i si rut. Chn rng sng au, chy mu nu rng. Cm gic bng nng nh la, i tin b kt, tiu sn . Li , ru vng dy. Mch trm sc hu lc. Trong mt s trng hp nng, c th thy du bt rt, cung, sng.
d/ Bnh cnh Ty y thng gp:
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2.4.13. Nhit thp Tm bo a/ Bnh nguyn: ngoi t n bnh: Phong, Nhit, Th, To xm nhp vo n phn dinh. V tr bnh l Tm v Tm bo. b/ Bnh sinh: Tm bo lc thuc Quyt m phong mc, c quan h biu l vi Thiu dng Tam tiu (Tng ha). Tm bo li l ngoi v ca Tm, bo v cho Thiu m qun ha. Do , d ngoi t l loi g, khi vo n Quyt m gy bnh th hi chng ca n s biu hin mang thuc tnh ca Phong, ca Ha. Chng trng ch yu gm
Ri lon chc nng Tm bo, Tm: hn m, ni sng. Triu chng mang tnh cht Ha nhit: st cao, mt nc. Triu chng mang tnh cht ca Phong: co git.
c/ Triu chng lm sng
Dng m thanh nhit.. Thanh Tm khai khiu. Thanh nhit lng huyt khai khiu.
f/ Phng dc: Thanh n bi c m (Dch chn nht c).
+ Phn tch bi thuc (B - thanh)
V thuc T gic Sinh a Xch thc Thch cao Tri mu Hong cm Hong lin Dc l ng y ng, mn, lnh. Thanh Tm, gii c Ngt, ng, lnh. B Thn, thanh nhit, lng huyt ng, lnh. Thanh nhit, lng huyt Ngt, cay, lnh. Thanh nhit t ha, Tr phin ch kht ng, lnh. Thanh nhit, ging ha ng, lnh. Thanh nhit, to thp ng, lnh. Thanh tm nhit, gii c
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V thuc Chi t an b Lin kiu Huyn sm Trc dip Ct cnh Cam tho
Dc l ng y ng, lnh. Thanh nhit, ging ha, thanh huyt nhit Ngt, ng, lnh. Thanh nhit, lng huyt, hot huyt ng, lnh. Thanh nhit, gii c ng, mn, lnh. Thanh nhit, lng huyt, gii c Ngt, lnh. Thanh Tm ha, li tiu, tr phin Ngt, ng, cay, bnh. Thng kh Ph, tiu m, dn thuc ln Ngt, bnh. iu ha v dn thuc
Phng thuc ny chnh l hp bi Bch h thang, T gic a hong thang, Hong lin gii c thang ri gia gim m thnh. Trong phng c Thch cao, Tri mu thanh i nhit phn kh, bo v tn dch. Hong cm, Hong lin, Chi t t ha nhit Tam tiu. T gic, Sinh a, Xch thc, an b thanh nhit gii c lng huyt tn t. Lin kiu, Huyn sm gii cc ha ph du. Trc dip, Ct cnh a thuc i ln. Cam tho iu ha cc v thuc. C th s dng bi An cung ngu hong hon (n bnh iu bin) gm T gic, X hng, Ngu hong, Bng phin, Hong cm, Hng hong, Hong lin, Chu sa, Ut kim, Chi t.
+ Cng thc huyt c th s dng
Tn huyt Tam m giao i chy C s l lun Giao hi huyt ca 3 kinh m/chn Hi ca mch c v 6 dng kinh, ch biu. Mnh nng, m hi t ra (t) S lnh, khng c m hi (b) Phi hp Khc tr, i chy, Thp tuyn, Hp cc l kinh nghim tr st cao Kinh Kim huyt/Thn iu ha v s thng huyn ph (l chn lng) Bch hi Thanh thn ch, tit nhit Tc dng iu tr T m Thanh nhit
Thanh nhit
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3. PH LC
Trong bnh hc ng y, c nhng bnh chng m nguyn nhn c th l ngoi nhn, cng c th l nhng nguyn nhn khc hoc c hai. C trng hp rt kh xc nh nguyn nhn (nhng trng hp co git, ng kinh m khi ln cn khng th xc nh c do ni hay ngoi phong). Phn ph lc ny s cp n nhng trng hp c bit ni trn. 3.1. V tht ha ging a/ Nguyn nhn v bnh sinh
Trng thc Tiu chy cp Trong bnh cnh tng ur mu. m nghn. d/ Php tr:
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3.2. V m h a/ Nguyn nhn Bnh n nhit lm tn thng m dch ca V. Nhng trng hp m h lu ngy sinh ni nhit lm tn thng m dch. b/ Triu chng lm sng:
Mi ming kh. Nng. n ung km. Thch ung. khan, nc cc. i tin phn kh cng. Tiu tin ngn t. Li kh . Mch t sc.
c/ Bnh cnh Ty y thng gp Vim d dy. Sau nhng bnh c st cao ko di.
i tho ng.
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d/ Php tr: dng V sinh tn. e/ Phng: Tng dch thang. (Thng hn lun)
+ Phn tch bi thuc
V thuc Huyn sm Sinh a Mch mn Thin hoa phn Hong lin Dc l ng y Mn, hi ng, hn vo Ph, V, Thn. Thanh nhit, lng huyt, t ha, gii c, sinh tn dch, tn kt Ngt, ng, hn vo Tm, Can, Tiu trng, Thn. Thanh nhit, lng huyt, dng m, sinh tn Ngt, hi ng, hi lnh. Vo Ph, V. Nhun Ph, sinh tn, li niu Ngt, chua, hn vo Ph, V, i trng. Sinh tn ch khi, ging ha, nhun to, bi nung, tiu thng ng, hn vo Tm, Can, m, i trng, V. Thanh nhit, to thp , thanh Tm
nu to bn th gia i hong
+ Cng thc huyt s dng
Tn huyt Tam m giao Xung dng Cng tn Khc tr Hp cc Tc tam l Thin khu Chi cu C s l lun Giao hi huyt ca 3 kinh m chn. Huyt c hiu b m Nguyn ca V Lc ca T Phi hp Khc tr, i chy, Hp cc l kinh nghim tr cm st Hp th huyt ca V M huyt ca i trng Kinh ha huyt ca Tam tiu. C tc dng tn kt, thng trng v Tc dng iu tr T m Dng V m Thanh nhit, h st
3.3. i trng h hn a/ Bnh nguyn: cm nhim hn t trn c a T, Thn dng h. b/ Bnh sinh
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ging trc, do chc nng truyn tng phn ca i trng cng s b nh hng, biu hin l i tiu phn lng, c thng xuyn.
Ngi nng n, mt mi, mt trng, s lnh, chn tay mt lnh. Tiu chy ra nc v phn xanh nh ct vt. n ung km, li dom, tiu trong di, au lng. Li nht, ru mng. Mch trm, tr, t.
d/ Bnh cnh Ty y thng gp
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- V tht ha ging c th do ngoi t (Thp t) v thng thc - Triu chng quan trng ca V tht ha ging: , a ma, au cng tc thng v. - Thuc tiu biu iu tr V tht ha ging: Bnh v tn, Bo ha hon. - V m h c th do ngoi t (n nhit t) v bi bnh m h lu ngy - Triu chng quan trng ca V m h: to bn, mi ming kh. - Thuc tiu biu iu tr V m h: Tng dch thang. - i trng h hn c th do ngoi t (hn t) trn c a T, Thn dng h - Triu chng quan trng ca i trng h hn: tiu phn nt ko di. Suy nhc - Thuc tiu biu iu tr i trng h hn: Chn v thang.
CU HI N TP
CU HI 5 CHN 1 - CHN CU NG
1. Nguyn nhn ca HC Hn thp khn T A. Cm nhim hn thp t B. Hn t truyn bin n Thi m T C. Bnh lu ngy ca T D. T kh h mt kin vn E. T dng h 2. Php tr thch hp cho HC Hn thp khn T A. Khu phong, tn hn, tr thp B. Tn hn, tr thp C. Tn hn, ha thp, kin T D. n trung, sp trng, ch t E. Tn hn, tr thp, gii biu 3. Nguyn nhn T V thp nhit A. Nhit t truyn n Thi m T B. Nhit lu ngy T V 102
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C. Cm nhim thp nhit t D. V m h E. Tm m h 4. Nhng triu chng ca HC T V thp nhit A. au thng v lan hng sn, st, tiu chy B. St, tiu chy, phn te vng, mch sc, hu lc C. au thng v, bun nn, lm ging, ru trng dy nht D. au thng v, bun ng, tay chn nng n E. Bng trng, st, kht m khng ung, bt rt, tay chn nng n 5. Php tr no sau y ph hp vi HC T V thp nhit A. Kin T li thp B. Dng V sinh tn C. Thanh nhit li thp D. Kin T ch t E. Kin T ha V 6. Nguyn nhn ca HC V tht ha ging A. Hn t B. Nhit t C. Phong t D. Thp t E. Th t 7. Nhng triu chng ca HC V tht ha ging A. au thng v, nn ma, mch huyn B. au thng v, nn ma, tiu khi to khi lng C. au thng v, nn ma, au hng sn D. au thng v, nn ma, bng y chng E. au thng v, nn ma, cu to 8. Nguyn nhn ca HC V m h A. Nhit t B. Thp t C. St ko di lm hi m D. Ni nhn E. Bnh lu ngy V 103
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9. Nhng triu chng gp trong HC V m h A. Mi kh, ming kht, n km, au thng v, ming hi B. Mi kh, ming kht, n km, phn kh, khan, mch t sc C. Mi kh, ming kht, n km, au thng v, si bng D. Mi kh, ming kht, n km, si bng, mch khn E. Mi kh, ming kht, n km, minh hi, si bng 10. Nguyn nhn ca HC V nhit ng thnh A. n t B. Nhit t C. Thp nhit t D. V m h E. n nhiu cht cay nng 11. Nhng triu chng ca HC V nhit ng thnh A. Ming kh, kht nc, cu to, tiu sn, mi li , rong kinh, rong huyt B. Ming kh, kht nc, cu to, tiu sn, o hn, mch trm sc v lc C. Ming kh, kht nc, cu to, tiu sn, chn rng sng au chy mu D. Ming kh, kht nc, cu to, tiu sn, o hn, hai g m E. Ming kh, kht nc, cu to, tiu sn, st v chiu, o hn 12. Php tr thch hp cho HC V nhit ng thnh A. Dng v sinh tn B. Thanh V nhun to C. T m thanh nhit D. Thanh V lng huyt E. Thanh V t ha
CU HI NHN QU
1. a. Trong HC Hn thp khn T, c triu chng bng y chng bi v b. Tnh cht ca hn thp t l lm cho kh ca V b tr tr A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai
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D. Nu a sai, b ng E. Nu a sai, b sai 2. Trong bi Hoc hng chnh kh tn gm Hoc hng, Bch trut, Phc linh, T t, Bch ch, Trn b, Hu phc, i phc b, Bn h ch, Ct cnh, Cam tho. a. T t lm thn bi v b. T t c tc dng l kh ha thp A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 3.a. Trong bi thuc Ct cn cm lin thang tr HC T, V thp nhit gm Ct cn, Hong lin, Hong cm, Nhn trn, Cam tho bc. V Ct cn lm thn bi v: b. Ct cn ngt cay thanh nhit T v li cn sinh tn, ch khi tr phin A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 4.a. Trong HC V tht ha ging, c triu chng au thng v lan ra hng sn, bi v: b. V mt chc nng ho ging nn Can mc tng tha A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 5.a. Trong bi Bo ho hon gm Sn tra, Thn khc, Trn b, Bn h ch, Phc linh, Lin kiu, La bc t dng trong V tht ha ging. Hai v Sn tra, Thn khc cng lm qun l bi v: b. C hai u c tc dng tiu thc tch
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A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 6.a. Trong HC V m h, c triu chng cu phn kh bi v b. Trong V m h V kh bt ging A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 7.a. Trong HC V nhit ng thnh, c triu chng hn m ni nhm bi v: b. Kinh V l kinh a huyt a kh, nay nhit phm vo huyt phn m gy ra A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 8. Trong phng huyt cha chng Hn thp khn T gm Cng tn, Kh hi, Thi bch, Phong long a. Chm b huyt Thi bch theo nguyn tc s dng ng du huyt; bi v: b. Thi bch l nguyn huyt ca kinh T A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 9.a. Trong phng huyt cha chng V tht ha ging gm Tc tam l, Phong long, Trung qun. Chm t Tc tam l; bi v: b. Chm t Tc tam l c tc dng ging trc kh, thng dng kh
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A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 10.a. Trong phng huyt cha chng V m h gm Xung dng, Cng tn, Trung qun, Tc tam l, Tam m giao. Chm b Xung dng; bi v: b. Xung dng l m huyt ca V, dng theo nguyn tc du m A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai
P N
CU HI 5 CHN 1 - CHN CU NG
STT 1 2 3 4 5 6 p n A C C E C D Stt 7 8 9 10 11 12 p n B A B A C D
CU HI NHN QU
STT 1 2 3 4 5 p n A C D E A STT 6 7 8 9 10 p n B B B A C
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Chng II
BNH HC PH - I TRNG
MC TIU
Sau khi hc tp, sinh vin PHI 1. Gii thch c c s l lun ca cc hi chng Ph m h, T Ph Thn kh h (t nguyn nhn n c ch sinh bnh v triu chng). 2. Nu c php tr ca nhng hi chng ni trn 3. Nu c y thnh phn ca 2 bi thuc Nht m tin, Sm linh bch trut tn gia gim. 4. Gii thch c cch cu to (tc dng v vai tr tng v) ca nhng bi thuc ni trn theo dc l ng y. 5. Nu y v gii thch c cch cu to ca nhng phng huyt iu tr thch hp cho nhng hi chng ni trn.
Bnh hc v iu tr bnh tng Ph v ph i trng l phn khi u ca chng th 2 ca quyn Bnh hc v iu tr. Chng ny cp n nhng bnh tt c cc tng ph gy bi ni nhn (ri lon tnh ch), hoc bi nhng nguyn nhn khc nh n ung (m thc), lao nhc, phng dc, bnh ni thng lu ngy... Trong chng ny hon ton khng cp n nhng bnh do ngoi nhn.
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+ Tnh cht ca ao h tuy phng lng nhng cng rt d dao ng khi c ngn gi thi qua. Do , tnh cht ca Ph cng d b tc ng bi cc nhn t bn ngoi, nn ngi xa cho rng Ph l mt tng rt non nt Ph vi kiu tng, rt d cm nhim ngoi t. + Tnh cht ca ao h l em li s ti mt iu ha s hanh kh v em li s m p i ph vi ci lnh lo ca kh hu. Do chc nng ca tng Ph l iu ha cho bn trong nhn th. Sch T Vn chng Linh lan b in ghi: Ph gi tng ph chi quan, tr tit xut yn. ni, Ph nh l mt ngi ph t cho Vua lm cng vic iu tit. + Nc h l d tr ca t i ph vi kh hn ca thi tit. C ngha l ao h lun lun to c s m thp cho t th mi i ph c vi s kh hn ca thi tit. y, ni n mi lin h gia Ph (Qu oi tng cho ao h) v T (Qu Khn tng cho t).
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3. Ph c chc nng iu ha cc tng ph khc, nh mt ngi tng ph gip Vua. Thin Linh lan b in lun vit: Ph gi tng ph chi quan, tr tit xut yn. 4. Ph c chc nng thng iu thy o, m Ph l thng ngun, Ph ch thng iu thy o. Ph vi thy chi thng nguyn . 5. Nhng vng c th v yu t tinh thn, tm l c lin quan n tng Ph
Mi: Kim qu chn ngn lun/T Vn vit: Khai khiu t, tng tinh
Ph. Linh khu mch thin: Ph kh thng vu t, Ph ha tc t nng tri hng x h. ni tinh thn v kh ca Ph m y th mi s nhn bit c mi thm thi.
Hn: Loi kinh tng/Tng tng loi, quyn 3: Hn chi vi dng, nng
ng tc, thng dng do chi nghi gic gi. ni Ph tng hn, m tnh ca hn l nng ng. Mi cm gic au hay nga cng u tri gic c. 6. Chc nng ca i trng l tng cht cn b ra ngoi. Linh lan b in lun/T Vn: i trng gi tin o chi quan, bin ha xut yn. L Din ch gii: Thc n trong V ngu nt, t ming di ca V truyn xung Tiu trng, Tiu trng phn bit ra thanh trc, cht nc vo ming trn ca Bng quang, cn b vo ming trn ca i trng, i trng tng cht cn b ra ngoi. 1.3. Mi tng quan vi cc tng ph khc
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Sau cng l mi lin quan gia Ph v Tm theo chiu tng khc (Tm
ha khc Ph kim). Do , Tm ha vng cng l nguyn nhn khi huyt. Ngoi ra, Tm ch huyt v Ph ch kh, kh hnh th huyt hnh, kh n th huyt n, khi khng th huyt khng c sinh ra. Huyt h th kh cng h.
2. NHNG HI CHNG BNH PH - I TRNG 2.1. Bnh ti Ph 2.1.1. Ph m h 2.1.1.1. Nguyn nhn
Sinh nhit: g m , phin nhit. H ha lm bc huyt: du xut huyt (ho ra mu) Ph dch gim: ho khan, kh kht. Ph kh suy gim: kh th, on hi.
2.1.1.4. Triu chng lm sng
Ho khan, ho c m hoc mu, c hng kh, ngc nng, ming kh, kht
nc. H hp ngn, ni kh, ting ni th rp. 111
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o hn, to bn. Nc tiu sm mu (vng hoc c), tiu sn. Li kh , ru trng kh. Mch nhanh nh, t sc, v lc.
2.1.1.4. Bnh cnh Ty y thng gp
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PH M H
- Chc nng ch yu b ri lon l chc nng ch kh ca Ph - Triu chng quan trng ca Ph m h: st v chiu, hai g m , hng kh, ho khan, hoc m dnh - Thuc tiu biu trong iu tr bnh chng Ph m h: nht m tin gia gim
Tng kh gim st: on kh, thiu kh nh hng n chc nng ch huyt ca Tm: sc mt trng bch, li nht. nh hng n chc nng cng c V biu: d b cm, t hn.
2.1.2.3. Triu chng lm sng
Ho khng c sc, ting ho yu nh. on kh, thiu kh. Sc mt trng bch. T hn. Cht li nht bu. Mch h nhc.
2.1.2.4. Bnh cnh Ty y thng gp
Lao phi. Hen ph qun mn Suy tim Bnh phi tc nghn mn Suy h hp mn
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2.1.2.5. Php tr B ch Ph kh 2.1.2.6. Phng dc Bo nguyn thang (Bc i tm gim B) Bi ny xut x t bi T qun nhng b Bch trut, Bch linh gia thm Hong k, Qu nhc, tng lng Nhn sm b kh n dng.
+ Phn tch bi thuc: (Php b)
V thuc Nhn sm Hong k Qu nhc Cam tho bc Dc l ng y V ngt ng hi m, qui kinh Ph, T, i b nguyn kh, ch tr T, Ph kh h nhc V ngt m, qui kinh Ph, T, V; b kh thng dng V cay ngt, qui kinh T Thn Tm Can; n kh huyt, n b dng kh V ngt bnh, qui kinh T V Ph Tm c tc dng b trung ch kh, iu ho tnh v ca Qu nhc
PH KH H
- Chc nng ch yu b ri lon l chc nng ch b mao (Ph v) v chc nng ch kh ca Ph - Triu chng quan trng ca Ph kh h: on kh, thiu sc, d b cm - Thuc tiu biu trong iu tr bnh chng Ph kh h: Bo nguyn thang
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2.2. Bnh ca ph do mi quan h tng sinh - tng khc 2.2.1. Ph Thn m h 2.2.1.1. Nguyn nhn
Khin Thn tinh bt c: di tinh nh hng chc nng ch ct ty: au lng, au nhc trong xng.
2.2.1.3. Triu chng lm sng
Ho khan, hoc ho c m t, dnh, kh khc Hng kh, nga. au lng, di tinh, au nhc trong xng, tiu t. Cht li . Mch t sc.
2.2.1.4. Bnh cnh Ty y thng gp
Lao phi.
2.2.1.5. Php tr B Ph, Thn m. 2.2.1.6. Phng dc
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PH THN M H
- Chc nng ch yu b ri lon l chc nng ch kh ca Ph, chc nng np kh, chc nng tng tinh v chc nng ch ct ty ca Thn - Triu chng quan trng ca Ph, Thn m h: ho, m dnh, au nhc khp xng, du suy nhc. - Thuc tiu biu trong iu tr bnh chng Ph, Thn m h: Bt tin thang
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2.2.2. T Ph Thn kh h 2.2.2.1. Nguyn nhn Do bnh ni thng ca mt trong 3 tng (T, Ph, Thn) u c th a n T, Ph, Thn kh h theo con ng Mu bnh cp t hoc T t mu kh. 2.2.2.2. Bnh sinh Ph kh suy h
Ph kh h (dng h): s lnh. Khng thng iu c thy o, m Ph l thng ngun nn thy thp
nh ng pha trn gy ph mt. T kh suy h
Tay chn lnh, au vng tht lng, au mi 2 gi. Li trong, mch ph nhc, v lc.
2.2.2.4. Bnh cnh Ty y thng gp
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T PH THN KH H
- Chc nng ch yu b ri lon l chc nng ch kh ca Ph, chc nng vn ha thy thp ca T, chc nng np kh, chc nng tng tinh ca Thn - Triu chng quan trng ca T, Ph, Thn kh h: th ngn, thiu sc, s lnh. - Thuc tiu biu trong iu tr bnh chng T, Ph, Thn kh h: Sm linh Bch trut tn
- Bnh ca chnh Ph: + Ph m h + Ph kh h - Bnh ca T, V trong mi quan h ng hnh: + Ph, Thn m h + T, Ph, Thn kh h
CU HI N TP
A. CU HI 5 CHN 1 - CHN CU NG 1. Bi Nht m tin gm A. Sinh a, Mch mn, a ct b, Tri mu, Bch thc, Cam tho. B. Sinh a, Huyn sm, a ct b, Tri mu, Bch thc, Thc a, Cam tho bc. C. Sinh a, Thin mn, Mch mn, Trn b, Hoi sn, Ch xc. D. Sinh a, Mch mn, a ct b, Tri mu, Hoi sn, Thc a, Cam tho bc. E. Sinh a, Mch mn, Huyn sm, Bch thc, Tri mu, Bi mu, A giao. 2. Phng huyt thch hp nht cho th Ph m h A. Quan nguyn, Kh hi, Ph du, Cch du. B. n trung, T du, Ph du, Thn du. 119
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C. Tc tam l, Hp cc, Quan nguyn, Thn du. D. Thi uyn, Thin lch, Ph du, Tam m giao v nhm B Thn m. E. Thi uyn, Thi xung, Tam m giao, n trung. 3. Nguyn nhn ca HC Ph m h A. Do Thn m h a n B. Do Can m h C. Do Tm m h D. Do V m h E. Do nhit t 4. Triu chng ca Ph m h A. Ho m hoc mu, h hp ngn, ho mnh n o B. Ho m hoc mu, h hp ngn, hai g m C. Ho m hoc mu, h hp ngn, t hn D. Ho m hoc mu, h hp ngn, au ngc khi th E. Ho m hoc mu, h hp ngn, nght mi 5. Triu chng ht vo ngn, th ra di trong HC T Ph Thn kh h l do: A. T kh h B. Thn kh h C. Ph kh h D. Ph v Thn kh h E. T v Ph kh h 6. Php tr thch hp cho HC T, Ph, Thn kh h A. B Thn c tinh, kin T l kh B. Kin T ch kh - C thn np kh C. n b Thn, kin t D. B Thn c tinh, Kin t b ph E. n b T ph thn B. CU HI NHN QU 1-a- Trong HC Ph m h c triu chng st hoc c cm gic nng bi v: b- m h sinh ni nhit
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A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 2- Trong bi Nht m tin gia gim gm c Sinh a, Mch mn, a ct b, Bch thc, Tri mu, Cam tho dng tr chng Ph m h. a- Mch mn vi qun bi v: b- C tc dng nhun Ph m, sinh tn dch A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 3-a- Trong HC T Ph Thn kh h c triu chng ng canh t, bi v: b- Trong HC ny c HC Thn kh h A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 4-a- Trong bi Sm linh bch trut gia gim tr T, Ph, Thn kh suy gm Bch bin u, Bch trut, Ht sen, d, i to, Nhn sm, Bch linh, Hoi sn, Ct cnh, Sa nhn, Cam tho. V Ct cnh lm s bi v: b- V Ct cnh tuyn Ph ha m A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 5-a. Trong hi chng Ph m h c kh th, on kh bi v: b. Ph m h lu ngy a n Ph kh h. 121
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A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 6- a. Trong hi chng T, Ph, Thn kh h, cu b Thi kh bi v: b. B Thi kh b T th sinh Ph kim. A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 7- Trong phng huyt cha chng Ph m h gm Thi uyn, Thin lch, Ph du, Tam m giao. a- Cu Tam m giao bi v: b- y l huyt hi ca kinh m t dng m dch cho Ph A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 8- Trong phng huyt cha chng T Ph Thn kh h gm Thn du, T du, Thi uyn, Thin lch, Ph du, n trung, Kh hi, Quan nguyn, Tc tam l, Thi bch, Phong long, i , Thiu ph a- B huyt n trung, Kh hi bi v: b- n trung ch v b tng kh, kh hi ch v b nguyn kh A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai
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P N
CU HI 5 CHN 1 - CHN CU NG
STT 1 2 3 p n A D A STT 4 5 6 p n B B B
CU HI NHN QU
STT 1 2 3 p n A A D STT 4 5 6 p n D A E STT 7 8 p n D A
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Bi 6
BNH HC T - V
MC TIU
Sau khi hc xong bi ny, sinh vin PHI 1. Gii thch c c s l lun ca cc hi chng (t nguyn nhn n c ch sinh bnh v triu chng)
T kh h bt kin vn. T kh h h hm. T kh h bt thng nhip huyt. T dng h Can T bt ho. T Thn dng h
2. Nu c php tr ca 6 hi chng ni trn. 3. Nu c thnh phn dc liu ca cc bi thuc:
T qun gia Tr linh, Trch t. B trung ch kh. T qun gia C mc, Trc bch dip sao en. Tiu dao gia Ut kim. Ph t l trung. Hu quy m
4. Gii thch c cu to (tc dng, vai tr ca tng v) ca nhng bi thuc ni trn. 5. Nu c cng thc huyt iu tr cho 6 hi chng ni trn. 6. Gii thch c cch cu to (tc dng ca huyt) ca cng thc huyt trn da theo cch vn dng du, m, nguyn, lc v ng du huyt.
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1. I CNG 1.1. Da trn c s hu thin bt qui Theo Y hc c truyn ng phng, tng T ng vi qu Khn. Qu Khn c tng l t. Vn vt u c t nui dng, do T cng c chc nng nui dng cc tng ph, kh quan khc trong nhn th. Y hc c truyn ng phng cho rng ph V ng vi qu Cn v c gii thch nh sau
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+ Thin m dng ng tng i lun, T Vn: T ch c nhc, t chi. Ng Thng Sinh Thnh thin v Lc tit tng tng lun, T Vn vit rng: T chi hp nhc gi, k vinh thn gi. T V k ba ti thn t bch. ni T, V cng vi c nhc biu l s vinh nhun tt p ra i mi. + Tuyn minh ng kh thin, T Vn: Ng tng s tng, T tng , T khai khiu ming. T kh thng ra ming. T ha t ming s nm bit c ng v. Kim qu chn ngn lun, T Vn v Mch thin, Linh khu cng ni nh vy. + Tuyn minh ng kh, T Vn vit: Ng tng s , T thp.
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2. NHNG HI CHNG BNH T V Nhng hi chng bnh ca T -V phn tch trong bi ny ch gm nhng bnh gy bi ni nhn (ri lon tnh ch), hoc bi nhng nguyn nhn khc nh n ung (m thc), lao nhc, phng dc, bnh ni thng lu ngy. 2.1. T kh h - T bt kin vn 2.1.1. Nguyn nhn
Khng vn hnh tn dch cho V, gy y tc bng, nn ma. Khng vn ha thy cc thnh dinh kh dn n bp tht teo nho, on
kh, thiu kh.
Mt mi, mt ngon ming, s lnh, sc mt vng ti. au vng thng v, i tiu nhiu ln trong ngy. Bun nn, nn ma.
n km vi y tc bng, si rut.
Huyt trng, tay chn nng n, gy rc, ph thng. H hp ngn, ni yu. Ru trng, li nht, bu. Mch tm tr, v lc, nhc.
2.1.4. Bnh cnh Ty y thng gp
Vim gan mn tn ti hoc tin trin, x gan c chng. Vim thn mn. Vim d dy t trng mn. Cc hi chng km hp thu (sprue tropical). Tiu chy do tiu ng.
Thiu men lactase. 2.1.5. Php tr Kin T li thp. 128
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2.1.6. Phng dc
Kh hi
B sinh ra kh. B huyt ny gip ch c cho chn tng vn hi c sinh kh, n h nguyn, chn c Thn dng Kinh nghim phi hp cc huyt bn (Chm cu t sinh kinh) tr au bng, n ung km M huyt ca V
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T KH H - T BT KIN VN
- Chc nng ch yu b ri lon l chc nng vn ha ca T - Ch chng (triu chng quan trng): n km vi y tc bng, on hi, ni yu, mch tm tr, v lc, nhc. - Thuc tiu biu trong iu tr bnh chng T kh h -T bt kin vn: T qun t thang gia Tr linh, Trch t
Thng kh khng cn dn n kh tr: tng ph sa dn. Thng thanh khng cn, thanh trc ln ln: tiu chy, tiu phn sng.
2.2.3. Triu chng lm sng
Sa t cung. Sa trc trng. Thch ung nc nng. Tay chn lnh, huyt trng trong lng. H hp ngn, ting ni yu. Li bu, ru li trng t, nht. Mch tr, nhu v lc, nhc.
2.2.4. Bnh cnh Ty y thng gp
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Kh hi
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T KH H H HM
- Chc nng ch yu b ri lon l chc nng thng ca T - Ch chng (triu chng quan trng): ri lon tiu ha. i cu phn sng. Sa trc trng. - Thuc tiu biu trong iu tr bnh chng T kh h h hm: b trung ch kh
Mt mi, mt ngon ming, kht nc. Sc mt nht, vng. Bun nn, i mu, sm mu. i tiu phn c mu, phn nho. Tiu mu, rong kinh, tay chn lnh, chy mu mi. Xut huyt di da. Li nht, mch trm.
2.3.4. Bnh cnh Ty y thng gp
Vim i trng chy mu. Cc ri lon v ng mu. X gan. Biu hin tiu ha ca hi chng tng ur huyt.
2.3.5. Php tr Kin T nhip huyt.
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2.3.6. Phng dc
Kh hi
Thi uyn
Hi ca mch.
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Cng nng ca T, V suy gim Km theo triu chng hn (dng h y ngoi hn): s lnh, tay chn
lnh, au bng, tiu chy khi gp phi lnh, gim khi chm nng. 2.4.3. Triu chng lm sng
Mt mi, mt ngon ming, s lnh hoc s gi. au gim vi sc nng, au thng v khi gp lnh. Thch ung nc
nng, tay chn nng, tay chn lnh, h hp ngn.
Hi chng km hp thu, hay tiu chy mn do ct d dy Vim d dy mn, vim ty mn, thiu men tiu ha rut Sprue, Whipple.
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Quan nguyn
Kh hi
T DNG H
- Trong bnh cnh T dng h c 2 nhm biu hin: nhm do ri lon nhng chc nng ca T v nhm hn chng. - Ch chng (triu chng quan trng): s lnh. Triu chng tng khi gp lnh. Ri lon tiu ha. - Thuc tiu biu trong iu tr bnh chng T dng h: Ph t l trung thang
Bc dc, bt rt. Gt gng, hay th di. au hng sn. y bng, chua, au thng v.
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Tiu dao tn gia Ut kim (Cc phng). Phn tch bi thuc: (Php b)
V thuc Si h Bch thc Ut kim ng qui Bch trut Bch linh Cam tho Dc l ng y ng, hn, vo Can, m, Tm bo, Tam tiu. T nhit, gii c, thng ng, chua, lnh, vo Can, T, Ph. Dng huyt, li thy, lim m Cay, ng, n vo T, Can. Hnh huyt, ph , hnh kh gii ut Ngt, cay, m vo Tm, Can, T. Dng huyt, hot huyt Ngt, ng, m vo T V. Kin T, to thp, ch hn, an thn Ngt, nht, bnh, vo Tm, T, Ph, Thn. Li niu thm thp, kin T, an thn Ngt, bnh, vo 12 kinh. B trung kh, ho hon, gii c
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CAN V BT HA
- Bnh chng Can, V bt ha lin quan cht ch vi yu t tnh ch - Ch chng (triu chng quan trng): bc dc, cu gt. Ri lon tiu ha. Mch huyn - Thuc tiu biu trong iu tr bnh chng Can, V bt ha: Tiu dao tn + Ut kim
2.6. T Thn dng h 2.6.1. Nguyn nhn v bnh sinh Ngun gc bnh l Thn dng h, Thn kh bt tc. Do nguyn nhn bnh bao gm tt c nhng nguyn nhn gy nn Thn kh bt tc, Thn dng h.
Dng h: tay chn lnh, s lnh, mt mi. Ti Thn: ng canh t, di tinh, lit dng, hot tinh, lnh cm. Ti T: tiu chy, cu phn sng, ri lon tiu ha.
2.6.2. Triu chng lm sng
Ngi mt mi, chng mt, tai , mt km. Thng ku au mi tht lng. S lnh, tay chn lnh, m hi t ra. Thng ku au bng, lnh bng,
bng trng, tiu ha ri lon, d tiu chy, ng canh t. Chm m thy d chu.
Tiu nhiu ln, tiu trong, tiu khng t ch. Di tinh, hot tinh, lit dng, v kinh. Li bu, ru li trng mng. Mch trm v lc.
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Suy nhc c th Ri lon tiu ha mn tnh Vim i trng mn Vim thn mn.
2.6.4. Php tr n b T Thn 2.6.5. Phng dc
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Cnh Nhc ton th tr T, Thn h hn, a chy lc gn sng gm Mc hng, Ph c ch, Nhc u khu, i to. Bi th 3 c xut x t Thm Th tn sinh dng tr sn kh do hn, thin try (thot v bn). Bi th 4 c xut x t Huyt chng nhn dng n b T Thn tr chng Thn t. Bi th 5 c xut x t C kim y thng tr tiu vt, tiu khng t ch do h yu. Bi thuc di y c xut x t Ni khoa trch yu (theo Chng tr chun thng). Tc dng iu tr: n Thn m T. Ch tr: c trng ch t (ng canh t).
Quan nguyn
Kh hi
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T THN DNG H
- Bnh chng T, Thn dng d c ngun gc bnh t Thn dng h - Ch chng (triu chng quan trng): s lnh. Ri lon tiu ha. Ng canh t. - Thuc tiu biu trong iu tr bnh chng T, Thn dng h: Hu quy m hoc T thn hon
- Bnh ca chnh T, V: + T kh h T bt kin vn + T kh h h hm + T kh h bt thng nhip huyt + T dng h - Bnh ca T, V trong mi quan h ng hnh: + T, Thn dng h + Can, V bt ha
CU HI N TP
A. CU HI 5 CHN 1. CHN CU NG NHT 1. Nguyn nhn ca T kh h A. Do thp t B. Do ngoi t truyn bin n Thi m T C. n ung khng iu D. Do hn t E. Do trng thc 2. Nhng triu chng ca T kh h bt kin vn A. Chn n, mt mi, tiu chy nhiu ln, mt vng ti, s lnh 140
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B. Chn n, mt mi, tiu chy nhiu ln, au thng v, s lnh C. Chn n, mt mi, tiu chy nhiu ln, au thng v, mch nhc D. Chn n, mt mi, tiu chy nhiu ln, c teo nho, thiu hi E. Chn n, mt mi, tiu chy nhiu ln, mch nhc, s lnh 3. Php tr no thch hp cho HC T kh h bt kin vn A. Kin T tiu thc B. Kin T li thp C. Tn hn to thp D. Kin T sinh huyt E. Kin T l kh 4. Triu chng ca T kh h h hm A. Mt mi tiu chy, n km, y bng, sa trc trng, tiu phn sng B. Mt mi tiu chy, n km, y bng, on kh, sc mt vng a C. Mt mi tiu chy, n km, y bng, on kh, mch tr v lc D. Mt mi tiu chy, n km, y bng, tiu chy, thch ung nng E. Mt mi tiu chy, n km, y bng, thch ung nng, tay chn lnh 5. Php tr thch hp cho chng T kh h h hm A. Kin T to thp B. n V kin trung C. Kin T thng D. Kin T l kh E. Kin T tiu thc 6. Triu chng ca T kh h bt thng nhip huyt A. Mt mi, chn n, sc mt vng nht, c teo nho B. Mt mi, chn n, sc mt vng nht, tiu phn sng C. Mt mi, chn n, sc mt vng nht, xut huyt r r cc khiu hoc di da D. Mt mi, chn n, sc mt vng nht, thiu hi E. Mt mi, chn n, sc mt vng nht, sa trc trng 7. Php tr no sau y ph hp vi HC T kh h bt thng nhip huyt A. Kin T ch huyt
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B. Thanh nhit lng huyt C. Kin T nhip huyt D. Kin T dng huyt E. Dng m sinh huyt 8. Nhng triu chng no sau y c th gp trong HC T dng h A. y bng, n km, tiu chy, mt mi, on kh B. y bng, n km, tiu chy, on kh, m long C. y bng, n km, tiu chy, s lnh, tay chn lnh D. y bng, n km, tiu chy, bng chng, mt mi E. y bng, n km, tiu chy, bng chng, ph thng B. CU HI NHN QU 1. a- Trong T kh h bt kin vn, c triu chng tay chn mi r khng c sc bi v: b- T kh h khng vn ha thy cc thnh kh, huyt nui dng c nhc t chi A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 2.a- Trong bi T qun gia Tr linh, Trch t tr chng T kh h bt kin vn gm Nhn sm, Bch trut, Bch linh, Cam tho, Tr linh, Trch t. V Nhn sm lm qun bi v: b- Nhn sm i b nguyn kh A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 3.a- Trong HC T kh h h hm, c triu chng sa gin cc tng ph bi v: b- T kh h th kh tr, a n huyt A. Nu a ng, b ng, a v b c lin quan nhn qu 142
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B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 4.a- Trong bi b trung ch kh tr HC T kh h h hm gm Si h, Thng ma, Nhn sm, Hong k, Bch trut, Trn b, Phc linh. V nhn sm lm thn bi v: b- Nhn sm b nguyn kh ch T th gip Thng ma, Si h thng dng A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 5.a- Trong HC T kh h bt thng nhip huyt, c du hiu chn tay lnh bi v: b- T kh h nn dng kh ca T khng thu t ra t chi A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 6.a- Trong bi T qun gia Trc b, C mc (sao en) tr HC T kh h bt thng nhip huyt gm Nhn sm, Bch linh, Bch trut, Cam tho, Trc b, C mc. Hai v Trc b, C mc (sao en) lm t bi v: b- Hai v ny c tc dng ch huyt theo l lun kin hc tc ch A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 7.a- Trong bi Ph t l trung tr chng T dng h gm Nhn sm, Bch trut, Cam tho, Can khng, Ph t. Cam tho lm thn bi v: b- Cam tho b trung kh, ha hon cn au 143
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A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 8. a- Trong HC T kh h bt kin vn, c triu chng ph thng; bi v: b- T kh h khng vn ha c thy thp A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 9. a- Trong phng huyt cha chng T kh h bt kin vn gm T du, Thi bch, Phong long, i , Thiu ph, Quan nguyn, Kh hi, Chng mn, Tc tam l. Chm b thi bch; bi v: b- Chm b Thi bch l tr T th, v Thi bch l th huyt ca T kinh A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 10. a- Trong phng huyt cha chng T kh h bt thng nhip huyt gm Thi bch, Phong long, T du, i , Thiu ph, n trung, Kh hi, Quan nguyn, Thi uyn. Chm b Thi uyn ch huyt; bi v: b- Thi uyn l huyt hi ca mch A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai
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P N
CU HI 5 CHN 1 - CHN CU NG
STT 1 2 3 4 p n C D B A STT 5 6 7 8 p n C C C C
CU HI NHN QU
STT 2 3 5 7 9 p n A A B D A STT 11 14 15 16 22 p n B D A B A
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Bi 7
MC TIU
Sau khi hc tp, ngi sinh vin PHI 1. Nu c tn gi 7 hi chng bnh tng Thn v ph Bng quang do nguyn nhn bn trong v nguyn nhn khc 2. Gii thch c c s l lun ca cc hi chng (t nguyn nhn n c ch sinh bnh v triu chng) 3. Nu c php tr ca 7 hi chng ni trn. 4. Nu c thnh phn dc liu ca cc bi thuc v gii thch c cu to (tc dng, vai tr ca tng v) ca nhng bi thuc nu trn. 5. Nu c cng thc huyt v gii thch c cch cu to (tc dng ca huyt) ca cng thc huyt trn da theo cch vn dng du, m, nguyn, lc v ng du huyt cho 7 hi chng ni trn.
1. I CNG 1.1. Da trn c s hu thin bt qui Theo Kinh dch, tng Thn ng vi qu Khm ca Hu thin bt qui. Qu Khm c gii thch nh sau
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chn u l do ha thiu, dng h. Nhng biu hin hay cm u l dng suy, ha yu. 1.2.4. Thn gi chc nng b tng Thn ch b tng, Can ch s tit gip lm cho c th c cn bng. Tt c cc hin tng h thot, thi tit qu mc l do chc nng b tng ca Thn b ri lon. Nh kh th, kh nghch l do Thn khng np c kh; tiu nhiu, tiu kht l do Thn khng gi c thy; m hi chy nh tm l do Thn khng lim c hn.... 1.2.5. Thn tng tinh Tinh ba ca ng cc c V thu nhn, T Ph chuyn ha, tng cha ni Thn. Tinh ba ca mi Tng ph c tng cha ni Thn. Thn cng s dng bin ha tinh ba ny thnh tinh sinh dc. Hot ng sinh dc mnh m hay yu t ph thuc vo tinh y. Tinh di do chng t Thn kh mnh, tinh t i l Thn kit, kh suy. 1.2.6. Thn ch k xo, tc cng chi quan Tt c s mnh m ca con ngi l do Thn. Thn suy lm cho c th suy nhc, tay chn run, cng, mt kh nng thc hin cc ng tc kho lo, tinh vi. 1.2.7. Thn ch ct ty Xng ct vng chi, ty di do, rng chc, khng lung lay, khng au nhc (theo ng y rng l phn tha ca ct) chng t Thn tt. au nhc xng ty, ci xng, chm pht trin l biu hin ca Thn km. 1.2.8. Thn khai khiu ra tai Chc nng ca tai l nghe. Nhng bnh l ca Thn c nh hng n kh nng nghe ca tai. Tai , ic, nghnh ngng, sc nghe km l Thn h. 1.2.9. Thn ch tin m, hu m Tin m l ni ra ca nc tiu, tuy l t Bng quang nhng vic vn hnh niu l nh kh ha ca Thn (Thn kh suy th i rt, i sn, i khng ht...Thn thy suy th i nhiu ln, i m). Tin m cng ng thi c lin quan n b sinh dc ngoi. Thn dng suy th dng khng cng, hnh s bt tc, lnh cm, lit dng. m mn l ni th hin tnh trng ca Thn, t m mao n m dch u th hin tnh trng Thn khe hay yu.
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Hu m l ni ra ca phn, tuy l t i trng nhng c lin quan n tnh trng thnh h ca Thn. Thn h lm ri lon cng nng hot ng gy to bn hoc tiu chy (ng canh t). 1.2.10. Thn tng ch ch do Thn lm ch. Kin cng quyt lm cho bng c iu d nh l Thn kh di do. Ngc li, Thn kh bt tc th tinh thn tr nn yu ui, thiu ch. 1.2.11. Khng thng Thn S hi lm hi Thn v ngc li Thn kh suy, bt tc th ngi bnh d kinh s. 1.2.12. Nhng vng c th c lin quan n tng Thn Do ng kinh Thn c i qua nhng vng tht lng, Can, Ph, Tm nn trong bnh l tng Thn thng hay xut hin nhng triu chng c lin quan n nhng mi quan h nu trn.
Quan h gia Thn vi Can l quan h gia tng ha v long ha, gia
ch v , gia thy v huyt, gia s tit v b tng. Mi quan h ny th hin trong chc nng Thn ch tc cng, ch cc vn ng tinh vi ca c th. 1.3. Chc nng sinh l ph Bng quang 1.3.1. Bng quang l chu , ni cha v thi nc tiu Thy dch qua qu trnh chuyn ha, phn cn b c a v cha ti Bng quang, nh vo s kh ha ca Thn m a ra ngoi theo ng niu. 1.3.2. Nhng mi quan h ca ph Bng quang * Ph tng: s quan h ny gip cho nc lu thng. Bng quang b kt, nc khng thi c, thy dch trn ngp c phu gy ph thng, cn tr chc nng ca Ph. Ph kh khng tuyn, b mao b kt th Bng quang phi thi nc tiu nhiu hn. Ph kh thi qu, b mao tng thi m hi th Bng quang nc t m m.
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* Tm tng: tm ha qu thnh, huyt Tiu trng th nc tiu trong Bng quang c mu. Tm m h thy dch thiu th nc tiu trong Bng quang t m m. * Can tng: chc nng s tit ca Can nh hng ti vic bi tit nc tiu ca Bng quang. S tit thi qu th tiu nhiu, s tit khng tt th b bch. * T tng: t vn ha thy cc, thng qua Tiu trng cht nc c a xung Bng quang. T ha thp thng qua vic thi nc tiu ca Bng quang. T thp, kin vn khng tt th i c, i ra dng trp. T nhip huyt khng tt th xut hin mu trong nc tiu. * Thn tng: thn ch thy, thy dch cha ti Bng quang. Thn khai khiu ra tin m, vic hnh niu do Thn sai khin.
- Kinh Dch quy np Thn, Bng quang vi 2 qu c lin quan mt thit vi nc (qu Khm v Kin), vi ngun gc ca s sng. Chc nng ca Thn, Bng quang v th c lin quan mt thit vi nhiu chc nng hot ng c bn ca c th nh: di truyn, sinh dc, bin dng v ng nhin c thn kinh -ni tit.
- Nhim v ch yu ca Thn: + m bo vic duy tr ni ging (di truyn v sinh dc) + Duy tr hot ng bin dng ca c th + Duy tr s cn bng nc in gii trong c th - Nhng biu hin ch yu khi Thn Bng quang b ri lon cng nng: + Ri lon hot ng bin dng + Ri lon hot ng sinh dc + Ri lon nc in gii + Ri lon hot ng ni tit - Nhng v tr thng c biu hin triu chng khi Thn b ri lon cng nng: + ton thn, nhiu chc nng hot ng + B sinh dc, tit niu + Tht lng, tai
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2. Nhng bnh chng thn - bng quang 2.1. Nhm bnh chng tng Thn Thn bao gm Thn m v Thn dng. Thn m thuc Thy. Thn dng ng trong Mnh mn, l chn ha ca tin thin, cng c th ni l ci ngun nhit nng ca c th, thn dng thuc Ha. Do vy, bnh l tn thng tng Thn cng gm 2 nhm
Can, Thn m h Ph, Thn kh h Ph, Thn m h T, Thn dng h Tm, Thn dng h
Do bnh lu ngy Do tn thng phn m dch ca c th. Thng gp trong nhng trng
hp st cao ko di, mt mu, mt tn dch.
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Ngi mt mi, tai, nghe km. Li , hng kh, lng bn tay chn nng. Di tinh, mng tinh, ri lon kinh nguyt. Mch trm, t, sc.
2.3.4. Bnh l Ty y thng gp Hi chng Thn m h l hi chng bnh l rt ph bin trn lm sng v gp trong rt nhiu bnh
Suy nhc c th, lo suy, suy nhc sau vim nhim ko di Lao phi, tiu ng Ri lon thn kinh chc nng Suy sinh dc.
2.3.5. Php tr Ty theo nguyn nhn sinh bnh, php tr c th
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Phn tch bi thuc Kim ta c tinh hon Bi ny c xut x t Thng hnh phng. C ti liu ghi bi ny xut x t sch Y phng lp gii. Ch tr: tinh hot khng cm c
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THN M H
- Chc nng ch yu b ri lon l chc nng b tng, tng tinh ca T - Ch chng (triu chng quan trng): st cn, au lng, tai. St v chiu - Thuc tiu biu trong iu tr bnh chng Thn m h: Lc v a hong hon
Tiu nhiu ln, tiu trong, tiu khng t ch. Di tinh, hot tinh, lit dng, v kinh. Li bu, ru li trng mng. Mch trm v lc.
2.4.4. Bnh cnh Ty y thng gp
Suy sinh dc, di tinh, lit dng Suy h hp mn, suy nhc c th, nhng bnh mn tnh c km suy
nhc.
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* Phn tch bi thuc Hu quy m Bi thuc ny c xut x t Y lc gii m. Tc dng iu tr: tun b Thn dng. Ch tr: Cha mnh mn tng ha suy, s lnh, ngi mt mi, 155
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chn tay lnh, lit dng, hot tinh, lng gi mm yu. Cha trng hp nguyn dng khng , nhc mt qu . T, V h hn.
* Phn tch bi thuc C tinh hon C tt c 4 bi thuc khc nhau cng mang tn C tinh hon. Bi 1 xut x t T sinh dng tr h tiu v Bng quang h hn, tiu c, huyt trng. Bi 2 c xut x t Chng tr chun thng dng tr thn kinh b tn thng, tinh thot, huyt trng, nc tiu ra dm d. Bi 3 c xut x t Y lc gii m dng tr di tinh, mng tinh. Bi thuc c cp y c xut x trong 540 bi thuc ng y. Ch tr: di tinh, di niu.
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- Chc nng ch yu b ri lon l chc nng b tng, tng tinh v np kh ca Thn - Ch chng (triu chng quan trng): mt mi, ri lon tit niu sinh dc. - Thuc tiu biu trong iu tr bnh chng Thn kh h: Thn kh hon, C tinh hon, Hu quy m
2.5. Bnh chng Thn dng h - thy trn 2.5.1. Bnh nguyn
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S lnh, s gi. Thng ku bng trng, tiu ha ri lon, d tiu chy. Sc mt nht nht, tay chn ph, tay chn lnh, m hi t ra. Tiu t, nc tiu trong. Phn lng. Li bu, ru li trng mng. Mch trm v lc.
2.5.4. Bnh cnh Ty y thng gp
* Phn tch bi thuc T sinh Thn kh hon Bi thuc c xut x t T sinh phng. y l bi Thn kh hon gia Ngu tt v Xa tin. C ti liu ghi xut x l Thin gia diu phng. Tc dng iu tr: n dng tiu thy. Ch tr: thn dng h khng ha c thy, ng chn lnh, tiu tin bt li.
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Quan nguyn
Kh hi
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- Chc nng ch yu b ri lon l chc nng kh ha nc ca Thn - Ch chng (triu chng quan trng): ph thng cc chi. au lng tai. S lnh - Thuc tiu biu trong iu tr bnh chng Thn dng h thy trn: T sinh thn kh hon, Chn v thang
2.6. Bnh chng Tm Thn dng h 2.6.1. Bnh nguyn Ngun gc bnh l Thn dng h, Thn kh bt tc. Do nguyn nhn bnh bao gm tt c nhng nguyn nhn gy nn Thn kh bt tc, Thn dng h. 2.6.2. Bnh sinh Thn dng, ng mnh mn, l chn ha ca tin thin, l ci ngun nhit nng ca tt c c th, tt c tng ph. Bnh gy nn do dng kh ca Thn h yu dn n Tm dng cng suy theo. Hp bnh gm cc triu chng mang c im.
Dng h: tay chn lnh, s lnh, mt mi. Ti Thn: di tinh, lit dng, hot tinh, lnh cm. Ti Tm: trm cm, ni kh, hi hp, ng km.
2.6.3. Triu chng lm sng
Ngi mt mi, khng mun hot ng. Tinh thn u oi, trm cm.
Chng mt, tai , mt km. Thng ku au mi tht lng.
S lnh, s gi. Tiu ha ri lon, d tiu chy. Sc mt nht nht, tay chn lnh, m hi t ra Tiu t, nc tiu trong. Phn lng. Li bu, ru li trng mng. Mch trm, tr, v lc
2.6.4. Bnh cnh Ty y thng gp
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2.6.5. Php tr n b Tm Thn. Thng dng cc thuc n b Thn dng (Ph t ch, Nhc qu), b Tm huyt (an sm, ng quy), an thn (Vin ch, B t nhn). * Phn tch bi thuc n b Tm Thn
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TM THN DNG H
- Chc nng ch yu b ri lon l chc nng ch ha, tng tinh v mi quan h vi no ty ca Thn - Ch chng (triu chng quan trng): u oi, trm cm. au lng tai. S lnh - Thuc tiu biu trong iu tr bnh chng Tm, Thn dng h: n b Tm, Thn
2.7. Bnh chng Thn T dng h 2.7.1. Bnh nguyn Ngun gc bnh l Thn dng h, Thn kh bt tc. Do nguyn nhn bnh bao gm tt c nhng nguyn nhn gy nn Thn kh bt tc, Thn dng h. 2.7.2. Bnh sinh Thn dng, ng mnh mn, l chn ha ca tin thin, l ci ngun nhit nng ca tt c c th, tt c tng ph. Ha ca hu thin T, V cn c ha ca tin thin nung nu mi c th pht huy tc dng chuyn vn tiu ha tt. Bnh gy nn do dng kh ca Thn h yu dn n dng kh ca T th cng suy theo, sinh ra chng tiu ha ri lon. Hp bnh gm cc triu chng mang c im
Dng h: tay chn lnh, s lnh, mt mi. Ti Thn: ng canh t, di tinh, lit dng, hot tinh, lnh cm. Ti T: tiu chy, cu phn sng, ri lon tiu ha.
2.7.3. Triu chng lm sng
Ngi mt mi, chng mt, tai , mt km. Thng ku au mi tht lng. S lnh, tay chn lnh, m hi t ra. Thng ku au bng, lnh bng,
bng trng, tiu ha ri lon, d tiu chy, ng canh t. Chm m thy d chu.
Tiu nhiu ln, tiu trong, tiu khng t ch. Di tinh, hot tinh, lit dng, v kinh. Li bu, ru li trng mng. Mch trm v lc.
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Suy nhc c th Ri lon tiu ha mn tnh Vim i trng mn Vim thn mn.
2.7.5. Php tr: n b T, Thn Nhng bi thuc ng y c th s dng
Hu quy m T thn hon Phn tch bi thuc Hu quy m (Xin xem phn Thn kh bt tc) Phn tch bi thuc T thn hon
C nhiu bi thuc cng tn T thn hon c ghi nhn vi nhiu xut x v ch nh s dng khc nhau. Bi th 1 xut x t Thy Trc ng kinh nghim phng tr Thn h, mt hoa, mt c mng. Bi th 2 xut x t Cnh Nhc ton th tr T, Thn h hn, a chy lc gn sng gm Mc hng, Ph c ch, Nhc u khu, i to. Bi th 3 c xut x t Thm Th tn sinh dng tr sn kh do hn, thin try (thot v bn). Bi th 4 c xut x t Huyt chng nhn dng n b T, Thn tr chng Thn t. Bi th 5 c xut x t C kim y thng tr tiu vt, tiu khng t ch do h yu. Bi thuc di y c xut x t Ni khoa trch yu (theo Chng tr chun thng). Tc dng iu tr: n Thn m T. Ch tr: c trng ch t (ng canh t).
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Quan nguyn
Kh hi
M huyt ca V
THN T DNG H
- Chc nng ch yu b ri lon l chc nng ch ha (ci ngun nhit nng) ca Thn v mi quan h Thn, T - Ch chng (triu chng quan trng): s lnh, mt mi, ng canh t, ri lon tiu ha - Thuc tiu biu trong iu tr bnh chng Tm, Thn dng h: Hu quy m, T thn hon
Do tinh b hao tn gy ra. Do bnh lu ngy. Do nhng bnh lm hao tn phn m dch ca c th.
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2.8.2. Bnh sinh Thn v Can c mi lin h t dng ln nhau. Thn thy sinh Can mc. S s tit iu t ca Can phi nh vo s t dng ca Thn. Can tng huyt, Thn tng tinh, m tinh v huyt u thuc m, cho nn Thn m h thng gy nn Can huyt h. Cc chng trng xut hin s mang cc thuc tnh
au u (nht l vng nh), cm gic cng. Ngi bt rt, run, ng km, mt mi, tai, nghe km, mt nhn km. Li , hng kh, lng bn tay chn nng. Di tinh, mng tinh, ri lon kinh nguyt. Mch t, sc.
2.8.4. Bnh l Ty y thng gp
Ri lon thn kinh chc nng Suy nhc thn kinh Cng gip Cao huyt p Tiu ng.
2.8.5. Php tr: t b Can Thn Nhng bi thuc ng y thng dng
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* Phn tch bi thuc i b m hon Bi i b m hon c ngun gc t Chu an kh. Tc dng iu tr: t m ging ha. Ch tr: cha chng Can, Thn m h: nhc trong xng, triu nhit, ho ra mu, phin nhit. Cha chng huyt nhit (xut hin to chng) bui sng mt, bui chiu nng, ng tm phin nhit, l ming li, tiu tin ngn . Ngi T, V h nhc khng nn dng.
* Phn tch bi thuc K cc a hong thang Bi thuc ny c ngun gc t Cc phng. L bi Lc v a hong gia K t v Cc hoa. Tc dng iu tr: t m ghm dng. Ch tr: cha chng Can, Thn m h: nhc trong xng, triu nhit, ho ra mu, phin nhit, huyt p cao, u vng, mt hoa, th lc gim.
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* Phn tch bi thuc B Can Thn Tc dng iu tr: t m ghm dng. B Thn, t m, dng Can huyt. Ch tr: st m, tai, hoa mt, o hn, i cu to bn, ngi bt rt kh chu, tiu but rt, sn , huyn vng.
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Tn huyt Thn du Phc lu Tam m giao Can du Thi xung Thn mn Bch hi A th
C s l lun Du huyt ca Thn lng Kinh Kim huyt/ThnB mu B Thn thy Giao hi huyt ca 3 kinh m / chn Du huyt ca Can lng Du Th huyt/CanT t T Can ha Du Th huyt/TmT t T Tm ha Hi ca c mch v 6 dng kinh
Tc dng iu tr ch Thy trng ha, km cha chng au lng B Thn m chng o hn T m B Can huyt Thanh Can ha, cha chng u chong mt hoa Thanh Tm ha, t Tm nhit. Thanh thn ch, tit nhit
cha
Cng thc 2: Thn du, Phc lu, Tam m giao, Can du, Thi xung, Ni
quan, Thn mn.
Tn huyt Thn du Phc lu Tam m giao Can du Thi xung Ni quan Thn mn C s l lun Du huyt ca Thn lng Kinh Kim huyt/ThnB mu B Thn thy Giao hi huyt ca 3 kinh m/chn Du huyt ca Can lng Du Th huyt/CanT t T Can ha Giao hi huyt ca Tm bo v mch m duy c hiu vng ngc Du Th huyt/TmT t T Tm ha Tc dng iu tr ch Thy trng ha, km cha chng au lng B Thn m cha chng o hn T m B Can huyt Thanh Can ha, cha chng u chong mt hoa Cha chng hi hp, au ngc gy kh th, ngn ngc Thanh Tm ha, t Tm nhit, cha chng tm phin
CAN THN M H
- Chc nng ch yu b ri lon l chc nng b tng, tng tinh ca Thn v chc nng ch s tit, tng huyt ca Can - Ch chng (triu chng quan trng): bt rt, nng trong ngi, st cn, ri lon gic ng - Thuc tiu biu trong iu tr bnh chng Can, Thn m h: b Can Thn: Lc v quy thc, K cc a hong thang, i b m hon
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2.9. Bnh chng Bng quang h hn 2.9.1. Bnh nguyn Do T, Thn dng h khng kh ha c Bng quang. 2.9.2. Bnh sinh Bng quang kim sot s cha ng v bi xut nc tiu (c thc). Nu v Thn dng h suy tt nhin chc nng ny s b nh hng. Trn lm sng s quan st c du chng ca Thn dng h cng vi triu chng ca Bng quang bt c (khng km gi) nh i sn, i dm. 2.9.3. Triu chng lm sng
Ngi mi mi, lng gi mi yu. Lit dng, di tinh. S lnh, tay chn lnh, sc mt trng nht. i sn, i dm, i lt nht, dng nc tiu khng mnh m ri r. Ru li mng. mch t nhc.
2.9.4. Bnh cnh Ty y thng gp
Ph i tin lit tuyn Lo suy, suy nhc c th Bnh l ty sng vng tht lng cng.
2.9.5. Php tr n Thn c sp. Bi thuc s dng gm
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Bi thuc di y c xut x t Tn Bin Trung y kinh nghim phng. Tc dng iu tr: n Thn c sp. Ch tr: chng tiu lt nht, tiu sn, tiu khng t ch nhng bnh nhn lo suy, T, Thn dng h.
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Quan nguyn
Kh hi
Kinh nghim ngi xa c dng phi hp Thn du, Trung cc, Tam m giao tr tiu nhiu ln (Chm cu i Thnh).
BNG QUANG H HN
- Chc nng ch yu b ri lon l chc nng kh ha Bng quang ca Thn - Ch chng (triu chng quan trng): i sn, i dm, i lt nht, dng nc tiu khng mnh m ri r, khng gi c nc tiu, s lnh. - Thuc tiu biu trong iu tr bnh chng Bng quang h hn: Tang phiu tiu tn, Cng hon
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- Bnh ca chnh Thn: + Thn m h + Thn dng h + Thn dng h thy trn - Bnh ca Thn trong mi quan h ng hnh: + Tm Thn dng h + Thn T dng h + Can Thn m h + Bng quang h hn
CU HI N TP
CU HI 5 CHN 1 - CHN CU NG 1. Nguyn nhn ca HC Thn m h A. Thiu m ha nhit B. Thiu m ha hn C. n ung khng ng D. Phng dc qu E. Lo bun ko di 2. Nhng triu chng ca HC Thn m h A. Ngi gy, au mi tht lng v gi, nng trong ngi, o hn, mng tinh B. Ngi nht nht, au mi lng gy, st cn v chiu, o hn C. Tai , mt hoa, hng kh, li , phin kht, bt rt khng yn D. Ri lon kinh nguyt, rong kinh ko di, lnh cm, bt lc E. Ngi nng, au lng, di tinh, lit dng, lnh cm 3. HC Thn kh bt tc KHNG do nguyn nhn no sau y gy nn A. Bnh ni thng lu ngy
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B. n ung tht thng C. Tnh ch bt thng D. Phng dc qu E. Lao tn 4. Php tr ph hp cho HC Thn kh bt tc A. n trung B. n khai C. n b D. Hi dng cu nghch E. n kinh 5. Nguyn nhn ca HC Thn dng h thy phim A. Tin thin bt tc v mc bnh lu ngy B. Hu thin bt tc v mc bnh lu ngy C. Lo bun qu v mc bnh lu ngy D. Khng hong tinh thn v mc bnh lu ngy E. Phng dc qu v mc bnh lu ngy 6. Nhng triu chng ca HC Thn dng h thy phim A. Mt mi, chng mt, tai , mt km, au mi tht lng B. S lnh, mt mi, tiu chy, ph tay chn C. Li bu, ru trng mng, mch trm v lc, phn lng D. Mt mi, s lnh, mi tht lng, tai, tiu chy, ph tay chn E. Mt mi, s lnh, au tht lng, mi gi 7. c im ca HC Tm, Thn dng h A. Mt mi B. Tay chn lnh gi C. Ho hen D. au nhc khp ngi E. Bt rt vt v 8. Php tr ph hp cho HC Tm Thn dng h A. n trung tn hn B. n b mnh mn 173
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C. n b Tm, Thn D. n dng thng mch E. An thn nh ch 9. Triu chng ca hi chng Bng quang h hn A. Bng di y trng, tiu sn, tiu lt nht, dng nc tiu ri r B. Bng dui trng y au, tiu tin t li C. Tiu sn, tiu dm, tiu lt nht D. Tiu sn, tiu c, tiu lt nht E. Cc cu trn u ng 10. Php tr ph hp vi hi chng Bng quang h hn A. n Thn c sp B. n b Bng quang C. n Bng quang bt c D. n hn ha thp E. n b Thn dng CU HI NHN QU 1. a- Trong HC Thn m h, c triu chng di tinh, bi v b- Thn tng tinh, nay Thn m h nn chc nng b tng b mt A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 2. a- Trong HC Thn kh bt tc, c triu chng lun mt mi bi v b- Thn ch k xo, Thn kh bt tc nn sinh triu chng ny A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai
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3. Trong bi thuc Hu qui m cha chng Thn kh bt tc gm Ph t ch, Qu, Thc a, Hoi sn, Sn th, K t, trng, Cam tho bc a- V trng lm t, bi v b- trng c tc dng b Can Thn, mnh gn ct A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 4. a- Trong HC Tm Thn dng h, c triu chng tiu lng, bi v b- Thn ch tin hu nh m, Thn h nn sinh ra triu chng ny A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 5. a- Trong HC Thn T dng h, c cc triu chng lit dng, lnh cm, ng canh t bi v b- T dng h nn khng cung cp tinh hu thin cho Thn khin Thn dng h yu m sinh ra triu chng ny A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 6. Trong bi thuc T thn hon gm Ph c ch, Ng v t, Ng th du, Nhc u khu, Can khng, i to, cha chng Thn, T dng h a- Ng v t lm thn, bi v b- Ng v t c tc dng c tinh lim hn, t Thn m b Thn dng A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai
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D. Nu a sai, b ng E. Nu a sai, b sai 7.a- Trong HC Bng quang h hn, c du hiu tiu gt, bi v b- Thn dng h khng kh ha c Bng quang nn chc nng cha ng v bi xut nc tiu b tr ngi A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 8. Trong nhm huyt n b Thn dng gm Thn du, Tam m giao, Mnh mn, Trung cc, Can du, Thi xung, Dng tuyn, Quan nguyn, Kh hi a- Chm huyt Thi xung l thanh Can ha cha chng u chong mt hoa, bi v b- Thi xung l du th huyt ca Can, chm t theo nguyn tc m thc t con A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 9. Trong phng huyt iu tr chng Thn T dng h gm Thn du, Tam m giao, Mnh mn, Quan nguyn, Kh hi, Thi bch, Lng mn, Tc tam l, Trung qun a- Chm huyt Chng mn, bi v b- Chng mn l m huyt ca T kinh A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai
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10. Trong phng huyt cha chng Bng quang h hn gm Thn du, Tam m giao, Mnh mn, Trung cc, Can du, Thi xung, Dng tuyn, Quan nguyn, Kh hi a- Chm b huyt Tam m giao t m, bi v. b- y l huyt hi ca kinh T, Can, Thn, dng n c tc dng t Thn m b Thn kh A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai
P N
CU HI 5 CHN 1 - CHN CU NG
STT 1 2 3 4 5 p n D A B C A STT 6 7 8 9 10 p n D A C C A
CU HI NHN QU
STT 1 2 3 4 5 p n A B D B B STT 6 7 8 9 10 p n D D A A A
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Bi 8
BNH HC CAN - M
MC TIU
Sau khi hc tp, sinh vin PHI 1. Nu c tn gi 8 hi chng bnh tng Can v ph m do nguyn nhn bn trong v nguyn nhn khc. 2. Gii thch c c s l lun ca cc hi chng (t nguyn nhn n c ch sinh bnh v triu chng). 3. Nu c php tr ca 8 hi chng ni trn. 4. Nu c thnh phn dc liu ca cc bi thuc v gii thch c cch cu to (tc dng, vai tr ca tng v) ca nhng bi thuc nu trn. 5. Nu c cng thc huyt v gii thch c cch cu to (tc dng ca huyt) ca cng thc huyt trn da theo cch vn dng du, m, nguyn, lc v ng du huyt cho 6 hi chng ni trn.
1. I CNG 1.1. Da trn c s hu thin bt qui Theo Kinh dch, tng Can ng vi qu Chn ca Hu thin bt qui.
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Bnh chng ca Ph m do ni nhn hoc do nguyn nhn khc thng thy do Can m h. Chc nng Can ch s tit b nh hng do tnh ch khng thoi mi, d kinh s. ng thi m cng b nh hng theo, m kh h sinh ra chng nghi ng, d lo lng. y cng l nhng triu chng thng gp trong m kh bt tc hay m h. 2.1. Bnh chng Can m h 2.1.1. Bnh nguyn
Can phn: au u vng nh, mt m, nhn km, hoa mt, chng mt,
au tc hng sn,...
au u, hoa mt, chng mt, nhn km, th lc gim st. St v chiu, ngi c cm gic nng, ra m hi trm. C th c ri lon kinh nguyt, au vng hng sn, au tht lng. Li , bu. Mch t, sc, v lc.
2.1.4. Bnh cnh Ty y thng gp
Tng huyt p Ri lon thn kinh chc nng. Ri lon kinh nguyt.
2.1.5. Php tr C th s dng nhng php tr sau
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Nhng bi thuc c th s dng trong bnh chng ny gm Nht qun tin gia gim, b Can Thn, a ct b m. * Phn tch bi Nht qun tin gia gim
* Phn tch bi thuc b Can Thn Tc dng iu tr: t m ghm dng. B Thn, t m, dng Can huyt. Ch tr: st m, tai, hoa mt, o hn, i cu to bn, ngi bt rt kh chu, tiu but rt, sn , huyn vng. Phn tch bi thuc: (Php b -thanh)
V thuc H th Hoi sn Thc a ng quy Trch t Si h Tho quyt minh (sao en) Dc l ng y Ngt, ng, m. B Can, Thn, mnh gn ct. Ngt, bnh. B T V, b Ph, Thn, sinh tn, ch kht, bnh suyn, sp tinh. Ngt, hi n. B Thn t m. B huyt Ngt, cay, n. B huyt, hot huyt. Dng Can huyt Thanh thp nhit Bng quang, Thn Bnh Can h st Thanh Can nhun to, an thn
* Phn tch bi a ct b m Xut x: cc phng (c ti liu ghi trong Thi bnh hu dn). Tc dng iu tr: b Thn, t m, dng Can huyt. Ch tr: st m, tai, hoa mt, o hn, i cu to bn, ngi bt rt kh chu, tiu but rt, sn . Ri lon kinh nguyt, kinh t. Thiu mu.
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CAN M H
- Chc nng ch yu b ri lon l chc nng s tit v tng huyt ca Can. - Ch chng (triu chng quan trng): hoa mt, th lc gim. St v chiu - Thuc tiu biu trong iu tr bnh chng Can m h: nht qun tin gia gim, b Can Thn, a ct b m
Do huyt h lm nh hng n chc nng tng huyt ca Can. Do Can m h, cng nng tng huyt b ri lon gy ra chng huyt h.
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2.2.2. Bnh sinh Do bnh l h Can m, chc nng ca Can huyt m bnh cnh lm sng c nhng c im
Huyt h: chng mt, sc nht, kinh t, v kinh. Ri lon Can phn: mt kh, nhn km, ri lon kinh nguyt. D gy bin chng Can huyt h sinh phong (xem phn Can phong ni ng).
2.2.3. Triu chng lm sng
Ngi mt mi, hoa mt, chng mt, tai, mt kh, nhn km. Sc mt
nht, nim nht, li bu nht.
Suy nhc c th Suy nhc thn kinh, ri lon thn kinh thc vt Thiu mu.
2.2.5. Php tr
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* Phn tch bi o hng t vt thang Xut x: nghim phng. Tc dng: dng huyt iu kinh. Ch tr: kinh nguyt bt iu, hnh kinh trc k c ln huyt cc. Phn tch bi thuc (Php b -tiu)
V thuc ng quy Bch thc Xuyn khung Sinh a o nhn Hng hoa Dng Can huyt ng, cht, chua. Nhun gan, dng Ph. Cay, n. Hot huyt, ch thng, hnh kh, khu phong Ngt, ng, hn. Sinh tn dch, lng huyt. ng, ngt, bnh. Ph huyt, hnh , nhun to, hot trng Cay, m. Ph huyt, sinh huyt Dc l ng y
* Phn tch bi T vt + iu kinh (30 cng thc) Tc dng: dng huyt iu kinh. Ch tr: kinh nguyt bt iu, hnh kinh chm v huyt h, huyt m sinh ra.
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CAN HUYT H
- Chc nng ch yu b ri lon l chc nng s tit v tng huyt ca Can. Trong bnh chng ny, ri lon chc nng tng huyt ca Can ni tri hn. - Ch chng (triu chng quan trng): sc mt nht, hoa mt, chng mt. - Thuc tiu biu trong iu tr bnh chng Can huyt h: Lng a thang, o hng t vt thang
Do Can m h nn khng ch c dng (Dng xung). Hoc do Thn m h khng t dng c Can huyt.
2.3.2. Bnh sinh Bnh cnh gm cc du chng ca m h dng xung. Tuy nhin du hiu dng xung rt r rt nh cn nng phng mt, run ry, trng thi kch thch. Nng hn s pht sinh thnh chng hu Can nhit ng phong. 2.3.3. Triu chng lm sng
au u, chng mt, cm gic nng phng mt. Hay mng m, mt cm gic, run, t, trng thi kch thch, tai, nghe
km, nhn km, hng kh, mt au.
Tng huyt p. Cn hng cm. Ri lon thn kinh chc nng, giai on tin mn kinh.
2.3.5. Php tr
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2.4. Bnh chng Can phong ni ng 2.4.1. Bnh nguyn Do 3 nguyn nhn
au u, chng mt, hoa mt, tai, ni kh hoc ni khng c. Tay chn co rt, run. Trng thi l m hoc mt thc. Sc mt , li run hoc co cng. Mch huyn, t.
2.4.4. Bnh cnh Ty y thng gp
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* Phn tch bi Linh dng cu ng thang Linh dng cu ng thang c ghi nhn c 2 xut x, mt trong Thng tc thng hn lun, mt t Tn bin Trung y kinh nghim phng. C 2 bi thuc u c cng ch nh iu tr, cng gm nhng dc liu nh nhau, im khc nhau ch yu l liu lng ca nhng dc liu c s dng.
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Cng thc huyt s dng trong cn: Bch hi, Nhn trung, Thp tuyn.
Tn huyt Bch hi Nhn trung Thp tuyn C s l lun Hi ca mch c v 6 kinh dng Hi ca mch c vi cc kinh Dng minh tay. Kt hp vi Nhn trung cp cu ngt, hn m Tc dng iu tr c hiu cha trng phong c hiu cp cu ngt, hn m, trng phong H st. Phi hp trong cha chng trng phong
Cng thc huyt s dng ngoi cn: Hnh gian, Thiu ph, Ni quan,
Thn mn, Thn du, Can du, Thi kh, Phi dng, Tam m giao.
Tn huyt Hnh gian Thiu ph C s l lun Hunh ha huyt/Can Hunh ha huyt/Tm Giao hi huyt ca Tm bo v Mch m duy c hiu vng ngc Du Th huyt/Tm Du huyt ca Can lng Bi du huyt/Thn Nguyn huyt/Thn Lc huyt/Thn Giao hi huyt ca 3 kinh m/chn T m Cha chng hi hp, au ngc gy kh th T Tm ha B Can huyt T m b Thn B Thn Tc dng iu tr Bnh can ging ha
CAN PHONG NI NG
- Chc nng ch yu b ri lon l chc nng ch cn ca Can. - Ch chng (triu chng quan trng): du co cng, co rt. Mch huyn - Thuc tiu biu trong iu tr bnh chng Can phong ni ng: Thin ma cu ng m, Linh dng cu ng thang
2.5. Bnh chng Can ha thng vim 2.5.1. Bnh nguyn Do tnh ch bt iu, cu gin lm thng Can khin Can kh b ut kt li. 191
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2.5.2. Bnh sinh Can kh ut kt li ha ha (mc sinh ha). Can ha thng vim l chng bnh thuc ha. Ha bc ln bc huyt vng hnh sinh ra cc chng xut huyt. 2.5.3. Triu chng lm sng
St cao hoc cm gic nng, mt , mt , hai g m . Ngi bt rt, d kch ng, hoa mt, chng mt, tai. Chy mu cam, i ma ra mu. au tc ngc, c th khc ra mu. Li , mch huyn sc.
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2.6. Bnh chng Can V bt ha 2.6.1. Bnh nguyn Do tnh ch bt iu, nh hng n cng nng s tit ca Can lm Can kh ut kt li. 2.6.2. Bnh sinh Can kh ut kt, honh nghch n cng nng T, V (mc khc th) sinh ra chng au cp thng v, ri lon tiu ha. 2.6.3. Triu chng lm sng
Ngi bc bi, bt rt, d kch thch. Cm gic c nht dnh c hng, ming ng, mt ngon ming. au bng thng v cp tnh, v tr au r rt, hi, bun nn, nn ma,
trung tin d chu. au tc hng sn. au bng kinh.
Mch huyn.
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Lot d dy t trng. Ri lon vn ng ng mt. Nhng trng hp ri lon tiu ha trong stress.
2.6.5. Php tr
iu ha Can T S Can ha V
Nhng bi thuc c ch nh gm iu ha can T, bi thuc tr lot d dy t trng. * Phn tch bi iu ha Can T Tc dng: s Can, l kh, gii ut, ha V. Ch tr: nhng trng hp tnh ch tht iu, cu gin gy ri lon tiu ha, hi, chua, au thng v, ngi bc dc, cu gt, khng thoi mi.
* Phn tch bi thuc tr lot d dy t trng Xut x: 30 cng thc thuc. Tc dng: s Can, ha V. Ch tr: nhng trng hp lot d dy, t trng.
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Cng thc huyt s dng gm Trung qun, Li cu, Hnh gian, Thi
xung, Thiu ph, Thn mn, Tc tam l.
Tn huyt Trung qun Tc tam l Li cu Hnh gian Thiu ph C s l lun M huyt ca V Kinh nghim ngi xa phi hp Trung qun kin V Lc huyt/Can Hunh ha huyt/Can Hunh ha huyt/Tm Du Th huyt/Can Thi xung Thn mn Ni quan Du Th huyt/Tm Giao hi huyt ca Tm bo v Mch m duy c hiu vng ngc Cha chng hi hp, au ngc gy kh th T Can kh thc Bnh can. T Can mc vng Thanh Can ha ging ha Tc dng iu tr Cha chng y trng bng, au bng.
CAN V BT HA
- Bnh chng Can V bt ha lin quan cht ch vi yu t tnh ch. - Chc nng ch yu b ri lon l chc nng s tit ca Can v chc nng thu np cc kh ca V. - Ch chng (triu chng quan trng): bc dc, cu gt. Ri lon tiu ha. Mch huyn - Thuc tiu biu trong iu tr bnh chng Can V bt ha: Tiu dao tn + Ut kim
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Do tinh b hao tn gy ra Do bnh lu ngy Do nhng bnh lm hao tn phn m dch ca c th.
2.7.2. Bnh sinh Thn v Can c mi lin h t dng ln nhau. Thn Thy sinh Can mc. S s tit iu t ca Can phi nh vo s t dng ca Thn. Can tng huyt, Thn tng tinh, m tinh v huyt u thuc m, cho nn Thn m h hay gy nn Can huyt h. Cc chng trng xut hin s mang cc thuc tnh
Ngi gy, thng au mi tht lng v u gi. Cm gic nng trong ngi, nht l v chiu v m, o hn. au u (nht l vng nh), cm gic cng. Ngi bt rt, run, ng km. Ngi mt mi, tai, nghe km. Li , hng kh, lng bn tay chn nng. Di tinh, mng tinh, ri lon kinh nguyt. Mch t, sc.
Ri lon thn kinh chc nng, suy nhc thn kinh Cng gip Tng huyt p Tiu ng.
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2.8. Bnh chng m kh bt tc (m h) 2.8.1. Bnh nguyn Do bnh lu ngy ca Can gy tn thng phn m. Can h lm nh hng n s quyt on ca m. 2.8.2. Bnh sinh Chng trng xut hin c nhng c im
Can phn: au u vng nh, mt m, nhn km, hoa mt, chng mt,
au tc hng sn,...
m h sinh ni nhit: o hn, st v chiu, cm gic nng, mch t sc... Tnh ch tht iu, khng thoi mi
2.8.3. Triu chng lm sng
au u, hoa mt, chng mt, nhn km, th lc gim st. St v chiu, ngi c cm gic nng, ra m hi trm. D kinh s, d cu
gt, do d, hot ng tr c gim st.
C th c ri lon kinh nguyt, au vng hng sn, au tht lng. Li , bu. Mch t sc v lc.
2.8.4. Bnh cnh Ty y thng gp
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CU HI N TP
CU HI 5 CHN 1 - CHN CU NG
1. Nguyn nhn ca HC Can m h A. Sang chn gy huyt B. Can m thp nhit C. Can kh ut kt D. Thn m h lu ngy E. Tnh ch ut kt 2. Triu chng ca HC Can m h A. St v chiu, ra m hi trm, au tht lng B. St v chiu, li rc, mch t sc v lc, au u, hoa mt C. au u, hoa mt, chng mt, li , mch t sc v lc, o hn D. Th lc km, au u, chng mt, ri lon kinh nguyt, cm gic nng E. au u, st v chiu, o hn, ri lon kinh nguyt, mch t sc. 3. Triu chng ca HC Can huyt h A. au u, hoa mt, chng mt, mt m, qung g, mch t sc B. Ri lon kinh nguyt, au vng hng sn, au tht lng, mch t sc C. St v chiu, ngi c cm gic nng, ra m hi trm, li , mch t sc D. Mt nhc, chng mt, kinh t, mt kh, nhn km, run, ri lon kinh nguyt E. au u, chng mt, hoa mt, tai, ni kh, li , mch t sc 4. Php tr no KHNG ph hp vi HC Can huyt h A. T b Can, Thn B. T m dng huyt C. T m thanh nhit D. Thanh nhit lng huyt E. T m ghm dng 5. Php tr no KHNG ph hp cho HC Can dng xung A. T m ging ha B. T m ghm dng 198
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C. T m ging nghch D. T m lng huyt E. S Can gii ut 6. Nguyn nhn ca HC Can ha thng vim A. Tnh ch tht iu B. n ung cay nng C. Chn thng huyt D. Chn thng mt mu E. Can Thn m h 7. Nhng triu chng ca HC Can ha thng vim A. St cao, au tc ngc, ho ra mu, chy mu mi B. St cao, mt , mt , hai g m , li , mch huyn sc C. Ngi bt rt, d kch ng, tai, hoa mt, chng mt D. Ngi d kch dng, chng mt hoa mt, mt , mt , th huyt E. St cao hoc cm gic nng, li , mch huyn sc, chy mu cam 8. Nguyn nhn no KHNG a n Can phong ni ng A. Can m h B. Can huyt h C. Can dng xung D. Can, Thn m h E. Can kh ut 9. Triu chng ca Can phong ni ng A. L m, mt thc B. Chng mt, hoa mt C. Tay chn co rt, run, git D. Mch huyn t E. au u, tai 10. Nguyn nhn ca HC Can, T bt ha A. Tnh ch ut c a n Can kh ut kt B. Do T kh h nn Can mc tng tha
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C. Do t ng a n huyt nh hng n chc nng tng huyt ca Can D. Do Thn m h a n Can mc vng ln T th E. Do Can m h CU HI NHN QU 1. a- Trong HC Can m h, c triu chng mt m, nhn km bi v b- Can khai khiu ra mt, nay m tinh khng nn c triu chng ny A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 2. Trong bi Nht qun tin cha chng Can m h gm Sa sm, Cu k, Sinh a, r Trinh n, Mch ng, H th a- Ba v Sinh a, Cu k, H th u lm qun bi v b- Ba v Sinh a, Cu k, H th u c tc dng b Can, Thn A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 3. a- Trong HC Can Thn m h, c triu chng ng km bi v b- Can tng huyt, nay Can m h, Can khng tng c huyt m sinh ra triu chng ny A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 4. Trong bi K cc a hong cha chng Can, Thn m h gm Thc a, Hoi sn, K t, Sn th, Phc linh, n b, Trch t, Cc hoa trng. a- V K t lm thn, bi v 200
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b- K t c tc dng nhun Ph to A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 5. a- Trong HC Can dng xung, c du hiu run ry, co git bi v b- Can dng xung l do Can huyt h, nay Can huyt km nn khng nui dng c cn A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 6. a- Trong HC Can ha thng vim, c th xut huyt bt k ch no, bi v b- Tnh cht ca ha l bc huyt vng hnh (mu khng i ng ng) A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 7. Trong bi thuc n chi tiu giao gm Si h, Chi t, Bc h, Sinh khng, Bch thc, ng qui, Phc linh, n b, Bch trut cha chng Can ho thng vim a- Hai v Bch thc, ng qui tng t vi nhau bi v b- Bch thc, ng qui c tc dng lim m A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai
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8. Trong phng huyt cha chng Can m h gm Can du, Thi xung, Quang minh, Thn du, Tam m giao, Thi kh, Phi dng, Thn mn a- Dng cp Thi xung, Quang minh b Can m bi v b- Thi xung, Quang minh l nguyn lc ca Can, m A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 9. Trong phng huyt cha chng Can huyt h gm Can du, Thi xung, Quang minh, Cch du, Huyt hi, Tam m giao, Thi kh, Phi dng, Ni quan a- Chm b huyt Cch du b huyt, bi v b- Cch du l du huyt thuc vng Tm, m Tm ch huyt A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai 10. Trong phng huyt iu tr chng Can dng xung gm Hnh gian, Thiu ph, Can du, Thn du, Thi kh, Phi dng, gia gim Ni quan, Thi dng, Bch hi, n ng a- Chm b huyt Hnh gian bnh Can; bi v b- Hnh gian l ha huyt ca Can, dng n theo nguyn tc m thc t con A. Nu a ng, b ng, a v b c lin quan nhn qu B. Nu a ng, b ng, a v b khng lin quan nhn qu C. Nu a ng, b sai D. Nu a sai, b ng E. Nu a sai, b sai
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P N
CU HI 5 CHN 1 - CHN CU NG
STT 1 2 3 4 5 p n D D D E E STT 6 7 8 9 10 p n A D E C A
CU HI NHN QU
STT 1 2 3 4 5 p n A C A B B STT 6 7 8 9 10 p n D C A C D
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Bi 9
MC TIU
Sau khi hc tp, sinh vin PHI 1. Nu c tn gi 10 hi chng bnh tng Tm v ph Tiu trng 2. Gii thch c c s l lun ca 10 hi chng (t nguyn nhn n c ch sinh bnh v triu chng) 3. Nu c php tr ca 10 hi chng ni trn. 4. Nu c thnh phn dc liu ca cc bi thuc v gii thch c cu to (tc dng, vai tr ca tng v) ca nhng bi thuc nu trn. 5. Nu c cng thc huyt iu tr v gii thch c cch cu to (tc dng ca huyt) ca cng thc huyt trn da theo cch vn dng du, m, nguyn, lc v ng du huyt.
1. I CNG 1.1. Da trn c s hu thin bt qui Theo Kinh dch, tng Tm ng vi qu Ly ca Hu thin bt qui. Qu Ly phng Nam (i xng vi qu Ly phng Bc l qu khm. ng vi tng Thn).
Biu tng ca Ly l mt tri, l la, l nng, l sng. Tm tng Ly v cng thuc ha, mang thuc tnh ca ha l nng, l
sng. Do , Tm l ni xut pht ca thn minh, s sng sut minh mn ca mi con ngi. 204
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Thin Bn thn, sch Linh khu ni: Ci n cng s sng l tinh, hai
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th sng, Thn mt th cht. Chnh v Tm l ch ca 12 kh quan, c kh nng thng nht lnh o cc tng ph, iu ha hot ng ln nhau nn tng ph mi lm trn trch nhim ca n m gn gi sc khe cho c th. Tri li Tm tng c bnh, th s hot ng ca cc tng ph khc cng sinh ri lon, m sinh bnh. Linh Lan b im lun sch T Vn ni:Ch sng sut th di yn lnh, ch khng sng sut th 12 kh quan suy khn
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1.2.7. Tm c Tm bo lc l ngoi v ca Tm, bo v Tm ng thi chp hnh mnh lnh ca Tm Thin t khch sch Linh khu ni: Tm l v i ch ca ng tng lc ph, ngoi t khng th lt vo c, nu lt vo c th Tm thng, Tm b thng th thn i mt, Thn mt th cht, cho nn mi th t kh vo u Tm bo. l ni r Tm bo lc c tc dng bo v Tm tng. 1.2.8. Nhng vng c th c lin quan n tng Tm Do ng kinh Tm c i qua honh cch m, Tiu trng, Ph, c hng, thc qun, mt nn trong bnh l tng Tm thng xut hin nhng triu chng c lin quan n mi quan h trn.
Tm v T c mi quan h tng sinh: Tm ha sinh T th. Tm v Ph c mi quan h tng khc: Tm ha khc Ph kim. Tm ch ha, qu Ly. Thn ch thy, qu Khm. Hai qu ny chng ln
nhau thnh qu Thi. Theo quan nim ng y, s kt hp gia ha v
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thy theo phng cch trn mang li kt qu tt (qu Thi). V c gi l thy ha k t (Tm ha v Thn thy giao ha nhau to qun bnh cho c th). 1.3. Chc nng sinh l tng Tm bo C th c ng tng nhng li c n lc ph. Trong mi quan h biu l gia tng v ph th do Tm c chc nng qun ch, l v vua (ti quan trng) nn cn phi c s bao bc bo v bn ngoi Tm. Vai tr ny c thc hin bi Tm bo. Tm bo lc thuc Tng ha, v Tm bo l thn s ca Tm. Tm bo l mng bao ca Tm, cn gi l th Tm ch, v c v nh tay ca Tm, thay mt Tm m hnh s. Tm quan h biu l vi ph Tam tiu. 1.3.1. Tm bo l t chc ngoi v ca Tm Bao bc tng Tm bo v cho Tm, ngn cn t kh xm nhp vo Tm. T kh xm nhp vo c th, ni chung t ngoi vo trong, t biu vo l. Nn chc nng chnh ca Tm bo l bo v cho Tm. 1.3.2. Nhng vng c th c lin quan n Tm bo Do ng knh Tm bo c i qua nhng vng ngc, sn, hm nch, dc b trong cnh tay gia 2 kinh Tm, Ph v xung c honh v bng lin lc 3 tng thng, trung, h ca Tam tiu, nn trong bnh l Tm bo c xut hin nhng triu chng c lin quan n mi quan h nu trn. Tm bo lc v Tam tiu c lin quan biu l v tng ph v trn ng kinh. Tm ch qun ha m Tm bo li l tng ha, trn lm sng cc triu chng bnh hay cng xut hin v hay c phi hp cha bnh. 1.4. Chc nng sinh l ph Tiu trng Ph Tiu trng v tng tm c mi quan h biu l vi nhau. l mi quan h gia ci sng rc r v ci nng, thuc dng. Do Tm v Tiu trng rt s nhit. Mi quan h ny biu hin nh Tm nhit nh hng Tiu trng gy tiu ... Thin Bn thn sch Linh khu ni: "Tm hp vi Tiu trng". Hp tc l quan h ln nhau, nh hng ln nhau gia 2 tng ph, nh nguyn nhn ca li v nt u l do Tm ha vng thnh (Tm khai khiu ra li) nhng chng li m nt thng li c c nhng chng tiu tin v t, thm ch tiu tin ra huyt, chnh l ph hp vi cu trong sch So th bnh nguyn "Tm ch huyt hp vi Tiu trng, nu Tm nhit huyt kt li Tiu trng th tiu tin ra huyt".
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1.4.1. Ph Tiu trng gi chc phn phn bit thanh trc Tiu trng tip th n ung c lm chn nh V. Cht tinh vi ca thc n chn nh ny c T kh ha thnh cht tinh a n ng tng lc ph gip tng ph hot ng. Cn li cht thy dch ca cn b a n Bng quang. Cht trc ca cn b a n i trng v bi tit ra ngoi hon thnh chc nng "ha vt". iu ni r, Tiu trng c cng nng phn bit thanh trc lm cho thy dch v cn b c phn chia ra rnh rt. V th nu cng nng Tiu trng khng c kin ton th s nh hng n i tiu tin. Th nn chng i lng m thy cc khng phn bit c v tiu tin ra nhiu hay t, m hay nht u c quan h vi Tiu trng. 1.4.2. Tiu trng gip dn dt ha ca Tm giao xung n vi Thn v Bng quang Tiu trng ngoi nhim v a trc dch xung Bng quang, cn nhim v a Ha ca Tm xung Thn v Bng quang, gip kh ha ln na trc dch cha Bng quang trc khi tiu tin ra ngoi. Phn c kh ha ny
Hai l thm nhp ra ngoi c biu t chi xut ra b mao. cng chnh
l V kh bo v mt ngoi ca thn th (Thi dng ch v lp ngoi cng ca c th con ngi). y l con ng m Bng quang v Tiu trng ng vai ha kh bo v bn ngoi c gi chung l Thi dng kinh. 1.4.3. Vng c th do kinh Thi dng Tiu trng chi phi
Vng b ngoi ngn t bn tay, cng tay, cnh tay, vai, quanh b vai. Tm. Ph Tiu trng. C, gc hm, ui mt. Trong tai. Mi, u mt.
Do khu vc chi phi v quan h ny m khi c bnh Thi dng Tiu trng s c cc triu chng nh au hng, sng di gc hm, cng c, tai, mt vng, au nhc cm, vai, cnh tay...
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Ni kinh vit: Tam tiu l quan nng khai ngi nc, thy o xut ra
t y. Nh vy, Tam tiu ch v kh o, v nh mt v quan trng coi iu khin vic khi x ng thy o cho lu thng (Quyt c chi quan) v khng c kh th thy khng ha, v Tam tiu cng l con ng vn hnh nc trong c th con ngi. Chng 31, sch Nn kinh ni: Tam tiu l ng li ca thc n, l ch kh lun chuyn i v ni ln chc nng ca Tam tiu l a kh huyt tn dch ca thc n i chu lu khp da d v tng ph. Thin Ng lung tn dch bit lun, sch Linh khu ni: n c 5 v vo ming u dn vo b cha ca n, Tn dch c to ra v theo ng li ring, Tam tiu a kh ra lm m p bp tht, tn dch ra nui dng b phu.... Thin Bn thn, sch Linh khu li ni: Tam Tiu l ph trung c (ch hi t ca ng nc) ng nc do m ra, thuc vi Bng quang. Vy tm li, Tam tiu l ng nguyn kh phn b thc n, ung chuyn ha ra vo, ch kh, ch Thy coi ton b hot ng kh ha trong c th con ngi. Tam tiu c 2 cng nng chnh:
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iu 31, sch Nn kinh ni: Thng tiu t di li xung n cch m ngang ch ming trn ca V, ch np m khng ch xut. Trung tiu l ngang gia trung qun ca V, khng cao khng thp, ch vic ngu nh thc n. H tiu ngang vi ming trn ca Bng quang, ch xut m khng ch np truyn tng cn b.
Thng Tiu
Thin Dinh V, sch Linh khu ni: Thng tiu nh sng m... Ni sng m l hnh dung Thng tiu nhiu kh. Thin Quyt kh, sch Linh khu ni: Thng tiu phn b kh ng cc i khp ni lm m da d, nui thn th, mt tc nh sng m ri xung gi l kh. Sch Trng Th loi kinh gii thch: T tn tinh kh ra, kh y nh sng m v quy v Ph, nn ni Thng tiu nh sng m. Chnh v Thng tiu a kh i khp ton thn m c tc dng lm m ngoi da, mt lng tc, v th phn c biu c dinh dng v do pht sinh c cng nng bo v ngoi (cng nng ny gi l V kh). Nu c nng ca Thng tiu mt bnh thng, s phn b b tr ngi, da d khng c s n nhun ca V kh, l chn lng m ng khng thun li s sinh ra hin tng rt run pht nng. Ngoi ra thng tiu cn c cng nng ch vic thu np. Np bao gm thu nhn c h hp v n ung, bi v V ch vic tip np n khng nn ra ngoi, Ph ch vic h hp. C 2 tng ph y u khai khiu thng tiu cho nn ni thng tiu c cng dng ch vic thu np.
Trung tiu
Thin Dinh v sinh hi, sch Linh khu ni: Trung tiu nh bt nc si ln. Bt nc si ln l ch vo trng thi ha sinh ca T V. Bi v nhn vo phm vi ca trung tiu v cng nng ca tng ph trong th ch yu l vn ha thy cc v chng bc kh huyt tn dch nui dng khp ton thn. Trong qu trnh y, ng lc ca mt lot hot ng ha sinh, tr cng nng ca T V trung tiu ra, th h tiu cng gp mt phn tc dng nht nh trong . Chc nng trung tiu bao gm: thu np cc kh, lc cn b, chng tn dch, lm thnh tinh hoa a ln Ph mch bin ha ra sc gi l huyt. Tc dng ca trung tiu ch yu l ha thy cc thnh ra kh huyt tn dch, l cht c tc dng dinh dng. S d gi nh bt nc si ln l mun ni n hot ng sinh l nh lm chn thc n ung, chng ha tn dch, tip thu tinh kh ca thy cc, ha sinh ra kh.
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H tiu
Thin Dinh v, sch Linh khu ni: H tiu nh ngi rnh. Sch Trng th loi kinh ni Ngi rnh l ch chy nc ra ni h tiu ch vic xut ch khng ch np. Cho nn cng nng ch yu ca h tiu l thm thy dch xung, gn lc ra thanh trc v bi tit ra i tiu tin tin m v hu m. 1.5.3. Nh vy, hot ng ca Tam tiu c th tm tt li nh sau 1.5.3.1. Con ng vn hnh nc (thng iu ng nc) trong c th u theo con ng ca Tam tiu Khi ta n ung vo, V l b cha v lm chn nh. T V cc vt cht dng gi l nc s thm v tn theo mn m, thm v tn c vo trong mn m l nh s tuyn b ca Ph kh. Nc t mn m s thm xung Bng quang, phn nc trong Tiu trng cng pht tn theo con ng ca h tiu vo Bng quang khi n cha ha kh. 1.5.3.2. Con ng ha kh hay ch tr cc kh ca Tam tiu Thy dch t khi n ung vo n bt c Tng ph no gip cho hot ng u c qu trnh kh ha to ra dng vt cht cho Tng ph , k c khi thm vo mn m, hoc t Tiu trng i ra u b ha chng ct ha thnh kh. Cn cc nc cha ha c nhp vo Bng quang, di y Bng quang l kh hi cng c tn l huyt tht. Qu trnh kh ha Bng quang bt ngun t huyt tht ny bc ln thnh kh (nc khng ha c s c thi ra ngoi). Kh c ha ny s bc ln theo con ng ca Tam tiu ln n hung cch, yt hu. y l con ng h (th ra ngoi). Phn kh theo mn m ra ngoi n t chi s theo con ng c nhc, xut ra b mao, chnh l V kh bo v mt ngoi ca c th. Nh vy ta bit rng s lin h gia tng ph vi nhau do con ng ca Tam tiu, Tam tiu l mn m. Gc ca n pht ra t Thn h tc Mnh mn. Phn trn ca n quy kt Tm bo lc, Tam tiu bao gm c ng tng lc ph, 12 kinh mch, c nhng cng dng h hp, tiu ha thc n ung hp th, bi tit, ha sinh kh huyt nn mi ni Tam tiu c quan h vi cng nng kh ha ca ton b c th. 1.5.3.3. Cc quan h ca Tam tiu a. Tam tiu thuc kinh th Thiu dng trong 12 kinh Khi u t cht ngn tay nhn pha ngn t ln dc theo ngoi c tay, ln khuu tay, dc pha ngoi cnh tay ln vai ra sau giao vi kinh mch tc Thiu dng, vo hm vai, ta ra chin trung lin lc vi Tm bo xung cch m ri n Tam tiu. 212
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b. Quan h gia Tam tiu v Tm bo Tm bo l ngoi v bao bc Tm nhng c coi l mt tng. Tam tiu l ph. Quan h gia Tm bo v Tam tiu l quan h gia tng v ph. Hn th na, Tam tiu l b phn bo v ngoi tng ph, Tm bo lc l bo v ngoi cho Tm, cng nh 2 ln thnh ca ca nh vua. Cho nn u thuc dng v u gi l tng ha. V th Tm bo v Tam tiu v cng dng l biu l thng nhau, phi hp cht ch vi nhau. 1.5.3.4. Triu chng bnh ca Tam tiu Bnh ca Tam tiu ch yu l v mt thy kh vn chuyn pht sinh chng ngi.
Nu thng tiu khng thng li th sinh suyn y. Trung tiu khng thng li th thy m ngng tr m bng y. H tiu khng thng li th thy ph n.
Mt khc do mi b phn ca Tam tiu u bao bc mt s Tng kh nn chng trng thng tiu lun bao gm chng trng ca Tm, Ph; chng trng trung tiu bao gm chng trng ca T, V v chng trng ca h tiu bao gm c Can, Thn, i, Tiu trng.
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2. NHNG BNH CHNG TM - TIU TRNG 2.1. Bnh chng tng Tm Tm bao gm Tm m v Tm dng, Tm huyt v Tm kh. Tm l v i ch, ng u hot ng tng ph ca c th. Do vy, bnh l tn thng tng Tm bao gm 2 nhm.
Nhm n bnh
+ Tm huyt ut tr. + m ha nhiu Tm. m m Tm khiu. + Tm huyt h. + Tm m h. Tm ha thng cang. + Tm kh h. + Tm dng h.
Nhm hp bnh
+ Tm T h. + Tm Thn bt giao. + Tm Ph kh h.
Do m trc (sn vt bnh l do kh h hoc dng h sinh ra). Do tnh ch b kch ng gy kh ut.
2.2.1.2. Bnh sinh Tm huyt ut tr l bnh cnh c bit ca mt biu hin thc chng trn nn tng h chng. l c th c sn kh h hoc dng h sinh ra m trc, m trc ngng t lm nh hng n s vn hnh chu lu ton thn ca Huyt. Hoc tnh ch b kch ng lm cho kh ut, cng nh hng n s vn hnh ca Huyt. M huyt dch l c s cho hot ng ca thn ch. Khi huyt dch vn hnh b ut tr, ngng t s sinh ra chng au, tc, du huyt. 2.2.1.3. Triu chng lm sng
Nng u, au u, chng mt. Hi hp, nh trng ngc. au vng trc ngc, au cp tim. Bt rt, nng mi, t but chi.
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Hot huyt, kh , hnh kh, ch thng. Thng dng ha . Nu nng: hi dng, cu nghch, ch kh, sinh mch.
* Phn tch bi thuc Huyt ph trc thang (Y Lm ci thc)
Bi ny do Vng Th Tr lp ra cha huyt ngc, huyt hnh khng thng li. Ngc au, u au khng khi, au nh kim chm, ch au c nh, hoc nc lu khng khi, hoc ung nc th sc, nn khan, hoc trng ngc hi hp, hoc m ng khng c, ng khng yn gic, d cu gt, li c im tm, ra li c huyt , hai mt thm qung tm. Mch sp hoc huyn khn.
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TM HUYT UT TR
- Chc nng ch yu b ri lon l chc nng ch huyt mch ca Tm. - Ch chng (triu chng quan trng): au cp tim, trng ngc, li c vt tm bm - Thuc tiu biu trong iu tr bnh chng Tm huyt ut tr: Huyt ph trc thang, Hot lc hiu linh n
Do ni thng tht tnh lm nhiu lon thn minh. Do bnh nhit li ung thuc nhit.
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m ha nhiu Tm
+ Vt v, mt ng. Ming ng, hng kh, li , ru li trng dy. D kinh s. + Ci ni huyn thuyn. Thao cung, nh mng ngi. Mch hot, hu lc.
m m tm khiu
+ Tinh thn n n. Ci ni mt mnh. t nhin ng ln. m kh kh. + Ru trng dy. Mch huyn hot.
Tm thn phn lit th hng phn Hng trm cm. Bin chng ri lon tm thn do dng thuc
2.1.2.5. Php tr
Mng thch cn m hon. (Ngc n qun phng, an kh tm php) T tuyt an. T hp hng hon.
* Phn tch bi thuc Mng thch cn m hon (Cn m hon)
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Mng thch tnh rt mnh, c kh nng trc m tch m phc, Trm hng iu t kh c, Hong cm kh hn, thanh ha thng tiu thanh tr ngun gc ca m, i hong kh hn, ng dch thc tch, m ng i xung, Tc dng chung ca bi l ging ha trc m. Nhn chung, sc thuc mnh, ngi sc yu, v ph n c mang khng dng trnh tn thng n chnh kh. * Phn tch bi T tuyt an (Ha t cc phng). Tc dng: thanh nhit gii c, trn kinh, khai khiu. Ch tr: nhit t hm bn trong, trng nhit, phin to, hn cung, ni nhm, ming kht, mi kh, tiu . St cao, co git.
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M HA NHIU TM - M M TM KHIU
- Chc nng ch yu b ri lon l chc nng ch thn minh ca Tm. - Ch chng (triu chng quan trng): pht cung, pht in hoc hn m - Thuc tiu biu trong iu tr bnh chng m ha nhiu Tm - m m Tm khiu: Mng thch cn m hon, T tuyt an, T hp hng hon
Do mc nhng bnh c tnh nhit lu ngy tn hi n Tm m. Do ni thng tht tnh, ng ch ha ha, ha nhit thng m.
2.1.3.2. Bnh sinh
Ri lon thn kinh chc nng. Ri lon thn kinh tim. Ri lon thn kinh thc vt sau vim nhim ko di. Tm cn suy nhc. Hi chng suy nhc mn.
2.1.3.5. Php tr
T dng Tm m, an thn. T m ging ha, tim dng an thn. Nhng bi thuc Y hc c truyn c th s dng.
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TM M H
- Chc nng ch yu b ri lon l chc nng ch thn minh v chc nng ch huyt mch ca Tm. - Ch chng (triu chng quan trng): chng m h ni nhit; hi hp, mt ng - Thuc tiu biu trong iu tr bnh chng Tm m h: Chu sa an thn hon, B t dng tm hon
Do mc bnh c tnh nhit lu ngy lm hao tn huyt dch. Do m h. Do s sinh ra huyt gim st. Do chn thng mt mu nhiu. Ph n sau sinh mt mu.
2.1.4.2. Bnh sinh
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Thiu mu. Suy nhc c th, suy nhc thn kinh. Suy tim.
2.1.4.5. Php tr Dng tm huyt, an thn. Nhng bi thuc Y hc c truyn c th s dng
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TM HUYT H
- Chc nng ch yu b ri lon l chc nng ch thn minh v ch huyt mch ca Tm. - Ch chng (triu chng quan trng): mt xanh, mi nht. Hi hp, trng ngc, mt ng - Thuc tiu biu trong iu tr bnh chng Tm huyt h: Thin vng b tm an, Dng tm thang
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Do bnh lu ngy Tm. Do Tm m h dn n Tm kh h. Ngi gi, lo suy, kh ton thn h yu nh hng n Tm kh.
2.1.5.2. Bnh sinh
Nng vng trc tim, mt ng; hay s hi. Hi hp, vn ng nhiu trng
ngc cng nhiu hn. Th ngn, thiu hi. T hn. Mt mi mt ng.
Cm gic nng, s lnh, kht. Da ti xanh, g m . Li nht, mm bu, ru trng. Mch t v lc.
2.1.5.4. Bnh cnh Ty y thng gp
Chong, huyt p thp Suy tim, hen ph qun mn. au tht ngc Lon nhp tim.
2.1.5.5. Php tr
B ch Tm kh
Nhng bi thuc Y hc c truyn c th s dng
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TM KH H
- Chc nng ch yu b ri lon l chc nng ch huyt mch ca Tm. - Ch chng (triu chng quan trng): mt xanh, mi nht. Hi hp, trng ngc, tng khi hot ng - Thuc tiu biu trong iu tr bnh chng Tm kh h: T qun t thang gia gim, Sm ph thang gia v
Tm dng h
+ S lnh, thch ung nc m. + au bng, tiu chy. Nc tiu trong. T hn. Tay chn lnh, + Ph n. au vng ngc, hi hp. Li nht, tm xm. Mch v lc.
Suy tim mn, bnh c tim thiu mu Suy h hp mn Huyt p thp Chong.
2.1.6.5. Php tr
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Chn v thang. c sm thang. Lc v hi dng m Hi dng cp cu thang. * Phn tch bi Chn v thang Xem phn hi chng Quyt m hn quyt. Phn tch bi thuc Lc v hi dng m
* Phn tch bi c sm thang Ch c c v Nhn sm. V Nhn sm ngt hi ng, tnh bnh. Tc dng: ch kh dng Tm, n dng hot huyt. * Phn tch bi thuc Hi dng cu cp thang (Thng hn lc th)
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TM DNG H
- Chc nng ch yu b ri lon l chc nng ch huyt mch ca Tm. Khi bnh nng s tn thng chc nng ch thn minh ca Tm - Ch chng (triu chng quan trng): s lnh, tay chn lnh. Hi hp, trng ngc. - Thuc tiu biu trong iu tr bnh chng Tm dng h: Chn v thang, c sm thang, Lc v hi dng m, Hi dng cp cu thang
Bnh c tnh nhit lu ngy tch nhit lm cho Tm m h. Bnh cnh Tm h trn nn tng c Thn m h.
2.1.7.2. Bnh sinh Tng Tm thuc dng, ch v Ha, tng cha Thn v v tr thng tiu. Tng Thn thuc m, ch v Thy tng cha Tinh, v v tr h tiu. tnh hung bnh thng, Tm ha giao xung c th gip cho chn dng trong Thn khin cho m thy c th ha sinh, Thn thy gip ln trn lm du cho Tm ha, Tm vi Thn, m v dng ch c ln nhau, cng nhau tn ti, thng ging nhp nhng gi l thy ha k t, thy ha giao ha nhau, gip c th m p h tiu, mt m thng tiu. Nu hai tng ny mt qun bnh a n s mt iu ha thy ha trong c th gi thy ha v t. Khi Tm ha b khuy ng do Tm m h hoc Tm huyt h. H ha bc ln, trong khi v c a c m h sn, hoc Thn m h, khng sc lm ch thy dch, khng kim gi c ha, sinh ra chng thng tiu th nng, bc ha; h tiu v 2 chn th lnh. Ha i ng ha, thy i ng thy
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sinh ra bnh chng Tm Thn khng giao nhau biu hin: hi hp, hay m, d kinh s, tai , tai ic, ming li mc mn, mi lng, mm gi, di tinh, bch trc ..v..v.. 2.1.7.3. Triu chng lm sng
Chng mt, mt ng, trm cm, hi hp. Bt rt, mt tr nh. tai, hoa
mt. Cm gic nng c v kh hng, bc nng mt.
Nc tiu sm mu, lng t. o hn, triu nhit, di tinh. au nhc ton thn, lng gi mi. Tiu ngn . Mch t sc.
2.1.7.4. Bnh cnh Ty y thng gp
Ri lon thn kinh chc nng. Suy nhc sinh dc Tm cn suy nhc. Tng huyt p. Suy nhc mn.
2.1.7.5. Php tr
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TM THN BT GIAO
- Chc nng ch yu b ri lon l chc nng ch thn minh ca Tm. - Ch chng (triu chng quan trng): mt ng, hi hp, trng ngc. - Thuc tiu biu trong iu tr bnh chng Tm Thn bt giao: b Tm Thn
Dinh dng km, khng cung cp thy cc to ra tinh huyt. Ph n sau khi sinh mt mu, hoc chn thng mt mu nhiu lm cho
huyt h.
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Trng ngc. Hi hp. Ng t. Hay m. Hay qun. Mt mi, gy yu, n km, bng y. i tin lng. Li nht bu. Mch t nhc.
2.1.8.4. Bnh cnh Ty y thng gp
Suy nhc c th. Thiu mu. Tm cn suy nhc X cng ng mch. Tng huyt p.
2.1.8.5. Php tr
B ch Tm T.
Nhng bi thuc ng y c th dng gm
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* Phn tch bi thuc phc mch thang (Chch Cam tho thang)
TM T H
- Chc nng ch yu b ri lon l chc nng ch thn minh ca Tm v chc nng vn ha thy thp ca T - Ch chng (triu chng quan trng): mt ng, hi hp, trng ngc, y bng, ri lon tiu ha. - Thuc tiu biu trong iu tr bnh chng Tm T h: Quy t thang, Phc mch thang, Bt trn thang gia gim
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Ho thiu hi. T hn. Da trng bch. Tiu t. Hi hp, trng ngc. Mch
h, t. 2.1.9.4. Bnh cnh Ty y thng gp
ch kh dng m B ch Tm Ph.
Cc bi thuc Y hc c truyn thng s dng
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TM PH KH H
- Chc nng ch yu b ri lon l chc nng ch thn minh ca Tm v chc nng ch kh ca Ph - Ch chng (triu chng quan trng): au ngc, kh th, trng ngc, thiu hi. - Thuc tiu biu trong iu tr bnh chng Tm Ph kh h: Bt trn thang, Nhn sm dng vinh thang
2.2. Bnh chng ph tiu trng (Tiu trng h hn) 2.2.1. Bnh nguyn
au bng m , thch xoa nn, si rut tiu chy. Tiu nhiu ln, trong di. Tay chn mt mi, lnh, khng c sc.
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Tri lnh, n sng lnh bnh cng tng. i tin lng, phn sng. Li nht, ru trng mng. Mch t nhc.
2.2.4. Bnh cnh Ty y thng gp
n trung kin T ch t.
* Phn tch bi thuc L trung thang (Thng hn lun)
TIU TRNG H HN
- Chc nng ch yu b ri lon l chc nng phn thanh trc ca Tiu trng - Ch chng (triu chng quan trng): Tay chn mt mi, lnh, khng c sc. Tri lnh, n sng lnh bnh cng tng. i tin lng, phn sng. - Thuc tiu biu trong iu tr bnh chng Tiu trng h hn: L trung thang
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CU HI N TP
A. CU HI 5 CHN 1 - CHN CU NG
1. Hi chng bnh no do mi quan h ca Thy v Ha mt qun bnh trong c th. A. Tm dng h. B. Tm T dng h. C. Tm Ph kh h. D. Tm Thn dng h. E. Tm Thn bt giao. 2. Hi chng bnh c c kh v huyt u suy A. m ha nhiu Tm, m m Tm khiu. B. Tm m h C. Tm Thn bt giao D. Tm T h. E. Tm Ph kh h 3. Triu chng: mt ng, hay mng, ni m, bt rt, gim tr nh, ng tm phin nhit, cn bc nng bng mt, st v chiu v m, tiu t, m hi trm, li kh, mch t sc... biu hin trong bnh cnh A. Thiu m ha nhit B. Tm huyt ut tr. C. Tm huyt h. D. Tm m h. E. m ha nhiu Tm 4. Nhm triu chng: tinh thn n n, ci ni mt mnh, t nhin ng ln, m kh kh, ru li trng dy, mch huyn hot l biu hin ca bnh chng A. Tm huyt ut tr B. Tm m h C. m ha nhiu Tm D. m m Tm khiu. E. Tm Thn bt giao
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5. Nhm triu chng: chng mt, mt ng, trm cm, hi hp, bt rt, mt tr nh, tai, hoa mt, cm gic nng c, kh hng, bc ha mt, o hn, triu nhit, au nhc ton thn, lng gi mi, lnh hai chn, tiu , mch t sc...l biu hin ca: A. Tm m h. B. Tm ha thng cang. C. Tm Thn h. D. Tm Thn bt giao E. Tm huyt h. 6. Nhm triu chng: ton thn mt mi, d di, au vng ngc, kh th, th nng nhanh, tay chn lnh, ho thiu hi, t hn, hi hp trng ngc, sc da trng bch, tiu t, mch t v lc l biu hin ca A. Tm kh h. B. Tm Thn bt giao. C. Tm kh huyt lng h. D. Tm T h. E. Tm Ph kh h 7. Triu chng c trng ca li trong hi chng Tm huyt ut tr A. Li cng, l lot, ru trng, ni kh. B. Li ru vng, li ming l lot, sng au. C. Li , c vt bm tm. D. Li kh, khng ru, u li . E. Li kh, nht nht, bu. 8. c tnh ca ph Tiu trng c nu ng nht A. Thi dng Tiu trng chi phi chi trn v ngc bng c quan h vi Tm. B. Cng dng ca thi dng Tiu trng l to nn con ng phi hp gia Doanh kh v V kh. C. Tiu trng ch v ha v huyt, thuc Doanh phn, l ni thanh dng trc m ln ln. D. Ph Tiu trng v tng Tm c cng tnh cht l ha, quan h biu l nhau. E. Tiu trng ng vi qu Kin, thuc tnh l Ha - Tm v Tiu trng quan h biu l.
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B. CU HI NHN QU 1. a. Quan h gia Tm vi Ph l mi quan h thng qua cng nng hot ng, bi v b. Tm ch huyt, Ph ch kh. Kh gip thc y huyt vn hnh v ngc li huyt ti nhun nui dng s hot ng ca kh. A. a ng, b ng, a v b c quan h nhn qu. B. a ng, b ng, a v b khng c quan h nhn qu. C. a ng, b sai. D. a sai, b ng. E. a sai, b sai. 2. a. Trong bnh chng m ha nhiu Tm, php tr l Thanh tm t ha tr m khai khiu, bi v b. Nhit cc sinh m lm nhiu lon thn minh. A. a ng, b ng, a v b c quan h nhn qu. B. a ng, b ng, a v b khng c quan h nhn qu. C. a ng, b sai. D. a sai, b ng. E. a sai, b sai. 3. a. Chng Tm T h c nguyn nhn t Tm m h gy ra, bi v b. Tm ha sinh T th. A. a ng, b ng, a v b c quan h nhn qu. B. a ng, b ng, a v b khng c quan h nhn qu. C. a ng, b sai. D. a sai, b ng. E. a sai, b sai. 4. a. Trong hi chng Tm T h c triu chng: n km, bng y, i tin lng, bi v b. T th c chc nng vn ha thy thp. A. a ng, b ng, a v b c quan h nhn qu. B. a ng, b ng, a v b khng c quan h nhn qu. C. a ng, b sai. D. a sai, b ng. E. a sai, b sai. 241
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5. a. Trong bnh cnh Tiu trng h hn c triu chng: si rut, tiu chy, bi v b. Hn t lm ri lon chc nng phn bit thanh trc ca Tiu trng. A. a ng, b ng, a v b c quan h nhn qu. B. a ng, b ng, a v b khng c quan h nhn qu. C. a ng, b sai. D. a sai, b ng. E. a sai, b sai. 6. a. Tm bo lc; Tiu trng u thuc tng ha, bi v b. Tm bo v Tiu trng u c quan h biu l vi Tm. A. a ng, b ng, a v b c quan h nhn qu. B. a ng, b ng, a v b khng c quan h nhn qu. C. a ng, b sai. D. a sai, b ng. E. a sai, b sai. 7. a. Triu chng ca Trung tiu h hn l bng au, si rut, tiu lng, bng y, bi v b. Trung tiu c quan h cht ch vi T V. A. a ng, b ng, a v b c quan h nhn qu. B. a ng, b ng, a v b khng c quan h nhn qu. C. a ng, b sai. D. a sai, b ng. E. a sai, b sai C. CU HI NHIU CU NG 1. Chc nng sinh l ca tng Tm bao gm A. Tm tng thn. Ch thn minh. B. Tm ch tng ha, khai khiu ra li. C. Tm ch huyt mch, vinh nhun ra mt. D. Tm c quan h biu l vi Tiu trng v c Tm bo che ch. E. Tm tng huyt, ch mch, vinh nhun ra mt.
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2. Php hi dng cu nghch c ch nh iu tr cho bnh chng A. Tm dng h. B. Tm Ph kh h. C. Thiu m ha hn. D. Tiu trng h hn. E. Quyt m hn huyt. 3. Triu chng c trng ca Tm m h A. Mt ng, bt rt, gim tr nh. B. St chiu v m, tay chn nng. C. Mt , u li kh, m hi trm. D. Cn bc nng bng u mt, ra m hi chn tay. E. Ng hay mng m, ni m, ng tm phin nhit. 4. Triu chng c trng ca Tm kh h A. on kh, th ngn, ho khi i t th. B. Hot ng lao ng nng bnh tng ln, nh trng ngc, mt mi. C. Sc mt xanh xao, nng vng trc tim, hi hp. D. Mt ng, hay s hi, hi hp, t hn. E. Mch sc, v lc. 5. Triu chng c trng ca bnh chng Tm, Thn bt giao A. Chng mt, mt ng, bt rt, hay qun, tai, trm cm. B. Nc tiu t, to bn, t hn, tay chn lnh. C. Bc nng mt, tay chn lnh, ming kh kht. D. o hn, triu nhit, di tinh, lng gi mi, lnh 2 chn. E. Trm cm, mt tr nh, hoa mt, tiu , t hn, lng gi mi. 6. Chc nng sinh l tng Tm bao gm A. Tng Thn, ch thn minh, chc nng qun ch. B. Ch huyt mch, khai khiu ra mt, vinh nhun ra mt. C. Ch Ha, ch huyt mch, quan h biu l vi Tiu trng. D. Ch Huyt mch, quan h vi Tam tiu v Tm bo. E. Khai khiu ra li, quan h k t vi tng Thn.
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7. Trong mi quan h chc nng vi tng Tm, vai tr no ca cc tng sau y l ng A. Tng khc vi Ph kim. B. Quan h gia Tm vi Ph l quan h hot ng gia kh v huyt. C. Tng sinh vi T Th v cng lm ch huyt. D. Quan h gia Tm vi Thn l quan h v t. E. Quan h gia Can, Tm, T l quan h tng sinh. 8. Hot ng ca li linh hot l do A. Tm huyt . B. Tm kh tt. C. Tm m thnh. D. Tm dng . E. Kh v huyt u tt. 9. Quan h gia Tm vi Tiu trng l quan h A. Gia tng v ph, quan h biu l. B. Kinh Tm c nhnh i qua Tiu trng. C. Gia qun ha v tng ha. D. Tng sinh. E. Tng khc. 10. Cc nguyn nhn gy nn H/C Tm huyt h A. Ngi gi, lo suy, kh suy a n huyt h. B. Do mc bnh c tnh nhit lu ngy, m h hao tn huyt dch. C. Do chn thng mt mu nhiu. D. Ph n c m h v sau sinh mt mu. E. Do kh huyt lng h.
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P N
CU HI 5 CHN 1 - CHN CU NG
STT 1 2 3 4 5 6 7 8 p n E E D D D E C C
CU HI NHN QU
STT 1 2 3 4 5 6 7 p n A B D A C C A
CU HI NHIU CU NG
STT 1 2 3 4 5 6 7 8 9 10 p n A, C, D C, E A, C, E B, C, D A, D A, C, E A, B, E B, D A, B, C B, C, D
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Bi 10
CCH K N THUC
MC TIU
Sau khi hc xong bi ny, sinh vin PHI 1. nh ngha c vai tr ca Qun - Thn - T - S trong mt bi thuc ng Y 2. nh ngha v lit k c cc thuc tng tu, tng s, tng y, tng st, tng , tng phn. 3. Nu c cc dc vt cm k v thn trng khi dng lc c thai. 4. Nu c cc cm k trong khi ung thuc. 5. Thuc lng c cc v thuc (cng vi liu lng) trong danh mc thuc c v gim c ca ng y.
1. NHNG PHNG CCH K N THUC Sau khi chn on, ngi thy thuc s cn cu vo tnh trng bnh c th m thit lp mt n thuc iu tr. ng y thng gi l bin chng lun tr (da vo bnh - chng ca ngi bnh m bin lun cch tr liu). C nhiu phng php k n thuc trong ng y. 1.1. C phng gia gim theo l lun ng y Theo phng php ny, ni dung bi thuc l nhng bi thuc c xc lp, ghi nhn kt qu t lu i qua nhiu th h, c ghi li trong cc sch kinh in. Khi iu tr ngi thy thuc thng tng thm (gia) hoc gim bt (gim) v thuc hay liu dng sao cho ph hp nht vi tnh hnh thc t ca bnh nhn. Mt v d nh cha chng Ngoi cm phong hn, biu thc (c s lnh, pht st, khng m hi, ngt mi, th suyn, hoc ho m, au u, au nhc cc khp, cng gy, mch ph khn) th bi thuc kinh in ng y s dng l bi Ma hong thang.
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u im
+ n gin, linh hot trong vic vn dng cc v thuc. + Khng phi nh nhiu bi thuc.
u im: d s dng, vn dng c nam dc. Khuyt im: khng bo m tnh l php ca ng y.
1.4. Theo toa cn bn Ni dung bi thuc theo toa cn bn c da theo kinh nghim ca qun dn y trong thi gian khng chin. Ngoi 10 -11 v thuc dng nhun tiu, nhun gan, nhun trng, nhun huyt, gii c c th, kch thch tiu ha, khai khiu, vic s dng toa cn bn cn gia thm Qu chi, Ta t, Hnh, Kinh gii, Bch ch.
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1.5. K n theo dc l tn y Trong giai on hin nay, khng ch ngi lng y, thy thuc c truyn s dng thuc c ngun gc t nhin tr bnh, m c nhng thy thuc Ty y cng quan tm ngy cng nhiu. V th, vic thit lp cc toa thuc iu tr c s dng thm c s dc l Ty y. Tiu biu cho phng php ny l cch thit lp bi thuc do Bi Ch Hiu xy dng (Gio s dc l hc). Bi thuc chung c gia gim Ta t Cam tho t Bc h Kinh gii Cc hoa Cc tn Gng ti.
Trong th phong hn
+ B Bc h, Cc hoa (tn lng gii biu) + B Cam tho t (Thanh nhit gii c).
u im: tha mn c yu cu iu tri ca ng y cng nh Ty y t l php n bin chng ca ng y cng nh phng php iu tr ca Ty y.
Nhc im: kh vn dng, i hi phi c mt trnh tinh thng v y l, dc l ca c ng v Ty y. 2. NHNG NI DUNG QUAN TRNG TRONG CCH K N THUC THEO L LUN NG Y 2.1. Vai tr ca cc v thuc trong mt n thuc (qun, thn, t, s) Vic cu to cc v thuc trong mt bi thuc nhm gii quyt nhng yu cu t ra trong iu tr nh sau
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Gii quyt nhng triu chng chnh, nhng triu chng thuc v nguyn
nhn gy bnh, nhng triu chng do tng bnh chnh th hin.
Gii quyt nhng triu chng ph, nhng triu chng do tng ph c
quan h (biu l hoc ng hnh) vi tng ph b bnh th hin.
Tng hot tnh ca v thuc chnh. a cc v thuc chnh n tng ph, kinh lc b bnh. iu ha tnh nng ca cc v thuc.
Do cc v thuc thng ng nhng vai tr sau y
Cam tho bc: ngt bnh vo 12 kinh, gim bt tnh cng pht ca
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Nhm cha triu chng bnh. Nhm iu ha tnh nng hoc/v dn kinh cho nhm trn.
2.2. Nhng yu t nh hng n v tr ca v thuc trong bi thuc Trong thc t iu tr, ngi thy thuc ng y cn phi ch n nhng nguyn tc sau y quyt nh v tr ca thuc trong tng bi thuc. 2.2.1. Tiu bn hon cp
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iu tr chng Quyt m hn quyt. Php tr: hi dng n l. Bi thuc kinh in: T nghch thang
Vai tr cc v thuc QUN THN T S Tn v thuc Ph t Can khng Cam tho Tc dng Hi dng n l Hi dng - n l
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3. S PHI NG CC V THUC TRONG MT N THUC Mc ch ca s phi ng cc v thuc l tng tc dng, tng hiu qu cc v ch dc, gim tc dng ph, gim c tnh cc v thuc nht l ch dc v sau cng l trnh lm mt hiu qu thuc hoc lm tng c tnh hn. C nhng loi phi ng sau.
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Ba u (t h). Khin ngu, i kch, Thng lc (trc thy). Tam tht (hot huyt). Sa hng (ph kh). Nga trut, Thy it, Manh trng (ph huyt).
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o nhn, Hng hoa (hot huyt). Bn h, i hong (t h). Ch thc (ph kh). Ph t, Can khng, Nhc qu (i nhit).
Cam tho bc phn Cam toi, Nguyn hoa, Hi to. u phn Bi mu, Bn h, Bch cp, Bch lim. L l phn Sm, T tn, Bch thc.
4.4. Cm k trong khi ung thuc
Cam tho bc, Hong lin, Ct cnh, mai king tht ln. Bc h king Ba ba. Phc linh king dm. Dng cc thuc n trung tr hn king n sng lnh. Dng cc thuc kin T tiu o king cht bo, tanh, nhn. Dng cc thuc an thn nh ch king cht kch thch.
CU HI N TP
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3. V thuc khi dng s lm mt tc dng ca mt v thuc khc, gi l A. Tng s B. Tng y C. Tng st D. Tng E. Tng phn 4. V thuc c chn lm Qun, l v thuc A. Gii quyt c triu chng bnh B. Gii quyt c nguyn nhn bnh C. Gii quyt c triu chng bnh gy bi tng ph c quan h vi tng bnh D. Dng gim c tnh ca mt loi thuc E. Dng iu ha tnh nng ca cc v thuc 5. V thuc c chn lm Thn, l v thuc A. Gii quyt c triu chng ch yu ca bnh B. Gii quyt c nguyn nhn bnh C. Gii quyt c triu chng bnh gy bi tng ph c quan h vi tng bnh D. Dng gim c tnh ca mt loi thuc E. Dng iu ha tnh nng ca cc v thuc 6. V thuc c chn lm T, l v thuc A. Gii quyt c triu chng bnh B. Gii quyt c nguyn nhn bnh C. Gii quyt c triu chng bnh gy bi tng ph c quan h vi tng bnh D. Dng gim c tnh ca mt loi thuc E. Dng iu ha tnh nng ca cc v thuc 7. V thuc c chn lm S, l v thuc A. Gii quyt c triu chng bnh B. Gii quyt c nguyn nhn bnh C. Gii quyt c triu chng bnh gy bi tng ph c quan h vi tng bnh D. Dng gim c tnh ca mt loi thuc E. Dng iu ha tnh nng ca cc v thuc 255
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8. Thuc cm dng khi c thai A. o nhn B. Ch thc C. Ph t D. Ba u E. Nhc qu 9. Thuc cm dng khi c thai A. Khin ngu B. Can khng C. o nhn D. Hng hoa E. Bn h ch 10. Vai tr cc v thuc trong bi Lc v cha Thn m h (gm Thc a, Hoi sn, n b, Trch t, Sn th, Phc linh) theo l, php, phng, dc A. Thc a lm Qun B. Sn th lm T C. Trch t lm S D. n b lm Thn E. Phc linh lm Qun
P N
CU HI 5 CHN 1 - CHN CU NG
STT 1 2 3 4 5 p n A A D B C STT 6 7 8 9 10 p n D E D A A
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1. 2. 3. 4. 5. 6.
B Mn YHDT, Trng i hc Y H Ni. Bi ging ng y tp I, tp II. Nh xut bn Y hc H Ni. B Mn ng Y. Trng i Hc Y khoa H Ni. Bi ging ng y tp II. Nh xut bn Y hc. 1979. Bi Ch Hiu. Dc l tr liu. Nh xut bn Cu Long. 1985 Bi Ch Hiu. Cch k n thuc. Dc l tr liu. 37-38. Nh xut bn Cu Long. 1985. Bi Ch Hiu, Trn Khit. Danh t Y hc c truyn. Nh xut bn Y hc. 1989. Dip Hin Thun. S tay nhng bi thuc thng dng. Dch gi Nguyn Cnh Phc, Nguyn Trung Ha. Hi Y hc dn tc TP.H Ch Minh - 1992. Tt Li. Nhng cy thuc v v thuc Vit Nam. Nh xut bn Khoa hc & K thut. 1977 Hong Ni kinh Linh khu I,II, III. Dch gi Hunh Minh c. Hi y hc dn tc c truyn ng Nai. 1990. Hong Qu (ngi dch). Khi yu chm cu hc Trung Quc. Trang 210. Nh xut bn Y hc H Ni. 2000 Hong Duy Tn, Trn Vn Nh. Tuyn tp phng thang ng y. Nh xut bn ng Nai. 1995 Hong Bo Chu. Phng thuc c truyn. Nh xut bn Y hc H Ni. 1995. Hunh Minh c. Ni kinh Linh Khu. Nh xut bn ng Nai. 1989. Nguyn Thin Quyn, Nguyn Mng Hng. T in ng y hc c truyn. Nh xut bn Khoa hc k thut. 1990. Nguyn Trung Ha. Tm tt Linh Khu - T Vn. Hi Y hc c truyn VN. - chi nhnh pha nam. 1988. Nguyn T Siu. Ni kinh T Vn. Nh xut bn Khai Tr. 1974. Nguyn Trung Ha. Gio trnh Thng hn v n bnh hc. Hi YHDT Ty Ninh ti xut bn nm 1985. Lu hnh ni b, trang 8 11 Nguyn Trung Ha. Gio trnh Thng hn. Vin YHDT TP. HCM. 1980 - Lu hnh ni b. S Y t Thanh Ha. Trung y khi lun tp thng. 1989 257
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Trn Vn K. Dc hc c truyn, trang 9, 276, 340, 368, 386, 482. Nh xut bn TP. H Ch Minh. 1995 Trng Trng Cnh. (Dch gi Hunh Minh c). Thng hn lun, quyn I. Nh xut bn ng Nai. 1995. Trn Thy. B mn Y hc c truyn, Trng i hc Y H Ni. Chuyn Ni khoa Y hc c truyn. Nh Xut bn Y hc H Ni. 1995. Tuyn thch danh t thut ng Trung y tp I. Hc vin Trung y v Vin nghin cu Trung y Qung ng bin son. Dch gi Nguyn Trung Ha, Ng Kim Dip. Phng tha k Vin YHDT. 1980. Trn Khit. ng y - L php phng dc. Trung tm o to v Nghin cu ng y DT. Ti liu ni b. 1990. Vin Y hc Trung y Bc Kinh. Phng t hc ging ngha. Dch gi Dng Hu Nam, Dng Trng Hiu. Nh xut bn Y hc. 1994.
23. 24.
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