Gastritisppt课件.ppt

GASTRITISMAIN CONTENTPathogenisisSymptomsDiagnosisTreatmentGENERAL PATHOGENISISGeneral pathogenisis:The etiology and pathogenesis of gastritisare complex and multiple,such as,injury in Zhongzhou by improper diet;impairing in stomach by the invasion of pathogenic factors;the disfunction of liver qi by suffering depression or angry a lot;or the insufficience of endowment,and the weakness of spleen and stomach,etc.As a whole,although the location of the disease is the stomach,but it has close relationship with spleen,liver,and kidney,.The characteristics of the pathogenesis is deficiency complicated with excess.病机总论：胃炎的病因病机，有饮食不节，戕伤中州；或外邪内侵，损及脾胃；或忧患郁怒，肝失疏泄，横逆犯胃，以及禀赋不足，脾胃虚弱等。其病在“胃”，但与“脾”、“肝”、“肾”关系密切，病机特点是虚中夹实。SPECIFIC PATHOGENISIS（一）饮食不节、损及脾胃Improper diet leads to the impairment of the spleen and stomach,such as the abnormality of hunger and satiety,or the untimely eating(饥饱失常或饮食无时）.Eating too much or too little both can result in gastropathy,Su Wen said that eating double or triple food than you can absorb leads to the impairment of the stomach and intestines(饮食自倍，肠胃乃伤）.SPECIFIC PATHOGENISIS（二）饮食不洁、损及脾胃Eating unclear food may impaire the spleen and stomach.One should pay attention to the cleanliness of what he eat.Diet unclearliness means eating the unsanitary or unhealty food,spoiled or toxic food.Diet unclearliness may lead to various Gastrointestinal diseases,such as bellyache,vomiting,diarrhea and dysentery,etc.（饮食不洁会导致多种胃肠道疾病，出现腹痛、吐泻、痢疾等病症）SPECIFIC PATHOGENISIS（三）抑郁伤肝，肝失疏泄Depression may have damage on the liver,and make the dysfunction of liver qi.The dysfunction of liver qi will lead to the disharmony between the spleen and stomach.As Linzheng Zhinan Yian said the liver is source of the onset,and the stomach is the loacation of the transfer(肝为起病之源，胃为传病之所SPECIFIC PATHOGENISIS（四）外感内伤、脾胃湿热Pathogenic factors and internal impairements are apt to cause the damp and heat of the spleen and stomach.Pathogenic factors,such as summer heat and damp,and cold heat and damp invade into the spleen and stomach will cause the internal stagnation of water-damp;drinking alcohol too much will also cause the damp and heat.(外感暑湿、寒湿，内侵脾胃，水湿内停；或饮酒过度，酿湿生热，损及胃腑)SPECIFIC PATHOGENISIS（五）气滞不行、瘀血阻络The stagnation of qi and blood.The chronic gastropathy and the persistent unhealed of it will cause the stanation of the qi and xue around rhe stomach;or the damages of the pulses by surgery will also leads to the internal growth of blood stagnation and makes it unable to nourish the stomach;or the stopage of liver qi caused by poor mood can also lead to stomach pain,fulness and belching etc.Linzheng Zhinan Yian said that if there exists a long and recurrent stomach pain,there must exist the sputum and blood stagnation.胃病日久，迁延不愈，气血阻滞胃腑；或术后损脉，瘀血内生，胃络失于滋养；或情绪不畅，肝气郁结，气滞血瘀，可致胃痛发作、嗳气痞满等症产生。正如临证指南医案。胃脘痛云：“胃痛久而屡发，必有凝痰聚瘀。”SPECIFIC PATHOGENISIS（六）虚火内生、胃阴不足The appearance of internal false-fire leads to the difficiency of stomach yin.Too much fat and sweet,pungent and spicy food,and excessive drinking will cause the accumulation of damp and heat,and if not ocured for a long time it might burn the stomach meridian;or the qi and blood stasis,causing the retention of pathogen,will transfer into heat;or the long time depression of liver qi which can transfer to fire.All the above reasons can burn the stomach,and damage the stomach yin.恣食肥甘辛辣，饮酒过度，蕴湿酿热，日久不愈，灼伤胃络；或气滞血瘀，病邪留滞，瘀久化热；或肝气久郁，化而为火，上述原因均可灼烧胃腑，损耗胃阴。SPECIFIC PATHOGENISIS（七）禀赋不足、脾胃虚弱Congenital absence and the weakness of the spleen and stomach.Too much frailness and tiredness of the body will damage the spleen and stomach.Lanshi Mizang said that a person who suffered from long period of difficiency in spleen and stomach,if there was cold in the stomach he would catch fullness,and if there was cold in the spleen he would suffer full disease.身体 虚弱，或劳倦内伤，中伤脾胃。兰室秘藏中谓“脾胃久虚之人，胃中寒则生胀满，或脏寒生满病。“SYMPTOMSNausea or recurrent upset stomach 恶心反胃或经常性胃不舒服Abdominal bloating 腹部胀气Abdominal pain 腹痛Vomiting 呕吐Indigestion 消化不良Burning or gnawing feeling in the stomach between meals or at night夜晚或两餐之间胃部有灼痛感Hiccups 打嗝Loss of appetite 食欲不振Vomiting blood or coffee ground-like material 吐血或咖啡样物质Black,tarry stools 大便黑或柏油样大便DIAGNOSIS -GASTRITIS CAUSED BY THE WEAKNESS OF THE SPLEEN AND STOMACH-GASTRITIS CAUSED BY THE WEAKNESS OF THE SPLEEN AND STOMACHWang-observing:low spirit,lack of vitality in the face,dull eyesight,and hypodynamia,and edema of the limbs;（情绪低落，面色无华，目光呆滞，困倦乏力，四肢浮肿）coating on the tongue-pale red tongue,thin and white moss with scalloped mark around the tongue.（苔质淡红，苔薄白，有齿痕）DIAGNOSIS -GASTRITIS CAUSED BY THE WEAKNESS OF THE SPLEEN AND STOMACH-GASTRITIS CAUSED BY THE WEAKNESS OF THE SPLEEN AND STOMACHWen-listenning:A).low voice（声音细微）B).slowly breath.（呼吸缓慢）DIAGNOSIS -GASTRITIS CAUSED BY THE WEAKNESS OF THE SPLEEN AND STOMACH-GASTRITIS CAUSED BY THE WEAKNESS OF THE SPLEEN AND STOMACHWen-questioning:the location of the pain-around the stomachthe charicteristic of the pain-dull and persistent paineating habit-irregular diet,always eating pungent,spicy or cold food,lifestyle-staying up late,eating snacks after 10:00 pm,no breakfast。DIAGNOSIS -GASTRITIS CAUSED BY THE WEAKNESS OF THE SPLEEN AND STOMACH-GASTRITIS CAUSED BY THE WEAKNESS OF THE SPLEEN AND STOMACHQie-feeling the pulse:A).deep and thready pulse,脉细而沉B).cold in hands and feet.手足冰冷TREATMENTAcupuncture treatmentMain acupoint-Tsusanli 足三里Neiguan 内关Assistant point-Chungwan 中脘Liangqiu 梁丘TREATMENTChinese medicinal treatmentRepresentative prescription-Banxia Xiexin Decoction 半夏泻心汤Pinellia tuber(12 grams),Scutellaria baicalensis(9 grams),dried ginger(9 g),ginseng(9 grams),Zhigancao(9 grams),Coptis chinensis(3 grams),jujube(4 pieces)半夏（12克）黄芩（9克）干姜（9克）人参（9克）炙甘草9克）黄连（3克）大枣（4枚）TREATMENTFood therapies:Food therapies principles:1.One should eat slowly,avoid overeating.2.Avoid spicy food,smoking and drinking,drink less strong tea and coffee.Avoid overheat,acid,smoked and pickled foods.At the same time,one should also avoid pills that are amyctic to stomach such as sodium salicylate,aspirin,indomethacin,(水杨酸钠，阿司匹林，吲哚美辛)etc.3.Eat digestible food,avoid cold,hard,rough,over amount fiber containing food,such as celery,leek,yellow bean sprouts.韭菜，芹菜，黄豆芽4.Eat foods with more protein and vitamins,such as eggs,milk,meat,fish,beans and green vegetables.5.If the patient has too little gastric acid,then he should eat more acidic food;for people have much more gastric acid,one should not eat acid-produced food,such as sugar,sweet cakes,sweet potato and strong tea,coffee,wine,gravy,but should intake appropriate food that can neutralize stomach acid,such as soda biscuits,baked bread.6.Pay attention to work and rest,healthy regime,having optimistic mood,avoid stress、anxiety、depression、angry moods,especially when intaking foods.General foods：Main courses:Dou kou buns:dou kou 15 grams,1000 grams of flour,jiao mian 50 grams.Make dough with flour and jiao mian,cover up for about 2 hours,wait for fermentation,add proper alkali and dou kou powder,Knead well,make buns,steam about 15 minutes.豆蔻包子：豆蔻15克，面粉1000克，焦面50克。用面粉和焦面和成面团，盖上约2个小时，等待发酵，加入适量的碱和豆寇粉，揉好，做馒头，蒸约15分钟。Radish cake:white radish 250 grams,250 grams of flour,100 grams of lean porks.Wash and slice radish,stir-fry until its half done.Chopp the meat into puree,add white radish,ginger,onions,salt into the stuffing.The amount of water and flour into the filling.Mix flour and water into into dough,made into flour slices,fill in the prepared fillings and fry in the pot until well done.萝卜糕：白萝卜250克，面粉250克，瘦猪肉100克。洗净，切片炒萝卜，直到它的一半。安排入肉泥，加入白萝卜，生姜，洋葱，成馅，盐。水和面粉制成的填充量。把面粉和水混合成面团，做成面片，充填填料，下锅炸至熟透。Stomach-nourishing porridge:100 grams of glutinous rice,shan yao 50 grams,red bean 50 grams,qian shi 25 grams,25 grams of yi mi,lotus 25 grams,10 jujubes,proper sugar.Wash the glutinous rice,peel and dice shan yao.Boil Glutinous rice for half an hour,then add other materials,braise through.Add appropriate amount of sugar for flavour.养胃粥：100克糯米饭，山药50克，赤小豆50克，千石25克，25克薏米，莲子25克，红枣10，适量的糖。糯米饭洗净，去皮切粒山窑。糯米饭煮半个小时，然后加入其他材料，将通过。口味加适量的糖。Dishes：Garlic taste cabbage:cabbage 500 grams,appropriate amount of ginger,wash and slice them.Smash one garlic.Fry garlic,ginger,add shredded cabbage,stir thoroughly and add in seasonings,boil for 2 minutes.蒜味卷心菜：卷心菜500克，适量的生姜，洗净，切片。粉碎一大蒜。大蒜生姜，炒，加入切碎的卷心菜，拌匀，加入调味料，煮2分钟。White pepper braised with pig tripe:One tripe,white pepper powder 10 grams,wipe on pig tripe,add rice wine,salt and soak for half an hour,add water,wine,ginger,stew with slow fire.白牛肚炖猪肚：牛肚之一，白胡椒粉10克，抹上猪肚，加入米酒，盐，浸泡半小时，加水，酒，生姜，慢火炖煮。Double taste duck:one duck,ding xiang，chen xiang each 9 grams,proper rice wine,onions,salt,soy sauce,sugar,MSG.Fry ding xiang、chen xiang with a little salt,soak the duck with rice wine,soy sauce,scallion,ginger for one hour,then add in water,wine,ginger and simmer well.双味鸭：一只鸭子，丁乡，陈翔各9克，适当的黄酒，葱，盐，酱油，糖。炒鼎祥、陈翔一点盐，黄酒，酱油，葱浸泡鸭，一小时，生姜，然后加入水，酒，生姜煮好。Soup:1、Da mai ren soup：cao gu 5 pieces,mutton 150g,da mai ren 50g,proper salt.Clean da mai cha and boil well in the pot.Clean the mutton,add in the aluminium pot along with cao gu,mix soup with da mai ren and stew with slow fire.Dice the mutton and add into the da mai soup,add a little salt and mix well.大麦仁汤：草菇5片，羊肉150g，大麦仁50g，适当的盐。干净的大麦茶和煮好的锅。干净的羊肉，放入铝锅随着草菇，大麦仁、炖文火拌汤。把羊肉加入大麦汤，加少许盐，拌匀。草菇2、Bai he li zhi soup：20g bai he,chuan lian zi 20g,li zhi he 20g,wu yao 15g.Mix them all in the pot and soak for 30g,then fry for 30g minutes,fry each material for 3 times and mix the three decoctions together.Apply one time in the morning and at night.百合荔枝汤：20g百合，川莲子20g，荔枝核20克，乌药15克。将它们全部混合在锅里浸泡30克，然后炒30分钟，煎3次，每种材料混合在一起的三方。适用于早上和晚上。