dien chan tich luy kinh nghiem 2011 cua ly ta minh giÃm Đau tỔng quÁt

Upload: tunggds

Post on 30-Oct-2015

877 views

Category:

Documents


3 download

TRANSCRIPT

GIM AU TNG QUT.

Vi DC-KLP th vic gim au khng kh, hu ht trng hp ch cn day,ln,co, hay g,bng vo sinh huyt phn chiu (hoc ng ng) ni ang b au khong 2 pht l m hay gim nhiu.

Nhng thc t khng t ln chng ta gp mt cn au ngoan c n mc day,co.vvmi tay, thm ch ni cu lm tht mnh n try da rm mu h n phng da m cn au vn tr tr nh ,vng nh ng..vntr gan cng tu nguyt..!!!???

Cc bn cn bit iu ny: nu tm ra sinh huyt (SH), lm kiu,dng cc k thut ca DC m khng gim au c th

1. ng l tm ng SH nhng khng ng vng cn tc ng.

2. Ci au ny c mt cng cao qu ngng iu chnh ca DC.

Vy, bn cn thay i :

1. Vi trng hp 1, bn tm vng cn tc ng theo bi Lm sao t T c, sau d SH trong vng ny theo k thut thch hp.

2. Nu lm theo nh trn 2-3 pht m vn khng hiu qu, bn nn ung thuc gim au, i thuc ngm ( 30 pht), bn lp li thao tc nu trn. Hiu qu gim au s cao v nhanh hn ch c thuc.nu vn khng thnh cng, bn nn nhp vin.......... tm cho ra nguyn nhn gy ra cn au qui c ....Trong mi trng hp, bn nn day cc huyt sau y trc khi tc ng vo SH : 124 + -, 34+ -, 106, 26. y l b huyt an thn gim au tng qut cho ton thn.

c ng bi T Minh vo lc 04:08 0 nhn xt

Gi email bi ng ny

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=5986708435973954809&target=blog" \o "BlogThis!" \t "_blank" BlogThis!

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=5986708435973954809&target=twitter" \o "Chia s ln Twitter" \t "_blank" Chia s ln Twitter

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=5986708435973954809&target=facebook" \o "Chia s ln Facebook" \t "_blank" Chia s ln Facebook

Th nm, ngy 14 thng t nm 2011

THNG BO

Blog chnh ca ti l http://vn.360plus.yahoo.com/taminhdc. Mi cc bn sang bn , c nhiu bi vit hn v thng xuyn b sung hn.

c ng bi T Minh vo lc 04:26 0 nhn xt

Gi email bi ng ny

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=8586002699917153373&target=blog" \o "BlogThis!" \t "_blank" BlogThis!

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=8586002699917153373&target=twitter" \o "Chia s ln Twitter" \t "_blank" Chia s ln Twitter

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=8586002699917153373&target=facebook" \o "Chia s ln Facebook" \t "_blank" Chia s ln Facebook

Th su, ngy 08 thng t nm 2011

PHNG HNG IU TR CC DI CHNG LIT.

ng ngy: 04:53 08-04-2011

Th mc: Chuyn DC-KLP

Lit do Tai Bin Mch Mu No (TBMMN,l tn gi chung ca xut huyt no v nghn mch mu no m trc y thng gi l nhn no), lit do Chn Thng S No (CTSN) v lit do Vim No (VN) u c cn nguyn t vic tn thng hoc b tc trong no. Tng t ta c lit do Chn Thng Ty Sng, lit do Vim Ty Ct Ngang; hai trng hp sau cng u do thng tn hoc chn p mt on ty sng gy lit.Tuy nguyn nhn khc nhau nhng cc trng hp nu trn u gy thng tn v chn p b tc cho no hay ty sng l h thn kinh (gm nhiu dy thn kinh chng cht). Ta bit,h thn kinh hot ng theo c ch ging nh c ch ca cc my dng in nng. H thng ny hot ng tt hay km l do cht lng my, cht lng dy dn; v do in p ca h thng hay thiu.Xt h thng qut my vn hnh nh in. Ta nhn bit h thng ny vn hnh c (thy cnh qut quay) nh cc thng s: in nng n, ng c, vt liu dn in, mch in thng sut,cnh qut. in p yu hay h thng ng c v dy dn km cht lng th qut quay yu; in p , ng c v dy dn tt th qut quay mnh; nu qu km th qut khng quay ni d in vn vo. Cnh qut quay hay khng l do nhng yu t trc n hi mc cn thit hay yu km.Tng t nh vy. Ta nhn bit c bp hot ng c hay b lit l thuc vo cc thng s: nng lng cung cp t mu; cht lng h thng thn kinh t no b n ty sng n cc dy thn kinh ngoi bin, cht lng cc khp TK (sinap). Cc thng s cn thit ny hi mt cch hon ho th h thn kinh ch huy cc c vn ng c nh ; mt hoc nhiu trong cc thng s ny khim khuyt th cc c vn ng yu hoc ra d tn hiu thn kinh vn n.Qut my khng quay ni khi in nng thiu, nu khng bit ta c cho in vo th mt thi gian sau h thng b chy. Tng t (nhng hi khp khing), khi mu n khng , h thn kinh khng ch huy ni cc c bp d cc t bo TK vn cn thoi thp sng. Nu thiu mu lu, vng t bo TK ny c th b cht hn v vic phc hi vn ng cho c do chng ch huy l khng cn hi vng.V th,vic phc hi sinh lc cho h thn kinh l bin php ch o ca vic iu tr cc th bnh bi lit. Trc y, Ty y dng cc loi thuc chng xut huyt, tan mu bm; na cui thp nin 90 Trung Quc xng v thc hin vic m s no ht mu cho bnh nhn b xut huyt no cng t nguyn l ny. T vic cu sng cho bnh nhn xut huyt no nng khng cn kh khn. Hiu qu iu tr di chng lit sau TBMMN cng tin b vt bc. Nhng trn thc t ta thy cn khng t BN vn phi chu di chng nng. V sao?Th v ch l thc t cho thy vic ci thin di chng cho cc bnh nhn tn thng no-ty c kt qu tt hn vn thuc lnh vc dng huyt d thuc bt c trng phi no. V sao?Nm 1988, ti xy dng c b Tan Mu Bm c cng dng ph tan mu rt mnh v c dng ph bin trong gii DC. B huyt ny hin nay c ti trin khai thm v t li tn mi TIU VIM KH v nhn thy tc dng ca n rng hn vic lm tan mu bm. B huyt ny lun c s dng gii quyt cc di chng ca chn thng, trong hu phu v u thnh cng tt p. Nhng mi n khong nm 1997-98 ti mi p dng vo vic cha lit do TBMMN sau khi cha thnh cng lit do chn thng ty v chn thng s no; v sau khi bit thng tin TQ tch hp s ht mu trong xut huyt no. Kt qu khng ng l hiu qu nhanh v cao hn cc phc trc p dng t 1987. Ti cng b rng ri khm ph mi ny trong K Yu 20 nm DC-KLP do Thy Chu ch bin.Mt th v bt ng khc na l vn c th can thip tt cc trng hp nghn mch mu no gy tai bin m trc y thng c gi l nhn no. K c trng hp nghn mch do mng x va .Khi p dng b TIU VIM KH vo vic cha di chng lit do cc nguyn nhn TBMMN,CTSN thnh cng, ti vn lun thc mc v sao Ty y ht mu , dng thuc tan mu m BN vn cn lit, nht l vi CTSN. Ch khi ti tr th chc nng vn ng c mi tin trin nhanh mt cch r rt ?Khng c phng tin tm hiu, ti nh t nu cc vn sau: C phi bin php ht mu bng phu thut ch gii quyt c cc vng mu ln thy c, CT hay MRI cng ch thy c cn mu ln nn kim tra thy rng thng. Cn nhng ht hng cu li ti kt u trong cc vi mch m CT v MRI khng thy c vn c th gy thiu mu cho cc t bo thn kinh ca n ph trch. V thiu mu nn cc t bo TK ny khng nng lng ch huy cc c lin quan, mc d t bo TK ny cha cht hn. C phi thuc khng nh tan ht c cc ht hng cu lit ti cn li trong cc vi mch mu ? C phi di chng lit vn cn v mu hay l v mt yu t khc khin cho cc t bo TK khng lm c vic?Hay l do c 2 yu t: huyt li ti v ci g khc mu cn tn ng trong h thng thn kinh khin h thng hot ng km hn.Nu th nu nhng gii p c cho r rng v chnh xc th ti chu thua v ngoi kh nng k thut.Khng gii p c nhng trn lm sng, ti lun thnh cng hn cc gii php khc. Bi c nhiu BN b vi nm tng c iu tr bng cc gii php khc, bi nhng thy thuc khc v khng ch mt thy thuc m vi thy thuc trc ti. Tuy nhin trong nhng trng hp ny, hiu qu ci thin khng cao hn nhiu, nhng vn c tin b thm sau khi ti iu tr. Cn nhng trng hp mi b, sau khi n nh c huyt p xut vin hoc sau khi m s no do chn thng xut vin m c ti tr ngay th khng ai l khng i ng c, tuy rng mc hi phc c khc nhau.T nhng kt qu ti tin l mnh ang ng hng v ng nht t trc n gi. Bi nguyn l rt ph hp vi Ty y c k thut cn lm sng c th. Ni ln iu ny l mt iu khng hay xt v kha cnh khim tn theo ng phng.NHNG.. hn 20 nm ln ln vi ngh, lang thang trong bi ng v ma nng khp hang cng ng hm ca Si Gn-Ch Ln v cc vng ln cn nh Bnh Dng, Bin Ha, Th c, Bnh Chnh, Nh B v hin nay l H Ni,chng kin bit bao cnh i au kh ca bnh nhn v gia nh h ti khng th im lng ch c hai ting khim tn!!Tin v dng kinh nghim nh nhoi ny ca ti hay khng l ty qu v nhng ngha v ca ti l phi ni ln s tht. Nu khng, ti c li vi nhng BN qua ca ti v vi nhng BN c th s mc phi trng hp au thng ny.Knh mong qu ng nghip v qu bc trng bi cm thng v lng th. By gi, ti xin trnh by ton b chi tit kinh nghim ca ti, tuy c ni n trong K Thut Chn Tr Bnh Bng DC-KLP Kt Hp ng Ty Y nhng hi ngn gn nn cc anh ch em cn yu v DC khng dng c v khng hiu hoc khng tin v thy qu n gin:Cc bn c ti liu hun luyn ca ti cn cp nht theo bi di y tuy rng c chung ta v ln ny ti s vit chi tit hn:

IU TR LIT DO TAI BIN MCH MU NO

V CHN THNG S NO.

---O---

Lng- y T Minh.

Tai bin mch mu no(TBMMN) v chn thng s no(CTSN) thng a n lit vn ng, i khi lit c cm gic v ri lon nng lc tinh thn. Ch c mt s t trng hp phc hi hon ton theo c ch t khi v c ch b, tuy nhin phi thy rng y l nh tn thng qu nh. C 2 c ch b: b ti no l vng no lnh lm thay chc nng cho vng no b thng; c ch b ti c l nhng c lnh lm thay vic cho c b tn thng. Cha ht, vo u thp nin 00 ca th k 21, ngi M pht hin ra rng cc t bo TK c th ti to nhng phi mt khong hn 3 nm. Chnh nh cc c ch ny m mt s BN ngho khng sc theo ui vic iu tr vn phc hi c mt s chc nng vn ng sau mt thi gian kh di.Tuy nhin, trn thc t khng phi ai cng may mn nh th. V cng c mt s BN b lit vi nm n ti cha mi bt u phc hi. Mt s t bnh nhn thot khi tnh trng lit ny mt cch ton din do may mn b tn thng tng i nh v c iu tr NG CCH NGAY T U. a s l li cho bnh nhn vi di tt v th xc hoc tinh thn khi b hi nng hoc c iu tr khng ng cch kp thi ngay t u.Trong di chng lit do TBMMN v CTSN th iu tr ng cn phi kt hp c ba gii php ng b mt cch kho lo : THUC MEN, TP LUYN, HUYT O.Vic dng thuc th ty, Ty hay ng cng c. Nhng theo kinh nghim ca ti - trong TBMMN - thi gian u nn dng thuc ty (c BS ch nh v theo di) cho n khi HA n nh tht s, v tuy xut vin HA ca BN vn c th li bt n v tai bin tip l iu rt d xy ra. Vic n nh HA kh phc tp, d phng php chng ta c th lm c nhng i hi phi vn dng y l rt nhiu v Ty ln ng y nn khng th trnh by trong bi vit ny, cc phc v huyt p hin nay thng mang tnh ct cn hn l iu tr . Cho nn cc anh ch em nn kt hp vi bc s chuyn khoa tim mch khng ch HA cho bnh nhn , trnh tai bin rt d xy ra tip theo khi HA cn dao ng.Tp luyn c hai phn : th ng v ch ng. Tp th ng l k thut vin hay ngi nh tp cho bnh nhn, lun lun rt cn khi b lit cng. Tp ch ng l bnh nhn t luyn tp theo s hng dn km cp ca K thut vin (trong thi gian u hoc t ngh ra cc t th trong sinh hot thng ngy trong giai on sau), ch cn t khi bnh nhn bt u vn ng c d cn rt yu t. Vic ny i hi bnh nhn phi c ch quyt thng bnh tt. Tuy nhin khng nn qu c sc s gy phn tc dng. Tt nht nn nh KTV trong thi gian u.V huyt o, ng hn l v DC-KLP , L CH CHNH CA BI NY. Ti xin cng hin cc kinh nghim sau y sau mi my nm chuyn nghin cu v iu tr loi bnh ny. C th ni rng y l phc iu tr c hiu cho bi lit do TBMMN v CTSN. Phc iu tr: Giai on mt: 156 - + , 38 - +, 7 - + , 50, 37, 61 - +, 3 - +, 290 - +, 16 - + , 26, 240, 347, phn chiu u theo hnh m, Dng v Trc din pha i bn b lit. Giai on hai: khi bnh nhn bt u t vn ng c cc c phn b lit d cn yu t, chng ta bt u tc ng thm phn chiu hoc cc b c phn b lit, pha cng bn b lit. Gm phn chiu na lng, tay chn bn lit. Tuy nhin ch tc ng bnh thng ch khng nn qu nhiu. ng thi khuyn bnh nhn nn bt u luyn tp ch ng mt cch va sc. S qu ti trong luyn tp s gy phn tc dng. Nn iu chnh tng trng cho bnh nhn theo bi Phc Hi Chnh Kh t hiu qu cao hn v hon chnh hn. Vi ti ch ta tc ng vo gy, lng, tay chn bn b lit. Trng hp dng b Tiu Vim Kh nu trn 3 tun m BN vn cha t ng, cha tp i c th cn ch vic iu chnh tng trng cho BN. V thng do huyt kh km qu nn c bp khng sc nng c th. Khi lc chn ca BN mnh, t ng kh lu khng ng nhng h bc i th li ng l do c tn thng vng tiu no, ta cn tc ng phn chiu tiu no l vng sn cn n ng, vng u mi v mi, cm (theo H phn chiu no b). Nu kt qu CT hay MRI cho bit c tn thng tiu no th ta cn can thip ngay vng ny t u mi c kt qu cao c.

K thut : day n hoc rung cc huyt v dng co nh co phn chiu u hoc c phn b lit theo cc hnh nu trn. Nu bn lit lnh mt hn bn lnh th nn tc ng huyt v vng phn chiu c bi du cao, sau khi nhit 2 bn nh nhau th khng dng du na. Nu nhit 2 bn nh nhau th khng cn dng du.

Bin lun: TBMMN v CTSN u lm tn thng no. Hu qu ca s tn thng ny l gy lit cho cc c phn vn ng lin quan di no nh mt, tay chn .v..v. V vy gc bnh l no , cc c phn ch l ngn. Do cu ly no b l vic u tin phi lm trong hai loi bnh chng ny. Nh vy khi no b c phc hi th tay chn lp tc phc hi. Ch nhng trng hp lu ngy cn c b teo rt th ta cn tc ng mnh trc tip vo cc vng t chi tm cch hi phc cc cn c ny. B huyt nu trn c tc dng tan mu bm, chng vim, lc no v ci thin s lu thng mu no.Ch : -Cn king c khng n ung cc thc chua,lnh v cc thc gy vim (xem bi hng dn v king c. Trnh tt c cc xc ng, cc thay i t ngt v nhit , v ng tc. -Vic ln thm tuy cn thit nhng ln qu nhiu tay chn (vi ba trm lt mi ni) khi no cha iu khin chng c ch khin cho cc c b nho thm v gy kh khn trong iu tr v sau m thi !! Tuy nhin trong lit cng th ln l bin php tt trong mi giai on nhng cng nn va phi.-Vic xung in vo tay chn cng khng nn dng qu sm v rt d gy phn tc dng khi t bo TK cn yu khng chu ng ni kch thch ca ging in c thi lng v cng cao hn ngng ca n lc by gi. M lc ny lm sao bit c sinh lc ca t bo TK l bao nhiu nu khng c o c bng my mc hin i ? Nu chng ta da vo cm gic ca bnh nhn chn cng v tn s xung, th xung bao lu l va ? iu ny khng th xc nh bng cm gic ch quan ca bnh nhn cng nh ca chng ta c. V vy cn thn trng trong vic xung in.-Trong CTSN chng ta s thng gp kin ca BS cho rng khng c chm cu m ch cn tp VLTL . Tuy nhin DC-KLP khng phi l chm cu v chng ta khng ng n vt thng u m ch dng huyt xa vng b thng . iu quan trng l khng nn dng nhng k thut mnh tay gy au n cho bnh nhn ang trong tnh trng suy yu v hot ng ca h thng TK . D sao c iu tr thm bng huyt vn mau phc hi hn l ch luyn tp sung, iu ny c xc nh trn thc t lm sng trong qu trnh lm vic ca ti. Nay ph bin cho cc anh ch em cng dng.Chc tt c anh ch em thnh cng trong vic p dng bi vit ny iu tr nhng bnh nhn b bi lit do hai nguyn nhn trn.Trong bi ny, ti ly v d l BN b lit bn tri minh ha hnh v vng phn chiu u cc hnh m, Dng, Trc din.

CCH DAY HUYT V CO TRONG IU TR DI CHNG LITBn dng u que d vch qua li cc huyt tht nh, Co cng vy, co tht nh, cng nh cng tt.NH NH GI THONG TRN DA. Mi huyt hay vng ch cn ti lui,qua li 30 lt, Ti v lui, qua v li c tnh l MT LT, c ngha l mi huyt c tip xc khong 60 ln.Khong ti lui ca u que d cng ngn cng tt, c ngha ch cn 1mm trc v sau huyt. V huyt DC trn mt rt nhiu, a s huyt cch nhau ch 2 n 3 mm. Nu khong ti lui ca u que d di qu, bn s tc ng mt lc 2-3 huyt. Nh vy, s khin cho tc dng mong mun s long i, s ri i v lc ny l s phi hp ca 2-3 huyt ch khng cn l khai thc tnh cht ca huyt ang day.Co cng vy, bn cn c gng co chnh xc v gn gng vng cn co, khng lan rng qu din tch hnh bn ang tc ng. Bi v khi co rng hn gii hn din tch hnh l bn ang tc ng vo phn chiu ca mt hnh khc ri. V d nh khi co phn chiu u ca hnh Dng v m. Bn co ring tng hnh, khng c li bing co mt lc hai hnh v thy chng gn nhau. V nu lm vy, v tnh bn tc ng cha cc c lng (hai vng ny hp li th phn chiu lng ch khng phi phn chiu hai mt trc v sau ca u BN. V nh th cc tn hiu cn truyn ti s chy v lng ch khng i n u ca BN. Do , thao tc ca bn khng t hiu qu mong mun.Vic tc ng rng ch nn dng khi thao tc ti ch. Thao tc ti ch c tc dng khc vi thao tc theo hnh. y l c im ca Din Chn-iu Khin Liu Php. Tc ng ti ch c tnh cht nh mt-xa nn cn rng hn vng c bnh tng cng lu thng mu ni c bnh. Cn tc ng theo hnh th li mang tnh dn truyn ca phn x thn kinh. Mi mt u dy thn kinh (huyt) ch n mt im trong c th theo hnh ang s dng nn khi tc ng theo phn chiu cn chnh xc. Cc bn cn lu iu ny pht huy ht tim nng ca huyt DC, khng ph sc, tn th gi v ch m li km tc dng.

c ng bi T Minh vo lc 00:43 0 nhn xt

Gi email bi ng ny

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=7460034820826533399&target=blog" \o "BlogThis!" \t "_blank" BlogThis!

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=7460034820826533399&target=twitter" \o "Chia s ln Twitter" \t "_blank" Chia s ln Twitter

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=7460034820826533399&target=facebook" \o "Chia s ln Facebook" \t "_blank" Chia s ln Facebook

Th by, ngy 12 thng hai nm 2011

GII QUYT VN CA TINH THN

i ngi gm mt chui thnh-bi,vui-bun.khoi-kh,sng-cc... t hay nhiu cng li du n trong tm tr. Nhng du n ny cng khai hay m thm, rm r hay lng thng, ngay tc khc hay ng yn ri ht nhin bng tnh. hot ng trong tinh thn chng ta.

i ngi, ai cng c t nht mt tai nn. Khng tai nn v vt cht cng tai nn v tinh thn. Khng trc tip cng gin tip, Khng nng n cng long thong. C khi ri cng qua i, c khi li khim khuyt khng sa cha c khng ch vt cht m c v tinh thn na. Loi ngi tn khng t cng phu tm cch gii quyt nhng di chng ny.V vt cht c th c gii phu hc, gene hc. V tinh thn c phn tm hc v tm l-y hc, cc gio iu tn giovv.Nhng coi b.khng thnh cng g lm. Vn cn lm ngi phi chu thiu mt ci g trn thn th. Vn cn phi gt chn ln trn trn tr mi m, gm nhm ni lng khng yn.

V tinh thn,nhiu iu khng vui ta mun dp b qua mt bn m khng c bi nhng tri buc ca thi quen, ca c tnh, ca tnh cm, ca o l, ca n np gia phong, ca nhn thc hnh thnh do tp qun dn tc, ca tn gio, c khi l do nh hng ca c loi ngivv.. Ha ra, con ngi chnh l n l ca nhng iu . Nhng iu do bm sinh v c nhng iu do hc hi t lc cn trong bng m (y hc ni vy).

Nhiu khi con tim bo nn nh th ny, l tr li biu nn nh th kialoay hoay mi g khng ra nh mt ng ch ri. Phn tch chi li vn ny khng d, xin cho chuyn vin v ngnh tm l lm vic cng bn.

Ti xin trnh by mt vi suy ngh ca ti:

i sng con ngi tht l tro ngoe.

- Bnh thng con ngi khng lm ch c phn vt cht c th ca mnh. Mc d mun a tay ln l a,mun i l i. Nhng kh lng nhn i kht, nhn tiu tiu. Mun tim p hay ngng theo mnh khng c. Thm ch c lc mun ng m khng th, mun n m nut khng tri qua c hng.

- Xt cho cng con ngi ch c th lm ch c phn v hnh ca mnh: tinh thn. V sao ti ni vy ? Bi,v tnh hay c , t nht trong i bn tng dng li mt mun no khng th thc hin c. Ri cm gic kh s v bt nh cng qua i. l lc bn lm ch c n vy. c kinh nghim, sao khng pht huy thm nh? Sao bn khng rn luyn nhng trng thi khng vui ra i nhanh hn, mi ngy mt nhanh hn. Cho n khi ch cn 30 giy l xong?

- Tri nng nh la, bn rt bc mnh nhng vn phi ra ng. Bn phi chu ng ci nng l iu khng th trnh n, nhng sao bn khng qung ci cc bc tc ng tri i nh? Qung n i, bn ch cn hi nng, nh c ngi.

- B thng v tai nn. Thn xc au n cha hay sao m bn li cn cho lng mnh au theo khi nguyn ra vn xui?

- Bn b mc ti, tin mt, cm hn k v li. , tin mt th mt ri. Ti g mt thm s thanh thn ch ?

- Tng t nh vy khi bn b ngi yu phn bi; ngi yu ra i, nu ko c c u? Bn hy lo nu ko s bnh an tm hn mnh th hay hn nhiu .

Nhiu lm, ngy no bn cn sng l cn phi i mt vi nhng iu lm bn mt vui, au kh, n cm m nh n sn, ging tri nm m nh ging tri gai ca Cu Tin khi cha git c Ph Sai (cu chuyn ny c thc, c k trong ng Chu Lit Quc).

Bn khng thng mnh sao? Chc chn l bn phi thng mnh, nhng bn khng bit cch thng khi c mi m p s bc dc v mun m khng c, c m ni on ght v khng thch m phi chu, c gi lng hn th v cha tr th tng xng c. Khin cho i bn ton l mu en cho d bn ang m mt ng tin vi ngi thn vy quanh. iu gy nh hng n h nu h cng nh bn: cha chu vt b nhng ni bun.

Hy loi b ni bun, gi li nim vui.

, ci ng ny ni nghe d lm. Phi, khng d nhng khng phi l khng c. Ch cn bn nui c mun thanh thn trong mi tnh hung cuc i ln hn hay t ra cng bng vi c mun thnh cng trong s nghip hay ni chung l trong mi vn khc ca cuc sng.

Ti xin trnh by kinh nghim loi b ni bun,gi li nim vui ca ti xem bn c dng c hay khng nha..

Vi khao kht chy bng , bn tp th su. Ht vo tht y ngc ri bng, theo di lung khng kh t mi, vo ngc ri trn xung bng. Cho n khi khng cn ht vo c na.Bn th ra, theo di lung hi thot ra cho n ht. C th, bt c lc no c th. Theo kinh nghim ca ti, khng cn quan tm n vic th nh hay mnh. C th , c th bn s t iu chnh. Hi th bn bt u lc no cng mnh v nhanh, nhng s nh v chm dn khi bn th c vi ln nh vy. Ri sau ny khi quen bn, khng cn th cng ngc bng na m ch cn th bnh thng, nhng cn duy tr s ch vo hi th vo v ra ang n u m thi.

Thi gian u, bn ch th su theo kiu khi mt mnh ngi hay nm rnh ri. Cn nhng lc khc bn cha lm c.

Khng sao, sau khi quen vi kiu th ny,bn hy bt u th khi i b bt c l do g. i t ging ng qua phng v sinh sau gic ng. i t phng v sinh qua bp, t bp qua bn n, t bn n vo phng thay qun o, trong khi thay qun o, khi i t nh ra xe..ri t xe vo phng lm vic.iu ny khng kh v cc ng tc va k c th thc hin c theo phn x, ch cn li th l c s tp trung c ch thi.

C l chng mt tun l l bn quen vi vic va th su va thc hin nhng ng tc thng thng ny.

K tip

Khi quen th nh trn, bn tp b nhng g n gin n trong u bn.

Nh c nh mt n hoa p, mt cu ni ca ai lm tm hn bn xao ng in t, lp tc bn hy tp trung tinh thn vo vic th su nh trn. Ch vo vic th, no bn s t ng qun dn cm gic ang c Chng s ra i khng li du vt. Bn s tng cng v cc chuyn vui ln dn. Cho n khi ch cn chng 3-5 hi th l mt cm gic vui thch. Lm c iu ny l bn bt u c kh nng vt b nhng u t phin mun quy nhiu bn c ri. Bn bt u tp xa ni bun.

T , bn c th v nn c nh li mt s kin khng vui no ca bn. Nu bn thy n dy ln trong bn s xao ng. Bn bt u th su, ch v ch ch n hi th ra-vo. Ch ch vo hi th, khng cho bt c iu g hin ra trong no bn. Nu c ci g khc vi hi th xut hin bn li ch vo hi th v ch hi th m thi. Bn kg cn c gng vt b ci ang lm bn xao ng, v khi c gng vt n ra, l v tnh bn ang nh ti n. Nh ti n l bn s qun ch vo hi th. Do , ch ch vo hi th vo-ra th no bn t ng qun ci kia. Bn s thy vn ca bn bin mt hi no khng hay. Bn s thy tim mnh ha hon, khng cn p nhanh mnh na, khng cn nh b ai bp cht na,hi th iu ha v quan trng nht l lng mnh nh hn.

Tuy vy bn hy tip tc luyn th vi cp cao hn: va th va lm ci g cn bn tm mt cht nh lt rau, ra chn bt, lau nh, ra xe.vv.. Ri sau khi quen, bn li nng cao hn na nh khi li xe, d nhin l chy vi tc trung bnh thi hay chm mt cht cng tt khi cha quen.

Nu bn lm c iu ny th bn s vt ni bun kh trong vng vi pht thi. V ng th chng 10 lt th vo ra l bn ti cng thin ng ri.hihi.

Thc cht ca cch th ny l t k m th, l bt no hot ng hay ngng ngh theo mun, l khng cho no lm nhng vic v ch hay c hi cho no (m thm xy ra thng xuyn),l tit kim nng lng cho no. T bn c th iu khin no lm nhng vic cn lm (hc bi,lm bi,tinh ton chi tiu, tnh ton cng vic trong s lm .) v ngh ngi khi khng cn cn lm vic na. Mi khi s dng tr c nhiu, cm thy mi mt, bn nn ngh v th nh th vi pht, nng lc tr c bn s phc hi.

Lc ny bn c th iu khin no hay tinh thn bn nh iu khin mt bng n: bt On (m) hay bt OFF (tt) rt d dng.

Bn nn nh rng,nhng nghin cu gn y ca khoa hc cho bit khi bn c cm xc xu (bun,gin,ght,cm th) l no bn s tit ra c cht gy hi cho c th. iu ny ng y bit lu: Gin hi Can, S hi Thnvv.

Vy th cch th ny khng ch gip bn an bnh tm hn m cn gin tip gip bn gi sc khe th xc. Ti sao khi lm vic tay chn mi mt bn c ngh mt m bn khng cho no ngh mt nh?

Bn c th c nghi vn: Vy ri mnh s nh khc cy mc, nh cc sao?

Khng, sau khi rn luyn thnh cng bin php ny,bn ch dng n khi c ci g lm cho tim bn b tht li, lm cho hi th bn hn lon, lm cho ngc bn nh ng cng, lm cho u bn b nng ln, lm cho mu bn b si lntm li l nhng g lm cho bn au lng,tc gin... m thi. Hoc khi bn mi mt tinh thn sau thi gian lm vic,hc hnh.

Cn li th.ti g li vt b cm gic hnh phc khi nh n n ci ca ng b,cha m,con, chu, ca ngi yu(nu bn ang yu),ca ngi bn tm giao, ca mt hnh ng p bn chng kin trn ng phvv.

h tr cho mc ch thanh thn trong mi tnh hung ny, bn c th suy ngm thm nh.

- Hnh nh ai cng c ni kh ring, khng ring g mnh.

- Hnh nh khng ai thot c bnh hon, tai nn v ci cht.

- Hay khng bng hn.

- Hnh nh ngi giu cng khc.Hnh nh ngi n xin cng c nhng ting ci khoi tr.

- Thch Ca cn b kit l, Jesus cn b ng inh, Khng T th bn ba c i khng yn thn.mnh u c bng my ng ??!!

- Hihihi.

Lng y T Minh,Hc Mn,24-12-2009.

c ng bi T Minh vo lc 17:05 0 nhn xt

Gi email bi ng ny

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=3671401146319864038&target=blog" \o "BlogThis!" \t "_blank" BlogThis!

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=3671401146319864038&target=twitter" \o "Chia s ln Twitter" \t "_blank" Chia s ln Twitter

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=3671401146319864038&target=facebook" \o "Chia s ln Facebook" \t "_blank" Chia s ln Facebook

Th su, ngy 04 thng hai nm 2011

HY O HUYT P HAI TAY V GII QUYT NGAY KHI C CHNH LCH.

Huyt p l s liu quan trng nht trong cc s liu sc khe v n biu th sc khe ca h thng tim v mch mu. Cc loi bnh khc cho d kh tr i na cng cn cho thi gian y hc tm cch khc phc.Tim mch m c vn th i khi n nh gc mt c th khe mnh tr trung ch trong vi pht ng h v y hc khng kp tr tay.

Mt trong nhng nguyn nhn khin cho nhiu ngi b tai bin d c khm sc khe nh k u n l tnh trng chnh lch huyt p hai tay.

Vit Nam hin nay, thi quen o huyt p ch mt tay kh ph bin. Ty theo v tr c sp xp c nh ca ngi o v ngi c o trong cc c s y t m bnh nhn ch c o huyt p bn tay tri hoc phi m thi. Nu i ni khc th li c th c o HA tay bn kia. V vy BN thng hay pht biu rng ch ny ni l HA cao bt ung thuc, ch kia li ni l HA bnh thng.. Thc cht l sao? Sao li c s bt ng gia hai ni nh vy?

Vn bit rng o HA bi 2 ngi khc nhau, bng 2 my khc nhau, thi im o khc nhau th tr s HA c th khc nhau. Nhng kh c th chp nhn s chnh lch xa n mc bc s phi a ra hai ch nh mu thun nhau n th.

l v c nhiu trng hp BN b tr ngi mt bn vng ng mch cnh tay-u. Khi mt bn b tr ngi th no bn b thiu mu, lp tc n gi tn hiu v tim yu cu tim tng cng mu cho n. Tim nhn lnh, th l co bp mnh hn bn no b thiu c mu hot ng. Th l cnh tay bn kia v tnh b nng cao p lc mu to ra s chnh lch HA hai tay. Chnh xc hn na l chnh lch huyt p hai bn cu no.

Th l h ung thuc HA th bn ny bnh thng m bn kia li b h thp,ng nhin vic t iu chnh li xy ra; c th HA khng th n nh c. V r rng vn khng c gii quyt ng.

Th l BS i thuc hoc BN i BS. C thcho n khi BN chn nn hoc l l vi hin trng HA ca mnh.

Nu ch o HA mt tay, tnh hnh ny s khng c pht hin. Th l, mt ngy no BN b tai bin, tht l oan ung!!

Lm th no ngn nga tnh trng ny? l phi o HA cho c hai tay tri v phi. Nu thy hai tay chnh lch nhau hn 10 s th cn o li mi bn 2 ln. V c khi BN hi hp khin HA th hin khng ng. o tay ny ri tay kia, lp li quy trnh 2 ln nh th th BN s gim hi hp v HA c th hin tng i ng vi th trng ca h. C khi o xong lt th nh th HA hai tay gn nh nhau.

Nhng nu tr s HA 2 tay chnh nhau hn 10 s th lm sao?

Bn hy lm nh sau:

Day vi du b TIU VIM KH (156 -+, 38 -+, 7 -+, 50, 37, 3 -+, 61 -+, 290 -+, 16 -+, 26), sau dng cy co nh co vng sn cn, vng n ng cng bn tay c HA thp hn (vng gia 2 mt v gia hai u lng my). Nu khng c cy co mini th bn c th dng u que d qut hai ni ny nhiu ln cho n khi thy da vng ny mm mi hn). n y, o li HA bn s thy tr s 2 tay s bng nhau hoc s chnh lch gim r rt. Nu tnh hnh khng c ci thin l bn gp mt trng hp phc tp ri . Hy chuyn BN n c s y t h gii quyt nu bn cha kinh nghim gii quyt.

y, ti a ra v d HA tay tri l 120/70, HA tay phi l 150/70 (chnh nhau 30 s). Phn b huyt l c nh, ch thay i vng sn cn v n ng cho ph hp vi bn c tr s HA thp m thi.

c ng bi T Minh vo lc 20:59 0 nhn xt

Gi email bi ng ny

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=5097042101122652340&target=blog" \o "BlogThis!" \t "_blank" BlogThis!

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=5097042101122652340&target=twitter" \o "Chia s ln Twitter" \t "_blank" Chia s ln Twitter

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=5097042101122652340&target=facebook" \o "Chia s ln Facebook" \t "_blank" Chia s ln Facebook

Th t, ngy 02 thng hai nm 2011

CHN BNH BNG MY O HUYT P.

Khi khm bnh v cha bnh cho mt bnh nhn. Nu nm vng s o huyt p v tnh hnh tim mch ca h, chng ta s rt an tm.

Bi vit ny trinh by nhng kinh nghim ca ti sau thi gian di nghin cu:

Huyt p cao l mt bnh chng phc tp v thng gy nguy him cho ngi bnh. Ti rt th v khi nghe BS Bi Xun Vnh pht biu trong chng trnh Sc khe cho mi ngi ca HTV rng: huyt p cao l mt bnh nguy him v nham him. Nguy him v c th gy t t, nham him v n thng hay gi v sng chung ha bnh vi bnh nhn ri nh mnh t ngt khin ngnh y i khi cng i ph khng kp, cha k n c th im lng khng bo hiu g c cho n khi bnh nhn b gc ng.

Huyt p nh th no ch c th xc nh bng my o huyt p. Bt mch ca ng y tuy c th phng on nhng khng th chnh xc c. V th, ti lun o huyt p cho bnh nhn t ngy. bit cch o HA.

Qua thi gian, ti c mt s kinh nghim dng my o HA chn on pht hin sm mt s bnh l v tim mch cho bnh nhn. Nht l vi cc bnh nhn lao ng, khng my hiu bit v cng khng my quan tm n sc khe nu bnh tnh khng hnh h h (ti vn theo ui cha bnh t thin hn 24 nm nay, hu ht l bnh nhn ngho).

Nhn thy pht hin ny tuy nh nhoi nhng qu gi cho mi ngi nn ti mnh dn a ln y. Ai thch th dng hu gp phn bo v sc khe cho bnh nhn v gim thiu tai nn ngh nghip cho nhng ai l m ngh cha bnh nh tui(!!!!).hihihi.

Trn nguyn tc, huyt p k (HAK) ch o huyt p l p lc mu tc ng ln thnh mch mu.

Mu l mt hn hp gm lng l huyt tng v c gm cc huyt cu (hng cu, tiu cu, bch cu).

Tr s huyt p,l p sut ca ging mu c hnh thnh bi:

Sc co bp v gin n ca tim (trng lc tim). Co bp to thnh tm thu, gin n to thnh tm trng.

nht ca mu: gm long hay nhy nht ca huyt tng (lng cht bo c trong huyt tng, cc cht khc ha tan trong huyt tng), v t l c/lng ca mu (s lng ca cc huyt cu/huyt tng).

S trn tru hay sn si ca lng ng mch.

sn chc ca c bp v cng (khc vi n hi ca thnh mch) ca ng mch cnh tay trn. Hai yu t ny nh hng rt t nhng c gp phn trong tr s ca huyt p. L thuc c a mi ngi.

y chnh l cc hin tng thy ng lc ca ging mu trong c th. Mi thng s va nu u th hin ln trng thi hot ng ca cy kim my o huyt p.

Ngoi ra trng thi hot ng kim ng h ca HAK cn th hin vi ngha khc ca tim v ng mch: tnh hnh van 2 l tht tri, van ng mch ch,tnh hnh ca thn kinh tim (nhp p, tc tim co, bin tim co-gin).

Da vo quy lut ca thy ng lc hc v c cu ch to ca HAK ti c cc nhn nh sau:

Khi ti hi cng phng (nguyn tc l kim HAK phi tr s 200 n 220) ln c bp cnh tay trn ri ng mch khin mch mu xp lp, khng cho mu i qua. Khi x hi; lc u p sut ti hi thng p sut mu, cy kim khng b tc ng nn tut dn u xung tr s thp. Trong khi , tim vn co bp v gin n theo nhp ca n. Khi ti hi b x kh, p sut h dn n mc ngang bng vi p sut ging mu th cy kim bt u b tc ng. N khng li mt cht xu ri mi tut tip. Nhp tim k tip th v ti hi vn tip tc x kh nn nhp co bp ny, p sut ti hi bt u thp hn p sut mu, do trc khi tip tc tut xung kim b tc ng lui li (hnh thnh tr s huyt p tm thu) mt khong cch tng ng vi s trng n ca ng mch v bin tim co, mu bt u i qua n ng mch quay c tay. C th cho n khi kh trong ti hi khng cn ln ng mch (thng qua lp c bp) ta thy kim khng cn b git lui m tc tut cng chm hn, hnh thnh tr s huyt p tm trng. Lc ny ging mu i qua t do khng gp lc cn tr no na.

Trn nguyn tc, khi o huyt p phi dng ng nghe nghe ting ng ca p sut mu p vo ti hi. Nhng trn thc t, v o nhiu ngi lin tc khin tai mnh b au, cc y t kinh nghim khng eo ng nghe m bt mch c tay theo di. Ti cng khng eo ng nghe nhng khng bt mch m ch theo di s hot ng ca kim ng h HAK. Thot u cng ch v s au tai thi. Mt thi gian sau ti nhn thy s hot ng ca kim HAK trn cc bnh nhn u khc nhau. Ch kho st mt thi gian di, kt hp vi cc chn on cn lm sng nh in tm (ECG), Siu m mu (Doppler) ti c cc kt lun sau:

1- Kim khng li 5 nhp tr ln trc khi git lui: a s l bnh nhn c b thiu nng mch vnh tim. Khi kt hp vi xem li ca ng y, nu thy li bu (thn li to b ra chon gn ht ming) v cht li nht, ng thi kim khng 7 nhp tr ln th a s l thiu mu c tim. Ti khng dm khng nh kt lun ny ng 100% (v c lp nghin cu v khng dm chc l mnh c th gp ht tt c cc kiu ca loi bnh ny) nhng hu ht l ng, nht l sau ny c phng tin siu m mu 3 chiu (Doppler). Trong mt ti liu v tim mch, GS Alain Carpentier c nu 0,5% bnh nhn thiu mu c tim khng c triu chng lm sng (nng ngc kh th,au tht ngc lan ln c u v ra cnh tay) v cng khng th hin trn ECG m ch th hin trn siu m mu m thi. Cho nn tuy kt qu ECG bnh thng m c hin tng ca HAK nu trn ta cng nn khuyn bnh nhn i siu m mu tim loi tr hoc xc nh c ang mc cn bnh nguy him ny hay khng.

2- Kim git lui c hai giai on khc nhau: giai on u ngn, giai on sau di hn l c h van 2 l. Kinh nghim cho bit t l ngn/di = l van h . Nu BN km thm hin tng thnh thong phi th di cho d chu th thng c h cc val bn tim phi : val Tnh mch ch, val ng mch phi hoc val 3 l. Mun bit chnh xc val no th cn siu m mu tim.

3- Khong git lui ca kim ngn t 3mmHg (thy ngn) tr li, a s l bnh nhn thuc th Dng suy. Ti t tn l Huyt p m Chng.Mt nc nh trn mt ng h HAK c gi tr bng 2mmHg.

4- Khong git lui ca kim di t 4mmHg tr ln, a s l BN thuc th m suy.Ti t tn l Huyt p Dng chng.

5- Khong git lui ca kim nm trong mc t 3mmHg n 4mmHg, a s l BN cn bng v m Dng.

6- Kim git lui lc nhanh lc chm, lc ngn lc di, c lc b nhp l thn kinh tim ca BN c vn .

Tuy khng dm khng nh chnh xc 100% cc nghin cu ny, nhng nh ni cc kt lun ny gip ch khng t cho chng ta. Mong tt c qu v khng b qua.

c ng bi T Minh vo lc 08:58 0 nhn xt

Gi email bi ng ny

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=4482013604394584754&target=blog" \o "BlogThis!" \t "_blank" BlogThis!

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=4482013604394584754&target=twitter" \o "Chia s ln Twitter" \t "_blank" Chia s ln Twitter

HYPERLINK "http://www.blogger.com/share-post.g?blogID=1225377328538892382&postID=4482013604394584754&target=facebook" \o "Chia s ln Facebook" \t "_blank" Chia s ln Facebook

Th nm, ngy 13 thng mt nm 2011

GIO N DC-KLP 2010

VI LI TM S.

Cng cc bn.

Ti n vi Din Chn iu Khin Liu Php mt cch rt tnh c. Tnh n nay l 16 nm l 1 thng (7 7 1986). Ti vo sau mt s anh ch em v trc mt s khc. iu c l khng quan trng cho lm. Quan trng l.ti yu thch DC mt cch nng nn v dai dng. C l v liu php ny qu hay, qu tuyt. Sut thi gian qua gn nh ti khng dng thuc trong iu tr cho bnh nhn . D rng vi mt vi loi bnh c tnh nguy him, ti c ng cho bnh nhn kt hp vi thuc nhng rt him.

T mt ngi khng bit g v y hc, ti vo mn phi. Qua thi gian, ti nghim dn dn nhng yu l ca mn DC. Qua nghin cu l thuyt (DC-KLP v y l ng Ty y) v thc hnh DC ti xy dng v thnh cng nhng phng thc iu tr nhiu loi bnh tng chng kh chm ti.

Ti cn nh ln u tin ti dng DC l cho chnh bn thn ti. Sau ba ngy c sch v ngi xem thy Chu cha bnh . Sng ch nht n ti b nhc u sau khi i chi v. nh ly thuc ra ung nhng cht nh ang hc DC. Th xem ra sao. Th l ly ngay salonpas, ct dn vi huyt. Chng 30 pht sau, u ti nh hn. T thnh cng ban u ny, ti trin khai cha bnh cho tt c ngi thn, bn b. Thi gian u hu ht l thnh cng !!!! n mc ti tng rng cha bnh khng kh !!?? V c nhng ca bnh ko di my nm, iu tr nhng thy thuc m khi nghe tn h ti hong hn v h thnh danh t lc ti cn h mi cha sch, vy m dng DC cha c vi ln bnh khi hn ?? n mc ti tng rng DC l v ch thin h !! Sau ny mi bit vn khng nh vy !!!

Ti c thy Chu cho xung ni sau 4 thng hc v t thc hnh nh. Vo cng tc ti Trung Tm DC, ti mi bt u thy kh. Bnh trm ngn kiu cch, bnh nhn cng chng ai ging ai. p dng kinh nghim bnh nhn ny cho bnh nhn khc c lc thnh cng c lc thua m m chng hiu ti sao !!?? Tn bnh khng rnh, c ch bnh nguyn nhn bnh li cng m tt !! Mc d vn c nhng thnh cng ngon mc nh va ni, nhng rt nhiu lc thua trng tay, m khng hiu ti sao !!

Thy Chu ch dy DC cn th.ng l i nu khng mun ni l ng d ng vi tt c cc mn phi khc (giai on ) n ti v mt s anh ch khc phi ln i hc thm v Chm cu v ng y !! Hc xong mi cho ng hay. Tuy nhin hc g th hc ti vn lm DC. Ch c khc l vn dng nhng y l ng v Ty vo DC iu tr cho bnh nhn ch khng hn ch dng thun ty theo sinh huyt hnh hay ng ng...vv.. Nu c phi hp huyt Th chm th cng theo nguyn tc sinh huyt. C ngha l vn dng nguyn l ca Din Chn vo cc phng php iu tr khc.

Ti tham gia t hun luyn t nm 1987 v nhn vai tr t trng T Gio V t . Son gio trnh, t chc lp theo ch o ca thy Chu. Nm 1988, ti bt u thy s cn thit trong vic ph bin kin thc y l cho hc vin nhng khng c thy Chu ng h. L do nh vy th chng trnh hun luyn ko di qu, khng bo m vic ph bin rng phng php cho mi ngi.

Mt hm, 1993, sau khi ti i Nga v ti c thy Chu gi vo v gi cho php dy ring cho nhng hc vin no c nhu cu.Ti bt u ph bin kinh nghim theo cch ring ca ti : kt hp y l ng Ty y vo Din Chn . Lc u , ti ch nhn dy nhng hc vin theo hc lp c bn Trung Tm, ti ch dy phn ring ca ti m thi. Chng trnh ny ko di hn ba thng (khong 80 tit hc). Nhng cng ch c nhng iu c bn nht ca ng Ty y v chuyn su v Din Chn m thi. Tht ra, chng trnh ny cha chn tr tt cho mi trng hp bnh l, nhng tm hn ch sai lm trong chn on v iu tr .

n nay, chng trnh ny c thc hin gn 10 nm. Ti dy khng nhiu v bn vic iu tr qu nhiu nhng c iu an i l nhng anh ch em do ti hun luyn u vng vng , thnh cng v hu ht u ang theo ngh Din Chn lin tc t n nay.

Bi ging ny c ti bin son li, c cp nht nhng kinh nghim ring mi nht. L tm huyt ca ti trong hn 16 nm hc v lm Din Chn . Cha tha mn lm v chng trnh ny, nhng thi gian c hn v yu cu cp bch, ti tm thi c kt c ti liu hng dn cc bn. Mong cc bn thng cm cho nhng g m cc bn cho rng thiu st.

Lng y T Minh. Thng 11-2002.

Thng 8-2010, nhn li mi ca L.y. ng Vn Ton, ti n Hi Phng bi dng v DC cho cc thnh vin CLB/DC y. Sau li n H Ni, Bc Ninh, Thi Bnh. Nhn thy cn b sung, chi tit ha hn ni dung tp sch ny, nn ti bin tp li v b sung cc bi vit mi cp nht cc kinh nghim mi v l thuyt cng nh thc hnh. Do c n bn ny mong gip ch thm cho cc bn.

H Ni, 15-11-2010.

CCH S DNG TI LIU

Vi iu cn nh khi c tp sch ny:

- Ti liu ny l kinh nghim ring nn vn cn dng km vi cc ti liu c do Thy CHU xut bn. C th cn nht: DC-KLP, Bi ging DC-KLP, Tuyn tp Hnh, Hnh huyt chnh din v trc din.

- c k mt ln cho n ht bit i cng ti liu ny trnh by nhng g.

- Cc phc (cng thc) iu tr trong ti liu ny lun lun mang tnh tng qut. Do khng my khi dng ht tt c cc huyt trong mi phc . Nn d sinh huyt da theo phc nu, ch dng cc huyt c bo bnh, nhng huyt cn li khng cn dng. Qua cch ny dn d cc bn s quen vi c ch bnh l v tm thy nhiu th v qua nhng trng hp cng tn bnh m chng ai ging ai. T , bn s t rt ra c nhng kinh nghim bn thn. l vn ling qu nht cho mi ngi m khng ai c th truyn dy c v bn s nh mi khng qun.

- Nhng b huyt ny khng ch c s dng mt m c th s dng cc b phn phn chiu khc nh bn tay, bn chn, lng, bng. Vn l bit xc nh huyt cc ni ny.

- Vi nhng anh ch em c y l vng, qua cc bi ny ti hy vng s gip hiu su hn v say m hn mn DC-KLP, d rng ti khng gii thch l php phng huyt. Vic l gii xin hn dp khc.

- iu quan trng nht trong chn on l phi tm cho ra bnh thuc m-dng, kh huyt, hn-nhit, h thc, trong Bt Cng.

Ti khng c tham vng gip cc bn tr thnh thy thuc gii nhng mong rng qua tp sch mng ny cc bn vng bng hn v hn ch sai lm khi iu tr cho mnh v cho gia nh

T Minh

Mobile: 091.8388718

E-mail: [email protected], [email protected] CHN-IU KHIN LIU PHP

YU QUYT

T Minh.

Mun gii Din chn iu khin Liu php cc bn cn thc hin cc iu sau y:

1- Thuc lu tt c hnh cn bn, cc h thng phn chiu ph (l cc hnh cha c v ra).

2- Thuc v hiu cc thuyt DC v thuyt KLP mt cch tng tn ch khng ch hiu ngha ca cu vn. iu ny cn thc hnh nhiu th mi thm su c.

3- Nm vng tc dng v k thut s dng , thao tc nhun nhuyn tt c cc dng c cha bnh.

4- Bit nhng im i cng c bn v gii phu c th, sinh l v bnh l ni khoa ty y.

5- Nm vng l thuyt c bn (nh m Dng, ng hnh, tng tng, bt cng, bt php ), bnh l ni khoa ng y.

6- Hc thm cc phng php chm cu, bm huyt khc nu gii cng tt. Tm cho ra s ging nhau v s khc nhau gia chng vi nhau cng nh gia chng vi DC.

7- Bn cn nh LINH NG khng c ngha l ba bi, v vy cn tn trng cc nguyn tc chn on, iu tr khng gy phn ng xu cho bnh nhn .

DC-KLP d sao cng ch l phng tin chn on v iu tr trong y hc dn tc nh cc phng tin khc (Th-Nh-u-Th-Tc chm, Chch l, Thp ch o.vv..) , y l gm c th hc, sinh l hc v bnh l hc mi l nn tng . Nn tng vng chc th mi pht huy tc dng ca phng tin c, bng khng rt d gy ri rm khi cha bnh m khng chn on, khng bit y l, khng c nguyn tc. iu ny khng ring g cho DC-KLP m cho mi phng php y hc.

Tnh i chng ca DC-KLP l khng th ph nhn, nhng cn bn y l li khng th khng hc. Nu khng, s c lc ta hi bnh nhn m khng h hay bit. cng l mt ci ti trong ngnh y vy. Mong c s ng cm ca cc anh ch em say m Din Chn.

TP H Ch Minh 21-12-1998.

MT S KHI NIM

THNG GP

Trong ng y, thng gp nhng cp khi nim m tuy gii thch kh chi tit nhng hnh nh vn t ra kh hiu vi ngi sinh sau mun nh chng ta nh chnh kh- t kh, ch kh khch kh v.vBi vit ny trnh by nhng ci hiu ca ring ti theo ngn ng ca hin i v b sung nhng nhn thc ca ring ti trn lm sng nhm gip cc bn hiu phn no cc ngha . Mong rng khi c sch ng y cc bn s thy d hiu hn.

Ch Khch : ch l c th, khch l yu t bn ngoi tc ng n c th. Thi tit v Thc phm l khch thng gp ca c th. Khi ta n vo, thc n vo b my tiu ha nhng vn cn l khch. Ch khi no tt c thc n c tiu ha, hp thu ri bin thnh dng cht d tr trong tng lai to thnh cc loi t bo, l mt thnh phn ca c th, th chng mi bin thnh ch. V th l ch th khng bao gi gy bnh. Ch c khch mi c th gy bnh, nhng khng phi khch no cng gy bnh. Ch nhng khch khng ha hp c vi c th hay c th khng chu ng ni khng ha gii ni mi gy bnh (tm b qu mc c th khng sc bin i thnh dng cht), thng c gi l T Khch (khch t) .

Chnh - T : Chnh kh l kh cn bn ca c th cn gi l nguyn kh. T kh l kh ca khch khng ha hp vi Chnh kh. Trn nguyn tc l ch khi no Chnh kh suy yu th t kh mi xm nhp v gy bnh c. Nhng trong thc t khi T kh qu mnh th d Chnh kh khng suy c th vn c th b nhim bnh c. Nh ta thy nu bng nhin a mt ngi t x nhit i sang a cc m khng c o qun chng lnh th d ang khe mnh th no i na h cng phi b cm lnh.

Biu L : Biu l bn ngoi. L l bn trong. Mi tng quan ny cng nn hiu mt cch tng i rng ch khng ch l mi lin h tng ph vi nhau. Nh ta thy nu da l biu th c l l. Tng l l th ph l biu. Kinh l biu th ph tng l l. Lc l biu th kinh l l. Vi DC-KLP th gn nh biu v l l mt. V ta bit khi bnh nhn b au d dy ( l ) hay au theo kinh V ( biu ) hay au cnh ngoi i ( biu ) th cng u cn huyt 39 trong chn on v iu tr . Cc huyt cn li - trong mt phc iu tr no - c dng cha theo c ch m thi.

Tiu Bn : Tiu l ngn bnh, Bn l gc bnh. y l mt cp nim kh l th v rc ri. V. cng rt tng i. Vi nhng bnh n gin mi mc th thng gc ngn l mt v thng l bnh thc. Nh thng thc gc hay ngn g cng V, ho khi b cm th gc hay ngn g cng Ph . Nhng vi nhng bnh mc phi lu th c th ngn v gc cch nhau.xa lc xa l. Thm ch c nhng trng hp bnh mi pht cng c GC v NGN cch xa nhau. Ngoi ra tnh tng i cn th hin ch mt GC ny c th l NGN ca mt GC khc.

Th d nh trong bnh Thn kinh ta. Ngn ca bnh l au chn, gc ca n l mt thng tn ca vng tht lng cng. Nhng bnh l tht lng cng c th l ngn ca mt trong nhng gc : vim khp, vi ha, long xng, chn thng, hn thp kt t, nhit thp kt t..v.v.. Trong chng nhc u (ngn) th gc c th l huyt p cao hay kinh mch b tc v nhiu gc khc na, nhng HA cao cng ch l ngn ca mt trong cc gc : hp mch mu thn, ri lon lipid mu, thiu mu c timvv. Cn kinh mch b tc th c th c gc do Dng h, m h, Hn t thc b, nhit t thc b hay cng c khi do tn thng kinh mch v chn thng c th hay tinh thn .

Tuy nhin cc bn cn bit rng ng v Ty y c ci nhn kh khc nhau v gc v ngn ca bnh. Cn thn ko c s nhm ln khng ng c.

Nhng theo kin ca ring ti th ch c hai GC: TIN THIN BT TC v HU THIN BT CHNH. TIN THIN BT TC l di truyn bm sinh ca mi ngi tip thu t cha m. HU THIN BT CHNH l nhng hot ng sai lm ca th xc v tinh thn. Sinh hot th xc nh lao ng, vui chi, n ung sai lm vi cng cao hay ko di khin c th h hao lch lc m sinh bnh. Do sinh hot tinh thn khng ng nh cho nhng nim khng tt (nng gin,hn th, lo lng) kch ng c th thng xuyn khin tinh thn b bnh hoc c th b nh hng sinh bnh .

V th, GC bnh su xa nht l y. Mt c th b khim khuyt v gene th c l ch c mai sau khi liu php gene hon chnh may ra mi cha tt c. R rng mt cu th khng th ht chn thng gi khi cn mi ra sn thi u, mt bnh nhn b ri lon tiu ha khng th khi bnh khi mi n ung thc sng - lnh. Mt bnh nhn b d ng khng th khi bnh nu c mi tip xc vi khng nguyn. Nh vy tr bnh l tr vo c th bnh nhn (gene) v sa i cc sinh hot khng ng cho bnh nhn th mi gi l c TR GC c .

H Thc : H v Thc l hai hin tng lun cn chn on ng trong ng y. Chn on H-Thc c ng th vic iu tr mi thnh cng an ton v rt ro c. Cc sch thng nh ngha H l suy yu thiu ht, Thc l d tha. Ta thng gp cc nim : H l chnh kh h, Thc l t kh thc c ngha v chnh kh suy yu nn pht bnh (thuc h chng), v t kh mnh gy ra bnh (thuc thc chng), y l nguyn tc phn nh h thc . Bnh lu thuc h, bnh mi pht thuc thc c ngha bnh lu m khng tr dt th bnh bin chuyn phc tp hn, pht trin ra ngoi c quan th bnh ban u v lm c th suy yu dn nn chnh kh b h, bnh mi pht l do khch t qu mnh xm nhp c th m chnh kh cha h nn ch c t kh thc. Nhng theo ti th nim ny ch l mt kinh nghim tham kho ch khng phi l nguyn tc, v trn lm sng c nhiu trng hp khng ng .

Hon Cp : Hon l thong th, Cp l gp rt . Trong ngn ng hin i chnh l bnh mn tnh v bnh cp tnh. Mt ngha khc l bnh khng nguy him v bnh nguy him tc thi. Mt ngha khc na l bnh iu tr bnh thng v bnh thuc din cp cu. Ta thng gp nim hon tr bn, cp tr tiu (bnh ha hon th tr gc , bnh cp bch th tr ngn), y l mt hng dn chnh xc v tuyt vi cho chng ta trong ng y. Kh khn ch l cn phn nh Gc v Ngn cho ng cha tr kp thi cho nhng bnh thuc loi cp.

Lng y T Minh.

NGUYN TC CHN ON

Quan im chung:

Tn dng mi phng php chn on hin nay ca y hc .

Sinh l hc Ty y, Bt-cng v Tng-tng ca ng y l cn bn nghin cu bnh l, l ch tiu chn on v theo di din bin iu tr .

Cc phng php chn on :

I -/ Ty y: o huyt p, s ,nn, nghe, hi v bnh, xem cc kt qu cn lm sng.

II -/ ng y:

1. Vng: dng mt quan st cc biu hin sinh l bnh l ca bnh nhn .

ng tc: chnh xc, dt khot, lanh l l bnh thng. Qu mc l Dng chng, yu km l m chng.

nh mt : linh hot, c thn l bnh thng . Long lanh pht ra nh l l dng, l v nh l m.

Da d: ti nhun, u mu, mu sc hp l l bnh thng. Mu sc qu bng l dng. Xn mu l m (d vng hay ).

Nim mc : hng u (nn xem nim mc ca tr khe mnh t 7 n 15 tui bit tiu chun). Xem thm bi Chn on v Huyt Kh.

2. Vn : dng tai nghe kho st:

Cch din t tng r rng mch lc chng mc (ty trnh ca mi ngi ) l bnh thng. Din t nhanh, nhy on l dng. Din t chm, tng trng lp l m.

m lng va phi ph hp vi bi cnh xung quanh l bnh thng. Ni ln, ni nhanh l dng. Ni nh, b lng cu ni l m. Tuy nhin, kha cnh ny cn ty thuc n np ring ca mi ngi.

Hi th u n nh nhng l bnh thng. Th nhanh mnh l dng. Th chm qu nh l m. Nu ngi c tp kh cng th cch chn on ny khng ng.

3. Thit : dng xc gic kho st bnh l bng cch s nn, xem mch.

Da tht c gn sn chc ph hp vi th trng l bnh thng. Co cng l thc, lng nho l h .

Nhit : bnh thng da ton thn c nhit tng i u. Khi c chnh lch khc l l c bnh. Ni bt thng nht l ni c ri lon: nng l nhit, lnh l hn. Cch ny chn on tng qut ton thn. i vi ni ang b au (cc b) th c thm ngha khc : ngoi yu t hn nhit ra cn c ngha nng l do kh b huyt , lnh l do kh thiu, huyt km .

Mch : xem thm v sch mch l . Cn lu nguyn l v mch cng thng nhc nh : x mch tng chng. V vy mch cng ch l mt yu t tham kho ch khng l yu t quyt nh. D nhin vi ngi gii mch th vic sai lm t khi xy ra, nhng nu khng ch kt hp vi Vng, Vn, Vn th khi sai lm s rt nghim trng.

4. Vn : theo ti, y l khu quan trng nht v cn linh ng kho lo vn dng kin thc tng qut (ngoi kin thc y hc) v suy lun trn thc t.

Cn quan tm n cc tnh hnh sau :

Ngh nghip: ngh nghip rt nh hng n sc khe. Nht l t th lm vic v tinh thn khi lm vic.

Ni c tr thng xuyn lu di (mi trng sng).

Thi quen sinh hot : cng lm vic ngh ngi, nhng th vui chi, thi quen tm ra.

Tnh hnh n ung. Cnh gic vi cu tr li n ung bnh thng. Phi hi cn k n mt ngy my ln, mi ln n bao nhiu, c ngon ming hay khng, c bit i bng hay khng? Ung mt ngy my ln, mi ln bao nhiu. Tnh c phn thc n lng nh canh, h tiuvv. Trung bnh mi ngi cn 1,5 n 2 lt nc mi ngy. Nhng cng cn ch n thi tit, vic ra m hi v vic tiu tin.

Hi v tiu tin: s ln i tiu ngy v m, lng nc tiu (khong 1,5 lt / 24 gi). Nc tiu hi vng, trong tro, mi khai nh m i l bnh thng.Trng l hn. c l c thp. au xt, d hay kh cc hin tng ny l triu chng chung ca nhiu bnh khc nhau, s cp n trong bnh thuc h Tit Niu.

Hi v i tin: my ngy mt ln. C mt s ngi hai ngy mi i mt ln u n nh th th y cng l bnh thng v h c i trng hi di. Tnh trng ca phn: cng kh hay nho ri, to hay nh, vng hay c mu khc. Cc hin tng ny s c cp trong bnh h Tiu Ho.

Ng: d hay kh vo gic, thng gic hay b tr gic, lc thc dy tnh to hay l . Nm u ng , ng kh thc dy l kh suy. t ng, ng d thc nhng ng li khng kh l kh thnh. Kh ng d thc v kh ng li l m-huyt suy. Xem thm bi Mt ng.

Vi ph n nn hi thm v kinh nguyt. Chu k u hay khng, chu k di (34 ngy) hay ngn (23 25). S ngy hnh kinh, hnh thc mu sc ca kinh.

Hi v thi im bnh tng gim, ma no gi no trong ngy bnh tng hay gim. Tng trong ma nng hay bui tra l nhit chng dng chng. Tng trong ma lnh hay chiu ti l hn chng m chng. Ni chung l yu t dng (nhit - to) hoc m (hn - thp) s lm tng thm bnh ng tnh vi n.

Hi cm gic:

- nhit: au , nga, mi , nng.

- hn: nhc, t, nng n, lnh. Ring trong bnh thoi ha cc khp tay chn, a m ct sng, cc t sng th cc triu chng ny khng c ngha hn m tuyt i. Cn xt thm bnh tng khi gp yu t m hn c xy ra hay khng mi c th kt lun c hn hay khng. V lun lun cc bnh ny lm bnh nhn c cc cm gic nu trn.

Tnh chu k kh lc (xem bi chu k kh lc v chu k 6 thin kh) nu bnh c quy lut v thi gian.

V Vn chn s c cp chi tit hn trong m t triu chng cc bnh.

III. D huyt :

L phng php chn on bng cch n cc huyt d tm cn nguyn ca bnh. Thc cht cch ny thuc Thit chn. Nhng trn lm sng n t ra kh c lp nu chng ta nm vng cc nguyn tc v nhun nhuyn k thut ca phng php. Ngoi DC-KLP ta nn vn dng thm kin thc ca tt c cc phng php (mn phi , trng phi) hin c nh Th chm, Nh chm, Th Tc chmvv.

Khi d huyt bng que d cn bit cc c im sau: khi vng huyt b cm cng l thc. Vng huyt b mm lm xung l h. Huyt b au mt cch bnh thng biu hin bnh nhit nhng cng c th l hn nh. au mt cch c bit khng chu ni l nhit. Khng au d dng sc rt mnh l hn nhiu (cn thn trng vi bnh nhn Tiu ng). Xem thm bi Chn on hn nhit bng huyt DC.

Khi d huyt bng ngi cu cn ch : huyt ht nng nhanh l huyt quan trng hn huyt ht nng chm. Va nng va but l hn nhiu. Va nng va nga l c nhit ln vo.

Nn nh chn on ng th iu tr mi ng v t c tai bin. M chn on bao gi cng kh hn iu tr. Do cn k lng trong khi chn on hn ch sai st. Vbao gi cng t hi rng hay l mnh sai ?, khi kt qu iu tr khng t nh mong mun. Khng nn p t rng do li ca bnh nhn vi phm v sinh hot hay n ung.vv mc d khng b qua yu t ny. Lun cn quan tm v tin cy bnh nhn sau khi by t quan im cn bit s tht v bnh chng din tin bnh. Khi chng ta tn trng v khng lm h s th bnh nhn s tn trng v thnh tht vi ta. Nu chng ta nghi ng li khai ca bnh nhn thiu chnh xc (v h ngoi ngnh Y nn i khi khng bit cch din t) th nn kho lo kim chng bng phng php d tm sinh huyt hoc c cu hi khc li nhng cng xc minh, khng nn la ry. Nn n cn vi cc bnh nhn thuc gii bnh dn trnh vn ha thp. Gii ny thng n s thy thuc hoc c tm trng ngi ngng nn khai bnh hay sai,st.

Lng y T Minh 1993.

CHN ON M DNG, HN NHIT

V H - THC.

Lng y T Minh.

A/- Hn Nhit:

Nhng triu chng ca hn nhit kh phong ph . Ty theo bnh m c cc chng khc nhau. Nhng mu cht vn l s a hoc s - nng v lnh, tng hay gim bnh khi c iu kin hn nhit tc ng . Cho nn rt gn li ta ch cn lu cc hin tng sau y:

1. Nhng hin tng bnh chng thuc hn: vi ton thn ta c s lnh, thch m, bnh tng ln khi gp yu t lnh. i vi cc b ta s vo vng c bnh thy lnh hn cc ni khc.

2. Nhng hin tng thuc bnh nhit: vi ton thn ta c s nng, a mt, bnh tng ln khi gp yu t nng. Vi cc b ta s vo vng c bnh thy nng hn cc ni khc.

3. Ni cch khc ta c mt bnh nhn c th tng trng hn hoc nhit v mc bnh chng hn hay nhit. Tng trng v bnh khng bt buc phi cng th loi.

Khng nn t cc cu hi c tnh p ch nh : h tri nng th bnh nng hn phi khng ? . V lc ny bnh nhn s d b m nh v hay tr li xui theo cu hi Phi, h nng l au hn M nn hi : Bnh tng khi tri nng hay tri lnh ? . Vi cu hi ny bnh nhn bt buc phi suy ngh v nh li mi tr li, th cu tr li s khch quan hn. Nu bnh nhn phn vn , ta nn khuyn khch bnh nhn v xem xt li v tr li sau. Khng nn hi thc, bnh nhn d b ri tr v tr li sai.

Ta thy, trong bnh Dng h, lun lun bnh nhn s lnh, da lnh. Trong bnh m h, bnh nhn lun s nng, da nng. m Dng u h th nng lnh u ght. Bin chu nng v lnh ca h rt hp. Cha ai thy nng hay lnh h ku nng hoc lnh.

Trn lm sng hi chng ton thn v triu chng cc b (ni c bnh) c khi thng nht c khi li khng thng nht nhau. V th cn chn on hai ln : ton thn v cc b.

1. Khi ton thn v cc b thng nht th ton thn s ci g th cc b tng triu chng theo khi gp ci . Th d: trong au khp, bnh nhn s lnh v khi tri lnh th khp au hn. Hoc bnh nhn s nng v khp cng au hn khi tri nng.

2. Khi ton thn v cc b khng thng nht th yu t nng v lnh ch nh hng ti mt kha cnh m thi. Hoc c khi nh hng tri ngc nhau. y s kh phc tp. V khp l loi bnh chng thng gp nht nn c nu lm v d in hnh, cc bnh khc cng suy lun tng t .

Ton thn m hay nng m khp lnh: thun ty l do khp b nhim lnh (khp rt lnh , y l bnh thuc thc xem phn h-thc di y) hoc do ton thn thiu mu hoc ch do khp b thiu mu (ti khp khng lnh lm nh trng hp trc , y l bnh do h xem phn h-thc di). Tuy nhin trn thc t cc loi ny hay trng hp nhau. y th khi tri lnh, khp s au hn. Khi tri nng khp li au t.

Ton thn mt hay lnh m khp nng: khp b nhim nng hoc nhim trng nh (nu nhim trng nng th c th bt buc phi st). Khi khp nhim nng th s gim bnh (au) khi gp yu t lnh. Nu l nhim trng th khp khng gim au m c khi cn au hn khi gp lnh !!

Trn thc t i lc chng ta s lng tng khi gp cc triu chng hn v nhit cng xut hin n ni kh phn nh l bnh thuc hn hay nhit. Hy bnh tnh xem xt. Ch n th trng bnh nhn v th trng l ngun gc ca mi vn . Mt th trng (chnh kh) vng mnh rt kh nhim bnh. Xem xt trong c th ni no lnh hay nng nht. Ni l ni ngoi t xm nhp gy b tc cho ton thn. iu chnh ni ny cho bnh thng li v iu chnh tng trng cho cn bng li th s ri rm nu trn s mt v cc triu chng s hin r hn. Trn lm sng nhiu khi ti ch iu chnh tng trng xong th bnh chng cng t bin mt.

B/- H Thc :

H l trng rng, suy yu, thiu thn. L bnh c nguyn nhn do suy yu hay thiu thn. Th d : suy nhc c th, suy nhc thn kinh, can dng h, thn m hV th khi ni n bnh thuc h l ni n tng trng ca bnh nhn hay mt tng ph no b suy yu hng hc. Nguyn nhn lm cho h th ty, c lc do bn cht t h , c khi do nguyn nhn bn ngoi tc ng.

Thc l y l d tha. L bnh do s d tha gy ra. Th d : cm lnh l do c th hp thu nhiu kh lnh nn b d tha kh lnh. Cm nng l do c th hp th qu nhiu hi nng sinh bnh. C th ni bnh thuc thc l do nguyn nhn bn ngoi tc ng vo khin c th khng chu ng ni m pht bnh .

iu kh nht l chn on ng v H - Thc v dng chng c th do dng vng c th do m h. m chng c th do m vng c th do dng h. Cn nh rng chng c th l chng ca tng trng c th l chng ca ring cn bnh m thi. Phi bit phn bit u l ca ton thn u l ca ring cn bnh.

Trn thc t, kinh nghim cho bit bnh thuc thc th triu chng mnh m, d di, n o, r rt. Bnh thuc h th triu chng nh nhng, du dng, phn pht, kn o. Kn o n mc i khi bnh nhn khng cm nhn c. Tuy vic chn mch s cho bit tng i r v bnh h thc nhng vic hc chn mch khng d. Cn s truyn th trc tip gia thy v tr. ng thi cn kinh nghim nhiu trong vic xem mch. V th trong thi gian qua, sau khi tm hiu v theo di ti tm ra hin tng nu trn. iu cn li l khi thy triu chng thc hay h th phi tm cho c v u m c triu chng ny. Ch cn bit cch t cu hi cho ph hp, kt hp vi c suy lun phn on, khm k theo tt c cc k thut khm bnh bit th vic chn on bnh thuc h hay thc tr nn d dng hn. Cn xem thm cc bi Chn on hn nhit bng huyt DC v Lm sao t t c ca ti.

C/- m Dng:

Trong ng y, m Dng l tng cng ca 6 cng lnh kia (hn , nhit, h, thc, biu, l). Ba cng thuc Dng l nhit (nng), thc(d tha), biu(bn ngoi). Ba cng thuc m l hn (lnh), h (suy yu), l (bn trong). C th ni khi mt bnh nhn xut hin triu chng ca ba cng thuc m hoc dng l c th kt lun bnh thuc m hay bnh thuc Dng. Trong cc y n, khi ngi ta ni dng chng c ngha l triu chng thuc Dng (chng nhit, chng thc, chng biu) - tng t cho t ng m chng. Nhng c lc ch c hai trong ba kha cnh thi, ngi ta cng ni l Dng chng hay m chng. iu ny do thi quen v khng nh hng g n kt qu chn on v thng l bnh n gin mi ni nh vy. Tuy nhin trong thc t th him khi triu chng li thun nht n nh vy m thng pha trn vi triu chng thuc m vi triu chng thuc dng. Nu bnh phc tp th bt buc ngi ta s ni k hn nh mt s t thng gp: h nhit (nng do h), h hn (lnh do h), biu nhit l hn (ngoi nng trong lnh), biu hn l nhit (ngoi lnh trong nng), biu h l thc (ngoi h, trong thc)..v.vHoc cn thn hn ngi ta s lit k y cc triu chng thuc m v thuc dng trc khi kt lun .

Tm li, Dng hay m ch l tng kt triu chng ca ba cng lnh th cp ca chng trong Bt Cng m thi. Tuy nhin ni nh vy l cng cha y v M v DNG cn l 2 thnh phn c bn ca c th. iu ny kh phc tp , xin c cp dp khc.

KT LUN:

Nh vy, khi chn on bnh ta lun cn chn on bnh thuc hn hay nhit, h hay thc cng lc c kt lun tng i v ng . Trong ng y th cn cn bit thm v biu (bn ngoi) v l (bn trong), nhng vi DC th hai yu t ny khng cn thit nn ti lc b. Xin xem thm bi Mt s khi nim thng gp.

CH THCH:

Dng chng: chng thuc dng gm c chng nhit, chng thc, chng xut hin bn ngoi.

m chng: chng thuc m gm chng lnh, chng h, chng thuc bn trong.

Biu chng: chng xut hin bn ngoi c th c th thy, s c nh cc bnh ngoi da, bnh vim khp

L chng: chng thuc bn trong l cc bnh chng ca tng ph nh vim gan, vim d dy, suy thn.

Chnh kh: sc lc tng th ca bnh nhn, sc mnh ni ti, sc khng. Cn c gi l nguyn kh.

T kh: yu t gy bnh nh vi khun, thi tit khc nghit, mi trng nhim, thc n khng hp...nn thng gi l ngoi t.

Bt cng: l 8 cng lnh (ging mi) dng trong chn on ca ng y, gm c m, Dng, H, Thc, Hn, Nhit, Biu , L. Rt n gin nhng bao trm phng php lun chn on ca ng y. Rt hiu nghim nu nm vng k thut chn on ny khi cng phi hp vi Tng tng.

Bi vit ny cha phi l bi ging v Bt Cng m ch nu ln nhng mu cht ca bt cng mong gip cc bn sau ny c c hi c sch ng y s d lnh hi hn m thi.

TP. H Ch Minh 1993.

CHN ON NHANH HN NHIT.

Chn on bnh thuc hn hay nhit l vic cn lm trc khi iu tr trnh sai lm. Vic ny va d dng va rc ri. D khi bnh mi pht hay bnh n gin. Rc ri khi bnh lu hoc bnh phc tp. Nhng nu cc bn nm vng nguyn tc sau ay th vn cng khng n ni kh. l cn tch ra hai phn ring bit: tng th v cc b.

i vi ton thn, ton thn s ci g l c th ang mc th bnh . C th ang b nhit th s cm thy s nhng yu t nng. C th ang b hn th s cm thy s nhng yu t lnh. Cc yu t nng hay lnh gm thi tit (nng ma gi bo), mi trng sinh hot (ngoi tri, trong nh, phng my lnh, nh bp), thc n ung (nhiu hay t nng lng).

i vi cc b ni c bnh c th (vim xoang, au thn kinh ta, vim d dyvv.) cng tng t. Nhng cng c khng t trng hp ngoi l, cn thn trng. Xin xem thm bi Chn on theo Bt Cng, Chn on hn nhit bng huyt DC.

Trong bi ny, ti cng hin thm cho cc bn mt phng php chn on hn nhit thun ty theo DC-KLP m ti tm ra sau nhiu nm thc hnh, c th ni rt chnh xc trong chn on cc b ni c bnh.m li d thc hnh v kt qu nhanh chng tc th.

Dng cy ln inh ln trn mt, vo vng phn chiu ni c bnh. Nu c hin tng au nh kim chm chch l bnh thuc nhit; bn s dng cy ln inh tr. Nu ni ln khng au th bnh thuc hn, phn chiu s bo nng vi ngi cu; bn s dng ngi cu tr. Nu ni ln bng ln inh khng au m ch au bng que d th hn nh, c th ch day hay co c xoa du tr bnh ch khng cn h ngi; trng hp ny h ngi cng c nhng hi mnh hn mc cn thit, rt d b qu liu gy phn ng ph khng tt.

Th d: bnh nhn au mng tri, ta dng ln inh ln cnh mi tri (phn chiu mng tri). Nu cnh mi tri au khi ln bng ln inh th mng tri ca bnh nhn b au do nhit. Nu cnh mi tri ca BN khng au, ta dng ngi cu d vng cnh mi tri ng k thut, vng ny s ht nng.

Mi cc bn dng th k thut n gin ny chn on v hn nhit.

Lng y T Minh.1993.

CHN ON V HUYT V KH.

Lng y T Minh.

CHN ON V HUYT

Chn on v huyt cn tng hp cc kha cnh sau:

1. Mu sc ca nim mc mt v li (cht li): hng u l tt. Nim mc mt v mi quan trng hn v c khi cht li biu hin bnh l ca tim. Cn xem xt nim mc ca tr khong t 5 17 tui khe mnh m ta bit ly chun. V mi th xem pha trong mi ni tip xc vi rng li (nu). V mt th chia lm hai phn trong v ngoi ca mt trong m mt. Mu hng phi tri u. Nu c n mu vng l c thp, n mu nu l thiu oxy, c tia mu l c huyt . Nht hay trng l huyt suy. Trong nht ngoi hng l ch thiu mu. Trong nht ngoi l thiu mu c h nhit. ton b th hoc thc nhit (bn chn m) hoc thng nhit h hn (BC lnh). Vi trng hp ny sau khi gii quyt hin trng bnh xong (do thc nhit hoc do thng nhit h hn) ta cn xt li m mt bit tnh trng tht ca huyt.

2. Mu sc ca da, ti nhun ca da, mu sc cc mng tay chn. Mu sc cc ni ny cn hng nhun ti bng v thun mu.

3. o huyt p xem tr s v quan st khong lui kim, tc lui kim: thiu mu khi HA tm thu t 100 tr xung km theo hin tng lui kim t hn 2 mmHg (1 nc trn mt ng h) nhng cng c khi km thm kh km (chc nng km) hay dng km (s lnh,thiu sc bn). C phi hp vi cc yu t k trn. Cn xem thm bi Cch o huyt p trong Cc bnh thng gp.

4. Xem mch: mch v lc.

5. Xem xt v hin trng Th dch. Vic ny cn tham kho cc xt nghim Cn lm sng.

Tng hp cc yu t trn xong, phn tch quyt on v huyt tnh trng no: tng lng mu, thnh phn mu, c tp cht hay khng, cc ni tit t (cn xt nghim).

CHN ON V KH

ng y m t Kh kh phc tp v l thnh phn v hnh, ch nhn bit m khng thy c. Ch Kh ca ng y bao gm kh tri, kh ca thc n v kh trong c th. Chng thng c cp mt cch hn nhin nn i khi gy hoang mang kh hiu cho ngi mi hc.Tuy nhin theo ti, nu ni v Kh trong c th th Kh l chc nng cc hot ng ca cc c quan. Cn kh thin nhin do c th hp thu v s dng th cn quy v thnh phn ca Thin kh. Ni theo cch Ty y th Kh l h thn kinh ca bnh nhn. Th d: Ph kh suy l chc nng h hp km, V kh dng suy l chc nng co bp v V kh m suy l chc nng tit dch v ca d dy km, i trng kh suy l chc nng truyn tng km (nhu ng rut) lm cho bn.v..v..Tng t ta c kh ton thn suy tng qut l Nguyn Kh (Chn kh) suy l chc nng hot ng thn kinh ca ton thn km lm c th li nht, u oi, thiu linh hot. iu ny th hin qua trng thi hot ng ton thn v v linh hot ca mt v mt; trng hp ny thng c Ty y chn on l suy nhc thn kinh, l trm cm.

i vi cc tng ph th xem xt da theo sinh l ca chng nh gi . Vi ngi gii mch th vic chn on v kh khng kh. Nhng nu khng bit xem mch th vi vic pht huy cch t cu hi kho lo cng vi s quan st bng mt, c suy lun , da trn hin tng khc vi sinh l bnh thng ca tng ph ta vn c th chn on v kh cng khng my kh khn (bnh l chnh l s khc thng ca sinh l).

im khc bit gia Dng suy v Kh suy l: Dng h lun c s lnh, thiu sc bn mc d vn sing nng tch cc. Cn Kh suy th khng s lnh, ch li u oi nhng khi b p buc th sc lm vic vn bn b. Mun phn bit Dng v Kh th cn t cu hi theo hng ny.

Tm li, d hiu theo ngn ng hin i, theo ti th kh l thn kinh, huyt l th dch ca c th.

Bi vit ny l kinh nghim thc t v khng theo hn ng y m c i chiu vi Ty y. Do s hi khc vi cc ti liu ng y c.

TP. H Ch Minh 1993.

CHN ON M THP THY

Thp l m thp, l m ca vt cht. Trong y hc c 2 loi thp: ngoi thp v ni thp. Ngoi thp l thp t mi trng bn ngoi xm nhp vo c th. Ni thp l thp do c th t sinh ra. Thy l nc. Nc l thnh phn cn thit cho c th, nhng c t l nht nh i vi th trng c th. Thiu hay tha nc u gy bnh. Nc tha b thn nhit lm nng s c ng li thnh thp, lu hn s c ng hn na v thnh m. Cho nn thy v thp d tr hn m.Ch c ngoi thp v thy mi gy bnh trc tip ngay tc th cho c th. Cn ni thp v m vn do c th sinh ra nn khng gy bnh ngay m ch gy tr ngi sinh l cho c th nu cn t. Khi c bnh r rng l thp v m kh nhiu khin sinh l c th kh hot ng m sinh bnh.

Triu chng bnh do m thp thy kh phong ph v phc tp. Thm ch c mt s tc gi ng y cho l qui bnh (bnh k qui). Nhiu trng hp bnh nhn cm thy kh chu khng thoi mi, cm thy mnh c bnh nhng thy thuc tm khng ra bnh, nht l khi dng Ty y chn on.

Thp, m vn khng hn khng nhit. Nhng rt d kt hp vi hn nhit to ra thp-hn, thp-nhit,m-hn, m-nhit. Do cn kt hp vi triu chng ca hn nhit chn on v iu tr chnh xc.

Mt s triu chng thng gp do thy, thp, m gy ra:

- Ngi lun u oi mi mt khng c l do.

- Gic ng m mt m khng khe khi thc gic.

- Ng d hay kh th cng thc gic kh khn. Khng tnh to ngay khi thc gic d ng khng thiu.

- T chi cm thy nng n hoc mi v c, nht l lng v chi di.

- Lun cm thy li bing.

- u c khng minh mn d khng thiu ng hay vn dng tr c qu nhiu. M trc y khng c hin tng ny, cng khng b stress, c ngha khng h c vn g v tinh thn. Cng khng b thiu nng tun hon no.

- Thay i mu sc da, nim mc. Hoc da mt ti nhun - theo la tui.

- Ph thng (n vo vng nhiu tht c chn bn chn b lm xung m khi th ra khng li ln ngay).

- Bo ph v c, n t n thiu cht m vn mp. Tuy nhin vi triu chng ny cn xem xt thm loi tr bnh tuyn Yn.

- Nhng bnh thuc loi x ha, sng ha u thuc dng m.

Lng y T Minh. 1988.

CHU K 12 KINH KH.

Lng y T Minh

C th c 12 tng ph, kh ca chng lin lc ra bn ngoi bng 12 kinh. Mi kinh c gi ch o ring. n gi ch no, kinh kh vng nht. Thng qua hin tng ny, ngi xa dng n t hay b cho chng. Nay, ti li dng n vo vic chn on truy tm bnh gc thuc kinh kh no v iu chnh kinh kh iu tr . Ch khi no bnh thuc lnh vc kh ca kinh th bin php ny mi c tc dng. i khi bnh ch do kinh kh gy ra, c khi bnh do c tng v kinh kh. Do , hiu qu iu tr cho ta bit bnh thuc kha cnh no.

Trn nguyn tc, khi kinh kh c bnh th c n gi ch o ca n th triu chng bnh tng ln. C hai trng hp thc v h. Thc l kinh kh qu mnh. H l kinh kh suy yu. Thc th lm gim kh lc ca n. H th tng kh lc n ln, nu khng hiu qu th ta gim kh lc ca kinh kh i lp ca n, c tnh theo gi i lp.

Th d: mt bnh nhn khi ng h c ti gn 2 gi sng l thc gic, qua 3 gi mi ng li c, y l gi Su l gi ca Can kh. Nu l chng thc ta day hay p lnh 50,70, nu l chng h ta h nh hay dn cao hay xc du 50,70. V h nh ,dn cao, hay xc du l b, day hay p lnh l t. Nu khng thnh cng ta chn kinh kh c gi i lp l gi Mi, gi ca Tiu trng.

Tng t cho cc loi bnh chng khc.

Bi th vn tt din t gi ch o ca 12 kinh kh:

Ph Dn, i Mo, V Thn cung,

T T, Tm Ng, Tiu Mi trung.

Bng Thn, Thn Du, Tm bo Tut,

Hi Tiu, T m, Su Can thng.

TP. H Ch Minh 1993

CHU K LC KH

Trong c th c 6 kh (chia ra 12 kinh kh) tng ng vi 6 kh trong thin nhin: Thi dng, Thiu dng, Dng minh, Thi m, Thiu m, Quyt m. Trong mt ngy 24 gi, 6 kh lun chuyn theo tng 4 ting ng h ni tip nhau. Trong gi ca kh no , kh vng nht. Kh suy nht khi thuc gi i ca n (TD : 9g i vi 21g) p dng trong chn on ta c bnh tng hay gim vo gi thin kh vng hay suy. Suy ra :

Nu gi thin kh vng m bnh tng l kinh kh hay tng ph tng ng b thc. Hoc kinh kh tng ph i xng ca n b suy. Th d: bnh tng t 9 gi n 13 gi, sau gim nh l gi thuc thin kh Thi dng. Suy ra kinh kh Thi dng thc hay kinh kh Thi m suy. Vic cn li l tm xem Th hay Tc kinh b bnh m x l thch hp.

Nu gi thin kh vng m bnh gim th kinh kh hay tng ph tng ng ca n b suy. Ta ch b chnh n.

TP. H Ch Minh. 1993.

Lng y T Minh

NGUYN TC IU TR .

Lng y T Minh

NHNG TRNG HP BNH CP CU:

Nhng trng hp sau y thuc loi cp cu ti bnh vin:

- au d di ti mt ni no trong c th thuc vng ngc, bng hay u, km st cao (trn 38 C).

- Huyt p s trn bng hay cao hn 170. Huyt p s di bng hay hn 110.Trong trng hp tng huyt p.

- Huyt p s trn thp hn 90. Huyt p s di thp hn 50. Trong trng hp tut huyt p.

Vi nhng trng hp ny ta ch tm thi can thip khi xa bnh vin hay trn ng a bnh nhn n bnh vin m thi.

NGUYN TC IU TR .

1. i vi bnh mi pht hoc bnh c triu chng d di, nu khng thuc loi cp cu nu trn th ta nn iu tr vo triu chng trc ri iu chnh tng th sau.

2. i vi bnh mn tnh hay bnh c triu chng tng i nh m bnh nhn chu ng c th ta nn iu chnh tng trng trc ri cha triu chng sau.

3. iu chnh tng trng th theo cc yu t chn on ca tng trng . iu tr triu chng cc b ni c bnh th theo cc yu t chn on ca cc b.

Vi cc nguyn tc sau:

- Hn (lnh) th lm cho m: bng cc k thut h, dn cao, xc du. Nhit (nng) th lm cho mt: bng cc k thut p lnh, g mai hoa, day vaseline, ln gai. Hai yu t ny bao trm cc k thut tc ng cho tt c cc c ch iu tr cn li di y.

- Dng h th b Dng bng B Thng c lm m bng h hay dn cao hay xoa du. m h th b m bng b B m huyt day bng vaseline. Kh h th b kh bng b Thng nhng khng gy m huyt. Huyt h th b huyt bng b b m huyt nhng k thut th ty h hn hay h nhit m chn k thut tng ng.

- Vim th tiu vim.

- Huyt th kh huyt bng b Tan mu bm.

- C m thp thy th tr m thp thy.

- Nhim trng th tiu vim bng day n vaseline, phi hp vi khng sinh.

- Xut tit th cm li (thu lim) bng b tan mu bm (cn c tn l b Thu lim), b B trung hay b Thng. Tuy nhin y cn chn on tm nguyn nhn do m hay dng h gy xut tit. y l mt vn hi kh, cn kinh nghim bin lun.

- Kh th lm cho ti nhun bng b B m huyt.

- Hng phn th c ch li bng b Ging.

- Trm cm th lm hng phn ln bng b Thng.

.v..v.

KINH NGHIM LM SNG.

1. Phi gim bng hay hn 30% ngay ti ch cc triu chng th mi ng. Nu km l cn thiu st.

2. Ngay ti ch gim m hm sau tng li nh c l trng ngn m cha trng gc.

3. Qua hm sau tuy c tng li nhng t hn ngy hm trc l trng c gc ln ngn. C th tip tc.

4. ang iu tr hoc iu tr ln u tin c gim nhng sau vi gi triu chng tng ln hn lc cha iu tr , th c th:

Chn on v iu tr sai: triu chng ko di.

Chn on ng nhng iu tr cha liu lng: triu chng tng ri gim dn.

Bnh nhn khng gi gn king c v sinh hot, n ung.

5. Triu chng ang gim m dng li khng gim thm, l bnh chuyn sang giai on mi. Cn thay i phng thc iu tr bng cch chn on li v ra phng n iu tr mi cho ph hp. Thng l tt v bnh gim nh , nhng khng c ngha l n gin hn v d tr hn giai on trc v n y l vo gn hn n phn ct li ca bnh.

KT LUN.

Tuy khm k ri mi c kt lun chn on nhng khng phi lc no cng c th trng 100% ngay trong ln khm u tin vi bin php lm sng (chnh v vy m Y hc hin i phi c cng xy dng cc phng tin khm cn lm sng hn ch sai lm trong chn on bnh). Ta ch chn on ng khi bnh n gin. Vi nhng bnh phc tp th c khi iu tr th vi ln mi ra vn . Mong cc bn khng ch quan to sai st trong vic chn tr. Lun lun t li vn khi iu tr thy khng c kt qu nh mong mun.

TP. H Ch Minh 15 07 2002.

HNG DN V KING C.

Lng y T Minh.

King c thc ra ch l trnh n nhng nguyn nhn gy bnh do bn ngoi a ti nh thc n ung, kh hu thi tit, sinh hot hng ngy. Mi mt ngy khi thc gic, c th chng ta bt u n nhn nhng yu t mi tc ng vo nh nng- ma-gi-bo-bi bm-mi hi-kh thivv..Khi bt u n sng l ta a mt s cht mi vo. Chua c ,cay c, ng- mn- ngt c ; ci no hp ci no khng hp vi ta ?

iu tr bnh m khng king c th hiu qu iu tr rt km, nu khng mun ni l s khng c kt qu. Chng ta thy hin nay xu hng ca Ty y cng bt u ch n vic khuyn bnh nhn king c trong khi tr bnh . Trc y vi mi nm, h hi n king c l y nh rng bnh nhn s b bc s c n cho mt hi. No l phi n cho dinh dng, no l bnh m cn c n th lm sao khe m tr bnh cvv..!!! Qu tht th ng y bt bnh nhn c n hi nhiu. C ni thy bng dn d king c n ung ca bnh nhn c n vi chc mn. C l vic ny xy ra l do bnh nhn ung thuc ng y, lun c s tng tc qua li gia thuc v thc n. V thc cht thuc ng y u c ngun gc thc vt hay ng vt, l mt dng thc n hi c bit vy thi.

Nu ch dng huyt tr bnh th chng ta khng s nhng tng tc nh ni m ch cn king c nhng tc nhn gy bnh m thi. l mt trong nhng u im ca phng php tr bnh khng dng thuc. Va an ton va n gin.

Trong qu trnh hnh ngh v nghin cu chn lc ti nhn thy ch cn king c theo cc nguyn tc:

1. iu kin mi trng khng thch hp : nng - lnh, m - kh , trong sch hay bi bm.

2. iu kin lm vic: thay i cng vic hay t ra cng ci thin thi quen trong lm vic i vi cc bnh do ngh nghip gy ra.

3. Thc n, ung : nu king c nh ng y lu nay tun theo ta s c mt danh sch rt di, thm ch hu nh khng cn g n ngoi m cc (go,la m) !! Bnh nhn s d ri vo tnh trng suy dinh dng. Do ti ch ch trng vo nhng mn trc tip gy bnh mt cch mnh m cho c th m thi. Gm cc nhm chnh.

- Nhm gy lnh cho c th trong nhng bnh do lnh : thc n ung p lnh, cc mn c v ng mnh nh kh qua, rau m, tim sen, rau ng, rau ng.Cc mn qu mt nh cam, da, thanh long, rau ay, b ngt..

- Nhm gy nng ro cho c th : cc mn n chin, cc thc c v cay nng nh tiu, t, ti, gng..Cc mn cung cp nng lng nhiu nh chocolate, cacao, cc loi ko bnh c dng ng

- Nhm gy co cn - c : cc cht c v chua m nh chanh,cam, thm (da), cc cht lm lnh c th .

- Nhm gy tr tr : hu ht cc mn c cht nhn u gy tr tr ng cho c th nh u bp, rau ay, mng ti, khoai mV cc cht lm h nhit.

- Nhm gy vim : hin nay ti ch pht hin ra hai mn gy vim rt mnh (trn c th vn b vim): tht g v cc loi mm nh mm tm, mm ruc, mm sc, mm thi(nc mm th v hi, c l v mn cao v qu trnh ln men hon chnh nn khng c c - hay t c ?? ).

- Nhm c cht ha hc pht sinh : tt c cc mn tri qua qu trnh ln men sinh hc (khc vi ln men cng nghip nh x du, magie ): nh chao, tng, bnh m, ru, bia..Lu : cc loi ny i khi nu chn vn khng phn ha c cc ha cht trong n nn vn gy bnh cho c th khi dng.

Ni chung khi bnh c lin quan ti gan (Can) v ty (T) th cn king c kh nhiu , nghing v hng cht gy vim v cht c ha cht l, v gan v ty l b my chnh trong x l ha cht ca c th (Can ch s tit, mu l T ch ha), d nhin t bo cng c nhng quy trnh x l ha cht nh ring. Vi Gan ta cn cn king c thm tht b, c bin c nh c ng, c chun, c nhm, c nc..cn cc loi c hin th dng c nh c chim, c thu, c bc m.Vi Ty ta cn cn king c thm cc cht gy lnh.

Cn cc loi bnh chng lin quan ta c theo bng hng dn nu trn m khuyn bnh nhn king c .

Theo triu chng ta c:

- Chng au nhc : c nhm gy lnh, gy co cn c.

- Chng vim (sng + nng + + au), chn thng : c nhm gy vim v nhm gy co cn c, nhm gy lnh (nu bnh thuc hn , nu l bnh thuc nhit th ngc li cn c nhm gy nng).

- Chng tr, sng n (khng nng ): c nhm gy tr tr, nhm gy co cn c, nhm gy lnh (v lnh cng l mt nguyn nhn gy tr tr cho c th).

- Chng c nhim trng hay vim do nhit : vim do nhim trng hay do nhit u gy ra triu chng au nhc. Tht ra trong ng y th phn chia kh r : au th do nhit, nhc l do hn , nhng hu ht bnh nhn khng th phn bit c hai triu chng ny m h thng gp chung hoc ni ln ln. Loi ny cn c cc mn gy nng ro, nhm gy vim.

- Cc chng c tnh d ng, cc loi bnh ngoi da: nhm c ha cht pht sinh.

Nh vy ta c mt ng li king c kh linh ng v theo gc bnh ch khng theo tn bnh. o d nh dn d bnh nhn .

TP. H Ch Minh 12 6 2002.

LM SAO T T C

T Minh.

Mc T Khoa, 1992.

D tm sinh huyt ri tc ng vo sinh huyt l vic chng ta bit v tng lm. Nhng d tm sinh huyt u, tc ng nh th no, bao nhiu lu c th t c T C (c thi, c v, c php, c ) ? Bi khun mt l kh d, ri li cn bn tay, bn chn, lng, bng, u, vnh tai !!! Lm sao m d cho ni phi khng cc bn ?

Nay, ti xin ng gp mt tm c sau mt thi gian di nghin cu v th nghim thy rt tt. Mong rng nhng kinh nghim ny s gip cc bn vng tm v vng tay hn trong vic s dng DC-KLP.

Nguyn, u nm 1992 ti sang Matxcva lm vic theo li mi ca h v theo c ca thy Chu. Lc y ang l ma ng, li l x lnh, hu ht cc trng hp u phi dng ngi cu iu tr, hiu qu tt. Nhng c mt s trng hp h mt khng c kt qu, thm ch c lc li xu hn, mc d v chn on r rng l thc hn . Ti rt ngc nhin. Trc , Vit Nam thnh thong cng c gp, nhng rt t khi v cha tm ra gii php tt. Mt phn do p lc bnh nhn qu ng khng rnh nghin cu cho ra vn . Mt khc phng php ch mi bt u trin khai ra ton thn, li khng c ging nm cho bnh nhn . Cho nn vic p dng cc h thng phn chiu ngoi b mt cha c trit nh hin nay.

Matxcva, iu kin, nn ti quyt tm nghin cu hin tng ny. Ti pht hin ra nhit cc vng c th ca trn cng mt bnh nhn khng ging nhau. T nhn xt ny, ti chuyn tm tm nhng vng c nhit bt hp l nht trn c th bnh nhn lm ni chn on v iu tr . T hiu qu iu tr c nng cao hn v nhanh hn v chnh xc hn trc. Ngoi tr cc trng hp st cao lm ri lon sinh l huyt nh trnh by. Hoc mt s trng hp lnh ton thn v mt cn au kch pht.

Th l vn nn lm sao t t c c gii.

Vn c v, c thi :

Hai yu t u tin l C THI, C V s n cng lc khi ta tm c vng chn tr c sinh huyt nm trong . l ni lnh nht hay nng nht trong c th bnh nhn trong khi cc ni khc c nhit bnh thng . Th d: Cc ni u m ring bn chn li lnh th bn chn l ni khm v tr bng ngi cu. Cc ni u mt m mt li nng th mt l ni d v tr bnh bng que d.

Vn c php ?

Ta cng bit, h bnh nhn nng th gii nhit, bnh nhn lnh th lm cho m, h au tay th cha tay nhng nu au tay do thiu mu c tim th cha bnh cho tim ch khng phi cha cho tay; nhc u th cha u nhng nhc u do to bn th li cha vo i trng ch khng cha cho u v.v chnh l c php, ch khng phi ch chn dng c l c php. D nhin khi nh c php ri th vic chn dng c k thut thch hp l vic phi lm pht huy ti a s C PHP.

Vn c ?

Bnh c nng c nh, c n gin c phc tp. Th trng bnh nhn c kho c yu, c nhy cm c chm p ng. Mi trng hp, mi thi im u chng ging nhau. Cc k thut vi cc mc ra nh h nng 3 ln, day ln vi pht v.v d sao cng ch gi bnh qun. Mun t c yu t C chng ta phi ch tht k cc triu chng, din bin trn thc t lm sng ngay trong lc ang thao tc iu tr .ng thi vn tip tc kho st cc din bin k tip. Mun vy chng ta cn ghi chp bnh n y . T chng ta mi c th suy ra v phn on mc tc ng thch hp cho mi ln iu tr . Nu khng rt d lm qu l hoc khng .

Mun t c cao hai yu t PHP v chng ta khng th khng nghin cu sinh l bnh l ng v Ty y lm nn tng trong phn on bnh chng. Ring yu t C th cn kinh nghim ring c c sau mt thi gian thc hnh nhiu, iu ny kh truyn t.

Ti va trnh by xong phng cch t T C. Tuy khng c g b him nhng mun lm c chng ta cn rn luyn nh mi vn khc. Mong cc bn thnh cng.

CHN ON HN NHIT

BNG HUYT DIN CHN

T-Minh.

TP.H Ch Minh, 21-12-1993.

Bnh nu khng thuc hn th thuc nhit hoc hn nhit ln ln. Trung y c cch chn on hn nhit. Cn DC th sao ? y l u t ca ti t khi hc v lm DC. Thi gian u gn nh ti phi da hon ton vo t chn ca Trung y. Sau , qua lm sng da vo huyt tnh v sinh huyt, ti tm cch xy dng k thut chn on ring cho DC. Trc, tha mn s tm ti ca mnh; sau l p ng nhu cu ca hc vin cha bit Trung y. May mn thay ti lm c iu ny, c th cha c hon chnh nhng n gp phn khng nh cho nhng ai cha bit hay bit Y v trong lm sng c mt s trng hp nh n m s nh bnh r rng hn. Xin th xem v vui th vi pht hin ny.

Trc ht, ta cn nh cc chng hn nhit va c ton thn va c cc b v s tng quan gia chng khng c quy lut. C ngha l c khi ton thn l hn m cc b li nhit, c khi ton thn nhit m cc b li hn. C khi ton thn ln cc b u hn hay nhit. V th, khi chn on hn nhit ta lun cn xem xt c hai kha cnh ton thn v cc b hn ch sai st.

A- Chn on hn nhit ton thn :

Hai dng c chnh c s dng y l que d v ngi cu. Cn thun thc v k thut, nu khng ta s b bo hiu sai v kt qu chn on s sai theo.

a- Dng que d: - au 26 l nhit biu.

- au 143 l nhit l.

- au 1 hoc 43 l hn nh l.

- au 19 l hn nh biu.

b- Dng ngi cu: ngi cu c dng khi khm bng que d khng c sinh huyt:

- nng 1 hoc 43 l hn nng l. Khi 43 nng l mt kh nng tng tr Dng kh. Khi 1 nng l mt kh nng khai pht Dng kh.

- nng 19 l hn nng biu.

- nng 143 l tinh huyt suy, mt kh nng tng tr m huyt. Kh tr hn cc trng hp khc.

- nng 26 l mt kh nng hp thu dng kh.

Lu : phi d c 4 huyt xong ri mi kt lun sau khi tng hp.

Nu vi c hai phng tin m khng thy sinh huyt th c th kt lun ton thn bnh nhn bnh ha, khng hn khng nhit. Ch cn cn khm hn nhit cc b m thi.

B- Chn on hn nhit cc b :

Nh cp, khi mt cc b c vn ( c quan b bnh ), ta vn cn khm ton thn tm s lin h nu c gia ton thn v cc b . Nu ton thn khng c g, ta ch cn khm cc b bit bnh thuc hn hay nhit.

a- Dng que d: tm sinh huyt da theo hnh phn chiu ni b bnh - ch yu trn mt. Nu bo au l bnh nhit. Nu l vng phn chiu nh c cnh tay, hay phng chiu xoang, ta dng ln inh nh ln vo ni ny, nu au l bnh nhit.

b- Dng ngi cu: khi bnh chng r rng m khm bng que d khng thy c huyt au l bnh hn. Dng ngi cu d s thy nng.

c- Khi huyt khng bo au m cng khng bo nng l tm cha ng, thay i h thng phn chiu .

d- Khi huyt bo nng ln bo au l hn nhit ln ln, hoc hn nh. Cn bnh tnh xem xt k.

Tuy vy, theo kinh nghim, d bnh hn nhit cc b bng huyt kh phc tp v huyt chu chi phi bi nhiu quy lut-nh i xng, giao thoa, phn hin v.v.... cn c nhiu kinh nghim h tr mi t sai lm. Do , nn phi hp vi s ti ch xt hn nhit - xem bi LM SAO T T C . ng thi nn hi triu chng tng vo ma no trong nm, gi no trong ngy tm hiu quy lut ri suy ra./.

CC B HUYT CN BN

IU CHNH TNG TRNG

(PHC HI CHNH KH)

B THNG

T Minh.

Thng v ging l hai th php thng gp trong y hc c truyn. Ch THNG y l ni gn cho d nh, ni y l THNG B DNG KH. Hn nhin n khng thay th cho tt c cc liu php tng t c trong y khoa (cng mc ch), cng nh gii quyt c tt c cc trng hp h suy dng-kh. Nhng n s gp phn khng nh trong vic tr bnh bng Din chn-KLP. Qua qu trnh tm ti th nghim v thnh cng trn thc t trong thi gian qua, nay ti xin trnh by nh sau.

A- PHC K THUT TC NG :

127 , 50 , 19 , 37 , 1 , 73 - + , 189 , 103 , 300 - +, 0 - +.

Nguyn tc chung: theo th t t di ln v t tri sang phi.

Sc mnh ca phc c sp xp theo th t nh sau:

1- H ri xoa du ri dn cao.

2- H, dn cao.

3- H, xoa du.

4- H thun ty.

5- Chm kim nu cn, tuy nhin k thut ny d gy vng chm. Hin nay chng ta khng cn dng kim m thay th kim chm bng k thut rung huyt.

6- Day n bng du.

7- Day n, dn cao.

8- Dn cao hoc xoa du.

9- Rung huyt hoc day n bng vaseline hoc bt c mt loi du no khc khng hi da nh du n, du da, kem dng da ca ph n , nhm mc ch trnh try da khi day qut.

10- Ln , g.

( Xem thm bi Hng dn k thut s dng dng ctrong sch Bi Ging. )

B- TC DNG :

B Thng c nhng tc dng chnh sau y :

- Thng Kh, b kh, thng Dng, b Dng. Ty theo m chn k thut thch hp.

- Hnh kh hnh huyt nhng hnh kh mnh hn r nt hn.

- Tng sc khng v thi kh cho c th.

- Lm m ngi ton thn. Xua tan hn kh nhim vo ngi.

- Lm hng phn thn kinh.

C- CH TR :

B THNG c tc dng hu ht trong nhng bnh chng c gc hn, r nt nht l do hn t thc. C th nu mt s bnh chng thng gp nh cm lnh, trng gi lnh, mc ma, vim ph qun do lnh (khng c tc nhn ha l), sa ni tng nh, t hn v.v Nhng iu tr lu di cn nhn nh ng cn bnh linh ng.

ng dng ca b THNG rt rng, tuy nhin mun dng tt cn c mt vn y l c bn ng y phn bit hn nhit h thc.

D- CHNG CH NH :

B THNG rt mnh khi dng trn b, nht l vi k thut h nng dn cao, xoa du hoc chm kim.

Khng nn dng b THNG trong cc trng hp sau:

- Bnh nhn c th trng m h huyt km, ngi gy kh.

- Huyt p cao dng chng. Nht l vi cc dng huyt p cao c cholesteron, c x m ng mch.

- Cc bnh c nhit l nh : tiu kht (tiu ng), h lao (suy nhc c th nng)

- Cc bnh c nhim trng v d gy bi nhim.

- Cc bnh vim lot v d gy xut huyt.

Ba trng hp sau c th dng vi k thut day vaseline khi c km bnh cp do nhit. Nhng cn xem xt theo di k trnh sai lm.

E- KINH NGHIM LM SNG :

1- Trng hp ngi bnh va km v huyt va suy v kh, nu dng trn b THNG s gy thin lch v kh huyt v n ch thng b kh. Trng hp ny nn dng b B TRUNG thch hp hn (xem b B TRUNG).

2- Ct cn tng huyt p m chng c cc triu chng nh sau:HA tng t ngt m trong lc bnh thng c th thuc loi thp, ton thn hay t chi hay ch bn chn lnh, c bit HA rt kh o v kim git rt nh ting p ng nghe rt nh; dng que d khm thy au hai huyt 1 v l9 m 26 v 143 khng au; c khi c 4 huyt ny u khng au (xem bi chn on hn nhit bng huyt Din chn). iu tr: Dng ngi cu h v xoa du mi huyt 3 ln. Lu : phi hi cc triu chng k trn, nu khng ta s sai lm ln khi l mt cn cao HA Dng chng.

Nu t chi lnh ngt m c 4 huyt u au th y l c a Dng chng m trng lnh bt ng lm tng thm HA, trng hp ny kh, khng nn can thip nu khng kinh nghim, nn cho i bnh vin.

Vic iu tr chng cao HA v lu di cn hiu sinh bnh l tm ra cn bnh. Bin php nu trn ch l tm thi ct cn m thi, khng phi l gii php iu tr.

3- Nhc khp: au nhc m khng nng , tri li s tay vo khp thy lnh hn cc ni khc. Nu bnh nhn khng b thiu mu qu ta c th dng b THNG. Kt qu nhanh v khng tn cng dng thm cc huyt phn chiu b v khi c nhiu khp au.

Tuy nhin, khi khp b thoi ha th liu php ny khng kt qu, ch mang tnh ct cn m thi. Khng nn dng lu di c hi cho khp.

4- Nhc u mn tnh: c lc hon ton thoi mi, c lc nhc d di. l lc c lnh xm nhp. Dng B THNG ct cn, iu tr lu di cn tm hiu tng th ca bnh nhn iu chnh li cho qun bnh.

F- VN N UNG, SINH HOT :

Khi s dng b THNG cn king c :

- n ung: khng dng cc th qu mt lnh nh nc , kem, yaourt lnh, nc p lnh, cam, nc da, bia, kh qua, u en, u xanh, rau m, thanh long, cc th c v chua.

- Sinh hot: c tm m, dm ma, dng qut my, phng lnh, nm nn nh khng c nm, i chn trn trong nh, khi ng nn mang v gi m chn.

G- KT LUN :

Tc dng ca b THNG rt rng v rt mnh. Khi p dng mt cch my mc d gy thin lch v m dng kh huyt .

Chn on k v m dng, kh huyt, hn nhit, h thc l vic cn lm trc khi bt tay vo iu tr .

c lng tnh hnh, theo di st sao din bin lm sng ngay ti ch v v sau c gii php, cng iu tr thch hp .

Lun lun d sinh huyt kim chng trc v trong khi iu tr phng sai lm.

TP H Ch Minh, 08-12-1998.

B GING

T-Minh.

Khi qut th b Ging c tnh cht ngc li vi b Thng. Tm ng dng khng rng ri nh b Thng v thuc kha cnh gn nh i lp.

A- PHC K THUT :

124 + - , 106, 34+ - , 26, 61+ - , 3+ - , 143, 39, 14+ -,222+ - , 85+ - ,156+ -, 87.

Khng phi lc no cng dng trn tt c cc huyt nu trn. Phi d sinh huyt dng cho thch ng vi tnh hnh bnh. C khi phi ty theo tng trng ca bnh nhn m chn lc li, ch dng mt s trong s cc sinh huyt c tm thy ch khng dng tt c cc sinh huyt.

D v tc ng huyt theo th t nu trn. i vi cc huyt kp th tc ng huyt bn phi trc, bn tri sau (ca ngi bnh).

K thut an ton v thch hp nht l dng k thut rung huyt, hoc dng ln v que d n day hoc qut vo huyt bng vaseline hoc cc loi du nhn v hi nh du n hoc kem dng da. Cng c th day tht nh phn pht khng cn vaseline vo mt da nhng ngi tr tui, da khng qu kh.

Nu st cao nn dng nc p vo huyt, mi huyt mt pht ct cn st.

B- TC DNG :

Cc tc dng chnh :

Ging kh: tc dng cao trong trng hp thc nhit.

H nhit: tnh h nhit kh mnh khi dng trn b.

An thn: tnh an thn r nt.

Tiu vim: ch c tnh h tr, v tnh tiu vim ca n khng mnh bng mt s phc khc.

C- CH TR :

B GING l phc ch lc tr cc bnh thuc THC NHIT. Trong lnh vc h nhit th ch c dng khi cn i ph tm thi vi triu chng (kh dng v cn vng y l ng y v phi k lng), khng dng trong iu tr lu di.

Nn dng cho cc trng hp sau: Cc chng st do nhim phi kh nng u cn dng B GING. Trc ht n h st cho bnh nhn, phng chng kinh git do st cao sau s tm nguyn nhn gy bnh iu tr tn gc. Mt s bnh thng gp: trng nng, st do nhim trng d nhin ch gim st cn dit trng th nn dng khng sinh, st khng r nguyn nhn (vi iu kin chn khng lnh).

Qua tnh an thn, ging kh, h nhit, b GING c dng ct cn tng Huyt p DNG CHNG, vi cc triu chng sau: mch vng Thi dng (mng tang) ni cm, mch c tay thuc dng Kin, Hot, Thc, chn khng lnh, mt mt c th ; o HA thy kim ng h git mnh, ting ng nghe p ln, hai huyt 26 v 15 c th 143 rt au. Trng hp ny nn day huyt 15 trc khi dng B GING.

Ngoi ra c th dng trong nhng trng hp suyn thc nhit. Trng hp ut nhit bn trong tng ph nh V, T, Can v.v.. Nhng trng hp mt ng do hng phn, lo lng suy ngh nhiu lm mt ng (ch c gi tr khi th trng bnh nhn cha suy yu). Nhng trng hp thn kinh chc nng ca mt c quan hng phn gy xo trn sinh l c quan, tng ph.

Lnh vc ng dng ca B GING kh rng nhng tt nht vn l dng tr cc bnh THC NHIT.

D- CHNG CH NH :

Thc t cho thy B GING ch c tnh t ch khng c tnh b. Do khng dng b Ging trong cc chng h nhit (nhng triu chng nng m , nng sau bui tra ngi bnh suy nhc) nhng ngi bnh mt ng lu ngy, n ung km, gy yu xanh xao.

E- NG BIN LM SNG :

1- Ct cn st bng nc p vo huyt. y ch cn dng cc huyt sau y theo th t: 26, 3, 143 hay 173, 87. Vi cc cc nc chng bng u ngn tay ci, p mi huyt chng mt pht ri i sang huyt khc cho n khi ht st.

2- Mt s trng hp bnh tm thn mi pht thuc chng cung trong ng y, cc chng trng nng. Nn ng bin nh sau : ch dng cc huyt sau y theo th t 124 -, 106 , 34 - , 26, 61 - , 3- , 143, 39, 14 - , 222 - , 85 - , 87.

C th ty nghi s dng cc k thut p lnh, day bng vaseline hoc chm kim. Bin php ny cng dng c trong trng hp st cao do vim nhim cp (vi iu kin chn khng lnh).

G- KT LUN :

B GING hu hiu trong cc chng nhit d biu hay l. Nhng ch c tnh T CH KHNG B. Cn thn trong khi s dng khng hi nguyn kh ca bnh nhn .

TP. H Ch Minh, 9-12-1998.

B B TRUNG

T-Minh

1-/ PHC .

- 127, 50, 19, 37, 1, 7 - +, 0 - +.

2-/ K THUT.

Day vaseline, g, day du hoc dn cao hoc h nng xc du. Ty tnh hnh tng trng ca bnh nhn m chn k thut thch hp.

3-/ TC DNG CH TR.

B trung tiu, b nguyn kh cp nh, tr tiu ha, tng sc khng, tng lc nh n va phi. H tr trong vic tr mi bnh chng c h suy. C th dng bi b cho cc trng hp suy nhc c th nh cha nh hng n phn m huyt (y l b huyt tin cho b B M HUYT sau ny).

4-/ KINH NGHIM LM SNG.

C mt s trng hp bnh nhn b kh huyt lng suy, hoc m dng lng suy ta khng th dng b THNG v c th lm lch qun bnh. Trng hp ny nn dng b B TRUNG bn chn,phi hp vi B M HUYT mt b dng kh v huyt chm chm v lc ny sc chu ng ca bnh nhn rt km, khng th b nhanh c.B huyt ny cng thuc loi an ton nu ch dng day vaseline, nhng khng nn dng trong trng hp c huyt p cao dng chng.

-----ooOOOoo-----

B THIU DNG

T Minh

PHC :

- 324, 131, 41(437), 235, 290, 184, 34, 156.

K THUT :

Trc ht cn chn on bnh thuc hn hay nhit ri iu tr mi c kt qu (xem li bi CHN ON HN NHIT BNG HUYT DIN CHN).

Bnh thuc hn: day du theo th t trn, mi huyt 30 ci, dn cao salonpas nu c. Nu khng t hiu qu cao (gim au t 3/10 tr ln ngay ti ch) th nn dng ngi cu h nng mi huyt 3 ln c bi du.

Bnh thuc nhit: hiu qu cao nht l p lnh (kh lm nu cha kinh nghim). Chm bng kim cng rt mnh. Nu khng bit chm hoc bnh nhn khng thch chm c th day n bng vaseline mi huyt 30 ci, ba vng cho mt ln iu tr, gii php ny hiu qu km hn. C th rung mi huyt 10 giy.

TC DNG, CH TR :

B THIU DNG ny chuyn ha gii kinh kh Thiu Dng.

C th dng trong cc bnh: nhc na u (migrain, thin u thng); tng nhn p (glaucome, cm nc), hn nhit vng lai (lc nng lc lnh); st rt (ch gip h cn, khng phi iu tr) ; ut c tm l (tc gin nhng khng pht tit c, mt dng stress); mt s ri lon chc nng gan mt.

KINH NGHIM LM SNG :

- Trng hp hiu qu km trong nhc u c th thm 12, 240, 107.

- Nu c tng nhn p thm 16, 199. Tuy nhin y l mt bnh nguy him v c th gy m la khi khng cha c nn nu khng vng vng th khng nn tr. Bnh ny s c trnh by chi tit trong mc bnh mt cui sch.

- Trng hp stress, nu hiu qu km c th thm 124, 34, 106, 173 hoc 143, 3 -

- Ri lon gan mt cn xc nh sinh huyt vng gan mt.

- Nu nhc u do d dng mch mu no, bit c qua chp CT hoc MRI, ch gim au ch khng tr khi c. Khuyn bnh nhn theo ch nh ca bnh vin gii phu khi cn. V y cng l mt loi bnh chng nguy him cho sc khe ca bnh nhn .

- Ch : v tr huyt 131 chnh xc gia tuyn L v khe mt ngoi, n chnh l huyt Ng V trong Th Chm, nay c thay bng huyt 24 trong hnh huyt n bn 2003 ca thy Chu. Huyt 199 gia huyt 197 v 421.

B IU HA

T Minh