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<span class="Apple-style-span" style="font-family: Verdana, Arial, Tahoma; line-height: normal; font-size: 12px; "><div class="content" style="padding-top: 12px; padding-right: 16px; padding-bottom: 12px; padding-left: 16px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font-size: 14px; line-height: 25px; color: rgb(51, 51, 51); "><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">一、包心包肝的病理本质</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> 包心包肝的病理本质不是单纯的大肠杆菌感染造成的,当然大肠杆菌感染可以造成包心包肝的病理现象,但并不是只有大肠杆菌感染才能造成包心包肝的,很多的疾病都会造成包心包肝,所谓的包心包肝现象只是炎症的一种变化,称之为炎症的纤维性渗出阶段的一种病理变化现象。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">二、纤维素炎症的病理调节</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> 1、炎症的定义:在致炎因子的作用下,机体产生的一种免疫反应。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">2、炎症的病理阶段:</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> (1)淋巴细胞侵润期:红肿热痛,治则清热解毒泻火。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">(2)浆液性渗出期:体液渗出。</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">(3)纤维素渗出期:纤维渗出。</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">(4)蛋白性渗出期:干酪样物。</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">三、常见的包心包肝病的鉴别</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">1、皮毛型纤维性渗出型炎症</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">(1)胸腺———传心包、心型</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> 头颈部皮下出血充血,胸腺肿胀, 胸腺连接的血管感染到心窝处,心冠脂肪充血后,出现心包集液,继而出现心包纤维化,胸气囊纤维化,肝脏浆膜纤维化,出现包心包肝现象。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> ①辨证分析:皮毛郁结逆传心肝,多为风寒风热感冒和慢性流感造成。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">2、气囊型纤维性炎症</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> (1)诊断顺序:胸气囊纤维性炎症严重,分两支路线发展,一支向腹气囊发展;一支向心包发展,最后引起包心包肝的纤维性炎症发生,以胸腔为主。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> (2)辨证分析:肺气郁结证———呼吸肌衰竭,多为高热通风不好,或空气中灰尘进入气囊导致的慢性无菌性炎症所致。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">3、呼吸道型纤维性炎症</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> (1)诊断顺序:鼻腔气管中有白色黄色痰液痰核出现,肺部又出血,炎性渗出物出现,或肺水肿现象发生,心肌肥大,肺心循环障碍,胸气囊肺侧出现纤维化样变,向心包部衍生,造成心包纤维化,向下衍生,引起腹气囊炎症,肾豆上部外周病变出现。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> (2)辨证分析:肺郁气滞,反侮心火,多为外感呼吸道炎症传变成肺炎引起。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">4、脾性纤维化炎症</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> (1)诊断顺序:脾脏坏死,出现凸起的增生性炎症,感染脾脏周围的浆膜发生炎症,出现两个方向的炎症蔓延矢量,一为向胸气囊发展,二为向腹气囊发展,最后出现包心包肝的严重病变。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> (2)辨证分析:脾气郁结,多为慢性淋巴系统病变引起</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">5、肾型纤维化炎症</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> (1)诊断顺序:肾肿,肾上浆膜纤维化,传至腹气囊,胸气囊,到包肝包心。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> (2)病理分析:肾郁造成肺气郁结,多为肾脏病变引起气囊病变引起。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> (3)辨证论治:利尿,宣肺,化痰。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">6、肠道性纤维素炎症</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">(1)诊断顺序:</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> 内有肠炎病变,外有肠系膜炎症,先有气泡样浆液性渗出,后有纤维化炎症,继而包肝,最后包心,腹腔干酪样物重于胸腔。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">(2)辨证分析:</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> 肠道湿热,传于肝心肺。多由肠道细菌寄生虫病变引起。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">7、四肢性纤维素型炎症</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> (1)诊断顺序:腿肢瘫痪,解剖见腿肌肌肉出血,或翅膀皮下,浆液型渗出,最后见腿肌出现纤维化炎症,内脏浆膜组织无变化,也无包心包肝现象,腹腔胸腔无变化,只见脾脏变性坏死。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> (2)病机分析:脾主四肢,主肌肉。脾气郁结造成肌肉郁结,肌肉瘫痪。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> <strong style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">8、心原型纤维素炎症</strong></p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> (1)诊断顺序:心脏冠状动脉充血,接下来是心包积液,日久不愈,出现纤维素渗出,发生心包纤维素型炎症,出现只包心,不包肝的病理变化。</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> (2)辨证分析:心气郁结,累及心包。多为气温高热,血压升高导致心包积液日久不愈产生</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 10px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "> 以后8种原因导致的包心包肝需要生产中注意区分诊断。</p></div><div class="dede_pages" style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; width: 712px; float: none; overflow-x: hidden; overflow-y: hidden; text-align: center; "><ul class="pagelist" style="padding-top: 12px; padding-right: 0px; padding-bottom: 12px; padding-left: 16px; margin-top: 0px; margin-right: auto; margin-bottom: 0px; margin-left: auto; list-style-type: none; list-style-position: initial; list-style-image: initial; float: none; clear: both; overflow-x: hidden; overflow-y: hidden; text-align: center; white-space: nowrap; "></ul></div><br style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "></span> |
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