gynecology and pediarics课件

1、gynecology and gynecology and pediatricspediatricslistening practicegynecologyanatomyvocabulary 骨盆pelvis 输卵管壶腹部 ampulla of fallopian tube 子宫uterus 伞部fimbria 宫颈cervix 输卵管峡部isthmus of fallopian tube 阴道vagina 阴道穹窿 fornix of vagina 产道birth canal 输卵管salpinx（fallopian tube） 卵巢ovary 子宫内膜 endometrium 附件adne

2、xa （including fallopian tube and ovary）common diseases in gynecology department menstruation disorders月经病 leukorrheal diseases带下病 pregnant disorders妊娠病 postpartum diseases产后病 miscellaneous diseases杂病menstruation disorders period (first menstruation) latest menstruation menstrual cycle lmp=last menst

3、rual period(末次月经) pmp=previous menstrual period（前次月经）menstruation disorders 月经提前（月经先期）月经提前（月经先期）advanced menstruation 月经延后（月经后期）月经延后（月经后期）delayed menstruation 崩漏崩漏 metrorrhagia and metrostaxiss 经期延长经期延长menostaxis 经间期出血经间期出血 intermenstrual bleeding 月经过多月经过多menorrhagia 月经过少月经过少hypomenorrhealeukorrheal

4、 diseases quantity: small, moderate, large color: white, yellow, green quality: sticky, watery, clear smell: peculiar smell, smelly, stinky itchy (itching): yes or no 带下过多leukorrhagia 带下过少small quantity of leucorrhea 卵巢功能早衰 pof=premature ovarian failurepregnant disorders gnpn g=gestation(妊娠) p=partu

5、rition（分娩） 堕胎（artificial）abortion 流产 miscarriage 习惯性流产habitual abortion 先兆流产(胎漏)threatened abortion 胎动不安fetal irritability/ restless fetus 异位妊娠 ectopic pregnancypostpartum diseases 1、病因病机：etiology and pathogenesis （1）亡血伤津blood exhaustion and body fluid injury （2）元气受损congenital qi injury （3）瘀血内阻blood

6、 stasis obstruction （4）外感六淫或饮食房劳所伤external contraction of six evils or improper diet and sexual overstrain 2、病机特点：characteristic of pathogenesis 多虚多瘀 mostly deficiency and blood stasispostpartum diseases 3、诊断：diagnosis （1）审小腹痛与不痛，以辩有无恶露停滞 inquiry the lower abdominal pain or not, to decide if theres

7、stagnation of lochia （2）审大便通与不通，以验津液的盛衰 inquiry the bowel movement is normal or not, to decide if theres injury of body fluid （3）审乳汁行与不行和饮食多少，以查胃气强弱 inquiry the lactation is unobstructed or not and the appetite, to decide the function of stomach.postpartum diseases 4、产后用药“三禁”： （1）禁大汗以防亡阳 profuse swe

8、ating is forbidden to prevent collapse of yang （2）禁峻下以防亡阴 purging the bowel is forbidden to prevent the collapse of yin （3）禁通利小便以防亡津液 promoting diuresis is forbidden to prevent the collapse of body fluidmiscellaneous diseases 癥瘕(zheng jia)abdominal mass 妇人下腹结块，伴有或胀、或痛、或满或异常出血者，称为癥瘕 lower abdominal m

9、ass, accompanied with distension, pain, fullness or abnormal bleeding, called (zheng jia) abdominal mass 盆腔炎 pelvic inflammation 不孕症 infertility/ sterility 子宫脱垂 prolapse of uterus/metroptosis /hysteroptosis病案1月经延后女，21岁主诉：月经紊乱8+年，发现pcos5+年 5-6 5-6 5-6现症：11 2+年后 持续1+年后，停经1年， 16 服西药，不服药月经不来 30 半年 30lmp

10、：1月31日，5天净，量中，色鲜红，无血块，无痛经。白带量中，有异味，呈水样。体毛重，体重近半年增加，纳眠可，小便调，大便稀溏2-3次/天，舌红苔薄白，脉弦细。辨证：脾肾不足方药：寿胎丸+四君子散加减case 1female, 21cc: irregular menstruation for more than 8 years, being diagnosed as pcos for more than 5 years.lmp：january， 31st, lasts for 5 days, moderate quantity, color is fresh red, no blood clo

11、ts, no dysmenorrheamoderate quantity of leucorrhea, peculiar smell/smelly(stinky), wateryheavy body hair, putting on weight in the recent half year, normal appetite and sleep, normal urination, lose stool 2-3 times a day, red tongue, thin white tongue coating, wiry and thin pulse.syndrome differenci

12、ation: deficiency of spleen and kidneyformula: shou tai wan and si jun zi tang modification.病案2痛经女，女，32岁岁主诉：发现主诉：发现“子宫内膜异位症，巧克力囊肿子宫内膜异位症，巧克力囊肿”6+年，伴经行腹痛年，伴经行腹痛6+年，加重年，加重2+月。月。既往史：既往史：04年输卵管造影显示两侧输卵管一侧不通，一侧积水。年输卵管造影显示两侧输卵管一侧不通，一侧积水。05年诊断为年诊断为“子宫内膜异位症，慢性盆腔炎子宫内膜异位症，慢性盆腔炎”，做腹腔镜手术，剥离左侧巧克力囊肿。，做腹腔镜手术，剥离左侧巧

13、克力囊肿。08年输卵管造影，显示通而不畅年输卵管造影，显示通而不畅 5-612 ，量中，无腹痛，量中，无腹痛 28lmp：3月月16号号3月月23号，量中，色暗，夹大量血块，伴小腹胀痛，腰酸号，量中，色暗，夹大量血块，伴小腹胀痛，腰酸白带稍多，色偏黄，无异味，无外阴瘙痒白带稍多，色偏黄，无异味，无外阴瘙痒纳眠可，二便调，情绪可，心理压力大，舌尖红苔黄腻，脉细，肛门坠胀。纳眠可，二便调，情绪可，心理压力大，舌尖红苔黄腻，脉细，肛门坠胀。辨证：痰热瘀结辨证：痰热瘀结方药：四逆散方药：四逆散+四妙散四妙散+失笑散加减失笑散加减case 2cc: be diagnosed as endometrios

14、is and chocolate cyst more than 6 years ago, accompanied with abdominal pain during menses. aggravated for more than 2 monthsprevious history: in 2004, hsg(hystero-salpingography) showed that one side of the salpinx is obstructed and the other side hydrops(dropsy).in 2005, was diagnosed as “endometr

15、iosis, chronic pelvic inflammation”, an operation was applied to peel off the chocolate cyst on the left side.in 2008, the hsg showed that the fallopian tubes are unobstructed but couldnt transport the ovum normally 5-612 ，moderate quantity，no abdominal pain 28lmp: 3.163.23, moderate quantity, dark

16、color, with lots of blood clots, accompanied with lower abdominal distention and pain lumbar aching. slightly large quantity of leucorrhea, slightly yellow, not smelly, not itchy of vulvaeappetite and sleep are normal, urination and defecation are normal, emotion is good, mental stress, the tip of t

17、he tongue is red with yellow greasy tongue coating, thin pulse, distending sensation of anus.syndrome differentiation: complex of phlegm, heat and blood stasis.formula: si ni san+ si miao san+ shi xiao san modification病案3停经女，23岁，g0p0主诉：停经7+月现症：患者7月前因工作压力大出现停经，否认性生活史。 512 lmp：3.20,5天净，量中，色质均无异常，无痛经，白

18、带正常，曾间断服中药治疗，月经未来潮 30 精神可，情绪烦躁，纳眠可，大便2-3日异性，小便色黄，舌红苔薄白，脉细弱辨证：肝郁血虚证方药：四物汤加减中成药：逍遥丸case 3female，23，g0p0cc：amenorrhea for more than 7 monthssymptoms：menses stopped 7months ago because of the working pressure, deny sexual life history 512 30 lmp：3.20, lasted for 5 days，moderate quantity, normal color an

19、d quality, no dysmenorrhea, leucorrhea is normal, used to take herbs on and off, but the menstruation still no coming.normal spirit, restlessness, normal appetite and sleep, pass the bowel once in 2-3 days, dark(deep-colored) urine, red tongue, thin white tongue coating, thin and weak pulsesyndrome differentiation: liver depression and blood deficiencyformula: si wu tang