懶人包系列
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多囊卵巢症候群PCOS(一)
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性功能
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肝（一）肝的西醫生理學
青少年
上呼吸道疾病
過敏
內科疾病
筋肉
中醫漫畫
2023年2月25日 星期六
皮膚問題
大壯天生好動，下了課常常就拎著一顆籃球往球場跑，非要打了個全身大汗這才開心的回教室上課。炎熱的夏日到了，大壯一如往常的每天打球，但他卻發覺上課的時候很難專心，總覺得身上到處都在癢。
「這幾天感覺有夠悶熱的啦，感覺汗都透不出去，黏在身上好難受。」
「奇怪了，手上、腳上、胸口肚子怎麼冒出一顆顆紅紅的疹子，好癢好難受啊，根本沒辦法上課啊！」
小刀從小皮膚就非常容易乾燥、龜裂，也常常覺得頭暈、倦怠乏力，讓他跟他的爸媽都很傷腦筋。再加上他時常覺得口乾舌燥，明明每天都有定時喝水補充水分，嘴唇、口腔卻常覺得很乾。
「啊啊啊，好癢啊，癢到渾身不對勁啊！」
明明知道會越抓越癢，小刀還是忍不住去搔抓身上乾癢的皮膚，總會摳下一片片暗沉的碎屑，有時候不小心抓得太用力時還會破皮流血。
呂醫師的話
皮膚癢、皮膚起疹子、皮膚脫屑，這些問題說大不大說小不小，通常不會嚴重到危及性命，但對大多數患者而言，絕對會大幅度的減低生活品質，就是所謂癢起來要人命。也要做好心理準備，因為類似這樣的問題會需要長期抗戰，像跟游擊隊作戰，很難一次就完全殲滅所有症狀，需要循序漸進，逐步改善。
首先可以檢視一下自己周遭的生活居住環境，若地處低窪或是常年在下雨空氣濕度很高的環境，體內便很容易累積濕氣，除了可以看診服用一些利濕、清濕氣的中藥之外，記得除濕機常開，保持乾燥。
有些人的皮膚問題肇因於過敏，可能是寵物皮毛，可能是空氣中的粉塵、灰塵，也有可能是飲食中的海鮮或是牛奶。可以稍微注意一下過往皮膚不適的症狀發生時，有無接觸特定過敏原，以利下次避免或排除過敏原，防止症狀的發生。
皮膚是保護人體內部，避免外在病原體侵襲的一道物理屏障，如果因為皮膚癢不斷搔抓到抓破皮的話，就好像自行摧毀了那道屏障，開門揖盜，歡迎各種各樣細菌、病毒、寄生蟲等等進到體內搞破壞，輕則發炎腫痛，重則可能發生細菌流竄全身的敗血症（sepsis)，不可不慎。
中醫方劑消風散內含辛涼解表的牛蒡子、蟬蛻疏風解熱；利水滲濕的蒼朮、木通去除濕邪；搭配石膏、知母加強清熱的效力，對於風邪、濕邪、熱邪所導致的風疹、濕疹頗具效果。
而當歸飲子這個方劑比較針對血虛、血燥的患者，內含四物湯以及何首烏補血活血，以生薑、防風、荊芥等辛溫解表藥物祛除風邪，整體改善患者皮膚癢以及脫屑的情形。
2023年2月18日 星期六
三伏/三九貼
「哈啾！！！」
大壯早上起來打了一個又大又響的噴嚏，把他睡在一旁的狗狗英雄都嚇醒了。
「討厭，又來了…」
兩行又長又濃的透明色鼻涕像是兩條麵條就掛在大壯的鼻孔上，晃來又晃去。
大壯趕緊拿了衛生紙把鼻涕擦乾淨，一邊擦一邊又打了好幾個噴嚏，更慘的是，他感覺到好像有些鼻涕倒流了。
「咳！咳！」
大壯用力的咳出來兩口濃痰，白白稠稠的，弄得整張衛生紙都是，還有一些沾到手了。
「我的媽啊…」
每到換季的時候，或是春天日夜溫差大的日子，大壯的鼻子就像一個壞掉的警報器，不斷的分泌出鼻水，搞得大壯睡覺也難睡，光打噴嚏就飽了，黑眼圈明顯得像是動物園裡的熊貓。
「該怎麼辦呢？」
小美是個剛步入青春期的少女，困擾的是最近月經來常常覺得下腹疼痛又腰痠，整個人很不舒服。冬天天氣冷的時候，小美的手腳冰冷的跟冰棒一樣，連用暖暖包都沒什麼起色，彷彿倒了一個熱水壺的熱水到太平洋似的，一點作用都沒有。
「抖抖抖抖….冷死我了，肚子又好痛，這樣是要怎麼上課啦？怎麼辦呢？」
「喔天啊，這已經是今天的第三次了。」
是的，這是今天小刀第三次去轟炸他們家的馬桶。瘦瘦小小的小刀比一般班上的同學矮了快一顆頭的高度，直叫他的爸媽急得像熱鍋上的螞蟻似的。明明平常吃飯胃口也不差，也不挑食，吸收硬是比別人差了一大截，整個人皮包骨，個頭又矮，又時常腹瀉拉肚子轟炸馬桶，大出一大堆稀稀水水的大便。
「拉到快虛脫了，身體快沒力氣了，怎麼辦..？」
呂醫師的話
不管是打噴嚏、流鼻水、鼻涕倒流的呼吸道症狀，還是少女痛經、手腳冰冷，甚至是消化不良、長期腹瀉，都可以來找中醫做三伏貼或是三九貼喔！
三伏貼和三九貼的敷貼時間分別在夏至和冬至這兩個最暖及最冷的節氣附近，皆使用辛熱的藥材諸如細辛、白芥子等敷貼在人體週邊的穴道。除了穴位敷貼之外，搭配中藥服用雙管齊下療效更佳！
過敏性鼻炎常打噴嚏流鼻水的患者可以敷貼在諸如第七頸椎的大椎穴提升陽氣，第七頸椎左右各0.5寸的定喘穴、第二胸椎左右各1.5寸的風門穴、鎖骨中央的天突穴改善呼吸道症狀！
痛經、手腳冰冷的女性朋友們可以敷貼在第二腰椎左右1.5寸的腎兪、腳踝內側的三陰交穴、太谿穴溫補身體，改善虛寒體質！
常態性腹瀉、消化不良的患者可以敷貼在臍下1.5寸以及3寸的氣海穴和關元穴、肚臍左右2寸的天樞穴，以及膝蓋下3寸的足三里穴，提升整體腸胃的吸收功能以及調節蠕動！
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注意事項
一般來說成人的敷貼時間約4個小時，小朋友則是2-3個小時，如果過程當中有出現輕微熱、刺、癢屬於正常現象，藥材正在發揮作用。若不舒服的感覺比較明顯，或是貼的地方已經出現一些發紅的狀況，可以提前撕下藥布沒關係，可能皮膚比較嬌嫩敏感，所以對於藥物的感受性比較強烈。
貼完當天儘量避免劇烈運動，因為出汗會使藥布滑落。飲食盡量清淡，烤的、炸的、辣的食物能免則免，太冰的飲料也要少喝。
誰不適合敷貼呢?
1. 孕婦
2. 1歲以下的小小朋友
3. 正在發燒或是急性感染中的病患
2023年2月11日 星期六
bald
Otis takes his dog Courage out for a ride. After he puts Courage on the passenger seat, he reaches out for his phone to play music. He accidentally turns on the phone camera and he is shocked by his retreating hairline.
“Oh boy….”
Back at the time of high school, Otis was the center of attention. He had long shiny hair and a big smile of white clean teeth. Prince Charming was no match for him. He won the heart of Jasmine and they got married later.
However, in order to maintain stylish and cool, Otis did a lot to his hair, either perm or dye them on a regular basis. Gradually his hair became oily and itchy and his hair weakened as well. To make matters worse, his job hasn’t been quite smooth lately: He had to work overtime a lot while his boss and clients kept picking on him. Irritated, exhausted and over stressed, he tends to scratch his head to feel some sense of relief, only to worsen his hair condition.
Saitama and Bruce have been best friends since college. They go to the gym together three times a week. They sometimes go jogging as well. In the beginning they were very weak, so weak that they couldn’t even complete one single push-up. However, thanks to their perseverance and determination，they are now strong enough to show some muscles at the beach. However, they discover something disturbing happening on their heads.
“ Hey Bruce, look at your hair! In my memory you used to have more of them!”
“ Your hair are lesser, too. Saitama, I thought I was looking at a lamp instead of your head this morning. Your scalp gets shiny!”
The two good friends google “ Muscle”、“Bald”
And the results:
“ LeBron, most scoring record holder, with a retreating hairline.”
“ Ginobli, great athlete with a killer-like Euro step. Used to have long smooth hair but is bald now.”
“ Jason Statham, former diving champion with abs out of marble stones and a shiny scalp.
“ The Rock, former WWE competitor, strongest man on earth.”
“ Hey Bruce, I’ve found a footage here when The Rock still got hair! “
“ Gee, it’s so hard for me to picture him with hair…”
The price of staying stylish is that all the chemicals would harm your hair and scalp gradually. Some people have strong hair to withstand them, while some just have to suffer the consequence of itchy and vulnerable scalp.
According to ancient Chinese medical documents, the liver collects the blood of the human body. The hair prospers with the blood as long as the liver is working fine. Anger and irritation would crumble the balance state of the liver, causing it to start a pathological fire, which affects the blood as well, resulting in a poor hair condition.
Ever felt weakness in your knees and waist? Chances are you might have insufficiency in your kidney. Kidney holds the essence of the human body, the insufficient state of kidney would lead to weakened and lesser hair.
So how do Chinese medical doctors deal with these kinds of situations? The key is balance, is to cut down on the excessive part and to supply the lacking part.
龍膽瀉肝湯(Long Dan Xie Gan Tang，soup of cleaning liver fire)、山梔子(Shan Chi t's， Fruits of [Gardenia jasminoides Ellis]) )are like good fire extinguishers to put out the burning pathological liver fire.
On the other hand，左歸丸(Tsou Gui Wan，pill of enhancing kidney functions)、杜仲(Du Chong，Tree barks of [(Eucommia ulmoides Oliv.) ])、熟地黃(Shou Di Huang，Roots of [ (Rehmannia glutinosa Libosch) ]) are like outstanding batteries to charge up the depleted kidney.
What’s the price of becoming strong? In addition to blood, sweat and tears and determination and perseverance, your hair. Males who are muscular tend to have a lot of testosterone in their bodies.
Testosterone is crucial to muscle growth and reproductive system, but harmful to hair. That’s why there are lots of great athletes, warriors or actors throughout history who are mighty as bulls but hairless as monks. Modern medicine would recommend Minoxidil as a method to increase hair growth. There is a similar Chinese herb counterpart called 何首烏(He Sho Wu，Roots of [Polygonum multiflorum Thunb.])which holds the function of nourishing liver and blood, flourishing one’s hair as a result.
It’s good to enjoy the sunlight. However, excessive UV rays could do some serious damage to the scalp. Good news is that there’s a simple way to provide physical shelter to the scalp and that is to wear a hat or cap. Be sure to take one with you out on a sunny day!
2023年2月4日 星期六
頭暈
小美最近大姨媽來，量都集中在頭幾天，血塊又多顏色也深，常常覺得身體疲勞沒什麼力氣，更糟的是，當她要變換姿勢從蹲或坐姿起身時，時常會覺得眼前一黑，腦袋一陣暈眩。
大明最近為了參加歌手的海選大賽，每天都跑步跑上好幾公里，又為了能讓自己的體重數字更好看一些，常常整天只吃一餐或是索性整天不吃。這一天，他感覺十分不舒服，除了頭暈得厲害之外，身體還不斷的冒冷汗。
大壯最近打完球之後吹風著涼感冒了，除了整天打噴嚏、流鼻水又鼻塞之外，整個頭常常覺得昏昏沈沈的，彷彿被人罩上一層濕布一樣，覺得頭很重，思緒也比平常慢上許多。
就讀醫學系的小刀起個大早要發奮念共筆拼期中，卻突然頭暈目眩、頭重腳輕，眼睛動個不停還有點噁心想吐。心慌了好一會兒小刀冷靜了下來，並綜合整理自己曾經學到的知識，判斷自己可能發生耳石脫落。
一種頭暈卻又好多種可能性
貧血會導致頭暈，特別是某些經期失血量較大的女性感受更深刻，若先天又伴隨地中海型或是缺鐵性貧血，症狀會更明顯。若變換姿勢時會出現視線漆黑的狀況，醫學上稱之為姿態性低血壓，也是跟貧血有些關係，處置上就是以改善貧血為主，並注意變換姿勢不宜過快過猛。西醫可能會推薦一些鐵劑補充，中醫可以用如四物湯或當歸、黃耆等中藥補氧氣血。
低血糖常常會出現頭暈以及冒冷汗的症狀，身體會感覺非常虛弱因為缺少運行所需的能量，也會影響肌肉的收縮力和協調性。挺多嘗試間歇性斷食的人會遭遇到這樣的不舒服，因此建議要這麼做的人身旁可以準備一些能量棒或是巧克力棒，以備不時之需，若是症狀太嚴重還是記得要去看醫生。
伴隨感冒出現的頭暈中醫可能鑑別診斷為有風、寒、濕邪侵襲，若覺得頭特別沉重像是罩了一層布似的，濕邪又稍微強烈了一些。中藥方藥上希望能達到祛風、散寒、除溼的效果，可能先以桂枝湯當作基底修復受損的營衛之氣，佐以辛溫解表藥諸如防風、羌活、麻黃等藥；鼻塞嚴重的加一些蒼耳子會有幫助，而蒼朮、陳皮可以多用一些以增強去除濕邪的力道。
耳石脫落成因很簡單，但是修復起來不簡單:人體算得上是對稱的，所以有雙耳、雙手、雙眼等成對器官，當無論哪一側的耳石受到外力或是自身影響，離開了原先的位置，便會導致兩側的不平衡，從而出現頭暈目眩、頭重腳輕、眼睛動個不停(眼振)、噁心想吐等等的症狀。這種情況不太需要吃藥或是打針，去尋求有經驗的耳鼻喉科醫師施行耳石復位術後，症狀便會有所改善。