高血壓頸項強痛 the hypertension combines with posterior headache and neck stiffness

案例 ---高血壓頸項強痛
Case ---hypertension
It complicated posterior headache and neck stiffness

姓名name:XXXX
性別sex:女 F
年齡age:59

現病史 (Present i11ness):
高血壓5年 服西藥控制中
血壓140/91mmHg
合併後腦痛及頸項僵硬 時好時壞 大約2周
Hypertension has been attacked for 5 years.
combined posterior headache and neck stiffness for about 2 weeks.

望診observation
舌紅苔少
舌下瘀脈明顯
Red tongue with less coating.
sublingual veins stasis obviously

問診inquiry:
食慾和大便正常
沒有睡眠障礙
Normal appetite and bowel movement
no sleeping disorder

切診Palpation:
脈細 Small pulse

中醫診斷TCM Diagnosis
肝陽上亢 高血壓
Hypertension due to liver yang hyperactivity

治療原則Treatment principles:
平肝潛陽，活血化瘀
pacify the liver to subdue yang
Promoting blood circulation to move away blood stasis

中藥處方Chinese medicine prescription::
天麻鉤藤飲加減 modify tian ma guo teng yin
鉤藤guo teng 3g
天麻tian ma 1g
懷牛膝 huai niu xi 1g
益母草yi mu cao 2g
葛根ge geng 4g
蒿本hao ben3g
赤芍ce cao 1g

針灸處方 acupuncture points selection
腦戶 穴 DU17
風府 穴 DU16
合谷 穴 LI 4
太衝 穴 LR3

醫囑Instructions:
1. 避免熬夜
2.少吃太鹹的食物和味素
3. 要有規律運動
4. 常常自己熱敷 並按摩第一頸椎
1. Don’t burn the midnight oil.
2. Avoid taking too much salt and MSG
3. Doing workout regularly.
4. Trying to massage C1 and put a hot pack on the first cervical vertebra frequently.

治療結果: the result of tratment
針灸後立即緩解
服藥一周後 未再復發
The headache and neck stiffness were released right after acupuncture.
It’s never recurrence after taking one week herbs.

高血壓有用藥控制好
不一定會有頭痛及脖子僵硬痠痛的問題
但如果壓力過大或生活型態欠佳
就有可能引發其他症狀
在臨床上 最常見的是 煩躁頭痛 後頸項痠緊
這個個案 治癒後
常會自我按摩 溫敷 第一頸椎(相應神經)
按摩 合谷穴及太衝穴
效果甚為滿意

虹彩炎Iritis

虹彩炎Iritis

初期多已清熱解毒消炎為主

洗肝明目湯為基礎方

再依個人的體質加減處治

也可以煮藥茶來喝

桑葉2兩 白菊花1兩 白茅根2兩 夏枯草1兩 甘草3錢

用2000cc的冷水浸泡一小時

再連浸汁  煮滾轉小火再 煮五分鐘即熄火 

過濾去渣

一天內喝完

喝到眼赤澀痛消失 

大約要3至7天

褥瘡 Bedsores (pressure sores)

褥瘡  Bedsores (pressure sores)

姓名name:XXXX
性別sex:女F
年齡age:87

現病史 (Present i11ness):
出血性中風 久病臥床 臀部薦椎骨褥瘡二個月
She got bedsore on her hip for two months due to prolonged bed rest.

望診Looking Examination:
舌紅無苔
褥瘡性潰瘍已經侵犯皮下筋膜組織
Red tongue without tongue coating.
The bedsore ulcer get into the subcutaneous fascia tissue

中醫診斷TCM Diagnosis
褥瘡
Pressure ulcers

治療方法Treatment method:
外敷紫雲膏一個半月
Apply Zi yun gao for one and half month

使用方法Directions:
一天敷兩次
Apply on it twice a day.
先以以生理時鹽水洗淨傷口 再敷上紫雲膏
Washing the wound with physiological saline before apply zhi yun gao

追蹤follow up:
治療後痊癒未再復發
recovered.

備註note:
成分 Ingredients:
紫草根zi cao gen 60g
當歸dang gui 60g
麻油 sesame oil 600g
豬油 pork lard 600g
黃蜂蠟 yellow beeswax

最佳的製作方法the best making method:
1.將當歸及紫草冷浸於麻油3-7天
2.慢火搾取豬油
3.七天後 豬油與麻油混在一起
4.以非常小的火煮到當歸變脆
5.過濾去渣後 再放入黃蠟
6.蠟的份量 會因天氣寒熱而異

1. Soaking dang gui and zi czo in sesame oil for 7 days
2. Getting pig lard by slowly fried.
3. The sesame oil needs to be mixed with pig lard after 7 days
4 Cooking it with very low fire till the dang gui become crispy.
5. Filtering the dregs away, and then put the yellow beeswax into the oil.
6.The amount of wax is depend on the weather condition.

失音Hoarseness

失音Hoarseness

沙啞的原因很多
我經驗的cases 有：

急性聲帶炎
大多是感冒引起的
很容易治癒

聲帶結節
大多是
話說太多太大聲
引起聲帶上皮角質增生而沙啞
此案例就是屬於這型的

聲帶息肉　
通常是單側發聲
它是聲帶長期充血不退引起的
所以中醫治療時
應在主方中加入
大量的玄參與蒲公英

聲帶萎縮　
大多是聲帶退化引起的
只能補腎水 與腎氣
臨床治療效果緩慢

聲帶麻痺　
大多是外科手術造成的傷害
中醫治療效果不佳

聲帶肉芽腫
大多是聲帶長期受刺激後引起的
如經常插管或長期胃酸逆流至咽喉或嘶吼
需要移除病因才能治癒

註記:
訶子是聲帶結節失聲沙啞的特效藥
但它很特殊
只能用含的
用沖泡開水煎劑就是無效
它的味道苦又澀
這是比較讓人難接受之處
但是臨床效果非常好
只要沙啞是因為話講太多或長期咳嗽引起的
非它莫屬
但初期感冒引起的沙啞 不宜使用

案例:

聲帶結節Vocal Fold Nodules (VFNs)
姓名name:XXXX
性別sex:女 F
年齡age:68
現病史 (Present i11ness):
聲音沙啞已經持續1個多月
咽喉不適 咽喉緊緊的感覺
西醫檢查 診斷為聲帶結節
Hoarseness has lasted more than one month
Throat tightness all the time
Western doctor diagnosed her with vocal cord nodule.
望診observation
舌紅苔黃
舌下瘀脈明顯
Red tonguewith yellow coating.
sublingual veins stasis obviously
問診inquiry:
食慾和大便正常
無過敏、飲酒、抽煙及.胃酸逆流等問題
但發病前有感冒咳嗽
Normal appetite and bowel movement
No allergies,and acid reflux problem
She got severe cough before hoarseness onset
切診Palpation::
脈弦
無頸部淋巴腫大
wiry pulse
No abnormal neck lymph nodes
中醫診斷TCM Diagnosis
血瘀型聲帶慢性的發炎
Chronic inflammation of the vocal cords due to blood stasis
治療原則Treatment principles:
養陰清熱，活血化瘀
Nurish yin and clear internal heat
Promoting blood circulation to move away blood stasis

中藥處方Chinese medicine prescription::
A.
木蝴蝶mu hu die 4g克
會厭逐瘀湯hui yan zhu yu tanng 10g
組成 composition of formula:
桃仁tao ren1 g
紅花huong hua1 g
甘草gan cao0.5g
桔梗jie geng0.5g
生地黃sheng di huang 1g
當歸dang gui1g
玄參xuan shen3g
柴胡cai hu0.5g
枳殼zhi ke0.5g
赤芍ci shao1g
14克分成四包 連續服用二周
total 14g Divided into four packets
take two weeks in a row
B.
另外 訶子打破 整顆口含 至無味 吐掉渣
藥量不限制
the other method is break the he zi into pieces and put in the mouth till tasteless and then spit out.
No limit for dosages
醫囑Instructions:
1. 避免大聲地說話
2. 多喝開水，忌吃刺激性和冰冷的食物
3. 勿吃太飽以防胃酸逆流
1. Avoid talking loudly.
2. Drink plenty of water, avoid eating spicy and icy food
3. Do not over eat to prevent acid regurgitation
1個月後追蹤follow up after30 days:
治療後痊癒未再復發
recovered.

註記note:
He Zi 最好的使用方法是整顆打破 含到嘴中 直到無味道才吐掉
它用沖泡開水煎劑就是無效
口噙的臨床效果非常好
但初期感冒引起的沙啞 不適合使用
The best way to take He Zi is break it into pieces and then put it in your mouth until tasteless then spit it out.
It is no effective by the decoction method.
The clinical effect is very good for the vocal fold nodules
However , it's not recommend for the exterior pathogen attacking stage.

胃出血 Gastric Bleeding

胃出血

Gastric Bleeding

古人說:單方一味 氣死名醫

20多年前 北京中醫藥大學 賀普仁教授來彰化中醫公會 教導火針

上課時 我很認真聽

他的每一句話 對我而言 如獲至寶

在課堂上 他提到 

胃出血的病人 其大便如柏油般烏黑

只要一位藥就能奏效

就是"生大黃" 調冰開水吞服

從此我的這類病人 幾乎這樣服用一天就止血

但一定要調 冰開水 服用 才有效喔 

案例

姓名name:XXXX

性別sex:男M

年齡age:71

現病史 (Present i11ness):

阻塞性中風 插鼻胃管餵食 已經二年

腹瀉 大便黑 一天

Ischemic stroke and on NG for 2 years 

Diarrhea with black stool

望診Looking Examination:

舌紅苔黃 

大便黑如柏油 一天

Red tongue with yellow coating 

black stool which looks like tarry

中醫診斷TCM Diagnosis 

血熱 胃出血

gastric bleeding due to internal heat in the blood

治療原則Treatment principles:

涼血止血 cool blod to stop bleeding

中藥處方:

生大黃粉12g 

Da huang 12g (hasn't been processed)

一定要拌冰水服用 

只服用一天即可

三餐飯前及睡前服用 

大部分的相同案例 服用一天即癒

To take 4 times a day before meal and sleep.

Must be mixed with icy water before taking.

For most cases can be cured in only one day

7天後的追蹤follow up after days:

治療後痊癒未再復發 

recovered.

EXCEL 2013 和 PPT2013 簡報教學影片分享

電腦學習 盡在巨匠

PPT2013 共有53個教學影片

EXCEL2013 共有66個教學影片

這些是我最近去巨匠電腦上完課後 

回家再自己錄製 保存的影片

如果你沒時間去上課 

這是很好的學習方法之一

巨匠每位老師都很優秀

所教的內容也都不同

所以我喜歡上不同老師的課程

我把最基礎的部分錄製起來

有心學習者

歡迎連結到我的　ＧＯＯＧＬＥ雲端硬碟　直接點＂下載　＂存取

　https://drive.google.com/folderview?id=0B6PAUQMw2WLSNllTamlFaEg4YnM&usp=sharing

　

這是免費又省時的漸進式學習

如果想更進一步

建議去巨匠電腦各分校上課

頸椎痛 Neck Pain

頸椎痛Neck Pain

案例

姓名name:XXXX 

性別sex:女F

年齡age:36

/婚姻marital status:未婚Single

職業occupation: 會計 accountant

現病史 (Present i11ness):

脖子僵硬 疼痛 左右旋轉不利 一周 

She complained that her neck was pain and stiffness.

It’s hard to turn around her head for one week.

望診Looking Examination:

舌紅苔白 舌下絡脈瘀阻

Red tongue white coating 

Sublingual collaterals Stagnation

問診Asking Examination:

二便正常 不易入睡 食慾尚可

Normal bowl movement and urination

Good appetite but hard to fall into sleep

觸診Touching Examination:

弦脈 斜方肌緊繃

Wiry pulse and muscle tension in trapezius

中醫診斷TCM Diagnosis 

血瘀型頸椎痛 neck pain with blood stasis

治療原則Treatment principles:

活血化瘀boost blood circulation

中藥處方:

桂枝湯gui zhi tang6g

合歡皮he huan pi3g 

葛根ge gen3g 

川芎cuan quong1g 

地龍di long1g

4*5天 

三餐飯後及睡前服用

To take 4 times a day after meal and before sleep.

二週追蹤follow up after 2 weeks: 

治療後痊癒未再復發 

recovered.

褥瘡 Bedsores (pressure sores)

褥瘡
Bedsores (pressure sores)

案例

姓名name:XXXX 

性別sex:女F 

年齡age:87

現病史 (Present i11ness):

出血性中風 久病臥床 臀部薦椎骨褥瘡二個月 

She got bedsore on her hip for two months due to prolonged bed rest.

望診Looking Examination:

舌紅無苔

褥瘡性潰瘍已經侵犯皮下筋膜組織 

Red tongue without tongue coating.

The bedsore ulcer get into the subcutaneous fascia tissue

中醫診斷TCM Diagnosis 

褥瘡

Pressure ulcers

治療方法Treatment method:

外敷紫雲膏一個半月

Apply Zi yun gao for one and half month

使用方法Directions: 

一天敷兩次

Apply on it twice a day.

先以以生理時鹽水洗淨傷口 再敷上紫雲膏

Washing the wound with physiological saline before apply zhi yun gao

追蹤follow up: 

治療後痊癒未再復發 

recovered.

備註note: 

成分 Ingredients:

紫草根zi cao gen 60g

當歸dang gui 60g

麻油 sesame oil 600g

豬油 pork lard 600g

黃蜂蠟 yellow beeswax

最佳的製作方法the best making method:

1.將當歸及紫草冷浸於麻油3-7天

2.慢火搾取豬油

3.七天後 豬油與麻油混在一起

4.以非常小的火煮到當歸變脆

5.過濾去渣後 再放入黃蠟

6.蠟的份量 會因天氣寒熱而異

1. Soaking dang gui and zi czo in sesame oil for 7 days

2. Getting pig lard by slowly fried.

3. The sesame oil needs to be mixed with pig lard after 7 days 

4 Cooking it with very low fire till the dang gui become crispy.

5. Filtering the dregs away, and then put the yellow beeswax into the oil. 

6.The amount of wax is depend on the weather condition.