jf^^ L^ongy TUB TINH DONG Y TRI UEU JiKt THUOC IMAM VI THUOC THONG DUNG m/VIFiNTINHBIHHTHl NXB HONG DUG Hgi LUAT GIA VIET NAM NHA XUAT BAN HONG OUfC 2D LY THAI Ta - HQAN KIEM - HA Npi OlEN THOAI: 04. 3g2eDD24 Email: nhaxuatbanhongduc@yahoo.com LU<tng Y TUE TINH DONG YTR! LIEU GAV THUOG NAM VA V! THUOC CH!U TRACH NHIEM XUAT BAN: BUI VIET BAG CHjU TRACH NHIEM NOI DUNG: LY BA TOAN Bien tap : Quynh Trang Sufa ban in : Minh Huy Ve bia : A.P In 1.CC0 ban kho 14.5cm x 20.5cm tgi Cty TNHH in Nhat Nam. So DKKHXB: 1092-2013/CXB/31-44/HD. In xong va nop luu chieu quy IV nam 2013. I NOI DAU C o the noi nhd si/ Uu da! cua thien nhien nen d Viet Nam ChungIta ton tai rat nhieu loai cay tu'di tot va hufu dung khong nhQng cho moi traci,.g ma ca cho con ngudi. Trong so do khong the khong ke den cay thuoc nam. Su' ton tai cua Chung da mang den mot tiem nang rat to Idn trong viec cham soc va bao ve siJc khoe con ngu'di. That vay, tren thu'c te da c6 rat nhieu lUdng y iJng dung cong dung va l0i I'ch cua nhiJng cay thuoc nam vao viec chu'a benh cho con ngu'di va hieu qua dgt du'dc rat dang ke. Khong nhu'ng the, trong dan gian con ton tsii rat nhieu bai thuoc hay dUdc bao che X\S chi'nh nhQng cay thuoc ton tsii ngay d xung quanh ndi chung ta dang sinh song ma vi mot ly do nao do, chung ta chu'a nhan biet ra chung. Quyen sach nay se cho ban thay ro xung quanh chung ta CO nhQng loai cay nao ma hang ngay chung ta thu'dng thay, thu'dng dung lam thQc an nhung khong biet rang do cung la mot cay thuoc c6 tac dung chQa benh cho chung ta. Quan trgng hdn, sach chi ra mot so' vi thuoc nam cu the de chu'a cac benh thong dung nhu cum, ho, giai doc, tieu ddm, tieu chay, an thai, va hudng dSn each thQc bao che nhQng bai thuoc hay de tranh sQ tu'dng ky va mang Igi ket qua tot nhat cho viec chQa benh. Hy vgng sach se la mot cam nang hQu I'ch cho ban trong viec tim hieu va Qng dung nhQng cay thuoc de tim quanh ta. Tac gia. [DONGT] TRI LIEU Cay Thuoc Nam va V| Thuoc TIEU Stf TUE TINH Tue Tinh Thien SM* (1623-1713), thtfcfng difcfc goi tat la Tue Tinh hoac Hue Tinh, ngLfcfi lang Nghia Phu, tong Van Thai, huyen Cam Giang, phii Thifgng Hong (p^ay la tinh Hai Diiong) difcfc phong la ong to nganh dtfcfc Viet Nam va la ngif&i md dau cho nen y difcfc CO truyen Viet Nam. Cac bo sach Nam Difoc than hieu va Hong Nghia giac t\i y thuf ciia ong khong chi c6 y nghia trong lich suf y hoc ma ca trong lich sijf van hoc Viet Nam. Nhieu the ky lua, Tue Tinh difcfc ton la vi thanh thuoc Nam. Tai Hai Difong c m den thcr ong d xa Cam Van, Cam Vu; d chua Hai Trieu lang Yen Trung, nay la chua Giam, xa Cam Scfn, huyen Cam Giang, c6 tifong Tue Tinh. TIEU sCr Neu nhiJng ket qua nghien cufu van hoc, ngon ngi? hoc Viet Nam sau nay khong dxia them bang chufng gi mdi thi truyin thuye't dia phLfOng va nhiJng cong trinh nghien cufu chuyen mon khac cho phep khang dinh Tue Tinh la mot nhan vat'doi Trail. Ong ten la Nguyen Bd Tinh, biet hieu la Trang TiJ V6 Dat, que d lang Xifa, tong Van Thai, huyen Cam Giang, phu Thifcfng Hong (nay la thon Nghia Phii, xa Cam Vu, huyen Cam Giang, tinh Hai Difang). Mo coi cha me tU luc 6 tuoi, Nguyin Ba Tinh dufgc cac nha isif chua Hai Trieu va chua Giao Thuy nuoi cho an hoc. Nam 22 tuoi, ong dau Thai hoc sinh difdi trieu vua Tran Du Tong, nhufng khong ra lam quan ma d lai chua di tu lay phap hieu la Tue Tinh. Nh'jfng ngay di tu cung la nhufng ngay ong chuyen hoc thuoc, lam thuoc, chufa benh ciVu ngtfcfi. TAU^-'^ (Lt^ttu. i'^pj^ <• 5 Nam 55 tuoi (1385), Tue Tinh bi difa di cong cho trieu dinh nha Minh. Sang Trung Quoc, ong vin lam thuoc, noi tieng, difcrc vua Minh phong la Dai y Thien sir, mat or do, khong ro nam nao. Bia van chi d lang Nghia Phii (do Nguygn Danh Nho soan nam 1697) cung cac t\i lieu khac d dia phifcfng deu ghi nhi/ vay. CONG^INH Y-DJOC Nhflng nam d trong ni/dc, Tue Tinh da cham chu nghe thuoc: trong cay thuoc, sifu tarn kinh nghiem chiJa benh trong dan gian, huan luyen y hoc cho cac tang do. Ong da tong hgp y difgc dan tpc CO truyen trong bo sach gia tri la bo Nam di/gc than hieu chia lam 10 khoa. Dac biet, ong c6 bo Hong Nghia giac tif y thif (2 quyen) bien soan bang quoc am, trong do c6 ban thao 500 vi thuoc nam, vie't b§ng thcf Nom Bifang luat, va bai "Phu thuoc Nam" 630 vi cung bang chOf Nom. Tha van Nom dcfi Tran rat hiem, neu qua thiTc do la tac phani ciia Tue Tinh thi chung khong chi gia tri trong y hoc ma con la tac pham quan trong trong lich suf van hoc bdi vi day la cac tac pham d thcfi ki dau cua van hoc chCf Nom. TiJf bao dcfi nay, gidi y hoc Viet Nam va nhan dan deu cong nhan Tue Tinh c6 cong lao to Idn trong viec xay ditag mot quan diem y hoc doc lap, tir chu, sat vdi thiTc te Viet Nam. Cau noi ciia ong: "Nam dugc tri Nam nhan" the hien quan diem day bien chijfng ve moi quan he mat thiet giifa con ngiTcri vdi moi trifcfng song xung quanh. Quan diem, ay d§n dat ong len ngoi vi cao nhat ciia nen y hoc co truyen Viet Nam: Ong Thanh thuoc Nam! Trong trUdc tac ciia minh, ong khong rap khuon theo cac trifdc tac ciia cac di/i tv\i6c. Ong khong difa kim, moc, thiiy, hoa, tho len dau ma xep cac cay c6 tru'dc tien! Ong cung phe phan tuf tifdng di doan ciia nhffng ng\ibi chi tin vao phu chu ma khong tin thuoc. Ong da neu ra nhieu phifcfng phap khac nbau de chijta benh nhif: cham, chich, chifcfm, bop, xoa, an, uong, hcf, xong, v.v. 6 •:• 'T^t^Ji}'\^^<LUiu.rs,4u. Tue Tinh da khong difng lai d vi tri mot thay thuoc chuTa benh, ong con tif minh truyen ba phifcfng phap ve sinh, to chufc ccf sd chaa benh trong nha chua va trong lang xom. Co tai lieu cho biet, trong 30 nam boat dpng or nong thon, Tue Tinh da xay difng 24 ngoi chua, bien cac chua nay thanh y xa chCta benh. Ong tap hpp nhieu y an: 182 chijfng benh difpc chffa bang 3.873 phifcfng thuoc. Ong cung luon luon nhac nhd moi ngifcfi chu y nguyen nhan gay benh; tim bien phap phong benh tich cifc. Tue Tinh nhan manh tac dung viec ren luyen than the va sinh hoat dieu dp. Ong neu phifcfng phap difSng sinh tom tat trong 14 chOf: Be tinh, duang khi, ton than Thanh tdm, qua due, thu chdn, luyen hinh. Tue Tinh con tap hpp nhffng bai thuoc chffa benh cho gia sue. Co the noi, ong da gop phan dat ccf sd cho nganh thii y dan tpc cua Viet Nam. Aa^ (LkOu ^d^k <' 7 PHAN Md DAU DAI Cl/dNG MOT SO BENH THONG THl/ClNG ' -oOo- 1. BENH CAM LANH Cam lanh la mot benh nhilm trung duomg ho hap tren. Co han 200 virus khac nhau c6 the gay ra cam lanh vcJi nhOfng trieu chijfng khac nhau. Dau hi^u va tri^u chiiCng Trieu chufng thiTorng xuat hien khoang 1-3 ngay sau khi tiep xuc v(Si virus va bao gom: • Ngat mui hoac chay niiac mui • Hong ngiia va dau • Ho • Dau ngUdi hoac dau dau nhe • Hat hai • Chdy nude mdt • Sot nhe • Met moi nhe. , 8 • t/u,.^c ez-wju/ge^w'. f)6nfl Y gTrt ai|u Nguyen nhdn - Mac dii CO horn 200 virus c6 the gay ra cac trieu chijfng cam lanh, song rhinovirus la thii pham hay gap nhat va rat d§ lay. Dieu tri Khong CO thuo'c chfla khoi cam lanh. Khang sinh khong c6 tac dung cho'ng lai virus gay benh. Cac thuo'c khong ke don dimg de chOfa cam lanh khong chiJa khoi benh cung nhxi khong lam cho benh nhanh khoi hofn. Difdi day la nhijttig iJu va nhixcfc diem ciia mot so' loai thuo'c hay dimg de dieu tri cam lanh. • Thuo'c gidm dau. Cac thuo'c gidm dau khong ke dan nhu acetaminophen thudng dugc sii dung de dieu tri sot va dau " dau khi bi cam lanh. Can nha rang acetaminophen c6 thi gay ton thuang gan, nhat la khi dung d lieu cao keo ddi. Khong dung aspirin cho tre em vi thuo'c c6 the gay ra hoi chiing Reye — mot benh hiem gap nhUng c6 the gay tH vong. • Thuo'c xit mui de gidm xung huyet mui. NhUng thuoc nay khong nen dung keo ddi vi c6 the gay viem niem mac mui man tinh. • Xi ro ho. Cdc loai xi ro ho khong c6 tdc dung dieu tri nguyen nhdn gdy ho trong cam lanh. Mot so loai chiia nhUng thdnh phdn Idm gidm ho, nhiing vai luang qud it nen khong du tdc dung hoac c6 the gdy hai cho tri. Trung tdm phbng chdng benh dich My (CDC) khuyen khong nen diing xi ro ho cho tre dilai 2 tuoi. Ho do cdm lanh thubng keo ddi it nhat la 2 - 3 tudn. Neu ho keo ddi Idu han, can cho tre di khdm bdc SI. Cdc bien phdp tU chdm soc khi hi cdm lanh gom: • Udng nhieu nUdc. • Nghi ngai day du. • Gin cho phong d luon dm vd dm. T.Wt C/wZrt ^a,J<. • 9 • Siic hong nhieu Idn trong ngay bang nUdc muoi dm hoqc udng ni/ac chanh dm pha vai mat ong de lam diu chS hong bi viem vd gidm ho. • Nh6 mui hhng nUdc mudi sinh ly di lam gidm xung huyet mui. Phong benh • Rda tay thudng xuyen. • Ve sinh nhd ciia sach se thong thodng, nhdt Id khi trong gia dinh CO ngiidi bi cam lanh. • Vdt bd khdn gidy ngay sau khi dung. • Khong dung chung bat dua, vat dung cd nhdn vai ngitdi khdc. • Trdnh tiep xuc Idu v6i ngubi bi cam lanh. 2. BENH CUM Benh ciim la benh viem nhilm cap tinh diTomg ho hap gay nen bori virus cum lay truyen nhanh, thucfng thanh dich. Trieu chiXng Benh cum c6 nhieu the lam sang, the thUcfng gap la: sau thcri gian nung benh ngan, khoang mot ngay, benh khdi phat rat dot ngot: sot, ret run nhieu Ian trong ngay, than nhiet tang len 39-40° ngay ngay dau, keo dai 3-5 ngay kem theo la met moi, dau nhiJc toan than, dau dau nhu biia bd, dau cac cor xuorng khdp, chan tay ra rori, da kho nong, mat bimg bitog, mat choi, chay nUdc mat, so mui, ngat mui, dau rat hong, c6 khi ho tiirc ngUc, khac dcfm hoac chay mau cam, mieng dang, buon non, tao bon. Sau do nhiet do giam dan, cac trieu chufng toan than giam dan trong 5-7 ngay. Mot so" benh nhan cao tudi hay bi met nhugc keo dai, su binh phuc cham. • Benh cum d tri em dudi 5 tudi thudng nhe, sot nhu cdm lanh. u tr& so sinh, bieu hien: viem tai, viem chum, viem thanh qudn cap, cd khi nhi&m doc than kinh nang ne. 10 • r/« :v/v«,v e/;^ t)6n9 Y gTrt • Ngodi ra con nhieu the khong rd trieu chdng hoac the nhe, gidng cdm lanh: chi c6 hat hai, sd mui, ho; cd the gap the ndng, rdt ndng do bien chiing ho hdp, tim mach, than kinh. Bien chufng • Ho hdp Id bien chitng chii yeu vd ndng nhdt: viem phdi tien phdt vd thii. phdt trong do viem phdi tien phat Id nang nhdt: nhiet do khong gidm vdo ngdy 3-5 ma tiep diin, kem kho thd, thd gap, tim tdi, khac ddm cd khi Idn mdu, nhanh chong ddn den suy hd hdp, suy tudn hodn roi tii vong neu khong dieu tri. • Benh cum con ddnh thiic nhUng benh tiem tdng nhU viem tai, viem xoang, viem nhiem di/dng tiet nieu • Benh cum d phu nd. mang thai hay gay bien chdng phdi hoac sdy thai. Neu mac trong 3 thdng dau c6 the gap benh ly thai, nhdt la ve he thdn kinh trung Uong, khong gay qudi thai. • Benh cum dc tinh hiem gap nhUng tit vong cao, khdi dau nhu cum thudng, roi xudt hien hoi chdng suy ho hdp do phu phdi cdp tinh gay tit vong do thieu oxy mdu khong khdc phuc duac. Dieu tri • Chii yeu la dieu tri trieu chitng ddi vdi the khong bien chiCng: dieu tri tai nhd, nghi ngai, ndm giudng, udng nhieu nUdc, dung thiCc an Idng dm, bd, dil vitamin, gidu vitamin C • Sit dung thudc ha sot khi benh nhdn bi sot cao. Khong diing khdng sinh de du phbng bien chitng boi nhiim • Tdi Id mot loai gia vi vd cung Id dugc lieu chda cdm cum rdt tot. Til xUa ong cha ta dd biet dung tdi de chda benh cum. Khdng nhUng vdy tdi con Id dUgc lieu hd trg dieu tri huyet dp, md mdu cao, tot cho tim, mach, hd trg tieu hoa. Chat alicin trong nhUa dau tdi ditgc cho Id cd tdc dung diet vi rut n^,^ e/uiw '^(j'^/v <• n chinh, chat nay rat di bi phd huy ngay cd d nhiet do thubng VI vdy nen ngdm rilau, ngdm dam hoac uong vien nang mem chiCa nhua ddu nhu vien ddu toi Tue Link (dang vien nen bgt toi hi mat hit tdc dung doi v6i vi rut cum). Toi tia , Viet nam cung diCgc cho Id c6 chiia nheu alicine nhdt Phong lay nhiem: • Khi cham benh cum, can kip thbi trien khai cdc bien phdp phong benh ngdn chdn dich Ian truyen • Khi phdt hien benh nhdn, nen cdch li tai nhd, cdch li phdn tan khong tap trung • Khi tiep xuc vdi benh nhdn thi ngUdi Idnh, nhdn vien y te phdi mang khdu trang day 4 I6p gac, trdnh tiep xuc vai ngiM benh d khodng cdch gdn (dudi Im). • Khi benh Ian trdn thdnh dich, can tam thbi dong cila cdc trUang hoc, khong to chiic cdc budi tap trung dong ngudi • Dung cdc bien phdp du phong dac hieu: khdng virus, inter- feron, vacxin 3. BENH DQNG KINH Dong kinh la mot ro'i loan pha vd qua trinh truyen tin hieu dien trong nao. Benh thuomg gay ra nhOng can co giat va mat y thijfc. Tuy nhien trieu chiJng benh c6 tile rat khac nhau. Dau hieu va trieu chitng Cofn dong kinh cue bo - Ccfn dong kinh cue bo dcfn gian: khong gay mat y thiJc. Chiing CO the thay doi cam xiic hoac thay doi each nhin, ngiiri, cam giac, nem hoac nghe. - Corn dong kinh cue bo phiJc tap. NhiJng corn nay lam thay doi y thile, khien benh nhan bi ma't y thufc trong mot thcri gian. Can dong kinh cue bo phiifc tap thifcfng gay ra cai nhin cham cham va 12 • X/Wve/wZtt/^c^v nhttng ciif dong khong co muc dich, nhiT be tay, hem moi, noi lam nham hoac nuo't khan. C<fn dgng kinh loan the - Can vang y thufc (dong kinh con nho), dac triftig bai cai nhin cham cham, nhiJng ciif dong kho nhan thay va mat y thilc thoang qua. - Ccfn dong kinh co. Thucfng bieu hien nhu nhumg dong tac giat cue dot ngpt a canh tay va chan. - Ccfn dong kinh mat triTcfng luc, khien benh nhan dot ngpt nga qui. - Dong kinh con Idn, la dang nang nhat, dac truiig bdi mat y thiifc, CO Cling va co giat toan than, doi khi benh nhan can phai liTori hoac tieu tien khong tiT ehii. Nguyen nhdn - Nhieu the dong kinh co lien quan den khuye't tat a gen dieu khien each truyen thong tin giQa eac te'bao nao, nhiTng chi co mot vai the hiem gap la phat sinh tilf nhChig khuye't tat gen dac thu. Mac du mot so' the benh dong kinh co tinh chat gia dinh, song di truyen ehi dong mot phan vai tro gay benh - co le thong qua viec khien ngircfi benh man cam hon vdi eac ye'u to' gay benh trong moi trufofng. - Trong nhieu trifomg hpp, dong kinh co the bat nguon tir mot tai nan, benh hoac chan thu'orng - nhuf dot qui - khien nao bi ton thuang hoac thieu oxi. Trong mot so' it trUorng hap, dong kinh co the CO nguyen nhan la kho'i u trong nao. Tuy nhien, khoang V2 so' benh nhan khong xae dinh dupc nguyen nhan gay benh. Xet nghi^m vd chdn doan • Mo td chi tiet can dong kinh. Do ngUdi benh co the khong nhd ditgc nhUng gi xdy ra, nen thay thudc se can nghe Idi ke ciia nhUng ngUdi da chiing kien ccfn dong kinh. e/«j« i^M,^k 13 • Khdm than kinh kiem tra phdn xa, triiang lUc ca, ca lUc, cam gidc, dang di, tU the, phoi hap dgng tdc vd thdng bang, cung nhu mot so cdu hoi de kiim tra khd ndng tU duy, nhan thi2c vd tri nhd. • Xet nghiem mdu de loai trii nhUng nguyen nhdn c6 the gay con CO giat nhU nhiim triing, ngo doc chi, thieu mdu hoac tiiu dUdng. • Cdc xet nghiem hinh dnh di phdt hien bat thuang trong ndo: dien ndo do, chup CT, chup cong hudng til (MRI), chup cat lap phdt positron (PET), chup cat lap vi tinh phdt photon dan (SPECT). Dieu tri • Thuoc chong dgng kinh. • Phdu thuat cdt bo vung ndo gay ra can dgng kinh. • Kich thich day phe vi. • Che do an kieng nghiem ngat gidu chat beo, protein vd it carbonhydrat de gidm sdn sinh xeton trong ca thi. 4. BENH GUT Benh gut, hay viem khdfp gut, la mot dang viem kh6p dac tritog hai nhufng corn dau dOf doi dot ngot, do va sung or khd'p. Day la mot ro'i loan phiJc tap CO the xay ra d bat ciif ai, song nam giori dl bi benh hon phu uuf. Phu nu: se bi tang kha nang mac benh sau khi man kinh. Dau hi^u va trieu chu'ng Dau hieu va trieu chiifng ciia gilt hau nhiT luon la cap tinh, xay ra dot ngot - thuomg vao ban dem - va khong c6 dau hieu bao tru'dfc. > 14 • T/wj; (2./v<ii4 -'rHc/./v f)6ng Y gfrt • Bau khdp dU dgi. Gut thubng dnh hudng den khap I6n cila ngon chdn cdi nhung c6 thi xdy ra d bdn chdn, co chdn, dau goi, bdn tay vd c6' tay. Bau thUbng keo ddi 5 den 10 ngdy ma sau da hit. Khd chiu gidm dan sau mot hai tudn, di lai khdp CO vi rat binh thudng vd khong dau. • Khdp bi sUng, ndng vd dd. Nguyen nhdn Nguyen nhan gay benh gut la do viem or khdrp do sir tich luy cac tinh the urat. Acid uric la mot chat dugc hinh thanh t\X qua trinh giang hoa purin. Chat nay c6 mat tu nhien trong ccf the cung nhu trong mot so' loai thuc pham, nhat la phii tang dpng vat. Binh thiforng acid uric hoa tan trong mau va di/cfc than bai xuat ra ngoai qua mi6c tieu. Neu vi ly do nao do cor the san sinh qua nhieu hoac bai xuat qua it chat nay thi acid uric c6 the tich luy, tao thanh nhOfng tinhh the hinh kim sac nhon (urat) trong khdp va cac mo xung quanh khdp, gay dau, viem va sUng. Xet nghiem vd chdn dodn • Lay dich tie khap bi benh de tim tinh thi acid uric trong bach cdu • Xet nghiem nUdc tiiu di do lilang acid uric dugc bai xuat • • Xet nghiem mdu do nong do acid uric trong mdu Dieu tri • Bd'i vdi can gut cap, cdc thuoc chdng viem phi steroid (NSAID), nhu ibuprofen vd naproxen co thi lam gidm dau. • Vdi nhUng triiang hap nung, co thi diing corticosteroid nhU prednisone. Cung co thi tiem cortisone vdo khdp bi benh di gidm dau. NhUng phuang phdp nay c6 nhUng tdc dung phu vd ndi chung khong nen tiem qud 3 Idn/ndm. • Khi can gut cap dd dugc kiim sodt, co thi dp dung nliUng bien phdp phong ngiia di Idm cham tdc do sdn sinh acid uric ciia ca thi hoac tang 13c do bdi xuat. Tt^c <2./v^« '^^«./t •> IS • Hy thiem thdo, day dau xUang Id hai vi thuoc y hoc cd truyin quy cua dan toe c6 tinh mat, tdc dung khu phong, trit thdp, hoat huyet, gidm dau, lai gdn cot, tri khap sUng nong do dau, cdc trUdng hap dau lUng moi gdi, dau minh mdy, di lai van dgng dau nhiCc do benh gut. Benh gout bi gay ra do qua nhieu axit uric trong mdu (con goi Id da axit uric): tren 420 pmol/L (d nam) hay 380 pmol/L (d n0. Vi vay viec thai tril Axit Uric Id rat cdn thiet. Thd phuc linh, Ty gidi, Hodng bd c6 tdc dung tang cUdng chiic ndng bdi tiet cua gan than, thdm thdp, lai nieu giup ddo thdi acid uric trong mdu vd chuyin hoa cdc chat khdc Id nguyen nhdn Idm tdng acid uric gay nen benh Gut. DUa vdo nhUng dac tinh cua cdc cay thudc tren da Idni ra sdn phdm la Gut Tue Linh. Gut Tue Linh cdn c6 sU ket hap bdi ban cua Nhdn sdm, Hodng ki, Thuc dia, NhU huang, Ddo nhdn c6 tdc dung bd khi, gidi doc, gidm dau, tdng ciCdng tudn hodn mdu, bdi bd ca the, chdng met moi, suy nhilgc, cdi thien cdc hoat dgng the luc vd tinh than ciia benh nhdn. Phong b^nh Khong CO each nao chae chan ngan ngiTa difcfc corn gut cap ban dau hoac ve sau, nhUng bac si c6 the ke dan mot so' thuoc de lam giam nguy cof hoac mufc do nang ciia cac dot benh xay ra sau nay. Nhu-ng thuoc nay gom allopurinol va probenecid. Khi dirge dung hang ngay, thuoc lam cham toe dp hinh thanh acid uric va day nhanh viee thai trijf chat nay ra khoi ca the. Noi chung, giu" nong dp acid uric trong gidi han binh thuomg la chia khoa de phong ngifa benh gut. 5. BENH COI XaONG - SUY DINH DUClNG Mot so' cong trinh nghien cuu cho tha'y, tre coi xUcfng khong xay ra rieng le ma di kem vdfi suy dinh dueng, thie'u vitamin A, thieu mau 16 • tiJ^cy\^,^e.iui«.>^pX t)6ng T gfrt 3^" Nguyen nhdn tre cdi xUcfng • Thieu dnh sdng mat trdi: Nhieu tre bi cdi xiiong chi vi cha me giU gin qud ky hoac khong c6 dieu kien cho tdm ndng (do yeu td dia ly khi hdu, mda dong, vimg nui silang md, nhd d chat chgi, 6 nhiem moi trUdng ). • Tinh trang thieu hut ndng vitamin D cua ngudi m.e trong thdi gian mang thai. • Che do an cua tre thieu cd vitamin D vd canxi, ty le canxi I photpho thdp: Che do an nhieu phytat (c6 nhieu trong tinh bgt), oxalat (c6 nhieu trong rau) vd chat xa cung Idm gidm hap thu canxi. TRE BI COI XlfONG Bieu hi^n c6 nguy ca hi cdi xiCafng • Be CO the vdn du cdn ndng vd chiiu cao, tuy nhien phu huynh cdn chii y cdc trieu chiCng: rang cham mgc, toe rung, hay giat minh, biit nit, gc sUa. Ngu khong yen gidc, hay khdc dem, dd mo hoi dau. Xuang bi mem, di bien dang nhU: dau bep, long ngUc gd, tay chdn cong, trdn do, cd 2 budu d dinh dau, thdp cham dong; dac biet, tuy tre bu bam nhUng CO nhdo Ngodi ra, ca the cdn gidm siic de khdng, tre hay bi nhiim trung ho hap. Neu khong dieu tri kip, be se cdi xi/ang that siX nhU: bi tay cdn vd, chdn cong vdng kieng, ngUc do hoac lep • Khi thdy be cd nhUng biiu hien tren ban cdn xem lg,i coi mdn an cd du cdc chat cdn thiet vd phu hap vdi Ida tudi, sd thich ciia be khong? Mdi ngay, trUdc 10 gid sdng, be cd dugc cdi bd qudn do de phai ndng 5 phut (vdi tre dudi 18 thdng) hoac diioc chai ngodi trdi it nhdt 30 phut (vdi tri Idn han)? Dm be den bac si de dugc tU vdn hoac chl dinh diing thudc. Da sd cdc be khi cd bieu hien tren khong phai chl cdi xUang ma cdn cd the bi suy dinh djJdn^Jzemj}]^^ trung khdc do ca the ^ia^t-sif^p^^fikfi^^^^^ THUAM Phong b^nh cbi xitorng • Trong thdi gian c6 thai va cho con bu, ngudi me nen danh thdi gian tdm ndng, di dao ngodi trbi. Nen an uong hap ly, chu y thiCc phdm gidu vitamin D, canxi de phdng trdnh cdi xiCang sam cho tre til trong bdo thai vd trong nhUng thdng ddu sau de. • Cho tre bu me ngay sau sinh, bu hodn todn trong 6 thdng , , ddu, sau do cho an bd sung. Chii y cho an ddu ma, thUc hien to mdu bdt bqt. Hang ngdy phdi cho tre tdm ndng 5-10 phut de CO du vitamin D. • Bd sung vitamin D 400 dan vi/ngdy cho tre de non, de thdp can. Mot trong nhUng bien phdp phdng benh cdi xiiong Id tang cUdng vitamin D vdo thiic phdm cho bd me vd tre em. DIEU TRI TRE COI XlfONG Bo xung canxi cho tre - Canxi luon can diTofc cung cap cho ca the trong suo't cac giai doan ciia cuoc song, t\i trong bao thai cho den khi trifdng thanh va ngudi gia. Theo khuyen cao cua Vien Dinh dudng quoc gia Viet Nam va RDA ciia My, m6i ngay tre em can khoang 500 -l.OOOmg canxi tiiy th^o do tudi. - SQa va cac che pham ciia sUa nhu sUa chua, banh flan, pho- mai la ngudn cung cap canxi quan trong, sau do la dau hu, hai san (ca nho nguyen xUcfng, tom tep nguyen v6 mdi chufa nhieu canxi), dau cac loai, me, rau xanh Can chii y la canxi trong sUa thi dl hap thu hon la canxi tilf cac ngudn thuc pham khac. Bo xung vitamin D cho tre cdi xUang - Ngoai viec cung cap day du cac thUc pham giau vitamin D nhu sufa, tnlng, gan, bor tre em moi do tudi deu can phai dugc tam nang nhe 15-20 phut mdi ngay. Anh nang nhe la nang trudc 9 gicf sang hoac 4-5 gid chieu. Can boc 16 da cang nhieu cang tot de anh 18 • rWc/weA,^>§^ nang trUc tiep chieu vao da thi se tao ra nhieu vitamin D. Sau jj^hi ra nang vai phut cho be am ngUcfi rdi me nen cdi bdrt non, vd, v^n ao hoac quan be cang nhieu cang to't. Khong phai nang qua cda kinh. Tre nho chua di dugc thi ba me can bong be' tre ra ngoai trdi de tam nang, ne'u tre da tu di duorc thi can nhac nhd va tao (Jieu kien cho tre ra moi trudng ben ngoai. Ba me dang cho con bu sGa me cung phai tam nang hang ngay de dam bao cho nhu cau vitamin D ciia chinh ngUdi me ddng thdi c6 dii vitamin D trong sOa me de cung cap cho tre. TRE SUY DINH DWNG Nguyen nhdn - Mot so cong trinh nghien ciJu cho thay, cdi xUomg khong xay ra rieng le ma di kem vdi suy dinh dudng, thie'u vitamin A, thie'u mau. Tre suy dinh dudng thudng hay ro'i loan hap thu cac chat, ke ca vitamin D va muo'i khoang; ddng thdi thie'u hut enzym chuyen hoa vitamin D. Ngugc lai, tinh trang thie'u vitamin D cung se lam giam sufc de khang ciia ccf the, tang cam nhilm vdi vi khuan, do do tang nguy ca suy dinh dUdng. Nhieu nghien cilu da chufng minh, tre suy dinh dUdng c6 nguy ca cdi xUang cao han so vdi tre binh thudng. - Tre CO can nang liic de thap (dudi 2.500g) c6 nguy ca coi xUang cao han tre c6 can nang luc de binh thudng. Nguyen nhan la ca the khong du triJ dii muo'i khoang va vitamin D trong thdi ky bao thai, ddng thdi he tho'ng men tham gia vao chuyen hoa vitamin D con ye'u. - Co hoi chijfng kem hap thu: Tinh trang thie'u vitamin D de xay ra d nhOng tre c6 hoi chufng nay. Cac benh tieu chay keo dai, nhilm ky sinh trimg dudng ruot, viem gan tac mat deu c6 anh hudng den hap thu vitamin D va tang nguy ca cdi xUang. Dieu tri tre suy dinh dU&ng • Tang so bda an trong ngdy: Cho trk an 5-6 bUa mdi ngdy, Xku^c n^,^ (Ll^ '^p/./v •:• 19 [...]... nghiem mau tmdc k h i mo hoac k h i c6 bien chufng nhir nhoi mau ccf t i m , tai bien mach mau nao; k h i b i n h i l m trimg da keo dai; benh nhan ni? hay bi ngiifa vimg k i n do n h i l m nam am ho, benh nhan nam bi liet difomg Tri^u - Cac trieu chuCng tieu nhieu, an nhieu, uo'ng nhieu, sut can nhanh la cac trieu chijfng thiTomg thay d ca hai loai Lu'cfng nifdc tieu thirorng tiT 3-4 l i t hoac horn... nhat Mufc dp phd bie'n gap 2 den 3 Ian or nam gidi, thudng xuat hien d do tudi t\i 20-30 Tai phat la c6 the xay ra Canxi c6 the ket hop vdi ca chat khac nhuf oxalat (chat phd bien nhat), phosphat hay carbonnat de tao thanh soi Oxalat xuat hien trong mot so' thiirc an Cac benh cua ruot non lam tang xu hirdng tao soi oxalat canxi - Soi axit uric phd bien hcfn d nam gidi Chung cd lien quan vdi benh gout... the ton tai trong gan vd gdy tai phdt benh trong nhieu nam - Halofantrine doi k h i cung dirac dung de dieu t r i so't ret Khong dung halofantrine cho ngudi dang dung mefloquine de phong sot ret hoac ngiTcfi bi benh t i m • P malariae Bugc phdt hien thdy d chdu Phi, c6 the gdy trieu chiing sot ret dien hinh nhung trong mot so it trUdng hap CO the nam yen trong mdu ma khong gdy trieu chiing Benh nhdn... tieu hod (do, ddy, rugt ) Idm len vung da hd vd phun • Mac qudn do bdo ho ' • Nam mdn khi ngu di nhieu Idn, nuoi con bdng sUa me md khong dn udng du chdt ddc biet Id Protid cd Calci de bii ddp lai han che hap thu calci, vitamin D, protid dudng tieu hoa L o a n g xi/crng l a mot ro'i loan chuyen hoa Thieu ndng cdc tuyen sinh due nam vd nU (suy buong trdng sdm, mdn kinh sdm, cdt buong trdng, thiiu ndng... thanh mach mau, cho'ng thoai hoa va bie'n dang te bao thanh mach T/Wt ^dt^A •:• 67 PHAN I M O T SO V I T H U O C NAM CHL/A B E N H T H O N G D U N G Cdch che bien: Cay moc hoang nhieu noi trong n U d c , ngi/cfi ta jgy canh dem ve trong cho dat am mat, nhieu mun Co the t h u j i ^ i 4 Ian trong nam vao thang 6 - 7, 8 - 9, 10 - 11 va 2 - 3 H a i ve phori tai xong dem cat t i n h dau T i n h dau Bac ha la... di chuyen xuong nieu quan, gay dau Can dau thifomg la nang va thiforng bat dau d vung sifcrn, sau do di chuyen xuong hang Cdc tri?u - Soi than la mot benh l i pho bien Khoang 5% phu nu" va khoang 10% nam gidi se mac i t nhat trong mot giai doan trudc tudi 70 Mot ngifdri da tijfng c6 soi than thong thuforng se l a i c6 trong tUcfng lai Soi than phd bien d nhOfng tre sinh non - Cac ye'u to' c6 t i n... g c6 x e t n g h i e m dac h i e u nao tap thi due hoac ditng vd nhin thd khi di Di ngoai ngay khi can Nhin khd vd kho ran Bieu tri: trong thdri gian hi h^nh phdi: Idu di ngoai • Idu se khien cho phdn NAm nghi, tuyet ngoai dac doi • Chiiam • Dung • Sue mieng Q u a i b i l a m o t l o a i v i e m t u y e n nirdfc b o t m a n g t a i do m o t l o a i • An v i r u s , l a y I a n qua d u d n g ho h a p... quan vdi benh gout hay hoa t r i lieu Soi axit uric chic'm khoang 10% tat ca cac loai soi - Soi xystin cd the h i n h thanh d nhOng ngiTdi mac xystin nieu La mot rd'i loan di truyen anh hirdng den ca nam va nOr - Soi struvite chu ye'u ducfc t i m tha'y d phu nff la ket qua cua n h i i m t r u n g dirdng tiet nieu Chung cd the Idn leu nhanh chdng va lam tac t h a n , nieu quan, hay bang quang - Cac... uo'ng deu dan nen cof the thirdng thieu cac Acid amin, vitamin, lysin, kem, Vi vay viec bo sung cac chat thiet yeu cho ccf the la dieu ma moi ngifdri deu mong muon San pham siro Tue Linh gom c6: Bot nam men bia thiiy phan CO chiifa 70-75% cac acid amin, trong do ham liiong Lysine rat cao (4%), vitamin nhom B, Canxi na khoang chat, cac chat chong lao hoa dac biet la Se, Glutathion cung cap duSng chat... khori phat cua dai thao diTorng (loai 1) or tre nho Vdi benh nhan dai thao diiorng loai 2 thirorng khong c6 bat ky trieu chufng nao or giai doan dau va v i vay benh thirorng chan doan muon khoang 7-10 nam (chi c6 each kiem tra difcfng mau cho phep chan doan diTgrc or giai doan nay) 46 • ThUc hi?n: N h i n doi 12 gior, uong 75 gam dirdng glucose trong 250ml nirdc (khong nong - khong lanh) D i n h liromg . tgi Cty TNHH in Nhat Nam. So DKKHXB: 1092-2013/CXB/31-44/HD. In xong va nop luu chieu quy IV nam 2013. I NOI DAU C o the noi nhd si/ Uu da! cua thien nhien nen d Viet Nam ChungIta ton. Hai Diiong) difcfc phong la ong to nganh dtfcfc Viet Nam va la ngif&i md dau cho nen y difcfc CO truyen Viet Nam. Cac bo sach Nam Difoc than hieu va Hong Nghia giac ti y thuf . do, khong ro nam nao. Bia van chi d lang Nghia Phii (do Nguygn Danh Nho soan nam 1697) cung cac ti lieu khac d dia phifcfng deu ghi nhi/ vay. CONG^INH Y-DJOC Nhflng nam d trong