Encyclopedia of Family Medicine

Chapter 44 Prevention of Common Diseases (5)
10. Pancreatitis
Pancreatitis is a chemical inflammation caused by the digestive enzymes of the pancreas digesting its own organs.In the acute phase, fasting is necessary, because after food and acidic gastric juice enter the duodenum, they can reflexively stimulate the pancreas to secrete digestive enzymes, thereby increasing the burden on the pancreas and affecting the recovery of inflammation.For the milder edema type, generally fast for 1 to 3 days, and gradually eat a small amount of liquid food after the epigastric pain and vomiting have basically disappeared.For example, pancreatitis is caused by overeating or alcoholism, and the diet should be strictly controlled after the illness or during the recovery period, especially high-fat foods should be avoided.Because fatty meat and some foods rich in fat and protein, including dumpling stuffing, fried foods, etc. are not easy to digest, they may activate pancreatic digestive enzymes, thereby aggravating or recurring.During the onset of pancreatitis, cold foods such as fruits, ice cream, ice cream, and sour plum soup, as well as high-fiber foods and gas-producing foods such as leeks, beans, and potatoes should be eaten less or not.In clinical practice, the most common is pancreatitis caused by excessive drinking, because acute pancreatitis is caused by digestive enzymes secreted by the pancreas to digest the glands.When the patient drinks again, the alcohol mixed liquid stimulates the pancreas through the pancreatic duct, blood vessels, lymphatic vessels, etc., causing obstruction of the pancreatic duct.The hypersecretion of the pancreas increases the pressure in the duct, which ruptures the epithelium of the pancreatic duct, causing duodenal fluid and bile fluid to flow through the bile duct, eventually leading to cell dysfunction of the pancreas, aggravating its own inflammation, congestion and edema, leading to hemorrhage and necrosis. Necrotizing pancreatitis is often life-threatening.

Therefore, patients with pancreatitis must strictly abide by the doctor's advice, do not eat indiscriminately during the fasting period, and must not drink alcohol.According to the theory of traditional Chinese medicine, it is necessary to avoid fat, sweet and thick flavors and hot and warm products, do not overeat, eat less raw and cold food, and quit drinking.If you can do this, you can effectively prevent the occurrence of pancreatitis.

11. Diabetes
Diabetes is a common endocrine and metabolic disease with a genetic predisposition. Relative or absolute insufficiency of insulin secretion causes carbohydrate, protein, and fat metabolism disorders. Diabetes is a chronic disease. During the treatment process, reasonable diet control is extremely important.Generally speaking, the diet of diabetic patients should be low in sugar, low in fat, low in calories and high in fiber.First of all, diabetes should avoid fat, sweet and thick taste.Diabetes is called diabetes in traditional Chinese medicine, which is caused by yin deficiency and dryness. However, fatty, sweet and thick-flavored foods have the disadvantage of hurting yin and helping heat, so they should not be eaten.If you eat fat, sweet and thick flavors for a long time, it will affect the digestion of the spleen and stomach. Excessive food in the stomach will stagnate, accumulate heat and transform dryness, damage yin and consume body fluid, and symptoms such as disappearing grains and easy hunger will appear, resulting in thirst. "Fat" refers to high-fat food, such as fatty meat, butter, egg yolk, etc.; "Gan" refers to food with high sugar content; , Huhe, star anise, fennel, cinnamon and fried food, etc.

Generally speaking, the fat intake should be less than 1 gram per kilogram of body weight per day. Too much fat will prevent the utilization of sugar and easily cause ketoacidosis. Therefore, you should eat less or no animal oil, and avoid animal offal, such as brain. , kidney, stomach, heart and other high cholesterol foods.Similarly, the intake of protein should also be determined as appropriate. If the disease is serious and the liver and kidney functions are not good, the intake of protein should be resolutely limited.Doctors have always warned patients to limit sugar, because fatty foods can greatly increase the risk of coronary heart disease, the consequences are more serious than diabetes itself.The purpose of carbohydrate-restricted foods is to increase the ability to control carbohydrate metabolism by reducing the patient's need for insulin.However, observations in recent years have found that people with diabetes suffer from cardiovascular disease due to over-reliance on the supply of fatty foods.According to statistics, about 70% to 80% of diabetic patients die from cardiovascular system diseases. It is because of this factor that experts propose that fatty foods should be reduced.For people with diabetes, it is most important to control the intake of sugar, so glucose that can be directly absorbed and sucrose that can be easily digested should be fasted to avoid a significant increase in blood sugar.

At present, it is advocated at home and abroad to give diabetic patients 10 grams to 20 grams of honey, once a day, as adjuvant therapy is advisable.However, it is necessary to refer to the patient's urine sugar and blood sugar, and not all patients can eat honey.Because honey contains about 1% sugar, of which 80% is glucose that can be absorbed without digestion, about 42% is sucrose that is easily digested and absorbed, and 2% fructose. The first two are absorbed quickly and concentratedly by the human body. Great impact on blood sugar fluctuations.Therefore, in the case of uncontrolled or unstable blood sugar and urine sugar, eating honey will increase blood sugar, which is very unfavorable for the treatment of the disease.If blood sugar and urine sugar have been controlled, when honey is needed for treatment or other reasons, the amount of staple food should be reduced at the same time.Generally eat 35 grams of honey, deduct the same amount of food that day.The time to eat is in the early morning or between meals, and it should be diluted with honey or put into medicinal juice.Although honey is a supplement, because it can be directly absorbed by the human body, it is easy to increase blood sugar. Therefore, under normal circumstances, diabetic patients should not eat honey or eat as little as possible, so as not to affect the disease and treatment.Second, diabetic patients should abstain from drinking alcohol.Alcohol in wine can generate a lot of heat, and each gram of alcohol can release 50 kcal of heat energy. Alcohol will aggravate the disease. Therefore, diabetic patients should resolutely limit drinking.Patients who are taking methamphetamine or insulin injections should especially avoid alcohol.Because drugs can stimulate insulin secretion and lower blood sugar, and alcohol has the effect of preventing the rise of sugar in the liver, such as taking drugs and drinking alcohol, can make blood sugar drop, and hypoglycemia is prone to occur.

In addition, alcohol is a kind of drug enzyme, which can accelerate the metabolism of drugs, significantly shorten the half-life, and significantly reduce the curative effect.Insulin can enhance the toxicity of alcohol, so diabetic patients should resolutely refrain from drinking white wine, wine, and preferably not beer when injecting insulin.Finally, diabetics should quit smoking.Nicotine can stimulate the secretion of adrenaline and increase blood sugar. A small amount of nicotine can excite the central nervous system, while a large amount of nicotine can inhibit or paralyze the central nervous system, which is extremely unfavorable to diabetic patients, especially those who rely on insulin therapy. Patients should quit smoking.Because such patients do not smoke, the peripheral blood vessels will continue to shrink and directly affect the absorption of insulin.Generally, smokers need to inject 15% to 20% more than non-smoking patients, while heavy smokers need to use 30% more insulin to be effective.Therefore, if diabetic patients want to restore their health, they should quit smoking as soon as possible.

Diabetes mellitus is a disorder of glucose metabolism caused by the lack of insulin secreted by pancreatic islets in the pancreas.After diabetics eat, especially after eating sugary foods, blood sugar rises significantly, causing the symptoms of "three more and one less" - eating more, drinking more, urinating more, losing weight, and in severe cases, heart disease may occur. , Cerebral and vascular complications.Watermelon contains a lot of fructose, which enters the body into glucose. Eating watermelon is like drinking sugar water, which will significantly increase blood sugar.This will increase the burden on the pancreas, increase urine sugar, and make diabetes aggravated.Therefore, it is best for diabetics not to eat watermelon.

12. Urinary tract stones
Urinary tract stones include ureteral stones, kidney stones, and bladder stones. They are complications of various metabolic diseases and are closely related to improper diet.The main component of urinary stones is calcium oxalate.If the human body takes too much oxalic acid, once the calcium oxalate in the urine is saturated, the calcium oxalate crystallizes and precipitates, and if this happens for a long time, stones will gradually form.Therefore, oxalate-rich foods such as spinach, tea, and citrus fruits are factors that promote urinary stones.Among them, spinach has the highest oxalic acid content, so ordinary people should not eat more, let alone those with urinary tract stones.Of course, the causes of urinary stone formation are very complicated. In addition to eating too much food high in oxalic acid, it is also directly related to the amount of calcium in the diet and the intestinal absorption capacity of oxalate.

In general, the diet of patients with urinary tract stones should be based on the normal diet, adding some fluids is better.To prevent urolithiasis, drink plenty of water and dilute the urine, which can reduce the concentration of oxalate in the urine.

13. Nephritis

In patients with nephritis, the amount of sodium excreted every day is reduced due to the decline of renal function, and part of the sodium is stored in the body.Sodium has the function of absorbing water. When there is too much sodium in the body, the osmotic pressure of sodium and water in the blood changes, and it seeps into the interstitial space to form edema.Severe edema can increase blood pressure and increase the burden on the heart, leading to heart failure.Therefore, patients with nephritis should control sodium intake, that is, eat less salty food.When there is edema, salt should be banned, and food containing salt should be avoided as much as possible. At the same time, it is not advisable to use salty traditional Chinese medicine Qiushi instead of salt, because the content of sodium chloride in Qiushi is more than 49%.In addition, because most fruits are nutritious, sweet and delicious, you can eat some even if you have a poor appetite.However, patients with acute nephritis, chronic nephritis and poor renal function should not eat bananas because the sodium content in bananas is high.

Nephritis with edema, high blood pressure, the intake of sodium must be controlled, the diet should be low-salt or no salt is better.If you eat a lot of bananas, it is equivalent to eating a small amount of salt, which will increase the sodium content in the blood, increase the burden on the kidneys, and aggravate symptoms such as edema and high blood pressure.Furthermore, bananas have the effect of smoothing the intestines and causing diarrhea, which is especially unfavorable for those with indigestion.Therefore, nephritis should not eat bananas.Patients with nephritis should also taboo high-protein foods and eat a lot of protein, which is harmful and unhelpful.After the protein is digested and absorbed by the gastrointestinal tract, it is metabolized by the liver, converted into amino acids, and finally converted into metabolites such as inositol, inositol, urea, etc. If the kidney function is not good, uremia may occur, and even life-threatening.Kidney disease also needs to control high cholesterol and irritating foods. Because of the high serum cholesterol in patients with chronic nephritis, in order to prevent hypercholesterolemia, it is best not to eat animal brain marrow, fish roe, shrimp roe, crab roe, egg yolk and animal offal.Tobacco, alcohol, strong tea, coffee, and spicy condiments such as onions, garlic, peppers and other irritating foods should also be avoided as much as possible.This shows that the dietary treatment of kidney disease is also very important.Whether the diet is appropriate has a very important relationship with the recovery of the disease.Improper diet can aggravate the condition or cause other complications.In short, kidney patients should first have a low-salt diet, and do not eat bananas, nor can they eat a high-protein diet, and cholesterol and stimulating foods should be controlled.

Patients with kidney disease need to ban salt when their kidney function is poor and there is obvious edema.Bananas also contain more sodium salt. If you eat a lot of bananas, it will cause sodium retention in the patient's blood, aggravate edema, increase the burden on the heart and kidneys, and make the condition worse.Some nephritis patients have diarrhea, and bananas have the effect of smoothing the intestines. Eating bananas will aggravate the diarrhea.

Transient ischemic attack
Transient ischemic attack (TIA), also known as small sudden attack, is a short-term, local lack of cerebral blood supply, causing its corresponding dysfunction. 24 hours without any neurological deficit.

The etiology of this disease is mainly atherosclerosis, and the pathogenesis is mostly considered to be caused by microembolism.In addition, cerebral vascular stenosis, hemodynamic changes, carotid artery compression, and blood hypercoagulability can all lead to this disease.

The disease mostly occurs in 50 to 70 years old, more men than women.The main features are: sudden onset, short duration, usually a few minutes to several hours, no more than 24 hours, no neurological deficit after recovery, often repeated attacks, and the symptoms of the attack depend on the involved arterial system.

Internal carotid artery system TIA, mainly manifested as contralateral unilateral weakness or incomplete hemiplegia, contralateral sensory disturbance, aphasia, one-time amaurosis, etc.

Vertebro-basilar artery system TIA is the most common symptom of vertigo, and diplopia, ataxia, balance disorder, and dysphagia may also occur at the same time.Crossed paralysis is a characteristic symptom of brainstem damage. A small number of patients have a fall attack, that is, sudden weakness of both lower limbs, fall to the ground, and stand up on their own before losing consciousness.This is caused by brainstem reticular ischemia.

Involvement of the limbic lobes may result in transient generalized amnesia that resolves after a few hours.

Migraine

Migraine is a recurring headache caused by vascular-nerve dysfunction, more women than men, and half of the cases have a family history.

Typical patients have obvious aura symptoms during the attack, the most common being visual disturbances, such as flashes, scotomas, hemianopia, etc., which last for about 10 to 30 minutes, followed by severe pain, eye pain or tingling, often accompanied by nausea , Vomiting, the patient was pale, photophobic, hi static, relieved after a few hours, and returned to normal the next day.

Most patients have no obvious aura symptoms, and the headache lasts for several days, which is called common migraine.A small number of patients may experience ipsilateral ophthalmoplegia after the headache is relieved, and return to normal after a few days.Some have hemiparesis and numbness as a precursor, and return to normal after the headache is relieved.Very few people have headache with dizziness and ataxia, which recover after a few hours, suggesting basilar artery spasm.

Sedatives and analgesics can be used to relieve mild and moderate migraine headaches, and severe cases should be used under the guidance of a doctor.

Try to avoid triggering factors such as fatigue, emotional stress, and lack of sleep.

Bronchial Asthma

Clinically, the disease can be divided into two categories: endogenous and exogenous.Extrinsic asthma often presents in childhood with a history of significant allergic reactions to multiple allergens.Intrinsic asthma is common in adults, and it is mostly caused by non-antigenic factors such as respiratory infection, cold air, irritating gas and other biological, physical and chemical or exercise, mental and nervous factors.

1.Exogenous asthma: Most patients have a history of exposure to allergens. During the attack, there are often signs of mucosal allergy such as itchy nose and eyelids, sneezing, runny nose or dry cough, followed by expiratory dyspnea with wheezing sounds, and chest tightness. , was forced to take a sitting position, and cyanosis occurred in severe cases.

2. Endogenous asthma: can be induced by a variety of non-allergic factors.Common infectious asthma, drug-induced asthma, occupational asthma, exercise-induced asthma and neuropsychiatric asthma.

3.Mixed asthma: Asthma attacks repeatedly for a long time, and various factors interact with each other, making the symptoms atypical or mixed.

4.Status Asthma: A severe asthma attack that lasts more than 24 hours.During the attack, mouth breathing and profuse sweating, obvious cyanosis, orthopnea, and respiratory and circulatory failure may occur if the disease cannot be controlled.

General care for bronchial asthma includes:

1.Psychological Nursing: When an asthma attack occurs, patients often have anxiety and fear. We should be considerate to the patient, provide psychological care and spiritual support, so that the patient can strengthen his confidence in fighting the disease and cooperate closely with various treatments.

2.Dust should be prevented from inhaling to prevent patients from inhaling and inducing or aggravating asthma.Those who are unable to take care of themselves due to severe asthma should do basic care and various life care.

3. Condition observation: Closely observe the aura symptoms of asthma attack, so as to give timely treatment and stop the attack.Asthma often occurs at night, so you should pay attention to it at night.For those with obvious dyspnea, oxygen should be inhaled, and oxygen should generally be given at a low concentration. Pay attention to the humidification, heat preservation and smoothness of the respiratory tract.

For those with sticky sputum that is difficult to cough up, take measures such as turning over, slapping the back, atomizing and humidifying the airway, suctioning sputum, and dripping infusions to correct dehydration.

4. Rehabilitation guidance: Provide health education to patients, popularize knowledge of asthma prevention and treatment, instruct them to avoid contact with allergens, advise smokers to quit smoking, and usually pay attention to preventing colds.Proper exercise to improve the body's immunity.

pneumothorax
Air entering the pleural cavity is called pneumothorax. At this time, the pressure in the pleural cavity increases, and even becomes positive pressure, compressing the lungs, resulting in varying degrees of pulmonary heart dysfunction.It is caused by trauma, basic lung disease, and artificial pneumothorax.There are three clinical types: closed (simple) pneumothorax, tension (high pressure) pneumothorax and communicating (open) pneumothorax.

Patients often have predisposing factors such as holding heavy objects, breath-holding, and strenuous exercise, and it also occurs during sleep.The patient suddenly felt chest pain on one side, shortness of breath, breathlessness, and may have cough and less sputum.In tension pneumothorax, due to the sudden increase in intrathoracic pressure, the lungs are compressed, the mediastinum is displaced, and severe respiratory and circulatory disturbance occurs. The patient has a tense expression, shortness of breath, often struggles to sit up, restlessness, cyanosis, cold sweat, and rapid pulse , collapse, and even respiratory failure, unconsciousness.

The patient should take a semi-recumbent position, which is conducive to breathing exercises, and oxygen should be inhaled when hypoxia occurs.The ward should be kept quiet, with fresh air, sufficient sunlight, suitable room temperature and humidity, restricted activities, and avoided excessive movement.The diet should contain more vegetables and fruits to keep the stool smooth.Avoid exerting force during defecation to increase the pressure of the pleural cavity and delay the healing of the pleural tear.

Pay attention to observe the changes in body temperature, pulse, blood pressure and respiration, such as shock symptoms such as increased dyspnea, cyanosis, profuse sweating, cold limbs, weak pulse, and drop in blood pressure.should be treated immediately.

Arrhythmia
Arrhythmia is a group of symptoms caused by abnormal cardiac excitation or conduction disorder caused by various reasons. Mild cases may be asymptomatic or only have the symptoms of the underlying disease causing arrhythmia. Severe cases may cause severe hemodynamic disorders. Threatening the patient's life.

1.Sinus arrhythmia, the normal cardiac pacemaker is located in the sinoatrial node, and the heart rhythm caused by the impulse of the sinoatrial node is called sinus rhythm.

(1) Sinus tachycardia: The frequency of sinus rhythm exceeds 100 beats/min, which is common in exercise, emotional agitation, fever, hyperthyroidism, anemia, heart failure, etc.

(2) Sinus bradycardia: frequency less than 60 beats/min, common in athletes, the elderly, taking digitalis, propranolol and other drugs, increased intracranial pressure, obstructive jaundice, hypothyroidism and some organic heart disease.Mild cases have no obvious symptoms, such as bradycardia, chest tightness, palpitations, and even syncope.

(3) Sinus arrhythmia: sinus rhythm, irregular rhythm.It is common in children and young adults and is mostly asymptomatic.

(4) Sinus arrest: Digitalis, quinidine and other drugs can cause arrest.If the pause time is too long, dizziness, syncope and even convulsions may occur.

(5) Sick sinus syndrome: a syndrome of various arrhythmias and symptoms, commonly seen in coronary heart disease, cardiomyopathy, myocarditis, rheumatic heart disease, congenital heart disease, etc. Fatigue, fainting occurs in severe cases.

(End of this chapter)