问题 单项选择题

患者,女,60岁。急性化脓性乳腺炎切开排脓,用红升丹药条引流2天,周围出现大片皮疹,瘙痒,疮口脓腐未尽。外治应首选

A.七三丹
B.五五丹
C.八二丹
D.黑虎丹
E.白降丹

答案

参考答案:C

解析:[考点评析]
1.病因病机: * * 疾病的发生,常因冲任失调、郁怒伤肝、忧思伤脾、劳伤心肾,气机逆乱而郁结于乳络;或先天遗传、禀赋不足、发育畸形及妊娠调养失宜;或饮食不节,湿热火毒内生,胃热上蒸;或外感六淫邪毒及感受特殊之毒;或跌仆损伤,瘀血阻络,痰湿凝聚或脓腐蕴结,导致 * * 疾病的形成和发展。 * * 与足少阴肾、足阳明胃、足厥阴肝经以及冲任二脉有密切的联系。若经络闭阻不畅,冲任失调,则可导致多种 * * 疾病的发生。
2.辨证论治:
内治:①肝郁胃热证:常见于乳痈、乳发等病。因肝气不舒,胃热蕴蒸,日久化热,致 * * 局部红肿热痛,脓水黄稠。伴有发热恶寒,口干而渴,尿赤便秘。舌红,苔黄或腻,脉弦数。治以疏肝解郁,清热解毒,选用瓜蒌牛蒡汤、银翘散或内疏黄连汤等。②气虚毒滞证:常见于乳岩、乳痈和乳发等病。气虚血少,正气虚衰,难以托毒,可致 * * 局部疮形平塌散漫,难脓难溃,或脓血清稀,久难收口。伴有少气懒言,语声低微,倦怠乏力。舌淡,脉细。治以扶正托毒,选用托里消毒散、透脓散等。③肝郁气滞冲任失调证:常见于乳癖、乳岩等病。忧思郁怒,情志失畅,肝气失疏而郁结,情志内伤还可导致冲任之脉失和而紊乱,因而可见 * * 胀痛,甚至形成 * * 肿块。伴有胸闷易怒,月经不调。舌苔薄白,脉弦滑。治以疏肝理气,调和冲任,选用逍遥散、开郁散及二仙汤等。④肝肾不足冲任失养证:常见于乳疬和乳癖等病。由于先天不足或后天失调,以致肝肾亏损,冲任失养而不调,可见 * * 胀痛常在经前加重, * * 肿块常与发育、月经、妊娠等有关,伴有头晕耳鸣,腰酸肢软,月经失调。舌苔薄白,脉弦细数。治以补益肝肾,调摄冲任,选用二仙汤、右归丸、六味地黄丸等。⑤肺肾阴虚痰凝证:常见于乳痨等病。由于肺肾阴亏,阴虚火旺,肺津不布,灼津为痰,痰火循经结于 * * ,可见 * * 肿块皮色不变,微微作痛,化脓迟缓,脓水清稀。伴有午后潮热,夜寐盗汗,形瘦食少。舌红,苔薄,脉细数。治以补肺益肾,滋阴清热化痰,选用消疬丸合开郁散、六味地黄丸合清骨散。⑥气血两虚证:常见于乳痈、乳发、乳岩、乳痨等病。全身气血两虚可由劳伤过度,久病失养等而致,除 * * 局部症状外,并有面色无华,气短乏力,食欲不振,头晕耳鸣,大便溏薄。舌淡,苔白,脉细无力或沉迟。治以补虚扶正,选用香贝养荣汤、归脾汤、八珍汤等。
外治:感染性 * * 病:应分辨属阳证的乳痈、乳发等病和属阴证的乳痨等病,按阳证、阴证疮疡分期处理。初起宜清热解毒,活血消肿为主,用金黄膏、玉露膏或回阳玉龙膏等外敷;成脓宜提毒祛腐,选用八二丹、九一丹外掺或药捻;溃后脓尽,用生肌玉红膏、生肌散等。肿瘤性 * * 病:常用温经和阳、化痰通络、消肿止痛等法,选用阳和解凝膏掺黑退消、桂麝散等。
3.乳发是发生在 * * 部肌肤之间,容易腐烂坏死的严重化脓性疾病,相当于西医的 * * 部蜂窝组织炎或 * * 坏疽。多发生于哺乳期妇女。其特点是 * * 部皮肤焮红漫肿,疼痛剧烈,毛孔深陷,皮肉迅速溃烂坏死,症情重者可发生热毒内攻的危象。本病病变范围比乳痈大。
4.乳痈是由热毒侵入 * * 所引起的一种急性化脓性疾病,相当于西医的急性乳腺炎。其特点是 * * 局部结块,红肿热痛,伴有全身发热、便干等全身症状。治疗:未成脓之前:暂停哺乳,同时采取措施使乳汁通畅排出。局部可用湿热敷,炎症早期可在炎灶四周注射青霉素,症状严重者,用有效抗生素。已成脓后,主要治疗措施是及时切开引流。如炎症明显,而波动感不明显时,用稍粗针头在压痛最明显处实行穿刺,及早发现深部脓肿。

阅读理解

This week is National Volunteer Week, a time for the Canadian Red Cross to recognize our dedicated (有奉献精神的) volunteers who devote their time and talents from coast to coast. Over the course of the week we will use this blog to share stories about our volunteers and the amazing work they do --- a small part of the outstanding individuals across the country.

Take Saskatchewan for example. Last year that province was hit by wide-spread flooding, a hurricane and forest fires. Canadian Red Cross staff and volunteers went to work right away and helped more than 2,100 adults and 775 children recover the basic necessities of life.

It’s important to share stories from volunteers to truly appreciate what they do. Christine Hoffman is a Disaster Response Volunteer in Canadian Red Cross in Saskatchewan. She’s a veteran Red Crosser for about 16 years. Still nothing could have prepared her for the call she took in the Recovery Center last year in response to flooding in Maple Greek. This story is best told in her own words. This is what she said:

“I will never forget the first phone call I took in the Recovery Centre. A young man called asking what services Red Cross was offering in town. As we were talking, he told me he had a rope in his backyard but he thought he would be using it for other reasons. My heart stopped. I told him to come to see us so we could work together on a plan to improve his situation. He came in a little while later. Nearly two hours later he left standing straight up with tear- filled eyes. He thanked me for convincing him to come in. His home had been destroyed, but together we put together a plan and he was eventually able to move back into his own home.”

During National Volunteer Week 2011, let’s thank Christine, and the many other volunteers like her. Thanks for making us proud!

小题1:According to the second paragraph, Canadian Red Cross’ action is ______

A.slow

B.quick

C.helpless

D.disappointing小题2:Which of the following is closet in meaning to the underlined word “veteran” in the third paragraph?

A.Careless

B.Experienced

C.Unskillful

D.Optimistic小题3:The underlined words in the forth paragraph expressed Christine Hoffman’s feeling of ____

A.excitement

B.anger

C.happiness

D.nervousness小题4:What can we infer from what Christine Hoffman said?

A.The young man felt sad for Christine Hoffman because of her poor experience

B.The young man was persuaded by Christine Hoffman and decided to live on

C.Christine Hoffman made the young man sad and he cried

D.Christine Hoffman offered to give the young man a little money to help him小题5:What is the text mainly about?

A.How to become a volunteer

B.An excellent volunteer and her family

C.Volunteers and their amazing work

D.What the Canadian Red Cross does

单项选择题