五、 月經前後諸症:                                                
  月經前後諸症是統指婦女在月經前或月經期出現的一系列症狀,大致可概括 
  兩大類:                                                           
  (一) 由於水納貯留所引起的症狀如水腫、乳脹、頭痛、經行瀉泄等。      
  (二) 是精神、神經症狀如煩躁、抑鬱等。其特點為症狀與經期有關,呈週  
       期性發作。                                                    
  (三) 根據伴隨月經週期出現的不同症狀,中醫分別歸於為『經行瀉泄』、  
       『經行頭痛』、『經行浮腫』、『經行發熱』、『經期口糜』等病名。
  (四) 現代醫學稱為經前緊張綜合症。                                  
                                                                     
  ☆ 病因病機:                                                      
  1.本病的發病機理,應從婦女的生理特點,月經前後的氣血盛虧變化,以及 
    患者體質等方面加以討論。體質是本病的重要因素。                   
                                                                     
  2.本病發生的內在條件因婦女以血為本,以血為用。由於經、孕、產、乳, 
    履傷於血,使婦女易處於陰血不足的狀態。但其屬生理狀態,對健康婦女 
    不足為病。                                                       
                                                                     
  3.臨床常以腎肝脾功能失調為主:                                     
  (1)肝氣鬱結,肝鬱化火(請參考課本P.150的說明)                       
  (2)肝腎陰虛,肝陽亢盛(請參考課本P.150的說明)                       
  (3)脾腎陽虛,水濕不化(請參考課本P.151的說明)                       
  (4)氣血不足,心脾兩虛(請參考課本P.151的說明)                       
  (5)瘀血內阻,經絡不暢(請參考課本P.151的說明)                       
                                                                     
  ☆ 臨床症狀:                                                      
  1.水納滯留引起的症狀:                                             
  (1)體表水腫  (2)顱內水腫  (3)乳腺組織水腫  (4)腹腔臟腑水腫         
  (5)肌肉及骨關節水腫                                                
                                                                     
  2.精神、神經症狀:精神緊張,煩躁易怒或抑鬱焦慮,頭疼、失眠、思想不 
  集中嚴重者精神情緒不穩,少數患者可出現交感神經系統功能紊亂。       
                                                                     
  ☆ 保健與預防:                                                    
  1.經期保持心情愉快,以使氣血調和,肝氣調達舒暢。                   
  2.慎食生冷瓜果,以免損傷脾陽。                                     
  3.屬熱症體質者避免辛熱溫燥之品。                                   
  4.經期或產後慎風冷。                                               
                                                                     
  六、 斷經前後症狀:                                                
  1.婦女由生育期到不能生育的生理過度階段,稱為更年期。               
  2.中醫認為婦女在絕經前後,腎氣漸衰,天癸漸竭,衝任虛衰,生殖能力降 
    低直至消失,本是婦女正常的生理改變,但有些婦女卻不能適應此階段的 
    生理變化,因而出現一系列症狀。                                   
  3.更年期到來的早晚、過程的長短、以及症狀的輕重皆與各自的體質、生活 
    環境、精神狀態、種族、家庭、氣候、營養等因素有關。               
                                                                     
  ☆ 症狀:                                                          
  1.血管舒縮綜合徵(請參考課本P.153的說明)                            
  2.精神、神經症狀(請參考課本P.153的說明)                            
  3.生殖器官(請參考課本P.153的說明)                                  
  4.皮膚變化(請參考課本P.153的說明)                                  
  5.骨與關節症狀(請參考課本P.153的說明)                              
  6.心血管病變(請參考課本P.153的說明)                                
                                                                     
  ☆ 病因:                                                          
  1.腎陰虛(請參考課本P.154的說明)                                    
  2.腎陽虛(請參考課本P.154的說明)                                    
                                                                     
  ☆ 保健與預防:                                                    
  1.飲食宜忌:(請參考課本P.154~P.155的四點說明)                      
  2.正確理解更年期的生理變化(請參考課本P.155的說明)                  
  3.更年期調攝(請參考課本P.155~P.156的兩點說明)                      
                                                                     
  ☆ 食療:?                                                      
  1.銀耳枸杞湯  2.蓮子粥  3.核桃芝麻丸(請參考課本P.156的詳細介紹)    
                                                                     
  【帶下病】                                                         
  帶下病是指帶下的量明顯增多,色、質發生異常或有臭氣,伴有其他症狀者。
  白帶是一種陰道的分泌,因陰道本身不含腺體,正常陰道分泌物主要來源是 
  來自子宮頸黏液腺,分泌物呈透明粘稠的酸性黏液,分泌物量和濃稠度依各 
  月經週期而有不同,所以婦女帶增多,首先要先辨別是生理性帶下還是病理 
  性帶下。                                                           
                                                                     
  ☆ 病因:                                                          
  1.西醫病因:若為病理性帶下常見的就是陰道炎,最常見的有黴菌性陰道炎 
  和滴蟲性陰道炎兩種。                                               
                                                                     
  (1) 黴菌性陰道炎:                                                 
  是在人體的抵抗力減弱時,陰道中的黴菌大量繁殖而引起的炎症。         
                                                                     
  (2) 滴蟲性陰道炎:                                                 
  是由病原體滴蟲所引起的陰道炎,是一種傳染病,主要是通過男女性交、共 
  用浴盆或便桶、互穿內褲等途徑而傳染致病;有時醫務人員消毒隔離不嚴也 
  會引起交叉感染。嚴重者會引起不孕症。                               
                                                                     
  2.中醫病因:在中醫方面認為帶下的形成,脾、腎受病或病邪直犯衝任、胞 
    宮,使任脈失固、帶粺失約,以致帶下量明顯增加,色質發生異常或有臭 
    氣而為帶下病。                                                   
                                                                     
  ☆ 保健:                                                          
  1.禁忌之物:                                                       
  (1) 忌辛辣煎炸及熱性食物                                           
  (2) 忌甜膩厚味                                                     
  (3) 忌煙酒                                                         
                                                                     
  2. 生活習慣:                                                      
  (1)平日衛生習慣要好,注意陰部的清潔與乾燥,半不要用肥皂或消毒劑清  
  洗陰部,因為陰部是一個弱酸性的環境,鹼性物質會破壞其酸性環境,     
  使得正常的菌種減少,增加不正常菌種增生的機會。                     
  (2)不要熬夜及吃冰冷寒涼之物,熬夜會傷陰液,化肝熱,阻塞任、帶二經  
  的運行,導致帶下增多。                                             
                                                                     
  ☆ 食療:                                                          
  1.馬齒莧燉雞蛋清  2.豬肚燉白果  3.冬瓜子飲  4.赤豆粥  5.白果豆漿   
                                                                     
  6.扁豆煮山藥(以上藥膳請參考課本P.156的詳細介紹)                    
                                                                     
  【妊娠與產後病】        妊娠保健概述                               
  1.妊娠期是指婦女從懷孕至胎兒娩出這一時期。                         
  2.在懷孕期間所產生的各種身體不適,在母體、胎兒造成不正常、不愉快   
    的反應,或日久漸減,或需藥物調治皆屬此範圍。                     
                                                                     
  ☆ 病因:                                                          
  妊娠病由中醫觀點來看,妊娠生理因應胎兒生長發育的需要,大致分成三   
  個方面探討:                                                       
  1.氣血為病:因胎孕主要依賴於氣血充足,營衛調和,若氣血不足,則胎   
    失所養,氣血不調,運行不暢,胞絡受阻。                           
  2.臟腑損傷:主要是脾腎二臟,因脾腎乃經血化生之源,若腎虛則胎失所   
    繫,胎產諸疾生焉。脾氣虛則飲食吸收運化不佳,氣血自然不足,胎元   
    自然不固。                                                       
  3.飲食勞倦,房事、七情所傷:導致相火或肝火損傷脾氣,導致胎動不安。 
                                                                     
  ☆ 保健:                                                          
  m禁忌之物》                                                        
  1. 忌食有墮胎作用的水產品                                          
  2. 忌食滑利之品                                                    
  3. 忌食杏仁及燥熱之品                                              
  4. 忌食黑木耳                                                      
  5. 忌食山楂                                                        
  6. 藥物禁忌                                                        
  7. 其他忌食中藥:                                                  
  如具有峻下滑利作用:大黃、芒硝、甘遂等等                           
  如具有辛香走竄功能的開竅藥:麝香、樟腦、冰片、蘇合香等等           
  如具有寒涼平肝藥:牛黃、代赭石、蜈蚣等等                           
  如具有活血怯瘀作用:蒲黃、川芎、月季花等等                         
  如具有抗腫瘤藥:馬錢子、莪朮等等                                   
  如具有麻醉止痛藥:川烏、天仙子、八角楓、兩面針等等                 
  如具有破氣作用藥物:枳實、青皮、厚朴等等                           
                                                                     
  ☆ 食療:                                                          
  由於妊娠期間,孕婦機體內各項代謝水平提高,胎兒的不斷生長,需       
  要母體提供更多營養。孕婦的飲食的數量和質量都必須有所提高,食       
  物中必須含有高質量蛋白質、多種維生素及礦物質鈣、磷、鐵等,以       
  滿足各個階段母體與胎兒營養所需。                                   
                                                                     
  1. 糖的攝取:由於妊娠期新陳代謝增強,需要的能量亦增加,糖便是      
     產生能量的主要來源。                                            
  2. 蛋白質的攝取:由於胎兒在其中生長發育、建造各種組織器官時,      
     都需要以蛋白質作為物質基礎,因此孕婦的蛋白質攝入量必須比普      
     通人高。                                                        
  3. 鐵質的攝取:鐵是胎兒造血的必要原料。                            
  4. 鈣和磷的攝取:紺、磷是組成胎兒骨骼的基本原料。                  
  5. 維生素的攝取:孕婦必須比平時攝取更多的各種維生素,以滿足胎      
     兒及自身的需要。                                                
  6. 參考食譜詳見課本P.166的介紹                                     
                                                                     
  【妊娠嘔吐】                                                       
  1. 妊娠後一開始就出現嚴重的噁心嘔吐、頭暈厭食、或食入即吐,重      
     則有人灼傷腸胃,有人造成身體電解質不平衡,影響身體健康者稱      
     之。                                                            
  2. 若在妊娠5週至3個月這段時間內有輕度噁心、厭食、偏食、或偶有      
     晨起嘔吐痰涎,則為常見的妊娠反應,不屬病態。                    
                                                                     
  【病因】                                                           
    本病的病因尚不明確,可能與妊娠期內分泌變化,尤其是絨毛膜促性     
    腺激素水平提高及孕婦精神緊張、維生素B缺乏有一定關係。            
                                                                     
    在中醫的理論上,發生惡阻的主要機理為:                           
  1. 氣(即衝脈之氣)上逆                                              
  2. 脾胃虛弱                                                        
  3. 肝胃不和、胃失和降                                              
                                                                     
  【保健】                                                           
  《禁忌之物》                                                       
  1. 忌食患者厭惡之物  2.忌食有特殊腥臭味的食物  3.忌食油膩食物      
  4.忌食過甜食物  5.藥物禁忌                                         
                                                                     
  【食療】                                                           
    由於本病患者脾胃功能較差,所以飲食原則為易消化而富有營養,並     
    保持大便暢通。                                                   
                                                                     
  1. 甘蔗薑汁  2.糯米扁豆秋梨粥  3.橄欖茶  4.橙子煎  5.綠豆橘皮烏梅煎
                                                                     
  6.葡萄藤煎                                                         
                                                                     
                                                                     
  【妊娠腹痛】                                                       
  1. 妊娠期間因胞脈受阻,氣血運行不暢而發生,以小戮疼痛為主證的病症  
     稱之,亦名胞阻。                                                
  2. 妊娠腹痛是孕期以小腹疼痛反覆發作,痛勢較緩,時發時止。          
                                                                     
  ☆病因                                                             
    妊娠腹痛的發病機理,要點在於胞脈阻滯或失養,氣血運行不暢。       
                                                                     
    1. 血虛  2.氣鬱  3.虛寒                                          
                                                                     
  ☆保健                                                             
  1. 懷孕後注意妊娠期衛生,保持心情舒暢,起居有常,不要過於勞累,避  
     虛邪賊風,戒房事,均是預防、減少妊娠腹痛發生的重要環節。        
  2. 妊娠腹痛,病在胞粺,尚未損及胎元,病勢亦多較輕,所以經及以效治  
     療、腹痛多能漸癒而預後良好。                                    
                                                                     
  ☆食療                                                             
    1. 茴香薑糖飲  2.歸芍蜜煎  3.木瓜糖片                            
                                                                     
  【產後保健概述】                                                   
                                                                     
  1. 產後在身體上變化最大的是生殖系統,妊娠期腹壁及子宮韌帶長期撐長  
      ,在產後呈現鬆弛現象,需要一定的營養與休息幫助鬆弛肌肉的恢復。 
  2. 子宮在恢復過程中,不斷有壞死脫落的細胞、血塊、子宮腔面滲出液排  
     出,統稱為惡露,惡露排出順暢乾淨與否是子宮恢復功能的基本條件。  
  3. 中醫認為,分娩時耗損大量氣血,致陰血驟虛,營衛不固,最易受病。  
  4. 產婦在新產後或產褥期發生分娩或產褥有關的疾病稱為『產後病』。    
                                                                     
  ☆ 病因                                                            
  1. 亡血傷津,元氣虧損  2.瘀血內阻,敗血妄行  3.外感六淫或飲食房勞  
     所傷                                                            
                                                                     
  【產褥期中醫調理】                                                 
  1. 產褥期一般稱為月子期,產褥期的調理及休息又稱為「坐月子」。      
  2. 產褥期是指胎兒娩出後至產婦生殖器官恢復正常的時間稱之,約需6~8週。
                                                                     
  【預防與保健】                                                     
  《禁忌之物》                                                       
  1. 產後禁人蔘;一週內禁麻油、酒。                                  
  2. 以少量多餐的方式進食。                                          
  3. 哺乳者禁食麥芽:因麥芽有回乳作用。                              
  4. 忌食油膩食物:產後胃腸蠕動較弱,易引起消化不良。                
  5. 勿食辛辣燥熱食物。                                              
  6. 忌食生冷食物:產後孕婦的脾胃功能尚未完全恢復,過於寒涼的食物會  
     損傷脾陽,影響消化。                                            
  7. 忌食堅硬粗糙及酸性食物:堅硬粗糙及酸性食物會損及牙齒,使產婦日  
     後留下牙齒易於酸痛鬆脫的後遺症。                                
  8. 適當控制食鹽:過鹹的食物有回乳作用。                            
  9. 忌烤、炸、辣、刺激性食物。                                      
  10. 少吃鹽,食物以清淡為主。                                       
  11. 食物一定要煮熟,且溫熱食用。                                   
  12. 傷口若有紅腫疼痛時,禁止吃麻油、酒煮食物。       &
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