Breakdown 1: Overview
I. Definition
All kinds of gynecological diseases that do not belong to the scope of diseases such as menstruation, belt, fetus and childbirth, but are closely related to female anatomy, physiology and pathogenesis are collectively called gynecological miscellaneous diseases.
Second, the scope.
Anesthesia, pelvic inflammatory disease, infertility, vulvar pruritus, vulvar ulcer, uterine prolapse, and impatience of women.
Fault 2: Accident
I. Definition
What is the name of a woman's abdomen caking, swelling, pain, fullness or abnormal bleeding? Accident? . Symptoms: tangible, fixed and persistent, with limited pain, and the disease belongs to blood. Treatment: treatment is form, gathering and dispersing are impermanent, pushing can move, pain has no fixed place, and disease belongs to qi.
Second, the etiology and pathogenesis
utilize
Regarding the definition of accident, the correct one is ().
A. Symptoms are mostly malignant and mostly benign.
B. the symptoms are tangible and fixed, and the pain is nowhere to be found.
C. gathering and dispersing are impermanent, moving is moving, and pain is fixed.
D. The woman's lower abdomen is caked, swollen, painful or full.
E. the syndrome belongs to qi disease and the syndrome belongs to blood disease.
【Q&ANo。 26 150 1060 1]
Correct answer d
Third, treatment based on syndrome differentiation.
1. Qi stagnation and blood stasis syndrome
The main symptoms: the lower abdomen is caked, tangible to the touch, painful or painless to press, small abdominal distension, irregular menstruation, large menstrual flow, difficult to clean up, and dark menstrual flow; Mental depression, chest tightness, dull complexion and wrong nails; The tongue is purple and dark, or has ecchymosis, and the pulse is heavy and astringent.
Treatment: promoting qi and blood circulation, removing blood stasis and eliminating symptoms.
Main prescription: Xiangling pill or rhubarb.
Which of the following is not the characteristic of abdominal pain of blood stasis type ()
A.there is a brick in the cell
B.the building blocks are hard
C. fixed; unchangeable
D. massage
E. the pain is not fixed
【Q&ANo。 26 150 10602]
Correct answer e
Aortic second sound
When the woman came to the clinic, she complained of abdominal mass, heavy menstrual flow, blood stasis, abdominal pain and non-menstrual period. Gynecological diagnosis is abdominal mass, pale and dark tongue with ecchymosis, and its treatment principle is ().
A. promoting blood circulation, removing blood stasis, resolving hard mass and eliminating symptoms
B. Eliminating phlegm and dampness, relieving depression and eliminating symptoms
C. soothing the liver and relieving depression, and promoting qi to relieve depression
D. detoxification and dehumidification, removing blood stasis and eliminating diseases
E. benefiting qi and nourishing blood, and regulating chong and ren.
Correct answer a
2. Phlegm-dampness and blood stasis syndrome
The main symptoms: the lower abdomen is caked, the touch is not firm, the fixation is difficult to move, the menstrual flow is large, the dripping is not clean, and the leucorrhea during menstruation increases; Chest pain and abdominal pain; The tongue is fat, purple-black, with ecchymosis and petechiae, white and thick coating, and slippery or heavy pulse.
Treatment: eliminating phlegm and dampness, promoting blood circulation and eliminating symptoms.
Main prescriptions: Cangfu Daotan Pill and Guizhi Fuling Pill.
3. Dampness, blood stasis syndrome
Main symptoms: mass in the lower abdomen, ups and downs in heat and cold, severe pain when touching, pain at lumbosacral junction, excessive menstrual flow, prolonged menstrual period, excessive leucorrhea, yellow pus, or mixed red and white; See body heat, thirst, restlessness, constipation and Huang Chi in urine; The tongue is dark red with ecchymosis, yellow fur and slippery pulse.
Treatment: clearing away heat and promoting diuresis, removing blood stasis and eliminating symptoms.
Main prescription: rhubarb peony soup plus Akebia stem and poria cocos.
4. Kidney deficiency and blood stasis syndrome
Main symptoms: lower abdomen caking and tenderness; Menstruation is more or less, menstrual abdominal pain is more severe, menstrual volume is purple and dark, long-term infertility or multiple abortions; Backache and knee weakness, dizziness and tinnitus; The tongue is dark and the pulse is thin.
Treatment: tonify kidney and promote blood circulation, eliminate symptoms and dissipate stagnation.
Main prescription: Bushen Quyu recipe or Yishen Tiaojing decoction.
Structural diagram of differential diagnosis and treatment of abdominal mass
1. Qi stagnation and blood stasis syndrome:
Promoting qi and blood circulation, removing blood stasis and eliminating symptoms? Xiangling pill or rhubarb (Eupolyphaga Seu Steleophaga) insect sting pill
2. Phlegm-dampness and blood stasis syndrome:
Eliminating phlegm and dampness, promoting blood circulation and eliminating symptoms? Cangfu Daotan Pill and Guizhi Fuling Pill
3. Syndrome of dampness and blood stasis:
Clearing heat and promoting diuresis, removing blood stasis and eliminating symptoms? Mutong Fuling Dahuang Mudan Decoction
4. Kidney deficiency and blood stasis syndrome:
Bushen Huoxue, eliminate symptoms and disperse nodules? Bushen Quyu Decoction or Yishen Tiaojing Decoction
Fourth, treatment considerations
There are many new diseases in clinic, which need to be attacked and broken; After a long illness or operation, it is mainly to replenish qi and blood and restore healthy qi. If the healthy qi has been restored and the lump has not been removed, the recovery is mainly based on breakthrough. If there is blood stasis after operation, it can replenish qi and blood, supplemented by products that promote qi and blood circulation, and pay attention to regulating its diet, stimulate appetite and improve spleen and stomach function.
Item 3: Pelvic Inflammation
I. Definition
Inflammation of female internal reproductive organs and their surrounding connective tissues and pelvic peritoneum is called pelvic inflammatory disease.
1. Acute pelvic inflammatory disease refers to acute inflammation of female internal reproductive organs and their surrounding connective tissues and pelvic peritoneum.
2. Chronic pelvic inflammatory disease is a chronic inflammation of female reproductive organs and their surrounding connective tissues and pelvic peritoneum, which is called chronic pelvic inflammatory disease.
Second, the etiology and pathogenesis
1. Acute pelvic inflammatory disease
(1) Excessive heat toxicity: evil toxin invades the uterus, stays in the uterus, turns heat into poison, and causes high fever, abdominal pain and restlessness.
(2) Damp-heat stasis: blood stasis and damp-heat are limited to less abdomen, and abdominal pain is difficult to heal after a long time.
2. Chronic pelvic inflammatory disease
(1) Damp-heat stagnation: Damp-heat evil invades and qi and blood are blocked.
(2) qi stagnation and blood stasis: qi stagnation and blood stasis, and the context is impassable.
(3) stagnation of cold and dampness: yang deficiency in the body, or invasion of cold and dampness, coagulation and blood stasis with turbid liquid phase in intrauterine blood.
(4) Qi deficiency and blood stasis: physical weakness, or internal injury of vital qi, poor blood circulation and blood stasis; Or long-term illness and blood stasis, long-term fatigue, lack of healthy qi, leading to qi deficiency and blood stasis syndrome.
Third, treatment based on syndrome differentiation.
1. Acute pelvic inflammatory disease
(1) Syndrome of Excessive Heat Poison
Main symptoms: high fever, abdominal pain, aversion to or aversion to cold, abdominal pain, dry throat and bitter taste, constipation, short and red urine, excessive leucorrhea, yellow color, or red and white, sticky, such as purulent blood, foul smell, heavy menstrual flow or endless dripping; Red tongue, thick yellow fur and slippery pulse.
Treatment: clearing away heat and toxic materials, promoting diuresis and expelling pus.
Main prescription: Wuwei Disinfection Drink combined with Dahuang Peony Decoction.
(2) Syndrome of damp-heat and blood stasis
Main symptoms: abdominal pain, refusal to press, or fullness, fluctuation of heat potential, alternating cold and heat, frequent leucorrhea, yellow color, strong taste, increased menstrual flow, prolonged menstrual period, endless dripping, loose or dry stool, short and red urine; Red tongue with petechiae, yellow greasy fur and slippery pulse.
Treatment: clearing away heat and promoting diuresis, removing blood stasis and relieving pain.
Main prescription: Xianfang Huosheng drink with coix seed and wax gourd kernel.
2. Chronic pelvic inflammatory disease
(1) Damp-heat and blood stasis syndrome
Main symptoms: less abdominal pain, or pain refusing to press, lumbosacral pain, low fever fluctuation, aggravated menstruation or fatigue, more leucorrhea, and thick yellow color; Chest tightness, anorexia, dry mouth, no desire to drink, loose stool, or secret knot, Huang Chi in urine; The tongue is fat, red in color, yellow and greasy in fur, and has a string or slippery pulse.
Treatment: clearing away heat and promoting diuresis, removing blood stasis and relieving pain.
The main prescription: Yinjia Pill or Danggui Shaoyao Powder plus Danshen, Ilex pubescens, honeysuckle and Tianqi tablets.
(2) Qi stagnation and blood stasis syndrome
The main symptoms: less abdominal pain or tingling, aggravated low back pain during menstruation, more menstrual flow, less pain when blood stasis is discharged, more leucorrhea, and long-term infertility after marriage; Premenstrual depression, breast pain; The tongue is purple and dark, with ecchymosis and petechiae, thin tongue coating and astringent pulse.
Treatment: promoting blood circulation and removing blood stasis, regulating qi and relieving pain.
Main prescription: Gexia Zhuyu decoction.
(3) Cold-dampness stagnation syndrome
Main symptoms: cold pain in the lower abdomen, or swelling pain, aggravated abdominal pain during menstruation, aversion to heat and cold, reduced heat pain, less menstrual blood, dark color, and dripping with the vagina after irregular menstruation; Mental fatigue, lumbosacral cold pain, frequent urination, long-term infertility after marriage; The tongue is dark red, the coating is white and greasy, and the pulse is deep and late.
Treatment: dispel cold and dampness, promote blood circulation and remove blood stasis.
Main prescription: Shaofu Zhuyu decoction.
(4) Qi deficiency and blood stasis syndrome
The main symptoms: pain in the lower abdomen, persistent for a long time, even pain in the lumbosacral region, aggravated menstruation, more menstrual lumps and more leucorrhea; Lack of energy, fatigue, eating less and staying more; The tongue is dark red with ecchymosis and petechiae, with white fur and weak pulse.
Treatment: Yiqi Jianpi, Huayu Sanjie.
Main prescription: Li Chong soup.
Structural diagram of dialectical treatment of pelvic inflammatory disease
1. Acute pelvic inflammatory disease
Syndrome of excessive heat toxin: clearing away heat and toxic materials, promoting diuresis and expelling pus? Wuwei Disinfection Drink Combined with Dahuang Mudan Decoction
Syndrome of dampness and blood stasis: clearing heat and promoting diuresis, removing blood stasis and relieving pain? Yi mi dong gua zi xian Fang huo Xue yin
2. Chronic pelvic inflammatory disease
Syndrome of dampness and blood stasis: clearing heat and promoting diuresis, removing blood stasis and relieving pain? Yinjia Pill or Danggui Shaoyao Powder plus Salvia Miltiorrhiza Radix,
Ilex pubescens, honeysuckle. And notoginseng.
Qi stagnation and blood stasis syndrome: promoting blood circulation and removing blood stasis, regulating qi and relieving pain? Gexia Zhuyu decoction
Syndrome of stagnation of cold and dampness: dispel cold and dampness, promote blood circulation and remove blood stasis? Shaofu Zhuyu decoction
Qi deficiency and blood stasis syndrome: benefiting qi and strengthening spleen, removing blood stasis and resolving stagnation? Li chongtang
utilize
Patient, female, 32 years old. Abdominal pain, burning sensation, lumbosacral pain, low fever fluctuation, excessive leucorrhea, yellow color, thick body, yellow tongue, yellow greasy fur and slippery pulse. The treatment is
A. clearing away heat and promoting diuresis, removing blood stasis and relieving pain B. promoting qi and blood circulation, removing blood stasis and relieving pain
C. Soothing the liver and regulating qi, removing blood stasis and relieving pain D. Cooling blood and activating blood, removing blood stasis and relieving pain
E. invigorating spleen and promoting diuresis, removing blood stasis and relieving pain
Correct answer a