《中医中药养生》PPT课件.ppt

血液系统疾病的食疗 Blood System Disease Food Therapy 5 1. 贫血：Anemia 2. 出血：Bleeding 3. 白血病：Leukaemia 4. 血栓：Thrombus 贫血的概念和分类： A decrease in normal number of red blood cells (RBCs) or less than the normal quantity of hemoglobin in the blood. However, it can include decreased oxygen-binding ability of each hemoglobin molecule due to deformity. 缺铁性贫血-Fe，儿童，女性（减肥，月经 男性铁排泄很少） 影响儿童智力发育，疲劳心慌 呼吸困难，颜面苍白 巨幼红细胞性贫血-B12, 叶酸缺乏 恶性贫血-骨髓 缺铁性贫血： 铁剂： 富马酸亚铁 硫酸亚铁 枸橼酸亚铁 右旋糖酐铁 Reticulocyte Red cell 干细胞 Why small sized RBC and light coulour ? Hemoglobin HeamGlobin Thalassemia Iron Protoporphyrin Iron deficiency Chronic diseases Sideroblastic anemia Erythroblast (有核红细胞) Reticulocyte Red cell Stem cell 为啥细胞小色素低？ Ferritin-iron storage protein, 24 subunits, hollow spherical structure within which iron is stored. 4500 Fe/protein. Heme Growing Children, Preganant Women, Menstruating Women 富马酸亚铁 硫酸亚铁 枸橼酸铁铵 右旋糖酐铁 Ads of Iron Gastrointestinal side effects: 1. Nausea, vomiting 2. Abdominal pain 3. Constipation Contraindications: 1. Severe damage to liver and renal function, or untreated urinary tract infections (口服和静脉注射都有毒？） 2. Iron overload 3. Non-iron deficiency anemia How to overcome? Vitamin C + Fe3+? Less B12 Vitamin B12 and Folic Acid 贫血的中医解释 萎黄，黄胖 虚损，虚劳 1.食物结构不合理 2.生长发育迅速 3.妊娠 4.月经过多 5.溃疡 6.长期使用阿司匹林 中医食疗： 正确的治疗：治疗溃疡，调理月经 治疗痔疮，调整膳食 改善体质，治疗过敏 宝宝贫血 1.表现：四季总好得病 鼻子眼角发黄 眼睑口唇苍白 精气神不太好 2.原因：牛奶、蔬菜过敏 严重地偏食 膳食不合理 哺乳妇贫血 2.辅食 蛋黄泥 肝脏泥 苹果（Vc) 含酸水果 菠菜 血肠 大枣 瘦肉 炒菜急火，加醋 1.4-6个月宝宝就把母亲的铁用光 靠辅食物来补铁 每100克的营养成分 能量328千卡 蛋白质15.2克 脂肪28.2克 碳水化合物3.4克 胆固醇1510毫克 维生素A438微克 硫胺素0.33毫克 核黄素0.29毫克 烟酸0.1毫克 维生素E5.06毫克 钙112毫克 磷240毫克 钾95毫克 钠54.9毫克 镁41毫克 铁6.5毫克 锌3.79毫克 硒27.01微克 铜0.28毫克 锰0.06毫克 蛋黄泥米粉水 100克猪肝含： 蛋白质21.3克， 脂肪4.5克， 碳水化合物1.4克， 钙 11毫克， 磷270毫克， 铁25.0毫克， 锌5.78毫克， 硫胺素0.40毫克， 核黄素2.11 毫克， 尼克酸16.2毫克， 抗坏血酸18毫克； 维生素A、 B1.B2 猪肝泥粥 苹果泥 菠菜每100克含： 水分91.8克， 蛋白质2.4克， 脂肪0.5克， 碳水化合物3.1克， 粗纤维0.7克，灰分1.5克， 胡萝卜素 3.87毫克， 维生素B10.04毫克， 维生素B20.13毫克， 尼克酸0.6毫克， 维生素C 39毫克， 钙72毫克，磷53毫克， 铁1.8毫克，钾502毫克， 钠98.6毫克， 镁34.3毫克，氯200毫克。 儿童偏食引起的贫血： 1.延长进食间隔，增强饥饿感， 有助于孩子体验饱腹感 进食时间可延长到3小时 2.限制零食和高热量食物 3.限定吃饭时间，不超过25分钟 4.把喜欢和不喜欢的食物参合到 一起给孩子吃 5.吃饭少说话，不要摆弄玩具 或看电视 6.父母做榜样不要偏食 7.父母做的饭菜也要可口 孩子吃西红柿可以去皮： 1.开水烫 2.微波炉打 3.炉火烤 4.直接刮 制成西红柿土豆排骨汤，适合孩子吃 刮皮土豆应及时放到冷水中，防止氧化 （酶的促进氧化作用） 姜、陈皮开胃助消化 宝宝：要少盐，肾脏发育尚不完全 胃：仓廪官 中医胃脘痛 饥饱痨 胃脘痛食疗： 1.枸杞子，绿豆 2.主食： 面条， 少吃米饭（酸） 米粥加碱熬制 3.小米粥红糖，馒头 本草纲目小米： 养肾气，去脾胃中热，益气。 陈者：苦，寒。治胃热消渴，利小便。 红糖：富含铁等，来自甘蔗。花生生吃，饭前4-6粒。 心理调节：胃病源自七情；气功运动 月经过多吃什么好？ 1. 韭菜炒羊肝 韭菜：消炎止血止痛 兴奋离体子宫 壮阳草 羊肝：养肝，明目 补血，清虚热 备料：羊肉500克，当归、生地各15克，干姜10克。 食用方法：羊肉洗净，切块，放砂锅中，并入洗净之 药及酱油、盐、糖、黄酒、清水各适量，红烧至肉烂 。 适用症：气虚所致月经量多。 备料：黄芪30克，粳米100克。 食用方法：先煎黄芪去渣、下米、煮作粥，空腹食之 。 适用症：气虚不能摄血之月经过多 橘皮丁香茶 1.橘皮丁香茶治疗胃寒、胃痛 方法：橘皮3克，丁香3克，煎水代茶饮 ，有理气、散寒、止痛的作用。 2.橘皮茶治疗食滞胃胀或气滞胃痛 方法：用鲜橘皮半个或干橘皮3克，切 丝，开水冲泡当茶饮，既能行气止痛又 可理气消胀 丁 香 Flos Caryophylli 来源：桃金娘科植物 丁香干燥花蕾 产地：坦桑尼亚， 马来西亚 海南广东引种 【化学成分与药理作用】 1.挥发油：15-20% 2.主要成分：丁香酚，78-95% 1. 刺激胃酸胃蛋白酶分泌 2. 抗病原微生物 3. 止泻作用 温里药 降胃气 【性状】 香气浓郁，味辛辣，有麻舌感 公丁香 母丁香 女子：氷冷酒， 一点， 两点， 三点 状元：丁香花， 百头， 千头， 寓头 质量好的丁香： 质坚实，富油性； 气芳香浓烈，味辛辣，有麻舌感。 以完整、朵大、油性足、颜色深红、 香气浓郁、入水下沉者为佳。 大叶丁香 丁香 消化系统 温里药：肉桂，附子，干姜，吴茱萸 胡椒，花椒，小茴香，丁香 行气药：陈皮，青皮，沉香 消食药 山 楂，降解脂肪的酶，促进胃蛋白酶分泌 提高胃蛋白酶活性，荤食 莱菔子 神 曲，荤素均可 麦 芽，素食 谷 芽 鸡内金 鸡矢藤 隔山消 阿 魏 山 楂 Fructus Crataegi 来源：蔷薇科植物山楂 的干燥成熟果实 产地：山东河北河南 辽宁 【化学成分与药理作用】 山楂酸 脂肪酶 1.促进消化：油腻食物 2.降血脂：活血化瘀 3.降血压 4.强心 5.治疗冻伤 性 状 1. 对胃肠道平滑肌的作用 陈皮挥发油对胃肠道有 温和的刺激作用，促进消化液分泌，排除肠管内积 气。陈皮煎剂可直接抑制肠管平滑肌，对抗乙酰胆 碱，具有解痉作用。 2. 祛痰平喘作用 陈皮挥发油有祛痰作用。煎剂、 醇提物有松弛气管平滑肌的平喘作用。 此外还有增强心肌收缩力、抗炎、增强免疫、抗氧 化等作用。 本品性温，味苦、辛。理气健脾，燥湿化痰。 用于胸脘胀满，食少吐泻，咳嗽痰多；用量310g ，水煎服。 Enterohepatic Circulation? CLINICAL PHARMACOLOGY 1. Nucleoprotein synthesis 2. Maintenance of erythropoiesis. To stimulate specifically the production of red blood cells, white blood cells, and platelets in persons suffering from certain megaloblastic anemias. Ads B12: 1. Hypersensitivuty 2. Increase cancer growth 3. Inactivated by VC When take Folic Acid? 叶酸不足，补充B12如何？ Aplastic Anemia A rare and serious blood disorder in which bone marrow stops making enough new blood cells 与缺铁性贫血的区别？与巨幼红细胞性贫血区别？ Etiology: Acquired: More common Inherited: Fanconi anemia Causes: 1. Drugs：Cytotoxic drug， Anti-inflammatory， Anti-convulsant 2. Virus 3. Chemicals 4. Immune The latest theory is:The latest theory is: there there is is an an intrinsic intrinsic derangement derangement of of hemopoietichemopoietic proliferativeproliferative capacity, capacity, which which is is consistent consistent with with life. life. The The immune immune mechanism mechanism attempt attempt to to destroy destroy the the abnormal abnormal cells cells (self (self cure) cure) and and the the clinical clinical course course and and complications depend on the plications depend on the balance. Anemia Infection Fever Bleeding Treatment of Aplastic Anemia 1. Withdrawal of etiological agents. 2. Supportive, blood transfusion et al. 3. Restoration of marrow activity: (1) Bone marrow transplant (2) Immunosuppressive treatment Prednisolone Cyclosporin Splenectomy (3) Androgens (4) Growth factors 输去掉白细胞的血有何好处？ Agents Used in Thrombus Heparin IV Injection Indications of Heparin Adverse reactions of Heparin 1. Bleeding 2. Heparin-induced Thrombocytopenia Coumarins Dicoumarol Warfarin Acenocoumarol Target- Vitamin K epoxide reductase Inhibition of Prothrombin VII, IX, X Protein C and S 1. Relationship between Dosage and Speed of Onset? 2. The only differnece among oral coumarins in producing and maintaining hypoprothrombinemia is? Toxicity of Coumarins 1. Hemorrhagic Disorder in the Fetus. 2. Birth defect of abnormal bone formation 3. Hemorrhgaic infarction during the first weeks of therapy Antiplatelet Drugs ADP-Adenosine Diphosphate,to induce platelet aggregation TXA2-Thromboxane A2, platelet activation and vassolconstriction 5-HT-Serotonin Aspirinlow dase, irreversible inhibition of TXA2, Ridogrelstrong inhibition of TXA2 Persantinvasodilator,in combination with aspirin Clopidogrel and Ticlopidine- Fibrinolytic Drugs Anistreplase Classification: Thrombolytic enzyme Action/Kinetics: Prepared by acylating human plasma derived from lys-plasminogen and purified streptokinase derived from group C beta-hemolytic streptococci. When prepared, anistreplase is an inactive derivative of a fibrinolytic enzyme although the compound can still bind to fibrin. Anistreplase is activated by deacylation and subsequent release of the anisoyl group in the blood stream. The production of plasmin from plasminogen occurs in both the blood stream and the thrombus leading to thrombolysis. Lyses thrombi obstructing coronary arteries and reduces the size of infarcts. t1/2: 70-120 min. Bleeding Drugs: Vitamin K Thrombin Adrenocorticosteroids 29 1. Glucocorticoid Excess: Cushings syndrome 2. Glucocorticoid Deficiency 3. Mineralocorticoid Excess: Primary Aldosteronism Addisons disease A disease caused by partial or total failure of adrenocortical function, which is characterized by a bronzelike pigmentation of the skin and mucous membranes, anemia, weakness, and low blood pressure. Effects of Glucocorticosteroids Mechanism of Action 1. Physiologic Effects (1) Direct Effects (2) Indirect Effects (3) Permissive Effects 2. Pharmacological Effects (1) Anti-Inflammatory Effect (2) Immunosuppressive Effect (3) Anti-Shock Effect (4) To lower body T (5) To stimulate bone marrow red cell production (6) To raise BP Clinical Pharmacology of Glucocorticoids 1. Adrenocortical Insufficiency (1) Chronic ( Addisons Disease) Infection Hypotension and Low blood suger level Shock or death When in stress, what about the dose? (2) Acute (Addisons Disease) Large dose, IV, and slowly to Maintenance Dose 2. Severe Infection 3. Auto-immune disease 4. Shock 5. Aplastic anemia 6. Local use 7. Replacement therapy Case 5 Iron Deficiency Anemia Secondary to Idiopathic Thrombocytopenic Purpura（ITP） A patient, 45 years old, from Fuxin, Liaoning, was diagnosed to be iron deficiency anemia secondary to Idiopathic Thrombocytopenic Purpura（ITP）and had been treated using medicines. Because of money problem. She stopped treatment by herself when recovered. Two tears later, today, her anemia with ITP took place again. Symptoms: chest pain, mout