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5.9 Inquiring of infantile and women's disease课程教案、知识点、字幕

同学们好

下面我们学习中医问诊之问经带和问小儿

由于这两部分涉及到妇科和儿科的问诊

我们仅作简单的介绍

首先是问经带

即问妇女的月经和带下

月经 是发育成熟的女子 有规律的周期性胞宫出血

月经通常从期 量 色 质这四个方面来描述

期 是指月经周期

女子月经初潮的时间是十三到十五岁

绝经期是四十九岁左右

对于成熟的女子来讲

月经周期从两个方面来描述

一个是月经周期

一个是行经期

正常月经周期 是二十八加减七天为一个月经周期

二十八加七为三十五天

二十八减七为二十一天

也就是说

当月经周期在二十一到三十五天之间

都属于正常的月经周期

正常行经期 通常是三到五天

最长不超过七天

量 是指月经的量

正常月经量适中

通常在五十到一百毫升左右

色 是指月经的颜色

正常月经血是稍微暗红色 又称为正红色

质 即月经的质地

(由于正常月经血是不凝固的)所以正常月经血的

质地是不稀不稠不夹杂血块的

如果月经在期 量 色 质上面表现出了异常

称为月经不调

在问妇女月经时 通常要问月经的周期

行经的天数 经量 经色 经质

有无闭经 痛经等等表现

必要时要询问末次月经的日期

初潮或绝经的年龄

月经不调 主要介绍以下四种

即经期异常 经量异常 经色经质异常

以及痛经等

首先我们来看第一个 经期异常

经期的异常 主要有月经先期

月经后期以及经期错乱三种

月经先期 是指经期常常提前七天以上

通常提前八到九天

月经先期与气虚 血热

肝郁 阴虚火旺有关

月经后期 是指经期经常推迟七天以上

通常推迟八到九天

月经后期与血虚 阳虚

气滞血瘀 寒凝血瘀有关

经期错乱 是指月经或提前或推后

经期不定

经期错乱通常与肝气郁结

脾肾虚损和瘀血阻滞有关

经量的异常 主要有月经过多 月经过少

崩漏和闭经四种

月经过多 是指月经量比以前明显增多

周期基本正常

月经过多通常是血热 气虚和血瘀的表现

月经过少 是指月经量明显少于正常

经期基本正常

月经过少通常是与血虚 肾气虚

寒凝 瘀血 痰湿阻滞有关

崩漏 是指是非行经期

阴道内大量出血

或持续下血 淋漓不断

崩漏与血热 脾肾气虚 瘀血阻滞有关

闭经 是指女子年满十八岁 尚未初潮

或者已经行经 又停经三个月以上

没有受孕者

就称为闭经

闭经与气血亏虚 肝肾不足

气滞血瘀 寒凝 痰湿阻滞有关

经色 经质的异常表现为以下三个方面

如果月经颜色淡红

质地比较稀薄 与血虚有关

如果月经颜色深红 质地比较稠厚

与血热有关

如果月经颜色紫暗 夹有血块

常常兼有小腹疼痛

这与寒凝血瘀有关

最后我们来讲痛经

痛经 是指在经期

或月经前 或月经后

出现周期性的小腹疼痛

或痛引腰骶 甚至剧痛难忍的症状

经前或者经期小腹的胀痛或刺痛 拒按

这与气滞血瘀有关

小腹灼热疼痛 拒按

平时带下黄稠臭秽

这与湿热郁结有关

小腹冷痛 遇暖则(痛)减

这与阳虚寒凝有关

经行后期 或者经后小腹隐痛 空痛

这与气血不足 气血亏虚有关

下面我们还介绍一下带下

带下 是指正常情况下

妇女阴道内有少量 无色 无臭的分泌物

问带下 主要是要问带下的

量 色 质和气味

带下异常主要有以下三种

白带 黄带和赤白带

白带 是指带下色白而量多

质稀如涕 淋漓不绝

它通常是脾肾阳虚 寒湿下注所引起的病变

黄带 是指带下色黄 质黏

而且很臭秽

通常是湿热下注所导致的

赤白带 是指白带中间夹有少量的血液

赤白杂见

这是肝经郁热 或湿热下注所导致的

以上是问经带的内容

最后一个就是问小儿的部分

我们简单的给同学们介绍一下

小儿的生理特点

主要是脏腑娇嫩 生机蓬勃 发育很迅速

所以相应的小儿的病理特点是

发病较快 变化较多 易虚易实 易寒易热

问小儿的时候 主要内容包括

小儿出生前后的情况

预防接种及传染病史

以及容易导致小儿致病的原因等等

问新生儿的疾病时

我们应该询问母亲妊娠期与产褥期

营养健康的状况

有何疾病 曾服用何种药物

分娩时是否足月 难产 以及早产

婴幼儿问诊 我们应该注意询问的重点是

询问喂养的方法 以及婴儿的

坐 爬 立 走 出牙

学语的迟早的情况

六个月到五周岁 应该注意询问预防接种

是否曾经患过传染病或者是某些接触史

容易导致小儿致病的原因 主要有以下几个方面

由于小孩脏腑娇嫩 抵抗力比较弱

所以小孩容易受到外邪的侵犯 易患外感病

小儿脾胃嫩弱 消化力比较差

所以比较容易出现呕吐 腹泻的病变

小儿神志发育还不完善

所以也比较容易受到惊吓

以上是问小儿所需要注意的一些内容

至此 问诊的内容全部讲解完毕

本章主要讲述了 问诊的意义和方法

问诊的内容 以及问现在症的内容

问诊是了解病情 诊察疾病的重要方法

在四诊占据着最重要的地位

但是中医诊断的原则是 四诊合参

所以问诊还需要结合其他三种诊断方法

才能准确诊断疾病

接下来 我们还将继续学习

四诊之望诊的方法

同学们 下次课再见

Diagnostics in Chinese Medicine课程列表:

Week 1 Introduction

-Introductory remark

--Introductory remark

--QQ groups、WeChat public account

-Introduction

--Introduction

--【Discussion 1】Why do you want to take this course?

-Unit test for Introduction

Week 1 Basic Theory of Chinese Medicine 1:Yin-Yang and Five Elements Theory

-1.1 Yin-yang theory

--1.1 Yin-yang theory

-1.2 The theory of five elements

--1.2.1 The theory of five elements

--1.2.2 Application of the theory of five elements

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 1

Week 2 Basic Theory of Chinese Medicine 2:Zang-Fu Theory

-2.0 Outline

--2.0 Outline

--【Discussion 2】How to understand the holistic view centered on the Zang Fu theory?

-2.1 Liver

--2.1 Liver

--【Discussion 3】Why is repose more important than vigorous exercise in recuperation for patients with

-2.2 Heart

--2.2 Heart

-2.3 Spleen

--2.3 Spleen

-2.4 Lung

--2.4 Lung

-2.5 Kidney

--2.5 Kidney

-2.6 Six fu organs

--2.6 Six fu organs

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 2

Week 3 Basic Theory of Chinese Medicine 3:Qi,Blood and Body Fluid Theory

-3.1 Qi

--3.1 Qi

-3.2 Blood

--3.2 Blood

-3.3 Body fluid

--3.3 Body fluid

-3.4 The relationship of qi, blood and body fluid

--3.4 The relationship of qi, blood and body fluid

--【Discussion 4】A discussion about the theory of qi, blood and body fluid

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 3

Week 4 Basic Theory of Chinese Medicine 4: The theory of etiologic factor

-4.0 Outline

--4.0 Outline

-4.1 Six exogenous factors

--4.1.1 Six exogenous factors

--4.1.2 Nature and pathogenicity of wind and cold

--4.1.3 Nature and pathogenicity of summer heat and damp

--4.1.4 Nature and pathogenicity of dryness and fire

-4.2 Etiology of visceral impairment

--4.2 Etiology of visceral impairment

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 4

Week 5 Diagnosis methods: Inquiry (1)

-5.0 Outline of inquiry

--5.0.1 Outline of inquiry(1)

--5.0.2 Outline of inquiry(2)

--【Discussion 5】If you were a patient, how would you describe your condition to your doctor first?

-5.1 Inquiry of Chills and fever

--5.1.1 Chills and fever(Aversion to cold with fever)

--5.1.2 Chills and fever(Chills without fever)

--5.1.3 Chills and fever(Fever without chills)

--5.1.4 Chills and fever(Alternative chills and fever)

--【Discussion 6】How to understand "if you have clinical manifestations of cold, that is exterior syndr

-5.2 Inquiry of perspiration

--5.2 Inquiry of perspiration

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 5

Week 6 Diagnosis methods: Inquiry (2)

-5.3 Inquiring of pain

--5.3 Inquiring of pain

--【Discussion 7】How to understand "stagnation leading to pain and innourish leading to pain"?

-5.4 Inquiring of head, body, thorax and abdomen

--5.4 Inquiring of head, body, thorax and abdomen

-5.5 Inquiring of ears and eyes

--5.5 Inquiring of ears and eyes

-5.6 Inquiring of sleep

--5.6 Inquiring of sleep

-5.7 Inquiring of food and drink, appetite and taste

--5.7 Inquiring of food and drink, appetite and taste

-5.8 Inquiring of defecation and urination

--5.8.1 Inquiring of defecation

--5.8.2 Inquiring of urination

-5.9 Inquiring of infantile and women's disease

--5.9 Inquiring of infantile and women's disease

-Unit test for week 6

Week 7 Diagnosis methods: Observation (1)

-6.0 Outline of Observation

--6.0 Outline of Observation

--【Discussion 8】Please use the whole body inspection (including the expression, complexion and figure)

-6.1.1 Observation of vitality

--6.1.1 Observation of vitality

-6.1.2 Observation of the color

--6.1.2.1 The content, principles of inspection of the color

--6.1.2.2 Indication of diseases by five colors

--【Discussion 9】How do you understand the normal complexion of a normal people?

-6.1.3 Observation of the appearance

--6.1.3 Observation of the appearance

-6.1.4 Observation of figure and posture

--6.1.4 Observation of figure and posture

-Unit test for week 7

Week 8 Diagnosis methods: Observation (2)

-6.2.1 Observation of head and face

--6.2.1 Observation of head and face

-6.2.2 Observation of five sensory organs

--6.2.2.1Observation of five sensory organs(observation of eyes,ears,nose)

--6.2.2.2Observation of five sensory organs(observation of lips,teeth and gums,throat)

-6.2.3 Observation of body

--6.2.3 Observation of body

-6.2.4 Observation of limbs

--6.2.4 Observation of limbs

-6.2.5 Observation of two lower orifices

--6.2.5 Observation of two lower orifices

-6.2.6 Observation of skin

--6.2.6 Observation of skin

-6.3 Observation of excreta

--6.3 Observation of excreta

-6.4 Observation of infantile fingerprints

--6.4 Observation of infantile fingerprints

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 8

Week 9 Diagnosis methods: Inspection of tongue

-7.1 Outline of tongue inspection

--7.1.1 The morphology and structure of the tongue

--7.1.2 The principle of tongue examination

--7.1.3 The method and precaution of tongue examination

--7.1.4 The content of tongue examination, normal tongue

-7.2 Inspection of tongue structure

--7.2.1 Observe the color of tongue

--7.2.2 Observe the shape of tongue

--7.2.3 Observe the states of tongue

--7.2.4 Observation of sublingual vein

-7.3 Observation of tongue coating

--7.3.1 Observation of coating texture

--7.3.2 Observe the color of coating

-7.4 Clinical significance of tongue diagnosis

--7.4 Clinical significance of tongue diagnosis

--【Discussion 10】Why to observe the tongue can be used to diagnose disease?

-Unit test for week 9

Week 10 Diagnosis methods::Pulse examination

-8.1 The principle of pulse examination

--8.1 The principle of pulse examination

-8.2 The regions and methods of pulse examination

--8.2 The regions and methods of pulse examination

-8.3 The elements of pulse examination and the normal pulse

--8.3 The elements of pulse examination and the normal pulse

-8.4 Characteristics and significance of pulse

--8.4.1 Superficial pulse, deep pulse, slow pulse, rapid pulse

--8.4.2 Surging pulse, thin pulse, long pulse, short pulse

--8.4.3 Feeble pulse, forceful pulse, slippery pulse, uneven

--8.4.4 Taut pulse, tense pulse,soggy pulse, moderate pulse

--8.4.5 Knotted, slow-regular-intermittent, irregularly abrupt

-8.5 Similar pulse, concurrent pulse, pulse indicating deterioration of visceral qi۞

--8.5 Similar pulse, concurrent pulse, pulse indicating deterioration of visceral qi۞

--【Discussion 11】Why is complex pulse more common than single-factor pulse?

-8.6 Women’s pulse, children’s pulse

--8.6 Women’s pulse, children’s pulse

-8.7 The clinical significance of pulse diagnosis

--8.7 The clinical significance of pulse diagnosis

-Unit test for week 10

Week 11 Diagnosis methods:Listening and smelling examination

-9.1 Listening

--9.1 Listening

-9.2.1 Abnormal sound

--9.2.1 Abnormal sound

-9.2.2 Abnormal language

--9.2.2 Abnormal language

-9.2.3 Respiratory abnormality

--9.2.3 Respiratory abnormality

-9.2.4 Cough

--9.2.4 Cough

--【Discussion 12】How to observe the patient's cough sound and sputum changes to determine whether the

-9.2.5 Abnormal sounds of the stomach and intestines

--9.2.5 Abnormal sounds of the stomach and intestines

-9.3 Smelling

--9.3 Smelling

--【Discussion 13】How to diagnose by smelling?

-Unit test for week 11

Week 12 Diagnosis methods:Palpation

-10.1 The method, meaning and precautions of palpation

--10.1 The method, meaning and precautions of palpation

-10.2 Contents of palpation

--10.2.1 Palpating chest and hypochondrium

--10.2.2 Palpating stomach and abdomen

--10.2.3 Palpating skin

--10.2.4 Palpating hands and feet, palpating acupoints

--【Discussion 14】How to determine whether external or internal injuries?

-Unit test for week 12

Conclusion

-Conclusion

--Conclusion

Final Exam

-Final Exam

--Final Exam

5.9 Inquiring of infantile and women's disease笔记与讨论

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