千江水月的部落格

  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。       &