TH NM, NGY 31 THNG MI HAI NM 2009

Bnh thng gp.

CC BNH THNG GP
Cc bi vit sau y gii thiu cng cc bn cch thc nhn din v gii quyt mt s bnh thng gp m ti thnh cng tng i l chc tay. Ga tr ca phc tng i n nh. Trong mn phi DC-KLP c th c nhiu phc gn hn, hay hn nhng bt buc cc bn phi nh nhiu phc cho mt bnh v phi m mm tm phc thch hp. l iu ha ra l kh ch khng phi d. y, ti xy dng kiu iu tr theo c ch bnh, mi u c v kh nhng khi quen th li rt d v ch cn thuc cc phc iu chnh theo c ch nh b m dng kh huyt, tiu vim, tr thpv.vsau l phn chiu hay ng ng l xong. Cc bnh c phn loi theo cc h thng bnh ca Ty y. V bnh danh (tn bnh ) a s cng c dng theo Ty y. iu ny gip cho cc bn c th p dng c khi bit tn ca chng bnh mnh ang can thip.Vic cn li l cn chn on hn - nhit ( lnh nng ) cho ng na l xong. Chc cc bn thnh cng.Mi thc mc nu c, hy lin lc v : Lng y T Minh. 97 / F 1 Quang Trung, phng 11, qun G Vp, TP.HCM. ,thoi: 5892836. -Mobile ( TD ): 091.8388718. E mail: taminhdc@yahoo.com, minhta2002@hotmail.com.
CCH CHN ON BNH DO LNH HAY DO NNG GY RA: - Bnh do lnh: au tng v m hay sng sm, tri tr lnh, tri ma hoc n ung lnh t nhit lng vo chng 30 pht sau th au tng. Ti gi l CC YU T LNH.

- Bnh do nng: au tng vo bui tra, tri tr nng, nng gt hoc n ung cay nng nhiu nhit lng chng 30 pht sau th au tng. Ti gi l CC YU T NNG. CCH IU TR: S dng cc cng thc iu tr bnh theo mt trong hai cch di y sau khi bit bnh do lnh hay do nng gy ra. - Bnh do lnh: nu bnh nng (lnh nhiu) th h xc du, bnh va va hoc nh cc bn dng du day vo huyt hoc qut hoc co cc phn chiu. Trng hp bnh do nhim m thp bn dng salonpas ct nh v dn ln huyt hoc vng phn chiu, nh vy trong 2 - 4 ting ng h. - Bnh do nng: nu bnh nng (nng nhiu) dng nc p vo cc huyt 2 pht mi huyt ri i sang huyt khc theo th t trong cng thc. Nu bnh va va bn dng que d ln gai hay ln inh. Nu bnh nh bn dng cch rung huyt, day n bng que d hoc co vi vaseline.

H H HP.
VIM HNG.
Nhng bnh chng thuc vim hng gm c: vim amidan, vim hng ht, vim vm khu ci, vim thanh qun , vim VA. Trong cc b phn ny th VA l b phn c v tr cao nht, thanh qun c v tr thp nht. Vim hng lun au hng c th c ho, c th c m. Nghe phi thy bnh thng. 1- Vim Amidal: ni v nut u au v c cm gic nghn nght hai bn c hng. iu tr : 26, 61, 37, 50, 38, 156, 12 n 240, 275, 14, 277. 2- Vim vm khu ci: ni au hn nut, khng nght, vng gia v trn hng (ch nght khi vim cp tnh v nng). iu tr: 26, 61, 37,50,38,156 v ng ng ( h khu bn tay, c hai mt). 3- Vim VA: au vng trn hng, ch tng nh khi nut, khng nght khi nut nhng c th c cm gic nght khi th .iu tr : Tiu vim, phn chiu VA ( vng trc huyt 57, vng 108 26 ). 4- Vim thanh qun: au vng di hng v nght khi ni ln nut nhng ni au hn. iu tr: 26,61,37,50,38,156, phn chiu ( vng t 14 ko thng xung gc xng hm di), ng ng (vng u mi).

5- Vim thanh i: R hoc mt ting, thng sau mt trn cm. Diu tr: 127,50,19,37,1,0 - + vng t 19 n 173. Phi chn on hn nhit c k thut tng ng. C khi hn nhit ln ln th cn tr theo hn trc ri nhit sau , cn phng trng hp vim do nhim trng. Cch nhn bit vim do nhim trng: au, c st i khi st cao, cha bng DC khng c hiu qu hay hiu qu km v tr bnh li ngay sau chng 30 pht. ./.

VIM MI.
Vim mi kh phc tp , c 4 nguyn nhn in hnh: vim mi do hn, vim mi do nhit, vim mi do hn nhit ln ln, vim mi do mi bi (khng nguyn). Vim mi thng c 2 kiu: dng khng nght v dng c nght. Tuy nhin trn thc t may mn lm ta mi gp mt bnh nhn vim mi ch c mt nguyn nhn, m thng l do 2 nguyn nhn tr ln v kiu vim th tng hp. 1- Vim mi do hn: ht hi khi gp yu t lnh nh sng sm, chiu ti, ma hay gi lnh. C th s mi nhng c im l nc mi long nh nc khng nhy nht. iu tr : dn b thng, lu dn 2 gi. 2- Vim mi do nhit: triu chng xy ra khi gp yu t nng ( ngc li vi trn). Nc mi c cht nhy nht. iu tr : day vaseline hoc rung huyt b Ging hoc b Tiu vim, co hoc ln gai nh phn chiu mi. Lu v vim nhim trng. 3- Vim mi do hn nhit ln ln : ht hi s mi khi thay i yu t nhit hoc mi trng. Nu nng c th ch cn t ni nng vo ni bng mt hoc t bng mt ra ni c nng cng u ht hi v s mi. iu tr : chia lm 2 giai on, giai on u dng b B Trung bng du v phn chiu mi, giai on sau dng day vaseline b Tiu vim v phn chiu mi . 4- Vim mi do khng nguyn (do mi hoc bi) : ht hi s mi khi gp khng nguyn. Khng nguyn c th l bi ng, bi khi xe, bi mc c trong vt dng c, bi trong nh, lng th vt, phn hoa, mi ha cht . iu tr : cng chia lm 2 giai on: giai on u iu tr nh vim mi dng hn, giai on sau dng b Ging phi hp b Tiu vim v co phn chiu mi. Nu trn l dng khng nght. Vim mi dng nght: triu chng ch yu l nght mi, c th km s mi. y l dng kh tr nht v c polyp trong mi, va c tnh vim ph n va vim xung huyt, va mang tnh d ng vi khng nguyn rt a dng, thm ch c khi c nh hng ca yu t thn kinh. Nu ch vim ph n th tng i d cha, cn tiu vim lc thp phn chiu polyp bng du . Vim xung huyt th dai dng hn cng tiu vim phn chiu polyp nhng khng dng du, kt qu rt hn ch. y

l dng phc tp nht nn hiu qu km v cn lun thay i phc k thut i ph vi din bin hng ngy. King c: lnh th c lnh, nhit th c nng, do khng nguyn v c polyp th trnh cc khng nguyn v lnh chua- g - mm- np -tm cua -rau mung. Kt lun :Trn lm sng t khi gp trng hp in hnh nh nu m thng c s pha tp nhau. Cn theo di triu chng mi ngy v bin i theo triu chng da vo cc nguyn tc nu trn i ph triu chng km vi iu tr gc bnh./.

VIM XOANG
Xoang l nhng mnh xng vng mt c cu to khng c m y l hang,c cc dy thn kinh v c bit l mu ra vo rt nhiu. Xoang b vim khi nhim trng hoc mu li v hoi t trong n. Cho nn ta thy trn thc t nhiu ca vim xoang dng khng sinh khng khi hoc khi chc xoang thy khng c m m ch ton l mu. DC-KLP iu tr bnh ny rt tt v ngoi tnh khng vim cn tnh khai thng tun hon huyt y. C hai loi xoang: xoang cn ( xoang hm trn, xoang trn, xoang sn trc ) v xoang su ( xoang sn sau, xoang bm ), tng cng c 5 xoang. Ngoi ra trn thc t ta thy thnh thong c bnh nhn b vim c xng sng mi, tuy nhin y khng c coi l xoang. Trn thc t ngi ta hay dng t VIM XOANG MI. Khi vim hai xoang tr ln th gi l vim a xoang. a s bnh nhn b vim a xoang. iu tr vim xoang mn: hn chng th day c du b Tiu Vim, 300, b v phng chiu cc vng xoang . Nhit chng th day bng vaseline phc trn. Nu bnh nhn c th trng m h th cn day b B m huyt trc . Khi vim xoang cp th bnh nhn c st. Cn chn on hn nhit dng k thut thch hp. Nu hn chng th cn h nng v xoa du theo phc nu trn 3 ln mi huyt v v tr. N nhit chng th y l c nhim trng, dng nc p lnh v kt hp vi khng sinh cho nhanh. King c: king tuyt i cc thc n ung sau: cc thc t t lnh,cc thc chua, g, mm, np. Trung bnh t 3 n 7 ln iu tr l bnh nhn ht nhc u. Nhng cc xoang cha khi vim hn, cn iu tr tip cho n ht sinh huyt cc vng xoang.

VIM PH QUN V HEN PH QUN.

Phi ni l vim ph-kh qun mi y . Trn thc t hai b phn ny ring bit nhau v c lc vim ring l nhng a s h vim kh qun th km vim ph qun v ngc li.

Ho l triu chng ban u, sau vi ngy khng gim c th s gy au hng. C th c m hoc khng. Phi c ting rt hay ran hoc c hai . St nu vim cp, khng st trong trng hp vim mn tnh, nhng khi vim mn th thng d b nhng t vim cp xen k. Cn ch hin tng ny c gii php ng kp thi. Vim ph qun mn tnh rt d chuyn thnh hen ph qun ( ngy nay ngi ta dng thut ng hi chng thuyn tc phi, hi chng ho-kh th phi, hi chng tc nghn phi, hi chng tc nghn h hp phi ch tt c triu chng kh th do phi v ph kh qun ). iu ny ring c nhn ti thy rng nh ngha ngy xa ng hn v suyn th khng c m m hen th bt buc phi c m d c th rt t, i khi t n mc bnh nhn khng cm thy c m , nghe phi cng khng r nt lm, nht l khi th trng BN suy kit. V trong thc t nguyn nhn v cch iu tr hen v suyn hon ton khc nhau ( nht l iu tr bng phng php DC) d rng hin tng bnh u th hin phi , trnh by trong bi Hen Suyn. Vim Ph qun:ho,thng thng l c m, nu ho nhiu th km au hng. Dng b Tiu vim, phn chiu kh ph qun, hn th lm m nng bng du hay ngi cu , nhit th lm day bng vaseline v ln gai. Nu m nhiu th nn dn cao. Lu dn 2 gi mi ngy. Nu vim cp th c st . Hn chng th phi dng ngi cu h xc du ri dn cao phc nh trn. Nhit chng l c nhim trng, nn phi hp vi khng sinh, v thuc ty nn khuyn bnh nhn theo kin BS v thuc ty khng thuc lnh vc ca chng ta ( Chng ta khng rnh thuc ty bng BS ). Nhng nu bnh nhn gy mn, m h kh khan th c th khng thy c m, thm ch nghe phi ch nghe rt ch khng c ting ran. Trng hp ny iu tr kh khn v bnh nhn suy kit lu. Cn va b m huyt va day tiu vim v phn chiu kh ph qun. K thut th ty nghi m ng bin cho ph hp. C mt s trng hp bnh nhn ch ho vi cn trong ngy, tr bng nhiu phng thc khng khi. Trc khi ho l nga hng d di, ho khan mt lc lu cho n khi khc ra c mt t nht hay mt ht m chng bng ht go mi ngng ho. Nghe phi thy bnh thng. y cng l vim Ph Qun nhng vng vim rt nh m li su. Dn Tiu vim, d tm sinh huyt vng b vim. Lu dn 2 gi. C tuyt i lnh, chua, g, mm, np. Hen ph qun: khi vim ph qun lu ngy m khng iu tr dt c, bnh c th chuyn sang th hen gi l hen ph qun. Triu chng gm c ho - t hay nhiu ty trng hp, sau l nght th. Cch iu tr nh vim ph qun , v bn cht l mt, ch khc nhau cp . Khi ph qun bt vim th cng gim nght th. Nu trn l hai trng hp cn c th cha c. Ngoi ra cn c cc bnh chng cng t vim ph qun m ra nhng rt nng , chng ta khng tr c v ngay c bnh vin tr cng rt kh khn : dn ph qun, tm ph mn. V ho ngp lu ngy

gy suy tim. Nhng nu mi b nh hng vo tim ta cng c th cha c, ch cn kin tr v kho lo, xem thm v H Tim Mch.

HEN SUYN
Thng thng ngi ta hay gi chung ngp th l hen suyn. Trc y khong vi chc nm thp nin 60,y hc chia lm hai loi vi hai triu chng khc nhau kh r l: HEN th va kh th va c m ko kh kh. SUYN th ch kh th m khng c m. Khng hiu v l do g m gn y ngi ta li gp chung hen v suyn li thnh HI CHNG TC NGHN PH QUN PHI v khng cn phn bit c m hay khng c m na. Theo nhn nh ring ca ti th nh ngha trc y l chnh xc. V thc t cho thy nu cn c theo ng y th hen v suyn c nhng triu chng v nguyn nhn gy bnh kh khc nhau cng nh cch iu tr rt khc. Ni bt nht l nu iu tr theo cc phng php s dng huyt th phng huyt khc xa nhau (th hin rt r khi dng DC-KLP). Cng theo kinh nghim ring ca ti th HEN l mt tin trin nng ca vim ph qun mn tnh m gc v ngn u phi( Ph), d nhin cc tng ph khc c nh hng n nhng ch l gin tip thng qua th trng chung trnh by trong bi Vim Ph Qun . Cn suyn l mt bnh c ngn phi nhng gc c th xa nh can, tm,thn, t, tiu trng, v vvc im l khi ln cn kh th khng c m ( nghe phi ch c ting rt thun ty ), ln cn thng c quy lut v km vi mt triu chng thuc ni tng khc . Chn on v iu tr SUYN th hon ton theo bin chng ng y. Trong khi HEN ph qun th li chn on v iu tr theo bin chng Ty y. y l mt iu rt th v vi ti khi nghin cu v tm ra gii php chn tr hai bnh chng ging m khc nhau ny. y ch cp n Suyn cn Hen c gp vi bi Vim Ph Qun trn. SUYN Suyn theo Ty y l mt bnh thuc loi d ng c nguyn nhn l sc khng km, theo ng y l do chnh kh h. Thc cht l cng . Vi Ty y th iu tr triu chng l ch yu. Tuy nhin ng y li cha tr tt hn v ci nhn v tng th bao qut hn. Trong khi nim v m Dng l c sc ring. V vy bi ny ch trnh by phng hng iu tr bnh ny theo ng y m thi. Theo ng y tm chia suyn ra lm 4 th : thc nhit, thc hn, h nhit, h hn. Tuy nhin bn cht ca suyn lun thuc h. S d c chng thc v gp yu t bt li cho c th, tng t nh Ty y nhn xt l trn nn bnh mn tnh c nhng t cp tnh. - Thc nhit: triu chng d di, bnh tng khi gp yu t nng. Yu t thuc nng nh thi tit nng, m thp (hanh kh), mn n nng (nhiu nng lng) nh

chocolat, cc loi tri cy c v ngt m. iu tr: t nhit mnh bng b Ging, phn chiu h h hp, v k thut th ty mc bnh ty th trng bnh nhn m chn cho thch hp. King c: cc yu t nng. - Thc hn: triu chng d di, bnh tng khi gp yu t lnh. Yu t lnh nh thi tit lnh, m cao (m t), mn n t nhit lng nh cc loi rau, qu khng ngt li nhiu nc nh cc loi da..iu tr: t hn mnh bng b Thng, phn chiu h h hp. V k thut th ty chn cho thch hp. King c: cc yu t lnh, cc yu t m t. - H nhit: triu chng nh nhng, bnh tng khi gp yu t nng, yu t gy mt sc. iu tr: lng b tng ph gc bnh bng b b m huyt nu huyt h, bng b B Trung nu kh h. Nu cn th thm phn chiu h h hp. K thut ty chn. King c cc yu t gy tng bnh. - H hn: triu chng nh nhng, bnh tng khi gp yu t lnh, khi gp yu t gy mt sc. n b tng ph gc bnh bng b B m huyt nu huyt h , bng b B Trung nu kh h. Nu cn th thm phn chiu h h hp. K thut ty chn. King c cc yu t gy tng bnh. Nhng cch phn loi ny ch p dng cho bnh l gy do nh hng ca tng th ln h h hp (sc khng km, theo Ty y) ch khng do mt tng ph no b lch lc gy ra. Do trn lm sng ta t gp suyn thc, nu gp cng cha kh d dng v thng l bnh mi pht hoc pht lu nhng tng trng bnh nhn cha h. Ch khi cha khng c, lu ngy tng trng b suy yu th bnh chuyn sang th h v kh cha hn. Rt kh khi th trng suy nng. Bn th bnh ny khng c quy lut theo gi gic trong ngy, ma trong nm hay theo mn n ring bit m ch theo quy lut nng v lnh hay mt sc m thi. Nu do cc tng ph b lch lc gy ra th ta li c cc yu t lin quan n tng tng hay chu k kinh kh. Phn bit thc v h bng triu chng bnh ca ng tng,ng hnh chnh v v xung khc. Tuy nhin cn lu v kha cnh m dng, kh huyt (tham kho thm bi Tm Tnh Hnh Ca Tng Trng, Lun v H Thc). C th l: - Ln cn khi gp gi, khi tc gin, khi n v chua v cay (Can hp vi T gy bnh), vo ma Xun, ma Thu, vo gi Su, gi Miv.v.. L lin quan n Can. - Ln cn khi gp nng hay lnh, khi vui mng, khi n v kht - v mn (Tm T hp bnh), vo ma H, ma ng, vo gi Ng, gi T. L lin quan n Tm. - Ln cn khi gp m t hay kh hanh, khi lo ngh, sau khi n xong, vo ma Trng hhay vo ma ma, vo ma Xun, vo gi T, gi Suv.v.. L thuc T.

- Ln cn khi gp mi l, khi bun ru, khi n v cay v kht (Ph T hp bnh), vo ma Thu, ma H, vo gi Dn, gi Thn. L lin quan ti Ph. y ti ch cp n cc tng, cn ph th sao ? Vi ph th cng tng t nh vy ch khc gi ln cn m thi. Nh vi cc triu chng ca Can Mc nhng gi ln cn l gi T Ng th ta phi ngh n ph m ch khng phi tng Can. Nhng ng qun Can m l biu l.Tng t cho cc ph khc. Vy, i vi bnh suyn ta cn phn bit hn nhit h thc v tng ph no b trc trc iu chnh li cho cn bng da theo nguyn tc H TH B, THC TH T. Bnh hn th dng n, bnh nhit th dng lng. ( xem thm bi Bn v n v Lng). V nh vy khng th c phc c hiu cho bnh Suyn m ch c phng n iu tr cho bnh Suyn m thi, v c th bnh nhn v cn nguyn bnh khng ai ging ai. Th d: 1- Bnh thuc Can khi bnh nhn ln cn mi khi tc gin, hoc n cht chua hoc khi tri tr gi nhiu. Thng ln cn gi Su ( Can thc) hoc gi Mi (Can h ) . 2- Bnh thuc Thn khi tri lnh hoc khi s hi hoc n mn v thng ln cn gi Du ( thc) hay gi Mo ( h ). Tng t cho cc tng ph khc. V th khng c phc m ch c nguyn tc iu tr : da theo triu chng ca ng y m chn on tng ph gc b bnh h hay thc, iu chnh tng ph l chnh, ph l ph. Th d: Nu do Can thc th t Can: 124, 34, 106, 26, 61, 156, 50. Nu do Can kh h th b Can kh: 127, 7 - +, 50, 19, 39, 37, 1, 0 - +, 41, 233, 50. Nu do Can huyt h th dng b B m huyt, 50, 70. Tng t cho cc tng ph khc./.

H NIU V SINH DC.

RI LON TIU TIN

RLTT gm c cc triu chng tiu t, tiu gt, tiu lt nht, tiu kh, tiu gp, tiu nhiu, tiu m, tiu vng sm, tiu , b tiu v v niu. Trung bnh mt ngy m mi ngi i tiu chng 3 n 5 ln. Nh th nu tiu t ln th mi ln phi tng lng ln, nu tiu lng t th s ln phi tng ln .Tng lng nc tiu khong 1,5 lt mu hi vng nht hn mu bia mt cht. Tuy nhin s lng v ln i tiu thay i theo thi tit , hot ng v n ung ca mi ngi. V l do thi

tit hay hot ng lm ra nhiu m hi hay ang b tiu chy th nc tiu s gim xung v mu sc m hn. Ch xem l bnh l khi triu chng RLTT khng thay i theo cc yu t gy nh hng nu trn. 1/- TIU T: Tiu t gm c s lng t hay s ln i tiu t. Nu BN ra nhiu m hi th gc bnh ch MH ra nhiu ch khng phi ng tiu ( cn iu tr lm gim MH ). Nu BN i tiu lng v nhiu ln trong ngy th gc ng i tin (cn iu tr tiu chy ). Nu tnh hnh MH v i tin caBN bnh thng th y mi l bnh l h niu.Gc bnh do Tam tiu khng thng, t chu nh hng ca hn nhit. Ch cn tc ng khai thng tam tiu v phn chiu thn . 2/- TIU GT: Tiu gt l hin tng tiu t km theo kh i tiu v c cm gic kh chu vng b phn sinh dc khi i tiu. Trng hp ny a s l do nhit ut vng h tiu v Tam tiu khng thng . iu tr nh trn nhng cn thm gii php h nhit. 3/- TIU LT NHT: l hin tng i tiu vi s lng t nhng nhiu ln trong ngy. y l mt triu chng rt thng gp do nhiu nguyn nhn khc nhau : thiu mu (khm k v huyt ca bnh nhn ), c vng bng quang yu ( tiu th d m nn tiu th kh), bng quang b chn p bi mt khi u trong hay ngoi n hay sa bng quang, c khi l phu tch bng quang (lun thy nng n vng ny, c th cn siu m chn on phn bit), vim bng quang mn tnh ( km hin tng tiu vng,tiu c, kh chu vng BQ). iu tr : theo c ch . 4/- TIU KH: l mc tiu nhng khi i tiu th kh khn, tiu chm chp, ng lu mi tiu c, thng xn thm nc tiu sau khi tiu xong. Nu do si bng quang ( si trn khng gy au si c cnh bn th gy au ) th c lc i rt d dng thng sut, xem phn si niu. Nu do ph i tin lit tuyn th i tiu lun lun kh khn. y l bnh l kh iu tr , kt qu chm nu u x, kt qu nhanh nu ph n. Chn on cn da vo kt qu siu m. iu tr : vim ph n th tiu vim lc thp, phn chiu TLT. U x th b Am huyt, tiu vim, phn chiu. phng ung th TLT., cn chn on thm theo cn lm sng ca Ty y. 5/- TIU GP: l mc tiu th phi i tiu ngay khng nn c. S lng nc tiu bnh thng ch khng t. Theo Ty y th cha r c ch. Nhng vi ng y th do dng kh h hm h tiu. Cn dng b Thng, cn chn on hn nhit chn k thut thch hp. 6/- TIU NHIU: l nhiu v s ln i tiu ln s lng nc tiu. Cn cnh gic vi bnh tiu ng. Theo Ty y c th do c RL tuyn tng, tuyn yn. Vi ng y th do thn dng suy. Cn khm k v Am Dng. Thng dng b Thng. Bin php n m. 7/- TIU M: Vi tr em th thng l tiu m, tiu dm cn n nh thn kinh. Vi ngi ln th thng do thn dng suy b Thng lm ch lc. Vi ngi gi th cn lu v tuyn Tin Lit.

8/- TIU VNG SM: do nhit vng h tiu hoc c th tiu trng. Thanh nhit tiu vim, phn chiu. 9/- TIU : l tiu c mu. y l mt bnh vim nhim ng niu, thuc din cp cu nu mi pht, nn u tin cho bnh nhn i theo bc s iu tr . Nu iu tr theo ty y m khng khi th mi nn nhn iu tr v n chuyn sang vim mn. Chn on hn nhit dng bin php chng vim thch hp. Tiu vim,phn chiu ni b vim trong h niu da theo kt qu chn on ca Ty y. 10/- B TIU: l mc tiu nhng khng tiu c. Bng di ca bnh nhn cng cng ln. y l trng hp cp cu, ch tm can thip trong khi ch nhp vin. C th do: si niu, co tht c vng bng quang ( cn chn on hn nhit). Lu : i khi chng ta can thip ngay c nhng coi chng nu do si bng quang th rt d ti pht. Do siu m chn on l bin php nn lm d iu tr c. 11/- V NIU: l khng c nc tiu trong Bng quang. i khi bnh nhn c cm gic mc tiu nhng khng tiu c, nu khng chn on k ta s lm l b tiu ! Cch chn on v niu l dng tay n t t vo bng di khu vc ca bng quang. Ta thy khng c lc i khng, hay ni cch khc ta s cm thy vng ny trng rng ( xp lp ). y l mt bnh chng do Thn mt kh nng lc nc tiu do khng c nc tiu. L mt loi bnh kh, c nhiu nguyn nhn , ti cha th kt lun c g mc d c thnh cng !

RI LON KINH NGUYT.

RLKN xt cho cng l ri lon tng th theo c hai kha cnh ng v Ty y. Vi Ty y th cn quan tm v tuyn ni tit v thn kinh cng nh thnh phn mu l chnh. Vi ng y th do ri lon v kh huyt m dng. Nhng ni chung vn khng ngoi cc chng suy yu m dng kh huyt gy b tc hoc khng huyt hnh kinh . Ngoi ra, i vi chm cu th s b tc kinh mch cng l mt nguyn nhn thng gp. Cn phn bit hn nhit. Hn th c thc hn v h hn, nhit th hu nh ch do h nhit ( c gc t m huyt h ), rt t khi do thc nhit. V vy, iu chnh RLKN chnh l iu chnh m dng kh huyt. Ni mt cch c th chnh l iu chnh tng th . Ngy no tng th cn bng th ngy kinh nguyt c iu chnh xong. Do , khng c phc c hiu. Nhng vi nghin cu c th ca Ty y , ngy nay chng ta thy khi bnh nhn c u bu trong t cung th thng gy rong huyt hoc ngy hnh kinh ko di. Do cn lu khi iu tr khng c hiu qu r rt. Tt nht l cho bnh nhn siu m loi tr bnh cn ny trc khi nhn iu tr . V mt u bu thng b xut huyt rt d bin chng thnh ung th.
SI NIU

Si niu l c si h thng bi tit nc tiu gm thn, niu qun v bng quang. Si c cu to bng nhiu cht v bng nhiu phng thc khc nhau. C loi rt d tan r c loi khng tan c , nhng siu m hay X quang khng th phn bit c l loi no ( hin nay, cn tng lai thch nhng tin b ca Ty y)! Chn on hn nhit tng th v cc b h niu. iu tr : iu chnh tng th , vi cc b ta c cc phn chiu thng gp sau : 1. H niu thuc H phn chiu ni tng mt. 2. H niu thuc H phn chiu ni tng trn trn. 3. H niu nm trong phn chiu H Dng ( vng huyt 43 xung n 143 , lan ra tuyn B hai bn). 4. Loa tai l thn, mi v cm l bng quang, niu qun chy t 0 xo theo b di xng g m xung n vng huyt 38. K thut: vi tng th ta chn k thut thch hp, iu chnh xong. Vi cc b h niu ta chn li k thut ph hp, phn chiu th ch cn dng h no nhy cm nht m thi: C hn: dng ngi cu h c xoa du theo h niu . C nhit: dng ln gai ln mnh theo h niu. Ln inh hiu qu cao hn ln cu gai. C th kt hp vi kt qu cn lm sng: pH ca nc tiu thp ta cho bnh nhn dng thm cht km nh rau ng om, rau ng gai..i khi l cht cht. pH ca nc tiu cao ta cho bnh nhn dng thm cht chua, trng hp ny ch dng khi bnh nhn khng c tin cn hay ang b lot d dy t trng. Lu : Ta nn khuyn bnh nhn dng mi ngy 4 - 5 ht Li i ( i, i i ) ngm nc n hon ton, b v v ht, ung phn cn li, c th pha ng cho d ung. V si hnh thnh c l do cc protein c trong nc tiu kt dnh cc tinh th li vi nhau, ht i c th lm tan cc protein ny gip phn lm r cc tinh th si. a s cc trng hp si thn ln u a n huyt p cao. Cn cn thn v c th gy tai bin tim mch cho bnh nhn . Ta thnh cng tng i d dng khi si nh 4 -5 mm tr li , nm vng b thn, niu qun hay bng quang.Nu si nm su trong nhu m thn th khng th

trc xut mt cch d dng c. V th ta thy c nhiu trng hp thnh cng rc r nhng cng khng t trng hp tht bi . Cn dn bnh nhn : ang trong giai on iu tr m bng nhin au qun bng v vng lng tng ng ( cn au qun thn) th phi nhp vin ngay, phng trng hp khi si i ngang qua niu qun lm rch niu qun l mt trng hp thuc dng cp cu ti bnh vin, nu nm nh l khng an ton cho tnh mng bnh nhn . TP. H Ch Minh 1993.

SUY NHC SINH DC.

SNSD gm c dng nuy , to tinh ( su tinh), lnh cm. C nhiu nguyn nhn : Do tng trng suy yu : kh nng sinh hot tnh dc gim dn . iu chnh tng trng . Do tm l : lc mnh lc yu, hoc n i vi ngi ny th tt ngi kia th khng tt. iu tr nh sau : dn cao 124, 34, 103, 106, 342, 340, 175, 107, 0 cho hn chng ( dng nuy) . Vi nhit chng ( to tinh ) th day vaseline 0+ -, 124, 34, 106, 60. Tuy nhin cng cn iu chnh thm v tng trng . Do b tc thn kinh vng tht lng v xng cng: tng gim thun theo triu chng au lng , khm thy c sinh huyt vng ny. Gii ta b tc vng ny.

HIM MUN.
Trc ht cn bit him mun l mt bnh khng lin quan n kh nng hot ng tnh dc. Mt ngi c nng lc tnh dc mnh vn c th v sinh hay him mun nh thng.Nhng nam nhn b to tinh vn c th gy th thai cho ph n bnh thng,nhng ph n lnh cm vn c th sinh n hng chc ln. Chng ta c th iu tr tng i d dng nhng trng hp him mun do c nng nh co tht ng dn tinh vi trng, tinh long, non so thiu nng, t cung lnh. Nu c bin i thc th nh u bu th kh khn hn, nhng vn c th iu tr nhng trng hp bu mm lnh tnh. Hu ht nguyn nhn gy him mun l vng h tiu - sinh thc kh ( vng c c quan sinh dc) b hn kh v thp kh nhim lu ngy. Kh lnh lm co tht cc c trn c vng v cc mch mu nui cc c quan vng ny. Do chng b thiu nng v sn sinh tinh trng hoc trng khng s lng hay cht lng. Cha k s co tht ng dn tinh hay vi trng lm nghn tc ng i ca tinh trng v trng. Vi t cung th v thiu mu lm gim kh nng nui dng trng d gy try thai sm. ( Ti tng thnh cng mt cas bnh nhn cn tr di 30 tui h thai 3 ln, BV i m v ct c t cung khi c thai ln th t, ti dng nguyn l ny lm m t cung trong khong 2 thng ( bng DC-KLP), sau v bn vic

ring, ti tm ngng, KQ l bnh nhn sinh c mt chu trai vo thng th 7, tuy sinh non nhng vn khe mnh v pht trin bnh thng ( mt nm sau khi chu 1 tui ti mi gp li bnh nhn trn khi c dn bn n nh ti tr bnh ). Vi bnh ny, khng c phc m ch l nguyn tc iu chnh tng trng v lm m t cung, bung trng, vi trng, tinh hon, ng dn tinh. Vi vi trng v ng dn tinh th cn cn bin php chng co tht ( g phn chiu vi du ). Nu b chn p do u bu trong hay ngoi ng ng th cn phi tr cho tiu u bu ny ( loi ny khng d ). Ngoi phc chnh chnh tng th th nhng vng tc ng ph gm c phn chiu v phng chiu vng ny, vng thn kinh ct sng lin quan t L1 n mm ct. Nu do b tc thn kinh vng ct sng tht lng ( au lng mn tnh ) th ch cn gii ta b tc vng ny .Ti cng thnh cng loi ny nam gii sau khi nhn thy anh ny him mun khng do thn suy ( theo ng y ) m do thn kinh vng ny b thiu nng, trng hp ny ch iu tr mt t 2 tun trc ngy rng trng ca v. Ngay ln v anh ta c thai.

H TIU HA.
CC BNH CHNG THNG GP THUC H TIU HA.
1- Nut nghn: nut vo kh khn, thm ch khng nut thc n thc ung xung c. y l c tr ngi vng t c hng n cui thc qun. Thng gp do c mt on thc qun b co tht ( do lnh, do kch xc thn kinh, do c tn thng , do thiu dinh dng cc b, c th do hn hp), cng c th do c khi u trong hay ngoi thc qun chn p. Cng c th do val Tm v khng m, nguyn nhn cng c nhiu. Khi chn on cn tm cho ra nguyn nhn c th, kt hp vi ni soi cng tt. iu tr : iu chnh tng trng, tr theo c ch, phn chiu ni c bnh ( cn d sinh huyt dc t 312 n 61 - . 2- An vo i ra: thng do hn t V, iu tr : lm m d dy. Cng c khi do d dy b vim lot, thc n c xt kch thch lm i, iu tr : theo c ch. Cn kt hp vi Ty y. Triu chng ny cng thng gp trong bnh vim hng tr em. Khc nhau ch vim hng th n vo l i ngay khng hon tt c ba n, cn nu do V hn th n xong mt lc sau mi i . 3- An khng tiu: c nhiu c ch: Do d dy khng co bp hay co bp yu: thc n b ln men chua nn s c chua, va au va tc vng thng v. iu tr : day du B Trung, phn chiu d dy.

 Do d dy khng tit dch v: au tc v xt xa bo bt trong d dy cng lc cng tng; iu tr : dng b B Am huyt v phn chiu d dy, hoc ung nc da ti mt cch chm ri cho n khi thy ht xt xa th ngng, thng ch cn chng ly ln. Do dch v d dy khng thnh phn: ch au tc m khng xt xa bo bt; iu tr : dng b B Am huyt, phn chiu d dy. Do Tiu trng b lnh: d dy tc nhiu hn au, nhn n th gim tc, khng hoc hi. Cn hai trng hp trn th d nhn n vn khng gim au tc c khi cn tng ln. iu tr : lm m Tiu trng. Lu : nu dng cc gii php nu trn m khng hiu qu th c th c tn thng thc th nh vim lot, u bu. 4- au bao t: c hai dng chnh thng gp l vim v lot hoc vim ln lot. Phng php chn on chnh xc nht l ni soi. Da vo lm sng, c cc bnh sau: Vim bao t do lnh: thng ln cn au v m khong 23g n 3 gi, khi au hay a nc ming ( nc gii) lt hoc hi mn. H XD phn chiu d dy. C n ung lnh. Lot d dy: au tng khi i, cng c lc n xong au hn c th gy i. Ct cn au bng vaseline hay nc . Nn tr theo Ty y cng thc ca Uc. C chua tuyt i n sut i th mi khng ti pht. C chua tuyt i n sut i th mi khng ti pht, tuy nhin, thnh thong c th dng mt ln vi nng thp. Hoc tt nht l dng vitamin C loi tan trong rut b sung vit. C cho c th c th b thiu do c chua. Nhng theo ti Vit Nam v cc x nhit i rt di do rau qu nn kh thiu vitamin C khi ta n ung vi mt ch hp l : khng n ung thc g lu di m nn lun thay i mn n tng ngy, trnh trng lp. Vim d dy: Vim ph n: thng do lnh, au tng khi n ung thc p lnh hay cc thc n qu mt , thng c nhng cn au v m km vi hin tng a nc ming hi mn hay nht. iu tr : lm m d dy ( bng xoa du, dn cao hay h ngi cu phn chiu d dy, day du tiu vim, 290, 7, 347. Vim xung huyt: cn au khng c quy lut . Day vaseline B Am huyt,Tiu vim, ln gai phn chiu d dy. Sa d dy: n vo th cm thy nng n vng d dy v mt mi ton thn tay chn nh khng c sc, nm ngh mt lc th ht, ngi dy hoc i ng mt lc th nng n v mt mi li ( khi cn no bng ). iu tr: ln u nn h xoa du b Thng, phn chiu d dy v vng trn d dy. Cc ln sau c th day co bng du. Nng th c th h xoa du ti vng bng theo nguyn tc phng chiu. Lu : c mt s bnh nhn c thi quen ung tht nhiu nc vo sng sm, y l mt nguyn nhn thng gp trong bnh sa d dy. Ung nc nhiu vo sng sm mi thc dy l theo mt l thuyt xut pht t Nht nhm mc ch d i

tin , tuy nhin c nhiu hu qu xu nh to tim,sa gin phc mc khin sa ni tng trong d dy d b nht, ph khng r nguyn nhn 5- Si rut: Tiu trng gim chc nng, c thy m trong rut, thng i cu phn nho hoc lng ln c . iu tr: lm m Tiu trng bng h xoa du hay dn cao, 290, 7, 347. 6- Tiu chy: Do nhim trng: au bng trc mt thi gian t 30 pht n 1 gi ri mi b i cu,khi i cu hu mn c cm gic b nng, phn rt hi thi, ln i cu u tin thng ch nho ch khng lng. Din bin t nh ti nng dn. n vng bng thy au: au vng quanh rn l vim Tiu trng, au vng hai bn hng l vim i trng. iu tr : Tiu vim, phn chiu. Nn dng nc p lnh, nn kt hp vi Bc s dng khng sinh ngay, khng nn lu c hi cho nim mc rut bin thnh ri lon mn tnh kh tr v sau. Do nhit t: au bng ri tiu chy ngay mt cch t ngt. Hu mn nng, phn lng ngay t ln i cu u tin v hi thi. c im l va i cu va nh rm, c khi bn tung te nh phun vi sen !! iu tr: p lnh 124, 34, 106, 26, 143, phn chiu Tiu v i trng. Do hn t: au bng ri i cu t ngt, phn lng chy nh rt nc khng nh rm, khng hi m tanh, khng nng hu mn. iu tr : h xoa du sau dn cao b Thng. Do nhim c thc phm : triu chng khng r rt v mt hn hay nhit, c th xut hin thm nhng triu chng ca nhim c nh chng mt, nhc u bun nn, nn . c bit l khng p ng r rt vi nhng liu php iu tr nu trn. iu tr : b Tiu Vim Gii c. 7- i tiu ra mu: Phn en: tn thng vng d dy hoc Tiu trng. Ra mu bm: tn thng vng kt trng ln hoc kt trng ngang. Ra mu ti: c tn thng vng kt trng xung, xung n vng hu mn. C th do vim cp, do u nht b v ming, do lot, do tr. Phc chung: 26, 61 - +, 38 - +, 156 - +, 16 - +,0 - +. Phn chiu vng b tn thng. Cn chn on hn hay nhit chng. D sinh huyt, c th kt hp n vng bng tm ni au tc.

Tr, thc cht l mt loi u nht trong trc trng. Dn gian thng gi l tr ni v khng thy, khng s c, nhng c mt s trng hp mn tr mc st b hu mn nn cng thy v s c. Nu l tr th ngn c th c nhit nhng gc lun l hn. Do ban u tr theo hn chng, giai on sau tr theo nhit chng. Hn chng th dng h xc du hoc day co vi du, nhit chng th dng day co vi vaseline ( khng dng nc , p lnh ch thch hp vi cc bnh cp tnh, tr l bnh mn tnh). Trong thc t c th phc tp hn l phi bin i hn nhit nh th my ln mi xong .ng qun iu chnh tng trng. 8- Sa trc trng ( ph: sa ni tng ): dn gian thng gi l tr ngoi v thy v s c. Ni chung v cc chng sa ni tng u cn B Thng. Ty th trng m h xc du hay ch day n, lun cn phn chiu ni tng b sa v h thng mc treo ni tng . C th tc ng theo h phng chiu. 9- Bn: Hoc vi ngy mi i cu mt ln hoc l i cu kh khn. Phn c th kh: bn to, phn c th nho: bn t. Phn c th to bnh thng hay phn cng c th nh chng bng ngn tay t. Cc tnh trng phn thng gp: u cng sau mm, phn to bnh thng : nhu ng rut km, c thp thy nh: day du B Trung, co dc theo phn chiu khung i trng. Cng t u n cui , phn to bnh thng :nhu ng rut km, khng c thp thy. iu tr nh trn nhng khng dng du m dng vaseline. T mm ti nho, hnh dng bnh thng: c thy m. Day du B Trung, 290 +, 7 - +, 347 - +, 87. T mm ti nho, phn nh nh ngn tay t: c thy m v ph n nim mc i trng. Day du hoc h xc du B Trung, 290 - +, 7 - +, 347 - +, phn chiu khung i trng. Phn nh cng nh phn d: c co tht hoc khi u chn p vng kt trng ngang hoc xung hoc vng Sigma. Lm sng: au c nh ti mt im cc vng nu trn trc khi mt cu v i cu. Cn lm sng: phim cn quang hay ni soi. iu tr : day vaseline B Am Huyt, phn chiu nu do co tht. Tiu vim, phn chiu nu do khi u .Lu : Trng hp ny nu au nhiu hoc c mu v tr khng dt c th nn ngh n ung th . 10- Vim i trng mn : c hai loi vi hai triu chng khc nhau. Loi th nht: tiu chy thng xuyn khi n ung phi thc n mt nh rau qu ti sng hay nu chn hoc mt s loi thc n ung khng thch hp vi c th. iu tr : day du v dn B Trung, tiu vim, phn chiu khung i trng, Tiu trng.

 Loi th hai: xen k vi nhng ngy bn khng i cu l c t nht mt ngy tiu chy. Chn on hn nhit cc b vng bn phi, di v bn phi rn . Day tiu vim, vng huyt 104 +. Cn chn on hn nhit c k thut tng ng . 11- au vng bng: y l loi triu chng thng gp vi hin tng au c vng bng, i khi khng xc nh c ni au chnh xc c th. C khi im au chy lng vng , c khi au lan ta c vng bng, c khi lan ra ti lng hay t lng lan ra trc bng Nhng khng gy i cu lng, nu c th ch mt ln ri thi. c im ca n l lun c st, c th cao. y l mt triu chng ca mt c quan no trong vng bng b vim cp hoc b tc nh tc mt, si niu. i vi triu chng ny mun chn on tng i ng cn n vng bng tm im trung tm ca vng au. Khi tm c trung tm im au th da vo c th hc m on c quan c vn . C th kt hp vi nhng triu chng chi tit km theo th chn on gn vi chnh xc hn. Th d: khi vim c thng bng th khng th t ngi dy c v trong khi c ngi dy th cn au tng d di; khi vim ty hay ng mt th khng th n ung g v n vo l nn i ngay..vv..Triu chng rt phong ph, cn kinh nghim nhiu. iu tr: nn a ngay n bnh vin gn nht v y thuc loi cp cu, cn nhiu phng tin k thut ca BV. Cc bn cn ghi nh : an ton cho bnh nhn l trn ht. Cho nn khng c gi bnh trong nhng trng hp thuc loi cp cu.

NGUYN TC CHN ON V IU TR BNH THUC H VN NG.

Lng y T Minh. H vn ng l h bnh thng gp nht. Bi v ai cng b au - nhc - mi c khp. Chn on bnh h vn ng lun cn chn on tng trng phi hp trong iu tr th mi c hiu qu cao. C ngha l song song vi iu tr ni b au ta cn iu chnh m dng kh huyt cho bnh nhn . Thm ch c khi ta ch cn iu chnh tng trng l cn au ca bnh nhn bin mt v kt qu rt bn, hay ni cch khc l cha tn gc cn bnh cho bnh nhn m khng cn iu tr cc b theo phn chiu hay phng chiu nh cc bn thng s dng trc y. Sau khi chn on tng trng xong ta mi chn on cc b ni b au, y ngoi trng thi bnh l (nh : chn thng, thp khp, vim ty, l lot, phng..vv..) ta cn phi chn on nguyn nhn gy bnh ( nh : vim tc mch, co tht mch, vim thn kinh, nhim trng.) , ng thi cng phi chn on hn nhit ti ch , c nh vy ta mi chn c phc iu tr v k thut tc ng thch hp nh day n c du hay khng c du, h nng, dn cao hay p lnh.

 Nu tng th v ti ch thun chiu v hn nhit th k thut khng thay i trong iu chnh tng th v iu tr ti ch. Nu tng th v ti ch nghch chiu v hn nhit th ta phi thay i k thut tc ng theo tng tnh cht ca n. Khi iu tr ta nn iu chnh tng th trc ( bng cc b Thng, Ging, iu ha, Tiu vim..vv..), iu chnh cc b sau ( bng cc phn chiu hay ng ng ca cc c quan c bnh ). Cc bn c th xem, s c lc va iu chnh tng th xong l bnh nhn ht bnh m khng cn tm phn chiu hay ti ch g c. TP H Ch Minh 1993.

NGUYN TC CHUNG CHN TR CHNG AU NHC.

Lng y

T Minh.

au nhc l mt triu chng rt thng gp. Vi Ty y, y l mt vn kh ln v phc tp n ni hin nay ngi ta phi lp ra chuyn khoa au nhc song song vi cc khoa khc c. Ni theo cch thng thng ta c nhiu nguyn nhn gy au: s nhim lnh gy co c hoc co mch, khi u chn p, cc mu ng hay mng x va mc kt li, s thiu mu cc b ti mt cn c no , mt chn thng. Tt c nhng th u c th gy au. Vi DC-KLP th vic gii quyt cc chng au nhc tng i tt. Ch yu cn phn on bnh do hn hay nhit, c nguyn nhn c nng hoc bin i thc th . Lun lun cn phn chiu hay ng ng ni b au , c khi cn phi dng n h kinh mch ca Th chm. 1. Do hn hay nhit: thng t ngt, tht thng, au tng khi gp yu t thun, gim khi gp yu t nghch. Hiu qu iu tr rt cao v trit . Thnh thong c nhng trng hp qu nng iu tr khng hiu qu th nn chuyn bnh, thng l phi dng thuc ty tht mnh chch thng vo ni au mi m !! Gn y c cy Hon - ngc ( cy con kh ) c tnh gim au kh mnh, c th dng 5 7 l ti cng hiu qu . iu tr : hn th lm m, nhit th lm cho mt. 2. Do vim nhim: au c nh, km st. au tng dn theo thi gian. B Tiu Vim lm ch lc. 3. Do tc mch: cng t ngt nhng triu chng hn nhit khng r rng, c im au trn cng v au dc theo ng di hoc ngoi trng im ny , c khi km theo t di yu sc . B Tan mu bm lm ch lc.

4. Do khi u : c nh, khi u kh m h nh ch m, t t au tng dn theo thi gian, khng st. Nhng cng c th t ngt khi gp u c tnh. B Tiu vim lm ch , phn chiu khi u , lc thp. Ta iu tr tt nhng trng hp u mm. Cc u thuc loi x cng th hiu qu khng cao v c hn ch. Mun bit chnh xc thuc loi no th phi nh cn lm sng . Theo ti trng hp u x nn u tin cho phu thut nu khng c g c bit. Hin nay ngnh phu thut c nhng tin b vt bc cn tn dng. Lu : Khng phi chng ta khng tr c bnh ny nhng kt qu hi tht thng v y l loi bnh c nhiu bt trc, li kh chn on bng lm sng. V vy hng dn bnh nhn theo Ty y chn on l iu nn lm. V mt khi u c th l lnh tnh m cng c th l ung th , ch c th xc nh bng cc bin php cn lm sng . 5. Do thiu mu cc b : triu chng y nh do lnh nhng nh nhng, thng xut hin vo sng sm khi va thc gic, gim dn trong ngy. Tng th thng b thiu mu. iu tr : dng b B Am huyt v phn chiu . Trng hp ny c khi do nghn mch nh v tr trn ni b au, cn cnh gic. 6. Do chn thng . iu tr : B Tan mu bm, Tiu vim, phn chiu , lc thp. Trong vic tm phn chiu ni c bnh, thng thng dng h phn chiu trn mt. Ch khi trn mt khng c sinh huyt hoc c m khng hiu qu ta mi nn tm cc h phn chiu bn tay, bn chn, lng, bng. Nu vn khng nh , ta vn dng thuyt ng ng, Ln cn, i xng tm sinh huyt. Nguyn tc l nh th, nhng nu cc bn mun nhanh th p dng bi vit Lm sao t t c v Chn on hn nhit bng huyt DC ca ti th vic tm sinh huyt phn chiu ni c bnh s nhanh gn hn v k thut tc ng s tt hn./. TP.H Ch Minh 1993.

BNH CHNG THUC H VN NG

Lng y T

Minh.

1. au gy vai. Gy vai thng au dt ngt sau mt gic ng. Nu l ln u tin hoc lu lu (vi nm)mi b mt ln th a s l do nhim lnh trong khi ng. Dng gii php lm m c th bng day du hay h c du b B Trung hay b Thng, phn chiu hoc ng ng gy vai. Thng thng ch tr mt ln l khi hn ngay ti ch. Nu khng khi hn ta iu tr tip nh sau: au khi ci u hoc quay u qua bn ny th au bn kia: h c du ng ng gy c tay v c chn. au khi nga u hoc quay u qua bn no th au bn : dn salonpas b Tiu vim, phn chiu gy theo H Dng.

Nu l trng hp thng xuyn, nhiu ln trong nm th c th c thoi ha vng ct sng c v ct sng lng trn (on t D1 n D4-5). Xem phn thoi ha ct sng. 1. au khp vai, kt khp vai: khp vai b au n mc khng th a tay ln chi tc hay ngoc tay ra sau lng c. Ty y gi l vim chu vai ( vim quanh vai ). Ln u nn h xoa du b Thng, Tiu vim, phn chiu khp vai H Dng, Am, Trc din, V no. Sy c du ti khp vai v quanh khp. Cc ngy sau ch cn day du b Tiu vim, phn chiu khp, sy du ti khp. Tuy nhin vic duy tr b Thng v h ngi cu bao nhiu ngy l ty th trng bnh nhn m quyt nh cho ph hp, phng s qu liu v ngi cu. y l mt bnh cp nhng li mang tnh cht ca bnh mn tnh, do nn iu tr theo dng mn tnh. Bnh nhn cn tp quay tay vng trn quanh khp th mi mau khi bnh, khi quay cn thng tay ch khng cong. 2. au lng: Hu ht mi trng hp au lng nu khng do chn thng vim ty th u do c trc trc cc khp t sng hay chnh cc t sng. Vi bnh l ca chnh t sng th ta c gy, v, xp l nhng bnh l khng th iu tr c ( cn phu thut thay t sng gi ). Cc bnh l ct sng c th iu tr : Trt t sng: au lng km t v yu chn khi ng v i lu, mt triu chng khi nm lu. Ch iu tr c khi rt nh, theo kinh nghim nhng ca bnh ti iu tr th khong 1/8 l cn tr c, t hn trt t sng 1 ca Ty y, cn chp X quang ni b au, thng xy ra vng L4-L5 v L5-S1. iu tr : chn on hn nhit, day B Trung vi k thut thch hp, phn chiu. Bt buc bnh nhn mang ai lng c nh ct sng. Hn ch i ng, tuyt i khng mang vc ci g. Vim khp t sng: au trong mi t th . Chn on hn nhit ri chn phng n thch hp. Hn th lm m, Tiu vim,phn chiu .Nhit th ch Tiu vim, phn chiu . King lnh-chua-g-mm-np. Thoi ha a m ( x cng, xp, hp ) : x cng th au nhiu khi chuyn ng sau khi nm yn lu, nh thc gic sau khi ng dy ; hot ng mt lc th gim dn nhng khng ht hn. Xp hay hp ch au nhiu khi ngi ng, nm th au gim. au nhiu khi mang vc nng, cng lc cng tng. Day B Am huyt, phn chiu . Hn ch i ng nhiu, tuyt i khng mang vc bt c ci g. Nn nm nhiu hn ngi, ng. Nn tp cc ng tc lm do lng. Thot v a m : vi Ty y y cng thuc thoi ha a m. Triu chng c trng l khi au khi khng, khng c quy lut. Day du B Trung,phn chiu . King chua lnh, phi mang ai lng. Tuy nhin ch iu tr c nhng trng hp rt nh, cha nh gi c mc no l cn cha c v X quang khng chn on c. Vi CT hay MRI th cha s ca bnh kt lun.

 Thoi ha ct sng: l mt t ch chung nhng thay i thc th ca ct sng: vi ha t sng( gai ct sng), xp t sng. Ch iu tr c vi ha ct sng. au nhiu th day B Trung vi du, phn chiu . Sau khi gim au nhiu m khng khi hn th chuyn qua day vaseline b B m huyt, phn chiu . Bnh ny iu tr lu, kt qu chm chp v c khi khng khi hn m thnh cng c mc . Ch thch: c nhiu anh ch em iu tr thy bnh nhn ht au hn th cho rng tr khi, nhng tht ra l ch tr c s vim phn mm quanh gai m thi ch gai th khng gim t no. Tuy nhin c nhiu trng hp gai bin mt l do may mn c l v cht liu cu to gai mm d tan r , iu ny c thc nhng cha bit chc chn nh u m im vi ha mt hn - trng hp ny kh t i. 3. au thn kinh ta : au chn km c cm gic kh chu vng tht lng hay vng mng (y l im khc bit vi au chn do tc mch) v au thn kinh ta lun c gc bnh l vng ct sng, vng khp cng-chu hay vng khp chu-i. Khm ti ch vng tht lng, cng-chu, chu-i tm gc bnh , Do ch cn iu tr tp trung vo vng gc bnh, khng nn iu tr vo vng chn (d kt qu rt nhanh) v khi mt triu chng au chn bnh nhn s ngng iu tr, v sau s ti pht nhanh v vng gc ca bnh cha iu tr xong. Chn on hn nhit, chn k thut thch hp, dng b Tiu vim, phn chiu v tc ng thm ti ch. Lu : v l bnh l ca xng khp nn cn chn on thm au do nguyn nhn c ch no ( vim khp, thoi ha khp, long xng gy bin dng xng, thoi ha a m.) c tin lng v phng n thch hp . 4. Bong gn: Dng b Tan mu bm, phn chiu . Nn km theo b Tiu vim hiu qu s cao hn. 5. Lit mt c phn no : dng b huyt Lit do tai bin MMN v CTSN v y l do tn thng khu tr ti no do v mch hay tc mch. Nu bnh nhn b st cao trc hoc trong khi lit din tin th li do siu vi tn cng vo h thn kinh. Trng hp ny kh tm phn chiu , nn chn on hn nhit, chn k thut v phc iu chnh tng th tng ng, tiu vim, phn chiu no ty v ton th c phn lit. TD : lit mt cnh tay ( hoc bn tay hoc mt vi ngn tay) th phn chiu y s l vng u, ct sng c di n CS lng trn ( vng D1 D5), cnh tay bn tay k c cc ngn. 6. Thp khp : au, sng, ti khp. Nng nhiu l nhit, m m l hn. Dng b Tiu vim lc thp - phn chiu ti ch ( kch thch quanh khp ) , k thut th theo hn nhit m chn. Vi h ngi cu ( hn chng ) th mi huyt ch nn h kch nng mt ln, khng nn h nhiu c hi v sau. Vi nhit chng th nn ln gai. Lu : cn cnh gic vi bnh Thp tim l mt th c bit ca thp khp, c nhim trng cho nn iu tr theo Ty y tt hn, ta ch nn h tr. Triu chng : thu nh hay b vim hng, sng -nng - -au ti khp, st t 38 C tr ln, nhp tim nhanh d st hay khng, c th c ri lon nhp tim. T khi d khng iu tr g c, khi khi khng li du vt g. Ti i ti li nhiu ln.

7. Thoi ha khp : triu chng c trng l cng vn ng cho khp th khp cng au. Ngh th gim. Lai ny ta ch cha triu chng gim au , khng th tr dt c v khp h hng. Dn d bnh nhn khng nn tp nng cho khp, khng mang vc bt c ci g. iu tr triu chng theo nguyn tc iu tr gim au. y ch l nhng bnh in hnh thng gp v c phng cch iu tr hi c bit. Tt c nhng trng hp cn li u theo cch iu tr tng qut: chn on tng th, chn on nguyn nhn c ch bnh, phn chiu . iu tr p ng theo cc yu t va tm c. TP. H Ch Minh 1993.

H THN KINH
Mt ng : l triu chng ca mt bnh no . V th cn chn on tng trng , lu n yu t tinh thn . V tinh thn th b An thn ( 124, 34, 106, 26 ) l ch lc. Nu thuc dng hng phn ta thm 3 + - , 222 + - , 156 + - , 87 . Nu thuc dng trm cm ( v suy nhc thn kinh ) ta thm : b Thng, 107, 175, 342, 340 . V th cht th iu chnh tng trng l chnh. i vi nhng trng hp mt ng c quy lut. Ta dng cc quy lut v Kinh kh v Thin kh bit iu chnh. c bit c mt loi mt ng khng iu tr c l mt ng lu nm nhng khng h nh hng r rt g ti tng trng c ???? Bnh nhn vn n ung sinh hot gn nh bnh thng, khng h gim cn gy mn g, kh nng lm vic tr c vn tt. Loi ny kh tr. Suy nhc thn kinh : vng u c cm gic kh chu cho ti au khi phi vn dng tr c . Khi bnh nng c th gy mt ng . Giai on u dn b Thng, 124, 34, 340, 175, 107. Giai on sau c th day du. Cung : l mt th bnh tm thn thuc loi hng phn, bnh nhn rt hung d. Nhng nu bnh nhn cn c th km ch khng hnh hung th c th tr c, y theo Ty y l rt nh, tuy nhin nu khng iu tr ng mc th c th nng thm v sau. B Ging lm ch lc trong giai on u. B B Am huyt trong giai on sau khi khi bnh .V hu ht bnh nhn mc bnh ny u c tnh trng Am h. in : l th bnh tm thn trm cm, thuc loi hin lnh khng ni nng ng chm ti ai . B Thng lm ch lc. C th thm 106,107, 175, 342, 340 .

Vim thn kinh V: triu chng : au rt, nng mt vng hay ton b mt bn mt. au tng khi c s va chm vo da mt, kh th nh rng ra mt .C khi ch cn mt cn gi thong qua cng lm au tng ln. iu tr : p lnh tiu vim, phn chiu mt mu bn tay bn chn . Cn iu chnh tng trng khi gim triu chng bnh. Lit mt : cn gi l Lit thn kinh VII. Bnh ny a s l mt dng tai bin nh nn cch iu tr cng l phc iu tr tai bin mch mu no ( ngay lc mi b bnh, na mt bn lit lun lun lnh hn bn lnh ). Cn tc ng thm c mt bn lit. Tuy nhin cng c trng hp lit mt do virus tn cng lm tn thng dy Thn kinh VII (na mt bn lit nng hn bn lnh ). Trng hp ny th nn dng b Tiu Vim , phn chiu dy TK VII. Loi ny kt qu rt hn ch v mt s dy TK b virus ph hng.

H TIM MCH
S LC V H TIM MCH
Lng y T Minh Qu tim l c quan c chc nng to mt lu lng mu lu thng cho ton c th, l mt my bm mu i v ht mu v. Gm : tm nh phi: ht mu en t tnh mch ch v thng qua van tnh mch ch bng cch dn n ( tm trng). Co bp (tm thu) a mu en xung tm tht phi thng qua van 3 l. Tm tht phi: ht mu en t tm nh phi bng cch dn n ( tm trng) ri co bp (tm thu) tng mu en ln phi thng qua van ng mch phi. Tm nh tri: dn ht mu t phi v thng qua van tnh mch phi. Ri co bp tng mu xung tht tri thng qua van 2 l. Tm tht tri: n ht mu t nh tri v ri co tng mu ra ng mch ch thng qua van ng mch ch. Tim c nui dng bng mt h thng mch mu dnh ring cho n gi l mch vnh. Mch vnh tim tri c s lng nhiu gp bi ln bn tim phi. Cc ng v tnh mch l cc ng dn mu lu thng. Mu t tim theo ng mch ch chy ra cc ng mch ri cc tiu ng mch v cc vi mch ( cn gi l mao mch ) n cc c quan, t bo. Mu en t cc t bo, c quan v cc vi tnh mch, dn v cc tiu tnh mch, v cc tnh mch ri dn v tnh mch ch, v tim. Gi chung l vng i tun hon.

 ng mch phi dn mu en t tm tht phi ln phi. Ti phi, mu nh carbonic v nhn oxy chuyn t en sang . Tnh mch phi dn mu t phi v tm nh tri. Gi chung l vng tiu tun hon. PHNG PHP O HUYT P: Theo nguyn tc, o HA lun cn ng nghe nghe ting mch p. Nhng trong thc t ti khng dng ng nghe m ch theo di trng thi hot ng ca kim m phc hin mt s chc nng khc ca huyt p k ngoi tr s tm thu v tm trng: Kim khng li 5 nhp trc khi git lui : t nht cng b thiu nng vnh, thng l thiu mu c tim nu cht li nht ti trng. Kim git lui ngn mt on ri git lui di hn : c h val 2 l, nhiu hay t ty mc chnh lch ca 2 trng thi ngn v di . Tr s tm trng 50 : h val ng mch ch. Kim git lui ngn 2 mmHg ( mt nc nh trn mt ng h HA k ) : trng lc tim yu. Dng h nu c s lnh. Nu khng s lnh l tm kh suy. Kim git lui di 4 mmHg ( 2 nc nh trn mt HA k ): trng lc tim mnh, mu long ( thnh phn c v lng ca mu khng ng t l : huyt tng nhiu hn huyt cu ). m h nu s nng, tm kh thnh nu khng s nng. Kiu git lui kim ny thng gp trong bnh ng huyt hay Lipid huyt, v cc trng hp c st cao. Kim git lui nhanh : mu long. Kim git lui chm : mu c ( huyt tng thiu, huyt cu d ), hoc c lipid huyt. Kim git lui lc nhanh lc chm hay lc di lc ngn hay c lc b nhp : ri lon thn kinh tim. Kim git lui khong 3 4 mmHg : trng lc tim bnh thng , m Dng tng i cn bng. TP. H Ch Minh 1995.

BNH H TIM MCH.

Lng y T Minh

Bnh thuc h tim mch a s l loi bnh c mc gy nguy him cao cho sc khe v tnh mng . Sau y l nhng bnh thng gp m ti c thnh cng phn no trong h bnh ny. 1. Ri lon thn kinh tim. L tn gi chung ca cc triu chng ri lon nhp tim (tim b nhp, tim p lc nhanh lc chm lc mnh lc yu, tim p nhanh hay chm u nhng qu mc bnh thng): iu chnh tng trng , co phn chiu tim, phn chiu cc nt thn kinh tim v mng Purkinge. 2. Thiu nng mch vnh. Nu nng cn c tn gi l Thiu mu c tim: c nhng cn nng ngc kh th , au tht ngc c khi lan ln u c v ra tay . Triu chng thng ch xut hin vi pht ri t bin mt, thng xut hin khi gng sc,khi xc ng hay khi nhim lnh. Li rt nht.Nguyn nhn do mch vnh b co tht hoc bt hp v mu ng hay mng x va,cng c th do u bu. iu chnh tng trng , tiu vim, tan mu bm, phn chiu tim, phn chiu mch vnh ( c 6 tuyn phn chiu mch vnh : t 0 vng ln 130 vo 65, t 0 vo 73, t 0 vo 61, t 0 vo 7, t 0 xo xung 29, t 0 xo xung 347 ). 3. Nhi mu c tim. y l tnh trng nng t xut ca thiu mu c tim. au d di vng ngc, v m hi nng, huyt p cao t ngt (HA tm thu trn 170) Thuc din cp cu ti bnh vin. 4. Huyt p thp. L mt bnh chng cn nhiu b n v c ch v nguyn nhn gy bnh .Tuy cng c thnh cng nhng khng chc chn nh cc bnh khc. Vn ly iu chnh tng th lm ch. 5. Huyt p cao. L triu chng ca mt bnh no trong c th. Phi tm cho ra cn bnh gc ny. Cha bnh gc xong th HA t h v n nh lu di. Trong thi gian cha tm ra gc bnh HA lun dao ng cao, cho nn cn duy tr thuc h p cho n khi HA bt u h n nh 2 tun lin tip th gim liu thuc HA, c th cho n khi HA tr v mc bnh thng, lc ny th b thuc, nu n nh sut hai tun lin tip th c th b hn thuc HA. Tuy vy c nhiu cas khng th b thuc h p c m phi ung mt liu thp nht thch hp n sut i. Cc bn khng nn ch quan vi loi bnh ny nh ch trng ca mt s thy khc, v c th gy hi khng cu vn c cho bnh nhn . C hai trng hp tng qut v tng HA. Huyt p cao m chng v Dng chng. Trong ct cn tng HA, dng b Thng khi HA cao m chng, dng b Ging khi HA cao dng chng. Trong iu tr, iu chnh tng trng lm ch lc. Tm thm tng ph c bnh v iu chnh tng ph ny. Tm hiu c ch gy bnh cho tng ph nh vim tc mch x ha vi ha ( si )..v.v khin tng ph mt hay gim chc nng. i khi tng HA ch do tc mch mt ni no trong c th, thng xy ra vng c gy hay vng u (mch cnh hay mch nn s) , lc ny HA hai tay s chnh lch r rng, thng mch l xong.

6. Ri lon tun hon no: nng u km chong vng, tng t th ng, khng thay i t th nm khi tr mnh. HA bnh thng hoc thp. iu tr : day du hay h c du B Thng, phn chiu u ( hn chng : thiu nng tun hon no). Day vaseline b Ging, phn chiu u ( nhit chng: huyt vng u khng thng, cha phi l huyt ). Mun khi bnh lu di cn iu chnh tng trng. 7. Ri lon tin nh : chng mt , tng khi thay i t th nht l khi nm tr mnh. Huyt p bnh thng. iu tr : day du hoc h c du B Thng, phn chiu u. Nhn xt : thng qua vic iu tr hai bnh chng ny, ti cho rng RL tin nh l mt dng thiu nng tun hon no dng c bit ch xy ra vng Tin nh. ng y gi bnh th 6 v th 7 ny l Huyn vng. 8. H v hp val tim : bnh val tim c 2 loi : bnh chc nng ( do thn kinh hoc nhng nguyn nhn khc ) v bnh tn thng thc th ( x ha thng do thp tim gy di chng , bnh tim bm sinh nh thng nh)chng ta ch nn nhn iu tr nhng trng hp bnh l chc nng. Chn on hn nhit, phn chiu val tim. Val tnh mch ch : vng huyt 129 +. Val ng mch phi : vng 60 +. Val 3 l : vng 73 + v ton b na mt bn phi t tuyn VI tr xung. Val ng mch ch : vng 60 - . Val tnh mch phi : vng 129 - . Val 2 l : vng 73 v ton b mt bn tri t tuyn VI tr xung. 9. Tm dng h : h c du 19, nu khng hiu qu th h c du B Trung hay Thng, 189. 10. Tm kh h : day vaseline 19. Nu khng hiu qu th dng b Thng, 189. King c : ni chung cn trnh nhng thay i t ngt v mi trng sng, thi tit, nhit , n ung. Khng nn b cm hay thng thc, nhng bc xc tnh cm vui ln bun cao . V king cc thc n theo c ch gy bnh trong LNH v CHUA l quan trng hng u v hai v ny lun lm co mch, co cn c. TP. H Ch Minh 1997.

IU TR LIT DO TAI BIN MCH MU NO V CHN THNG S NO.

---O--Lng- y T Minh.
Tai bin mch mu no(TBMMN) v chn thng s no(CTSN) thng a n lit vn ng, i khi lit c cm gic v ri lon nng lc tinh thn. Ch c mt s t trng hp phc hi hon ton theo c ch t khi v c ch b, tuy nhin phi thy rng y l nh tn thng qu nh. Mt s t bnh nhn thot khi tnh

trng lit ny mt cch ton din do may mn b tn thng tng i nh v c iu tr NG CCH NGAY T U. a s l li cho bnh nhn vi di tt v th xc hoc tinh thn khi b hi nng hoc c iu tr khng ng cch kp thi ngay t u. Trong di chng lit do TBMMN v CTSN th iu tr ng cn phi kt hp c ba gii php ng b mt cch kho lo : THUC MEN, TP LUYN, HUYT O. Vic dng thuc th ty, Ty hay ng cng c. Nhng theo kinh nghim ca ti - trong TBMMN - thi gian u nn dng thuc ty ( c BS ch nh v theo di) cho n khi HA n nh tht s . Vic n nh HA kh phc tp, d phng php chng ta c th lm c nhng i hi phi vn dng y l rt nhiu v Ty ln ng y nn khng th trnh by trong bi vit ny, cc phc v huyt p hin nay thng mang tnh ct cn hn l iu tr . Cho nn cc anh ch em nn kt hp vi bc s chuyn khoa tim mch khng ch HA cho bnh nhn , trnh tai bin rt d xy ra tip theo khi HA cn dao ng. Tp luyn c hai phn : th ng v ch ng. Tp th ng l k thut vin hay ngi nh tp cho bnh nhn , lun lun rt cn khi b lit cng . Tp ch ng l bnh nhn t luyn tp theo s hng dn km cp ca K thut vin ( trong thi gian u hoc t ngh ra cc t th trong sinh hot thng ngy trong giai on sau ), ch cn t khi bnh nhn bt u vn ng c d cn rt yu t. Vic ny i hi bnh nhn phi c ch quyt thng bnh tt. Tuy nhin khng nn qu c sc s gy phn tc dng. Tt nht nn nh KTV trong thi gian u. V huyt o, ng hn l v DC-KLP , L CH CHNH CA BI NY. Ti xin cng hin cc kinh nghim sau y sau mi my nm chuyn nghin cu v iu tr loi bnh ny. C th ni rng y l phc iu tr c hiu cho bi lit do TBMMN v CTSN. Phc iu tr: Giai on u: 156 - + , 38 - +, 7 - + , 50, 37, 61 - +, 3 +, 290 +, 16 + , 26, 240, 347, phn chiu u theo hnh m, Dng v Trc din. Giai on sau: khi bnh nhn bt u t vn ng c cc c phn b lit d cn yu t, chng ta bt u tc ng thm phn chiu hoc cc b c phn b lit. Tuy nhin ch tc ng bnh thng ch khng nn qu nhiu. ng thi khuyn bnh nhn nn bt u luyn tp ch ng mt cch va sc. S qu ti trong luyn tp s gy phn tc dng. Nn iu chnh tng trng cho bnh nhn t hiu qu cao hn v hon chnh hn. K thut : day n ( hoc g hoc rung ) cc huyt v dng co nh co phn chiu u hoc c phn b lit theo cc hnh nu trn.

Bin lun: TBMMN v CTSN u lm tn thng no. Hu qu ca s tn thng ny l gy lit cho cc c phn vn ng lin quan di no nh mt, tay chn .v..v. V vy gc bnh l no , cc c phn ch l ngn. Do cu ly no b l vic u tin phi lm trong hai loi bnh chng ny. Nh vy khi no b c phc hi th tay chn lp tc phc hi. Ch nhng trng hp lu ngy cn c b teo rt th ta cn tc ng mnh vo cc vng t chi tm cch hi phc cc cn c ny. B huyt nu trn c tc dng tan mu bm, chng vim, lc no v ci thin s lu thng mu no. Ch : -Vic ln thm tuy cn thit nhng ln qu nhiu tay chn ( vi ba trm lt mi ni ) khi no cha iu khin chng c ch khin cho cc c b nho thm v gy kh khn trong iu tr v sau m thi !! Tuy nhin trong lit cng th ln l bin php tt trong mi giai on nhng cng nn va phi. -Vic xung in vo tay chn cng khng nn dng qu sm v rt d gy phn tc dng khi t bo TK cn yu khng chu ng ni kch thch ca ging in c thi lng v cng cao hn ngng ca n lc by gi. M lc ny lm sao bit c sinh lc ca t bo TK l bao nhiu nu khng c o c bng my mc hin i ? Nu chng ta da vo cm gic ca bnh nhn chn cng v tn s xung, th xung bao lu l va ? iu ny khng th xc nh bng cm gic ch quan ca bnh nhn cng nh ca chng ta c. V vy cn thn trng trong vic xung in. -Trong CTSN chng ta s thng gp kin ca BS cho rng khng c chm cu m ch cn tp VLTL . Tuy nhin DC-KLP khng phi l chm cu v chng ta khng ng n vt thng u m ch dng huyt xa vng b thng . iu quan trng l khng nn dng nhng k thut mnh tay gy au n cho bnh nhn ang trong tnh trng suy yu v hot ng ca h thng TK . D sao c iu tr thm bng huyt vn mau phc hi hn l ch luyn tp sung, iu ny c xc nh trn thc t lm sng trong qu trnh lm vic ca ti. Nay ph bin cho cc anh ch em cng dng. Chc tt c anh ch em thnh cng trong vic p dng bi vit ny iu tr nhng bnh nhn b bi lit do hai nguyn nhn trn.

26 3 2000.
K nim 20 nm DC-KLP. CH THCH : lit do TBMMN l mt bnh ca h thn kinh nhng li l hu qu ca nhng vn ca nhng ni tng bn di v h tun hon . Do mun iu tr tt loi bnh ny th ta cn iu tr tt cc bnh ca cc ni tng sau khi cc triu chng lit gim . C nh vy th mi c th t c mong mun gi kt qu iu tr n nh cho bnh nhn lu di, trnh v ngn nga ti pht cho

bnh nhn c , v loi bnh ny rt d ti pht . V vy m ti xp loi bnh ny sau cc bnh h thng khc. Bi v khi hc n y cc bn phn no c hiu bit v bnh ca cc h thng kia . BNH V MT au mt cp tnh ( vim kt mc mt ): c hai th hn v nhit. Hn th day du hoc h hoc dn cao Tiu vim, phn chiu mt mt. Nhit th p lnh tiu vim, phn chiu mt mu bn tay v mu bn chn, mi. Thoi ha thn kinh th gic, thoi ha vng mc : hai bnh ny v c bn c cch cha ging nhau. L loi bnh thuc ni chng trong Nhn Khoa ca ng y. Nu thuc bch, thanh ( tht ra l mu lam ) hay hong chng th cn d tr . Nu thuc xch chng th rt kh tr. Nu thuc Hc chng th khng cn tr c. Xt theo triu chng th bnh nhn cm thy trc mt mnh nh c mt mn khi trng ( bch chng), khi lam (thanh chng ) , khi vng ( hong chng ), khi ( xch chng ) hay mt mn en ti mt (hc chng ). Hc chng bt tr v lc ny cc t bo thn kinh cht hn khng cn kh nng tip th nh sng na . C trng hp bnh nhn ch thy mn khi xut hin mt vi im hay vng hay mt gc no trong mt ( mt phn trong th trng ca bnh nhn ) . iu tr : day vaseline B B Am Huyt, co vaseline phn chiu mt ca hnh m (vng huyt 197, 421 ). Phc ny ch mi c ng dng thnh cng vi Bch chng v Thanh chng . Tng nhn p ( glaucome, cm nc ) : au u v nhc mt xut hin cng lc vi gim th lc. Khi b tng nhn p mt bn th triu chng y ht nh Thin u thng (migrain). Hy ngh ngay n tng nhn p khi xut hin bn triu chng cng lc: nhc u , nhc mt , bun nn ( i ), gim th lc. Tuy nhin mun chnh xc cn o nhn p chuyn khoa mt . Vi nhng bnh nhn ngho khng i o c ta c th d theo b huyt sau y. iu tr : chn on hn nhit xong, chn k thut thch hp. Phc : 324, 131, 41 ( 437 ), 235, 290, 184, 16, 34, 199. Lu : huyt 199 l trung im ca huyt 421 v 197, huyt 131 ny chnh l huyt Ng V ca Th Chm (hnh huyt hin nay v sai v tr ca 131 , v tr ca n b thay th bng huyt s 2 ???!!! y l mt trc trc trong vic iu hnh chuyn mn ca nhm nghin cu DC-KLP sau nm 1996!!). c thy tinh th ( c nhn mt, c pha l th , cm kh , cm ): loi bnh ny c c im l sau mi ln iu tr th bnh nhn cm thy mt sng hn ln - chng hai ting ng h . Khin chng ta ln bnh nhn h hi nhng tht ra kt qu cui cng l con s khng . Hin nay ti vn cn ang nghin cu thm v bnh ny . V trn nguyn tc ng ngn m cha ng gc . L mt : khng tr c nu l bnh bm sinh. Tr c do bnh, chn on hn nhit tng th v hn nhit cc b mt . Khm tm c iu khin mt b bnh. Hoc

do bn ny yu (hay lit ) hoc do bn kia b co rt. iu tr theo c ch tm thy. Chy nc mt sng: c 2 trng hp , mt l do tuyn l hot ng qu mnh, hai l do tuyn thot l b tc . C hai u c nguyn nhn do ang vim hoc di chng ca vim. Vim c th do nhim trng cng c th do chc nng . Chn on nguyn nhn gy vim c phng thc ph hp. iu tr : dng b Tiu Vim, phn chiu b phn b vim , tc. Cn th : loi bnh ny c c ch kh phc tp v kt qu iu tr khng chc chn . Cn cn nghin cu thm. Gim th lc : chn on v iu chnh tng trng , phn chiu mt . C kt qu tt vi iu kin khng do tui gi . Chp mt ( lo mt ) : dn b Tiu vim, phn chiu mt lo . Nu mt cha mng m th mt s tiu, nu mt mng m th s v m v tiu sau . Sp mi mt : day du B Trung, 1 n 26, h phn chiu mt H Am , c th h thm theo cc sinh huyt vng cung my. Ti a 3 ngy iu tr khng thy hiu qu th nn day thm b Tan Mu Bm. Tuy nhin y l mt bnh c kh nhiu nguyn nhn phc tp, Ti cha gp ht mi trng hp . Phc ny ch cha ngn m thi. Git mi mt : nu m git , git nhp tha ( my mt ) : day du B B Trung, tiu vim, phn chiu mt, cc huyt quanh mt. Nu b git mnh v nhp nhanh n mc nhm hn li th rt kh tr, ch gim sau mi t iu tr ch khng khi hn v do virus lm hng dy thn kinh iu khin mi mt . CC BNH LINH TINH. Cc bnh sau y tht ra c th xp vo cc h bnh theo Ty y. Nhng v hi chng cho v l loi cho nn ti tm xp chng vo bnh linh tinh. M hi tay chn: c 3 th . Th m h : h b m huyt bn chn. Th Dng h : h B Trung hoc b Thng bn chn. Th ri lon thn kinh thc vt : khng thuc mt trong hai th kia, day du hoc day vaseline ( theo hn hay nhit chng) Hoa Gip Tch. Nhng trong thc t hay c s pha trn gia ba th vi nhau nn cn linh ng . Khi u lnh tnh : chn on hn nhit chn k thut tng ng, Tiu vim, phn chiu khi u. Khi u lnh tnh v : iu tr nh trn. Ring phn chiu th dng mt, bng cch nh hng khi u theo mt ng h vi nm v l trc kim , hng ca khi u c tnh theo hng ca kim ch gi . TD : khi u thng ngay trn nm v l

v tr 12 gi , i chiu ln mt vi con ngi l trc kim ng h th phn chiu khi u thng trn con ngi ; khi u bn phi ca nm v v tr 3 gi th phn chiu ca n bn phi ca con ngi v tr 3 gi ( bnh nhn phi nhm mt v nhn thng ). Di leo ( Zona ) :Ty y xem l bnh TK lin sn b virus tn cng ( vim TK lin sn ). Nn ch c bin php phng chng bi nhim, DC-KLP iu tr kh tt. Triu chng : ni mn rp, au nng rt. iu tr : p lnh tiu vim ,phn chiu ( hay nht l hnh Dng v H trc din ). Cm : Cm gm c cm lnh ( bn chn lnh trong khi c th st nng ), cm nng (bn chn m nng), cm nc ( bn chn bnh thng, c th thy n lnh ch khng st r rt ). Cm lnh v cm nng lun c km theo cm gi ( phong hn, phong nhit ). Cm lnh th dng b Thng, ty theo mc bnh m chn k thut thch hp . Cm nng th dng b Ging , ty mc m chn k thut thch hp. Cm nc th dng ngi cu h b Tr m thp thy t di ln trn. Nn cho BN xng hi l gii php tt nht cho cm nc. Lu : nu chn on v iu tr ng m kt qu km, ch gim m khng dt hn, th y l c nguyn nhn suy nhc c th km theo, cn bi dng cho bnh nhn bng cc loi thuc b. Cm : triu chng nh cm, km theo l au nhc ton thn t xng,khp, c bp. Ln iu tr u tin dng ngi cu h b Thng ri dn cao, lu dn 2 gi. G cao cho huyt ngh 1 gi ri dn li. C th cho n cui ngy. C th lu dn khi i ng. Thng thng th sau 3 ngy l bnh lui hon ton, lc ny bnh nhn s thy c th nng bc thm tm, c th tm c v khi bnh hon ton . Cng cn lu n nguyn nhn suy nhc c th km theo. Ngt xu : C nhiu nguyn nhn khin bnh nhn ngt xu. Bin php sau y ch nhm cu tnh cho bnh nhn tm thi m thi. Bm mnh 19 bng mt ngn tay ci cho n khi thy bnh nhn c hi nhc nhch th nh ngn tay ci cn li vo 127, hai ngn tr vo hai huyt 60, hai ngn p t vo hai huyt s 0 cho n khi bnh nhn tnh hn. C trng hp bnh nhn tnh li ri, ta bung tay ra th bnh nhn li xu ngay th y l do bnh nhn ang i bng cn cho bnh nhn n bt c mt mn g c lm bng bt ng cc th bnh nhn s tnh lun c . Theo ng y Cc kh (kh ca ng cc ) hnh kh rt nhanh . TP. H Ch Minh 1993. Lng y T Minh

KT LUN
Trn y l nhng kinh nghim tm huyt thc t trn lm sng ca ti sau nhiu nm p dng v nghin cu DC-KLP trong vic tr bnh thu c nhiu kt qu khng ng. Tuy c gng khch quan v thn trng trong nghin cu nhng

nng lc c hn v li n c nn c th cn sai st. Cha k c nhiu loi bnh chng cha h gp. Nhng khng th ni nhng g m mnh cha h va chm hoc va chm cn t cha kt lun. Cho nn s lng bnh chng c cp khng nhiu, nhng tt c u t thc t iu tr m rt ra quy lut v xy dng thnh phc . Ti mong cc bn tip tc tm ti v xc nh thm phc iu tr cho nhng bnh chng cn li cha c ni n y v mong c trao i kinh nghim hu xy dng mn DC-KLP ngy cng hon thin hn. Xin lin h:

Lng y T Minh 97 / F 1 Quang Trung, phng 11, qun G Vp, TP.HCM in thoi: 5892836. in thoi di ng: 091.8388718. E-mail: taminhdc@yahoo.com, minhta2002@hotmail.com