店员经典教材：口咽腔部疾病的症状、诊断、用药

店员经典教材：口咽腔部疾病的症状、诊断、用药 店员经典教材:口咽腔部疾病的症状、诊断、用药 口咽腔中最常见的疾病是急性咽炎、慢性咽炎、急性扁桃体炎、慢性扁桃体炎。对于中医、西医对四种疾病的不同认识，药店从业人员都应有所了解。下面分别从病因、症状、诊断要点、治疗等方面对上述四种疾病进行了与。 一、急性咽炎 1、概述:是咽粘膜、粘膜下组织及其淋巴组织的急性炎症，常为上呼吸道感染的一部分。可单独发生，也可由急性鼻炎向下蔓延所致，秋冬及冬春之交发病率较高。与中医相对应的疾病多为风热型“喉痹”。 2、病因: (1)西医:病毒感染，以萨科奇病毒、腺病毒、副流感病毒为主;还有细菌感染，以链球菌、葡萄球菌、肺炎双球菌为主;以及粉尘、烟雾等刺激性因素。诱因主要是受凉、疲劳、烟酒过度及全身抵抗力下降等。 (2)中医:常因气候急剧变化，起居不慎，肺卫失固，而为风热邪毒乘虚侵犯，从口鼻直袭咽喉，内伤于肺，相搏不去，致咽喉肿痛而为喉痹。此时邪在卫，故病情较轻，若由误治，失治，或肺胃邪热壅盛传里，则出现胃经热盛之证候，病情转重。 3、症状:起病较急，初起时咽部干燥，灼热。继有咽痛，空咽时咽痛往往比进食时更加明显，疼痛可放射到耳部。全身情况一般较轻，严重者表现为发热、头痛、食欲不振和四肢酸痛等。可出现颌下淋巴结肿大，且有压痛。 4、诊断要点: (1)咽痛，吞咽疼痛加剧; (2)发热，体温可达39?; (3)咽粘膜弥漫性充血肿胀，咽峡部明显，悬雍垂水肿; (4)颌下淋巴结肿大并有压痛。 5、治疗: approval, approval of the supervisor, according to design drawings and a model, before extensive construction. (6) the external finishing locally with special materials, according to the drawing requirements. Interior decoration of 12.9 (1) the scope and use of interior decoration materials according to map. Strict construction the contractor, to rework parts of the material, work, all responsible. (2) Interior finish: cement stone floors, self-levelling floor cement stone chip kicks; flying white walls; flying pink roof. (3) decorating approaches strictly in accordance with design drawings and construction. Decor decoration see repair parts. (4) Interior lamps, specifications must be approved by the design people agree, supervisor approval can be installed. 12.10 balustrades (...Construction organization and allocation of resources of the 13th chapter 13.1 setting principle 1 principle, respond to requirements of the tender documents; 2, adapting to the construction characteristics and the principles of the standard construction site conditions; 3, efficient, capable, flexible and professional to configure the principle; 4, in favor of principles of construction, scheduling and contract management; 5, in favor of contract duration, the project quality and safety principles. 13.2 organizational structure our company is engaged in water conservancy and hydropower engineering construction engineering company. For many years through the construction of water conservancy and hydropower project, has accumulated some experience in construction technology, cultivate a group of construction personnel are capable of doing. As well as (1)西医:休息，多饮水，进易消化食物，通便;给解热镇痛药;早期应用抗病毒药，对感染重者给抗生素;局部治疗。 (2)中医:一、风热外侵，肺经有热。症见初起咽部干燥灼热，微痛，吞咽感觉不利，其后逐渐加重，有异物阻塞感。全身有发热，恶寒，头痛，咳嗽痰黄，苔薄白或微黄。治宜疏风清热，解毒利咽，比如银翘解毒丸。二、邪毒传里，肺胃热盛。症见咽部疼痛逐渐加剧，痰涎多，吞咽困难，言语艰涩，咽喉梗塞感。全身症状为高热，口干喜饮，头痛剧，痰黄而粘稠，大便秘结，小便黄，舌赤苔黄。治以泄热解毒，利咽消肿。 6、提示顾客:注意清淡饮食，避免咽喉刺激。 三、慢性咽炎 1、概述:为咽部粘膜，粘膜下及淋巴组织的弥漫性慢性炎症，常为上呼吸道慢性炎症的一部分。与中医相对应的疾病多为虚火型“喉痹”。 2、病因: (1)西医:急性咽炎反复发作转为慢性;上呼吸道慢性炎症刺激，如慢性鼻窦炎、鼻咽部炎、慢性扁桃体炎、龋齿等;长期烟酒过度，或受粉尘、有害气体的刺激，均可引起本病;职业因素(用嗓多者)及体质因素;多种慢性病，如贫血、消化不良、胃食管反流性疾病、心血管疾病、慢性下呼吸道炎症、肝肾疾病等都可引发本病。 (2)中医:以肺肾亏损、津液不足、虚火上炎，循经上蒸，熏蒸咽喉为多见。诱因是各种刺激，如化学气体、粉尘、烟酒辛辣等。如迁延不愈、用药失当，则也可出现气虚喉痹、阳虚喉痹等。 3、症状:咽部可有各种不适感，如异物感、灼热、干燥、痒、微痛等。由于咽后壁常有较粘稠的分泌物刺激，常在晨起时出现较频繁的刺激性咳嗽，严重时可引起作呕，咳嗽时一般无分泌物咳出。全身症状不明显。 4、诊断要点: (1)咽部不适感常有“吭”、“喀”等清嗓动作; approval, approval of the supervisor, according to design drawings and a model, before extensive construction. (6) the external finishing locally with special materials, according to the drawing requirements. Interior decoration of 12.9 (1) the scope and use of interior decoration materials according to map. Strict construction the contractor, to rework parts of the material, work, all responsible. (2) Interior finish: cement stone floors, self-levelling floor cement stone chip kicks; flying white walls; flying pink roof. (3) decorating approaches strictly in accordance with design drawings and construction. Decor decoration see repair parts. (4) Interior lamps, specifications must be approved by the design people agree, supervisor approval can be installed. 12.10 balustrades (...Construction organization and allocation of resources of the 13th chapter 13.1 setting principle 1 principle, respond to requirements of the tender documents; 2, adapting to the construction characteristics and the principles of the standard construction site conditions; 3, efficient, capable, flexible and professional to configure the principle; 4, in favor of principles of construction, scheduling and contract management; 5, in favor of contract duration, the project quality and safety principles. 13.2 organizational structure our company is engaged in water conservancy and hydropower engineering construction engineering company. For many years through the construction of water conservancy and hydropower project, has accumulated some experience in construction technology, cultivate a group of construction personnel are capable of doing. As well as第 1 页 共 2 页 (2)病程长，时轻时重。 此病可细分为慢性单纯性咽炎、慢性萎缩性咽炎、慢性肥厚性咽炎等，药店无法具体诊断，了解即可。 5、治疗: (1)西医:主要是忌烟洒，防粉尘，处理鼻及鼻窦疾病，恢复鼻呼吸，少用嗓，少作清嗓动作等对因治疗;通过运动和饮食提高免疫力;局部治疗 (2)中医:一、肺阴亏虚。症见咽中不适，因咽痒而易引发咳嗽、恶心、干呕等，多于早晨较轻，午后及入夜加重。并可有午后颧红，精神疲乏，手足心热，乏力，舌质红或干、少苔。治宜养阴清肺，比如养阴清肺丸。二、肾阴虚损。除上述咽部症状外，还可见头晕眼花，耳鸣，耳聋，腰膝痠软，虚烦失眠，舌红少苔。治宜滋阴降火，清利咽喉，比如知柏地黄丸。 6、提示顾客:应经常告诫顾客，避免病因刺激比用药治疗更为关键。 四、急性扁桃体炎 1、概述:为腭扁桃体的急性非特异性炎症，常继发于上呼吸道感染，并伴有程度不等的咽部粘膜和淋巴组织的急性炎症。与中医对应的病名为“风热乳娥”。 2、病因: (1)西医:乙型溶血性链球菌为本病的主要致病菌，细菌和病毒混合感染者亦不少见。受凉、潮湿、过度劳累、烟酒过度、有害气体剌激、上呼吸道有慢性病灶存在等均可成为诱因。 (2)中医:病因一是风热外侵，肺经有热。咽喉为肺胃所属，风热邪毒入侵于肺，咽喉首当其冲;二是邪热传里，肺胃热盛。肺胃火热上蒸，搏结于喉核，灼腐肌膜，喉核肿大。 3、症状:起病急，可有畏寒、高热、头痛、食欲下降、疲乏无力、周身不适、便秘等。小儿患者可因高热而引起抽搐、呕吐及昏睡;剧烈咽痛常放射至耳部，多伴有吞咽困approval, approval of the supervisor, according to design drawings and a model, before extensive construction. (6) the external finishing locally with special materials, according to the drawing requirements. Interior decoration of 12.9 (1) the scope and use of interior decoration materials according to map. Strict construction the contractor, to rework parts of the material, work, all responsible. (2) Interior finish: cement stone floors, self-levelling floor cement stone chip kicks; flying white walls; flying pink roof. (3) decorating approaches strictly in accordance with design drawings and construction. Decor decoration see repair parts. (4) Interior lamps, specifications must be approved by the design people agree, supervisor approval can be installed. 12.10 balustrades (...Construction organization and allocation of resources of the 13th chapter 13.1 setting principle 1 principle, respond to requirements of the tender documents; 2, adapting to the construction characteristics and the principles of the standard construction site conditions; 3, efficient, capable, flexible and professional to configure the principle; 4, in favor of principles of construction, scheduling and contract management; 5, in favor of contract duration, the project quality and safety principles. 13.2 organizational structure our company is engaged in water conservancy and hydropower engineering construction engineering company. For many years through the construction of water conservancy and hydropower project, has accumulated some experience in construction technology, cultivate a group of construction personnel are capable of doing. As well as 难。部分出现下颌角淋巴结肿大，可出现转头受限。炎症波及咽鼓管时则出现耳闷、耳鸣、耳痛甚至听力下降。葡萄球菌感染者，扁桃体肿大较显著，在幼儿还可引起呼吸困难。 4、诊断要点: (1)咽痛剧烈，可能放射到耳部; (2)发热可达40?;扁桃体红肿，有脓性分泌物; (3)颌下淋巴结肿大，有压痛。 此病可分为卡他性、滤泡性、隐窝性，了解即可。十岁以下儿童要考虑腺样体炎(咽扁桃体炎)。 5、治疗: (1)西医:休息，多饮水，食易消化食物，给退热止痛剂，足量、足时使用抗生素，首选青霉素，或磺胺类、第二代头孢类;外加局部治疗 (2)中医:一、风热外侵，肺经有热。症见咽部干燥灼热，喉核红肿，连及周围，并见发热恶寒，头痛，鼻塞，体倦怠，咳嗽有痰，舌边尖红，苔薄白或微黄。治宜疏风清热，消肿利咽。二、邪热传里，肺胃热盛。疼痛剧烈，连及耳根及颌下，吞咽困难，有堵塞感，或有声嘶。喉核红肿，表面或有黄白色脓点。全身高热，口渴，咳嗽痰稠黄，口臭，腹胀，大便秘结，小便黄，舌质红赤，苔黄厚。治宜泄热解毒，利咽消肿。 6、提示顾客:急性扁桃体炎的病原体可通过飞沫或直接接触传染，部队、工厂、学校等地要注意预防传染。 五、慢性扁桃体炎 1、概述:多由急性扁桃体炎反复发作或因腭扁桃体隐窝引流不畅，窝内细菌、病毒滋生感染而演变为慢性炎症。与中医对应的病名为“虚火乳娥”。 2、病因: approval, approval of the supervisor, according to design drawings and a model, before extensive construction. (6) the external finishing locally with special materials, according to the drawing requirements. Interior decoration of 12.9 (1) the scope and use of interior decoration materials according to map. Strict construction the contractor, to rework parts of the material, work, all responsible. (2) Interior finish: cement stone floors, self-levelling floor cement stone chip kicks; flying white walls; flying pink roof. (3) decorating approaches strictly in accordance with design drawings and construction. Decor decoration see repair parts. (4) Interior lamps, specifications must be approved by the design people agree, supervisor approval can be installed. 12.10 balustrades (...Construction organization and allocation of resources of the 13th chapter 13.1 setting principle 1 principle, respond to requirements of the tender documents; 2, adapting to the construction characteristics and the principles of the standard construction site conditions; 3, efficient, capable, flexible and professional to configure the principle; 4, in favor of principles of construction, scheduling and contract management; 5, in favor of contract duration, the project quality and safety principles. 13.2 organizational structure our company is engaged in water conservancy and hydropower engineering construction engineering company. For many years through the construction of water conservancy and hydropower project, has accumulated some experience in construction technology, cultivate a group of construction personnel are capable of doing. As well as第 3 页 共 4 页 (1)西医:链球菌和葡萄球菌为本病的主要致病菌。急性扁桃体炎反复发作，使隐窝内上皮坏死，隐窝引流不畅，细菌与炎性渗出物聚集其中，导致本病;继发于急性传染病，如猩红热、白喉、流感、麻疹等。也可继发于鼻腔及鼻窦等邻近组织器官感染。 (2)中医:脏腑虚损，虚火上炎为主要病因，多因风热乳娥或风热喉痹未治愈、日久邪热伤阴而致，或温热病后余邪未清而引发。 3、症状:常有急性扁桃体炎反复发作病史，发作时常有咽痛;发作间歇期自觉症状少，可有咽内发干、发痒、异物感、刺激性咳嗽等轻微症状;小儿患者如扁桃体过度肥大，可能出现呼吸不畅、睡眠打鼾、吞咽或言语共鸣障碍。 4、诊断要点:一、有急性扁桃体炎发作史或扁桃体周围脓肿史;二、扁桃体及舌腭弓充血，呈暗红色或紫红色，扁桃体表面不平或呈多叶状，如挤压舌腭弓可见黄白色分泌物被挤出。两颌下淋巴结肿大。此病可分为纤维型、增生型和隐窝型，了解即可。 5、治疗: (1)西医:提高机体抵抗力减少急性发作。 (2)中医:一、肺阴亏虚。症见干焮不适，微痛，微痒，干咳无痰或痰少而黏，哽哽不利，喉核肥大，潮红，连及周围，喉核上或有黄白色脓点。一般午后症状明显，并可有午后颧红，精神疲乏，手足心热，讲话乏力，舌质红或干、少苔。治宜养阴清肺，比如养阴清肺丸。二、肾阴虚损。症见干焮不适，微痛，哽哽不利，口干不喜多饮，喉核症状同上。还可见头晕眼花，耳鸣，耳聋，腰膝痠软，虚烦失眠，舌红少苔。治宜滋阴降火，清利咽喉，比如知柏地黄丸。 6、提示顾客:对于急性扁桃体炎应治疗彻底，避免其转成慢性;小儿打鼾或言语障碍须考虑此病。 六、有些病我们管不了 对于给儿童买药治疗咽部疾患的顾客，需要提醒家长是否有热灼伤或吞食异物，如果顾客回忆后怀疑可能有上述情况，建议其迅速到医院检查。 approval, approval of the supervisor, according to design drawings and a model, before extensive construction. (6) the external finishing locally with special materials, according to the drawing requirements. Interior decoration of 12.9 (1) the scope and use of interior decoration materials according to map. Strict construction the contractor, to rework parts of the material, work, all responsible. (2) Interior finish: cement stone floors, self-levelling floor cement stone chip kicks; flying white walls; flying pink roof. (3) decorating approaches strictly in accordance with design drawings and construction. Decor decoration see repair parts. (4) Interior lamps, specifications must be approved by the design people agree, supervisor approval can be installed. 12.10 balustrades (...Construction organization and allocation of resources of the 13th chapter 13.1 setting principle 1 principle, respond to requirements of the tender documents; 2, adapting to the construction characteristics and the principles of the standard construction site conditions; 3, efficient, capable, flexible and professional to configure the principle; 4, in favor of principles of construction, scheduling and contract management; 5, in favor of contract duration, the project quality and safety principles. 13.2 organizational structure our company is engaged in water conservancy and hydropower engineering construction engineering company. For many years through the construction of water conservancy and hydropower project, has accumulated some experience in construction technology, cultivate a group of construction personnel are capable of doing. As well as 另外，引发咽部异常感觉(如痒、灼热、堵塞等)的不仅仅有咽部疾患和精神因素，还有很多周围器官或全身性疾病是药店无法处理的，如果在问诊中出现了疑似的一些症状，也需要推荐顾客就医做详细检查。 比如颈综合征(由颈部骨质及周围软组织病变引起)，喉部疾病(如慢性喉炎、早期喉外癌、一侧声带麻痹、喉部良性肿瘤等)，慢性外耳道炎，慢性中耳炎，甲状舌管囊肿，甲状腺疾病(如甲状腺肿、炎症及肿瘤等)，消化道疾病(如胃及十二指肠溃疡病、幽门痉挛、胃恶性肿瘤、胆道蛔虫病、胆石症等)，心血管系统疾病(如左室肥大、高血压性心脏病、心包积液、主动脉瘤等)，肺部疾病(如气管和支气管炎、肺肿瘤和脓肿、肺炎等)，膈疝、屈光不正、严重的缺铁性贫血，风湿病，痛风，重症肌无力，甲状腺功能减退等。 approval, approval of the supervisor, according to design drawings and a model, before extensive construction. (6) the external finishing locally with special materials, according to the drawing requirements. Interior decoration of 12.9 (1) the scope and use of interior decoration materials according to map. Strict construction the contractor, to rework parts of the material, work, all responsible. (2) Interior finish: cement stone floors, self-levelling floor cement stone chip kicks; flying white walls; flying pink roof. (3) decorating approaches strictly in accordance with design drawings and construction. Decor decoration see repair parts. (4) Interior lamps, specifications must be approved by the design people agree, supervisor approval can be installed. 12.10 balustrades (...Construction organization and allocation of resources of the 13th chapter 13.1 setting principle 1 principle, respond to requirements of the tender documents; 2, adapting to the construction characteristics and the principles of the standard construction site conditions; 3, efficient, capable, flexible and professional to configure the principle; 4, in favor of principles of construction, scheduling and contract management; 5, in favor of contract duration, the project quality and safety principles. 13.2 organizational structure our company is engaged in water conservancy and hydropower engineering construction engineering company. For many years through the construction of water conservancy and hydropower project, has accumulated some experience in construction technology, cultivate a group of construction personnel are capable of doing. As well as第 5 页 共 6 页