What is the reason of uterus bleeding？

What is the reason bleeding
1. Functional bleeding
Abnormal uterine bleeding, bleeding can be too much, too little, too frequent or irregular, or postmenopausal bleeding. Abnormal bleeding in women, about 25% are caused by organic disease. The remaining 75% were caused by the impact of the regulation of the reproductive system hormone disorders. These hormones are the hypothalamus, pituitary, in women of reproductive age are common, this type of bleeding, called functional uterine bleeding. Before puberty and after menopause vaginal bleeding, bleeding is not normal.
Medically abnormal uterine bleeding no systemic or genital organic disease occurs is called dysfunctional uterine bleeding, often referred to as dysfunctional uterine bleeding. DUB into ovulatory and anovulatory DUB DUB categories, anovulatory DUB most common, accounting for about 85%. Women from menarche beginning to the end of amenorrhea, dysfunctional uterine bleeding can occur. It has reported that 20% of adolescent dysfunctional uterine bleeding, DUB growth accounted for 30% of premenopausal dysfunctional uterine bleeding accounted for 50%.

2. caused by organic diseases
Vaginal bleeding: the vulva, vaginal injury, sexual abuse, vaginitis (including infections caused by foreign body), uterine infection, or abnormal blood clotting diseases, such as leukemia, thrombocytopenia can cause vaginal bleeding. In addition, cancer and benign tumors, such as uterine fibroids, adenomyosis, having hormone secretory function of ovarian cancer, also can cause vaginal bleeding. Sometimes urethra prolapse may also cause bleeding.
3. vaginal diseases caused by
Vaginal cancer vaginal diseases, for example, when the vaginal wall surface of the tumor may be due to infection and necrosis of time, can cause irregular bleeding, but generally not a lot of bleeding.

4. The six common reasons
1 reason, many women taking oral, often miss one or two half-way without stopping, which would cause endometrial exfoliation and bleeding. When taking hormone therapy to regulate menstruation or bleeding, because without stopping there as such a situation. Therefore, women taking birth control pills, the best under the guidance of a doctor, to avoid health jeopardized.
Cause 2, in the muscular uterine fibroids can deform factor increases, leaving the intimal area increases menorrhagia and bleeding for too long. The contraction of the uterus fibroids impede or affect the blood supply causing chronic pelvic congestion, so that more than bleeding.
Cause 3, uterine fibroids with the presence of anovulatory ovarian or endometrial hyperplastic polyp formation, resulting in menorrhagia. If with chronic pelvic inflammatory disease, it may lead to increased congestion leaving menstruation.
Reason 4, benign uterine bleeding is one of the reasons, especially in the uterine cavity lump protruding fibroids, and endometrial polyps. Because these tumors or blood vessel-rich surface, or covering their uterus on endometrial thick blood vessels, but also because these vessels are periodically generated, it is easy bleeding.
Reason 5, submucosal fibroids may be because the mucosal surface area is increased and the occurrence of ulcers and infections, local congestion caused by menorrhagia, too frequent, and irregular menstruation than dripping bleeding.
Cause 6, menopause, irregular menstruation.

Urinary symptoms and coping

Normal adult daytime urination 4-6 times, 0-2 times a night, significantly increased frequency of urination said. Frequent urination is a symptom, not a disease. A variety of reasons can cause increased frequency of urination, but no pain, also known as frequent urination. Causes more frequent urination, including neuropsychological factors, weak after the illness, parasites. Except for children with urinary tract infections need, vulva or penis local inflammation. Chinese medicine, frequent urination in children is mainly due to physical weakness, kidney qi, bladder constraint incompetence, not due to its chemical declared. In addition too tired Insufficiency two dirty all true, is not on the virtual system, the virtual earth can not make water, air bladder weakness flowers, and frequent urination occurs. Therefore, frequent urination mostly Xu Zheng, need to rest, eat foods rich in plant organic active alkali foods, eat less meat, eat more vegetables.
First, the volume increases: When the volume increases, frequency of urination will increase accordingly. In physiological conditions, such as drinking lots of water, eating watermelon, drinking beer, because the increase in the amount of water, filtered through regulation and the role of the kidneys, urine output increased frequency of urination has increased, giving rise to frequent urination. In pathological conditions, such as part of diabetes insipidus patients more drinking, more urine, urination and more. But no urination discomfort.
Second, inflammation: inflammation within the bladder, nerves feel the threshold value decreases, the urine center in the excited state, resulting in frequent urination, and decreased urine output (adult <300 500="" acute="" amp="" an="" as="" can="" children="" chronic="" commonly="" cystitis="" dermatitis="" dysuria="" especially="" far.="" font="" frequency="" frequent="" go="" head="" important="" in="" inflammation="" irritation="" is="" known="" ldquo="" ml="" more="" obvious.="" of="" often="" others="" package="" penis="" prostatitis="" pyelonephritis="" rdquo="" second="" simultaneously="" such="" symptom="" symptoms="" the="" therefore="" three="" to="" tract="" tuberculosis="" urethritis="" urgency="" urinary="" urination="" vulva="" with="">
Third, non-inflammatory stimulation: such as urinary calculi, foreign bodies, usually with urinary frequency as the main performance.
Fourth, reduced bladder capacity: such as bladder lesions, pregnancy increased uterine pressure, tuberculosis, bladder contracture or large bladder calculi.
V. neuropsychiatric urinary frequency: frequent urination found only in daylight or at night before going to sleep, often seen in the case of hysteria or nervous patients. At this time also accompanied by urgency, dysuria.
1, the control diet, avoid excessive intake of acidic substances, increased acidic. Acid-base balance of the diet for prevention of frequent urination is a very important aspect. Diet should eat foods rich in plant organic active alkali foods, eat less meat, eat more vegetables. Qiama rich in plant organic active alkali, can quickly rid the body of toxic acid, so acid-base balance, maintaining a healthy body, reducing pressure on the kidney. Meanwhile Qiama also rich in flavonoids, can effectively repair kidney detoxification function.
2, to regular outdoor exercise in the sun to do more exercise more sweat, can help rid the body of excess acid, and more fresh air to reduce the risk of disease. Contribute to people's health.
3, maintain a good mood, do not have too much psychological pressure, the pressure is too heavy can cause deposition of acidic substances, affecting the normal metabolism. Appropriate to regulate mood and stress itself can maintain a weak alkaline, so frequent urination, away from everyone.
4, life to the law, irregular habits of people, such as the night singing karaoke OK, playing mahjong, night out and other living without the law, will increase the acidic. Virus easily invade. It should develop good habits, so as to maintain a weak alkaline, so far from their viruses.
5, away from tobacco and alcohol. Tobacco, alcohol is a typical acidic foods, unrestrained smoking, drinking, the body can easily lead to acidification.
6, not to eat contaminated food, such as contaminated water, crops, poultry, fish balls, eat some organic food, to prevent the disease from the mouth.

Male genital warts treatment

Male genital warts treatment must be integrated: therapeutic incentives (prepuce, gonorrhea), improve immunity, antiviral. Generally as long as adhere to standardized comprehensive treatment are cured. Physical therapy may also be used, such as laser, electrocautery, freezing and so on. First, the need for increased immunity.
1. Surgical treatment
Treatment incentives: prepuce, gonorrhea. For single, small area warts can be surgically removed; on the huge warts and can be used Mohs's surgery. When surgical biopsy freeze damage if excision.
2. Cryotherapy
The use of low-temperature -196 ℃ liquid nitrogen, freezing method using pressure treatment of genital warts, and promote wart tissue necrosis. This law applies to a small number, a small area of ​​genital warts. 1 to 2 times a feasible treatment interval of one week.
3. Laser treatment
Usually CO2 laser using cauterization treatment of genital warts, this therapy is ideal for penis or perianal warts. For single or small number of multiple warts possible one-time treatment of multiple warts or large area of ​​2 to 3 times a viable treatment interval is usually one week.
4. electrocautery treatment
High frequency electric knife excision EA or warts. This treatment applies to a small number, a small area of ​​genital warts.
5. The microwave treatment
Microwave surgery, lidocaine local anesthesia, the rod-shaped probe tip of radiation directly to the wart genital warts insert substrate, when you see the wart smaller, darken, when the soft to hard, the completion of the solidification heat radiation, namely withdrawable probe. Solidification of the lesions can clamp the clip removed. To prevent recurrence, can repeat the bottom of the remaining base solidified again.
6.β- ray treatment
This method is effective, no pain, no injury, less side effects, recurrence rate, in clinical promotional value.
7. Drug Therapy
(1) podophyllin this therapy is suitable for warts moist areas, such as occurred in the prepuce and the glans never circumcision surgery genital warts. With 20% podophyllin tincture applied to lesions at or before treatment to protect the quality of oil antibacterial cream normal skin or mucous membrane lesions around, and then applicator. 4 to 6 hours after treatment with 30% boric acid water or soapy water. If necessary, repeat after 3 days of medication. The drug is a drug of choice for treatment of this disease abroad, usually with once more.
(2) drugs to kill the virus is present, the macrocyclic triterpenoids main principle is the main treatment, macrocyclic triterpenoids can kill hidden in the skin and mucous membranes of the HPV virus. These drugs long course of treatment, the wart off slower, but the recurrence rate is very low.
(3) abrasives or disinfectant commonly 30% to 50% trichloroacetic acid, dichloroacetic acid, or saturated, or 18% peracetic acid. With 10% salicylic acid, acetic acid or 40% formaldehyde, 2% liquefied phenol, 75% ethanol mixed solution of distilled water 100ml, dispensing topically, for the glans, perianal warts, daily or every other day, with good results. 20% of available iodine disinfectants treated, or 2.5% to 5% iodine was injected into the base of the wart or treated with benzalkonium bromide, or with topical 0.1% to 0.2%, the latter must comply with systemic therapy.
(4) ①5- anticancer drug fluorouracil (5-Fu) 2.5% ~ 5% fluorouracil wet compress treatment of penile, perianal genital warts. Polyethylene glycol can also be used as a substrate was added 5% of its dry mass of 5-Fu powder made of suppository treatment of genital warts male urethra. 5-Fu substrate can also be injected, multi-batch injection may. ② thiotepa is mainly used for 5-Fu treatment failure urethral warts, side effects have urethritis. 10mg FDA also added 10ml saline soak the affected area, treatment of male penis, the glans Coronal warts. Mainly used after other methods of treatment, there are remnants of the wart or recurrence. This solution may be further diluted twice partial immersion, to prevent recurrence. ③ colchicine can be 2% to 8% saline solution treated, treatment of penile warts, superficial erosion can occur after coating.

Genital warts

There are different subtypes of HPV. The most common cause of genital warts and other HPV have 6,11. HPV is easy to survive and reproduce in the human body warm and humid conditions, so the external genitalia and anus are most prone to infection site. Dissemination of the following ways:
1. sexual contact
The main route of transmission. So the disease in a sexual relationship disorder crowd prone.
2. indirect contact
Some patients may be due to less contact with the patient used items spread of disease, such as underwear, towels, bath, toilet circle.
3. MTCT
Delivery process occurs through the birth canal and the baby's throat papillomatosis spread and so on.

The incubation period is 1-8 months, an average of three months, mainly in the sexually active population.
1. Typical warts
Genital and perianal predilection sites, more common in male foreskin, frenulum, Coronal, glans, urethra, penis, anus, rectum and the scrotum, more common in women in the size of the labia, after joint, vestibule, clitoris, cervix and perianal. Even outside the visible parts of the genital and perianal, such as the armpits, the navel, mouth, breast and toes and so on. Vaginitis female and male prepuce is a contributing factor to the occurrence of genital warts.
Early damage to small reddish papules, then gradually increase increase, single or clustered distribution, moist and soft, uneven surface, was papillary, cauliflower or chicken coronavirus projections. Red or dirty gray. Roots often pedicle, and prone to erosion exudate, easy to touch the bleeding. Purulent lesions often crack between smoldering, causing fetid, and may cause secondary infection due to scratching. The disease often have no symptoms, some patients may appear foreign body sensation, pain, itching, or painful sexual intercourse. Genital warts can occur in rectal pain, bloody diarrhea, tenesmus.
2.HPV subclinical
Refers to HPV infection in the clinic is not visually recognizable, but the acetic acid white test (with 5% acetic acid solution was found wet smear or partial white), pathological or nucleic acid detection techniques to discover evidence of HPV infection.
3. Relationship with Tumor
A large number of epidemiological data indicate, HPV infection (primarily high-risk HPV, such as HPV-16,18-type) and the incidence of genital cancer are closely related, such as cervical cancer, penile cancer.

General prognosis is good after treatment. But no matter what method of treatment, they are likely to recur.

Depression

Depression
A common mental illness, mainly for depression, reduce interest, pessimistic, slow thinking, lack of initiative, guilt from sin, diet, poor sleep, worry about suffering from various diseases, multiple body feel discomfort, severe It may appear suicidal thoughts and behavior. Depression is the highest suicide rate of psychiatric disease. A high incidence of depression, almost every seven adults is a depression, so it is called psychiatry cold. Depression has become the global disease burden caused serious human second most important disease for patients suffering caused by their families, the loss to society is unmatched by other diseases. The main reason for this situation is the community's lack of proper understanding of depression, so patients do not want to prejudice psychiatric treatment. In China, only 2% of the patients with depression had received treatment, a large number of patients do not get timely treatment, disease progression, or even serious consequences of suicide. On the other hand, due to the lack of public knowledge about depression, symptoms of depression disgruntled mistaken, it can not be given due understanding and emotional support to the patient greater psychological pressure, so that further deterioration.
Types of depression
First, bipolar depression that is manic depression, referred to as bipolar disorder. Both manic and the depressive state two main performance, can be recurrent intermittent alternating same patient and to be a state-based, recurrent, cyclical and can be alleviated, intermittent mental activity of patients with completely normal, generally do not performance personality defect.
Second, the endogenous depression that is lazy, stay, change, worry, worry "five" sign (brain relative or absolute lack of biogenic amines).
Third, masked depression low mood and depression symptoms are not obvious, often shows a variety of somatic symptoms, such as palpitations, chest tightness, epigastric discomfort, shortness of breath, sweating, weight loss, insomnia, psychomotor retardation and agitation etc. .
Fourth, adolescent depression, can lead students to have learning difficulties, attention deficit, memory loss, or a sudden drop in the overall decline in grades, weariness, fear of school, truancy or school refusal.
Five patients with hypertension secondary to depression if, after taking antihypertensive drugs, resulting in continued depressed mood, depression.
Sixth, postpartum depression, which especially their babies have a strong guilt, inferiority, hatred, fear, disgust, or the child's abnormal psychology. Crying, insomnia, could not eat, depression, depression is a common symptom of these patients.
Seven white-collar depression, young men and women suffering from depression neuroendocrine system disorders, normal menstrual cycles have been disrupted, a variety of symptoms, in addition to mental depression, depression, idleness, love sulking, thought-over, insomnia, dreams, dizziness, forgetfulness and other major mental symptoms, anorexia, nausea, vomiting, abdominal distension and other symptoms of digestion and absorption dysfunction, irregular menstruation, menstrual pain and other gynecological symptoms are not uncommon.
Hazard edit insomnia
The impact of insomnia on health, given their first performance in adverse physiological. Studies show that long-term harm insomnia, skin lost its luster, agitated just the slightest, there are many patients with severe insomnia after experiencing long-term insomnia torture also suffered other health hazards of serious physical illness. Although insomnia is very common in life, but we must pay attention to, it causes many other diseases. Long-term insomnia to patients effects include: insomnia may cause a variety of diseases as hypertension, coronary heart disease, stroke, breast cancer, paralysis, diabetes occurs.
If we have long been plagued by insomnia, not sleep for two consecutive nights, the regulation of vascular and autonomic nerve dysfunction can occur, appear sympathetic nerve, causing his blood pressure; if you sleep only four hours per night, which will reduce the amount of insulin secretion, if the continuation of this situation a week is enough to make people healthy prodromal symptoms of diabetes appear.
Insomnia symptoms more than a month, can be called in the clinical long-term insomnia, chronic insomnia can last several years to several decades, and some even have a habit of insomnia, such as a big pressure, I often could not sleep. Long-term insomnia must pay attention, to take positive measures.
Symptoms of insomnia, depression, performance editing
Psychiatric symptoms of insomnia, depression,
People suffering from insomnia, depression, often appear in the night waking, dreams, difficulty falling asleep and other sleep disorders. Recurring mind some unpleasant memories, or anxious about the future.
Early morning wake up can not be restored with plenty of energy, thinking ability is not clear, daytime easy dizziness, fatigue, weakness or drowsiness. Further cognitive impairment, decreased ability to work with learning, memory loss, inability to concentrate and so is not the more common symptoms of insomnia, depression.
Somatic symptoms of depression, insomnia
Insomnia symptoms of depression include both psychiatric symptoms, there are also physical symptoms, insomnia is the most common form of physical symptoms.
In addition, insomnia, depression, patients will feel a sense of tightness in the chest and throat, appetite disorders, constipation, weight loss, headache, body aches, and gastrointestinal symptoms and other physical symptoms.
Depression Five harm editor
1, a person fierce despair: the harmful consequences of the most serious is the patient self-mutilation, suicidal thinking and behavior appear. Thought depressed mood can cause depression in patients with negative, pessimistic, always immersed in self-condemnation, self-esteem among the despair about the future.
2, physical torture continues: not only harm the mental health damage, and it will bring much physical symptoms. Such as loss of appetite and fatigue. The discomfort may be related to various organs, autonomic dysfunction symptoms are more common. Physical symptoms of patients with depression are often found to be unsubstantiated, and many non-specific, difficult to locate, but not necessarily rule out physical disease.
3, long-lasting bad mood: Depression hazards common point is that the patient will experience the most pain, bad mood. And this pessimism is no obvious external cause appears therefore very difficult to resolve, so that was the mood of patients with depression in pessimism among the total. On the other hand, is always accompanied by depression and anxiety, depression to menopause, represented by depressed patients not only suffer from this type of depression, but there will be inexplicable mental stress, panic restless anxiety.
4, destroying the human spirit: Depression second point reflects the great harm, it is full of energy to an otherwise normal people become downhearted, transfixed state will be severe. And depression patients are not interested in everything around to speak of, work, study not a little passion, ideology is slow, usually by people who are neat become slovenly.
5, deprivation of sleep: refractory depression patients often sleep disorder, manifested as insomnia, difficulty falling asleep, waking, disordered sleep patterns, sleep quality and poor form.

Retinopathy

Currently GRP exact pathogenesis is not yet clear. Related hematologic abnormalities in the pathogenesis of detail remains to be elucidated. Hyperglycemia is known to cause a variety of biochemical and physiological changes have been caused by capillary endothelial cell damage. Pathological changes include retinal capillary pericytes reduced basement membrane thickening, capillary lumen decreases capillary endothelial barrier (blood retina barrier) decompensation.
Diabetic retinopathy is due to diabetes, in addition to systemic symptoms of polydipsia, polyphagia, polyuria and urine, is characterized by elevated blood sugar, there will also appear bright red eyes retinal capillary hemangioma, flame-like bleeding, the late gray bleeding, bright red neovascularization, vitreous prone to red blood retinal changes the main feature for the diagnosis and prognosis meaningful. Age greater the longer the duration, the higher the incidence of fundus. Young greater than the risk of elderly patients, the prognosis is often poor. If diabetes can be controlled in time, not only the occurrence of fewer opportunities, while also less retinal damage, retinopathy otherwise gradually increased, the occurrence of repeated bleeding, leading to the proliferation of retinal changes and even retinal detachment, or complicated cataract.
Central vision loss, a central scotoma, visual distortion, no vitreous inflammatory changes in the fundus macular yellow gray exudative lesions and bleeding, round or oval, ill-defined, slightly elevated, a size of about 1 / 4 to 3/2 disc diameter (PD), the following is more common in 1PD, at the edge of the lesion has an arcuate or circular bleeding, sometimes was radial arrangement of spotting, the outer periphery of the lesion with a pigment disorders, lesions mostly fovea as the center and radius of the range 1PD, the end of the course, the formation of a yellowish white macular scar.

Since retinopathy more diabetic complications, and therefore should be the main control diabetes and blood pressure, diabetes control and complications examination confirmed the strength of the insulin therapy can delay the IDDM patients with diabetic retinopathy, nephropathy, and neuropathy onset and slow down its progress. visual symptoms are blurred vision, sudden loss of vision one or both eyes, black spots or flashing lights who appeared in perspective, all should be ready to see an ophthalmologist consultation.

How to do REVIEW child cough?

REVIEW child cough how to do? Children are very vulnerable to troubled cough, during the summer, although fewer colds, but often out of the air-conditioned rooms in the summer, causing temperature changes, children often susceptible to cough problems.

First, how do children often cough

Summer diseases cause respiratory infection is a common problem in children, due to the summer indoor and outdoor temperature, once the respiratory tract by the invasion, then it is easy to cause coughing. Cough in the sense there are many medical perspective, the parents according to different conditions, different treatment. Cough need treatment as soon as possible, once found to be treatment as soon as the lightest case, parents need to worry about this time. Because this time to rest just need to pay more attention to diet, usually three to five days will be cured.



Cough long time: If the cough is more than one week and cough more frequent, even with high fever, you should bring the child to the hospital, if the check without exception, may be a virus infection, usually without antibiotic treatment, as long as the attention to rest, diet, then taking some anti-virus, cough medicines can be, if it is a bacterial infection, it should be applied under the guidance of doctors antibiotics, neither the abuse of antibiotics, so as not to cause the body flora, reduced immunity, and even affect the liver and kidney function.

Cough with wheezing: asthma associated with crowing sound like if a child coughs, it should go to hospital for treatment as soon as possible, the doctor will use hormones and bronchodilators according to the situation.

If you find that your child is a bad cough, the more the longer the delay, they should immediately go to hospital for examination and treatment, because this time can easily lead to mycoplasma infection or tuberculosis infection. So the children cough should pay attention to it. If your child cough capricious, these methods can improve the child's immune function.

1, rational nutrition: in the growth and development stages of children, such as the lack of some nutrients, such as calcium, iron, zinc, vitamin, the child's immune system will decline. Therefore, usually should pay attention to the children a balanced diet, if necessary, ask the doctor to check whether the lack of certain nutrients, and make the appropriate supplement.

2, regular exercise: the right amount of exercise can improve the body function, cardiopulmonary child's ability to enhance the metabolism, improve children's ability to adapt to the environment. From the cool autumn beginning, children should be allowed to wear thin some more to outdoor activities, fresh air, so that children gradually adapt to the cold environment, improve the ability to keep out the cold.


How do children cough

3, pay attention to the cleanliness of the environment: the child's day room ventilation, if parents respiratory tract infection, should minimize contact with the child. In some special cases, such as during influenza, you can take medicine to prevent colds, recurrent respiratory tract infections in children may be appropriate to take some immune enhancer under the guidance of doctors.

Second, the children ate fast cough

garlic

Garlic is a very good sterilization, stomach food. In Chinese medicine point of view, garlic sterilization detoxification, treatment Stomach. Garlic can be well protected human cardiovascular, liver, eat some garlic in spring time can be a good prevention of infections. Therefore, an appropriate amount of water a day to drink some garlic treating children cough.

Summer TCM Act

Summer health vary, different physical persons health approach should be different. Chinese medicine will be divided into seven categories person's body, and what kind of constitution do you belong? Here, Xiao Bian introduce you to seven categories of physical performance as well as summer health principles to help you find your health methods.
The concept of TCM
TCM refers to the traditional Chinese medicine theory, follow the collection of biochemical changes of yin and yang, the science of the human body to restore and maintain the vitality of life and health. Mental health is through the mind Yi Yang, photo transfer emotions and spice up their lives and other methods to achieve the maintenance of the body, reduce disease, improve health, longevity purposes.
Chinese medicine the human physique is divided into seven categories: gentleness, phlegm, yang quality, qi, yin deficiency, damp quality male thermal mass.
First, gentleness
Such people fat, thin, well-proportioned, robust and powerful, the eyes of God, energetic. Its principle is to coordinate health yin and yang, qi and blood flow, promote metabolism. No taboo on the variety in the diet.
Second, phlegm
Such people waist abdominal fatness, physically heavy tired bear to restore should Shugan gas. Yi Shi diet with stomach, qi, promoting blood circulation thing, such as orange peel, rose, jasmine, hawthorn and so on.
Third, Yang and quality
Such people cold, limbs not warm, often feel cold back and below the knee. Yang quality should Warming spleen and kidney, sports and fitness oriented. Yi Shi warm food, such as litchi, longan, mutton.
Fourth, Qi deficiency
Such persons limbs, fatigue, muscle and soft, do not like sports. Qi replenishing Insufficiency should be based, to be more careful shelter evil. Yi Shi diet nature calm, partial temperature of the material, such as yam, longan, lotus seeds and so on.
Fifth, yin deficiency
Mostly thin or elongated shape of the person, such person is afraid of the heat, dysphoria hot, dry skin or oily. Health principle is nourishing Yin Jiang Huo, sedative, to food conditioning, the mind nursed back to health-based. The diet should not eat warm dry, spicy, fragrant food. Yi Shi moist items, such as grapes, pears, bitter gourd, cucumber and so on.
Sixth, hot and humid quality
Such people more yellowish color, the "cloud" instead of refreshing feeling. Nursed back to health should be to spleen dewetting, Shuganlidan based. Yi Shi light diet dewetting of things, such as melon, bitter gourd, mung beans, barley, seaweed and so on.
Seven male thermal mass
Such human cell sturdy, ruddy, sound and high rough. It should be nursed back to health Sheng Jin Yin based. Diet should eat fruits and vegetables, especially cucumber, bitter gourd, watermelon, pears, apples, rock candy and so on.

Treatment of periodontal disease

(A) basic treatment
The treatment of periodontitis and eliminate the cause from the two-pronged approach to reduce the symptoms.
1. The need for periodontal treatment, such as scaling, scaling, root planing and the like.
2. The need for periodontal surgery and with drug treatment. After the treatment, most patients can get rid of periodontal disease, loose teeth to be stable, chewing function of patients did not significantly affected. However, there will still be some patients, because absorption of alveolar inflammatory damage, reduced ability to support the teeth can not afford the normal bite force, occlusal trauma occurs, which further aggravate alveolar bone resorption, resulting in a vicious cycle. On the clinical manifestations of loose teeth, shift, inability to chew and discomfort, severe tooth can lead to tooth loss or removal of their own. After periodontal treatment, there will still be individual teeth, even more stars and the whole arch of the remaining loose teeth, it is difficult to exercise normal chewing function, once the above problems, you need to use restorative treatment of periodontitis.
(B) repair treatment
Repair therapy has become an important part of the comprehensive treatment of periodontal, restorative treatment of periodontitis is based periodontal treatment, through prosthetics ways to improve the loose teeth, shift and chewing weakness and other symptoms. Its fundamental purpose is to disperse the teeth together, eliminating the trauma, the establishment of coordination occlusal relationship; loosening teeth, missing teeth repair, control pathological loosening, promote healing of periodontal tissue, restore chewing function, improve the body health.
Repair treatment of periodontitis include occlusal adjustment, orthodontic therapy and periodontal splinting and so on.
1. occlusal adjustment
By grinding the teeth cusp or ridge, improve tooth shape, and to eliminate their early contacts and occlusal interference between the jaw teeth, thereby eliminating traumatic stress, establish contact relationships between functional teeth on the lower jaw and restore the periodontal tissue physiological stimulation to maintain healthy periodontal tissue.
(1) excessive cusp teeth caused by traumatic bite force;
(2) has not caused significant occlusal traumatic bite force, but may be a potential trauma factors, such as the upper and lower front teeth or teeth after clinching bite, jaw exercise influence;
(3) tooth morphology abnormalities such long teeth, deformed teeth, tooth twist like. However, there are often contraindications: can not accurately determine the presence or absence or premature occlusal interference between the upper and lower teeth.
2. Orthodontic Treatment
Is an important method for comprehensive treatment of periodontitis, by resetting the loosening teeth, tooth long axis and change direction of the force, eliminate traumatic bite force, it is conducive to the recovery and healing of periodontal tissue.
(1) aligned crowded misplaced teeth to facilitate plaque control;
(2) Anterior deep overbite;
(3) pre-rational dental sector shift and a gap;
(4) to the posterior mesial inclination formed deep intrabony by orthodontic treatment to make it erect, and near the deep bags can also be eliminated. However, there are often contraindications: ① untreated periodontitis; ② despite treatment, but there is still inflammation, plaque is not controlled, the disease is still active stage; ③ alveolar bone loss of more than 1/2 of the root length of teeth .
3. splints
Currently, commonly used in clinical splints to fix loose teeth, distributed occlusal force, improve the patient's chewing function, it will be a plurality of loose teeth together, or loose teeth fixed on the healthy teeth, making new chew unit.
According to the length of time, the splints can be divided into permanent and temporary splint splint, permanent splint and comprising: a fixed permanent splint, removable splint permanent, fixed removable joint splint (telescopic crown) and the like. Compared with a temporary splint, permanent splint splint can play a good stabilizing effect, loosening teeth, distributed occlusal force, reduce the load on periodontal tissue, and ultimately achieve the purpose of tissue healing and repair.
(1) a temporary splint Indications ① acute periodontitis teeth fixed; ② fixing loose teeth due to trauma caused; ③ reduce or avoid occlusal adjustment or surgical periodontal teeth to bring external force; ④ in making permanent splint process, in order to continue to prevent periodontal tissue damage, first with a temporary splint; ⑤ temporary splint therapy as a transitional measure, understand periodontitis restorative treatment effect, if good, long-lasting back splint .
(2) permanent splint Indications ① The temporary splint proved good effect; ② substantially eliminate or control periodontal disease, loose teeth require long-term fixed; ③ formula adapted to removable partial denture or a fixed denture conditions were .

What is periodontal disease?

Periodontal disease is one of the most common human diseases. Plaque, inflammation is considered to be the cause of periodontal disease. Periodontal disease is a multifactorial disease, no single factor can lead to periodontal tissue destruction, and even tooth loss. Maintained between bacteria and host intrusion defense function of a state of equilibrium, periodontal is in a healthy state. Internal and external factors can affect the balance of this dynamic. Exogenous factors (locality promoting factor), such as poor oral hygiene, poor dental calculus, food impaction, traumatic occlusion, iatrogenic factors, the point of contact, smoking and other endogenous factors (body promoting factors), such as adverse endocrine, metabolic disorders, immunodeficiency, chronic wasting disease, malnutrition, genetic factors, so that host resistance weakened, leading to periodontal tissue damage to susceptible bacteria and thus prone to periodontal disease. Also known as periodontal pocket blind bag, located around the teeth, periodontal tissue inflammation after formation. On the surface there is no dental periodontal pocket which must be oral with a sharp probe or special measuring periodontal pocket probe inspection in order to know whether the periodontal pocket and depth. A tooth can have several periodontal pocket, the medicine will be referred to the periodontal pocket buccal, lingual periodontal pocket, the periodontal pocket mesial, distal periodontal pocket. If further points down, the periodontal pocket can be divided into the bone and bone bags within bags and so on. Why should share the periodontal pocket so fine? Because the formation of periodontal pockets showed that the tooth had periodontitis, and periodontal pocket is so important symbol of the clinical diagnosis of periodontitis, inflammation results. So periodontal pocket is how did this happen? Generally considered periodontal pocket due to periodontal tissue by bacterial infection and stimulate local factors, especially plaque stimulate the gums, causing gum tissue inflammation and necrosis, inflammation constantly along the root the apical direction, so the formation of pathological capsular bag, at the same time causing the destruction of alveolar bone. This capsular bag easily accumulating food and bacteria that often cause bladder fester, the bag wall bladder symptoms such as swelling. So periodontal pocket and was said to be the gingival sulcus deepened. Periodontal pockets of granulation tissue is tissue that is easily inflamed tissue, so the periodontal pocket long-term recurrent infection, not self-healing. If it reaches the apical periodontal pocket, leading to tooth loss, periodontal pocket at this time to heal. Why when the presence of teeth, periodontal pockets are not self-heal it? Some people think that the periodontal pocket there is a substance that can destroy periodontal tissue. This substance was envisaged that osteoclasts, but after an experimental study of the periodontal pocket, has not yet found the presence of osteoclasts.

Why are breast tenderness

Some MM found their breasts often produces pain, severe cases may even affect their daily life and efficiency. So, what causes breast pain is it? The following Xiaobian to answer.
1, puberty breast pain
9-13-year-old girl began to develop breasts, breast tissue under the nipple appear as pea beans to a large dome-shaped induration, slight pain. After menarche, puberty with breast development and maturation will go away.
2, menstrual breast tenderness
It is the most common type of breast pain, accounting for about 65% of all breast pain, with an average age of 35 years occurred. More pain appears 3-7 days before menstruation or worsen gradually disappear or reduce menstrual cramps after. Monthly level of pain is not consistent, common for heaviness, pain or dull pain or occasional brief sense of acupuncture. And accompanied by tenderness of breast nodules, oppression, or aggravated by activity at hand was.
3, chest pain caused by mastitis
This pain is very obvious, unbearable, accompanied by red, swollen, hot, mostly in the early postpartum 1-2 months. Because milk stasis, inflammation, infection caused by blockage of pain, the pain can also be caused by bacteria nipple infection.

4, chest pain caused by cervical spondylosis
Cervical disease can cause chest pain, due to cervical degeneration, cervical nerve roots caused by involvement. This pain is more chronic, and is unilateral. The degree of pain and often related to the position of the neck, breast tenderness addition, there are the pectoralis major muscle tenderness touch, and neck pillows, shoulder and arm pain and discomfort, often on the x-ray signs of degenerative disease, and breast itself no abnormalities.

How the treatment of foot and mouth disease?

Core Tip: foot and mouth disease is an often occurs in the hands, feet and mouth rash, herpes disease, more common in children 5 years of age. The incidence of foot and mouth disease is seasonal, usually in the summer and the onset of the season, it is a contagious disease, infectious is relatively strong, the job must be timely treatment. So how treatment fastest foot and mouth disease?
HFMD is a common occurrence in the hands, feet and mouth rash, herpes disease, more common in children 5 years of age. The incidence of foot and mouth disease is seasonal, usually in the summer and the onset of the season, it is a contagious disease, infectious is relatively strong, the job must be timely treatment. So how treatment fastest foot and mouth disease?
HFMD how treatment fastest
1, food therapy
Many parts of the foot and mouth disease incidence in children are in the mouth, that is in the innermost long herpes, some children will be accompanied by ulcers and bad breath phenomenon, this time must pay attention to food hygiene, and a child with Patchouli , light bamboo and other Jianshui drink, so you can achieve the purpose of clear fire, if the impact of the disease to the appetite of children can also add some of the malt in the water, so you can play the role of an appetizer.
2. Washing method
Parents Once the child has HFMD must take immediate measures can be used to wash the outer approach to treatment. Such as the use Sophora, wild chrysanthemum like boiled water, and then naturally cooled to the appropriate temperature, use the water to soak hands and feet, so you can play a very good clearing away heat, cooling effect for foot and mouth treatment of the disease is very helpful, but also can prevent exacerbations.

HFMD how treatment fastest? Through our introduction, I believe we have learned about the treatment of the foot and mouth disease. HFMD usually can be self-healing, suffering from foot and mouth disease in children Parents also need to pay attention to prevention, the use of bottles of children would have to pay attention to cleaning and disinfection, reduce the incidence of the disease.

What is Efficacy and role of banana ?

Efficacy and role of banana what?
Bananas banana plants Gan banana fruit. Southeastern Asian origin, are cultivated all over southern China, Taiwan, Guangdong most. Autumn harvest mature fruit, treated deastringent, wash fresh use. Banana sweet and cold, with a high medicinal value. The main function is to clear the stomach, constipation, and a heat lungs, only polydipsia, fill in essence, drug hangover and other effects.
Banana What effect has it?
1, intestines Road
Banana contains rich in soluble fiber, which is pectin, can help digestion, adjust gastrointestinal function.
2, prevention and treatment of gastric ulcers
Patients with gastrointestinal ulcers often taking phenylbutazone, often cause stomach bleeding. The banana contains a chemical substance can prevent gastric ulcers, gastric mucosal cells can stimulate growth and reproduction, eating bananas can stimulate the growth of cells in the gastric mucosa, making the stomach to be protected, then play the prevention and treatment of gastric ulcer role.
3, lower cholesterol
High cholesterol can cause coronary heart disease, the banana stalk has a cholesterol-lowering effect. Cholesterol is too high, the available banana stalk 50 grams, slices with boiling water brewed into tea, and even drink 10 to 20 days, you can lower cholesterol.
4, help sleep
Bananas insomnia or emotional stress are also effective, because the protein contained in bananas, with amino acids, calm nerves results, so before going to bed to eat bananas, how many can play some of the sedation.

Children frequent sneezing may not be cold

Many parents and friends may encounter such a situation, when the child has a cough, runny nose phenomenon, eat a lot of cold medicine still does not work. Experts said that children's cold generally 7-10 days to heal, if more than this time, it should be suspected allergic rhinitis mischief.
More than seven days or cured cold allergic rhinitis
In fact, cold medicine is called "acute rhinitis", mainly caused by a virus. Mostly because the body defenses are weakened, more common in children with a cold constitution thin, poor immunity of children, they tend to suffer from viral infections, and cold symptoms, children with colds also susceptible to environmental factors, such as poor indoor ventilation, air conditioning was too big, crowded, climate change induced. While children accompanied by fatigue, loss of appetite, fever and other symptoms, which requires parents to carefully observe and identify.
Cold, namely acute rhinitis, such as the correct diagnosis and aggressive treatment of most patients 7-10 days after recovery. As sicker, headache is more obvious, and the emergence of a large number of purulent nasal discharge, facial pain, phlegm, cough, ear swelling and that is the development of acute sinusitis.
If more than 7-10 days, children are still "nasal congestion, runny nose, sneezing," and other symptoms can no longer thought it was cold, but should consider allergic rhinitis.
Allergic rhinitis how to detect?
This time is allergic disease predilection season, more dust in the air, animal dander, all kinds of pollen, dust mites, dust, large increase, especially in spring, flowers, trees, grasses are beginning to open, many children go after They are prone to allergies, causing allergic diseases.

Specific symptoms of coughing, sneezing, like rubbing the eyes and nose, runny nose, etc., involved in the disease atopic dermatitis, allergic conjunctivitis, allergic cough, allergic rhinitis and asthma, are generally aged 3-5 year old. When a child has allergic rhinitis, often stuffy nose, nasal itching, sneezing, it is worth noting that when these symptoms in the morning or when temperature changes more common in children with allergic rhinitis accompanied by family history.
There are always some children nasal congestion, sneezing, runny nose, but because it is not able to express, so parents ignore how to find children with allergic rhinitis. Experts suggest that children who show these cases should attract the attention of parents: ① cold frequent attacks, and the last is not good, the next began, the day nasal congestion, runny nose, sneezing. Parents should be alert to these situations. ② young age children, the elderly are like as often cough, sputum, hoarseness, but also pay attention to these cases. Children without asthma and acute infections, which often do not cough, sputum, because of postnasal drip caused by rhinitis. ③ mouth breathing during sleep, the "allergic appearance" that children continue to rub the nose with a finger or palm front, or some people because of nasal itching, do crooked mouth, nose, etc. towering strange movements.

Prostatitis: Inflammation of the prostate

Inflammation, usually refers to the reaction after the bacteria invade the tissues and organs that occur. Thus, prostate inevitably contain different amounts of bacteria in its secretion of fluid in the event of inflammation. When sex with orgasm and semen into the vagina, prostate fluid is a part of the seminal fluid in which bacteria also entered the vagina, then it stands to reason that these bacteria can also cause inflammation in the female reproductive tract.


    Are pathogenic bacteria there are many factors, mainly by: (1) the strength of the virulence of bacteria; the number (2) number of bacteria; (3) how the victims of violations of resistance. decided.

    If you are in the acute phase, fever and other systemic symptoms, perineal pain or discomfort and feeling heavy urination, discharge of more bacteria, the possibility of infection as well.

    Chronic prostatitis is a general term for a group of diseases, including chronic bacterial prostatitis, nonbacterial prostatitis and prostate pain. Among them, non-bacterial prostatitis Although the symptoms of prostatitis, prostatic fluid can also be found in the cells, but not bacterial culture. The prostate pain only appear like prostatitis patients as perineal soreness, micturition dribbling unclear, at the end of urinary symptoms turbid liquid, etc., but finding out prostatic fluid white blood cells may be due to pelvic floor muscle tension caused. Of course, the latter two cases will not cause infected.

semen on women's health benefit

A miraculous: help eliminate insomnia


Everyone is eager to have a deep, sweet sleep, but insomnia caused by a variety of reasons, often troubled you. Especially women, are more likely to insomnia. When undergoing a harmonious sexual life, the nervous excitement of the body began to relax tired muscles are able to meet later in the stretch, drowsiness naturally hit, help to eliminate insomnia. And sex life more happy, and afterwards the more easily fall asleep.

Miraculous II: relieve premenstrual syndrome

Women in 5-7 days before menstruation, pelvic blood flow increases, it may cause swelling and spasm, causing abdominal pain or bloating. The sex life of muscle contraction, can promote blood flow to accelerate the pelvic area into the general blood circulation, and relieve pressure on the pelvis, thus reducing abdominal discomfort.

Miraculous three: semen help women vaginal disinfection

Experiments show that there is an antibacterial substance in semen - semen cytoplasm, it can kill staphylococcus, streptococcus, pneumococcus bacteria. So it can help female genital against microorganisms. Long-term no sexual life of women, more prone to vaginitis, endometritis, salpingitis and other illnesses.

Miraculous four: help protect the young minds

According to the Japanese medical research shows that: "use and disuse" of atrophy, but also to a lack of sexual life. Proper sex life helps prevent brain aging and metabolism, memory is also strong.

The benefits of semen semen semen on women's health benefits

Miraculous Five: effective to reduce the incidence of heart disease and myocardial infarction

Sex can make the pelvis, limbs, joints, muscles, spine more activities to promote blood circulation, strengthen the heart and lung capacity. Dangerous people have a harmonious sexual life of heart disease than people who sexual disharmony at least 10% reduction in risk.

Miraculous Six: alleviate or relieve pain disorder

Sex even with aspirin have the same effect, it sounds a bit marvelous. However, a large number of medical institutions feedback confirmed the sex life can stimulate the central nervous system that secrete a chemical called amine polyphenols, weakened pain quite effective.

The benefits of semen semen semen on women's health benefits

Miraculous Seven: reduce the incidence of skin diseases

Poor skin blood circulation, can cause acne, dark spots and other skin diseases. And moderate sex will accelerate blood circulation, balance metabolism, make the skin smooth and delicate, and play a role in prevention and treatment of skin diseases.

Miraculous eight: improve resistance to diseases of the immune system

Modern civilized life, but let people's immune systems are more vulnerable than ever. Colds, high blood pressure, all kinds of ulcers are often hide become obvious. Sex can make a balanced secretion of adrenaline, muscle contraction first, then relax, creating a virtuous cycle in which the immune system can be maintained in good condition.

The benefits of semen semen semen on women's health benefits

Miraculous nine: the promotion of women's reproductive health

Estrogen can make women maintain the structure and function of good blood circulation system, regular sexual life of women, estrogen levels than occasional sexual intercourse is much higher. Thereby strengthening the physiological function of the ovaries, normal menstruation, but also to postpone menopause, and every time sex will cause genital secretions increase, to prevent drying of the vaginal mucosa.

Miraculous ten: slow aging


Women in about thirty-five, began to loose bone, sex can regulate cholesterol and maintain bone density and slow down osteoporosis. So that the whole people look light gait, the body's flexibility is also strong.

Miraculous XI: to make men stronger

Moderate healthy sex life, can make men's testosterone secretion increased, so that more muscular men, weight gain, improved bone marrow function, but also to reduce body fat accumulation.

skin disease

skin disease

Summer weather, hot flashes, is conducive to all kinds of fungi, bacteria growth and reproduction, coupled with the summer people sweat easily prone skin moist, if not wipe and dry, the fungus will harm our skin, causing the skin disease psoriasis. The most common skin disease psoriasis have athlete's foot, which is what we call "beriberi", people who like to wear leather shoes easy to get athlete's foot, because shoes airtight, foot humidity and temperature increased. In addition, many young men in the summer easy infection and tinea versicolor (sweat stain), which is related to a large amount of perspiration. If sweating, not cleaned, fungi multiply on the skin, the formation of pimples, blisters, scaling, etc., damage the skin.

For infants and young children, summer is the most common skin prickly heat, heat rash is a common summer skin disease in infants, sweat, sweat pores lead to blockage of skin abnormalities. Occur in the neck, chest, back, armpits, the needle to the grain size of pimples, skin redness around, improper handling easy to secondary infection.

How to prevent

Whether summer or infant heat rash skin disease in adults, are due to sweat more, it can not be cleaned, due to dry, therefore, to prevent such skin diseases most important thing is to keep the skin clean and dry. Adults and children should bathe, to the timely replacement of sweat clothes, adults can choose some of the texture of fresh, breathable clothing and socks, living appliances apart to use. Infants may be appropriately prescribe air conditioning, rubbed lip.

Heat stroke

Heat stroke

Hot summer weather, can easily lead to heat stroke, which is mainly because people in high temperature environments, temperature regulation loss of balance, excessive body heat savings, water and salt metabolism disorders caused. The disease usually occurs in the summer heat accompanied by humid weather, ranging appear sweating, dizziness after heat stroke, chest tightness, heart palpitations, nausea, vomiting and other symptoms; there will be severe cramps or fainting, life-threatening.

How to prevent

Summer heat stroke symptoms is not obvious, or did not pay attention, often overlooked. Therefore, if you find yourself or someone else has heat stroke performance, you should quickly leave the high-temperature environment to a cool well ventilated place to rest; more drinking salt water; you can also apply cool oil, wind spirits, etc. in the forehead, or taking Dishui Huoxiangzhengqi water and other traditional Chinese medicine. If lower blood pressure, exhaustion and other symptoms should immediately go to the hospital.

Summer to go out, it is best to avoid the 10:00 to 4:00 pm this time, we must go out to do protection work, such as playing beach umbrella, wear a hat, sunglasses, prepare adequate water and beverages; drugs carry some summer cooling as Dishui, wind spirits, etc; clothes also try to use cotton, linen, silk and other fabrics, chemical fiber category clothing and want to avoid the heat can not be sweating a lot, causing heat stroke.

Tuberculosis

Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis, can invade many organs, the formation of pulmonary involvement tuberculosis (pulrnonary tuberculosis) is the most common. Row of bacteria important source of infection for the patient. The human body is not necessarily infected with TB disease, when the resistance is reduced or increased cell-mediated allergy, it may cause clinical disease. The basic pathological features of the disease exudative, cheese necrosis and other proliferative tissue reaction, formation of voids. Apart from a few acute onset gather outside, mostly chronic clinical course. It manifested as fever, weight loss, fatigue and other symptoms of cough, hemoptysis and other respiratory manifestations. If timely diagnosis, and to the proper treatment, most of the available clinical recovery. Since the 1950s, the trend of tuberculosis has decreased, but the regional epidemic control is still uneven, it is still currently a prominent public health issue, is one of the top ten causes of death in the country.
Antituberculosis chemotherapy for TB control play a decisive role, reasonable intralesional chemotherapy can destroy the bacteria, ultimately recovered. Rest and nutrition therapy only play a supporting role.
First, the anti-TB chemotherapy (referred to chemotherapy)
(A) Principles of chemotherapy
The main effects of chemotherapy is to shorten the infectious period and reduce mortality, morbidity and infection. For each particular patient, for the main measures to achieve clinical and biological cure, chemotherapy is a reasonable means of active tuberculosis insisted early in conjunction with, adequate, regular and full use of the principles of sensitive drugs. Mainly refers to the so-called Early early treatment of patients, if it is found immediately after diagnosis and drug treatment; joint action is defined according to the characteristics of the disease and anti-TB drugs, combined with two or more drugs to enhance and ensure the efficacy; refers to an appropriate amount depending on the condition and provide for different dosage of different individuals; the law even if the patient must strictly follow the prescribed method of administration of chemotherapy, to adhere to a regular treatment, can not arbitrarily change the program or undue free withdrawal is also not free to intermittent medication; patients must follow the full program Naizhi adhere to the rule set by the full course of treatment, short-course chemotherapy is usually 6 to 9 months. Generally, untreated patients with standard treatment in accordance with the above principles, the efficacy of up to 98%, the recurrence rate of less than 2%.
Active TB are indications of chemotherapy. Induration of long lesions they do not need chemotherapy. As part of the induration, sputum negative, could observe a stage, if X-rays show no active lesions, sputum is still negative, no obvious toxic symptoms of tuberculosis, also do not need chemotherapy.
1, early, in conjunction with, adequate, regular and full medication active lesions in exudative stage, or cheese-like necrosis and even the formation of hollow, mainly Mycobacterium tuberculosis bacteria in Group A lesion growth metabolism, anti-TB drugs are often You can maximize the bactericidal or bacteriostatic effect. Local lesions rich blood supply, drug concentrations would also be conducted to help promote inflammation absorption components, reduced or closed cavity, sputum negative. Therefore, early active lesions reasonable chemotherapy, results were satisfactory.
Experiments show that lung lesions cheese per 1g tissue or cavity, about 106 to 1010 TB. Never had contact with TB TB drugs, sensitivity to drugs are not identical. About every 105 to 106 TB bacteria may have a genetic mutation because isoniazid or streptomycin resistance. Meanwhile the two drugs are resistant TB by about 1011, only one, but three kinds of bacteria resistant to drugs is less. As can be seen in a single-drug therapy, although can be nipped in the portion susceptible, but may leave a small number of resistant bacteria continue to multiply, eventually grow resistant advantages. Such as joint use of two or more drugs, reduce drug-resistant, the effect is better than single drugs.
The dose should be appropriate, inadequate dosage, the drug within the organization in order to achieve an effective concentration letter, and easy to produce bacterial secondary resistance. Excessive drug is easy to produce adverse reactions. TB slow growth, sometimes only occasionally breeding (B, C bacteria), and should therefore be the drug in the body long-term effective concentration. Regularly throughout treatment, but early withdrawal is the key to successful chemotherapy.
2, can play a bactericidal effect of TB drugs and blood (including macrophages) drug concentration in normal doses, to achieve the above in vitro minimum inhibitory concentration (MIC) of 10 times, otherwise the only antimicrobial effect. Conventional dosage isoniazid and rifampicin inside and outside the cell can reach that level, said the whole fungicides. Pyrazinamide and streptomycin are also fungicides, but streptomycin to play the biggest role in the slightly alkaline environment, and rarely penetrate phagocytic cells, intracellular TB invalid. Although pyrazinamide can penetrate phagocytic cells, but only have a bactericidal effect in acidic environments, so both are only half as fungicides. Ethambutol, sodium aminosalicylate, etc. are bacteriostatic agents, when conventional doses of the drug concentration can not be more than 10 times the MIC, increase the dose is prone to adverse reactions.
TB mostly in the early lesion within the extracellular, then isoniazid bactericidal effect is the strongest, followed by streptomycin. Inflammation of the tissue local pH decrease, slowing bacterial metabolism (C flora), together with some of phagocytic cells in the TB (B flora), are sensitive to rifampin and pyrazinamide. Such residual bacteria killing (B flora), helps to reduce future recurrence.
(B) chemotherapy
1, the "standard" chemotherapy and conventional short-course chemotherapy in the past 12 to 18 months using the therapy, known as the "standard" chemotherapy, but the long duration, many patients can not be completed, the effect is limited. Since the advent of rifampicin, and in combination with other drugs, found that 6 to 9 months of therapy (DOTS) with standard chemotherapy has the same effect, it is now widely used short-course chemotherapy, the program requested must comprise two bactericidal drugs, iso isoniazid and rifampicin, a strong bactericidal (bacteria of A) and sterilization (for B, C bacteria) effect.
2 ,. intermittent treatment, two-stage drug experiments showed that after a few hours in contact with TB drugs, often retard the growth of the number of days. Therefore, regular medication three times a week (intermittent treatment), can achieve the same effect with the drug every day. Within 1 to 3 months to start chemotherapy, daily dosing (strengthening stage), three times a week after intermittent treatment (consolidation phase), the effect of daily medication is basically the same, facilitate the monitoring of medication to ensure complete a full course of chemotherapy. When using intermittent therapy medication three times a week, should the combination, each of isoniazid, rifampicin, ethambutol dose may be appropriate to increase; however streptomycin, p-amino salicylic acid, sodium acetate, sulfur isonicotinoyl amine more adverse reactions, each dose should not be increased (table 1).
Table dose commonly used anti-TB drugs for adults and major adverse effects
Drug name abbreviations daily dose (g) intermittent treatment 1, (g) bacteriostatic mechanism of adverse reactions
Isoniazid H, INH0.30.6 ~ 0.8DNA peripheral neuritis synthesis, sometimes liver damage
Rifampicin R, RFP0.45 ~ 0.6 * 0.6 ~ 0.9mRNA synthetic liver damage, allergic reactions
Streptomycin S, SM0.75 ~ 1.0 △ 0.75 ~ 1.0 protein synthesis hearing loss, dizziness, impaired renal function
Pyrazinamide Z, PZA1.5 ~ 2.02 ~ 3 pyrazine acid inhibitory gastrointestinal discomfort, liver dysfunction, hyperuricemia, joint pain
Ethambutol E, EMB0.75 ~ 1.0 ** 1.5 ~ 2.0RNA synthetic optic neuritis
Amino salicylic acid sodium P, PAS8 ~ 12 *** 10 ~ 12 intermediary metabolism gastrointestinal discomfort, allergic reactions, liver damage
Propylthiouracil isonicotinoyl amines 1321Th0.5 ~ 0.750.5 ~ 1.0 protein synthesis gastrointestinal discomfort, liver damage
Kanamycin K, KM0.75 ~ 1.0 △ 0.75 ~ 1.0 protein synthesis hearing loss, dizziness, impaired renal function
Capreomycin Cp, CPM0.75 ~ 1.0 △ 0.75 ~ 1.0 protein synthesis hearing loss, dizziness, impaired renal function
Note: * weight <50kg 0.45="" 0.6="" 0.75g.="" 15mg="" 25mg="" 2="" according="" adjusted="" also="" amount="" are="" body="" daily="" doses="" drugs="" each="" elderly="" first="" font="" is="" kg="" minutes="" months="" of="" once="" other="" reduced="" s="" subsequently="" th="" to="" weight="" with="" z="">
3, anti-tuberculosis drug supervision administration at least six months, even take up to a year and a half, patients often difficult to adhere to. Urge timely medical treatment, strengthening visits, obtain the patient cooperation is particularly necessary. Strengthening stage once-daily administration, the peak plasma concentration can be formed, compared with daily fractionated treatment efficacy is preferred, and the convenience of patients, improve patient adherence to medication and complete the full rate.
(Iii) anti-TB drugs
Ideal anti-TB drugs sterilization, sterilization or strong antimicrobial effect, low toxicity and reduce adverse reactions, adequate inexpensive, easy to use, drug source; orally or injected drugs can achieve an effective concentration in the blood, and It can penetrate phagocytic cells, or cerebrospinal fluid within the peritoneal cavity, rapid and lasting effect.
1, isoniazid (isoniazid, H) has a strong bactericidal, it can be administered orally, fewer adverse reactions, low cost and other advantages. Its main function is to inhibit M. tuberculosis deoxyribonucleic acid (DNA) synthesis and hinder bacterial cell wall synthesis. After oral administration, rapid absorption, tissue infiltration, through blood-brain barrier, killing intracellular metabolism of active TB or stationary. Pleural effusion, cheese-like lesions and drug concentrations in cerebrospinal fluid are also quite high. The usual dose for adults daily 300mg (or daily 4 ~ 8mg / kg), an oral; children daily 5-10mg / kg (not to exceed daily 300mg). Tuberculous meningitis and acute tuberculosis millet dose may be increased (there may be complicated by peripheral neuritis, can prevent 300mg of vitamin B6 daily while increasing the dose; but large doses of vitamin B6 can affect the efficacy of isoniazid, so use when general dose of isoniazid, no need to add vitamin B6), until the acute toxicity symptoms recoverable conventional dose. Isoniazid in vivo inactivated by acetylation, acetylated individual differences in speed are often lower rapid acetylation blood concentration, there shall be considered to increase the dose intermittent administration.
Conventional dose of the drug adverse reactions occur rarely, occasionally peripheral neuritis, central nervous system toxicity (excitatory or inhibitory), liver damage (serum alanine aminotransferase) and the like. 3 months of isoniazid alone, sputum resistance rate up to 70%.
2, rifampicin (rifampin, R) is a semi-synthetic derivative of rifamycin, a broad-spectrum antibiotic. Its mechanism is to kill TB bacteria inhibiting RNA polymerase, hinder its mRNA synthesis. Intracellular rifampicin, a strong external metabolism and reproduction occasionally TB (A, B, C bacteria) have a role, often in combination with isoniazid. Adult 1 day, fasting oral administration of 450 ~ 600mg. The drug adverse reactions are mild, in addition to gastrointestinal discomfort, flu syndrome, the occasional transient hepatic dysfunction. Long rifamycin derivatives such as rifapentine (rifapentine, DL473) long half-life in humans, orally once a week, with daily rifampin similar effect. Rifamycin spiral piperidine (ansamycin, LM427, rifabutin) have some effect on other anti-TB drug failure strain (eg bird complex mycobacteria) than rifampin strong.
3, streptomycin (streptomycin, S) is a broad spectrum aminoglycoside antibiotic, has bactericidal action against TB, TB can interfere with the activity, impede protein synthesis. TB less effect on the cell. Dosage: Adult daily intramuscular injection 1g (50 years of age or renal dysfunction available 0.5 ~ 0.75g). Intermittent therapy twice a week, every muscle injection 1g. Pregnant women with caution.
The main side effects of streptomycin for the eighth cranial nerve damage, manifested as dizziness, tinnitus, deafness, severe cases should be promptly discontinued, severe renal impairment should not be used. Other allergic rash, exfoliative dermatitis, drug fever, etc., anaphylactic shock is rare. Monotherapy is easy to produce drug resistance. Other aminoglycoside antibiotics, such as kanamycin, capreomycin, purple neomycin although also anti-TB effect, but the effect is not and streptomycin, similar adverse reactions.
4, pyrazinamide (pyrazinamide, Z) can kill within phagocytes, acidic environment of TB. Dose: daily 1.5g, 3 times orally, occasionally hyperuricemia, joint pain, gastrointestinal discomfort and liver damage and other adverse reactions.
5, ethambutol (ethambutol, E) of TB has antibacterial effects, when combined with other anti-TB drugs and may retard bacterial resistance to other drugs. Dosage: 25mg / kg, 1 times a day orally for 8 weeks to 15mg / kg, adverse reactions to their little advantage, occasional gastrointestinal discomfort. Overdose can play the ball after optic neuritis, vision loss, reduced vision, central blind spot, etc., can be restored more than once the withdrawal.
6, p-aminosalicylic within (sodium para-aminosalicylate.P) of antibacterial drugs with streptomycin, isoniazid, or in combination with other anti-TB drugs, can delay the onset of resistance to other drugs. The antibacterial effect may during the synthesis of folic acid with TB ammonia acid (PABA) competition, affect the metabolism of Mycobacterium tuberculosis. Dosage: Adult daily 8 ~ 12g, every 2 to 3 times a day orally. Adverse reactions are loss of appetite, nausea, vomiting and diarrhea. The drug after meals can reduce gastrointestinal reactions, can also add a daily 12g dark intravenous infusion in 5% to 10% glucose solution 500ml, and a month later still changed to oral.
(Iv) chemotherapy
Depending on the severity, with or without sputum and bacterial resistance, as well as the economic situation, drug supply source, the choice of chemotherapy. No matter which must comply with the aforementioned principles can only be effective chemotherapy.
1 newly diagnosed cases of anti-TB program without drug treatment, some sputum smear-positive TB (smear), severe illness, infectious; and some smear-negative, small lesions, the use of chemotherapy also have different strength.
Smear positive cases, regardless of whether the culture is positive, can be utilized to isoniazid (H), rifampicin (R) and pyrazinamide (Z) based on a combination of the six-month DOTS program. Soon sputum often negative, short course, to facilitate follow-up management.
(1) strengthen the first two months of streptomycin (or ethambutol), isoniazid, rifampin and pyrazinamide, 1 day; after four months continue with isoniazid and rifampicin flat, 1 day to 2S (E) HRZ / 4HR representation.
(2) may also be a period of consolidation in the drug every other day (ie medication three times a week) to 2S (E) HRZ / 4H3R3. (Lower right corner number is the number of drugs per week).
(3) can also be intermittent throughout the medication to 2S3 (E3) H3R3Z3 / 4H3R3 representation.
(4) to strengthen the use of isoniazid, streptomycin and sodium aminosalicylate (amine or an alcohol), a period of consolidation with two kinds of drugs for 10 months, to 2HSP (E) / 10HP (E) represented.
(5) strengthening of a month with isoniazid, streptomycin, consolidation of 11 months of treatment twice a week to 1HS / 11H2S2 representation.
Above (1), (2), (3) for the short term chemotherapy, (4), (5) the "standard protocol." If conditions permit, to make use of short-course chemotherapy program.
Smear Yin Pui Yin patient, except may be smear positive patients with significant new social program miliary tuberculosis or hole, using the following regimens: ①2SHRZ / 2H2R2; ②3H2R2Z2 / 2H2R2 (every other day throughout the application); ③1SH / 11HP (or E).
Of untreated patients, International Union Against Tuberculosis and Lung Disease Association recommended chemical solution is suitable for the national anti-TB (Table II), development of treatment programs available for reference.
Table II countries tuberculosis chemotherapy Tuberculosis Plan
Course of chemotherapy treatment regimens
6 months 2RHZ / 4RH8 months 2SRHZ / 6TH or 6EH
2ERHZ / 4RH or 4R2H22SRHZ / 6S2H2Z2
2SRHZ / 4RH or 4R2H2
2, retreatment regimen as the first treatment of chemotherapy unreasonable, TB produce secondary resistance, sputum remains positive, persistent recurrent disease. Retreatment cases should choose joint sensitive drugs. Drug sensitivity test helps select the medication, but time-consuming longer, larger expenses. Clinically patients according to previous drug use, select an unused past few used or has joint rules used drugs (which may still be susceptible to the bacteria), and the other set programs, joint two kinds or two kinds more sensitive drugs.
Retreatment cases, generally available the following scenario:
(1) 2S (E) HRZ / 4HR, supervise chemotherapy administration to ensure laws. At the end of six months of treatment, if still negative sputum, consolidation period may be extended for two months. As prolonged treatment is still sputum remains positive, retreatment may be following the program.
(2) newly diagnosed patients failed rule, available 2S3H3Z3E3 / 6H3R3E3.
(3) chronic row of bacteria sensitive to first-line drugs were available and combined with second-line drugs, such as kanamycin toxin (K), propylthiouracil isonicotinoyl amine (1321Th), capreomycin (Cp), should be closely observed adverse drug reactions, medication 6 to 12 months is appropriate. Fluoroquinolones have antituberculosis moderate effect on the cases commonly used drugs has generated resistance, may be added in combination with the program. If bacteria overcast fistula, or serious adverse reactions, indications are discontinued.
(V) determine the condition and efficacy assessment, treatment failure
1, according to the extent of disease and therapeutic evaluation of activities can be divided into the aforementioned known disease progression, and improved absorption of the stable. General improvement of absorption and stability of the condition improved, advanced for the worse. Its judgment should be based on clinical symptoms, X-ray showing the row of bacteria and comprehensive analysis of the situation.
(1) Clinical symptoms: observe whether the afternoon fever, night sweats, loss of appetite, general shortage, weight loss and other TB symptoms worsen and procedural changes. Such symptoms were relieved or disappeared prompted condition improved; or if symptoms significantly changed from a light weight indicates deterioration. In addition, cough, sputum, hemoptysis and other changes in respiratory symptoms may be used as a reference.
(2) X-ray examination: the condition is judged indispensable indicators, is also an important basis for monitoring of the disease outcome of patients with no obvious clinical symptoms mainly rely on X-ray, X-ray can determine the lesion location, extent, nature , but also to control observation of dynamic change. Cottony clouds infiltrates absorb, dissipate, narrow; or converted to higher density, clear boundary of proliferative diseases such as fibrosis, calcification; original narrow cavity, said Deng Jun closed condition improved or cured. Conversely, the proliferative lesions into exudative lesions or invasive lesions expand, bronchial disseminated or acute, subacute hematogenous, caseous necrotic lesions, cavitation, etc. are deteriorated performance.
(3) sputum: tuberculosis in the sputum bacteria row or not is an important indicator to determine the condition assessment procedures and efficacy. Sputum examination and high specificity less affected by human factors. If sputum remains positive, compared with open tuberculosis, suggesting a high degree of disease activity, and for the social source of infection of tuberculosis, pose a threat to the surrounding population. After treatment repeatedly checked and found negative for TB or less, which is indicative of better; such as monthly sputum examination at least once, months were negative, it means that into the stable. Then, if the row of bacteria appear again for disease worsening performance. ESR acceleration prompted active disease worsening; but not have active tuberculosis ESR growth, lesions improved and stable patients were nearly normal erythrocyte sedimentation rate.
2, the end of the course of treatment failure sputum negative conversion failed, or in transit positive effect, X-ray showed lesions not absorbed, stable, and further deterioration, both indicate treatment failure, a so-called refractory pulmonary tuberculosis. Study its causes, in addition to drug-resistant TB infection, medication is not standardized, intermittent medication or monotherapy, but still with some patients chemotherapy drug allergies, chemotherapy drugs can not be used because of serious adverse reactions or chemotherapy drugs is difficult to adhere to treatment, the body immunocompromised (HIV infection), poor physical and other factors.
Drug-resistant tuberculosis (DR-TB) especially multidrug-resistant tuberculosis (MDR-TB) epidemic seriously, we are making anti-TB treatment is facing new challenges. 1994, WHO and the International Union Against Tuberculosis Lung Disease began anti-TB drug resistance monitoring of global planning, which lasted 3 years of work showed that, in 35 countries on five continents monitoring delegates found 20 percent of the world's population of double-resistant HR MDR-TB accounted for 2% to 14%, most of them belonging monotherapy, irregular, secondary multidrug resistance unreasonable treatment of joint programs human factors caused. In countries with weak TB control, primary multi-drug resistance was also found an upward trend. Once the occurrence of drug-resistant tuberculosis, chemotherapy drugs they use expensive price, poor efficacy, serious adverse events, treatment costs may be 100 times the new smear positive pulmonary tuberculosis patients. Adhere to the rational use of chemotherapy, and adopt comprehensive prevention and control measures, improve immune function and help prevent the occurrence of drug-resistant TB.
In order to effectively prevent treatment failure, chemotherapy must be properly formulated, patients should insist on an early, regular, regular, full combined with sensitive drugs under the supervision of. Only in the case of resistance has serious adverse reactions or indeed confirmed that the bacteria has been generated, it changed to a new chemotherapy. The new program should include two or more sensitive drugs.
Second, symptomatic treatment
(A) toxic symptoms
Toxic symptoms of tuberculosis and more effective anti-TB treatment can disappear in 1 to week, usually you do not have special treatment. Severe toxic symptoms of tuberculosis caseous pneumonia, acute miliary tuberculosis, tuberculous meningitis, high fever, etc., or a large number of tuberculous pleurisy with pleural effusion, should be bed rest and the use of anti-TB drugs as soon as possible. Also in the use of effective anti-TB drugs at the same time, the addition of corticosteroids (commonly prednisone daily 15 ~ 20mg, three to oral) to reduce inflammation and allergic reactions, and promote absorption of exudate, reducing fibrous tissue formation and pleural adhesions. Toxicity symptoms to be severe, prednisone dose decreasing to 6 to 8 weeks withdrawal. Glucocorticoids pleural thickening and has no role in the formation of adhesions. Therefore, it should be used with caution in effective anti-TB treatment basis.
(B) hemoptysis
If only a small amount of bloody sputum or hemoptysis, symptomatic treatment, including rest, cough, sedation, commonly used drugs Pentoxyverine soil root powder, codeine, carbazochrome (security network of blood) and the like. Old and feeble, pulmonary insufficiency, caution strong antitussive, so as to avoid inhibiting reverse cough and respiratory center, so that can not be discharged blood clots caused by suffocation. To exclude other reasons hemoptysis, such as mitral stenosis, pulmonary infection, pulmonary infarction, coagulation disorders, autoimmune diseases.
Moderate or heavy hemoptysis should be strict bed rest, ice packs placed chest and alternate with blood. Lateral position, will remain in the blood gently intratracheal cough. Vasopressin 10U applied to 20 ~ 30ml saline or glucose solution, the slow intravenous infusion (15 to 20 minutes), then 10 ~ 40U in 500ml of 5% glucose solution intravenous maintenance therapy. Posterior pituitary is known as contraction of small arteries, including the coronary artery and capillary action to reduce pulmonary blood flow, thereby reducing hemoptysis. The drug can still smooth muscle contraction of the uterus and therefore avoid for pregnant women and patients with hypertension, coronary atherosclerotic heart disease. Injection too fast can cause nausea, it is intended, palpitations, pale and other adverse reactions.
If excessive hemoptysis, blood transfusion may be appropriate discretion. Than those who hemoptysis, bleeding sites can be found by bronchoscopy, noradrenaline 2 ~ 4mg + 4 ℃ saline 10 ~ 20ml topical instillation. Or placed Fogarty balloon catheter (outer diameter 1mm, inflatable 0.5 ~ 5.0ml) with bronchoscopy clogging the bleeding site to stop bleeding. In addition to still use Kinoshita method with thrombin or fibrinogen bronchoscopy lavage hemostasis, should be fully prepared to make the necessary rescue. Repeated hemoptysis by the above method is invalid, no activity contralateral lung disease, pulmonary function reserve acceptable nor obvious contraindications, consider lobectomy, segmentectomy in clear bleeding site conditions.
Hemoptysis suffocation is the leading cause of hemoptysis necrosis, need to guard against, and actively preparing for the rescue before hemoptysis asphyxia symptoms include chest tightness, gas hold back, a lip cyanosis, pallor, cold sweat dripping, irritability. Rescue measures should be particularly injection keep the airway open, take Trendelenburg prone position high of 45 °, pat the back, the rapid discharge of blood, and dig or suction outlet as soon as possible, pharynx, larynx, nasal blood clots. Rigid bronchoscopy is necessary to attract, endotracheal intubation or tracheotomy to relieve airway obstruction.
Third, the surgical treatment
Surgery has been less used in the treatment of tuberculosis. Of greater than 3cm of tuberculosis and lung cancer is difficult to identify the ball, one-sided hollow fiber retreatment thick, long-term medical treatment failed to sputum conversion by, or unilateral destroyed lung with bronchiectasis, has lost function and have repeatedly hemoptysis or secondary infection, can be used for lung or pneumonectomy. Tuberculous empyema and (or) bronchial fistula after medical therapy and ipsilateral active TB, it is desirable for the lung - pleural resection. Surgical treatment contraindications are: bronchial mucosa with active tuberculosis, but not removed within the scope of those poor general condition or have significant heart, lung, liver and kidney dysfunction.