DANH MỤC QUY TRÌNH KỸ THUẬT Y HỌC CỔ TRUYỀN

DANH MC QUY TRNH K THUT Y HC C TRUYN
B Y T CNG HA X HI CH NGHA
VIT NAM
c lp T do Hnh phc
DANH MC
Quy trnh k thut Y hc c truyn
( Ban hnh km theo Quyt nh s: 26/2008/Q-BYT

Ngy 22/7/2008 ca B trng B Y t)
STT Quy trnh Trang

1 Quy trnh khm bnh Y hc c truyn 9
2 Vng chn 10
3 Vn chn 13
4 Vn chn 13
5 Thit chn 18
6 Quy trnh chn on bng Y hc c truyn 21
7 Quy trnh k n thuc Y hc c truyn 24
8 in chm phc hi chc nng lit vn ng do vim no 28
9 in chm iu tr gim thnh lc 30
10 in chm iu tr mt ting 32
11 in chm iu tr gim th lc 34
12 in chm iu tr tc tia sa 35
13 in chm iu tr bo ph 37
14 in chm iu tr mt ng 39
15 in chm iu tr au u 41
16 in chm iu tr hen xuyn 43
17 in chm iu tr bu c n thun 45
18 in chm iu tr song th 46
19 in chm iu tr nn 48
20 in chm iu tr nc 49
21 in chm iu tr sp mi 51
22 in chm iu tr h tr cai nghin ma ty 53
23 in chm iu tr au quanh khp vai 55
24 in chm iu tr au lng 57
25 in chm iu tr au thn kinh ta 59
26 in chm iu tr chp lo 60
27 in chm iu tr i dm 62
28 in chm iu tr lit rut c nng 63
29 in chm iu tr lit na ngi do tai bin mch mu no 65
30 in chm iu tr lit 2 chi di 68
31 in chm iu tr tng huyt p 70
32 in chm iu tr to bn 71
33 in chm iu tr ri lon thn kinh chc nng 73
34 in chm gim au trong lot d dy t trng 75
35 in chm gim au do si thn, si niu qun 76
36 in chm gim au do vim i trng mn 78
37 in chm gim au do si mt 79
38 in chm iu tr vim a khp dng thp 80
39 in chm iu tr lit dng 82
40 in chm iu tr thng kinh 85
41 in chm iu tr kinh nguyt khng u 88
42 in chm iu tr di tinh 91
43 in chm iu tr lit dy thn kinh s VII ngoi bin 93
44 in chm iu tr au dy thn kinh s V 95
45 in chm iu tr vo c cp 97
46 in chm iu tr hi chng vai gy 98
47 in chm iu tr au dy thn kinh lin sn 100
48 Chm t phu thut xoang sng hm 101
49 Chm t phu thut vim tai xng chm 103
50 Chm t phu thut mt 105
51 Chm t phu thut amidan 107
52 Chm t phu thut bu c 109
Chm t phu thut si niu qun mt phn ba trn,si i b
53 111
thn
54 Chm t phu thut si niu qun mt phn ba gia v di 113
55 Chm t phu thut d dy 115
56 Chm t phu thut ly si ti mt, ct ti mt 117
57 Chm t phu thut si bng quang 119
58 Chm t phu thut thot v bn 121
59 Chm t phu thut u x t cung 123
60 Chm t phu thut u nang bung trng 125
61 Chm t phu thut u v, ung th v 127
62 Chm t phu thut tuyn c 129
63 iu tr tng huyt p 131
64 iu tr huyt p thp 132
65 iu tr u lnh tnh tuyn tin lit 134
66 iu tr hi chng rut kch thch 135
67 iu tr ri lon lipid mu 137
68 Quy trnh iu tr tht tr ni 139
69 iu tr r hu mn 142
70 Quy trnh gic 145
71 Quy trnh sc thuc thang 148
72 Quy trnh bm huyt 149
ng dng nguyn tc iu tr vo bt php trong lo khoa
73 151
YHCT
74 Nguyn tc iu tr lo khoa Y hc c truyn 153
75 Quy trnh tp dng sinh 155
76 Quy trnh ung thuc sc 156
77 Quy trnh ngm nc thuc 159
78 Quy trnh xng thuc, khi thuc 160
79 iu tr cm cm 162
80 iu tr au tht lng 164
81 iu tr thp khp 168
82 iu tr suy nhc thn kinh 171
83 iu tr my ay 173
84 Phu thut tr bng my ZZ.II.D v iu tr kt hp YHCT 176
85 Quy trnh xng hi thuc YHCT 178
86 Quy trnh ngm thuc v xng hi 179
87 Quy trnh chm ngi cu 182
88 Quy trnh ct tr bng my Laser CO2 183
89 iu tr au thn hng 185
90 iu tr di chng tai bin mch mu no bng YHCT 188
91 iu tr vim ng mch chi 192
92 iu tr hen ph qun 198
93 iu tr vim quanh khp vai bng kt hp YHCT-YHH 202
94 iu tr lit thn kinh VII ngoi bin 206
Quy trinh 01: KHM BNH YHCT
I. I CNG: Cng nh y hc hin i, khi mt bnh nhn n iu tr bng cc phng php c a y h c c truy n, cc
thy thuc y hc c truyn cng phi th t thc hin cc bc nh: 1.Thm khm bnh nhn: y h c c truy n g i l T
chn. 2. Chn on bnh: y hc c truyn gi l chn on Bt Cng, chn on t ng ph , chn on b nh danh 3. ra
phng php iu tr: y hc c truyn gi l Php iu tr.
II. CH NH:
Tt c cc bnh nhn khi n iu tr bng cc phng php ca y hc c truy n.
III. CHNG CH NH:
Nhng bnh nhn mc cc bnh khng thuc din iu tr bng cc phng php c a y h c c truy n.
IV. CHUN B:
1. Cn b y t: y, bc s, lng y c o to theo quy ch.
2. Phng tin:
* Bn, gh thy thuc v bnh nhn ngi, ging bnh nhn nm khi khm.
* Phng khm cn thong, nh sng t nhin.
3. Ngi bnh
* H s, bnh n: ng theo mu bnh n kt hp y hc hin i vi y hc c truy n.
* T th bnh nhn khi khm: Ngi bn phi hoc bn tri bn ca thy thuc
V. CC BC TIN HNH KHM BNH:
Y hc c truyn gi l T Chn.
Vy T Chn l g? T Chn l bn phng php khm bnh ca y hc c truyn gm: Nhn (vng chn), nghe ng i (v n
chn), hi (vn chn), bt mch, s nn (thit chn), nhm thu thp cc tri u chng ch quan v khch quan c a ng i
bnh.
Quy trinh 02: VNG CHN

.
Thy thuc dng mt quan st thn, sc, hnh thi, mt mi, mi, li, ru li ca ngi bnh bi t tnh hnh b nh t t
bn trong ca c th phn nh ra bn ngoi.
1.1. Nhn Thn: Thn l s hot ng v tinh thn, thc l s hot ng ca tng ph bn trong c th biu hi n ra ngoi.
* Cn Thn: mt sng, tnh to, bnh nh
* Khng cn Thn: Mt mi, th , lnh m vi mi trng xung quanh, bnh nng.
* Gi thn (hi quang phn chiu): Bnh rt nng, c th suy kit, song t nhin t nh to tr l i, thm n u ng l d u
hiu chnh kh sp thot, tin lng xu.
1.2. Nhn sc: Nhn sc mt bnh nhn, khi c bnh s bin i nh:
* Sc : do nhit
- ton mt: Thc nhit thng gp trong st do nhim khun, do say nng
- Hai g m , st v chiu do m h sinh ni nhit thng gp nhng bnh nhn st ko di, lao ph i.
* Sc vng do h, thp.
- Vng ti, sng bng l do thp nhit (Hong n nhim khun)
- Vng xm, ti l do hn thp (Hong n do mt, tan huy t) vng da do m t
- Vng nht do t h khng vn ho c thu thp.
* Sc trng do h hn, do mt mu cp.
- Sc trng km theo ph: Thn dng h
- Sc trng bch t ngt xut hin ngi b bnh cp tnh l dng kh sp thot.
- Sc trng cn gp nhng bnh nhn au bng do lnh, ngi b chn thng mt nhi u mu.
* Sc en do thn h, dng kh h.
* Sc xanh do huyt, cn au ni tng, st cao co git tr em.
1.3. Nhn hnh thi, ng thi ngi bnh:
- Nhn hnh thi bit tnh trng kho hay yu ca 5 tng bn trong:
+ Da, lng kh l ph h
+ C nhc teo nho l t h
+ Xng nh, rng chm mc l thn h
+ Chn tay run, co qup l can huyt h
+ Ngi bo n t, hay th gp l t h km m thp
+ Ngi gy, n kho, mau i l v ho.
- Nhn ng thi ca ngi bnh bit bnh thuc m hay thuc dng:
+ Thch ng, nm quay mt ra ngoi bnh thuc dng.
+ Thch yn tnh, nm quay mt vo trong bnh thuc m.
1.4. Nhn mt: Nhn lng trng mt ca bnh nhn.
- Lng trng c mu : Bnh tm
- Lng trng c mu xanh: Bnh can
- Lng trng c mu vng: Bnh t
- Lng trng c mu en: Bnh thn.
1.5. Nhn mi:
- u mi c mu xanh: au bng
- u mi hn en: Trong ngc c m m
- u mi trng: Kh h hoc mt mu nhiu
- u mi vng: Do thp
- u mi : Do ph nhit
1.6. Nhn mi:
- Mi , kh: Do nhit
- Mi trng nht: Do huyt h (thiu mu)
- Mi xanh, tm: l huyt
- Mi xanh en: Do hn
- Mi l lot: Do v nhit
1.7. Nhn da:
- Ph, n lm lu: do thu thp
- Ph, n khng lm: do kh tr
- Da vng ti sng, km theo st cao: chng dng hong
- Da vng xm, khng st: chng m hong
- Ban chn trn da:
+ Nt ban chn ti nhun l chnh kh cha h
+ Ban chn mu tm l nhit thnh
+ Nt ban chn xm l chnh kh h.
1.8. Xem li: chia lm 2 phn.
* Cht li: l t chc c, mch ca li.
* Ru li: l mng ph trn b mt ca li.
Ngi kho mnh bnh thng: cht li mm mi, hot ng t nhin, mu hng, ru li tr ng m ng, khng kh, t v a
phi, khi b bnh c cc thay i.
1.8.1. Cht li.
* V mu sc:
- Nht mu: Do hn chng, h chng, dng kh suy hoc kh huy t khng y .
- : do nhit c bnh l, thc c nhit hoc h nhit (m h ho vng)
- ging: do nhit thnh, t kh vo n phn dinh, huyt. cc bnh nhn mc bnh mn tnh do m h ho vng
hoc tn dch b suy gim nhiu.
- Li xanh, tm: c th l do hn, c th do nhit. Nu do nhit th cht li xanh tm nhi u, l i kh. N u do hn ch t l i
xanh tm, t nhun. Nu do huyt cht li xanh tm c im huy t.
* V hnh dng li.
- Li ph n: Bnh thuc thc chng, nhit chng, c vt hn rng ra li: do h hn ho c m k t.
- Li sng to, trng nht: T thn dng h; li sng to, hng : thp nhit hay nhit c mnh.
- Li mng nh, t: Do tm t h, kh huyt h, suy nhc c th nu li mng, nh, ging do m h nhi t th nh, tn
dch hao tn.
- u li ph i: Tm ho thnh; hai bn li ph i: Can m ho thnh; gia li ph i: do v nhit.
* ng thi ca li.
- Li yu, mu nht: kh huyt h.
- Li lit, mu : m h kit.
- Li lit, xm: Nhit thnh lm m h tn.
- Li cng khng c ng c: Nhit nhp tm bo, trng phong
- Li lch: Trng phong (tai bin mch mu no)
- Li run: Do tm t, kh huyt h
- Li rt ngn: bnh trm trng, nu li rt ngn, t l hn ngng tr cn mch, nu li r t ng n, ph n l do m
thp, nu li rt ngn, , kh do nhit thnh, thng m.
- Li th ra ngoi: Tm t c nhit hoc bm sinh pht dc km (bi no)
1.8.2. Ru li.
* Ru li mu trng: Bnh thuc hn chng, biu chng.
- Trng mng do phong hn.
- Trng mng, u li : do phong nhit
- Trng trn do thp hoc m m
- Trng dnh do m trc, thp t gy ra
- Trng, kh nt n: t nhit bn trong thnh, tn dch hao tn nhiu.
* Ru li mu vng: Bnh thuc l chng.
- Vng mng: nhit l nh.
- Vng dy, kh: nhit thnh l, tn dch hao tn
- Vng dnh: do thp nhit hoc m nhit
* Ru li xm en: Bnh rt nng.
- Ru li xm en, kh: nhit thnh lm tn thng tn dch nhiu.
- Ru li xm en, trn, nhun: dng h, hn thnh thu thp tr bn trong.
- Ru li dnh, hi: Trng v c nhit hoc thc tch li t v gy ra.
Ch : phng php nhn (vng chn) ca y hc c truyn cn thc hin trong i u ki n nh sng t nhin th m i m b o
chnh xc. i vi tr em di 3 tui cn kt hp xem ch tay chn on chnh xc hn.
Quy trinh 03: VN CHN

.
1. Thy thuc dng tai nghe ting ni, hi th, ting ho, ting nc ca ngi bnh. 2 Thy thuc dng m i ng i h i
th, cc cht thi nh: phn, nc tiu, kh h ca bnh nhn gip phn bit tnh tr ng b nh thu c h hay th c, b nh
thuc hn hay thuc nhit ca ngi bnh ra pht iu tr ph hp (thc t hi n nay th y thu c c th h i ng i b nh
tip nhn cc thng tin ny)
2.1. Nghe ting ni ca ngi bnh:
- Ting ni nh, thu tho khng ra hi: chng h
- Ting ni to, mnh: chng thc
- Ni ngng, khng r m t: trng phong m
- Lm bm ni mt mnh: tm thn h tn.
2.2 Nghe ting th ca ngi bnh:
- Ting th to, mnh l thc chng: thng gp trong cc bnh cp tnh.
- Ting th nh, ngn, gp l h chng: Thng gp trong cc bnh nhn nng, m lu ngy.
2.3. Nghe ting ho ca ngi bnh:
- Ho c m l thu
- Ho khng c m l khi.
- Ho khan l bnh ni thng: Ph m h
- Bnh cp tnh m khn ting: ph thc nhit
- Bnh lu ngy m khn ting: Ph m h.
- Ho km theo ht hi, s mi, s lnh, st nh l b cm mo phong hn.
- Ho tng cn km theo nn ma l ho g (bch nht khi)
3. Ngi cc cht bi tit ca bnh nhn:
- Phn tanh, hi, long do t h
- Phn chua, thi khm do tch nhit, thc tch.
- Nc tiu khai, c do thp nhit.
- Nc tiu trong, khng khai, s lng nhiu: thn dng h.
- Nc tiu nhiu, c rui bu, kin u: i tho ng
- Kh h ( ca ph n) mu vng, mi hi: thp nhit (vim nhim b phn sinh d c)
- Kh h mu trng, s lng nhiu: h hn.
- hi; c mi chua, hng l do t v b ng tr, tiu ho khng tt.
- Hi th hi km theo l lot nim mc ming, li l do v nhit.
Quy trinh 04: VN CHN

.
VN CHN L cch hi bnh (vn chn) lm bnh n theo YHCT. Ln lt ti n hnh theo cc b c sau:
1. L do i khm bnh v hon cnh xut hin bnh:
- L do chnh lm ngi bnh lo lng v phi i khm bnh, mc bnh ca l do ny

- L do ny xut hin trong hon cnh no: sau cm nhim lc t (ngoi nhn), sau r i lo n tnh ch (n i nhn) hay sau
chn thng, trng th cn, lao ng nng nhc, n ung thiu thn hoc nhiu ng t bo, s ng l nh... (b t n i ngo i
nhn)
2. Din bin bnh:
o Din bin ca triu chng chnh:
- Xut hin t bao gi, trong hon cnh no?

- Din bin ca triu chng c biu hin g c bit trong ngy, tu n... c lin quan g v i th i ti t, kh h u (ngo i nhn),
s thay i tnh ch (ni nhn), n ung, lao ng, sinh hot (bt ni ngoi nhn) ... khng?
- Nu l triu chng ca bnh c nay nng ln, th l do g lm bnh nng ln hoc c di n bi n b t th ng?
o Din bin ca triu chng km theo:
- Cc triu chng km theo ny xut hin khi no, trc hay sau tri u chng chnh?
- Cc triu chng km theo cng c lin quan g ti cc nguyn nhn ngo i nhn, n i nhn hay b t n i ngo i nhn khng
- Ch khai thc c cc triu chng m tnh km theo c gi tr chn on phn bi t. V d : ng i b nh ch au u khi
cng thng, mt mi, khng au tng khi thay i thi tit = au u do tht tnh
o Cc phng php iu tr s dng v kt qu:
* Nu ngi bnh ch dng cc phng php iu tr YHH n thun, ch hi lt qua, khng tm hi u su.
*C gng khai thc k v ht cc phng php iu tr bng YHCT m ngi b nh s d ng, cc ph ng php c th
l:
+ Phng php khng dng thuc:
- Ngi bnh t lm: t xoa bp, chm nng...
- Khm cha bnh ti cc c s y t t nhn hoc cng lp: chm cu, xoa bp, bm huy t, tp kh cng d ng sinh... cc
phng php ny s dng ring r hay phi hp vi phng php vi nhau
+ Phng php dng thuc: dng thuc dng ngoi hay thuc ung
- Dng thuc, cch s dng,
- Dng theo ch nh ca ai (t dng theo kinh nghim gia nh, theo l i khuyn c a ng i quen, theo h ng d n c a l ng
y, thy thuc...)
- Nu dng thuc thang c bit tn bi thuc hay thnh phn bi thu c khng? N u khng bi t th c bi t ch n on b nh
khng, u chn on ?
+ Tt c cc phng php iu tr ny t c kt qu th no ?
3. Hi thm cc c im ca YHCT: trong qu trnh hi bnh, tu tng chng c th, hy hi thm cc tri u chng
mang tnh c th ca YHCT nh sau:
3.1. Hi v hn - nhit v m hi: l hi v cm gic nng lnh, m hi, thi gian v kim chng.
Ch yu hi c hay khng c pht st, s lnh ? Thi gian ngn hay di ? Mc n ng hay nh ? Cc tri u ch ng km theo
? C hay khng c m hi, tnh cht v lng nhiu hay t ?
+ Bnh mi bt u c pht st, s lnh l ngoi cm biu chng, trong :
- Pht st nh, s lnh nhiu, khng c m hi l ngoi cm phong hn biu th c chng
- Pht st cao, s lnh t, c m hi l ngoi cm phong nhit biu h chng
+ Lc c cm gic nng, lc c cm gic lnh l hn nhit vng lai. N u th i gian pht b nh ng n, km mi ng ng, h ng
kh, hoa mt, chng mt, ngc sn y tc... l chng bnh bn biu bn l
+ St cao, khng s lnh, c ra m hi, nc tiu vng sm, i tin to, ming kht, cht li l l th c nhi t
+ Bnh ko di, thng hay st m v bui chiu (triu nhit), ngc v lng bn tay lng bn chn c c m gic nng (ng
tm phin nhit), km theo g m , mi kh, o hn (ra m hi trm) l biu hi n m h sinh n i nhi t.
+ S lnh, chn tay lnh, hi th ngn gp (on kh), ngi mt mi v lc, t ra m hi (t hn) l dng h .
+ Mt s tnh cht c bit ca m hi:
- M hi vng: thp nhit; dnh nht: vong m (bnh nng).
- M hi nhiu na ngi: trng phong.
- M hi nhiu khng dt, ngi v chn tay lnh: thot dng.
3.2. Hi v u, thn, ngc v bng, t chi: l hi v v tr, c im, tnh cht v thi gian din bin ca bnh, tu v tr au
tm tn thng tng ph, kinh lc.
* u au v vng u:
- u au lin tc, ch yu hai bn thi dng, km theo pht st, s lnh... a s l do ngo i c m
- au u khi au, khi ngng, thng km theo c hoa mt, chng mt, khng nng, khng l nh... a s l do n i th ng -
l chng
- au nhiu hoc ch mt bn u thuc v ni phong, huyt h
- Ban ngy au u, khi lao ng mt mi au tng do dng h
- au u bui chiu... thuc huyt h, au u vo na m... a s thuc m h
- au u km hoa mt, chng mt, mt , ming ng... l do can m ho mnh
- au u km hoa mt chng mt, hi hp nh trng ngc, th ngn gp, khng c lc... do kh huy t h nh c
- Bng nhin vng u l thc chng. Vng u ko di l h chng
- u c cm gic au, tc, nng, cng cng... nh b bc thuc thp nng
- V tr au u: cc ng kinh dng u i ln u, cc ng kinh m c vi nhnh ln u. au vng trn thu c kinh
dng minh, au sau gy thuc kinh thi dng, au hai bn u thuc kinh thi u d ng, au nh u thu c kinh quy t
m.
* Thn mnh, t chi au mi:
- Ton thn au mi, pht st, s lnh... a s l do ngoi cm
- au mi ngi lu ngy... a s l do kh huyt bt tc
- au mi vng tht lng ... a s l thuc thn h
- Cc khp t chi, cn ct, c bp c cm gic au t, hay cc khp sng au c tnh di chuy n hay c nh... a s l
do phong hn thp t
- Tay chn, thn mnh t di, nga thng do kh huyt km
* au tc vng ngc:
- Ngc au, st cao, khc c ra mu m... a s l do Ph ung (abcs phi)
- Ngc au, km theo st v chiu, ho khan, t m, trong m c dnh mu... a s l do Ph lao (lao ph i)
- au ngc lan ln trn b vai, hay au d di phn sau xng c, t cm thy vng ngc nh c mt p l c n ng vo,
l chng Hung t
* au vng bng:
- au bng vng trn rn, nn khan hay nn ra bt di, gp lnh au tng... a s l v hn
- Bng trn chng au, hi, nut chua... a s l do thc ngng
- au bng quanh rn, khi au, khi ngng, km theo lm ging, bun nn... a s l au b ng giun
- au bng, pht st, i tin phn nho nt km c mu mi... l thp nhit - thc chng
- au bng m , i tin phn nho nt, s lnh tay chn lnh... l hn thp - h chng
- Thng au bng xut hin t ngt l thc chng, au bng ko di a s l h chng.
- ang au bng, n vo au tng l thc chng. Sau khi n m bng bt au l h chng
- au bng d di, ch au c nh, khi khm s nn au tng ln (c n) l thc chng
- au xut hin t t, m , v tr au khng c nh khi thm khm, xoa nn th c cm gic d chu (thi n n) l h chng
3.3. Hi v n ung: cn hi n ung nhng g ? Lng n, khu v, phn ng sau khi n, cho ti cm gic kht, ung
nc
- ang mc bnh vn n ung gn nh bnh thng, l v kh cha b tn thng
- Chn n, y bng, hay hi: v c tch ngng (thc chng)
* n khng ngon ming, khng tiu: h chng
* n vo bng chng thm: thc chng
* n vo d chu: h chng; kh chu: thc chng
* n vo y tc, lu tiu: tch tr
- n nhiu mau i: a s l v ho (cn ch loi tr chng tiu kht)
- Ming kht, thch ung nc mt: nhit l
thch ung nc m: hn l
khng mun ung, ung vo li nn ra: thp nhit l
ung vo khng ht kht: m h sinh ni nhit
- Ming nht, khng kht hoc l biu chng cha chuyn vo l hoc l dng h - hn bn trong m ch (l ch ng).
- Ming ng l can m thp nhit, ming chua l trng v tch ngng, ming ngt cng l t h c th p nhi t.
- Khu v trc khi mc bnh: c th l nguyn nhn gy ra bnh hin nay. Hay n s ng l nh, ng t bo: d t n th ng
dng kh t v. n nhiu cay nng, ung ru nhiu d lm hao tn tn dch, gy i tin to
3. Hi v i tin v tiu tin: hi r v s ln v tnh trng ca i - tiu tin v cc du hiu km theo
o i tin:
i d hay kh:
- i tin kh thuc thc.

- i tin d hn bnh thng hoc khng cm c thuc h
Phn to hay lng:
- Kh (to) hn bnh thng l nhit va, nu bn li tng hn l nhit nng.

- Phn lng long thng thuc hn, nhng i khi l nhit hoc thc.
Tnh cht phn:
- i tin phn c mu mi, km theo au bng qun, mt rn, ton thn st l chng L (thp nhi t).
- i tin phn en nh b c ph, mi thi khn... l vi n huy t (xut huy t ng tiu ho trn).
- i tin phn c mu ti a s l cn huyt (chy mu do Tr).
- i tin phn sng nho, nt, trc khi i i tin khng au bng... a s l t v h hn.
- i tn phn nho nt, c mi chua hi, phn ln nhn, sng phn c bt, tr c khi i ti n th au b ng, sau khi i ti n
th gim au, l hin tng thc ngng
- Sng sm au bng, i ngoi lng ... a s l thn dng h.
o Tiu tin:
i d hn hay kh hn:
- Tiu tin kh, nh git: chng thc (u x tin lit tuyn, vim bng quang cp, si bng quang...)
- Sau m khng i c: ri lon kh ho bng quang
- i d hn, d sn i khng cm c: chng h
Mu sc, s lng:
- Nc tiu trong, i nhiu: hn

- Nc tiu vng sm, i t: nhit
- Nc tiu c, i rt, i but: thp nhit
Thi gian i tiu: i tiu nhiu v m, hay i dm... l thn h
o Hi v gic ng: tm hiu v mt ng, ng d hoc ng hay m

o Mt ng:
- Kh ng, n ung gim st, mt mi, hay qun, hi hp, d hong ht... l Tm t lng h
- Ngi bt rt, kh chu khng ng c, st m , o hn, cht li , kh (t tn), mch t sc.. l m h .
- Sau khi mc bnh nng, ngi gi kh huyt b suy gim thng dn n m ng khng yn, ng t, ming li d b vim
nhim, u li .. l tnh trng tm huyt h, tm ho vng
- Mt ng, ng hay m, au u, ming ng, tnh tnh nng ny, d cu gin... do can ho vng. Khi m hay la ht l m
kh h, hay v nhit
o Ng nhiu :
- Ngi lun mt mi, ng nhiu l kh h.

- Sau khi n m mi mt, mun ng.. l t bt tc.
- Sau khi b bnh ko di m ng nhiu .. l chnh kh cha hi phc
- Ngi nng n, mt mi, ng nhiu, mch hon... l thp tr
3. Hi v tai: trong YHCT, gia tai vi cc tng ph nh thn, can, m c lin quan mt thit
- ic lu ngy a s l thn h, kh h
- Trong bnh n nhit m xut hin tai nghe km l biu hin nhit t gy t n th ng ph n m d ch
- Tai xut hin t t, tng dn, km tm phin, u vng l thn h
- Tai xut hin t ngt, km theo tc ngc, au vng mng sn, ming ng, i tin kh to, nn m a, b n chn l can
m ho vng
o Ring i vi ph n cn hi thm v kinh, i, thai, sn:
o Kinh nguyt:
- Khi no bt u c kinh, sch kinh cha, khi no?

- Chu k ko di bao lu, s lng nhiu hay t, tnh cht kinh nguy t, c thng kinh hay khng ?
- Kinh nguyt trc k, lng nhiu, xm c, ming kh, mi ... l huyt nhit. Kinh tm en, ln mu c c l th c
nhit
- Kinh nguyt sau k, lng kinh t, nht long, sc mt nht... l huy t h. N u nh km tay chn l nh, s c m t nh t l
h hn. Nu kinh tm sm, thnh cc, bng di au - c n l tnh trng kh ngng, huy t
- Mu kinh c mi hi l nhit chng, c mi tanh l hn chng
o Kh h (i h): mi v mu sc, tnh cht ca kh h ?...
- Trong long, tanh l h hn,

- Vng, c, hi... l thp nhit
o hay cha kt hn ?
- Tnh hnh sinh : s ln c mang, ln ? C hay khng c kh ? S ln sy, no ht thai ?

- Sau khi , sn dch ra lin tc, km theo bng di au - c n... l huy t nhit
Quy trinh 05: THIT CHN

Thit chn l phng php khm bnh gm bt mch (mch chn) v thm khm t chi v cc b ph n c a c th (xc
chn)
.
1. MCH CHN:
1.1. Phng php bt mch:
o Chun b:
- Ngi bnh: ngi bnh yn tnh, thanh thn, khng lo lng. Hai tay xui, lng bn tay ng a ln trn, m ch khng b
p. Tt nht l bt mch vo lc sng sm khi mi ng dy.
- Thy thuc: thoi mi, khng b phn tn t tng
V tr bt mch: c tay ngi bnh, ch ng mch quay i qua, gi l Thn khu. on ng mch quay i qua c
tay ny chia lm 3 b: B thn, B quan v B xch. ngang mm trm tr l B quan, trn b quan l B th n, d i b
quan l B xch.
Ngi thy thuc u tin t ngn tay gia vo b quan (mc l mm trm tr), sau t ngn tr vo b th n, r i sau
cng t ngn nhn vo b xch. Thng 3 ngn tay, t va kht nhau, nu ngi bnh cao qu, th t 3 ngn tay xa nhau
ra mt cht
o Cc cch bt mch:
- Tng khn: xem chung c 3 b nhn nh tnh hnh chung

- Vi khn: xem tng b v chn on bnh chng ca tng tng ph khc nhau. Bn c tay tri ng i b nh b th n t ng
ng vi tng tm, b quan tng can, b xch tng thn (m). Bn c tay phi b thn tng ng vi t ng ph , b quan t ng
t, b xch tng thn (dng).
Thng phi hp c hai cch xem, tng khn trc, ri vi khn sau
- Khi bt mch, cn dng lc cc ngn tay khc nhau xem xt t m. Khi ngn tay t nh th g i l khinh n, khi ngn
tay hi dng lc th gi l trung n. Khi ngn tay dng lc n su xu ng th g i l tr ng n
1.2. c im v bnh chng khi bt mch:
1.2.1. Mch bnh thng: l mt hi th (mt tc) c 4 - 5 nhp mch p (khong 70 - 80 ln/pht), khng ra nng c ng
khng su, khng to khng nh, mch u n th gi l mch ha hon
1.2.2. Mt s biu hin bnh l thng gp ca mch;
o nng su ca mch: mch ph v mch trm
- Mch ph: t ngn tay nh cm thy cm gic mch p r, n dn xung mch p yu i, thng b nh bi u.
Ph m c lc l biu thc, ph m v lc l biu h.
Mc bnh ngoi cm, s lnh, pht st, khng ra m hi, mch ph khn l biu thc hn. C ng b b nh ngo i c m, s gi,
pht st, ra m hi, mch ph nhc l biu h hn. Bnh truyn nhim cp tnh thi k u a s th y m ch ph
- Mch trm: t ngn tay nh cha thy cm gic mch p, dng lc n ngn tay xung su (trung n), m i c c m gic
mch p, thng bnh vo l.
Mch trm c lc l l thc. Mch trm v lc l l h.
o Tn s mch: mch tr v mch sc
- Mch tr: l mt hi th c 3 mch p (khong di 60 ln/pht), thuc v hn chng

Mch ph tr l biu hn, mch trm tr l l hn.
Mch tr c lc l thc hn, mch tr v lc l h hn.
Nu ngi bnh xut hin lng gi au mi, i ngoi lng vo lc sng sm, au bng, li nhu n, m ch tr m tr v l c l
biu hin hi chng thn dng h- thuc l h hn
- Mch sc: l mt hi th c trn 5 mch p (khong trn 90 ln/pht), thuc v nhi t chng
Mch sc c lc l thc nhit, mch sc t nhc l m h sinh ni nhit.
o Cng mch: mch h v mch thc
- Mch thc: l mch p cho cm gic cng, y, chc, nh lp xe bm cng, p c lc (hu lc), thuc thc chng, do
nhit, ho, thc tch...
Thc hot l m thp ngng kt. Mch thc huyn l can kh ut kt
- Mch h: l mch p cho cm gic mm, khng y, n mnh thng mt, v lc, thuc h chng, do kh, huy t, ho c
m, dng h.
o Tc tun hon trong lng mch: mch hot v mch sp
- Mch hot: l mch n i rt lu li, c cm gic nh di ngn tay c nhng ht chu l n. Th ng g p tr em, ph n
khi c kinh hay c thai. Nhng ngi b m thp (v hnh do ri lon lipit mu v h u hnh do ho kh c m), th c ng ng...
- Mch sp: l mch n i rt kh khn, n nh l cha n, i nh l cha i. Do huy t h, kh tr hoc hn ng ng.
o cng mm ca mch: mch huyn v mch khn :
- Mch huyn: cng, nh s si dy n, cng, th mch khn cp, c lc. i din cho can thc (can phong, can kh u t
kt...), cn gp trong cc chng c au. Mch huyn hot l m m.
- Mch khn: cng, nh s trn si dy thng (khng thng bng, c ch li ch lm), th mch khn c p, c l c. C ng
thng gp trong cc chng bnh c au, hn chng.
B ngoi cm phong hn mch ph khn, khi l hn mch trm khn.
Chng t th hn t vi cc khp au d di, c nh mt ch, chm nng au, a s l mch huy n kh n.
Khi c biu hin x cng ng mch th cng xut hin mch khn
Ngoi ra cn c mt s loi mch khc nh hng, kt, i, sc... nhng trn lm sng t gp hn.
2. XC CHN:
Xc chn l phng php thm khm bng s nn trong YHCT. Ngi thy thuc s nn vng bng, t chi, da th t (b phu,
c nhc) tm cc biu hin bt thng.
2.1. S vng bng (phc chn):
- Bng au, n xung au gim l thin n, thuc h chng, n xung au t ng l c n, thu c th c chng.
- C u cc bng, cng, c hnh th di tay l huyt , mm, di ng, n tan, khng c hnh th di tay l kh tr
- Bng di nng, chn tay lnh l gi hn; lnh, chn tay lnh l ni hn; m, chn tay lnh l ngo i hn
2.2. S da tht (b phu v c nhc): ch yu tm hiu m - lnh
- Da: nhun hay kh, c m hi hay khng, lnh hay nng
Da mi s thy nng, n su v lu bt dn l nhit biu.
Xem c ph, ni gai, ban chn, nt phng khng ?
- C nhc: c co cng c l thc chng, c mm hay nho l h chng
2.3. S t chi:
- Mu bn tay, lng nng l ngoi cm pht st
- Lng bn tay, bn chn m nng hn mu l m h sinh ni nhit.
- Tay chn lnh l dng h
- Tr em st cao, u chi lnh c th xut hin co git
- Khi i tin lng, mch t nhc, tay chn lnh l i tin lng kh cm, tay chn cn nng m d c m h n
- S nn cc khp xem c gy xng khng, cc khp c sng, nng, h n ch vn ng hay c ng kh p, bi n d ng khng
?
2.4. S ng i ca kinh mch: tm cc im phn ng du huyt v khch huyt. Bnh l ca ng kinh thng xut
hin sm nht nhng du hiu phn ng trn huyt khch v huy t du ca ng kinh . Trong YHCT g i l kinh l c ch n.
Quy trinh 06: CHN ON BNG Y HC C TRUYN
.
I. I CNG: Chn on y hc c truyn l mt mt xch quan trng trong chui mt xch th m khm lm sng, chn
on v iu tr gp phn ng k vo kt qu tr liu. Qu trnh chn on c thc hi n ti p sau cc b c th m khm
lm sng. (T chn: Vng, Vn, Vn, Thit) v lm nn tng cho mt xch iu tr v d phng. cng v c chn on c
chnh xc i hi mt xch khm lm sng (t chn) phi chnh xc v y khng b st v b qua b t c khu no,
ng thi cn tn trng tnh khch quan trong qu trnh thm khm, d liu thng tin v b nh t t.
c mt kt qu chn on ng hp l v logic cn tun th cc nguyn t c c b n c a quy trnh ch n on, n m ch c
cng lnh ca bt cng ni ring v h thng l lun ca y hc c truy n ni chung c bi t l l lu n h c thuy t m
dng v ng hnh, bi n xuyn sut ton b lnh vc y hc c truy n t sinh l, bnh l n th m khm lm sng, chn
on, iu tr v d phng.
II. CC BC CHUN B:
m bo cho vic chn on c chnh xc y khng b st cn tun th cc quy trnh sau:
1. Xem v c k cc thng tin thu c t vic khm bnh.
Vic xem xt v thm nh k cc thng tin (triu chng) thu c t vi c th m khm l cng vi c quan tr ng v c n thi t,
bi trn c s ca vic lm ny s gip thy thuc thit lp cc mi lin h t cc thng tin r i r c thnh m t h th ng cc
thng tin c mi lin h vi nhau to nn cc hi chng bnh l qua gip th y thu c h ng n vi c l a ch n m t ch n
on ph hp nht v gip cho vic chn on loi tr.
2. Cn nm vng tm cng lnh chn on (bt cng).
Ni dung tm cng lnh gip cho cc thy thuc trong khi chn on cn phi ch ra c v tr nng su, tnh hn nhi t,
trng thi h thc v xu th chung ca bnh thuc m hay dng, t gip cho vi c chn on nguyn nhn v ra cc
phng php cha bnh chnh xc.
Ni dung ca tm cng lnh l:
2.1. Biu v l
Biu v l l hai cng lnh ch v tr nng su ca bnh tt, gip nh gi tin l ng v ra ph ng php ch a b nh thch
hp: bnh biu th dng php hn, bnh l th dng php thanh, h, n, b
2.1.1.Biu chng: Bnh biu l nng, ngoi, gn, xng, c nhc, kinh lc, bnh cm mo v bnh truy n nhi m
thi k u y hc c truyn gi l phn v, tng ng vi y hc hin i l vim long v kh i pht.
- Cc biu hin lm sng ca biu chng: pht st, s gi, s lnh, ru li trng mng, au u, au mnh, ng t m i, ho,
mch ph.
2.1.2. L chng: L l bnh bn trong, su thng l cc bnh thuc cc tng ph, bnh truy n nhi m, nhi m trng (n
bnh) giai on ton pht (t kh vo phn kh, dinh v huy t)
- Cc biu hin lm sng ca l chng: st cao, kht, m sng, cht li , ru li vng, nc ti u t s c , to bn hay
a chy, nn ma, au bng, mch trm
Biu v l cn kt hp vi cc cng lnh khc nh h, thc, hn, nhit v s ln ln gia biu l.
2.2. Hn v nhit
Hn v nhit l hai cng lnh dng nh gi tnh cht ca bnh gip cho th y thu c chn on lo i hnh c a b nh l
hn hay nhit ra phng php cha bnh hp l (Bnh hn dng thuc nhi t, b nh nhi t dng thu c hn, nhi t th
chm, hn th cu).
2.2.1. Hn chng: S lnh, thch m, ming nht, khng kht, sc mt xanh trng, chn tay lnh, nc tiu trong di, i
tin lng, cht li nht, ru li trng mng (biu hn) trng dy (l hn), mch trr m tr (l hn) ho c ph kh n (bi u hn).
2.2.2. Nhit chng: St, thch mt, mt , tay chn nng, tiu tin t , i tin to, cht li , ru li vng kh (vng
mng l biu nhit, vng dy l l nhit), mch sc (ph sc l biu nhit, hng sc l l nhi t).
Hn chng thng thuc m thnh, nhit chng thng thuc dng thnh. Hn nhit cn phi hp vi cc c ng l nh khc,
ln ln vi nhau, tht gi ln nhau.
2.3. H v Thc
H v thc l hai cng lnh dng nh gi trng thi ngi bnh v tc nhn gy b nh trn c s ra ph ng
php cha bnh.
2.3.1 H chng: H chng l biu hin ca chnh kh (bao gm cc mt: m, dng, kh, huy t) suy nh c nn trn lm
sng biu hin h suy: m h, dng h, kh h v huyt h. Do c hin tng h nhc nn phn ng c a c th chng l i
tc nhn gy bnh b gim st.
Nhng biu hin chnh ca h chng trn lm sng: bnh thng mc lu, tinh thn yu u i, mt m i, khng c s c,
sc mt trng, ngi gy, th ngn, hi hp i tiu lun hoc khng t ch, t ra m hi (t hn) ho c ra m hi tr m ( o
hn), cht li nht, mch t
2.3.2. Thc chng: Thc chng l do cm phi ngoi t hay do kh tr, huyt , m tch, nc, giun sn gy bnh.
Nhng biu hin ca thc chng trn lm sng: bnh thng mi mc, ngc bng y chng, au c n, i ti n to bn,
mt rn, i tin b, i but, i dt, hi th th v mnh, phin to, ru li vng, mch thc, hu lc
2.4. m v dng
m v dng l hai cng lnh tng qut nh gi xu th pht tri n bnh v nh ng hi n tng hn, nhi t, h , th c lun
lun phi hp v ln ln vi nhau.
S mt thng bng m dng biu hin bng s thin thng (m thnh, dng thnh) hay thin suy (m h , d ng h , vong
m, vong dng).
2.4.1. m chng v dng chng:
- m chng thng bao gm cc hi chng h v hn phi hp vi nhau.
- Dng chng thng bao gm cc hi chng thc v nhit phi hp vi nhau.
2.4.2.m h v dng h:
- m h: thng do tn dch, huyt khng y lm cho phn dng ni ln sinh ra chng h nhi t m h sinh n i nhi t:
triu nhit, au nhc trong xng, g m , o hn, ng tm phin nhit, ming kh, h ng kh, l i t ru, m ch t
sc
- Dng h: thng do cng nng (phn dng) trong c th gim st c bit l v kh suy lm cho ph n m v t tr i sinh
chng dng h sinh ngoi hn: s lnh, chn tay lnh, n khng tiu, i tin lng, tiu tin trong di, l i nh t b u, ru
li trng, mch nhc v lc
2.4.3. Vong m vong dng:
- Vong m: L hin tng mt nc do ra m hi hoc a chy nhiu: kht thch ung nc lnh, chn tay m, m hi nng
v mn khng dnh, li kh, mch ph v lc v.v
- Vong dng: l kt qu ca s vong m n giai on no s gy vong dng xut hin chong, tru m ch cn g i l
thot dng: ngi lnh, tay chn lnh, m hi lnh nht dnh, khng kht thch ung nc nng, l i nhu n, m ch vi
mun tuyt v.v
3. Cn nm vng c s phi hp ca cc cng lnh, hin tng chn gi, bn biu bn l:
3.1. S phi hp gia cc cng lnh
3.1.1. Biu l hn nhit:
- Biu hn: S lnh nhiu, st t, au ngi, khng c m hi, tri lnh bnh tng ln, ru li tr ng m ng, m ch ph kh n
- Biu nhit: S lnh t, st nhiu, ming hi kht, li ru vng mng, mch ph sc
- L hn: Ngi lnh, tay chn lnh, i tin lng, tiu tin trong di, li nht bu, ru tr ng dy, m ch tr m tr
- L nhit: Ngi nng, mt , ming kh kht, cht li , ru vng dy, i tin to, tiu vng, mch sc
3.1.2. Biu l h thc:
- Biu h: S gi, t ra m hi, ru li mng, mch ph hon
- Biu thc: S lnh, s gi, au mnh, khng c m hi, ru mng, mch ph hu lc
- L h, l thc (xem phn bt cng)
3.2. S ln ln (thc tp) gia cc cng lnh
- Biu l ln ln: Va c bnh biu va c l
- Hn nhit ln ln: Bnh va c chng hn va c chng nhit
- H thc ln ln: Bnh va c c h va c c thc
3.3. Hin tng chn gi
L hin tng triu chng bnh xut hin khng ph hp vi bn cht, vi nguyn nhn c a b nh. C hai hi n t ng sau:
3.3.1. Chn hn gi nhit: Bn cht ca bnh l hn (chn hn) nhng biu hin ra bn ngoi l cc tri u chng thu c v
nhit (gi nhit). V d au bng a chy do lnh (chn hn) gy mt nc, mt i n gi i d n n s t cao (gi nhi t).
3.3.2. Bnh nhit gi hn: Nhim trng gy st cao, vt v, kht nc (chn nhit) bnh din bin nng gy sc nhi m trng
rt run, mch nhanh tay chn lnh, v m hi, huyt p tt (gi hn).
3.4. Hin tng bn biu bn l: Bnh t khng biu m cng khng l, bnh thuc kinh thiu dng, lc nng, lc rt.
Quy trinh 07: K N THUC Y HC C TRUYN
.
I. I CNG: Theo quy nh mt n thuc d YHH hay YHCT u phi ghi r h tn, a ch, s gi y php, ch k con
du, in thoi v Email (nu c) ca thy thuc. H tn, tui, gii tnh, a ch ca bnh nhn, chn on xc nh b nh
theo YHCT (nu l thy thuc YHCT) v YHH, tn thuc, liu lng, cch dng.
YHCT c nhiu cch k n thuc nhng nguyn tc vn phi da vo t chn (Vng, Vn, Vn, Thi t), bi n chng lu n tr , chn on, php i u
tr ghi mt n thuc vi Qun, Thn, T, S (Qun l mt hoc nhiu v c tc dng i u tr nguyn nhn chnh, Th n l v thu c c tc
dng lm tng tc dng v hn ch c tnh ca Qun, T l mt hoc nhiu v c tc d ng i u tr tri u chng ho c b nh km theo, S l m t
v thuc c tc dng dn thuc vo ni b bnh v d ung). C th Thn, T, S kim cho nhau v c n d a vo th i ti t, n i , i s ng, gi i
tnh, tui ca ngi bnh thm hoc bt v thuc, ng thi phi ch tnh nng tc dng ca v thuc, cch phi hp v tng tc c h i
ca cc v thuc trnh tai bin v thuc.
II. CH NH:
n thuc YHCT c th ghi cho tt c cc loi bnh, nht l bnh mn tnh, c n cn kt hp cng ho c sau v i cc ph ng php i u tr
YHH nh iu tr ung th, iu tr sau phu thut
n thuc YHCT ngoi dng ung, c th ghi iu tr bn ngoi nh ngm, ra, rc hoc xoaC ng c th ghi n phng b nh.
III. CHNG CH NH:
- Sau phu thut tiu ho, phi cha cho php n i vi thuc ung.
- Cc bnh khng ung c c th dng tim.
- Bnh nhn d ng thuc.
- Bnh nhn s ung thuc YHCT.
IV. CHUN B:
4.1. Cn b
- Bc s YHCT
- Lng y, y s YHCT.
4.2. Phng tin
- Phng khm, gi bt mch
4.3. Bnh nhn
- C h s bnh n Y hc hin i v Y hc c truyn.
- C n thuc YHCT.
- Phi c n lu ghi y liu lng.
V. CC BC TIN HNH:
Sau khi c chn on v php iu tr theo YHCT, da vo trnh ca thy thuc, tnh hnh b nh, kinh t ng i b nh v i u ki n c s y t c
th dng mt trong cc cch k n sau:
5.1. Cch k n theo toa cn bn
5.1.1. Cu to bi thuc: gm hai phn:
- Phn iu ho c th l phn c bn gm 6 tc dng

Thanh nhit gii c Si t
Nhun huyt Huyt d
Li niu R c tranh
Nhun trng Mung tru
Kch thch tiu ho Gng hoc S
Nhun gan Rau m
- Phn tn cng bnh
Da vo bnh thm hoc bt v trn cho ph hp, c th, nu b kit l thm c sa, nu mt ng thm L vng, n u a chy b nhu n trng
gia Bp iLiu dng tu thuc vo tui, tr em bng 1/2 1/4 liu ngi ln.
5.1.2. Cch s dng:

- Nu trong ngi nng hoc st th dng ti, nu trong ngi lnh th sao vng
- Cc v thuc trn nu thiu th thay bng cc v khc cng tc dng nh Si t thay B cng anh.
- Liu dng v v thuc c th tng gim tu tnh hnh bnh v tu i ca ngi bnh.
5.2. Cch k n theo nghim phng
Dng cc bi thuc ca thy thuc rt ra qua kinh nghim ca bn thn, hay t p th i u tr c k t qu , cc bi thu c ny c th nghin
cu hoc cha nghin cu, ph thuc vo cc thy thuc cng hin. V d: Vin sen vng iu tr mt ng . BTD i u tr li t d ng
5.3. Cch k n theo gia truyn
Dng cc bi thuc theo kinh nghim ngi xa li iu tr mt bnh hoc chng bnh c k t qu . Cch k n ny th ng khng thng qua
l lun YHCT, v d: Thuc Cam hng bc iu tr chng suy dinh dng tr em, khng thay i li u l ng v thnh ph n.
5.4. Cch k n theo c phng
Dng cc bi thuc t cc sch ca ngi xa li iu tr mt bnh hoc mt chng bnh nh t nh. V d : bi L c v i u tr chng m h .
Cc bi thuc ny c qun thn t s r rng.
Cch dng c th thm gia v hoc bt v hoc gim liu lng ph hp vi bnh nhng khng qu nhi u v . V d nh n u th n m h th
dng bi Lc v, nhng nu mt ng th thm Vin ch hoc To nhn, nu di tinh th b Trch t ho c gi m li u, cc bi thu c c ph ng c th
bn ra th trng khng phi th c tnh cp v bn trng din.
5.5. Cch k n thuc theo i php lp phng
Cch ghi ny rt ph bin, phi tun theo php iu tr, s phi ng cc v thuc v Qun, Th n, t, S , b nh c p tnh th ng ch ghi 3 thang
dng trong 3 ngy/1 ln khm, bnh mn tnh thng ghi 6 thang dng trong 6-7 ngy, thu c vin thu c hon c ng dng theo th i gian trn.
Ghi n thuc phi da vo t chn, bin chng sau chn on v da vo chn on c php i u tr , d a vo php i u tr thnh l p bi
thuc, v d:
- Qua t chn: Pht hin cc triu chng nh ngi gy, da xanh, cht li nht, ru li trng, ni v th yu, n l nh au b ng y b ng, i
tin phn nt v sng, tay chn lnh, mch trm t.
- Bin chng: Da xanh, tay chn lnh n lnh au bng, i tin phn nt, ru li trng, mch hn - y b ng, n km, phn s ng, g y, m ch
trm t do t v h, mt ng do t nh hng n tm
- Chn on:
+ Bt cng: L h hn
+ Chn on tng ph: T v h
- Php iu tr: n trung, kin t, tiu thc v an thn

- Phng dc: (Theo i php lp phng)
Mc hng 06g ng sm 12g
Bch thc 12g Sa nhn 06g
Bch trut 08g Thn khc 10g
Lin nhc 12g Hong k 12g
Can khng 06g
Nh vy Mc hng, Sa nhn, ng sm, Bch trut, Hong k l Qun, Bch thc l Thn, Lin nhc, Thn khc l T, Can kh ng v a l S
va l Qun do tc dng n trung.
5.6. Cch k n thuc theo kt hp YHCT vi YHH
- Dng cch k n theo 5 cch trn nhng thm cc v thuc YHCT c nghin c u c ch tc d ng c a YHH m th y thu c ch n
on bnh theo YHH.
- V d: Chn on YHH l tin mn kinh, chn on YHCT l can ho vng dng bi an chi tiu giao chng ta c th cho thm B ch t t l
v Bch tt l c nghin cu iu tr tin mn kinh tt do tng estrogen.
- Dng cch k n theo 5 cch trn c th kt hp thm cc thuc ca YHH.
5.7. Cch sc thuc thang
Mi thang thuc u sc 3 ln, mi ln cho hai bt ly 1/2 bt (cng c th cho 3 bt ly 1 bt), hai ln sau mi ln cho 3 bt cn mt bt. Trn
u chia 3 ln trong ngy ung lc thuc cn m, thuc b ung sau n 1 ting.
V thuc tn tn (cay thm) cho sau cc v thuc khc khng sc lu.
VI. CH :
- Khi ghi n thuc YHCT phi khm bnh t m (T chn) bin chng ri chn on sau ra mt php i u tr ph h p t ghi n thu c
m bo ton din trit . Khi ghi n thuc ch Qun, Thn, T, S, cch phi hp cc v thuc, trnh t ng tc c h i c a cc v thu c.
- Ghi n thuc phi da vo bnh tnh, gii, tui, ngh nghip, ch , thi tit. Mt n thuc c t v m tc d ng l t t nh t.
- Ghi n phi ch tng tc gia cc v thuc nht l tng tc c hi.
VII. TAI BIN V CCH X TR:
- Ng c thuc ung: Phi x tr cp cu nh ng c thc n.
- Phn ng thuc: Phi iu tr chng chong, chng phn v theo phc .
- Hin nay do khoa hc k thut pht trin nn nghin cu c kt qu v c tnh c a cc v thu c YHCT cho nn c n trnh.
Quy trinh 8: IN CHM PHC HI CHC NNG LIT VN NG DO VIM NO
.
1. I CNG: Vim no l bnh biu hin trn lm sng bng hi chng nhim khun thn kinh, l i nhi u di chng n ng
n v thn kinh-tm thn, c th dn ti tn ph sut i, l gnh nng cho gia nh v x hi. Theo y h c c truy n, b nh
vim no c xp vo chng n bnh do nhit c xm nhp vo c th lm dinh huy t hao ki t, cn m ch suy t n, thu
ho bt iu, kinh lc b tc, cc khiu khng thng li di chng gim hoc mt vn ng km theo ri lo n tm tr
Phng php in chm phc hi chc nng vn ng cho ngi bnh b vim no h c th t ph c v b n thn trong
sinh hot v cuc sng, ngoi ra c th t lao ng, gim bt kh khn cho gia nh v x h i. Ngoi ra i n chm cn c
tc dng phc hi mt s chc nng c bn ngi bnh b vim no nh khng ni c, khng nhn c, suy gi m tr
tu...
2. CH NH:
- Ngi mc vim no giai on di chng.
3. CHNG CH NH:
- Bnh ang trong giai on cp, ngi bnh cha t th c.
- Cn hn m
- Suy tun hon, suy h hp.
- Bnh tim bm sinh.
- St cao do bi nhim vim phi - vim ph qun.
- ang ri lon in gii do mt nc, a chy, st.
- C cn ng kinh lin tc in hnh trn lm sng.
4. CHUN B:
4.1. Cn b y t: Bc s, Y s, Lng y c o to v chm cu.
4.2. Phng tin
- My in chm hai tn s b, t
- Kim chm cu v khun, loi: 6-8-10-15 cm, dng ring cho tng ngi bnh
- Khay men, km c mu, bng, cn 700
4.3. Ngi bnh
- Ngi bnh c khm v lm h s bnh n theo qui nh.
- T th ngi bnh nm sp hoc nm nga.
5. CC BC TIN HNH:
5.1. Phc huyt
-T th nm nga:
+ Bch hi + Gii kh
+ Thi dng + Huyt hi
+ Thng lim tuyn + Tam m giao
+ Ngoi kim tn ngc dch + Trung
+ Khc tr + Thi xung
+ Hp cc + Tc tam l
+ Ni quan + Thng c h
+ Bt t + a ng hi
- T th nm sp:
+ Phong tr + Trt bin
+ Phong ph + Hon khiu
+ mn + U trung
+ i chu + Tha sn
+ Gip tch C3-C7, L1-S5 + Cn ln
+ Khc tr + Dng lng tuyn
+ Hp cc + Thi kh
+ Lao cung + Thn du
+ Bt t + i trng du
5.2.Th thut
Xc nh v st trng da vng huyt, chm kim nhanh qua da, y kim t t t i huy t, chm ph i t c kh.
-T th nm nga:
Chm t:
+ Bch hi + Khc tr
+ Thi dng + Hp cc
+ Thng lim tuyn + Ni quan
+ Ngoi kim tn ngc dch + Bt t
+ Gii kh + a ng hi
Chm b:
+ Huyt Hi
+ Tam m giao xuyn Trung
+ Thi xung
+ Tc tam l xuyn Thng c h
-T th nm sp:
Chm t:
+ Phong tr + Gip tch C3- C7, L1- S5
+ Phong ph + Hp cc xuyn Lao cung
+ mn + Trt bin xuyn Hon khiu
+ i chu + U trung
+ Khc tr + Tha sn
+ Bt t + Cn ln
Chm b:
+ Dng lng tuyn + Thn du
+ Thi kh + i trng du
5.3. Kch thch bng my in chm
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
- Cng : t 14-150 microAmpe, tng dn ti ngng bnh nhn chu c.
- Thi gian: 20- 30 pht cho mt ln in chm.
5.4. Liu trnh iu tr
- in chm ngy mt ln, mt liu trnh iu tr t 25-30 ln chm, ngi bnh ngh 30 ngy iu tr li u trnh ti p theo.
6. THEO DI V X L TAI BIN:

6.1. Theo di
- Ton trng bnh nhn.
6.2. X l tai bin
- Vng chm: Ngi bnh hoa mt chng mt, v m hi, mch nhanh, sc mt nht nht. X l: tt my in chm, rt kim
ngay, lau m hi, m, ung nc ch ng nng, cho ngi bnh nm ngh ti ch. Day bm cc huy t: Thi d ng, N i
quan. Theo di st mch, huyt p
- Chy mu khi rt kim: dng bng kh v khun n ti ch, khng day.
Quy trinh 9: IN CHM IU TR GIM THNH LC
.
1. I CNG: Gim thnh lc l gim mt phn hoc mt hon ton chc nng nghe do nhiu nguyn nhn khc nhau
nh: ic t ngt mc phi, vim no, u dy thn kinh s VIII, thiu nng tu n hon no, vim tai gi a, chn th ng s
no, ng c thuc... Theo y hc c truyn, ic thuc chng kh h, do thn kh h sinh ra tai ic (th n khai khi u t i
nh), c th c trng hp do hn t xm nhp vo kinh Thiu dng gy kh b m sinh ra i c.
2. CH NH:
Gim hoc mt thnh lc mi la tui, mi nguyn nhn .
3. CHNG CH NH:
+ Ngi bnh c ch nh cp cu ngoi khoa
+ Ngi bnh ang st ko di hoc mt nc, mt mu.
+ Suy tim, lon nhp tim.
4. CHUN B:
4.1. Cn b y t: Bc s, Y s, Lng y c o to v chm cu .
4.2. Phng tin
- My in chm hai tn s b, t .
- Kim chm cu v khun, loi: 6-8-10-15 cm, dng ring cho tng ngi bnh
4.3. Ngi bnh
- T th ngi bnh nm nga hoc ngi.
5. CC BC TIN HNH:
5.1-Phc huyt
- Bch hi - Hu thnh hi - Phong tr
- Uyn ct - Thnh cung - Chi cu
- Nh mn - Tam dng lc - phong
- Thi kh - Hp cc - Thn du
- ic I - ic II
5.2-Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t t t i huy t, chm ph i t c kh.
- Chm t:
+ Bch hi + Phong tr + Thnh cung xuyn Nh mn
+ phong + ic I + ic II
+ Hu thnh hi + Uyn ct + Hp cc
+ Chi cu xuyn Tam dng lc
- Chm b:
+ Thi kh + Thn du
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
5.4. Liu trnh iu tr
6.1. Theo di: Ton trng bnh nhn.
6.2. X l tai bin
- Chy mu khi rt kim: dng bng kh v khun n ti ch, khng day
Quy trinh 10: IN CHM IU TR MT TING

.
1. I CNG: Hin tng khn ting hoc mt hon ton ting ni do nhiu nguyn nhn khc nhau nh : do i c nn
khng nghe c (bm sinh) dn n khng ni c, do vim no, chn thng s no, di chng tai bi n m ch mu no
hoc do trng phong (cm phong hn...) gy nn. Theo y hc c truy n, do b t c thanh khi u (thanh khi u khng thng)
m sinh bnh ( khu)
2. CH NH:
Khn ting hoc mt ting, khng ni c do nhiu nguyn nhn khc nhau, mi la tui
3. CHNG CH NH:
+ Ngi bnh c ch nh cp cu ngoi khoa.
+ Ngi bnh ang b st ko di hoc mt nc, mt mu.
+ K thanh qun hoc lao thanh qun.
4.CHUN B:
4.1.Cn b y t: Bc s, Y s, Lng y c o to v chm cu .
4.2. Phng tin
- Kim chm cu v khun, loi: 6-8-10 cm, dng ring cho tng ngi bnh
4.3. Ngi bnh
5. CC BC TIN HNH:
5.1. Phc huyt
- Ni quan - Ngoi ngc dch - Thin t
- Amian - mn - Phong ph
- Thng lim tuyn - Hp cc - Ngoi kim tn
- Tam m giao
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t t t i huy t, chm ph i t c kh.
- Chm t:
+ Ni quan + Thin t + mn
+ Thng lim tuyn + Ngoi kim tn + Ngoi ngc dch
+ Amian + Phong ph + Hp cc
- Chm b:
+ Tam m giao
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
5.4. Liu trnh iu tr
6.1. Theo di
- Ton trng bnh nhn.
6.2. X l tai bin
Quy trinh 11: IN CHM IU TR GIM TH LC
.
1. I CNG: L hin tng gim hoc mt hon ton kh nng nhn do nhiu nguyn nhn nh sang chn t i m t, ch n
thng s no, vim no, p xe no, u no, vim th thn kinh nguyn pht, thi u n ng tu n hon no, ch y mu no....
Theo y hc c truyn: bnh thuc cc kinh Can, Thn v Can kh, Thn kh iu ho th nh m c thng minh
2. CH NH: Gim hoc mt th lc mi la tui, mi nguyn nhn.
3. CHNG CH NH:
+ Ngi bnh c ch nh cp cu ngoi khoa.
+ Ngi bnh ang b st ko di hoc mt nc, mt mu.
4. CHUN B:
4.1. Cn b y t: Bc s, Y s, Lng y c o to v chm cu .
4.2. Phng tin
4.3. Ngi bnh
5. CC BC TIN HNH:
5.1. Phc huyt
- Bch hi - Ton trc - Tnh minh
- Dng bch - Ng yu - Thi dng
- ng t liu - Phong tr - Quyn liu
- Hp cc - Hnh gian - Thi xung
- i chu - Tam dng lc - Chng mn
- Tam m giao - Thi kh - Thn du
- Quan nguyn - Thi bch
5.2-Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t t t i huy t, chm ph i t c kh:
5.2.1 .Thc chng:
- Chm t :
+ Bch hi + Phong tr + Hp cc
+ Ton trc xuyn Tnh minh + Hnh gian + Thi xung
+ Dng bch xuyn Ng yu + i chu + Tam dng lc
+ Thi dng xuyn ng t liu + Quyn liu xuyn ln mt
5.2.2. H chng: Ngoi cc huyt nh thc chng, chm b cc huyt sau:

- Can h: B Thi xung, Chng mn,Tam m giao
- Thn h : B Thi kh, Thn du, Quan nguyn
- T h: B Thi bch, Tam m giao

- Tn s: + T: 6- 20Hz, + B: 0,5- 4Hz
5.4. Liu trnh iu tr
6. THEO DI V X L TAI BIN
6.1. Theo di: Ton trng bnh nhn.
6.2. X l tai bin
Quy trinh 12: IN CHM IU TR TC TIA SA
.
1. I CNG: Tc tia sa l hin tng b m ang trong thi k cho con b bu v b t c tia s a, s a khng xu ng c
khi cho con b gy p xe v nu khng c iu tr kp thi. Theo y hc c truy n, t c tia sa hay cn g i l nh ung hay
nh phng (chng bnh sinh ra v). Nguyn nhn do can ut v v nhit - c th do b u v khng gi c s ch ho c m
sa nhiu con b t nn dn ti sa b tc, khng ra ngoi c, khng thng d n n b t c kinh kh.
2. CH NH:
Ngi bnh ang trong thi k cho con b, v b sng au, sa khng xung c.
3. CHNG CH NH:
+ C ch nh m p xe v do sa b tc qu lu.
+ Ngi bnh ang b mt nc, mt mu.
4. CHUN B:
4.1. Cn b y t: Bc s, Y s, Lng y c o to v chm cu.
4.2. Phng tin
- My in chm hai tn s b, t.
4.3. Ngi bnh
5. CC BC TIN HNH:
5.1. Phc huyt
+ Kin tnh + Nh cn + Xch trch
+ Thi xung + Hp cc + Tc tam l
+ Chin trung + Tam m giao + Can du
5.2. Th thut
- Chm t :
+ Kin tnh + Nh cn
+ Xch trch + Thi xung
+ Hp cc + Tc tam l
+ Chin trung
- Chm b :
+ Tam m giao + Can du
- Ch : Khng nn chm vo nm v
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
5.4. Liu trnh iu tr
- in chm ngy hai ln, chm n khi thng sa th ngh chm.
6.1. Theo di
- Ton trng bnh nhn.
6.2. X l tai bin
quan. Theo di st mch, huyt p.
Quy trinh 13: IN CHM IU TR BO PH
.
1. I CNG: - Theo Y hc hin i: Bo ph l tnh trng c th tch tr qu nhiu lng m lm nh h ng x u n s c
kho. - Nu BMI thuc khong t 20-25: bnh thng - Nu BMI > 25: tha cn - N u BMI > 30: Bo ph + T 30 34,99: Bo
ph I + T 35 39,9: Bo ph II + > 40: Bo ph III - Theo Y h c c truy n: Bo ph l tnh tr ng tr kh lin quan
n chng m m. - Mc ch ca chm cu l gim cn, a ch s BMI dn v gii hn bnh thng.
2. CH NH:
Cc trng hp tha cn, bo ph do ch n ung, sinh hot
3. CHNG CH NH:
- Bo ph, tha cn do cc bnh ni tit: Thiu nng tuyn gip, to cc chi, Cushing
- Bo ph sau dng mt s thuc (corticoid, thuc iu tr tm thn, thuc ng a thai)
4. CHUN B:
4.1. Cn b y t: Bc s, y s, lng y c o to v chm cu.
4.2. Phng tin
- Khay men, km c mu, bng, cn 70.
- Kim chm cu v khun, loi 10- 15- 20cm, dng ring cho tng ngi bnh.
4.3. Ngi bnh
- T th nm nga
5. CC BC TIN HNH:
5.1. Phc huyt
- Huyt hi - Thin khu - m lim
- Thu o - m lng tuyn - Phong long
- Chng mn - Tc tam l - i mch
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t t theo h ng huy t nh (chm xuyn
huyt), chm phi t c kh.
- Chm t:
+ Chng mn xuyn i mch
+ Thin khu xuyn Thu o
+ Phong long xuyn Tc tam l
- Chm b:
+ Huyt hi xuyn m lim
+ m lng tuyn.
- Tn s: + T: 6- 20Hz, + B: 0,5- 4Hz
- Cng : T 14-150micro Ampe, tng dn n ngng ngi bnh chu c.
- Thi gian: 20-30 pht cho mt ln in chm
5.4. Liu trnh iu tr
in chm mt ngy mt ln, mt liu trnh iu tr khong 60 ln.
6.1. Theo di: Ti ch v ton trng ca ngi bnh
6.2. X l tai bin
- Vng chm: Ngi bnh hoa mt, chng mt, v m hi, mch nhanh, sc mt nht nht: rt kim ngay, lau m hi, m,
ung nc ch ng nng, nm ngh ti ch. Theo di mch, huyt p.
7. NH GI KT QU:
Cn nng
BMI
<>-Vng bng, vng mng, vng i
Quy trinh 14: IN CHM IU TR MT NG
.
1. I CNG: - Mt ng l tnh trng kh ng hay gim v s lng hoc cht lng gic ng. - Theo y hc c truyn: mt
ng thuc chng tht min do hot ng khng iu ho ca ng ch (thn, hn, phch, , tr) - M c ch c a i u tr m t
ng l a ngi bnh vo gic ng d hn, nng cao s lng v cht lng gic ng
2. CH NH:
- Mt ng do tm cn suy nhc
- iu tr kt hp trong cc bnh thuc th khc
3. CHNG CH NH:
Ngi bnh mc cc chng bnh a chy mu (khng chm cu c)
4. CHUN B:
4.2. Phng tin
- Kim chm cu v khun loi 10cm: 4 ci, 15cm: 2 ci, 20cm: 4 ci
4.3. Ngi bnh
- Ngi bnh t th nm
5. CC BC TIN HNH:
5.1. Phc huyt
- Thn mn - Gian s - Ni quan - Khc tr
- Hp cc - Thi xung - Gii kh - Thin khu
- Tam m giao - Thi bch - m lng tuyn - Thi kh
- Trung qun - Khu kh - Tc tam l - Hnh gian
- Trung - Thin khu - Chng mn - Quan nguyn
- Kinh mn - Thn du - i chy - Bch hi
- Thi dng - Phong tr - ng t liu
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim nhanh qua da, y kim t t t i huy t theo h ng t hay b , chm ph i t
c kh.
- Do tm m h, chm b:
+ Thn mn + Ni quan
+ Gian s + Thi xung
- Do tm dng vng, chm t:
+ Thn mn + Gii kh
+ Gian s + Thin khu
+ Ni quan + Hp cc
- Do Tm T khuy tn:
Chm b:
+Thn mn + Ni quan
+ Tam m giao + Thi bch
+ m lng tuyn + Chng mn
+ Thi xung
Chm t:
+ Trung qun + Thi dng
+ Thin khu
- Do Tm Thn bt giao:
Chm b:
+ Thi kh + Thn du + Quan nguyn.
Chm t:
+ Thn mn + Ni quan + Thi dng.
- Do Can huyt h tn, chm b:
+ Thi kh + Chng mn
+ Trung + Tam m giao
+ Thi xung + Ni quan
+ Tc tam l.
- Do Can kh thin thnh, chm t:
+ Hnh gian + Bch hi
+ Phong tr + Khu kh
+ Khc tr + ng t liu
+ Thin khu + i chy
+ Chng mn + Kinh mn.
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
- Cng : T 14-150micro Ampe
- Thi gian: 20- 30 pht cho mt ln in chm
5.4. Liu trnh
in chm mt ngy mt ln, mt liu trnh iu tr t 2- 4 tun tu theo mc v din bin ca bnh.
6.THEO DI V X L TAI BIN
6.1. Theo di: Ton trng, cc triu chng km theo nu c.
6.2. X l tai bin
- Vng chm: Ngi bnh hoa mt, chng mt, v m hi, mch nhanh, sc mt nht nht: rt kim ngay, lau m hi, m,
ung nc ch ng nng, nm ngh ti ch. Theo di mch, huyt p.
Quy trinh 15: IN CHM IU TR AU U
.
1. I CNG: - au u l mt trong nhng chng bnh thng gp c phm vi r ng nhi u chuyn khoa: n i, tai m i
hng, rng hm mt, ch ti cc bnh u no, p xe no, d dng mch no, vim nhim h thn kinh. - Theo y h c c
truyn, au u thuc chng u thng, nm trong chng tm cn suy nhc do cm ph i ngo i t ho c r i lo n cng n ng
hot ng ca cc tng ph.
2. CH NH:
- au u cha r nguyn nhn
- au u r nguyn nhn c ch nh kt hp in chm.
3. CHNG CH NH:
- au u do khi u (c km hi chng tng p lc ni s).
4. CHUN B:
4.2. Phng tin
- Kim chm v khun loi 6cm, dng ring tng ngi bnh.
4.3. Ngi bnh.
5. CC BC TIN HNH:
5.1. Phc huyt
- Bch hi - T thn thng - Phong tr
- Thi dng - Thng tinh - Hp cc
- Quan nguyn - Kh hi - n trung
- Tc tam l - Cch du - Can du
- Huyt hi - Tam m giao - Khc tr
- i chu - Phong long - Lit khuyt
- Phong ph - Ph du - Thi Uyn
- Xch trch - Hnh gian - Nhn nghinh
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t t theo h ng huy t nh, chm ph i t c
kh.
- Chm t:
+ Bch hi + T thn thng
+ Phong tr + Thi dng
+ Thng tinh + Hp cc
- Nu do kh h, chm b thm cc huyt:
+ Quan nguyn + Kh hi
+ n trung + Tc tam l.
- Nu do huyt h, chm b thm cc huyt:
+ Cch du + Can du
+ Huyt hi + Tam m giao
- Nu do nhit ho, chm t thm cc huyt:
+ Khc tr + i chu
- Nu do m thp, chm t thm cc huyt:
+ Phong long + Lit khuyt
chm b: + Tam m giao + Tc tam l
- Nu do cm mo phong hn: chm t thm cc huyt: Phong ph, Lit khuyt v chm b Ph du, Thi Uyn.
- Nu do cm mo phong nhit: chm t thm cc huyt:
+ Phong ph + Trung ph
+ Xch trch.
- Nu do huyt p cao: chm t thm cc huyt:
+ Khc tr
+ Hnh gian
+ chm bnh b bnh t Tc tam l.
- Nu do huyt p thp: chm b thm cc huyt:
+ Nhn nghinh + Kh hi
+ Quan nguyn
- Tn s: 3-40 Hz
- Cng : T 14-150micro Ampe, tng dn n ngng ngi bnh chu c.
5.4. Liu trnh
in chm mt ngy mt ln, iu tr triu chng kt hp vi iu tr nguyn nhn cho n khi b nh nhn n nh.
6.1.Theo di: Theo di ton trng, triu chng au v cc triu chng km theo ca ngi bnh.
6.2. X l tai bin
- Vng chm: Ngi bnh hoa mt, chng mt, v m hi, mch nhanh, sc mt nht nht. X l: rt kim ngay, lau m hi,
m, ung nc ch ng nng, nm ngh ti ch. Theo di mch, huyt p.
Quy trinh 16: IN CHM IU TR HEN SUYN

94 quy trinh KT YHCT
1. I CNG: - Hen ph qun l mt bnh m nim mc ph qun tng nhy cm vi nhng cht kch thch khc nhau,
biu hin bng tc nghn ph qun ngy cng tng sinh ra kh th m ngi ta gi l c n hen. - Theo y h c c truy n: Hen
ph qun l phm vi ca chng ho suyn, m m l mt bnh thng xy ra nhng ngi c c a d ng. - M c ch
ca iu tr ct cn hen ph qun khi c cn v phng nga cn hen ph qun.
2. CH NH:
- Chm thi k tin cn ngn chn cn hen.
- Chm trong khi ln cn hen ct cn hen.
- Chm thi k ha hon (ngoi cn) nng cao chnh kh ca c th , i u ha kh huy t gp ph n i u tr b nh c n.
3. CHNG CH NH:
- Ph phi cp, hen tim, trn kh mng phi.
4. CHUN B:
4.2. Phng tin
- Kim chm 4-10 cm v khun, bnh nhn c s dng kim ring.
- Khay men, bng, cn 70, km c mu.
4.3. Ngi bnh
- Ty theo tnh trng ca bnh m ngi bnh c th nm sp, nga, hoc ngi t th fowller.
5. CC BC TIN HNH:
5.1. Phc huyt v
+ Tc tam l + Ph du
+ Thn du + Thin t
+ Chin trung + nh suyn
+ Thin t + Kh x
+ Hp cc + Lit khuyt.
+ Trung ph
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t t t i huy t theo h ng b , t nh, chm ph i
t c kh.
* Trong cn hen
- Chng h hn, chm b cc huyt:
+ Tc tam l + Ph du
+ Thn du +Thin t (hoc Kh x)
+ Chin trung + Hoc cu cc huyt ni trn.
- Chng thc nhit, chm t cc huyt:
+ nh suyn + Thin t
+ Kh x + Hp cc
+ Lit khuyt.
* iu tr ct cn, chm t cc huyt:
+ Thin t + Kh x
+ Trung ph + nh suyn
+ Hp cc.
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
- Cng : T 14 -150micro Ampe
- Thi gian: 20 - 30 pht cho mt ln in chm
5.6. Liu trnh: Nhiu ln trong ngy khi thy cn kh th xut hin. Chm t 2 - 6 tu n tu theo m c b nh.
6.1. Theo di: Ton trng v s din bin ca cn kh th (cng , tnh cht, s cn kh th trong ngy).
6.2. X l tai bin
- Vng chm: Ngi bnh hoa mt chng mt, v m hi, mch nhanh, sc mt nht nht. X l: lau m hi, m, ung
nc ch ng nng, nm ngh ti ch. Theo di mch, huyt p.
Quy trinh 17: IN CHM IU TR BU C N THUN
.
1. I CNG: - Bu c n thun l bnh ph i tuyn gip m khng c km theo c ng hay suy gi m chc n ng c a
tuyn. - Theo y hc c truyn, bnh sinh ra do tnh ch ut kt hoc do m th p ng ng t t , v . - M c ch c a i u tr l
lm nh dn bu, lm chm qu trnh pht trin ca bu.
2. CH NH:
Bu c giai on I, II, cha c biu hin chn p gy tr ngi n h hp v cc t chc ln c n.
3. CHNG CH NH:
- Bu c qu ln ( III, IV) gy chn p, nh hng n chc nng h hp.
- Bu c nhng ngi c ri lon v mu chy, mu ng
4. CHUN B:
4.2. Phng tin
- Kim mng chm v khun, loi 20cm: 6 ci, 15cm: 6 ci, 10cm: 10 ci, dng ring cho t ng ng i.
4.3. Ngi bnh
- T th nm nga.
5. CC BC TIN HNH:
5.1. Phc huyt
- Hp cc - Ph t
- Nhn nghinh - Thy t
- Thin t - Ni quan
- A th huyt
5.2. Th thut
- Xc nh v st trng da vng huyt, chm kim nhanh qua da, y kim t t t i huy t theo h ng nh, chm phi t
c kh.
- Chm t:
+ Hp cc + Ph t
+ Nhn nghinh + Thy t
+ Thin t + Ni quan
+ Hoc c th dng kim chm xung quanh bu theo A th huy t v chm thng vo gi a b u
- Tn s: + T: 6- 20Hz, + B: 0,5- 4Hz
5.4. Liu trnh
in chm mt ngy mt ln, mt liu trnh iu tr t 14-28 ln tu mc bnh.
6.1. Theo di: ton trng, to nh ca bu.
6.2. X l tai bin
- Vng chm: Ngi bnh hoa mt chng mt, mch nhanh, p ng chm. X tr: rt kim ngay, m, ung nc ch ng
nng, nm ngh ti ch. Theo di mch, huyt p.
Quy trinh 18: IN CHM IU TR SONG TH
.
1. I CNG: Song th l nhn vt thy nho khng r, vt c hai hnh song song chen nhau.
2. CH NH:
- Song th c nng do ri lon vn mch th gic.
- Song th do lc.
3. CHNG CH NH:
- Song th do bnh l ca gai th.
- Song th do bnh l ca dy thn kinh th gic (lao, u no).
4. CHUN B:
4.2. Phng tin
- Kim chm cu v khun, loi 6 - 8cm, c dng ring cho tng ngi bnh.
4.3. Ngi bnh
- T th ngi bnh c th ngi hoc nm.
5. CC BC TIN HNH:
5.1. Phc huyt
- Phong tr
- ng t liu
- Dng bch
- Quyn liu
- Ng yu
- Hp cc
- Ton trc
- Tc tam l
- Tnh minh
- Thi kh
- Thi dng
5.2. Th thut
- Chm t:
+ Phong tr bn i din vi bn b bnh, chm hng v bn mt b bnh.
+ Dng bch xuyn Ng yu
+ Ton trc xuyn Tnh minh
+ Thi dng xuyn ng t liu
+ Quyn liu chm hng ln mt
+ Hp cc
- Chm b cc huyt hai bn:
+ Tc tam l
+ Thi kh
- Tn s: + T: 6- 20Hz, + B: 0,5- 4Hz
- Cng : t 14-150 microAmpe, tng dn ti ngng ngi bnh chu c.
5.4. Liu trnh iu tr
- in chm ngy mt ln, mt liu trnh iu tr t 10-15 ln chm, ty theo mc tin tri n ca bnh c th ti n hnh 2-3
liu trnh lin tc
6.1. Theo di
- Ton trng ngi bnh.
6.2. X l tai bin
ngay, lau m hi, m, ung nc ch ng nng, cho ngi bnh nm ngh ti ch. day bm cc huy t: Thi d ng, N i
Quy trinh 19: IN CHM IU TR NN
.
1. I CNG: in chm cc huyt v theo phc c chn on theo l lun y hc c truy n i u tr c t c n nn
hoc gim nn.
2. CH NH:
- Nn do n phi thc n lnh.
- Nn do ung cc cht kch thch nh ru, bia.
- Nn do ri lon vn mch no.
- Nn c nng (sau phu thut d dy).
3. CHNG CH NH:
- Nn do u no, tng p lc ni s.
- Nn do u thng v.
- Nn do ung th d dy hoc ung th di cn vo d dy.
- Nn do ng c thc n.
4. CHUN B:
4.2. Phng tin
- Kim chm v khun, loi 6cm - 8cm, c dng ring cho tng ngi bnh.
4.3. Ngi bnh
- T th ngi bnh nm nga.
5. CC BC TIN HNH:
5.1. Phc huyt
- Thy t - Thi dng - Kh x
- ng t liu - n trung - Ni quan
- Thin t - Thn mn - Lng mn
- Cu v - Trung qun - Tc tam l
- Tam m giao
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim nhanh qua da, y kim t t t i huy t, chm ph i t c kh:
- Chm t:
+ Thy t xuyn Kh x + n trung
+ Thi dng xuyn ng t liu + Ni quan
+ Thn mn + Lng mn
+ Cu v + Trung qun
- Chm bnh b bnh t: Tc tam l
- Chm b: Tam m giao
- Tn s: + T: 6- 20Hz, + B: 0,5- 4Hz
- Cng : t 14- 150 micro Ampe, tng dn ti ngng ngi bnh chu c.
5.4. Liu trnh iu tr
in chm ngy mt ln, mt liu trnh iu tr t 5-7 ngy, ty theo mc bnh c th ko di thm 1-2 li u trnh.
6.1. Theo di
- Ton trng bnh nhn.
6.2. X l tai bin
ngay, lau m hi, m, ung nc ch ng nng, cho ngi bnh nm ngh ti ch, day bm cc huy t: Thi d ng, N i
Quy trinh 20: IN CHM IU TR NC
.
1. I CNG: in chm cc huyt v theo phc nhm ct cn nc v ht nc.
2. CH NH:
- Nc do ut c, cng thng thn kinh.
- Nc do n ung.
- Nc do lnh.
- Nc sau phu thut bng.
3. CHNG CH NH:
- Nc do khi u chn p
- Nc do ung th di cn d dy.
- Nc do hp mn v (bnh lot d dy hnh t trng c ch nh ngoi khoa).
4. CHUN B:
4.2. Phng tin
- Kim chm cu v khun, loi 6- 8- 10cm, dng ring cho tng ngi bnh.
4.3. Ngi bnh
- Ngi bnh c khm v lm h s bnh n theo qui nh
- T th bnh nhn nm nga.
5. CC BC TIN HNH:
5.1. Phc huyt
- Phong tr - Lng mn - Bch hi
- Thin khu - Thng tinh - Chng mn
- Thi dng - i mch - ng t liu
- Ni quan - Thy t - Tc tam l
- Kh x - Tam m giao
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim nhanh qua da, y kim t t t i huy t, chm ph i t c kh:
- Chm t:
+ Phong tr + Bch hi
+ Thng tinh + Thi dng xuyn ng t liu
+ Lng mn + Thy t xuyn Kh x
+ Thin khu + Chng mn xuyn i mch
+ Ni quan
- Chm b:
+ Tc tam l + Tam m giao
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
- Thi gian: 20 - 30 pht cho mt ln in chm.
5.4. Liu trnh iu tr:
T 5 - 7 ngy ty theo mc bnh c th ko di thm thi gian.
6.1. Theo di
- Ton trng bnh nhn .
6.2. X l tai bin
Quy trinh 21: IN CHM IU TR SP MI
.
1. I CNG: in chm gip bnh nhn t b ma ty v cai nghin ma ty ti ha nhp vi cng ng.
2. CH NH:
- Sp mi c nng.
- Sp mi do nhc c (sng th sp mi, chiu hn).
- Sp mi do chn thng.
3. CHNG CH NH:
- Sp mi do u no c xc nh qua thm khm v chn on hnh nh.
- Sp mi bm sinh.
4. CHUN B:
4.1. Cn b y t: Bc s, y s, lng y c o to v chm cu
4.2. Phng tin
- Kim chm cu v khun, loi 6 - 8cm, dng ring cho tng ngi bnh.
4.3. Ngi bnh:
- T th nm nga
5. CC BC TIN HNH:
5.1. Phc huyt
- Ton trc - Quyn liu - Ng yu
- Hp cc - Dng bch - Tc tam l
- Thi dng - ng t liu - Tam m giao
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim nhanh qua da, y kim t t t i huy t, chm ph i t c kh.
- Chm t:
+ Ton trc xuyn ng t liu + Ng yu xuyn Dng bch
+ Thi dng xuyn ng t liu + Quyn liu hng ln mt
+ Hp cc
- Chm b:
+ Tc tam l + Tam m giao
- Tn s: + T: 6- 20Hz, + B: 0,5- 4Hz
5.4. Liu trnh iu tr
in chm ngy mt ln, mt liu trnh t 10- 15 ln chm, tu theo mc tin trin ca bnh c th tin hnh 2- 3 li u
trnh lin tc.
6.1. Theo di
- Ton trng bnh nhn.
6.2. X l tai bin
Quy trinh 22: IN CHM IU TR H TR CAI NGHIN MA TU
.
1. I CNG: in chm gip bnh nhn t b ma ty v cai nghin ma ty ti ha nhp vi cng ng.
2. CH NH:
Ngi bnh nghin ma tu (heroin, thuc phin, morphinbng cc phng thc ht, ht, chch), quy t tm t nguy n cai
v chp nhn iu tr h tr cai nghin bng phng php in chm.
3. CHNG CH NH:
- Ngi bnh c thi gian chy mu ko di
- Bnh tm thn phn lit
- Cc bnh nhim khun cp tnh nng
- Suy tim nng ( III, IV)
- Ph do suy dinh dng
- Suy gan, suy thn
4. CHUN B:
4.1. Cn b y t: Bc s, y s, lng y c chng nhn c bi dng, tp hun v chm cu, in chm iu tr h tr cai
nghin ma tu.
4.2. Phng tin
- Kim chm cu v khun loi 6-8-10 cm, kim dng mt ln, mi bnh nhn cn 200-400 kim chm c u cho 1 li u trnh i u
tr.
- Khay, km c mu, bng, cn 70.
4.3. Ngi bnh
- c lm h s bnh n theo qui nh:
+ Nu c s khm cha bnh: s dng mu bnh n chung do B Y t ban hnh
+ Nu c s cai nghin ma tu hoc cai nghin ma tu ti cng ng: s dng mu BYT BCA ngy 24 thng 01 n m
2003 ca B Lao ng Thng binh v X hi, B y t, B cng an h ng dn thc hin mt s iu ca Ngh nh s
56/2002/N - CP ngy 15/5/2002 ca Chnh ph v t chc cai nghin ma tu t i gia nh v c ng ng.
- Ngi bnh c gii thch r rng v phng php in chm iu tr h tr cai nghin ma tu v nhng yu cu thc
hin trong qu trnh iu tr phi hp tt vi thy thuc.
- Mi ngi bnh cn c mt bung ring trong qu trnh iu tr ct cn.
5. CC BC TIN HNH:
5.1. Chn thi im in chm: in chm trc khi ngi bnh c trng thi tin cn 15-20 pht ( ct cn)
5.2. Phc huyt:
* Hi chng Can - m
- Triu chng: Ngi bnh thm ma tu, hay cu gt, bt rt kh chu, au u, mt ng, li , ru li vng dy, tiu tin
vng, kht nc.
- Mch: Huyn, sc
- Php iu tr: bnh can, ging ho, thng kinh hot lc
- Th php - Huyt v:
Chm t: Hnh gian, Phong tr, Thi dng
Chm b: Thi kh, Thn du
*. Hi chng T V
- Triu chng: Ngi bnh thm ma tu, tng tit nc di, au bng i ngoi (c khi i ngoi ra mu) nn hoc nn ra
mu, ming ng hoc chn tay mi nhc, ngp, chy nc mt nhiu, cht li nht, ru li mng.
- Mch: H nhc
- Php iu tr: Kin t, ho v
- Th php Huyt v:
Chm t: Hp cc, Thin khu, Trung qun, Ni quan
Chm b: Tam m giao, Tc tam l
*. Hi chng Tm Tm bo Tiu trng Tam tiu

- Triu chng: ngi bnh thm ma tu, au bng, tc ngc, hi hp, tim p nhanh, bn chn, gai gai rt, kh ng, li ,
ru li dy.
- Mch: Hng, sc.
- Php iu tr: Thanh tm, an thn.
- Th php Huyt v:
Chm t: Hp cc, Ni quan, Khc tr.
Chm b: Thi Kh hoc Thn Mn, Quan nguyn, Kh hi
*. Hi chng Thn Bng quang

- Triu chng: Ngi bnh thm ma tu, au lng, mi xng khp, nhc trong ng chn, trong ct sng (c d cm), d
mng tinh, lit dng (nam gii) kh h, ri lon kinh nguyt, v kinh (n gii), cht li nht, ru trng mng.
- Mch: Trm, nhc
- Php iu tr: B Thn, ch thng
- Th php Huyt v:
Chm t: Gip tch L2 L3 ( Thn tch ), Khc tr, Th liu
Chm b: Thn du, Tam m giao
*. Hi chng Ph - i trng
- Triu chng: Ngi bnh thm ma tu, kh th, tc ngc, bt rt, cm gic nght c, au bng, i tin to; cht li ,
ru li vng dy, nt n.
- Mch: Thc, sc
- Php iu tr: Thanh nhit, tuyn ph kh, thng kinh hot lc
- Th php Huyt v:
Chm t: Hp cc, Khc tr, Kh x, Quyn liu xuyn Nghinh hng.
Chm b: Xch trch, Tc tam l
5.3. T th ngi bnh: ngi bnh nm t th thun li cho v tr cc huyt c in chm
5.4. Th thut:
- St khun vng huyt
- Chm kim v kch thch huyt theo tng th bnh theo phc huy t. Kim chm ch dng m t l n, sau khi chm hu i.
- Tn s: + T: 6- 20Hz, + B: 0,5- 4Hz
- Cng : t 14- 150 micro Ampe, tng dn ti ngng bnh nhn chu c.
5.6. Thi gian v liu trnh
- Thi gian iu tr trung bnh l 7 ngy
- S ln in chm trong 3 ngy u ph thuc vo s ln xut hin trng thi tin c n c a ng i b nh. T ngy th 4 tr i
ch in chm mi ngy 3 ln (sng, tra, chiu)
- iu tr duy tr: duy tr hiu qu iu tr th phi in chm tip tc 2 n 3 thng, m i tu n 3 l n; v c th lu h n tu
theo tnh trng bnh l ca ngi bnh.
6.1. Theo di
- Ton trng bnh nhn .
6.2. X l tai bin
Quy trinh 23: IN CHM IU TR AU QUANH KHP VAI

.
1. I CNG: - au quanh khp vai do bnh l ca dy chng, bao khp vai. - au quanh kh p vai thu c chng t c a y
hc c truyn, bnh thng do phong, hn, thp gy ra.
2. CH NH:
Ngi bnh c chn on au quanh khp vai.
3. CHNG CH NH:
Cc trng hp au quanh khp vai c km theo nhim trng ti ch.
4. CHUN B:
4.2. Phng tin
- Kim chm cu v khun, loi: 6-10-15cm, dng ring cho tng ngi bnh.
4.3. Ngi bnh
- T th ngi c th ngi hoc nm.
5. CC BC TIN HNH:
5.1. Phc huyt
- Kin tnh - Kin ngung
- Kin trinh - T nhu
- Thin tuyn - Khc tr.
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t t theo h ng huy t nh, chm t v ph i t
c kh.
Chm t: - Kin ngung xuyn T nhu hoc t huyt Kin ngung xuyn Khc tr.
- Kin trinh
- Thin tuyn
- Kin tnh hng ti mm vai.
- Tn s t : 6-20Hz.
5.4. Liu trnh iu tr
in chm ngy mt ln, mt liu trnh iu tr t 10-15 ln chm, c th tin hnh 2-3 liu trnh lin tc.
6.1. Theo di: Nu c biu hin hn ch vn ng khp vai nn kt hp vi xoa bp bm huy t, hoc cc ph ng php ph c
hi chc nng khc, khi phc li cc ng tc vn ng ca khp vai.
6.2. X l tai bin
Quy trinh 24: IN CHM IU TR AU LNG
.
1. I CNG: - au lng l mt chng bnh do nhiu nguyn nhn. - Nguyn nhn do c m nhi m ph i hn th p, b ng, do
mang vc nng, sai t th (gy au lng cp) hoc do thn h (gy au lng mn). M c ch c a chm c u lm cho ng i
ht au, tr li sinh hot bnh thng.
2. CH NH:
au lng do hn thp, do thn h, do huyt.
3. CHNG CH NH:
au lng do lao ct sng hoc do cc khi u chn p.
4. CHUN B:
4.1. Cn b y t
Bc s, y s, lng y c o to v chm cu.
4.2. Phng tin
- Kim chm cu v khun loi: 6-10-15cm, dng ring cho tng ngi.
4.3. Ngi bnh
- T th nm sp.
5. CC BC TIN HNH:
5.1. Phc huyt
+ au lng th hn thp:
- Thn du - Dng lng tuyn
- Yu dng quan - Cn ln
- Th liu - y trung
- Hon khiu
+ Nu au vng b vai:
- Gip tch D1, D3 - Kin ngoi du
- Kin tnh - Kin trung du
- Kin liu
+ au lng th thn h:
- Thn du - y trung
- Mnh mn
- Nu thn dng h thm: Ch tht, Quan nguyn.
+ au lng th huyt:
- A th huyt - Th liu
- Trt bin - y trung
- Hon khiu - Cch du
- Yu dng quan - Dng lng tuyn
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t t theo h ng huy t nh, t c kh.
+ au lng th hn thp, th thn h: Chm b cc huyt trn kt hp vi cu.
Nu au vng b vai chm t cc huyt: Gip tch D1-D3, Kin tnh, Kin liu, Kin ngoi du, Kin trung du.
+ au lng th huyt: Chm t mnh huyt Trt bin xuyn Hon khiu, A th huy t, Yu dng quan, Th liu, y trung,
Dng lng tuyn.
Kt hp vi xoa bp n, day, ln trn vng au.
+ Nu au dc ct sng: Chm t mnh vi kim di xuyn trn cc huyt Gip tch tng ng vi vng au.
Kt hp chm ri cu cc huyt : i chy, Phong ph, Tch trung, Yu du, Thn du.
- Tn s: + T: 6- 20Hz, + B: 0,5- 4Hz
5.4. Liu trnh iu tr
in chm ngy mt ln, mt liu trnh iu tr t 10-15 ln chm, c th tin hnh 2-3 liu trnh lin tc.
6.1. Theo di: Theo di s tin trin ca ngi bnh, nu sau mt liu trnh m khng c chuy n bi n r, c n ph i xc nh
nguyn nhn do u, c hng iu tr thch hp tip theo, trng hp do thot v a m c n ph i k t h p v i ko dn
ct sng hoc phi phu thut.
6.2. X l tai bin
Quy trinh 25: IN CHM IU TR AU THN KINH TA
.
1. I CNG: - au thn kinh ta l mt chng bnh do nhiu nguyn nhn c nng v th c th gy ra nh : do l nh, thot
v a m, vim nhim, khi u chn p... - Theo y hc c truyn au thn kinh t a c miu t trong ph m vi chng t,
nguyn nhn thng do phong, hn, thp, nhit xm phm vo kinh Bng quang v kinh m gy ra.
2. CH NH:
au thn kinh ta do phong hn thp, do thoi ha ct sng.
3. CHNG CH NH:
au thn kinh ta km theo nhim trng ti ch.
4. CHUN B:

4.2. Phng tin
- Kim chm cu v khun, loi: 6-10-15cm, dng ring cho tng ngi.
4.3. Ngi bnh:
- T th nm sp hoc nm nghing, chng au cho ngi bnh.
5. CC BC TIN HNH:
5.1. Phc huyt
- Gip tch L3, L5, S1 - i trng du
- Th liu - Trt bin
- Hon khiu - Tha ph
- y trung - Tha sn
- Cn ln - Dng lng tuyn.
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t t theo h ng huy t nh, chm ph i t c kh.
- Chm t:
+ i trng du + Tha sn
+ Th liu + Cn ln.
+ y trung + Gip tch L3 -S1
+ Trt bin xuyn ti huyt Hon khiu hoc xuyn ti huy t Tha ph
+ Dng lng tuyn xuyn ti huyt Dng giao.

- Tn s: t: 6-20Hz.
- Cng : 14-150micro Ampe
5.4. Liu trnh iu tr
in chm mt ngy mt ln, mt liu trnh iu tr t 10-15 ln, c th tin hnh 2-3 liu trnh lin t c.
6.1. Theo di: Theo di ti ch v ton thn
6.2. X l tai bin
- Vng chm: Ngi bnh hoa mt, chng mt, v m hi, mch nhanh, sc mt nht nht. X l: rt kim ngay, lau m hi, m, ung n c ch
ng nng, nm ngh ti ch. Theo di mch, huyt p.
- Chy mu khi rt kim: dng bng v khun n ti ch, khng day.
Quy trinh 26: IN CHM IU TR CHP, LO

1. I CNG: - Chp l nhim trng sn mi, lo l nhim trng tuy n b mi, bnh hay ti pht. - Theo Y h c c truy n:
Phong v nhit tc ng ln nhau tn hi vng mi mt gy nn lo, hoc nhit c ca hai kinh i tr ng v kinh V b c
ln mi mt gy chp. - Mc ch ca chm nhm thanh nhit tiu vim vng mi mt, lm kh i b nh.
2. CH NH:
Bnh mi mc, cn trong giai on vim cha c m.
3. CHNG CH NH:
Chp lo c nhn x hoc c m.
4. CHUN B:
4.2. Phng tin
- Kim chm cu v khun, loi 6cm, dng ring cho tng ngi.
4.3. Ngi bnh:
- T th ngi.
5. CC BC TIN HNH:
5.1. Phc huyt
- Bn mt bnh:
+ Tnh minh + Ton trc
+ Tha khp + ng t liu
+ Dng bch
+ Ph du (2 bn)
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t t theo h ng huy t nh, t c kh. Chm
t cc huyt nu trn.
- Tn s t : 6-20Hz.
5.4. Liu trnh iu tr
in chm mt ngy mt ln, mi liu trnh t 3 n 7 ln.
6.1. Theo di
Theo di ti ch v ton thn
6.2. X l tai bin
Quy trinh 27: IN CHM IU TR I DM

1. I CNG: - i dm l bnh khi ng i m khng bit, bnh thng gp tr em. - Nguyn nhn ch y u do kh ha
ca Thn v Tam tiu suy yu, kh m dng h tiu mt thng bng, lm cho co bp ca bng quang b ri lo n gy nn.
2. CH NH:
Ngi bnh trn 3 tui vn cn i dm v khng c nguyn nhn th c th khc.
3. CHNG CH NH:
i dm do nhng nguyn nhn thc th.
4. CHUN B:
4.2. Phng tin
- Kim chm cu v khun, loi: 6-8cm, dng ring cho tng ngi.
4.3. Ngi bnh
- T th ngi nm nghing.
5. CC BC TIN HNH:
5.1. Phc huyt:
- Bch hi - i chy
- Ni quan - Quan nguyn
- T cung - Lan mn
- Tam m giao - Nhin cc
- Thn du
5.2. Th thut
kh.
- Chm t:
+ Bch hi
+ i chy
+ Ni quan
+ T cung hng mi kim v pha huyt Khc ct.
- Chm b:
+ Quan nguyn + Nhin cc
+ Lan mn + Thn du
+ Tam m giao
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
- Cng : T 14-150 micro Ampe
5.4. Liu trnh iu tr
in chm mt ngy mt ln, mt liu trnh iu tr 10 ngy, c th tin hnh 2-3 liu trnh lin t c.
6.1. Theo di:
- Theo di ti ch v ton thn
- Theo di s ln i dm mt m, nh gi kt qu iu tr.
6.2. X l tai bin
Quy trinh 28: IN CHM IU TR LIT RUT C NNG

1. I CNG: - Lit rut l tnh trng gim hoc mt nhu ng ru t do nhiu nguyn nhn. - M c ch chm nh m khi
phc li nhu ng bnh thng ca rut.
2. CH NH:
Lit rut c nng do: phu thut vng bng, sau sang chn ty sng
3. CHNG CH NH:
Lit rut c ch nh ngoi khoa.
4. CHUN B:
4.2. Phng tin
- Kim chm cu v khun, loi: 6-10cm, dng ring cho tng ngi.
4.3. Ngi bnh
- T th nm nga.
5. CC BC TIN HNH:
5.1. Phc huyt
- Hp cc - Chi cu
- Trung qun - Thin khu
- i mch - Tc tam l
- Tam m giao - Kh hi
- i trng du - Th liu.
5.2. Th thut
kh.
- Chm t:
+ Hp cc + Chi cu
+ Trung qun + Thin khu
+ i trng du + Th liu.
+ i mch xuyn Duy o
- Chm b:
- Tam m giao - Kh hi
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
5.4. Liu trnh iu tr:
in chm mt ngy mt ln, mt liu trnh iu tr t 2-4 ln ty theo mc bnh.
6.1. Theo di: Ton trng ngi bnh, nu c du hiu tc rut c hc phi mi bc s ngoi khoa hi chn x tr k p th i.
6.2. X l tai bin:
Quy trinh 29: IN CHM IU TR LIT NA NGI DO TAI BIN MCH MU NO

1. I CNG: - Tai bin mch mu no (TBMMN) l s xy ra t ngt cc thiu st chc n ng th n kinh th ng l khu tr
hn lan to, tn ti qu 24 gi hoc gy t vong trong 24 gi. Cc khm xt loi tr nguyn nhn chn th ng. - Theo Y
hc c truyn; bn thn bt toi thuc chng trng phong. - Mc ch ca quy trnh ny: Nh m h ng d n cho cn b y t
cc tuyn p dng iu tr.
2. CH NH:
Ngi bnh lit na ngi, khng hn m; mch, huyt p, nhp th n nh.
3. CHNG CH NH:
Ngi bnh ang hn m, cc ch s mch, huyt p, nhp th cha n nh.
4. CHUN B:
4.2. Phng tin:
- Kim chm cu v khun, loi 6- 20cm, dng ring cho tng ngi bnh.
4.3. Ngi bnh
- c khm v lm h s bnh n theo quy nh
- T th nm nga hoc nm nghing
5. CC BC TIN HNH:
5.1. Phc huyt
* Chng thc:
- Bch hi - Thi dng - ng t liu
- Phong tr - i chu - Ngoi quan
- Chi cu - Dng lng tuyn - m lng tuyn
- Khu kh - Hnh gian - Trung
- Can du - m du - Thi kh
- m cc - Tam m giao - K mn
- Chng mn - Tc tam l - Tam m giao
- Huyt hi - Lim tuyn - Bng lim tuyn
- Thng lim tuyn - Ngoi kim tn - Ngoi ngc dch
- mn - Quyn liu - H quan
- a thng - Gip xa - Tha tng
- phong - Gip tch C4-C7 - Tch trung
- Kin tnh - T nhu - Kin trinh
- Cc tuyn - Khc tr - Th tam l
- Chi cu - Ngoi quan - Bt t
- Gip tch D12- L5 - Yu dng quan - Hon khiu
- Tha ph - Trt bin - n mn
- Tha sn - U trung - Cn ln
- Thng c h - Gii kh - Khu kh
- a ng hi
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t t theo hng huyt nh, chm phi t c
kh.
* Chng thc:
+Chm t cc huyt:
- Phong tr - i chu - Ngoi quan
- Chi cu - Dng lng tuyn - m lng tuyn
- Khu kh - Hnh gian - Trung
- Can du - m du
+ Chm b cc huyt:
- Thi kh - m cc - Tam m giao
*Chng h:
+ Chm t cc huyt:
- Bch hi - Phong tr
- Trung - Hnh gian
- Chm b cc huyt:
- K mn - Chng mn - Tc tam l
- Tam m giao - Huyt hi - Thi kh
- m cc
* Huyt chung cho hai th:

- Tht ngn, chm t cc huyt:
- Lim tuyn - Bng lim tuyn
- Thng lim tuyn - Ngoi kim tn
- Ngoi ngc dch - mn
- Lit mt, chm t cc huyt:
- Quyn liu xuyn H quan
- a thng xuyn Gip xa
- Tha tng
- Phong.
- Lit tay, chm t cc huyt:
- Gip tch C4-C7 - i chu xuyn Tch trung
- Kin tnh xuyn T nhu - Kin trinh xuyn Cc tuyn
- Khc tr xuyn Th tam l - Chi cu xuyn Ngoi quan
- Bt t
- Lit chn, chm t cc huyt:
- Gip tch D12- L5 - Tch trung xuyn Yu dng quan
- Hon khiu xuyn Tha ph - Trt bin xuyn Hon khiu
- n mn xuyn Tha ph - Tha sn xuyn U trung
- Cn ln - Thng c h
- Gii kh - Khu kh
- a ng hi
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
- Cng : 14 -150 micro Ampe, tng dn ti ngng bnh nhn chu c.
5.4. Liu trnh iu tr
Ngy chm 1 ln, liu trnh t 30 45 ln chm, tu theo mc bnh, sau c th nhc li liu trnh tip theo.
6.THEO DI V X L TAI BIN
6.1.Theo di: Theo di ton trng v din bin ca bnh.
6.2. X l tai bin
- Vng chm: Ngi bnh hoa mt chng mt, v m hi, mch nhanh, sc mt nht nht. X l: tt my, rt kim ngay, lau
m hi, m, hoc nm ni thong mt, ung nc ng, nm ngh ti ch. Kim tra mch, huyt p.
- Chy mu sau khi rt kim: dng bng v khun p ti ch, khng day.
Quy trinh 30: IN CHM IU TR LIT HAI CHI DI

1. I CNG: - Lit hai chi di l biu hin gim hoc mt kh nng vn ng hu hai chn. - B nh thu c chng nuy
theo Y hc c truyn
2. CH NH:
Ngi bnh lit hai chi di qua giai on cp, ht st, khng c du hiu vim nhi m , n nh m ch, huy t p.
3. CHNG CH NH:
Ngi bnh cn trong giai on cp, cn st, cc ch s mch, huy t p cha n nh.
4. CHUN B:
4.2. Phng tin:
- Kim chm cu v khun, loi 6- 20cm, dng ring cho tng ngi bnh.
4.3. Ngi bnh
- T th nm nga hoc nm sp
5. CC BC TIN HNH:
5.1. Phc huyt
- Gip tch tng ng vng tn thng tu sng - i chy
- Tch trung - Yu dng quan - i trng du
- Hon khiu - Tha ph - n mn
- U trung - Tha sn - Cn ln
- Hc nh - Lng khu - Phc th
- Thng c h - Phong long - Dng lng tuyn
- Gii kh - Khu kh - a ng hi
- Thi kh - m cc - Tam m giao
- Huyt hi - Chng mn - K mn
- Quan nguyn - Kh hi - Trt bin
- T cung - Trung cc - Honh ct
- Bng cng - Cng hu m
5.2. Th thut
kh.
- Chm t cc huyt:
+ Gip tch tng ng vng tn thng tu sng.
+ i try xuyn Tch trung + Tch trung xuyn Yu dng quan
+ i trng du + Hon khiu xuyn Tha ph
+ n mn xuyn Tha ph + U trung xuyn n mn
+ Tha sn xuyn U trung + Cn ln
+ Lng khu xuyn Phc th + Hc nh
+ Phong long xuyn Dng lng tuyn + Thng c h
+ Gii kh + Khu kh
+ a ng hi
- Chm b cc huyt:
+ Thi kh + m cc + Tam m giao
+ Huyt hi + Chng mn + K mn
- Nu c ri lon c trn tiu tin khng t ch, chm t cc huyt :
+ Trt bin + T cung
+ Trung cc + Honh ct
- Nu c ri lon c trn i tin khng t ch, chm t cc huyt:
+ Bng cng + Cng hu m.
- Tn s: + T: 6- 20Hz, + B: 0,5- 4Hz
- Cng : 14-150 microAmpe, tng dn ti ngng bnh nhn chu c.
5.4. Liu trnh iu tr
Ngy chm mt ln, mt liu trnh t 30 45 ln chm, tu theo mc bnh, sau c th nhc li liu trnh ti p theo.
6.THEO DI V X L TAI BIN:
6.2. X l tai bin
- Vng chm: Ngi bnh hoa mt chng mt, v m hi, mch nhanh, sc mt nht nht. X l: rt kim ngay, lau m hi
m, hoc nm ni thong mt, ung nc ng, nm ngh ti ch. Kim tra mch , huyt p.
- Chy mu khi rt kim: dng bng v khun p ti ch, khng day.
Quy trinh 31: IN CHM IU TR TNG HUYT P

1. I CNG: - Tng huyt p l triu chng ca nhiu bnh, nhiu nguyn nhn. Khi khng tm c nguyn nhn c
gi l bnh tng huyt p nguyn pht, gi l tng huy t p khi s t i a trn 140mmHg v s t i thi u trn 90mmHg. -
Theo Y hc c truyn, tng huyt p thuc phm vi chng huy n vng, u chong, can phong, can d ng.
2. CH NH:
iu tr kt hp khi c tng huyt p nguyn pht.
3. CHNG CH NH:
Ngi bnh c tng huyt p th pht, c du hiu ca bin chng do tng huy t p.
4. CHUN B:
4.2. Phng tin
4.3. Ngi bnh
- T th nm nga
5. CC BC TIN HNH:
5.1. Phc huyt
- Sut cc - Phong tr - Hnh gian
- Trung - Khu kh - Can du
- m du - Ngoi quan - Ni quan
- Khc tr - Thin khu - Dng lng tuyn
- m lng tuyn - Thn du - Thi kh
- m cc - Tam m giao - Huyt hi
- Chng mn - K mn - Phong long
- Thn mn.
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim nhanh qua da, y kim t t theo hng huyt nh, chm phi t c
kh.
- Chm t cc huyt:
- Bch hi - Thi dng xuyn ng t liu
- Sut cc - Phong tr
- Hnh gian - Trung
- Khu kh - Can du
- m du - Ngoi quan xuyn Ni quan
- Khc tr - Thin khu
- Dng lng tuyn xuyn m lng tuyn
- Chm b cc huyt:
- Thn du - Thi kh - m cc
- Tam m giao - Huyt hi - Chng mn
- K mn - Phong long - Thn mn.
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
5.4. Liu trnh iu tr
Ngy in chm mt ln, mt liu trnh iu tr t 20 30 ln chm; tu theo mc bnh, sau c th nh c l i li u trnh
tip theo.
6.1. Theo di: Theo di ton trng v din bin ca bnh.
6.2. X l tai bin
m, hoc nm ni thong mt, ung nc ng, nm ngh ti ch. Kim tra mch, huyt p.
- Chy mu khi rt kim: dng bng kh v khun p ti ch, khng day.
Quy trinh 32: IN CHM IU TR TO BN

1. I CNG: - To bn l khi bnh nhn i tin hai hay t ln hn mi tu n hoc qu kh kh n v c ng th ng khi i ti n.
- Theo Y hc c truyn, to bn l chng i i tin kh, 5-7 ngy cha i tin c do tch t th c n, u ng c nhi t, b
kh hm hoc c th suy nhc.
2. CH NH:
iu tr kt hp khi c to bn c nng
3. CHNG CH NH:
Ngi bnh c du hiu tc rut, dnh rut.
4. CHUN B:
4.2. Phng tin
- Kim chm cu v khun, loi t 6- 8cm, dng ring cho tng ngi bnh.
4.3. Ngi bnh
- T th nm nga
V. CC BC TIN HNH:
5.1. Phc huyt
- Bch hi - Thi dng - Khc tr
- Chi cu - Thin khu - T cung
- i mch - i trng du - Tc tam l
- Tam m giao - Thn du - Thi kh
- Huyt hi - Chng mn - K mn
5.2. Th thut
kh.
* Th thc nhit:
+ Chm t cc huyt:
- Bch hi - Thi dng - Khc tr
- Chi cu - Thin khu - T cung
- i mch - i trng du
+ Chm b cc huyt:
- Tc tam l - Tam m giao
* Th h nhc:
+ Chm t cc huyt:
- T cung - i mch - i trng du
+ Chm b cc huyt:
- Thn du - Thi kh - Tc tam l
- K mn
5.3 Kch thch bng my in chm
- Tn s: + T: 6- 20Hz, + B: 0,5- 4Hz
- Cng : 14-150 microAmpe, tng dn ti ngng bnh nhn chu c.
5.4. Liu trnh iu tr
Ngy in chm mt ln, mt liu trnh t 20 30 ln chm tu theo mc bnh, sau c th nh c l i li u trnh ti p
theo.
6.2. X l tai bin
m, hoc nm ni thong mt, ung nc ng, nm ngh ti ch. Kim tra mch , huyt p.
Quy trinh 33: IN CHM IU TR RI LON THN KINH CHC NNG

1. I CNG: - Ri lon thn kinh chc nng (Histeria) thng xut hin sau nhng chn th ng tm th n nh ng ng i
c nhn cch yu, d b m th, d t m th, c xu hng ly k ho, hnh vi mang kch tnh, thch c m i ng i ch
n. -Theo Y hc c truyn, bnh thuc chng ut (tm qu).
2. CH NH:
iu tr kt hp khi c to bn c nng.
3. CHNG CH NH: Trong trng hp bnh nhn c du hiu tc, dnh rut.
IV. CHUN B:
4.2. Phng tin:
- Kim chm cu v khun, loi t 6 - 8cm, dng ring cho tng ngi bnh.
4.3. Ngi bnh
- T th nm nga
5. CC BC TIN HNH:
5.1. Phc huyt
- Bch hi - Thi dng - Sut cc
- Phong tr - Dng bch - Can du
- m du - Hp cc - Ni quan
- Trung - Thi xung - Tc tam l
- Tam m giao - Thn mn - Thn du
- Thi kh - Huyt hi - Chng mn
- K mn
5.2. Th thut
kh.
* Th thc nhit :
+ Chm t cc huyt:
- Bch hi - Thi dng - Sut cc
- Phong tr - Dng bch - Can du
- m du - Hp cc - Ni quan
- Trung - Thi xung
+ Chm b cc huyt:
- Tc tam l - Tam m giao - Thn mn.
* Th h nhc:
+ Chm t cc huyt:
- Bch hi - Thi dng
- Dng bch - Sut cc
- Hp cc
+ Chm b cc huyt:
- Thn du - Thi kh - Tc taml
- K mn - Ni quan - Thn mn
5.3 Kch thch bng my in chm
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
5.4. Liu trnh iu tr
Ngy in chm mt ln, mt liu trnh t 20 30 ln chm, tu theo mc bnh, sau c th nh c l i li u trnh ti p
theo.
6.2. X l tai bin:
m, hoc nm ni thong mt, ung nc ng, nm ngh ti ch. Kim tra mch, huyt p.
Quy trinh 34: IN CHM GIM AU TRONG LOT D DY T TRNG

1. I CNG: - Lot d dy t trng l mt bnh l c tn thng lot nim mc, h nim m c th m ch ti c l p c c a
d dy hnh t trng. - Theo Y hc c truyn, gi l chng v qun thng, thng g p hai th l can kh ph m v ho c t v
h hn. - Mc ch: Lm gim au cho ngi bnh b lot d dy t trng.
2. CH NH:
Ngi bnh b au do lot d dy t trng.
3. CHNG CH NH:
Trng hp c ch nh can thip ngoi khoa.
4. CHUN B:
4.2. Phng tin
- Kim chm cu v trng dng mt ln.
4.3. Ngi bnh
- Ngi bnh nm nghing, chn di dui, chn trn co.
5. CC BC TIN HNH:
5.1. Phc huyt
- Th Can kh phm V
- Trung qun - K mn
- C khuyt - Ni quan
- Tc tam l - Dng lng tuyn
- Th T V h hn
- T du - V du qun
- C khuyt - Chng mn
- Ni quan - Tc tam l
- Tam m giao
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t i huy t theo h ng nh, chm ph i t c
kh.
- Th Can kh phm V, chm t:
- Trung qun - K mn (2 bn)
- C khuyt - Ni quan (2 bn)
- Tc tam l (2 bn ) - Dng lng tuyn (2 bn)
- Th T V h hn: chm b hoc cu cc huyt hai bn:
- T du - V du qun
- C khuyt - Chng mn
- Ni quan - Tc tam l
- Tam m giao
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
5.4. Liu trnh
in chm ngy 2-3 ln ty theo s cn au, chm cho n khi ngi bnh ht au.
6.1. Theo di: Ton trng ngi bnh.
6.2. X l tai bin
Quy trinh 35: IN CHM GIM AU DO SI THN, SI NIU QUN

1. I CNG: - Cn au do si thn v si niu qun l triu chng thng gp ca niu khoa, xu t hi n khi vin s i di
chuyn trong i b thn, niu qun gy tn thng niu qun, co tht niu qun hoc gy t c d n n c ng tr ng t ng t
v bao thn, i b thn hoc niu qun. Cn au thng xut hin t ngt sau vn ng ho c i m t qung ng di b
xc v lc l nhiu. - Theo Y hc c truyn: gi l chng Thch lm (i ra si) - Mc ch: Gi m au cho ng i b nh b
au do si thn, si niu qun.
2. CH NH: Nhng ngi bnh c cn au qun do si thn v si niu qun.
3. CHNG CH NH: Nhng trng hp c ch nh can thip ngoi khoa.
4. CHUN B:
4.2. Phng tin:
4.3. Ngi bnh
- Ngi bnh nm nghing, chn di dui, chn trn co.
5. CC BC TIN HNH:
5.1. Phc huyt
- m cc - Thn du
- Bng quang du - Trung cc
5.2. Th thut
kh.
Chm t: - Tc tam l - Tam m giao
- m cc - Thn du
- Bng quang du - Trung cc
- Tn s t: 6 -20Hz.
- Cng : 14 -150micro Ampe
- Thi gian: 20 -30 pht cho mt ln in chm
5.4. Liu trnh
in chm ngy 2-3 ln khi cn au xut hin, chm cho n khi khng thy cn au xut hin.
6.2. X l tai bin:
7. NH GI KT QU:
Cn au ca ngi bnh du dn ti ht au.
Quy trinh 36: IN CHM GIM AU DO VIM I TRNG MN

1. I CNG: Vim i trng mn hay gp nht l do ri lon chc nng i trng khng c t n th ng th c th v i bi u
hin l au v ri lon i tin. Ngoi ra, cn c cc th c tn thng thc th nh nhim k sinh trng (l amip), lao ru t,
vim lot i trc trng chy mu - Y hc c truyn gi l chng i trng thp nhi t - M c ch: Lm gi m au cho
bnh nhn b au bng do vim i trng mn.
2. CH NH: au bng do vim i trng mn
3. CHNG CH NH: au bng ngoi khoa
4. CHUN B:
4.2. Phng tin
4.3. Ngi bnh
- Ngi bnh nm nghing, chn di dui, chn trn co
5. CC BC TIN HNH:
5.1. Phc huyt
- i trng du - Thin khu
- Thch mn - Ni quan
5.2. Th thut
kh.
+ Chm t 2 bn: - i trng du - Thin khu
- Thch mn - Ni quan
+ Chm b 2 bn: Tam m giao
+ Chm bnh 2 bn: Tc tam l
- Tn s t: 6-20Hz.
- Cng : 14-150micro Ampe, tng dn ti ngng bnh nhn chu c
5.4. Liu trnh
in chm ngy 1-3 ln khi cn au xut hin, chm cho n khi du au.
6.1. Theo di: Ton trng ngi bnh, cn au.
6.2. X l tai bin
7. NH GI KT QU:
Quy trinh 37: IN CHM GIM AU DO SI MT

1. I CNG: au do si mt l nhng cn au do si trong ng mt di chuy n gy t n th ng ng m t ho c gy t c
ng mt lm cng, dn ng mt pha trn ch tc. - Y hc c truyn, au do si mt nm trong chng m th ch, hi p
thng. - Mc ch: Lm gim au cho bnh nhn b au do si ng mt
2. CH NH: au bng do si mt
3. CHNG CH NH: au bng ngoi khoa
4. CHUN B:
4.2. Phng tin
4.3. Ngi bnh
- Ngi bnh nm nghing bn tri, chn di dui, chn trn co.
5. CC BC TIN HNH:
5.1. Phc huyt
- m du - Can du - Nht nguyt
- K mn - Chng mn - i mch
- Hnh gian - Dng lng tuyn
5.2. Th thut
kh.
+ Chm t 2 bn: - Hnh gian - Dng lng tuyn
+ Chm t bn phi: - m du - Can du
- Nht nguyt - K mn
- Chng mn - i mch
- Tn s t: 6-20Hz.
- Cng : 14-150micro Ampe, tng dn ti ngng bnh nhn chu c
5.4. Liu trnh
in chm ngy 1-3 ln khi cn au xut hin, chm cho n khi du au.
6.1. Theo di: Ton trng ngi bnh, cn au.
6.2. X l tai bin
7. NH GI KT QU:
Quy trinh 38: IN CHM IU TR VIM A KHP DNG THP

1. I CNG: - Vim a khp dng thp l bnh khp mn tnh cha r cn nguyn, c coi l b nh t mi n bi u hi n c
trng l hin tng vim mng hot dch n mn cc khp ngoi bin i xng, di n bi n ko di, ti n tri n t ng t v
xng di sn gy bin dng khp, dnh khp v gim chc nng hot ng ca khp. - Theo Y hc c truy n Vim a
khp dng thp thuc chng t ch s b tc kinh kh cc khp gy au, sng nng lu ngy gy bi n d ng kh p, c ng
khp
2. CH NH:
- au sng nng mt hay nhiu khp xng.
- au co cng cc c khng dui ra c.
- au nhc ton thn, t mi cc khp, bp tht, tay chn nng n c ng kh khn.
3. CHNG CH NH:
- au sng cc khp trn bnh cnh nng khc nh: Hn m, ng c, i tho ng, vim t c t nh m ch chi
- Bnh cc cht to keo, dy dnh cc khp, nhim trng cc c, khp.
- Bong sn chm khp gi.
4. CHUN B:
4.2. Phng tin:
- Kim chm cu v khun, loi 6 - 20 cm, dng ring cho tng ngi bnh.
4.3. Ngi bnh:
- T th nm hoc ngi thoi mi
5. CC BC TIN HNH:
5.1. Phc huyt
- Tc tam l - Quan nguyn
- Thn du - Huyt hi
Tu theo v tr b bnh m chn thm cc huyt:
* Khp vai: + Kin tnh + Kin ngung
+ Kin trinh + Trung ph
* Khp c tay, bn tay: + Ngoi quan + Hp cc
+ Lao cung + Bt t
+ Dng tr + Hu kh
* Khp hng: + Trt bin + Hon khiu
+ Th liu + Gip tch L2-S1
* Khp gi: + c t + Tt nhn
+ Huyt hi + U trung
+ Dng lng tuyn
* Khp bn chn, c chn: + Gii kh + Thi kh
+ Cn ln + Bt phong
5.2. Th thut
kh.
- Chm b: + Tc tam l + Quan nguyn
+ Thn du + Huyt hi.
- Chm t:
* Khp vai: + Kin tnh + Kin ngung
+ Kin trinh + Trung ph
* Khp c tay, bn tay: + Hp cc (xuyn) Lao cung
+ Ngoi quan + Bt t
+ Dng tr + Hu kh
* Khp hng: + Trt bin + Hon khiu
+ Th liu + Gip tch L2-S1
* Khp gi: + c t + Tt nhn
+ Huyt hi + U trung
+ Dng lng tuyn
* Khp bn chn, c chn: + Gii kh + Thi kh
+ Cn ln + Bt phong.
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
- Thi gian: 20-30 pht cho mt ln in chm.
5.4. Liu trnh
in chm ngy mt ln, kt hp vi iu tr nguyn nhn cho n khi bnh nhn n nh.
Quy trinh 39: IN CHM IU TR LIT DNG

1. I CNG: - Lit dng l bnh ca nam gii, biu hin dng vt khng cng (mm r) hoc c c ng khng c ng
hoc cng cng nhng khng bn thc hin cn thit tho mn cho mt ln giao hp. Hip hi quc t nghin c u li t
dng (International Sciety for Impoten Reseach-ISIR) th ng nh t g i tn l Erectide Dysfunetion vi t t t l ED. - Y h c
c truyn gi l dng nuy v cn nuy, ch yu l tng thn dng hao tn, h nhc c th do can, tm, t v thn hoc
cc nguyn nhn khc gy nn.
2. CH NH:
- Tt c nam gii quan h tnh dc nhng lit dng nguyn nhn do tm l hoc do cc yu t, nguy c khc nh ht
thuc l, nghin ru, tai bin khi dng thuc nh Cemitidine, cc thuc hng thn, thuc gin c quan h tnh dc
qu , cc bnh mn tnh, gim Testosteron
3. CHNG CH NH:
- Lit dng do thc th (sinh hc) nh dng vt khng c th hang, x cng dng vt (bnh Peyromie) khng c tinh
hon, lit tu.
- Ngi bnh c cc chng ch nh ca chm v cu.
4. CHUN B:
- Tt c thy thuc iu tr nn l nam gii v phi am hiu su v bnh nam hc nht l li t d ng, ph i bi t tm l ti p
xc vi ngi bnh.
4.2. Phng tin
- Phng khm v iu tr phi kn o, thong mt, khng c n gii.
- Kim ho chm v trng
- Khay, km c mu, bng, cn 70.
- Hp cp cu chng chong.
- Mi ngi hoc iu ngi.
4.3. Ngi bnh
- c lm h s bnh n theo quy nh, c bit phi c phn khm v iu tr cho ng i b nh li t d ng
- C v hoc ngi tnh i theo khi hi qu trnh sinh hot tnh dc nh gi trung th c v ham mu n, li t d ng v
nguyn nhn gy lit dng ngi ph n hay khng.
5. CC BC TIN HNH:
5.1. Phc huyt
5.1.1. Th thn dng h
- Bch hi - Quan nguyn
- Kh hi - Thn du
- Thi kh - Mnh mn
- Thn khuyt - Ch m
5.1.2. Th tm t h
- Tc tam l - Thn mn
- Tam m giao - Bch hi
- Thn khuyt - Ch m.
5.1.3. Th can kh ut
- Ch m - Thn mn
- Thn khuyt - Thi xung
- K mn - Bch hi
5.1.4. Th m thp
- Bch hi - Ch m
- Hp cc - Thn khuyt
5.1.5. Th kh tr huyt :
- Huyt hi - Kh hi
- Bch hi - Ch m.
- Thn khuyt.
5.2. Th thut
- Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t i huy t theo h ng nh, chm phi t c
kh.
5.2.1. Th thn dng h
- n chm hoc chm b:
+ Bch hi + Ch m
+ Thn du + Thi kh
+ Mnh mn
- Cu: Thn khuyt
5.2.2. Th tm t h
- Chm b:
+ Tc tam l + Thn mn
+ Tam m giao + Bch hi
+ Ch m.
- Cu: Thn khuyt
5.2.3. Th can kh ut
- Chm b: + Ch m + Quy u
+ Thn mn
- Cu: Thn khuyt
- Chm t: + Thi xung + K mn
+ Bch hi
5.2.4. Th m thp
- Chm t: + Bch hi + Ch m
+ Hp cc
- Cu b: +Thn khuyt
- Chm b: + Tc tam l + Tam m giao
5.2.5. Th kh tr huyt :
- Chm t: + Huyt hi + Kh hi
+ Bch hi + Ch m.
- Cu: Thn khuyt.
- Dng iu ngi cu trn cc kim chm 15 pht.
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
- Cng : 14 -15micro Ampe
- Thi gian: 20 -30 pht cho mt ln in chm.
5.4. Liu trnh: in chm mt ngy mt ln, kt hp vi iu tr nguyn nhn cho n khi bnh nhn n nh.
7. CH :
- Phi loi tr cc yu t nguy c gy bnh
- C th kt hp chm cu vi thuc Y hc c truyn hoc kt hp vi thuc Y hc hin i.
- Cn c ch n ung sinh hot hp l v t vn v tnh dc hc.
Quy trinh 40: IN CHM IU TR THNG KINH

1. I CNG: - Thng kinh l trc khi c kinh, trong khi c kinh hoc sau khi c kinh ngi n gii thy au nhi u
bng di, thng do nguyn nhn c nng nh do lnh, tinh thn cng thng (stress, tm l) v r i lo n n i ti t n gi i
tui dy th, ph n tin mn kinh. Ngoi ra do nguyn nhn thc th nh u x t cung, d dng t cung, u nang bung
trng - Theo Y hc c truyn, do lnh hoc do tnh ch khng th thi lm cho huyt kh tr bo cung m gy au.
Ngoi ra do kh huyt h nhc cho nn kinh mch bo cung khng c nui dng y nn gy au.
2. CH NH:
- Thng kinh nguyn nhn do c nng
3. CHNG CH NH:
- Thng kinh nguyn nhn do thc th th nn iu tr theo Y hc hi n i.
- Ngi b thng kinh mc cc bnh km theo c chng ch nh ca chm cu.
4. CHUN B:
4.2. Phng tin:
- Kim chm v khun, loi 6-10 cm, dng ring cho tng ngi bnh.
- Hp thuc chng chong
- Mi ngi, iu ngi v bao dim cu
4.3. Ngi bnh
5. CC BC TIN HNH:
5.1. Phc huyt
5.1.1. Th hn
- Huyt hi - T cung
- Tam m giao - Quan nguyn
- Trung cc - T du
- Thn du - Kh hi
- Ni quan
5.1.2. Th huyt
- Tam m giao - Trung
- Huyt hi - Hp cc
- Thin khu
5.1.3.Th kh tr
- Kh hi - Trung cc
- Tam m giao - T cung
- Thin khu
5.1.4. Th kh huyt u h
- Tam m giao - Huyt hi
- Quan nguyn - Tc tam l
5.2. Th thut: Chm kim qua da nhanh, y kim theo hng xuyn kim nh, chm phi t c kh.
5.2.1. Th hn
* Th thc hn:
- Cu hoc n chm : + Huyt hi + T cung
+ Tam m giao + Quan nguyn
+ Trung cc + T du
+ Thn du
* Th h hn:
- Cu hoc n chm b: + Huyt hi + T cung
+ Tam m giao + Quan nguyn
+ Trung cc + T du
+ Thn du + Kh hi
+ Ni quan
5.2.2. Th huyt
- Chm t: + Tam m giao + Trung
+ Huyt hi
- Chm b: + Hp cc + Thin khu
5.2.3.Th kh tr
- Chm t: + Kh hi + Trung cc
+ Tam m giao + T cung
+ Thin khu
5.2.4. Th kh huyt u h
- Chm b: + Tam m giao + Huyt hi
+ Quan nguyn + Tc tam l
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
- Thi gian: 20-30 pht cho mt ln in chm.
5.4. Liu trnh
in chm mt ngy mt ln, kt hp vi iu tr nguyn nhn cho n khi ngi bnh n nh.
7. CH :
- Nu thu chm phi th phn ng trc tim i vi thuc dng thu chm.
- Loi tr nguyn nhn, nn chm n k kinh trc mt tun.
Quy trinh 41: IN CHM IU TR KINH NGUYT KHNG U

1. I CNG: - Kinh nguyt khng u l kinh c thay i v chu k kinh (kinh trc k, kinh sau k, kinh
khng nh k), lng kinh nhiu hoc kinh t, nguyn nhn ch yu l c nng nh do: Stress tm l, ri lon
ni tit tui dy th, tui tin mn kinh, nhiu, suy nhc c th ngoi ra cn do nguyn nhn thc th
nh d dng t cung, dy, teo nim mc t cung, u t cung bung trng, tn thng ct sng.
- Theo Y hc c truyn, nguyn nhn ca bnh thng do lnh, n cc thc n cay, nng, r i lo n tnh ch, lao ng qu
sc, phng dc qu , thp nhit h tiu lm xung nhm ri lon sinh ra. iu tr chm cu c hiu qu vi cc nguyn
nhn do c nng.
2. CH NH:
- N gii c kinh nguyt khng u c nng c chn on chuyn khoa ph s n. N u do nguyn nhn khc ph i
iu tr Y hc hin i c th kt hp vi chm cu.
3. CHNG CH NH:
- Kinh nguyt khng u do nguyn nhn thc th
- Ngi bnh c chng ch nh ca chm cu v thu chm
4. CHUN B:
4.2. Phng tin:
- Khay men, km c mu, bng, cn700
- Mi ngi hay iu ngi, dim
4.3. Ngi bnh:
- Ngi bnh c khm chuyn khoa ph sn chn on xc nh v nguyn nhn, c lm h s b nh n theo qui nh.
5. CC BC TIN HNH:
5.1. Phc huyt
- Khc tr - Hp cc - Thi xung
- Tm m giao - Quan nguyn - Huyt hi
- Kh hi - Trung - Tc tam l
- Tam m giao - T cung - Ni quan
- Thin khu - Hnh gian - Trung cc
- Cch du - Can du - Thn du
- Ni quan - Thn mn - on hng
5.2.Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim theo h ng nh, chm ph i t c kh.
5.2.1. Kinh trc k:
* Th huyt nhit: chm t cc huyt:
- Khc tr - Hp cc - Thi xung
- Tm m giao - Quan nguyn - Huyt hi
* Th kh h: chm b cc huyt:
- Kh hi - Trung
5.2.2. Kinh sau k:
* Th huyt h: chm b cc huyt:
- Kh hi - Trung
* Th h hn (huyt hn): cu hoc n chm b cc huyt:
- Huyt hi - Quan nguyn - Kh hi
- Tam m giao - T cung - Ni quan
- Thin khu
* Th can kh ut: chm t cc huyt:
- Huyt hi - Tam m giao - Hnh gian
- T cung - Trung cc - Cch du
- Can du - Thn du - Ni quan
- Thn mn
5.2.3. Kinh khng nh k:
* Th can ut: chm t cc huyt:
- Tam m giao - Huyt hi - Ni quan
- Hnh gian - T cung - Kh hi
* Th thn kh h: cu hoc n chm b cc huyt:
- Kh hi - Quan nguyn - Tam m giao
- Thn du - T cung
5.2.4. Kinh nguyt qu nhiu (a kinh):
* Th huyt nhit: chm t cc huyt:
- Khc tr - Thi xung - Quan nguyn
- Tam m giao - T cung - Huyt hi
- on hng
* Th kh h: chm b cc huyt, c th chm n k trc 7 ngy:
- Tam m giao - Quan nguyn - Kh hi
- Tc tam l - T cung - on hng
5.2.5. Kinh qu t (thiu kinh):
* Th huyt h: chm b cc huyt:
- Huyt hi - Quan nguyn
- Cch du - Tam m giao
* Th thn m h: chm b cc huyt:
- Tam m giao - Quan nguyn
- Thn du - T cung
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
- Cng : 14-150 micro Ampe, tng dn ti ngng bnh nhn chu c.
5.4. Liu trnh iu tr
- in chm ngy mt ln, 1 liu trnh iu tr 15-30 ngy, c th iu tr 2-3 liu trnh.
- Kt hp vi iu tr nguyn nhn cho n khi bnh nhn n nh.
6.2. X l tai bin
7. CH :
Nn loi tr cc nguyn nhn (nu c), c th chm trc k kinh 1 tu n.
Quy trinh 42: IN CHM IU TR DI TINH

1. I CNG: - Di tinh l tnh trng bnh l ca nam gii t xut tinh m khng c giao h p. Tinh d ch t chy trong khi
ng m khng bit hoc khi i tiu tin tinh dch ra theo, nu nng tinh dch t chy lin t c lm cho ng i n ng suy
sp v th cht cng nh tinh thn. Nguyn nhn thng do tm l chim ti 80-90% nh m ng tinh, th dm, ho t tinh
ko di. Ngoi ra c nguyn nhn khc nh bnh tm thn, t n thng c t s ng, t n th ng c quan sinh d c, vim u
tuyn tin lit, vim bao quy u v dng vt hoc h tit niu
- Theo Y hc c truyn, di tinh c coi l bnh ca thn m (v tinh dch thuc m) b r i lo n, nguyn nhn c th do n i
nhn (tht tnh), do ngoi nhn thp nhit h tiu, do bt ngoi ni nhn u gy nh h ng tr c ti p th n m ho c gy nh
hng ti thn dng, tm, t, can, sau nh hng ti thn m lm thn m b ri lon gy nn.
2. CH NH:
- Nam gii t tui thnh nin c di tinh.
- Nguyn nhn di tinh l do tm l, nu do cc nguyn nhn khc ph i k t h p v i Y h c hi n i i u tr cc nguyn
nhn .
3. CHNG CH NH:
- Di tinh khng do nguyn nhn tm l.
- Ngi bnh c cc chng ch nh ca chm cu v thu chm.
4. CHUN B:
4.1. Cn b y t:
- Bc s, y s, lng y c o to v chm cu
- Thy thuc iu tr nn l nam gii, hiu su v bnh nam hc nht l di tinh, phi bit tm l ti p xc v i ng i b nh.
4.2. Phng tin
- Mi ngi hay iu ngi, dim
4.3. Ngi bnh
- c lm h s bnh n theo quy nh, c bit phi c phn dng khm cho ng i b nh v di tinh.
- C v hoc c ngi tnh i cng hi tnh hnh sinh hot tnh dc gp ph n nh gi trung th c v di tinh v nguyn
nhn gy di tinh.
5. CC BC TIN HNH:
5.1 Phc huyt
- Quan nguyn - Kh hi - Bt liu
- Thn du - Mnh mn - Trng cng
- Trung cc - Tm du - Thn mn
- Ni quan - Tc tam l - Tam m giao
- Dng lng tuyn - Thi xung
5.2.Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim theo h ng nh, chm ph i t c kh.
* Th thn dng h:
+ Cu hoc n chm theo phng php b cc huyt sau:
- Quan nguyn - Kh hi - Bt liu
- Thn du - Mnh mn
+ Chm t: Trng cng
5.2.2. Th m h ha vng - Tm thn bt giao:
+ Chm t:
- Trng cng - Bt liu
- Mnh mn - Trung cc
+ Chm b:
- Thn du - Tm du
* Nu th tm thn bt giao, chm cc huyt:
- Thn mn - Ni quan
5.2.3. Th tm t h:
+ Chm t:
- Trng cng - Bt liu
+ Chm b:
- Thn du - Mnh mn - Tc tam l
- Tam m giao - Thn mn - Ni quan
5.2.4. Th thp nhit h tiu:
+ Chm t:
- Trng cng - Quan nguyn
- Kh hi - Bt liu
+ Chm b:
- Thn du - Dng lng tuyn
- Thi xung - Tam m giao
- Tc tam l
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
5.4. Liu trnh iu tr
- in chm ngy mt ln, 1 liu trnh iu tr 15-30 ngy, c th iu tr 2-3 liu trnh.
- Kt hp vi iu tr nguyn nhn cho n khi bnh nhn n nh.
6.2. X l tai bin
7. CH :
- Cn loi tr cc nguyn nhn yu t nguy c gy bnh.
Quy trinh 43: IN CHM IU TR LIT DY THN KINH S VII NGOI BIN
1. I CNG: - Lit dy thn kinh s VII ngoi bin l mt hoc gim vn ng na m t c a nh ng c bm da m t do dy

thn kinh s VII chi phi, c du hiu C-harles-Bell dng tnh. - Theo Y hc c truy n, b nh thu c chng kh u nhn oa
t do phong hn, phong nhit, huyt xm phm vo lc mch ca ba kinh dng m t lm kh huy t km i u ho kinh
cn thiu dinh dng khng co li c. Bnh nhn thng c biu hin ming mo, mt bn li t nh m khng kn.
2. CH NH:
Lit thn kinh s VII do lnh, nhim khun, nhim virus, chn thng .
3. CHNG CH NH:
Lit thn kinh s VII trong bnh cnh nng khc: hn m, u no, p xe no, suy h h p, tai bi n m ch mu no vng thn
no, bnh nhn tm thn.
4. CHUN B:
4.1. Cn b y t: Bc s , y s , lng y c o to v chm cu.
4.2. Phng tin:
- Khay men, km c mu, bng, cn700
4.3. Ngi bnh
5. CC BC TIN HNH:
5.1. Phc huyt :
- Thi dng - ng t liu - Dng bch
- Ng yu - Ton trc - Tnh minh
- Quyn liu - Nghinh hng - a thng
- Gip xa - Nhn trung - Phong tr
- Bch hi - Tha tng - Hp cc
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t t hng huy t nh, chm ph i t c kh .
Chm t:
- Thi dng xuyn ng t liu - Dng bch xuyn Ng yu
- Ton trc xuyn Tnh minh - Quyn liu xuyn Nghinh hng
- a thng xuyn Gip xa - Nhn trung
- Phong tr - Bch hi
- Tha tng - Hp cc bn i din
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
5.4. Liu trnh iu tr
- in chm ngy mt ln, mt liu trnh iu tr t 15-30 ln chm tu theo mc bnh v p ng i u tr .
6.1. Theo di: ton trng bnh nhn
6.2. X l tai bin
Quy trinh 44: IN CHM IU TR AU DY THN KINH S V

1. I CNG: - au dy thn kinh s V tin pht (au dy thn kinh tam thoa) l nh ng c n au xu t hi n t ng t d d i
vng da mt bn mt. Cn au xut hin t nhin hay do ng chm vo im bng n . Trong c n au b nh nhn c
th c co git c mt, v m hi, chy nc mt, nc mi. Phn ln bnh nhn trn 50 tu i. Khm ngoi cn khng th y
c triu chng khch quan thn kinh. - Theo Y hc c truy n, au thn kinh s V thu c chng Th ng phong do Trng V
nhit hoc Can m nhit sinh phong nhit i ln gy tc tr vn hnh kh huy t cc kinh d ng cng bn m t .
2. CH NH:
au dy thn kinh V tin pht (au dy thn kinh tam thoa)
3. CHNG CH NH:
au thn kinh V nm trong bnh cnh c tn thng thn kinh thc th: lit c nhai, mt ph n x gic m c, li t cc dy
thn kinh s no khc, x cng ri rc, u no.
4. CHUN B:
4.1. Cn b y t: Bc s , y s , lng y c o to v chm cu.
4.2. Phng tin
4.3. Ngi bnh
5. CC BC TIN HNH:
5.1. Phc huyt
- Bch hi - Phong tr - A th huyt - Hp cc
- Dng bch - Ng yu - Ton trc - Tnh minh
- Thi dng - ng t liu - u duy - Quyn liu
- phong - Sut cc - Nh mn - Thnh cung
- Nghinh hng - a thng - Gip xa - Tha tng
- H quan
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh y kim t t theo h ng nh, chm ph i t c kh.
Mi ln chn 6-8 huyt di y, chm t:
*Tng huyt: + Bch hi + Phong tr
+ A th huyt + Hp cc
*Chn cc huyt nm trn vng da do nhnh dy thn V chi phi :
+ au nhnh V1: + Dng bch xuyn Ng yu
+ Ton trc xuyn Tnh minh
+ Thi dng xuyn ng t liu
+ u duy
+au nhnh V2 : + Quyn liu hng khe chn bm hm
+ phong
+ Sut cc
+ Nh mn xuyn Thnh cung
+ Nghinh hng
+au nhnh V3 : + a thng xuyn Gip xa
+ Tha tng
+ H quan
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
5.4. Liu trnh iu tr
- in chm ngy mt ln, mt liu trnh iu tr t 10-15 ln chm tu theo mc bnh v p ng iu tr .
6.1. Theo di: ton trng bnh nhn, cng v tn s cn au
6.2. X l tai bin
Quy trinh 45: IN CHM IU TR VO C CP
1. I CNG: - Vo c cp l chng bnh thng gp trong lm sng, xut hin au vng vai gy t ng t khm th y c
vng vai gy (c thang, c c n chm co cng), quay c kh khn. Nguyn nhn th ng do khi ng g i qu cao, nhi m
lnh hoc do vn ng sai t th. - Theo Y hc c truyn, bnh thuc chng Lc chm do t u l s h , phong hn xm
nhp gy tn thng kinh lc hoc do ng lch gi , t th c khng t nhin gy co rt cn m ch .
2. CH NH:
Vo c cp do lnh, do vn ng sai t th.
3. CHNG CH NH:
Vo c cp trong bnh cnh c p tu c ( vim tu, thot v a m th trung tm, u tu , r ng tu )
4. CHUN B:
4.1. Cn b y t: Bc s, y s , lng y c o to v chm cu.
4.2. Phng tin
4.3. Ngi bnh
- T th ngi bnh ngi.
5. CC BC TIN HNH:
5.1. Phc huyt
- Phong tr - Phong ph - Thin tr
- i chu - Kin trung du - Kin tnh
- Lc chm - A th huyt
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh y kim t t theo h ng nh, chm ph i t c kh.
- i chu - Kin trung du - Kin tnh
- Lc chm - A th huyt
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
5.4. Liu trnh iu tr
- in chm ngy mt ln, mt liu trnh iu tr t 5-10 ln chm tu theo mc bnh v p ng i u tr .
6.1. Theo di: ton trng bnh nhn, vn ng c, hiu qu gim au.
6.2. X l tai bin
Quy trinh 46: IN CHM IU TR HI CHNG VAI GY

1. I CNG: - Hi chng au vai gy l bnh hay gp trn lm sng, bnh lin quan n bnh l t sng c . Tu theo
mc v v tr tn thng bnh nhn c nhng ri lon cm gic v vn ng do cc r thn kinh thu c m r i th n kinh
cnh tay chi phi. Thng gp au hoc t sau gy lan xung vai tay c th n c ho c k t h p v i y u, gi m tr ng l c
cc c tong ng vi cc r thn kinh b thng tn chi phi . - Theo Y hc c truy n, do t u l s h phong hn th p th a
c xm nhp gy tn thng kinh lc, cn tr lu thng kh huy t, gy au. Bnh lu ngy gy t n th ng cn c gy y u,
teo c.
2. CH NH: au vai gy do thoi ho t sng c
3. CHNG CH NH:
au vai gy trong bnh cnh c p tu c (vim tu , thot v a m th trung tm, u tu , r ng tu )
4. CHUN B:
4.2. Phng tin
4.3. Ngi bnh
- T th ngi bnh ngi.
5. CC BC TIN HNH:
5.1. Phc huyt
- Gip tch C4-C7 - i chu - Kin trung du
- Kin tnh - Kin ngung - Kin trinh
- Thin tng - Khc tr - Tiu hi
- Ngoi quan - Hp cc - Lc chm
- Hu kh - A th huyt
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh y kim t t theo h ng nh, chm phi t c kh.
- Gip tch C4-C7 - i chu - Kin trung du
- Kin tnh - Kin ngung - Kin trinh
- Thin tng - Khc tr - Tiu hi
- Ngoi quan - Hp cc - Lc chm
- Hu kh - A th huyt
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
- Cng : 14 -150 microAmpe, tng dn ti ngng bnh nhn chu c.
5.4. Liu trnh iu tr

- in chm ngy mt ln, mt liu trnh iu tr t 10- 20 ln chm tu theo mc bnh v p ng i u tr .
6.1. Theo di: ton trng bnh nhn, ri lon cm gic , vn ng .
6.2. X l tai bin
Quy trinh 47: IN CHM IU TR AU DY THN KINH LIN SN

1. I CNG: - au dy thn kinh lin sn l bnh cnh xut hin khi dy thn kinh lin s n b t n th ng (vim nhi m,
chn p) tu vo v tr mc , s lng dy thn kinh lin sn b tn thng trn lm sng m b nh nhn c bi u hi n
khc nhau. Bnh thng au ti ni tn thng khi n vo, au chy dc theo ng i c a dy th n kinh, au t ng khi ho,
ht th su, cng dn lng ngc. au thn kinh lin sn hay gp trong bnh l ct sng, chn th ng l ng ng c, Zona. -
Theo Y hc c truyn, bnh thuc chng Hip thng do Can kh ut kt, Can ho qu m nh ho c do kh tr huy t , m
m. Bnh nhn thng au mt hoc hai bn mn sn, ngc sn y tc, d cu gin, ming ng, m ch huy n, kh n.
2. CH NH:
au thn kinh lin sn do lnh, sau chn thng, Zona .
3. CHNG CH NH:
au thn kinh lin sn triu chng trong bnh cnh c p tu ( Lao c t sng, u tu , chn th ng c t s ng )
4. CHUN B:
4.2. Phng tin
4.3. Ngi bnh
- T th ngi bnh nm nghing, bn au quay ln pha trn
5. CC BC TIN HNH:
5.1. Phc huyt
- Ni quan - Chng mn - i bao
- Thin tr - Hnh gian - A th huyt
- Phong long - K mn - Chi cu
- Can du - Thi kh - Huyt hi
5.2. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh y kim t t theo h ng nh, chm ph i t c kh .
Mi ln chn 6-8 huyt di y, chm t, kim nghing 450:
* Tng huyt: - Ni quan - Chng mn - i bao
- Thin tr - Hnh gian - A th huyt
* Th m m: - Phong long - K mn - Chi cu
* Th Huyt : - Can du - Thi kh - Huyt hi
- Tn s: + T: 6 - 20Hz, + B: 0,5 - 4Hz
- Cng : 14 -150 microAmpe, tng dn ti ngng bnh nhn chu c.
5.4. Liu trnh iu tr
- in chm ngy mt ln, mt liu trnh iu tr t 10 - 15 ln chm tu theo mc bnh v p ng i u tr .
6.1. Theo di: ton trng bnh nhn, din bin au.
6.2. X l tai bin
Quy trinh 48: CHM T PHU THUT XOANG SNG HM

1. I CNG: - L phng php v cm phu thut xoang sng hm. - Mc ch: m bo v cm cho phu thu t xoang
sng hm tin hnh thun li v an ton.
2. CH NH:
- Vim xoang sng hm, polyp mi, lch vch ngn mi c ch nh phu thut ca chuyn khoa Tai m i h ng.
3. CHNG CH NH:
- Ngi bnh di 18 tui
- Ngi bnh c bnh tm thn, ng kinh, bnh tim nng
- Ngi bnh khng hp tc vi chm t
- Ph n c thai
- Ngi bnh c huyt p cao trn 180/110mmHg.
4. CHUN B:
4.1. Cn b y t: 01 bc s; 01 k thut vin hoc lng y c o to chm t.
4.2. Phng tin
- Kim chm cu v trng loi: 6- 8-10cm
- Bm tim v trng 5ml, bng, cn st trng, km c mu.
- Thuc:
+ Atropin sunphat 0,25mg x 01 ng
+ Seduxen 10mg x 01 ng
+ Morphin 10mg x 01 ng
+ Fentanyl 5mg/10ml x 01 ng.
- Cc phng tin, dng c, thuc hi sc cp cu.
4.3. Ngi bnh:
- c lm h s bnh n chuyn khoa tai mi hng theo quy nh.
- c gii thch bit cm gic cng tc nng tay v vng mt khi chm t.
5. CC BC TIN HNH:
5.1. Phc huyt
- Hp cc - Ngoi quan
- phong - T thng
- Quyn liu - Nghinh hng
5.2. T th ngi bnh: nm nga, hai tay dang.
5.3. Th thut
kh.
Chm t cc huyt hai bn:
- Hp cc: chm kim nghing 45, su 1-2 thn
- Ngoi quan: chm kim nghing 60 -70, su 1,5 - 2,5 thn
- phong: chm kim nghing 60-70 hng v pha xoang sng hm, su 3-4 thn.
- Quyn liu xuyn Nghinh hng: mng chm, kim nghing 45.
- T thng: chm kim nghing 30, su 0,5 thn
- Tn s: cao ngay t u 25-55Hz.
- Cng : tng dn t 40-300micro-Ampe.
- Thi gian: kch thch ban u t 20-30 pht s t v duy tr kch thch trong su t qu trnh ph u thu t.
5.5. Thuc h tr
a.Tim tnh mch chm 5-10 pht trc khi rch da:
- Atropin sunphat 0,5mg/1kg cn nng.
- Seduxen 0,2mg/kg cn nng.
- Morphin 0,2mg/kg cn nng.
b. Tim tnh mch chm khi cn thit tng cng: Fentanyl 2mg/kg cn nng.
6.1. Trong khi chm
- Chm huyt Quyn liu nu su qu, kim s vo trong ming, phi chnh kim nng h n.
- Chm huyt phong vng xng hm trn v di, khng t yu cu v su v gy au: rt kim ra v chm l i.
- Vng chm: ngi bnh ra m hi, lnh tot: rt ht kim, bm huyt Nhn trung. Ch 15 pht, chm l i n u v n v ng chm
th rt kim, i phng php v cm; nu ngi bnh bnh thng th li tip tc chm tin hnh ph u thu t.
6.2. Sau khi chm
Nu chy mu sau khi rt kim, dng bng kh v khun, n cm mu ti ch, khng day.
7. NH GI KT QU:
Khi kch thch my, bnh nhn c cm gic t b, nng lan t u ngn tay ln. Sau 20-25 pht c m gic ny lan n
khuu tay, bnh nhn khng nhc c bn tay, cng tay, ng thi vng m c cm gic t b, c ng, n ng. l th i i m
bt u tin hnh phu thut.
Quy trinh 49: CHM T PHU THUT VIM TAI XNG CHM
1. I CNG: - L phng php v cm phu thut vim tai xng chm. - Mc ch: m bo v cm cho phu thu t
vim tai xng chm tin hnh thun li v an ton
2. CH NH:
- Nhng bnh nhn b vim tai xng chm c ch nh phu thut ca chuyn khoa tai m i h ng.
3. CHNG CH NH:
- Ngi bnh di 18 tui
- Ph n c thai
4. CHUN B:
4.2. Phng tin
- Thuc:
- Cc phng tin, dng c, thuc hi sc cp cu khi cn.
4.3. Ngi bnh
- c lm h s bnh n chuyn khoa tai mi hng theo quy nh.
- c gii thch bit cm gic cng tc nng tay v vng m khi chm t.
5. CC BC TIN HNH:
5.1. Phc huyt
- Hp cc - Ngoi quan
- phong - Sut cc
- Phong tr - An min II
- Nh mn - Thnh hi.
5.3. Th thut
kh.
Chm t cc huyt hai bn:
- Hp cc: chm kim nghing 45, su 1-2 thn
- Ngoi quan: chm kim nghing 60-70, su 1,5-2,5 thn
- phong: chm kim vung gc vi mt da, su 1,5-2 thn.
- Sut cc bn bnh: chm kim nghing 10-15, su 1,5-2 thn.
- Phong tr xuyn An min II: chm t, su 1,5-2 thn, phi t c kh.
- Nh mn xuyn Thnh hi: chm kim nghing 10-15, su 1,5-2 thn.
- Cng : tng dn t 40-300micro-Ampe
5.5. Thuc h tr
6.1. Trong khi chm
- Vng chm: ngi bnh ra m hi, lnh tot. X l: rt ht kim, bm huyt Nhn trung. Ch 15 pht, chm li nu vn
vng chm th rt kim, i phng php v cm; nu ngi bnh bnh thng th li tip t c chm ti n hnh ph u thu t.
6.2. Sau khi chm
Nu chy mu sau khi rt kim, dng bng kh v khun n cm mu ti ch, khng day.
7. NH GI KT QU:
khuu tay, bnh nhn khng nhc c bn tay, cng tay, ng thi vng tai c cm gic t b, c ng, n ng. l th i i m
Quy trinh 50: CHM T PHU THUT MT
1. I CNG: - L phng php v cm phu thut mt. - Mc ch: m bo v cm cho phu thut mt tin hnh
thun li v an ton
2. CH NH:
- Nhng bnh nhn glcm, c thy tinh th, qum, lc, mng mt c ch nh phu thut ca chuyn khoa m t.
3. CHNG CH NH:
- Ngi bnh di 18 tui
- Ph n c thai
4. CHUN B:
4.2. Phng tin
- Thuc:
4.3. Ngi bnh:
- c lm h s bnh n chuyn khoa mt theo quy nh.
- c gii thch bit cm gic cng tc nng tay v vng mt khi chm t.
5. CC BC TIN HNH:
5.1. Phc huyt
- Hp cc - Ni quan
- Thi dng - Quyn liu
- Ton trc xuyn Ty trc khng - phong
5.3. Th thut
kh.
Chm t cc huyt:
- Hp cc 2 bn: chm kim nghing 45, su 1-2 thn.
- Ni quan 2 bn: chm kim nghing 60-70, su 1,5-2,5 thn.
- Ton trc xuyn Ty trc khng: kim nghing 15.
- phong: chm kim nghing 60-70 hng v pha mt m, su 3-4 thn.
- Thi dng: chm kim nghing 35, su 1-1,5 thn, a kim qua khe xng nh gia cung g m v x ng thi d ng, khi
c kh bnh nhn c cm gic tc su vo sau hc mt.
- Quyn liu: chm kim thng gc, phi a c mi kim vo khe bm hm, bnh nhn c cm gic t c vo sau h c m t.
- Cng : tng dn t 40-300 micro-Ampe
5.5. Thuc h tr: Seduxen 0,2mg/kg tim bp trc khi chm.
6.1. Trong khi chm
- Chm huyt Quyn liu nu su qu, kim s vo trong ming, phi chnh kim nng h n.
- Chm huyt phong vng xng hm trn v di, khng t yu cu v su v gy au: rt kim ra v chm l i.
- Vng chm: ngi bnh ra m hi, lnh tot. X l: rt ht kim, bm huyt Nhn trung. Ch 15 pht, chm l i n u v n v ng
chm th rt kim, i phng php v cm; nu ngi bnh bnh thng th li tip t c chm ti n hnh ph u thu t.
6.2. Sau khi chm
7. NH GI KT QU:
khuu tay, bnh nhn khng nhc c bn tay, cng tay, ng thi vng mt c cm gic t b, c ng, n ng. l th i
im bt u tin hnh phu thut.
uy trinh 51: CHM T PHU THUT AMIDAN

1. I CNG: - L phng php v cm phu thut amidan. - Mc ch: m bo v cm cho phu thut amidan ti n
hnh thun li v an ton
2. CH NH:
- Nhng bnh nhn c ch nh ct amidan ca chuyn khoa tai mi hng.
3. CHNG CH NH:
- Ngi bnh di 18 tui
- Ph n c thai
4. CHUN B:
4.2. Phng tin
- Kim chm cu v trng loi 6- 8- 10cm
- Bm tim v trng 5ml, 10ml, bng, cn st trng, km c mu.
- Thuc:
- Cc phng tin, dng c, thuc hi sc cp.
4.3. Ngi bnh
- H s bnh n chuyn khoa tai mi hng theo quy nh.
5. CC BC TIN HNH:
5.1. Phc huyt
- Hp cc - Ni quan
- Amidan - Thin t
- Thng lim tuyn.
5.2. T th ngi bnh: nm nga, vai k gi u nga ra sau, hai tay dang.
5.3. Th thut
kh.
Chm t:
- Hp cc 2 bn: chm kim nghing 45, su 1-2 thn.
- Ni quan 2 bn: chm kim nghing 30, su 1,5-2,5 thn.
- Amidan 2 bn: chm su 1,5-2,5 thn hng v gc li cng bn.
- Thin t: chm su 0,5-1 thn.
- Thng lim tuyn: chm su 1-1,5 thn, hng kim v gc li.
- Cng : tng dn t 40 -300micro Ampe
- Thi gian: kch thch ban u t 20 -30 pht s t v duy tr kch thch trong su t qu trnh ph u thu t.
5.5. Thuc h tr
Tim tnh mch chm trc khi m 10 -15 pht:
- Atropin sunphat 0,25mg x 01 ng.
- Seduxen 10mg x 01 ng.
6.1. Trong khi chm
- Vng chm: ngi bnh ra m hi, lnh tot. X tr: rt ht kim, bm huyt Nhn trung. Ch 15 pht, chm li nu vn
6.2. Sau khi chm
7. NH GI KT QU:
khuu tay, bnh nhn khng nhc c bn tay, cng tay, ng thi vng m c cm gic t b, c ng, n ng. l th i i m
Quy trinh 52: CHM T PHU THUT BU C

1. I CNG: - L phng php v cm phu thut bu c. - Mc ch: m bo v cm cho phu thut bu c ti n
hnh thun li v an ton
2. CH NH:
- Bu tuyn gip n thun c ch nh phu thut.
- Basedow c ch nh phu thut.
- U nang gip mng c ch nh phu thut.
3. CHNG CH NH:
- Ngi bnh di 18 tui
- Ph n c thai
4. CHUN B:
4.2. Phng tin
- Thuc:
+ Fentanyl 5mg/10ml x 01 ng
4.3. Ngi bnh
- c lm h s bnh n chuyn khoa phu thut u bu theo quy nh.
5. CC BC TIN HNH:
5.1. Phc huyt
- Hp cc - Ni quan
- phong - Nhn nghinh
- Kh x - Ph t
- Khuyt bn - Vn mn
- Du ph
5.2. T th ngi bnh: nm nga, hai tay dang, k gi cho c nga ti a.
5.3. Th thut
kh.
- Chm t:
+ Hp cc: chm kim nghing 45, su 1-1,5 thn
+ Ni quan: chm kim nghing 30, su 1-1,5 thn
+ phong: chm kim nghing 30, su 2-2,5 thn
- Nu bu to, dng phng php mng chm:
+ Nhn nghinh xuyn Kh x hoc Ph t xuyn Khuy t b n
+ Khuyt bn xuyn Kh x hoc Vn mn xuyn Du ph
- Cng : tng dn t 40-300micro-Ampe.
5.5. Thuc h tr
b. Tim tnh mch chm khi cn thit tng cng
- Fentanyl 2mg/kg cn nng.
6.1. Trong khi chm
- Vng chm: ngi bnh ra m hi, lnh tot. X tr: rt ht kim, bm huyt Nhn trung. Ch 15 pht, chm l i n u v n
6.2. Sau khi chm
7. NH GI KT QU:
khuu tay, bnh nhn khng nhc c bn tay, cng tay, ng thi vng c c cm gic t b, c ng, n ng. l th i i m
bt u tin hnh phu thut. Trong qu trnh m bnh nhn phi hon ton tnh to, ph i h p c v i k thu t vin
kim sot c ging ni.
Quy trinh 53: CHM T PHU THUT SI NIU QUN MT PHN BA TRN, SI I B
THN
1. I CNG: - L phng php v cm phu thut si niu qun mt phn ba trn, si i b th n. - M c ch: m b o
v cm cho phu thut si niu qun mt phn ba trn, si i b thn tin hnh thun li v an ton
2. CH NH:
- Ngi bnh c si niu qun mt phn ba trn, si i b thn c ch nh phu thut c a chuyn khoa ti t ni u.
3. CHNG CH NH:
- Ngi bnh di 18 tui
- Ph n c thai
4. CHUN B:
4.2. Phng tin
- Kim chm cu v trng, loi 6- 8-10- 30cm
- Thuc:
4.3. Ngi bnh
- c lm h s bnh n chuyn khoa tit niu theo quy nh
- c gii thch bit cm gic cng tc nng chn v vng m khi chm t.
5. CC BC TIN HNH:
5.1. Phc huyt
- Tam m giao
- Tc tam l
- Gip tch D8, D10, L2.
- ng m: 2 kim song song 2 bn ng m, xut pht t huyt Gip tch tng ng.
5.2. T th ngi bnh: nm nghing, pha m quay ln trn, k gi mn sn i din.
- Tay bn m vng ln m u.
5.3. Th thut
kh.
- Tam m giao 2 bn: chm t, kim nghing gc 45 su 1,5-2 thn.
- Tc tam l 2 bn: chm bnh b bnh t, kim su 1,5-2,5 thn.
- Gip tch D8, D10, L2: chm t, kim thng gc vi mt da, hng kim hi chch ra ngoi, su 2-3 th n.
- ng m: p dng th thut cung chm, kim di 30cm.
- Cng : tng dn t 40-300 micro-Ampe.
5.5. Thuc h tr
6.1. Trong khi chm
- Trong khi chm cc huyt gip tch hng kim i khng ng c th m ph i gai ngang, rt kim chm l i.
- Huyt ng m: phi lun lun kim sot mi kim khng mi kim vo trong bng.
6.2. Sau khi chm
7. NH GI KT QU:
Sau khi kch thch my, bnh nhn c cm gic t b, nng lan t ngn chn ln. Sau 20-25 pht, c m gic ny lan ln n
u gi, ng thi vng bng trn c cm gic t b, cng, nng. l thi im bt u tin hnh ph u thu t.
Quy trinh 54: CHM T PHU THUT SI NIU QUN MT PHN BA GIA V DI
1. I CNG - L phng php v cm phu thut si niu qun mt phn ba gia v di. - Mc ch: m bo v cm cho phu thut
si niu qun mt phn ba gia v di tin hnh thun li v an ton
2. CH NH
- Ngi bnh c si niu qun mt phn ba gia v mt phn ba di, c ch nh phu thut ca chuyn khoa tit niu.
3. CHNG CH NH
- Ngi bnh di 18 tui
- Ph n c thai
4. CHUN B
4.1. Cn b y t: 01 bc s; 01 k thut vin hoc lng y c o to chm t
4.2. Phng tin
- Kim chm cu v trng: loi 6- 8-10- 30cm
- Thuc:
Atropin sunphat 0,25mg x 01 ng,
Seduxen 10mg x 01 ng,
Morphin 10mg x 01 ng,
Fentanyl 5mg/10ml x 01 ng.
4.3. Ngi bnh
- H s bnh n thng quy chuyn khoa tit niu theo quy nh.
5. CC BC TIN HNH
5.1. Phc huyt
- Tam m giao - Tc tam l
- Gip tch D8, D10, L2 - ng m: i mch xuyn Duy o
i honh xuyn Ph x bn m.
5.3. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t t theo hng huyt nh, chm phi t c kh.
- Tam m giao: chm t, kim nghing gc 45 su 1,5-2 thn.
- Tc tam l: chm bnh b bnh t, kim su 1,5-2,5 thn.
- Gip tch D8, D10, L2: chm t, kim thng gc vi mt da, hng kim hi chch ra ngoi, su 2-3 thn.
- ng m: + i mch xuyn Duy o, mng chm.
+ i honh xuyn Ph x, mng chm.
- Thi gian: kch thch ban u t 20-30 pht s t v duy tr kch thch trong sut qu trnh phu thut.
5.5. Thuc h tr
6.1. Trong khi chm
- Trong khi chm cc huyt gip tch hng kim i khng ng c th m phi gai ngang, rt kim chm li.
- Vng chm: ngi bnh ra m hi, lnh tot. X l: rt ht kim, bm huyt Nhn trung. Ch 15 pht, chm li nu vn vng chm th rt
kim, i phng php v cm; nu ngi bnh bnh thng th li tip tc chm tin hnh phu thut.
6.2. Sau khi chm
7. NH GI KT QU
Sau khi kch thch my, bnh nhn c cm gic t b, nng lan t ngn chn ln. Sau 20-25 pht, cm gic ny lan ln n u gi, ng thi
vng bng c cm gic t b, cng, nng. l thi im bt u tin hnh phu thut.
Quy trinh 55: CHM T PHU THUT D DY

1. I CNG - nh ngha: L phng php v cm phu thut d dy. - Mc ch: m bo v cm cho ph u thu t d
dy tin hnh thun li v an ton .
2. CH NH
- Nhng bnh nhn hp mn v, lot b cong nh, lot d dy, xut huy t tiu ha nhi u l n c ch nh ph u thu t c a
chuyn khoa tiu ha.
3. CHNG CH NH
- Ngi bnh di 18 tui
- Ph n c thai
4. CHUN B
4.2. Phng tin
- Kim chm cu v trng loi 6- 8-10- 30cm
- Thuc:
+ Seduxen 10mg x 01 ng,
4.3. Ngi bnh
- c lm h s bnh n chuyn khoa tiu ha theo quy nh.
5. CC BC TIN HNH
5.1. Phc huyt
- Tam m giao 2 bn - Tc tam l 2 bn
- Gip tch D8, D12 - Thin khu xuyn Bt dung 2 bn
- Chng mn xuyn K mn 2 bn - Nhn nghinh xuyn Kh x 2 bn
5.3.Th thut
kh.
- Tam m giao: chm t, kim nghing gc 45 su 1,5-2 thn.
- Tc tam l: chm bnh b bnh t, kim su 1,5-2,5 thn.
- Gip tch D8, D12: chm t, kim thng gc vi mt da, hng kim hi chch ra ngoi, su 2-3 thn.
- Dng phng php mng chm, chm cc huyt o:
+ Thin khu xuyn Bt dung
+ Chng mn xuyn K mn
+ Nhn nghinh xuyn Kh x
5.5. Thuc h tr
b. Tim tnh mch chm khi cn thit tng cng:
6.1. Trong khi chm
- Trong khi chm cc huyt Gip tch hng kim i khng ng c th m ph i gai ngang, rt kim chm l i.
6.2. Sau khi chm
7. NH GI KT QU
Quy trinh 56: CHM T PHU THUT LY SI TI MT, CT TI MT

1. I CNG - L phng php v cm phu thut ly si ti mt, ct ti mt. - Mc ch: m bo v cm cho ph u
thut ly si ti mt, ct ti mt tin hnh thun li v an ton.
2. CH NH
- Nhng bnh nhn b si ti mt, vim ti mt mn tnh c ch nh phu thu t c a chuyn khoa tiu ha.
3. CHNG CH NH
- Ngi bnh di 18 tui
- Ph n c thai
4. CHUN B
4.2. Phng tin
- Thuc:
4.3. Ngi bnh
- c lm h s bnh n thng quy chuyn khoa tiu ha.
5. CC BC TIN HNH
5.1. Phc huyt
- Gip tch D10, D12
- ng m: +Thin khu + Bt dung
+ i mch + K mn
5.3. Th thut
kh.
- Tam m giao: chm t, kim nghing gc 45 su 1,5-2 thn, phi t c kh.
- Tc tam l: chm bnh b bnh t, kim su 1,5-2,5 thn, phi t c kh.
- Gip tch D10, D12: chm t, kim thng gc vi mt da, hng kim hi chch ra ngoi, su 2-3 thn, ph i t c kh.
- ng m: Thin khu xuyn Bt dung: mng chm, phi t c kh.
i mch xuyn K mn: mng chm, phi t c kh.
- Cng : tng dn t s 40-300micro-Ampe.
5.5. Thuc h tr
6.1. Trong khi chm
- Huyt ng m: phi kim sot c mi kim khng mi kim vo trong bng.
6.2. Sau khi chm
7. NH GI KT QU
Quy trinh 57: CHM T PHU THUT SI BNG QUANG
1. I CNG - L phng php v cm phu thut ly si bng quang. - Mc ch: m bo v c m cho ph u thu t l y
si bng quang tin hnh thun li v an ton.
2. CH NH
- Bnh nhn c si bng quang, c ch nh phu thut ca chuyn khoa ti t ni u.
3. CHNG CH NH
- Ngi bnh di 18 tui
- Ph n c thai
4. CHUN B
4.2. Phng tin
- Kim chm cu v trng loi 6- 8- 10- 30cm
- Thuc:
4.3. Ngi bnh
- c lm h s bnh n chuyn khoa tit niu theo quy nh.
5. CC BC TIN HNH
5.1. Phc huyt
- Gip tch D12, L2 - Th liu
- ng m: + Thin khu + Honh ct 2
+ Duy o + Honh ct
+ Ng xu + Thin khu
5.3. Th thut
kh.
- Tam m giao (2 bn): chm t, kim nghing 45 su 1,5-2 thn.
- Tc tam l (2 bn): chm bnh b bnh t, kim su 1,5-2,5 thn.
- Gip tch D12, L2 ( 2 bn): chm kim thng gc vi mt da, hng kim hi chch ra ngoi, su 2-3 th n.
- Th liu (2 bn): phi a c kim vo l xng cng, bnh nhn c cm gic t c xu ng m t sau mng ho c t c vo
trong tiu khung.
- ng m: Dng phng php Mng chm:
+ Chm Thin khu xuyn Honh ct (nu m ng trng gia)
+ Chm Duy o xuyn Honh ct, Ng xu xuyn Thin khu (n u m ng vng cung).
- Cng : tng dn t s 40-300 micro-Ampe.
5.5. Thuc h tr
6.1. Trong khi chm
- Vng chm: ngi bnh ra m hi, ngi lnh tot. X tr: rt ht kim, bm huyt Nhn trung. Ch 15 pht, chm l i n u
vn vng chm th rt kim, i phng php v cm; nu ngi bnh bnh thng th li tip tc chm ti n hnh ph u thu t.
6.2. Sau khi chm
7. NH GI KT QU
u gi, ng thi vng bng di c cm gic t b, cng, nng. l thi im bt u tin hnh ph u thu t.
Quy trinh 58: CHM T PHU THUT THOAT VI BEN

1. I CNG - L phng php v cm phu thut thot v bn. - Mc ch: m bo v cm cho phu thut thot v b n
tin hnh thun li v an ton.
2. CH NH
- Nhng bnh nhn b thot v bn c ch nh phu thut ca chuyn khoa tiu ha.
3. CHNG CH NH
- Ngi bnh di 18 tui
- Ph n c thai
4. CHUN B
4.2. Phng tin
- Thuc:
4.3. Ngi bnh
- c lm h s bnh n chuyn khoa tiu ha theo quy nh.
5. CC BC TIN HNH
5.1. Phc huyt:
- Gip tch D12 - Th liu
- ng m: + Thin khu + Kh xung
+ Duy o + Xung mn
5.3. Th thut
kh.
- Tam m giao 2 bn: chm t, kim nghing gc 45 su 1,5-2 thn
- Tc tam l 2 bn: chm bnh b bnh t, kim su 1,5-2,5 thn
- Gip tch D12 bn m: chm kim thng gc vi mt da, hng kim hi chch ra ngoi, su 2-3 th n
- Th liu bn m: phi a c kim vo l xng cng, bnh nhn c cm gic t c xung m t sau mng ho c t c vo
trong tiu khung.
- ng m: dng phng php mng chm:
+ Thin khu xuyn Kh xung
+ Duy o xuyn Xung mn
5.5. Thuc h tr
6.1. Trong khi chm
6.2. Sau khi chm
7. NH GI KT QU
Quy trinh 59: CHM T PHU THUT U X T CUNG

1. I CNG - L phng php v cm phu thut u x t cung. - Mc ch: m bo v cm cho phu thu t u x t
cung tin hnh thun li v an ton.
2. CH NH
- Ngi bnh c u x t cung, c ch nh phu thut ca chuyn khoa sn.
3. CHNG CH NH
- Ngi bnh di 18 tui
- Ph n c thai
4. CHUN B
4.2. Phng tin
- Thuc: Atropin sunphat 0,25mg x 01 ng, Seduxen 10mg x 01 ng,
Morphin 10mg x 01 ng, Fentanyl 5mg/10ml x 01 ng.
4.3. Ngi bnh
- c lm h s bnh n chuyn khoa sn theo quy nh.
5. CC BC TIN HNH
5.1. Phc huyt
- Gip tch D12, L2 - Th Liu
- ng m: + Thin khu + Honh ct
+ Duy o + Ng xu
5.3. Th thut
kh.
- Tam m giao 2 bn: chm t, kim nghing gc 45 su 1,5-2 thn.
- Tc tam l 2 bn: chm bnh b bnh t, kim su 1,5-2,5 thn.
- Gip tch D12, L2: chm kim thng gc vi mt da, hng kim hi chch ra ngoi, su 2-3 thn.
- Th liu: phi a c kim vo l xng cng, bnh nhn c cm gic tc xung mt sau mng ho c t c vo trong ti u
khung.
- ng m: dng phng php Mng chm:
+ Thin khu xuyn Honh ct (nu m ng trng gia)
+ Duy o xuyn Honh ct
+ Ng xu xuyn Thin khu (nu m ng vng cung).
5.5. Thuc h tr
6.1. Trong khi chm
6.2. Sau khi chm
7. NH GI KT QU
Quy trinh 60: CHM T PHU THUT U NANG BUNG TRNG

1. I CNG - L phng php v cm phu thut u nang bung trng. - Mc ch: m bo v c m cho ph u thu t u
nang bung trng tin hnh thun li v an ton.
1. I CNG
- L phng php v cm phu thut u nang bung trng.
- Mc ch: m bo v cm cho phu thut u nang bung trng tin hnh thun li v an ton.
2. CH NH
- Ngi bnh c u nang bung trng, c ch nh phu thut ca chuyn khoa sn.
3. CHNG CH NH
- Ngi bnh di 18 tui
- Ph n c thai
4. CHUN B
4.2. Phng tin
- Thuc:
3.3. Ngi bnh
- c lm h s bnh n chuyn khoa sn theo quy nh.
5. CC BC TIN HNH
5.1. Phc huyt
- Gip tch D12, L2 - Th liu
- ng m: + Thin khu + Honh ct
+ Duy o + Ng xu
5.3. Th thut
kh.
- Tam m giao 2 bn: chm t, kim nghing gc 45 su 1,5-2 thn
- Tc tam l 2 bn: chm bnh b bnh t, kim su 1,5-2,5 thn
- Gip tch D12, L2 2 bn: chm kim thng gc vi mt da, hng kim hi chch ra ngoi, su 2-3 th n.
- Th liu 2 bn: phi a c kim vo l xng cng, bnh nhn c cm gic tc xu ng m t sau mng ho c t c vo
trong tiu khung.
- ng m: dng phng php Mng chm:
+ Thin khu xuyn Honh ct 2 bn (nu m ng trng gia)
+ Duy o xuyn Honh ct 2 bn
+ Ng xu xuyn Thin khu 2 bn (nu m ng vng cung).
- Nu ng m vng cung ch mt bn th ch chm kim ng m bn m.
- Cng : tng dn t s 40-300micro-Ampe.
5.5. Thuc h tr
6.1. Trong khi chm
- Vng chm: ngi bnh ra m hi, lnh tot: rt ht kim, bm huyt Nhn trung. Ch 15 pht, chm l i n u v n v ng chm
th rt kim, i phng php v cm; nu ngi bnh bnh thng th li tip tc chm tin hnh ph u thu t.
6.2. Sau khi chm
7. NH GI KT QU
Quy trinh 61: CHM T PHU THUT U V, UNG TH V
I. I CNG - L phng php v cm phu thut u v, ung th v. - Mc ch: m bo v cm cho phu thut u v, ung th v tin
hnh thun li v an ton.
II. CH NH
- Ngi bnh nhn c u lnh v hoc ung th v c th di cn hoc hoc cha, c ch nh phu thut patay, hoc no vt hch nch ca
chuyn khoa u bu.
III. CHNG CH NH
- Ngi bnh di 18 tui
- Ph n c thai
VI. CHUN B
4.1. Cn b y t: 01 bc s; 01 k thut vin hoc lng y c o to chm t
4.2. Phng tin
- Thuc:
Atropin sunphat 0,25mg x 01 ng,
Seduxen 10mg x 01 ng,
Morphin 10mg x 01 ng,
Fentanyl 5mg/10ml x 01 ng.
4.3. Ngi bnh
- c lm h s bnh n chuyn khoa u bu theo quy nh.
V. CC BC TIN HNH
5.1. Phc huyt
- Hp cc - Ni quan
- Thin tuyn - Cc tuyn
- Kin trinh
- ng m: + K mn + i bao
+ Thin tr + T cung
5.2. T th ngi bnh: nm nga, hai tay dang, tay bn m dang ti a.
5.3. Th thut
Xc nh v st trng da vng huyt, chm kim qua da nhanh, y kim t t theo hng huyt nh, chm phi t c kh.
- Chm t:
+ Hp cc: chm kim nghing 45, su1-2 thn
+ Ni quan: chm kim nghing 60-70, su 1,5-2,5 thn
- Mng chm:
+ Thin tuyn xuyn Cc tuyn
+ Kin trinh xuyn Cc tuyn
- ng m:
+ K mn: dng kim 15cm chm nghing 15, hng kim v pha huyt Nh cn bn i din, lun kim di da v trn cc xng sn,
di 6-7 thn (12-15cm).
+ i bao: dng kim di 15cm chm kim nghing 10-15, hng kim v pha Cc tuyn, lun kim di da v trn cc xng sn, di 5-
6 thn (10-12cm).
+ Thin tr: dng kim di 10cm chm nghing 45, hng kim v pha huyt Cc tuyn su 0,2-0,3 thn (0,4-0,6cm).
+ T cung: dng kim di 10cm chm nghing 15, hng kim v pha rn, lun kim di da trn xng c, chm su 0,3-0,5thn (0,6-
1cm).
- Thi gian: kch thch ban u t 20-30 pht s t v duy tr kch thch trong sut qu trnh phu thut.
5.5. Thuc h tr
- Atropin sunphat 0,5mg/1kg cn nng,
VI. THEO DI V X L TAI BIN
6.1. Trong khi chm
- Huyt ng m: Phi kim sot c mi kim, trnh chm vo xng v phi.
- Vng chm: ngi bnh ra m hi, lnh tot. X l: rt ht kim, bm huyt Nhn trung. Ch 15 pht, chm li nu vn vng chm th rt
kim, i phng php v cm; nu ngi bnh bnh thng th li tip tc chm tin hnh phu thut.
6.2. Sau khi chm
VII. NH GI KT QU
Sau khi kch thch my, bnh nhn c cm gic t b, nng lan t u ngn tay ln. Sau 20-25 pht, cm gic ny lan ln n khuu tay, ng
thi vng ngc c cm gic t b, cng, nng. l thi im bt u tin hnh phu thut.
Quy trinh 62: CHM T PHU THUT TUYN C

I. I CNG - L phng php v cm phu thut tuyn c. - Mc ch: m bo v cm cho phu thut tuy n c ti n
hnh thun li v an ton.
II. CH NH
- Ngi bnh trn 18 tui c xc nh l nhc c do cn tuy n c c ch nh ph u thu t l y b tuy n c c a chuyn
khoa phu thut lng ngc.
III. CHNG CH NH
- Ngi bnh di 18 tui
- Ph n c thai
IV. CHUN B
4.2. Phng tin
- Thuc:
4.3. Ngi bnh
- c lm h s bnh n chuyn khoa phu thut lng ngc theo quy nh.
5. CC BC TIN HNH
5.1. Phc huyt
- Hp cc
- Ni quan
- Gip tch C7,D1.
- ng m: + Du ph + Thn phong
5.2. T th bnh nhn: Bnh nhn nm nga, hai tay dang.
5.3. Th thut:
kh.
- Chm t:
+ Hp cc 2 bn: chm kim nghing 45, su 1-2 thn
+ Ni quan 2 bn: chm t, kim nghing 60-70, su 1,5-2,5 thn
+ Gip tch C7, D1: chm t, kim thng gc vi mt da, hng kim hi chch ra ngoi, su 2-3 thn, ph i t c kh.
- ng m: chm theo phng php mng chm: Du ph xuyn Thn phong
5.5. Thuc h tr:
VI. THEO DI V X L TAI BIN
6.1. Trong khi chm
- Huyt ng m phi kim sot c mi kim, trnh chm vo xng v phi.
6.2. Sau khi chm
VII. NH GI KT QU
Sau khi kch thch my, bnh nhn c cm gic t b, nng lan t u ngn tay ln. Sau 20-25 pht, c m gic ny lan ln
n khuu tay, ng thi vng ngc c cm gic t b, cng, nng. l thi im bt u tin hnh ph u thu t.
uy trinh 63:IU TR BNH TNG HUYT P

I. I CNG Tng huyt p ng mch ngi trng thnh c xc nh khi huy t p tm thu l n h n ho c b ng
140mmHg v/hoc huyt p tm trng ln hn hoc bng 90mmHg. Y hc c truy n x p b nh t ng huy t p thu c ph m
vi mt s chng huyn vng, u thng, chnh xung. Huyn vng l thut ng y hc c truy n m t m t tnh tr ng
bnh l c biu hin hoa mt chng mt, chong vng xy xm, chng chnh nh ngi trn thuy n. Theo quan ni m c a y
hc c truyn, nguyn nhn chnh gy ra chng huyn vng l do cc yu t th t tnh, m th c b t i u v n i th ng h
tn, nh hng chnh n cc tng tm, can, t v thn.
II. CHN ON
Ngi bnh thy hoa mt chng mt, chong vng xy xm, o huy t p trong i u ki n ngh ng i 30 pht tr c khi
o c ch s huyt p trn 140/90mmHg.
1. Bnh danh: Huyn vng.
2. Chn on bt cng: Tu theo tng th bnh.
3. Nguyn tc iu tr ch yu: Bnh can tc phong, t m tim dng, tr m ha trc, hot huy t li thy.
III. CC TH BNH V IU TR
1. Can dng thng cang
- Triu chng lm sng: Ngi bnh thy cng vng u, hoa mt, tai, mt , tnh tnh nng ny hay cu gi n, mi ng
ng, ng km. Li , mch huyn.
- Php iu tr: Bnh can tim dng, thanh ho, tc phong.
- Phng dc: Thin ma cu ng m gia gim
Bi thuc tham kho: Thin ma 08g, Cu ng 16g, Thch quy t minh 20g, tr ng 16g, Tang k sinh 12g, ch m u
12g, Ngu tt 12g, Chi t 12g, Hong cm 12g, Phc thn 16g, D giao ng 20g.
2. Th m thp
- Triu chng lm sng: Hoa mt chng mt, cm gic nng n, bng y, n t d nn, ng hay m. Li bu, ru tr ng
nhn, mch nhu hot.
- Php iu tr: To thp tiu m, kin t ha v
- Phng dc: Bn h bch trut thin ma thang
Bi thuc tham kho: Bn h 12g, Trn b 08g, Phc linh 12g, Cam tho 04g, B ch tru t 12g, Thin ma 08g, Sinh
khng 4 lt, i to 3 qu.
3. Th can thn m h
- Triu chng lm sng: Hoa mt chng mt, vng u, mt mi, hay qun, au lng mi gi, tai mt ng, c th di tinh.
Lng bn tay bn chn nng, tiu vng, li , mch huyn t.
- Php iu tr: B thn t m
- Phng dc: K cc a hong: Thc a 12g, Hoi sn 16g, Sn th 12g, K t 16g, an b 12g, Trch t 10g, B ch linh
12g, Cc hoa 12g.
Quy trinh 64: IU TR HUYT P THP
I. I CNG Chng huyt p thp l tnh trng bnh l hay gp cc la tu i. B nh ko di s lm gi m s c kho , lm
gim hoc mt kh nng lm vic, d dn n tai bin mch mu no. y l bnh kh iu tr khi, nhng n u c ch d
phng v iu tr kp thi th vn c tin lng tt.
Hng s sinh hc v huyt p ca ngi Vit Nam trng thnh nh sau: huy t p tm thu trong gi i h n 90 - 140mmHg,
huyt p tm trng: 60 - 90mmHg. Nu huyt p tm thu di mc ti thiu (< 90) th c coi l b huy t p th p. Theo
Harrison khi huyt p tm thu gim thp mn tnh < 100mmHg th c coi l b huy t p th p.
Y hc c truyn xp huyt p thp trong phm tr chng huy n vng, ch tnh tr ng hoa m t, vng u, chng m t. Huy n
l mc huyn, ch mt hoa hoc trc mt ti sm; vng l u vng, cm thy mi vt xung quang xoay chuy n nh ng i
trn tu xe. Hai chng ny thng ng thi xy ra nn c tn l huy n vng.
II. CHN ON
1. Bnh danh: Huyn vng.
2. Chn on: da trn nhng tiu chun sau:
- Huyt p tm thu < 90mmHg, huyt p tm trng < 60mmHg.
- C chng mt mt mi, nhn vt khng r, hoc huyn quy t, hoc c cc bi u hi n c a thi u mu no.
- Ngoi im 2 km thm cc triu chng ca thn kinh trung ng.
1. Kh m lng h
- Triu chng: hi hp chng mt, mt mi v lc, tm phin mt ng, m nhiu hay qun, tc ngc on kh, ming kh
tiu vng, u li t ru, mch t sc.
- Php iu tr: ch kh t m, b tm an thn.
- Phng dc: Sinh mch m hp trch cam tho thang gia gim
Bi thuc tham kho: ng sm 15g, A giao15g, Bch thc15g, H th ch 15g, Sinh a 10g, Mch mn 10g,
ng quy 10g, Ch xc 10g, Trch cam tho 10g, D giao ng 12g, Bch linh 12g, Hong k 20g, Ng v t 20g.
2. Tm t lng h
- Triu chng: hi hp chng mt, mt ng m nhiu, n km bng y, mt mi v lc, sc mt vng a, mi mng tay nh t
nht, hoc kinh nguyt tht iu, li hng nht, ru trng mch t nhc.
- Php iu tr: ch kh b huyt, kin t dng tm.
- Phng dc: Quy t thang gia gim
Bi thuc tham kho: Bch trut 10g, Bch linh 10g, ng quy 10g, Vin tr 10g, Trch cam th o 10g, ng sm 15g,
Toan to nhn 15g, Hong k 30g, Long nhn 30g, Qu chi 9g, Ch xc 12g, Mc h ng 6g.
3. T thn lng h
- Triu chng: Chng mt tai, mt mi v lc, on kh ngi ni, n km bng trng, lng gi mi au, ng t hay qun,
li nht ru mng, mch trm t.
- Php iu tr: Kin t b thn.
- Phng dc: Sm hong cam k thang.
Bi thuc tham kho: K t 10g, H o nhc 10g, Bch linh 10g, Bch tru t 10g, Hong tinh 10g, Vin tr 10g, Trch
cam tho 10g, ng sm 15g, Toan to nhn 15g, Hong k 20g, H th 12g, Mc hng 6g.
4. Can thn bt tc
- Triu chng: au u hoa mt chng mt, mt kh, tai, ming hng kh, run chn tay, l ng g i au m i, ng tm phi n
nhit, ng t m nhiu, i tin kh sp, li t ru, mch t.
- Php iu tr: b thn nhu can, t m ging ho.
- Phng dc: K cc a hong gia gim.
Bi thuc tham kho: K t 10g, Cc hoa 10g, an b 10g, Trch t 10g, Bch linh 10g, Sn th 10g, ng quy 10g,
Mch ng 10g, ng sm 10g, Thc a 20g, Hoi sn 20g, Hong k 15g.
5. Tm thn dng h
- Triu chng: hi hp chng mt, tc ngc on kh, mt mi v lc, ngi lnh, s lnh, lng gi au mi, tiu tin trong
di, i tin khng thnh bi, li nht, ru trng mng, mch trm.
- Php iu tr: n b tm thn, chn hng dng kh.
- Phng dc: Dng tm thang hp thn kh hon gia gim.
Bi thuc tham kho: ng sm 10g, ng quy 10g, Vin tr 10g, Ph t ch 10g, Sn th 10g, K t 10g, Hoi sn
10g, Trch cam tho 10g, Bch linh 15g, Toan to nhn 15g, Hong k 20g, Qu nhc 9g, Th c a 12g.
Quy trinh 65: IU TR U PH I LNH TNH TUYN TIN LIT

I. I CNG Y hc c truyn xp u ph i lnh tnh tin lit tuy n thuc ph m vi chng long b . Long b th ng do th p
nhit, kh kt, huyt , t h, thn h m gy nn bng quang kh ho bt li, bi tit n c ti u kh kh n. N c ti u bi ti t
tng git gi l long; tiu tin khng thng, bun tiu nhng khng tiu tin c g i l b . Trn lm sng th ng g i
chung l chng long b, thng gp nam gii c tui, ph n sau sinh v bnh nhn sau phu thu t.
II. CHN ON
1. Bnh danh: Long b, da theo tiu chun chn on:
- Tiu tin khng thng, tia nc tiu yu, y chng bng di, khng c i bu t.
- Thng gp nam gii ln tui, ph n sau sinh , bnh nhn sau phu thut.
- Thm trc trng nam gii c ph i tuyn tin lit.
- Cc phng php cn lm sng h tr: Soi bng quang, siu m.
2. Chn on bt cng: Phn lm Thc chng v H chng
3. Chn on tng ph: Bnh v ca long b ch yu ti bng quang nhng c quan h mt thit vi Ph, Tam tiu, T, Th n.
Trong bin chng lun tr cn phn r h thc, thp nhit, kh tr kt. Nguyn tc iu tr c b n l L c ph d
thng vi dng, ly thng lm trng. Thc chng th nn thanh thp nhit, tn k t, l i kh c thng thu o; H ch ng
th nn b T Thn tr kh ho. Trn lm sng, cc th thng gp sau:
1. Thp nhit h tr
- Triu chng: Tiu t, kh tiu tin, nc tiu nh git, y chng bng di, ming kh khng thch ung nc, cht l i
, ru li vng nht, mch sc.
- Php iu tr: Thanh nhit li thp, thng li tiu tin.
- Phng dc: Bt chnh tn.
Bi thuc tham kho: Xa tin t 12g, C mch 12g, Bin xc 12g, Hot thch 15g, Chi t 9g, Cam tho 6g, Mc thng
9g, i hong 9g; sc ung ngy 1 thang.
2. Can ut kh tr
- Triu chng: b tiu t ngt, au ngc sn, bng di chng au, ming ng, ru li tr ng mng, m ch huy n t .
- Php iu tr: S iu kh c, thng li tiu tin.
- Phng dc: Trm hng tn.
Bi thuc tham kho: Trm hng 15g, Thch v 15g, Hot thch 15g, Vng bt lu hnh 15g, ng quy 15g, ng
qu t 15g, Bch thc 20g, Trch cam tho 8g, Qut b 8g; nghin thnh bt, mi ln ung 6g.
3. trc tc tr
- Triu chng: Tiu dt, khng thng, tia nc tiu nh yu, au chng bng di, cht li tm c i m huy t, m ch
huyn t.
- Php iu tr: Hnh tn kt, thng li thu o.
- Phng dc: i ng hon.
Bi thuc tham kho: i hong 120g, Mang tiu 30g, o nhn 60 ht, ng quy 30g, Sinh a 30g, Xuyn s n
gip 30g, Qu chi 15g ; nghin thnh bt mn, luyn mt lm hon, ngy ung 9g chia 2 ln.
4. Thn kh h tn
- Triu chng: Cm gic tc nng vng bng di, bun tiu nhng khng i tiu c hoc tiu ti n nh gi t khng thnh
tia, au lng mi gi, tinh thn u m, chn n, sc mt nht, li nht, ru li trng mng, mch trm t nhc.
- Php iu tr: B thn ch kh.
- Phng dc: Thn kh hon.
Bi thuc tham kho: Thc a 24g, Hoi sn 12g, Sn th 12g, Trch t 9g, Phc linh 9g, an b 9g, Qu chi 3g, Ph
t 3g; sc ung ngy mt thang.
Quy trinh 66: IU TR HI CHNG RUT KCH THCH
I. I CNG Hi chng rut kch thch l hi chng ri lon chc nng i trng thng gp trn lm sng. Bnh biu hin bng cc triu
chng: au bng, trng bng, ri lon chc nng i tin. Tri qua cc thi k, bnh c cc tn gi khc nhau nh: vim i trng tng tit;
vim i trng co tht; ri lon chc nng i trng, hoc hi chng i trng d kch thch v cho n nay thng nht vi bnh danh l Hi
chng rut kch thch.
Nguyn nhn ca bnh cho n nay vn cha r rng. C nhiu quan im cho rng bnh c lin quan n yu t tinh thn, hoc yu t qu
mn, thng qua h thng thn kinh th dch v mt s yu t khc dn n chc nng co bp, bi tit ca i trng ri lon m gy ra cc biu
hin bnh l nhng khng c tn thng thc th ca i trng.
Y hc c truyn khng c bnh danh ny. Cn c vo cc biu hin ca hi chng rut kch thch, c th quy np bnh thuc phm vi cc
chng Tit t.
II. CHN ON
1. Bnh danh:
- Bnh danh theo y hc hin i: Hi chng rut kch thch, theo cc tiu chun ca Roma - 1988:
+ au bng, i tin xong th au, hoc km theo s thay i v s ln i tin v tnh cht ca phn.
+ C t nht 2 hoc hn 2 cc c im sau:
a.Thay i s ln i tin;
b.Thay i tnh cht ca phn (to, nt, lng);
c.Thay i tnh cht i tin (mt rn, i tin cm gic khng ht phn);
d.i tin phn nhy.
+ Trng bng.
- Bnh danh theo y hc c truyn: Tit t.
2. Chn on bt cng: tu theo tng th bnh.
3. Chn on tng ph: biu hin bnh l ti i trng nhng nguyn nhn v c ch bnh sinh c lin quan n mt s tng ph nh: t, v,
can, thn.
Cn c vo cc biu hin lm sng ca hi chng v tng kt cc bo co khoa hc nghin cu p dng y hc c truyn iu tr Hi
chng rut kch thch, c th phn thnh 7 th theo y hc c truyn. l cc th: T v h nhc; Can mc tha t; T v m h; Hn nhit
thc tp; T thn dng h; Kh tr trng v; Thp nhit lu tr. Trn thc t lm sng c 3 th thng gp nht l T v h nhc, Can t bt
ho v T thn dng h.
1. T v h nhc
- Triu chng:
+ i tin phn lng nt hoc c khi phn sng, khi n cc thc n nhiu du m th s ln i tin tng km theo c cht nhy.
+ Ngi gy, mt mi, n km.
+ Li: bu, ru trng mng.
- Php iu tr: kin T, dng V, ch kh ch tit.
- Phng dc: dng bi T qun t thang hoc Sm linh bch trut tn gia gim.
Bi thuc tham kho: ng sm 12g, Bch trut 12g, Bch linh 12g, Chch cam tho 06g, Hoi sn 15g, Bch bin u 15g, d 15g,
Thn khc 15g, Mch nha 15g, Lin nhc 15g.
2. Can t bt ho
- Triu chng: y tc ngc sn, n km, ri lon tiu ho; mi khi tc gin hoc hi hp lo lng th xut hin au bng, si bng, i tin
phn lng nt .
+ Li: cht li hng, ru trng mng.
+ Mch: huyn
- Php iu tr: S can l kh, kin t ch t.
- Phng dc: dng bi Thng t yu phng gia gim.
Bi thuc tham kho: Bch trut 15g, Bch thc 12g, Phng phong 12g, Trn b 06g, Si h 06g, Mc hng 06g, Ch xc 12g, Hng
ph 10g, Cam tho 06g.
3. T thn dng h
Th bnh ny thng gp bnh nhn cao tui hoc c qu trnh bnh lu ngy
- Triu chng: i tin phn lng nt, thm ch c khi i tin ra thc n cha tiu. Khi c triu chng si bng l bnh nhn mun i tin, i
tin xong th d chu. au bng, gp lnh th au tng, chm m thy d chu; khi n thc n sng lnh th bnh d xut hin. Chn tay lnh,
au lng mi gi.
+ Li: cht li nht, ru trng mng.
+ Mch: trm t
- Php iu tr: n b t thn, c sp ch t.
- Phng dc: dng bi Ph t l trung hon phi hp vi bi T thn hon gia gim.
Bi thuc tham kho: Ph t 10g, Can khng 10g, Ng th du 06g, Nhc u khu 10g, Ng v t 06g, Bch trut 12g, ng sm 12g,
Phng phong 10g, Xch thc chi 15g, Kha t 12g, Chch cam tho 06g.
Quy trinh 67: IU TR RI LON LIPID MU

. I CNG Ri lon lipid mu l tnh trng ri lon chuyn ha m trong c th dn n n ng cht m trong huy t
tng vt ra khi phm vi cho php. V i b phn cht m kt hp vi protein huy t thanh v n chuy n kh p ton thn
nn ri lon m mu thng phn nh bng ri lon lipoprotein mu. V ri lon lipid mu c quan h m t thi t v i v a x
ng mch, bnh mch vnh, bnh bo ph v tiu ng nn vic iu tr ri lon lipid mu ngy cng c ch .
I
ng y vn khng c bnh danh ri lon lipid mu, nhng trong y vn c ni n m t s chng b nh c bi u hi n lm
sng, bnh nguyn, bnh sinh v nguyn tc tr liu tng t nh chng bnh ny. C n c bi u hi n ch y u c a b nh nhn
nh ngi bo tr, chn tay t mi nng n, hoa mt chng mt, ngc sn y tc, hung t tm thng c th qui n p
chng ri lon lipid mu vo cc chng bnh c lin quan vi m trc nh m th p, tr c tr , huy n v ng ho c hung t.
II. CHN ON
1. Bnh danh: Ty theo biu hin ch yu ca mi bnh nhn m t chn on thuc mt trong cc b nh danh: m th p,
trc tr, huyn vng hoc hung t.
2. Chn on bt cng: L h hip thc
3. Chn on tng ph: can, t, thn
1. T h thp thnh
- Triu chng: u nng ngi mt, chn tay t mi, bng y n km, hay qun, sc mt km nhun, mi mt nng ho c hai
chn ph thng, ming nht khng kht, i tin lng nt, tiu tin trong di, li b cht nh t, ru tr ng nh y, m ch tr m
hon v lc.
- Php tr: ch kh kin t, ha v thm thp.
- Phng dc: Sm linh bch trut tn gia gim.
Bi thuc tham kho: ng sm 18g, Bch linh 15g, Bch trut sao 12g, Chch cam tho 6g, d nhn 20g, Ct cnh 12g,
Sa nhn 8g (cho sau), Trch t 15g, Tr linh 12g, H dip 12g; mi ngy 1 thang, sc ung 2 l n.
2. m trc ni tr
- Triu chng: hnh th bo ph, nng u u m, phn ng chm chp, ngc bng y tc, chn tay t nng, n km b ng
y, ho khc m, hoc nn e n km, li nht ru trng dy dnh, mch huy n hot thc.
- Php tr: kin t ha v, hnh kh tr m.
- Phng dc: ch m thang gia gim.
Bi thuc tham kho: Trn b 10g, Bn h ch 12g, m nam tinh 10g, Bch linh 15g, Chch cam th o 6g, Ch th c 12g,
Thch xng b 10g, ng sm 18g, Bch trut 12g, Sinh khng 9g, i to 12g; mi ngy 1 thang, sc u ng 2 l n.
3. Thp nhit ni un
- Triu chng: ngi mt u nng, trong ngc phin mun, hoa mt chng mt, bng y n km, mi ng ng m kh, i
tin lng nt nng mi, tiu tin vng, li ru vng nhy dnh, mch hot sc.
- Php tr: thanh nhit ha m, hnh kh tiu tr.
- Phng dc: Nhn trn hao thang gia gim
Bi thuc tham kho: Nhn trn 18g, i hong 3g, Chi t 9g, Ct kh c 12g, H dip 12g, S n tra 15g, Trch t 15g, Hoc
hng 12g, Cam tho 6g; mi ngy 1 thang, sc ung 2 ln.
4. Kh tr huyt
- Triu chng: ngc tc au, tm qu kh on, cht li m tm hoc c ban im huy t, ru mng m ch t sp ho c tr m
sp.
- Php tr: s can l kh, hot huyt thng mch.
- Phng dc: Huyt ph trc thang gia gim
Bi thuc tham kho: o nhn 12g, Hng hoa 9g, ng qui 9g, Sinh a hong 15g, Xuyn khung 15g, Xch th c 15g,
Ngu tt 12g, Ct cnh 10g, Si h 9g, Ch xc 10g; mi ngy 1 thang, sc ung 2 ln.
5. Thn tinh bt tc
- Triu chng: u vng mt hoa, tht min a mng, kin vong tai, lng gi au mi, chn tay t b, tc r ng r ng long,
hnh ng chm chp, ming kh hng to, cht li nht ti, ru trng mng hoc khng ru, m ch tr m nh c.
- Php tr: b ch thn tinh, sung in no ty.
- Phng dc: Hu qui m gia gim.
Bi thuc tham kho: Thc a 15g, Hoi sn 15g, Sn th 12g, K t 15g, Cao qui bn 12g (ha nng), Cao l c gic 12g
(ha nng), Th ty t 15g, trng 15g, H th 12g, N trinh t 12g, ch tr nhn 10g; mi ngy 1 thang, s c u ng 2 l n.
6. m h dng khng
- Triu chng: au u, hoa mt chng mt, phin to d cu, tht min a mng, lng gi au m i, m t m tai , ng tm
phin nhit, na m o hn, chn tay t b, li t ru hoc khng ru, mch huy n t sc.
- Php tr: t m b thn, bnh can tim dng.
- Phng dc: Thin ma cu ng thang gia gim.
Bi thuc tham kho: Thin ma 12g, Cu ng 18g, trng 18g, Ngu tt 12g, Bch thc 12g, Phc linh 15g, Tang k
sinh 15g, Chi t 10g, Thch quyt minh 30g, D giao ng 18g, N trinh t 12g, Quy t minh t 15g, Cam th o 6g; m i ngy
1 thang, sc ung 2 ln.
Quy trinh 68: QUY TRNH THT TR Ni
I. I CNG Tr l mt cu trc mng mch bnh thng, ng vai tr trong vic khp kn lng ng hu mn. Bnh tr l mt tp hp cc
biu hin bnh l, c lin quan n nhng thay i ca mng mch tr. Nhng biu hin chnh c th l: chy mu tr, tc mch tr, sa li bi
tr...
1. Phn loi
- Phn loi theo gii phu: Ly ng lc lm mc ngi ta phn ra: Tr ni, Tr ngoi, Tr hn hp, Tr vng.
- Phn loi theo v tr: Ngi bnh t th nm nga (t th sn khoa), s phn b thng thng nht ca cc bi tr l v tr 3h, 8h, 11h.
- Phn loi theo mc : (Ch p dng cho tr ni). Theo tiu chun ca bnh vin St. Marks - Lun n chia bnh tr lm 4 : T I n
IV
2. Chn on
- Ba triu chng thng gp nht trn lm sng l: i tin ra mu, Sa tr, au, ngoi ra c th gp: Chy dch, nga, thiu mu.
- Thm khm: Ngoi vic nhn th thm ng hu mn l ng tc bt buc i vi khm bnh nhn tr nhm xc chn nhng tn thng i km
vi bnh tr nh p xe, r, nt hu mn, ung th hu mn trc trng...
3. iu tr theo y hc hin i
- iu tr ni khoa:
+ Ngn chn cc yu t thun li bng: Ch n: trnh ru, c ph, gia v cay, chua... Trnh ngi xm i li nhiu, lm vic nng trong t
tr cp. iu tr cc ri lon i tin: to bn, a lng.
+ Dng thuc iu tr c tc dng:
Tr tnh mch, gim tr tnh mch nh cc thuc h Flavonoid, Futozid: Daflon, Vitamin PP.
Gim au chng nga nh: Menthol, cc dn xut ca Cocain v Proctolog, Preparlion-H.
Chng nhim khun: dng khng sinh cc loi.
Chng ph n.
iu tr ni khoa c tc dng tt vi tr ni I, II, III. iu tr phi hp trong cc t tr cp II, III, IV lm gim cc triu chng, chun
b tt cho iu tr bng th thut.
- iu tr bng th thut:
+ Tim thuc lm s ho tr: Ch yu s dng vi tr I, II ang chy mu. C th dng cc thuc nh: du Phenol (Anuselrol), Poldocanol
(Aetoxisclerol),... Hoc nc si tim trc tip vo bi tr.
+ Tht bi tr: tht cao su hoc ch line.
+ Lm ng bi tr: bng nit lng hoc Protoxynito; Hoc dng dao in 1 cc, 2 cc hay dng in trc tip p st vo gc bi tr v tng dn
in th ln 16mA.
- iu tr bng phu thut: Mt s phng php phu thut c dng ph bin nh: Phng php Whitehead, Phng php m ca A.Park,
Phng php Toupet, Phng php Miligan Morgan, Phng php Ferguson; Phng php longo, y l phng php mi c nhiu u im,
nhng chi ph iu tr cn cao nn cha p ng cho i b phn bnh nhn nc ta.
II. PHNG PHP THT TR NI
Trong Y hc c truyn, bnh tr c bnh danh l Tr sang v cng c nhiu cch iu tr nh: chm cu, ung thuc, ngm, xng, bi p
thuc v tht tr... Mi phng php u c gi tr, tuy nhin hiu qu iu tr ph thuc vo ch nh cho tng loi tr v mc ca bnh.
1. Ch nh
Phng php ny c ch nh ch yu cho cc bnh nhn c tr ni II, III.
2. Chng ch nh: vi cc bnh nhn:
- C bnh cp tnh kt hp vng hu mn (r, nt k, p xe, chm hu mn...).
- C cc bnh ton thn khc: Suy gan, thn, nhim khun cp tnh, bnh c tnh, ri lon ng mu...
3. Chun b
- Chun b nhn vin y t: Kp th thut gm t nht 2 ngi: 1 Bc s c kinh nghim v 1 y t ph.
- Chun b bnh nhn:
+ Thm khm ti ch hu mn, soi hu mn trc trng; phn tr ni.
+ Thm khm ton thn c y hc hin i v y hc c truyn.
+ Phn loi theo th bnh y hc c truyn: Th to nhit, th kh h h hm, th huyt .
+ Trc khi tin hnh th thut: bnh nhn c tht tho sch 2 ln; c th dng thuc trn tnh cho bnh nhn trc khi th thut; th phn
ng vi thuc v cm v khng sinh.
- Chun b dng c:
Dng c S lng Mc ch
Bm kim tim loi 10ml 1 chic Gy t
Bm tim loi 5 ml 1 chic Tim dung dch kh tr
Km qu tim 1 chic Kp bi tr
Ko cong 1 chic Ct tch bi tr
Ch line Khong 10 si Tht tr
Loa soi hoc m vt 1 chic Thm khm bi tr su
Thuc gy t 10 ml Novocaine 0,25% Gy t bi tr
Dung dich kh tr 3 -4 ml Gy hoi t tr sau tht
Cn iod 20ml St trng
Cao sinh c 1 tup Bi vo bi tr sau tht
Gc v trng Khong 20 ming Thm mu + bng p
Bng 1 cun Bng p
Thuc khc Cafein v tr tim Cp cu khi co tai bin4. Cc bc tin hnh th thut tht tr
(1) St khun vng hu mn
(2) V cm: gy t ti ch di nim mc mi bi tr khong 4 5 ml Novocaine 0,25%.
(3) Kp bi tr sau khi gy t, kp st chn tr bng km qu tim, trnh kp xung di ng lc.
(4) Tht bi tr bng ch line: Nu chn tr qu rng nn tin hnh khu s tm ti gc tr.
(5) Tim dung dch kh tr Sunphat ng vo bi tr tht, bi tr phng chuyn mu xanh xm.
(6) Ct tch b mt bi tr bng ko cong, gii phng dung dch kh tr sau khi dung dch ngm u ton b bi tr.
(7) Bi Cao Sinh C chng vim, gim au v a cc bi tr tht tr li lng ng hu mn.
5. iu tr chm sc sau th thut
- Ti ch: (bt u t ngy th nht sau th thut) Ngm ra hu mn bng dung dch thuc ngm tr (T1) sau i tin. Thay bng, bm Cao
Sinh C vo lng hu mn sau khi ngm ra.
- Thuc ung: ung thuc sc hng ngy tu theo tng th YHCT:
+ Th to nhit: dng bi Tiu dao hp Ho hoa tn gia gim v
+ Th kh h h hm: dng bi B trung ch kh gia gim v
+ Th huyt : dng bi Huyt ph trc gia gim v
- n ung: Ngy u c th n cho tht trnh i tin sm; king ru, bia v cc thc n cay nng.
6. Theo di, x tr sau th thut
- au: tu theo mc au, c th ln lt chn la cc bin php phng hoc x tr sau: xoa bm cc huyt Bt liu, gi kim loa tai, ngm hu
mn trong nc thuc m hoc s dng thuc gim au khi cc bin php trn km hiu qu.
- Chy mu:
+ Nu chy mu sm ngy th nht hoc th hai thng do:
Thm mu t chn ch: gia tng cc v thuc ch huyt vo thang thuc sc nu c th hoc p mt s bt thuc ti ch hoc phun dung dch
kh tr vo v tr r mu.
Nu tut ch (thng nhng trng hp ny gy au v sng n): phi tin hnh tht li, s dng cc bin php gim au, gia tng cc v thuc
hot huyt vo thuc sc, chng sng n
+ Nu chy mu mun (thng vo giai on tiu rng hoi t tr sm): gia tng cc v thuc ch huyt vo thuc sc, p mt s bt thuc ti
ch cm mu...
- B tiu: tu mc la chn cc bin php x tr nh xoa, chm nng h v hoc chm cu (tu thuc vo tnh trng kch
thch gy co tht c tht hay gim trng lc c bng quang sau v cm m tin hnh chn huyt). Nu x tr tt, rt hn hu
phi chuyn phng php thng tiu.
Quy trinh 69: IU TR R HU MN
I. I CNG R hu mn bao gi cng bt ngun t cc apxe hu mn trc trng. R hu mn gm c mt ng hm do t chc ht vim

mn tnh to nn; ni t l trong (l nguyn thu m vo mt hc ca ng lc) vi mt, hay hai ba l ngoi, (gi l l th pht, nm da
tng sinh mn, gn hay xa l hu mn hoc nm trn cao trong lng ng hu mn).
1. Phn loi
- R n gin hay phc tp:
+ R n gin l khi ch c mt ng hm ni l trong vi mt l ngoi.
+ R phc tp l khi ng hm i cong queo, gp khc, c nhiu nhnh, nhiu ngc ngch.
- nh lut Goodsall (1900):
Bnh nhn nm t th ph khoa, k mt ng ngang i qua l hu mn. Trong loi r m l ngoi nm trc ng ngang th ng r theo
ng nan hoa i thng vo ng lc. Trong loi r m l ngoi nm sau ng ngang th l trong nm 6h.
- Phn loi theo v tr v ng i ca ng r:
+ R di nim mc: ng r, l trong, l ngoi hon ton nm trong lng hu mn. ng r rt nng ngay di nim mc v rt ngn.
+ R di nim mc da: thng l ngoi da gn ngay l hu mn.
+ R lin c tht: l r ngoi nm pha ngoi gn l hu mn.
+ R xuyn c tht thp: ng r i xuyn qua phn di cc c tht, l ngoi nm xa l hu mn.
+ R xuyn c tht cao: ng r i xuyn qua phn trn cc c tht, l ngoi nm xa l hu mn.
+ R trn c tht: ng r i ngay b trn c tht, l ngoi nm xa l hu mn.
+ R ngoi c tht : ng r i t khoang ngoi c nng xuyn qua c nng (khng xuyn qua c tht) ra ngoi da. L r ngoi thng
xa l hu mn. R ngoi c tht thng l hu qu ca p xe trn c nng hu mn.
2. Chn on
- Bnh nhn n khm v thy chy nc vng hoc m cnh hu mn, ti din nhiu ln sau mt ln ln nht cnh hu mn t v hoc
c trch..
- Thy thuc nhn thy gn l hu mn mt ch da sn, ni cao, gia c mt l nh - l l ngoi ca ng r t c th c mt vi
git m trng ng hoc t nc vng chy ra.
- Hnh nh chp X quang ng r vi lipiodol gip xc nh chn on v phn no gip nh gi thng tn.
- Cn tm mt s thng tn c bit khc nh: lao, Crohn hoc HIV... hoc cc thng tn i km nh tr, nt k hu mn...
3. Nguyn tc iu tr
- Khi bnh: phi lm mt m x ca thnh ng r m lnh quanh dnh li vi nhau, khp kn ng r.
- Khng lm tn thng c tht.
Trn nguyn tc , nhiu phng php phu thut c p dng, trong nhiu tc gi p dng phng php dn lu di ngy bng si
nylon ri ct dn dn c tht bng dy cao su, trnh t c tht t ngt.
II. PHNG PHP M NG R DN BNG DY CAO SU KT HP VI Y HC C TRUYN

Trong y hc c truyn bnh r hu mn c bnh danh l Giang lu v cc y gia y hc c truyn cng c phng php s dng nhng si dy
c lm t cc cy, c thuc hoc c tm thuc lun vo ng r iu tr.
1. Ch nh v chng ch nh:
- Ch nh ch yu cho cc r hu mn n gin, r di nim mc, r di nim mc da, r lin c tht, r xuyn c tht thp, r xuyn c
tht cao.
- Chng ch nh: lao ang tin trin, Crohn, bnh nhn c km theo cc bnh khc nh hng n qu trnh v cm nh: mt s bnh tim
mch, h hp, suy gan, thn...
2. Chun b
- Nhn vin y t: kp th thut t nht l 3 ngi: mt bc s c kinh nghim, mt nhn vin ph dng c v mt nhn vin v cm c kinh
nghim.
- Chun b bnh nhn:
+ R hu mn khng bao gi cn can thip cp cu; th thut phi c tin hnh trong nhng iu kin thun li nht. Cn iu tr trc cc
yu t nguyn nhn nh lao... v cc bnh mn tnh i km nh cao huyt p, vim ph qun mn, tiu ng...
+ Thm khm ton thn c y hc hin i v y hc c truyn: phn loi theo th bnh y hc c truyn: th thp nhit (thc chng), th kh huyt
lng h (h chng), h thc thc tp.
+ Lm sch i trng: bng ch n t b, tht tho hoc thuc ra rut nh Fortran...
+ V cm: Phng php v cm thng c dng l gy t vng vi yu cu t c l phi lm gin c c tht; v tt hn l nn gy t
ng cng nu c iu kin.
- Chun b dng c:
Dng c S lng Mc ch
Bm kim tim loi 10ml 1 chic Gy t vng
Bm tim loi 5 ml 1 chic Bm Xanh methylen nu cn
B que thm mm t nht l 2 que Thm ng d tm l trong
Dao m 1 chic Rch da
Ch line Khong 10 si C nh ch cao su
Dy cao su 2 3 si Tht ng r
Thuc gy t 10 ml Novocaine 0,25% Gy t vng hoc ng cng
Cn iod 20 ml St trng
Cao sinh c 1 tup Bi vo hu mn
Gc v trng Khong 20 ming Thm mu + bng p
Bng 1 cun Bng p
Thuc khc Cafein v tr tim Cp cu khi c tai bin
3. Cc bc tin hnh th thut

- Bnh nhn nm t th sn khoa, st khun hu mn bng cn iod.
- Tm l trong: dng que thm bng kim loi thn nh, d un cong, u trn, t vo l ngoi v nh nhng t t y dn vo su.
- t dy cao su vo ng r: khi u que thm chui qua l trong vo lng hu mn s un cong que thm u que thm ra ngoi l hu
mn. Buc c nh dy cao su vo u ny ca que thm bng ch line. Rt que thm ngc li dy cao su c t vo ng r t l
trong.
- Tht ng r bng dy cao su: Rch da t ming l ngoi ng r ti mp hu mn, ko 2 u dy cao su sao cho cng gy thiu
mu cc b c th ct m ng r dn dn. C nh hai u dy cao su bng ch line.
- Bm cao sinh c vo lng hu mn, t gc ph ngoi v bng li.
4. Chm sc bnh nhn
- Ton thn:
+ Ch n ung v sinh hot bnh thng.
+ Ung thuc sc hng ngy theo ch nh ca tng th y hc c truyn.
+ La chn cc phng php sau gim au: Gi kim loa tai, in chm, thuc (Alaxan, Mophen...).
- Ti ch:
+ Bnh nhn t ngm, ra hu mn bng dung dch ngm tr 10% (pha t bt ngm tr), mi ln 15 pht, 2 ln/ngy. Sau bm cao sinh c
vo lng hu mn, v ng r ang m ri bng li.
+ Thy thuc hng ngy kim tra tin m ca ng r: nu ng r m qu nhanh phi ni lng bt dy cao su (tr nhng ng r
xuyn c tht thp). Nu dy cao su lng qu phi tht thm cho cng (thng phi tht thm 2-3 ln). Nu ng m b dnh lin hai
mp kiu bc cu phi kp thi tch v t gc tm cao sinh c chng dnh.
- X tr cc tai bin gn:
+ B tiu tin: La chn cc bin php: Xoa, chm nng h v; bm huyt, in chm; thng tiu.
+ Vim lan to: Sau th thut 24 gi, tnh trng ton thn v ti ch xu i (ton thn - st, au tng ln; ti ch sng, nng, , au) th tin
hnh ngay cc bin php: Ni lng dy cao su hoc m rng hn l ngoi ti khoang trung gian hoc m dn lu khoang trung gian bng mt
l khc. Tng cng ngm ra hu mn (c v thi gian v s ln). C th dng khng sinh ton thn kt hp.
Khng c coi th thut iu tr r l n gin. Xc nh phn loi r, nh gi tn thng, nhn nh gii phu hu mn .. l vic khng d
dng, thng rt kh c kt lun chc chn. Vic chm sc sau m i hi t m kin tr v hiu bit.
Quy trinh 71: SC THUC THANG
I. MC CH: Thng qua nhit si ca nc tc ng vo cc v thuc lm cho cht thuc ho tan trong nc si, lm cho tnh dc c
ho hon v gim c tc dng ph ca thuc ri cht ly nc thuc ung.
II. CH NH, CHNG CH NH CA THUC SC:
1. Ch nh: Dng cho bnh nhn cp tnh (c ngoi cm v ni thng) t thc, iu kh. Dng cho bnh mn tnh b h, iu kh
2. Chng ch nh: Khng c chng ch nh r, ch yu l sc ng cch m bo cht lng thuc dng cho bnh cp tnh v bnh mn
tnh.
III. CHUN B:
1. Dng c:
- Gi thuc sc (cn gi ring thuc sc trc, thuc sc sau).
- m thuc, c th dng cc loi sau: m t, m snh, ni nhm, xoong nhm, ni thp khng g, ni p sut, m sc thuc bng in.
- Nc sc thuc: nc sch.
- Bp sc thuc: Cc loi bp: bp ci, bp than ci, bp than t ong, bp gas, bp in... u dng c.
- Bt hoc phch cht, ng nc thuc.
2. Bnh nhn:
Bnh nhn c hng dn cch sc thuc nu mang thuc v nh t sc ly.
3. Thy thuc:
- Bit c tc dng ca thang thuc, sc ly kh hay ly v.
- Bit c k thut sc thang thuc ny v thi im cho cc v thuc gi ring vo trc vo sau theo n.
IV. CC BC TIN HNH:
- thuc vo m thuc, ri nc ngp mt thuc khong 2 cm.
- Nu dng m thuc c vi: ly giy gi thuc lt di mt vung v nt vi m ngn khng cho thuc si bng ln trn ra ngoi.
- t m thuc ln bp.
- Mi u cho la to (v ho) cho chng si. Khi si, tu loi thuc, dng 1 trong 2 cch sau:
+ Vi thuc cn ly kh cha bnh biu, thanh nhit: vn xung mc la va nc thuc si nh khong 20 pht gi kh ca thuc
v ho cht thuc. Ch sc 1 ln.
+ Vi thuc cn ly v cha cc bnh h tn: Vn xung mc la va nh si m khong 60 pht ho tan cht thuc v ly v. iu
chnh ngn la thuc si nhng khng tro ra. Cht ly nc thuc th nht. Li nc vo ngp thuc khong 1cm, tip tc sc nh trn,
ri cht ly nc thuc th 2.
- Ch : + Thuc l khong vt: p v nh, sc 10 - 15 pht ri mi cho thuc cn li vo sc tip.
+ Thuc c sn, t (Hong th, R lau) hoc thuc lng ln (L cn, Mao cn, Trc nh, H kh tho) sc trc, cht ly nc lm nc sc.
Vi thuc cho vo sau: Thuc phng hng (thm, c tinh du): Khi sp sc xong mi cho thuc vo, 4 - 5 pht sau th bc ra (Bc h, Sa
nhn, u khu, Nhc qu). Vi thuc qu: V d Nhn sm: thi lt, chng nc cch thu cho nh, cht ly nc sm ho vi nc thuc
ung. B sm c th n.
+ V d: Sc ring nh Nhn sm, hoc mi ra ung nh T gic.
+ Nhc qu: C th mi vi nc thuc ung.
- Vi cc thuc khc: nh A giao, Qui giao, Lc gic giao, ... Sau khi sc thuc xong, cht nc thuc, cho cao vo, gia nhit ho tan cao
vo thuc.
- Vi thuc bt (nh Hot thch tn mn): Cho vo vi ri sc trnh khi cht nc thuc bt ra theo v khi ung s vng hng.
- Trong khi sc thuc bng cc loi bp, cn:
+ Lun c mt iu chnh ngn la cho ph hp, hoc iu chnh np vung ni cho thch hp thuc khng tro ra ngoi.
+ Khng thuc cn ht v chy. Nu thuc cn cn cho thm nc cho cht thuc c th ho tan tt.
V. GHI CHP, BO CO: Nhng din bin bt thng khi sc nh: tro ht nc, cn ht nc, chy thuc, khng cho thuc vo sc trc
hoc cho vo sau khi sc, ...
Quy trinh 72: QUY TRNH BM HUYT

Thut ng Bm huyt c hiu l dng ngn tay tc ng vo huy t vi cc th thu t: n (huy t), day (huy t), i m
(huyt), bm (huyt). n huyt l dng u ngn tay n vo huy t theo h ng chch kho ng 450, kho ng 1 pht. Day huy t
l trn c s n, di chuyn ngn tay theo hng trn trn huy t khong 1 pht. i m huy t l dng u ngn tay tc ng
vo huyt theo hng thng ng (khong 900) khong 1 pht. B m huy t l dng mng ngn tay ci tc ng m nh t
ngt vo vng huyt ri nh ngay.
I. MC CH:
Lm cho dinh v iu ho, th cn, hot lc, qua iu ho c kh c b ri lon lm mm cn c v gi m au.
II. CH NH, CHNG CH NH:
1. Ch nh: Tng i rng.
Cm mo, mt mi, suy nhc, tiu ho km, au nhc c khp (au c gy, au vai, au lng) au b ng, au u, au
rng, i dm, di chng bi lit, di chng trng phong, lit dy thn kinh ngoi vi, au dy th n kinh ngo i vi, m t ng , lc
mt, cn th, ngt mi... C th dng trong cp cu ngt, bt tnh.
2. Chng ch nh: Bnh ly cp, ung th, da liu, mn nht, bnh cn cp cu, x l ngoi khoa, ph n mang thai, bnh
tm thn, nhng ngi say ru, ngi suy kit.
III. CHUN B:
1. Dng c:
- Ct mng tay
- Bng thm nc tit khun
- L cn 700
- Nc nng v chu ra
- Khn sch
- Khay men ct mng tay, bng, l cn
Gh ngi, ging nm chc chn

2. Bnh nhn:
- c hng dn quy trnh, v tr bm huyt v ng bm huy t
- Chun b tm l hp tc vi thy thuc trong qu trnh bm huy t
3. Thy thuc:
- Ct ngn mng tay
- Gii thiu quy trnh bm huyt, nht l ni r nhng ni cn bm nh ng c, b ng, l ng... ng i b nh r. Th y thu c ch
c bm huyt nhng ni khi bnh nhn ng .
- Gii thiu cm gic khi bm huyt bnh nhn bit r trc khi tip nhn bm huy t.
4. a im:
- Ch bm huyt cho n cn kn o, sch s.
IV. CC BC TIN HNH:
- Bnh nhn (ngi, nm) t th thch hp, bc l ni cn bm huyt v phi hp vi thy thuc trong qu trnh b m huy t.
- Thy thuc
- Dng cn st trng tay
- ng v tr trc, sau, cnh bnh nhn, thch hp cho cng vic bm huy t.
- Xc nh v tr cn bm (huyt trn ng kinh, huyt ngoi ng kinh, huy t a th ), b m huy t ng th i theo di ph n
ng ca ngi bnh, gii thch nhng cm gic ca bnh nhn khi c bm huy t.
- Lc bm t nh n mc bnh nhn chu c, khng lm tn thng da bnh nhn v gy ng t su do qu au.
- Bm ln lt tng huyt theo yu cu ca iu tr.
V. GHI CHP V BO CO:
Thy thuc ghi: Th thut bm, tn huyt dng, phn ng ca bnh nhn khi c b m huy t, thay i c a tri u ch ng sau
khi bm huyt.
VI. DN D HNG DN BNH NHN:
Theo di nhng thay i trong ngi (au ch bnh, au ch bm, chy mu di da ch b m, m t m i u o i h n hay
d chu, thay i ca triu chng bnh...).
Bnh nhn t bm nu bit cch lm.
Quy trinh 73: NG DNG NGUYN TC IU TR VO BT PHP TRONG LO KHOA Y HC C TRUYN
Php iu tr dng trong Lo khoa c bn tng t nh i vi php iu tr thng thng. Tuy nhin, do c th ngi c tui c s thay i v
sinh l, bnh l nn khi ra php iu tr cng nn ch ti nhng im ring bit nhm tun th nguyn tc iu tr..
1.Hn php:
L phng php s dng cc v thuc tn n gii biu, tn lng gii biu. Thng dng cho ngi gi b ngoi cm. C cc php sau:
* ch kh gii biu: kt hp ch kh vi gii biu; dng cho ngi gi ngoi cm biu chng c kim kh h.
* T m gii biu: kt hp php t m vi php gii biu; dng cho ngi gi b ngoi cm biu chng km m h.
* Tr dng gii biu: kt hp hai php n dng v gii biu; dng cho ngi gi b ngoi cm kim dng h.
* Dng huyt gii biu: kt hp php dng huyt vi php gii biu; dng cho ngi gi biu chng km theo c huyt h.
2.Th php:
t dng i vi ngi gi do d gy tn thng chnh kh.
3.H php:
Khi vn dng h php i vi ngi c tui, nn tng dng cc php hon h, nhun h, hoc kt hp vi cc thuc ph chnh. Khng nn dng
php tun h. Trong Lo khoa, thng dng mt s php sau y:
* ch kh t h: dng cho ngi c tui kh h tin b v cc chng khc c lu t thc l kim kh h.
* T m t h: dng cho ngi c tui c m h, tin b hoc cc chng to nhit thng tn, hoc c thc t ni lu kim m h m c ch
nh dng php t h.
* Dng huyt t h: dng cho ngi c tui huyt h, trng v to, gy b a hoc cc chng khc c thc t ni lu kim huyt h.
* n dng t h: dng cho ngi c tui dng h hn ngng, tin b v cc chng thc t ni lu km theo dng h.
4.Ho php:
Ngi c tui thng sng c n, d c ut c, nn cc chng can v bt ho, v trng tht iu ... d xut hin nn ho php thng c
dng ngi c tui. Thng dng mt s php sau y:
* Ho gii thiu dng: dng khi t kinh thiu dng m. Cc chng hn nhit vng lai, ngc sn y tc, tm phin, bun nn, khng
mun n.
* iu ho can t: dng trong trng hp can kh ut kt, honh nghch phm v, hoc t h bt vn nh hng n chc nng s tit ca can
gy chng can t bt ho. Triu chng thng thy: tc ngc, au sn, bng trng mn, khng mun n, i tin lng.
* iu ho trng v: dng trng hp t phm trng v, hn nhit thc tp, thng ging tht iu. Triu chng thng thy: tc ngc vng trc
tim, bun nn, nn, au bng, si bng.
5.n php:
* n trung kh hn: dng cho cc chng trung tiu h hn. Triu chng: chn tay lnh, bng trng y hoc au do lnh, khng mun n,
li trng nhun, ru mng, mch trm t hoc trm tr.
* Hi dng cu nghch: dng trong trng hp m thnh dng suy, dng kh mun tuyt. Biu hin: t chi lnh, s lnh, thch nm, tinh
thn mi mt, mch trm vi hoc trm t.
* n kinh tn hn: dng trong trng hp dng kh bt tc, kinh mch th hn t, huyt dch vn hnh bt thng xng. Biu hin bng cc
chng: chn tay quyt lnh; lng au gi mi; li nht, ru li trng; mch trm t.
6.Thanh php:
i vi ngi gi, khi vn dng php thanh nhit thng kt hp vi ch kh sinh tn, do nhit thng gy thng tn v hi kh. Thng dng
cc php sau:
* ch kh thanh nhit: dng khi nhit thnh phn kh v c kim chng kh h.
* T m thanh nhit: dng trong trng hp m h pht nhit v cc chng t nhit thng m.
* Thanh nhit sinh tn: thng dng cho nhit thnh ph v; cc chng c tn thng tn dch.
7.Tiu php:
L php hay dng trong Lo khoa. Mt s php thng dng l:
* Hnh kh: dng cho chng kh c ut tr. Khi dng cho ngi gi, nn chn cc thuc c tnh bnh ho nh pht th; hoc dng kt hp vi
cc thuc ch kh dng m.
* Kh : dng khi huyt hnh bt xng, hoc huyt phn tr; u l nhng chng hay gp ngi cao tui. Chng c th chia thnh 4
loi ln l hn, nhit, h, thc.
- Hn chng huyt : thng dng php hot huyt ho kt hp vi n kinh tn hn.

- Nhit chng huyt : nn kt hp hot huyt ho vi thanh nhit gii c, hoc thanh nhit lng huyt hoc t nhit thng ph.
- Thc chng huyt : nn dng php hot huyt ho phi vi l kh hnh kh.
- H chng huyt : nn phi vi ch kh, dng huyt, t m hoc n dng. Ngi gi a phn do h dn n , nn b h kh l php
hay dng.
* Li thp: trong Lo khoa, cn c vo bin chng lun tr, thng dng cc php sau: n ho thu thp, thanh nhit li thp, li thu thng
lm v li thu tiu thng.
* Ho m: m t l mt trong nhng nhn t lin quan ti nhiu chng bnh ngi gi. Do vy, ho m l php thng dng. C cc php
thng dng sau:
- To thp ho m.
- n dng ho m.
- Thanh nhit ho m.
- Nhun to ho m.
- Tc phong ho m.
- Tiu thc ho m.
- Dc m khai khiu.
- Nhuyn kin tiu m ...
* Tiu o: ngi gi t v h nhc, t tht kin vn, v bt th np nn d gy tch tr m thc. Trong Lo khoa khi dng php tiu o nn
phi vi thuc kin t ch kh, hoc vi php thanh nhit, hay thuc hnh kh , o tr ... tu theo bin chng.
8. B php:
ngi gi tng ph h suy, chnh kh bt tc, th nhc a bnh; thng c h l chnh. V vy php b ng nhin l dng nhiu trong Lo
khoa. C 1 s cch dng sau:
* B kh: thng b kh ca 2 tng t ph. Dng cho cc trng hp kh h, huyt h.
* B dng: thng ch trng n t dng v thn dng.
* B m: cha cc chng m h.
* B huyt: cha cc chng huyt h.
Quy trinh 74: NGUYN TC IU TR LO KHOA Y HC C TRUYN

C th con ngi tui cng cao th nhng bin i v sinh l, bnh l ngy cng r r t. Vn chm sc, phng b nh v
iu tr cho ngi cao tui c nhng c im ring, khc vi la tu i thanh nin v trung nin. ng i c tu i, kh n ng
khng ca c th suy gim, m dng tht iu, kh huyt bt tc, tng ph h suy. V vy, vi c chm sc, phng b nh
v iu tr cho ngi cao tui, ngoi vic phi tun theo nhng nguyn t c chung c a y h c c truy n, cn ph i tun th
nhng quy tc sau y:
B h phi ch hai tng t, thn:
Theo sch Linh khu, thin Nin cho rng: con ngi sau 50 tu i th cng nng c a ng t ng d n d n b h suy; khi ,
bnh tt rt d sinh ra v l nguyn nhn ch yu ca c ch bnh sinh ngi c tu i; trong , t v th n l hai t ng
ch yu. Bi v t ch hu thin, l ngun gc sinh ho ca kh huyt; thn ch tin thin, l n i cha th y ho , i u ti t
m dng. Do , khi iu tr bnh cho ngi c tui phi ch n vi c bi b, bo t n cng n ng c a ng t ng, l c ph .
Trong , c bit ch hai tng t, thn v ng nhin l phi da trn c s bin chng lun tr . D ng d c c ng khng
nn dng qu mnh, qu thin lch, k c b php cng khng nn dng thu n b m nn dng i u b .
Cc phng thuc iu b t thng dng: T qun t thang, Hng sa lc qun t thang, Sm linh b ch tru t tn, D cng
tn...
Cc phng thuc iu b thn: T quy hon, Hu quy hon, Lc v, Bt v ...
Kh t phi cng b kim thi:
Khi c th giai on lo ho, cng nng ca tng ph, kh nng khng ca c th gi m st, m d ng m t tnh bnh
hnh. Khi c th b bnh, ngoi chng h cn cm phi ngoi t. Do , khi iu tr phi dng php cng b kim thi khi
kh t khng lm tn thng chnh kh.
o Ph chnh phi tin hnh t t:
i vi ngi c tui, trong qu trnh iu tr tuy l ly php b lm ch nhng phi tin hnh t t. Nn dng i u b ,
khng c dng php tun b; Khi b, khng nn dng cc i t . B i v t v khi y h suy, cng n ng v n ho gi m
st, kh nng hp thu km nn khi dng thuc b phi ch n cng nng ca t v, bo v trung chu. Nn ti n hnh
iu tr theo nguyn tc: b m khng tr, t m khng ngy, dng m khng to... Trong khi dng thu c ph i bi t cch
phi ng, sao cho c b c t, c thng c ging, c ng c m.
Tm li, khi dng php b i vi ngi c tui khng nhng cn trnh s thin l ch m cn yu c u b m khng tr , lm
cho kh huyt lu thng, t v kin vn, m dng bnh hnh.
o Khi lp phng thuc phi r rng:

Bnh tnh ngi c tui thng din ra rt phc tp: h thc ln ln, hn nhit thc t p, ng t ng khuy t n, kh huy t b t
tc. Khi iu tr, khng nhng cn phi iu tr ch chng m cn phi ch n nhng chng tr ng km theo. Do , c n
c s phi ng cc v thuc mt cch nghim ngt, ch khch phn minh.
o Khi dng thuc, ch yu l s thng:
i vi ngi c tui, cng nng ca tng ph h suy, kh c thng ging tht thng, kh ng ng nn huy t tr ; ho c tnh
tnh d b c ch, can kh khng c s thng, ut li m gy bnh; hoc do ngi gi c nhi u b nh, kh huy t h suy m
ut li. V vy, khi iu tr cn s thng kh huyt, thng dng Tiu dao tn, Si h s can tn, T ngh ch tn ...
o Khi iu tr, phi ch n tnh trng hon, cp mt cch hp l:
Bnh thng phn ra hon, cp nn khi iu tr phi ch n tiu, bn. i vi ngi c tu i, c th suy nh c, s c
khng gim st, tnh trng bnh tt c khi bin i rt cp tnh. Do , i vi nh ng b nh c p tnh, nn dng y h c hi n
i; khi c ch nh kt hp vi y hc c truyn th phng chm l cn iu tr gp, nhng vi c cng t khng nn thi qu
chnh kh c th phc hi sau khi t c gii. Trng hp bnh khng cp tnh th vi c i u tr c n ti n hnh t t .
Bi v bnh tt ngi c tui thng l mn tnh, km theo chnh kh h suy, kh nng ph c h i chm, nn n u nng v i
th vic iu tr s khng c hiu qu.
o Ch ch dinh dng trong qu trnh iu tr:
Do ngi c tui chnh kh h suy, c th suy nhc nn trong qu trnh iu tr c n ch ch dinh d ng ph h p v i

tnh trng bnh tt nng cao sc khng ca c th, phng bnh t t pht sinh. ng th i, ch dinh d ng c ng
cn ph hp vi qu trnh iu tr.
Quy trinh 75: QUY TRNH TP DNG SINH
I. NH NGHA Dng sinh l phng php t rn luyn gi gn sc kho, nng cao th lc, tng cng sc chu ng, kh nng thch ng
ca c th v rn luyn bn lnh ca con ngi. Tp dng sinh cn phng bnh, phc hi chc nng, cha mt s bnh mn tnh, gp phn
nng cao cht lng cuc sng tin ti sng lu, sng kho v sng c ch.
II. CH NH
i vi ngi kho mnh tp dng sinh tng cng sc kho.
Tp th gin chng stress, ch yu cha cc bnh mt ng, nhc u, suy nhc thn kinh, tng huyt p
Tp th tng cng chc nng h hp, ch yu cha cc bnh nh hen ph qun, suy gim chc nng h hp ngi gi, ngi vim ph
qun mn, suy gim chc nng h hp do cc bnh phi mn tnh
Tp cc ng tc chng x cng tng cng v phc hi chc nng h vn ng, cc bnh khp mn tnh, thoi ho ct sng
III. CHNG CH NH
Tp luyn phi theo trnh t tng dn khng nn tp ngay cc ng tc kh c th gy ra mt s tai bin.
Mt s ng tc khi tp phi lu , v d tp ng tc trng chui, th 4 th cho ngi bnh tng huyt p, mt s ng tc chng x cng tp
cho ngi bnh thot v a m
IV. CHUN B
1. Cn b chuyn khoa
Bc s chuyn khoa YHCT
Y, Bc s c o to Dng sinh
2. Chun b hon cnh tp:
Chn phng tp thong mt, nh sng va phi, khng c gi la, yn tnh, ch nm, ngi hoc ng thch hp. Thng tp vo bui ti trc
khi i ng hoc sng dy
3. Ngi tp:
Sp xp thi gian tp hp l, i tiu tin trc khi tp, khng tp lc no, i, khng tp lc say ru bia, ni rng qun o.
V. CC BC TIN HNH
1. Luyn th gin
Chun b t th nm hay ngi
Thc hin 3 bc k thut
+ a c th vo trng thi yn tnh (ct t lin lc vi xung quanh)
+ Theo di vo hi th
+ Ra lnh cho cc c th lng
2. Luyn th
Trnh t theo cc bc:
Chun b t th nm nga
Th t nhin
Th su
Th c nn
Th 4 th
3. Tp cc ng tc chng x cng
Ln lt tp cc t th:
Tp cc ng tc t th nm
Tp cc ng tc t th ngi bnh thng
Tp cc ng tc t th ngi xp vnh, t xoa bp bm huyt.
Tp cc ng tc t th ng
VI. THEO DI V X TR TAI BIN
Nhn chung tp dng sinh khng c tai bin, trong vng vi ngy u tp luyn thng au mi cc c, lu ngi c huyt p cao khng
nn tp cc ng tc gng sc, ngi c thot v a m khng tp cc ng tc p ct sng s lm tng tit trin ca thot v.
Quy trinh 76: QUY TRNH UNG THUC SC
I. MC CH: a ton b cc cht thuc vo ng tiu ho, di dng ho tan trong nc c hp thu d dng, nhanh chng.
1. Ch nh: Cc bnh cp tnh, mn tnh
2. Chng ch nh: Khng r rng.
III. CHUN B:
1. Dng c:
- Thuc sc ng trong l, chai, phch, m...
- Bt (chn, ca...)
2. Bnh nhn:
c bit gi ung thuc ( c mt)
3. Thy thuc:
Bit tc dng ca thuc sc (cng, b) d cho ung vo thi im thch hp (xem ch thch).
- Bit lng dng cho bnh nhn 1 ln (xem ch thch).
- Bit s lng dng trong ngy.
- Bit tc dng ca thuc (hiu qu, tc dng c).
- Bit cch cho ung thuc.
4. a im: Ti ging bnh nhn.
IV. CC BC TIN HNH:
- Bnh nhn c mt ti ging.
- Thy thuc:
+ Mang thuc n ging cho bnh nhn
+ Rt thuc vo bt, trao cho bnh nhn v hng dn cch ung.
+ Ch bnh nhn ung xong, mang bt i.
- Bnh nhn:
+ Ung thuc vi s c mt ca thy thuc.
+ Ngh 15 - 20 pht sau khi ung.
V. GHI CHP BO CO:
- Phn ng ca bnh nhn khi ung thuc: Khng c g; ung khng ht; ung xong lm ging nh c cn hng; ung xong bun nn v
nn; ung xong bng m ch au bng, mun i a, ung xong ni mn nga, ung xong ngi nng hn, lnh hn, mt mi hn, ung xong
trong ngi d chu bnh gim...
VI. DN D HNG DN BNH NHN:
- Theo di cm gic khi ung thuc vo trong ngi (m hn, lnh hn).
- Theo di hiu qu ca thuc: V d: V m hi ngi st, cm lnh, ht au bng i a ngi a chy do hn, i a ra phn ngi to
bn...
- Theo di tc dng ph ca thuc: nh bun nn, nn, au bng, chng bng a chy; hoc sau khi ra m hi, m hi tip tc ra khng dt
(ngi b cm lnh), sau khi i ngoi c ri, tip tc a chy ( ngi to bn)...
- Phn nh kp thi cho thy thuc kp thi x l.
Ch thch:
- Mt vi iu cn bit v d dy, rut, khi cho ung thuc.
+ Kh nng cha ti a ca d dy l 1,5 lt. V vy lng thc n ung cho vo va mc, lng thuc cho cn va .
+ S hp thu d dy mc hn ch. Nc mt s thuc, ru c hp thu qua thnh d dy vo tnh mch. Thuc ru c th c hp
thu d dy.
+ D dy co bp trn thc n vi dch v, tiu ho thc n thnh v chp chuyn qua co tht mn v xung t trng xung rut non. Ung
thuc sau khi n, thuc c trn vi thc n d dy cng xung rut.
+ C tht mn v trng thi co trng lc nh nn mn v thng h m, nc v cc cht na lng i qua, thc n c kch thc ln v
th rn s b ngn li. Ung thuc lc cha n thuc c th d dy xung rut non.
+ Rut non hon tt vic tiu ho thc n, cc sn phm tiu ho c hp thu cng vi vitamin, cht in gii, nc. Thuc c hp thu
rut non.
- Lng thuc ung:
Ngi ln thng mt bt tng ng 250ml/1 ln (ngi dn thng ni 3 bt nc sc cn 1 bt). Tr em thng gim liu, bng 1/2
hoc 1/3 ca ngi ln. Vi tr em nn hoc a chy, ung liu trn vn nn, vn a chy th gim liu d dy, rut c iu kin tip nhn
thuc, hp thu thuc.
- Thi gian ung thuc: Hin nay hay dng:
+ i vi chng bnh cp, ung thuc khi cn, khng c gi gic quy nh.
+ i vi chng bnh mn: Thng ung trc khi n 1 gi.
Ch : Nu l thuc c kch thch nim mc d dy, rut, nn n xong ri ung gim kch thch; Nu l thuc dng tm an thn cha mt
ng, nn ung trc khi ng; Nu l thuc cha st rt, nn ung trc cn 2 gi.
- Cng c th ung thuc theo kinh nghim c truyn.
+ Bnh thng tiu (ngc tr ln u) th n ri ung thuc.
+ Bnh trung tiu (c quan vng bng trn), h tiu (c quan vng bng di, chi di) th ung thuc ri n.
+ Bnh kinh mch t chi, ung thuc vo sng sm lc cha n.
+ Bnh xng tu, ung thuc vo lc no bui ti.
- Ung thuc nng, thuc ngui tu trng thi bnh tt:
+ Ni chung, nn ung thuc lc cn m.
+ Nu l bnh nhit, phi dng thuc hn, song cng ung thuc cn m d dy d tip nhn thuc. Nu ung thuc ngui d dy d c phn
ng nn.
+ Nu ung thuc xong c nn, cn xem xt cc hng sau:
Nu chn on ng (bnh nhit ung thuc hn, bnh hn ung thuc nhit) m vn nn th hoc gim lng thuc cho ung nhiu ln,
hoc cho thm gng sng chng nn.
Nu chn on sai:
- Bnh l chn hn gi nhit (v biu hin c nhit r tuy gc bnh l hn) li chn on l bnh nhit, cho thuc hn nn nn. Phi i dng
thuc nhit v ung thuc ngui.
- Nu bnh l chn nhit gi hn (biu hiu c hn r, song gc bnh l nhit) li chn on l bnh hn, cho thuc nhit nn nn, phi i dng
thuc nhit, ung thuc m nng.
- Vi bnh nhn hn m: nghing u, dn tng tha, hoc cho thuc qua ng xng d dy./.
Quy trinh 77: QUY TRNH NGM NC THUC
I. MC CH: nhit v cht thuc ho tn trong nc, tc ng thm vo da nhm iu ho kinh kh, hot huyt, khu t.
II. CH INH, CHNG CH NH:
1. Ch nh: Ngi u oi mt mi, gn c chn tay au mi n, mt s bnh ngoi ra, tr d hu mn, b i a.
2. Chng ch nh: Khng c chng ch nh r rng.
III. CHUN B:
1. Dng c:
- Thuc ngm (thuc bt ho vi nc si. V d: Bt ngm tr, thuc sn ho vi nc si, nh thuc ngm chm kt hp tc ng ln
cc vng bn chn, thuc thang sc sau khi xng hi nc thuc ri ngm.
- Chu ngm c nc nng 40 - 450 ho thuc hoc nc nng 40 - 500
- Khn lau sch.
- Qun o sch thay nu cn.
- Gh ngi cho bnh nhn.
2. Bnh nhn: c hng dn quy trnh ngm
3. Thy thuc:
- Hiu r tc dng ca thuc ngm
- Hng dn cho bnh nhn cch ngm
- Chun b chu thuc ngm cho bnh nhn.
4. a im: Kn o, sch s, thut tin cho vic ngm.
VI. CC BC TIN HNH:
- Bnh nhn bc l b phn cn ngm
- Kim tra nhit ca nc ngm xem nng qu hoc cha nng iu chnh.
- Ngm vo nc thuc nng 20 - 30 pht.
- Trong qu trnh ngm, t ra, t xoa bp vng ngm tng hiu qu.
- Ngm xong, lau kh.
- X l vt tn thng da nu c.
- Chnh n trang phc.
- Lm v sinh phng, chu ngm.
V. GHI CHP, BO CO:
- Lng thuc, nhit nc, thi gian ngm.
- Nhng din bin trong qu trnh ngm, thay i cc triu chng.
VI. HNG DN BNH NHN:
- Gi gn v sinh ni ngm.
- Theo di thay i sau khi ngm v thng bo vi thy thuc nu cn.
Quy trinh 78: QUY TRNH XNG HI, KHI THUC
I. MC CH: hi thuc, khi thuc trc tip tc ng vo ni c bnh, nhm iu ho kinh kh, hot huyt, khu t.
1. Ch nh:
L nht ngoi da, tr, b i tiu tin, phong thp, au nhc, tr mi, vim mi, vim xoang, au mt .
2. Chng ch nh:
Ch dng phng php ny cho ch b bnh.
III. CHUN B:
C 2 cch xng hi nc thuc v xng khi thuc.
1. Dng c:
* Dng c cho xng hi nc thuc:
- Ni nc xng (dng xng tr, tng sinh mn), bt nc si (dng xng mt).
- Thuc xng ph hp (thuc phin nu nc xng hoc thuc bt, nc lm sn ho vi nc si xng).
- Gh ngi thch hp (gh l thng, gh thng).
- Phu bng giy dy ( hng hi thuc to vo ni xng (v d: mt).
- Khn kh sch lau kh ch xng.
* Dng c cho xng khi thuc:
- Bt / ni, than (ci) hng.
- Thuc xng (bt) thch hp.
- Phu bng giy dy d dn khi thuc to vo ni xng (v d: k ngn tay, chn, mi...).
2. Bnh nhn:
- c hng dn cch xng xng ng ch.
- Lm theo ng qui trnh trnh b bng v t hiu qu cao.
3. Thy thuc:
- Hng dn cho BN cch xng.
- Chun b ni xng cho bnh nhn.
IV. CC BC TIN HNH:
A. Xng hi nc thuc:
- Thy thuc: Xc nh v tr cn xng chn t th thch hp cho bnh nhn; Nu nc (thuc) xng (nh xng gii cm) hoc ho thuc c
sn vo bt (c) nc si, t chp phu ln ming cc, l h hng vo ni nh xng (v d: mt).
- Bnh nhn:
* Bc l v tr cn xng (V d: ci qun xng vng hu mn, tng sinh mn, hoc b knh xng mt);
* t ni xng xung di gh thng l, m vung ni chc thng giy bo (l chui) xng; hoc chp phu hng vo mt xng. Ch
lc u trnh phi qu nhiu hi nng hoc qu gn d gy bng;
- Khi nng gim nhiu th ngng xng;
- Lau kh vng xng;
- Chnh n trang phc.
B. Xng khi thuc:
1. Thy thuc:
- Xc nh v tr cn xng chn t th thch hp cho bnh nhn.
- t ni / bt than hng vo v tr cn thit.
- Ly bt thuc lng dng rc vo l than hng t ly khi.
2. Bnh nhn:
- t th thch hp, bc l ni cn xng (V d: b tt, m rng k chn, hoc ci qun ngi trn gh thng t xng hu mn, hoc b khu
trang xng mi).
- T t v tr xng vo ng ch khi bc ln, hoc chp phu ln ming bt, chp phu hng vo mi khi ln l mi.
- Khi ch xng c 1 lp khi ng li th dng.
- Ngy c th xng 2 ln.
VI. DN D BNH NHN SAU KHI XNG:
- T theo di nhng thay i ca cc triu chng.
- Nu cn phi x l, bo co ngay vi thy thuc./
Quy trinh 79: IU TR CM CM
I. I CNG: Cm mo v cm l nhng chng bnh rt ph bin, nh hng khng t n sc kho cng ng. Theo Y hc c truyn, cm
mo v cm chnh l bnh cnh cm mo phong hn v cm mo phong nhit xy ra khi phong t (phong hn, phong nhit) xm phm vo c
th nhn lc chnh kh gim st (sc khng c th km). Cc phng php iu tr v phng bnh cm cm theo Y hc c truyn tng i
n gin, r tin, hiu qu, c th cha sm ti nh v tuyn y t c s, cng ng d chp nhn, gp phn trong cng tc chm sc sc kho
ban u. Theo Y hc hin i, cm mo l bnh cm lnh, cm l bnh cnh nhim virut cm.
II. CH NH:
Cm mo phong hn: Cm mo (cn c tn gi l thng phong)
Cm mo phong nhit: Cm (cn c tn gi l thi hnh cm mo)
III. CHNG CH NH:
- Cc bnh nhn st cha r nguyn nhn
IV. CHUN B:
Cn b y t: Y, bc s, lng y c o to theo quy ch
Phng tin: Ngoi cc dng c dng cho cc bnh nhn nm iu tr ni tr, phi c cc v thuc nam, thuc bc iu tr cm cm,
phng tin sc thuc ung, un nc xng phc v ngi bnh.
Ngi bnh: h s bnh n theo ng mu bnh n kt hp y hc hin i vi y hc c truyn.
V. CC BC TIN HNH:
Y hc c truyn chia thnh 2 th
1. Th cm mo phong hn:
Triu chng: Mi ngt, ni khn, ht hi, chy nc mi trong hoc nga hng, ho, m nhiu trng long, thm ch au u, au mnh my,
s gi, s lnh, pht st, khng m hi, ru li trng mng, mch ph.
Chn on bt cng: Biu thc hn
Chn on nguyn nhn: Phong hn
Php iu tr: Pht tn phong hn (Tn n gii biu)
iu tr bng thuc:
Thuc xng: L phng php rt ph bin v c cng ng a chung. Dc liu s dng r tin, d kim, sn c a phng, kt qu li
cao. C nhng trng hp cm mo ch cn xng mt ln l khi.
Bi thuc xng: Nu ni xng vi 3 loi l:
L c tc dng khng sinh: l hnh, l ti.
L c tc dng h st: l tre, l dui.
L c tinh du, c tc dng st trng ng h hp: l chanh, l bi, l ta t, l kinh gii, l bc h, l s, l hng nhu,...
Mi th mt nm, Tng cng khong 200-300g, ra sch l, cho vo ni khong 2-3 lit nc, un si. c bit nhng l c tinh du cho vo
sau khi nc si, y kn vung, un si li, bc ra. Khi xng chm chn kn c ngi bnh v ni xng, m ni nc xng t t cho hi
nng mi tinh du bc ln bnh nhn. Xng t 10 - 20 pht. Xng xong, lau sch m hi, thay qun o, trnh gi lnh. Sau khi xng, n bt
cho hnh vi ta t (n nng).
Bt cho gii cm:
Go t 30g L ta t thi nh 8g
Mui 1g Gng sng 3 lt
Hnh sng gi nh 3 c
Go nu tht nh ri cho hnh, gng, l ta t v mui vo. Nu c trng g, nh vo cho 1 qu, khuy u, em ra n khi cn nng. n xong
p chn 30 pht cho ra m hi, sau lau kh v thay o qun.
Thuc ung:
Kinh gii 12g Ta t 12g Sinh khng 3 lt
Bch ch 12g Trn b 6g
Qu chi 6g Bc h 10g
Sc ung ngy 1 thang, ung 1 3 thang.
2. Th cm mo phong nhit:
Triu chng lm sng: Pht st, hi s gi, s lnh, c ra m hi, au u, ngt mi hoc chy nc mi nng, hu hng sng au, ho ra
m c, ru li vng mng, mch ph sc.
Chn on bt cng: Biu thc nhit
Chn on nguyn nhn: Phong nhit
Php iu tr: Pht tn phong nhit (Tn lng gii biu)
iu tr c th:
Thuc ung:
Bc h 10g K u nga 12g
Ct cn 10g Cam tho t 10g
a lin 10g L du 10g
L tre 10g Bch ch 10g
Cc tn 10g Ci xay 10g
Sc ung ngy 1 thang. Ung 3 thang.
3. Phng bnh:
Cm cm l mt bnh ph bin, cm thnh dch, nh hng khng t n sc kho cng ng. Cc phng php d phng cm cm theo Y hc
c truyn r tin, d kim, sn c a phng khin cng ng d chp nhn gm cc bin php sau:
Trong ma dch: nng cao sc khng, gi c th khng b lnh khi thi tit thay i.
Pht hin sm cch ly.
Hn ch tip xc, hn ch tp trung ng ngi khi c dch.
Thi gian c cm hng dn mi ngi dng:
Ti: mi ba n km vi nhnh ti sng. Ngi ln 3 nhnh. Tr em n 1 nhnh.
Ru ti: Gi nt 200g ti ngm trong 1 lt ru trong 2 ngy, lc ly ru. Mi tun ung 3 ngy, mi ngy t 30-50 git.
Khi c dch cm dng bng tm du ti bi v ht vo l mi vo bui sng, chiu (hoc gi mi). Cng thc: ti gi nt 20g + du vng hoc
du lc 200ml.
Chm hoc day n huyt Tc tam l hng ngy.
Khi mc bnh: p dng cc phng php iu tr tin li, n gin nh nh gi, nu ni nc xng, chm cu hoc dng cc v thuc sn
c a phng.
i vi th nng, c bin chng phi pht hin v iu tr kp thi.
Tm li: Cm cm l bnh thng gp, c bit ni mt dn ng v mang tnh truyn nhim. Do cng tc d phng ng vai tr quan
trng nn cn phi tng cng cng tc tuyn truyn v sinh, rn luyn thn th, tng cng th lc. Trong thi gian bnh lu hnh phi tim
phng dch, v sinh mi trng.
Quy trinh 80: IU TR AU VNG THT LNG
I. I CNG:
au tht lng mt bn hay hai bn ct sng l mt chng bnh do nhiu nguyn nhn gy ra. C th chia lm 2 loi: au lng cp v au lng
mn.
Bnh danh: Y hc c truyn gi chng au lng l: Yu thng
Phn loi v nguyn nhn gy bnh:
au lng cp:
- au lng cp do hn thp: Xy ra t ngt do b lnh, ma, m thp gy co cng c sng lng mt bn hoc c hai bn.
- au lng cp do vim ct sng: dy chng ct sng b vim, b ph n chn p vo thn kinh gy au vng ct sng tht lng. Theo Y hc c
truyn: do thp nhit.
- au lng cp khi thay i t th t ngt; hoc mang vc nng sai t th; sang chn vng sng lng. Theo Y hc c truyn: do kh tr, huyt
.
au lng mn:
- Thng do vim ct sng mn tnh
- Thoi ho ct sng
- Lao; ung th
- au cc ni tng ngc, bng lan to ra sau lng
- au lng c nng do thng kinh
- Suy nhc thn kinh
iu tr chng au lng cn iu tr nguyn nhn, kt hp vi cha chng au lng bng thuc, chm cu, xoa bp.
II. CH NH:
- au lng cp do lnh v m
- au lng cp do thay i t th hay vc nng, lch t th
- au lng do vim ct sng
- au lng do tm cn suy nhc; au lng ngi gi do ct sng b thoi ho
III. CHNG CH NH:
- au lng do lao
- au lng do ung th
IV. CHUN B:
Cn b y t: Y, bc s, lng y c o to theo quy ch
Phng tin: Ngoi cc dng c dng cho cc bnh nhn nm iu tr ni tr, phi c cc v thuc nam, thuc bc iu tr au tht lng,
phng tin sc thuc phc v ngi bnh.
Ngi bnh: h s bnh n theo ng mu bnh n kt hp y hc hin i vi y hc c truyn.
V. CC BC TIN HNH:
Y hc c truyn chia thnh 4 th:
1. au lng cp do hn thp:
Triu chng: au lng xy ra t ngt, sau khi b lnh, ma, m thp, au nhiu, khng ci c, ho v tr mnh cng au, thng au mt
bn, n cc c sng lng bn au co cng, mch trm huyn.
Chn on bt cng: Biu thc hn
Nguyn nhn: Hn thp
Chn on tng ph, kinh lc: Bnh kinh lc
Phng php iu tr: Khu phong, tn hn, tr thp, n kinh hot lc (hnh kh, hot huyt)
iu tr bng thuc: (theo i php lp phng)
Thin nin kin 8g Y d 16g
R l lt 8g Trn b 6g
R cy xu h 16g C xc 12g
Qu chi 8g K huyt ng 16g
T gii 16g
Sc ung ngy 1 thang chia 2 ln, ung 7 ngy
2. au lng cp do thay i t th hay vc nng, lch t th:
Triu chng: Sau khi vc nng lch ngi, hoc sau mt ng tc thay i t th t nhin b au mt bn sng lng, au d di mt ch,
vn ng hn ch, nhiu khi khng ci, i li c, c co cng.
Chn on bt cng: Thc chng
Nguyn nhn: Kh tr, huyt .
Phng php iu tr: hot huyt, hnh kh (th cn hot lc)
iu tr c th:
Dng thuc (theo i php lp phng
an sm 12g Ut kim 8g
Xuyn khung 12g Ch xc 6g
Ngu tt 12g Trn b 6g
T mc 8g Hng ph 6gSc ung ngy 1 thang chia 2 ln, ung 7 ngy
3. au lng do vim ct sng:
Triu chng: C sng, nng, , vng ct sng lng au
Chn on bt cng: Thc nhit
Nguyn nhn: thp, nhit.
Phng php iu tr: Khu phong, thanh nhit gii c, hot thuyt, li niu, tr thp
iu tr:
Dng thuc (theo i php lp phng)
Th phc linh 16g Ngu tt 16g
Hy thim 12g Xuyn khung 12g
R xu h 12g d 12g
K u nga 16g Bch trut 10g
Kim ngn hoa 12g Cam tho 6g
Vi voi 12g Nu c st cao thm: Sinh a 10g, Huyn sm 10g
Sc ung ngy 1 thang chia 2 ln, 7 ngy
4. au lng do tm cn suy nhc; au lng ngi gi do ct sng b thoi ho

4.1. au lng do tm cn suy nhc (Th can thn h)
Triu chng: au lng, tai, ng t, hi hp, nhc u, tiu tin vng, i tin to, tr nh gim, ming kh, mch t sc, nam gii c th b di
tinh, n c th ri lon kinh nguyt.
Chn on bt cng: Biu, l tng kim, thin nhit
Nguyn nhn: Can thn h
Chn on tng ph, kinh lc: Bnh tng ph ln kinh lc
Phng php iu tr: B thn m, b can huyt, an thn, c tinh (nam), iu ho kinh nguyt (n). Nu km theo thn dng h th thm b
thn dng.
iu tr: Bi thuc (Theo i php lp phng):
Thc a 12g Long nhn 12g
K t 12g Kim anh 8g
Hong tinh 12g Khim thc 8g
H th 12g Th ty t 8g
To nhn 8g Tc on 12g
B t nhn 8g Ba kch 8gNgy sc ung 1 thang chia 2 ln, ung t 15 n 30 thang
Nu do suy nhc thn kinh, c bn l cha ton thn nh nu ra bi suy nhc thn kinh, thm cc thuc b va b thn: Ba kch,
trng,... va cha au lng nh: Ngu tt, Tc on, Cu tch.
4.2. au lng ngi gi do b thoi ho ct sng: (Nu do thoi ho ct sng ngi gi, cng dng cc thuc cha au lng, b thn, tr
phong hn thp nh cc thuc nu bi thoi ho ct sng)
Triu chng: au lng nhiu, au tng khi tri lnh, chm nng au, chn tay lnh, s lnh, ru li trng; km cc chng can thn h:
lng gi mi au, tiu tin nhiu, tai, ng t, mch trm t.
Chn on bt cng: Biu, l tng kim, thin hn
Chn on tng ph, kinh lc: Bnh c tng ph ln kinh lc
Phng php iu tr: Khu phong, tn hn, tr thp; b can thn;
iu tr c th:
- Khng dng thuc
- Dng thuc (theo i php lp phng)
Khng hot 8g ng quy 12g

Phng phong 8g Trch tho 4g
Xch thc 12g Sinh khng 4g
Khng hong 12g i to 12g
Hong k 20g Sc ung ngy 1 thang chia 2 ln ung 15 n 30 ngy.
Tc dng b kh huyt, tr phong thp.
5. PHNG BNH:
Sau khi iu tr n nh cn ch nhng iu sau y phng bnh ti pht:
Ch gi m, trnh lnh, nht l i vi vng tht lng v chi di.
Khi lao ng th lc cn ch khi ng tt, nht l khi ng vng tht lng v chi di.
Khi lao ng th lc hoc khi tp luyn cn mc va phi, trnh qu sc, ch trnh cc ng tc t ngt.
Quy trinh 81: IU TR BNH THP KHP

I. i cng: Theo YHCT nguyn nhn mc bnh khp l do v kh ca c th khng y , cc loi t kh nh: Phong, hn, thp, nhit xm
phm vo cn, c, xng khp, kinh lc lm cho s vn hnh ca kh huyt b tc li gy cc chng au nhc, sng, nng, , au ti cc khp.
Do tui gi can thn suy yu hoc b bnh lu ngy lm cho kh huyt gim st dn ti thn khng ch c ct ty, can huyt h khng nui
dng c cn gy bin dng teo c dnh khp. Y.H.C.T gi tn l chng t.
II. Ch nh:
- au nhc cc khp khng c sng, nng .
- Bnh khp khng do vim (Thoi ha khp)
- Vim khp dng thp khng c bin chng.
III. Chng ch nh:
- Thp khp cp, lao khp, ung th khp, vim khp do vi khun, chn thng khp
IV.Chun b:
1.Cn b y t: Y, Bc s, lng y c o to theo quy ch.
2.Phng tin: C cc v thuc nam hoc thuc Bc phc v cho vic iu tr bnh khp. Nu bnh nhn iu tr ni tr, ngoi cc dng
ca bnh nhn ra, phi c phng tin sc thuc cho bnh nhn ung hng ngy.
3. Ngi bnh:
H s bnh n theo mu bnh n kt hp YHH vi YHCT
IV. Cc bc tin hnh:
Sau khi khm bnh (t chn) Y.H.C.T cn c vo cc triu chng lm sng ni bc ca ngi bnh chia ra cc th bnh khc nhau v ra
cch cha ph hp , Y.H.C.T chia thnh 5 th bnh nh sau:
1. Th phong t (cn gi l hnh t):

1.1. Triu chng: au di chuyn nhiu khp , au cc khp nh l chnh, khng c sng, nng, , s gi, ru li trng mng, mch ph.
1.2. Chn on bt cng: Biu chng
1.3. Chn on nguyn nhn: Phong, hn, thp (Phong l chnh)
1.4. Chn on tng ph, kinh lc: Bnh kinh lc
1.5. Php iu tr: Khu phong, tn hn, tr thp , hnh kh hot huyt
1.6. iu tr bng thuc: K n theo i php lp phng
Hy thim
K u nga
Uy linh tin
Qu chi
Bch ch
T gii 10g
12g
12g
08g
10g
12g d
Th phc linh
C xc
R ngh
Cam tho
Hng ph 16g
10g
12g
10g
08g
10g
Cch dng: Sc ung mt ngy mt thang, liu trnh t 15-20 ngy.
2. Th hn t (cn gi l thng t):

2.1 Triu chng: au d di mt khp, khng c sng nng , tri lnh au tng, chm nng au, tay chn lnh, s lnh, ru li
trng, mch huyn khn
2.1 Chn on bt cng: Biu chng thin hn
2.3 Chn on nguyn nhn: Hn , phong, thp (Hn l chnh)
2.4 Chn on tng ph, kinh lc: Bnh kinh lc
2.5 Php iu tr: Tn hn, khu phong, tr thp, hnh kh, hot huyt
2.6 iu tr bng thuc: K n theo i php lp phng
Qu chi
Sinh khng
Bch ch
Thin nin kin
L lt
Ng gia b 10g
10g
10g
10g
12g
10g d
Th phc linh
Thng trut
C xc
Xuyn khung
Hng ph 16g
12g
10g
10g
10g
10g
Cch dng: Sc ung ngy 01 thang, ung lc thuc cn m nng, ung lin tc 15-20 ngy.
3. Th thp t (Cn gi l trc t):

3.1 Triu chng: Cc khp nhc mi, t b, au mi cc c, vn ng kh, ming nht, tri lnh m au tng, ru li dnh nht, mch hon.
3.2 Chn on bt cng: Biu chng
3.3 Chn on nguyn nhn: Thp, phong, hn (Thp l chnh)
3.4 Chn on tng ph, kinh lc: Bnh kinh lc
3.5 Php iu tr: Tr thp, khu phong, hnh kh hot huyt
3.6 iu tr bng thuc: K n theo i php lp phng.
d
T gii
Th phc linh
C mi
Xuyn khung
Ng gia b 16g
16g
10g
16g
10g
12g
L lt
Uy linh tin
C xc
an Sm
Hng ph
10g
10g
10g
10g
10g
Cch dng: Sc ung ngy 01 thang, liu trnh ung 15-20 ngy
4. Th nhit t (Tng ng vi t tin trin ca vim khp dng thp, thoi ha khp):
4.1 Triu chng: Cc khp sng, nng , au, i xng, n au, ban ngy nh, m nng hn, co dui c ng kh khn, st, ra nhiu m hi,
s gi, ru li vng mng, cht li , nc tiu vng, mch hot sc
4.2 Chn on bt cng: Biu thc nhit
4.3 Chn on nguyn nhn: Phong, thp nhit
4.4 Chn on tng ph kinh lc : Bnh kinh lc
4.5 Php iu tr: Khu phong, Thanh nhit gii c, lng huyt, tr thp, hnh kh hot huyt.
Hy thim
Cy xu h
R c gai
Kim ngn hoa
Rp c
Si t 16g
12g
10g
10g
10g
10g Sinh a
Huyn sm
d
Trch t
C xc
Nga trut 12g
12g
16g
12g
12g
16g
Cch dng: Sc ung ngy 01 thang, liu trnh 15-20 ngy
5. Th m kinh lc (Tng ng vi giai on cui ca vim khp dng thp, thoi khp c bin dng, teo c, dnh khp):
5.1 Chn on bt cng: Biu l tng kim
5.2 Chn on nguyn nhn: Phong, hn, Thp kt hp vi can thn h.
5.3 Chn on tng ph, kinh lc: Bnh kinh lc, tng ph
5.4 Php iu tr: Khu phong, thanh nhit, tr thp ha m, thng lc, b can thn
Dng cc v thuc nh trn gia thm cc v thuc c tc dng tr m thng lc, B can thn nh:
Bch gii t
Bn h ch
Bch cng tm 10g
10g
10g Xuyn sn gip
o nhn
Hng Hoa 08g
10g
10g Thc a
H Th
trng 10g
10g
10g
- Cch dng: Sc ung ngy mt thang

- Liu trnh: 15-30 thang nn ung vo nhng thng lnh, m phng bnh ti pht
6. Phng bnh:
- Phng chng lnh, m
- Thng xuyn tp luyn, xoa bp cc khp
- n ung cht dinh dng, Vitamin, trnh bo ph
Quy trinh 82: IU TR SUY NHC THN KINH
I. I CNG: Cc ri lon tm cn l mt nhm nhiu ri lon c cn nguyn tm l trong bnh l tm thn, chim 3-5% dn s, nh v mt
triu chng, nhng tin trin ko di v phc tp do ph thuc vo nhiu nhn t (nhn cch, stress, mi trng x hi). Trong bnh tm
cn suy nhc thng gp nht, vi cc biu hin mt ng, nhc u v gim tr nh, 60% gp nhng ngi lao ng tr c, t 30-50 tui,
thnh th v nam gii nhiu hn. Bnh c miu t trong phm vi nhiu chng ca YHCT, tu theo triu chng ni bt nh kinh qu (tim p
hi hp tng lc), chnh xung (tim p hi hp ko di), kin vong (hay qun), u thng (nhc u), di tinh, tht min (mt ng).
II. CH NH: bnh suy nhc thn kinh
III. CHNG CH NH: hi chng suy nhc thn kinh
IV. CHUN B:
1. Cn b y t: y bc s, lng y c o to theo quy ch
2. Phng tin: cc v thuc Nam hoc Bc phc v cho iu tr suy nhc thn kinh, phng tin sc thuc.
3. Ngi bnh: c lm h s bnh n theo mu bnh n kt hp YHH vi YHCT
V. CC BC TIN HNH:
Sau khi khm bnh theo YHCT (t chn), cn c vo triu chng lm sng ch yu ca ngi bnh, bnh suy nhc thn kinh c th chia thnh
3 th theo YHCT, v cch cha c th nh sau :
1. Th Can kh ut kt (Th hng phn tng):
1.1. Triu chng: Nhc u d di tng cn, thng vng nh. Mt ng, ng kh vo gic. Nng ny, d tc gin, hay th di, ngc sn
y tc, mi khi tc gin bnh li tng ln. Hay qun, chn n, bng chng, y hi. Li , ru trng, mch huyn. Sc kho ton thn cn
tt.
Nu can kh ut ho ho, ngi bnh s kht nc, thch ung nc mt, nc tiu vng sm, to bn. Mt v mt , ming ng. Li , ru
vng, mch huyn sc.
1.2. Chn on:
- Bt cng: l thc nhit
- Nguyn nhn: lo bun, ut c qu hoc ko di
- Tng ph: can kh ut kt
1.3. Php iu tr:
S can l kh, an thn (l kh gii ut hoc s can gii ut, an thn)
1.4. iu tr bng thuc: k n theo i php lp phng
Si h 12g Mn kinh 10 g Lc tin 10 g
Cc hoa 08g Thanh b 06 g To nhn 12 g
Bch thc 12g Hng ph 08 g Ngy sc ung 1 thang, chia 2 ln. Liu trnh 20-30 ngy
2. Th Can thn m h (Th c ch gim):
2.1. Triu chng: Nhc u m , u chong, tai , hoa mt, hay qun, eo lng au mi. Hi hp trng ngc. Ng t, khng ngon gic, hay m,
d tnh, dy sm, chim bao di tinh. Nc tiu vng, i tin thnh thong to. Li t ru, mch t hi sc.
Nu thin v m h ho vng, ngi bnh thnh thong c cn bc ho, mt mt , au u tng ln. Tm phin, khng ng, d cu gt.
Ming kh, nc tiu , i tin to. Mch huyn t sc.
2.2. Chn on:
- Bt cng: l h nhit
- Nguyn nhn: lo bun, ut c, s hi qu hoc ko di
- Tng ph: can thn m h
2.3. Php iu tr:
- Thin v can thn m h: t b can thn, an thn, c tinh.
- Thin v m h ho vng: t m ging ho, dng tm an thn.
Thc a 16 g ng quy 12 g Khim thc 12 g

en sao 08 g Cht cht 12 g Kim anh 08 g
Bch thc 12 g Long nhn 12 g
H th 12 g To nhn 10 g
Sc ung ngy mt thang, hoc hon vin ngy ung 30g. Liu trnh 20-30 ngy.
Nu do m h ho vng gia Quy bn 20g, Mit gip 20g t m ging ho.
3. Th m dng lng h (Th hng phn v c ch u gim):

3.1. Triu chng: Mt mi, tay chn r ri v lnh, s lnh. Nhc u m , ko di, hoa mt chng mt. Mt ng ton gic. Tr nh gim hoc
nng hn th mt kh nng lao ng tr c v chn tay, n km, chn n, nht ming. Di tinh, lit dng, eo lng au mi. Mch trm t v lc.
3.2. Chn on:
- Bt cng: l h hn
- Nguyn nhn: lo bun, ut c, s hi qu hoc ko di
- Tng ph: thn m dng u h
3.3. Php iu tr: B thn m v dng, an thn, c tinh.
Thc a 16 g trng 10 g To nhn 10 g

Hoi sn 10 g Ba kch 12 g Long nhn 12 g
H th 12 g Cao ban long 16 g Khim thc 12 g
Quy bn 16 g Nhc qu 04 g Kim anh 12 g
Ph c ch 12 g Ph t 06 g
Sc ung ngy mt thang. Hoc tn bt hon vin, ung 30g/ngy vi nc mui nht. Liu trnh 30 - 45 ngy.
4. Phng bnh:
- C gng trnh cng thng, lo u... qu mc, ko di hoc stress.
- Nu khng t khc phc c cc trng thi tm l ny, nn luyn tp kh cng dng sinh c th ly li thng bng tm l.
Quy trinh 83: IU TR BNH MY AY
I. I CNG: y l mt bnh da liu c tnh qu mn thng gp. Lm sng biu hin bng: Ni m ay to nh khng u, c th cc b,
nhng cng c th lan to ton thn, bnh pht t ngt, tin trin nhanh, bin mt cng nhanh v khng li so, bnh ny thuc phm vi
chng n chn ca YHCT.
II. CH NH:
- Bnh s: ngi bnh c th c tin s tip xc thc n, thuc kh nghi gy d ng. C th c tin s mc bnh nhim trng hoc bnh l
nhim. C tin s cc bnh d ng nhng ngi cng gia tc vi bnh nhn.
- Triu chng:
+ Ni m ay xut hin rt t nhin. Nhng tn thng ny c hnh dnh, kch thc khng ging nhau, mu hng nht hoc nh mu da,
ranh gii r, nhiu khi nhng ban m ay dnh lin vi nhau thnh mt mng.
+ Bnh nhn cm thy nga d di, c khi c cm gic nng rt.
+ Tn thng thng tn ti vi gi sau th bin mt v khng li du vt g, c khi pht li nhiu ln trong ngy.
+ Ni pht bnh thng khng c nh, c th cc b, cng c th ton thn, ngay c nim mc cng b nh hng.
+ Triu chng vch da c th dng tnh.
III. CHNG CH NH:
- My ay pht sinh nim mc ng tiu ho, c th gy bun nn, nn, au bng.
- My ay pht sinh nim mc ng h hp c th gy nn kh th.
IV. CHUN B:
1. Cn b y t, y bc s, lng y c o to theo quy nh.
2. Phng tin
- C cc v thuc Bc, Nam iu tr my ay.
- C iu kin v trang b sc thuc.
3. Ngi bnh: c h s bnh n theo mu YHH kt hp YHCT.
V. CC BC TIN HNH:
Sau khi khm bnh bng YHCT (t chn), da vo cc triu chng chia bnh thnh:
1. Th phong nhit:
1.1. Triu chng: bnh pht rt nhanh, my ay mu , nga d di, km theo pht st, bun nn, hng sng au, bun nn, au bng, khi gp
nng th bnh nng ln, ru li vng mng, mch ph sc.
1.2. Chn on bt cng: Biu thc nhit
1.3. Chn on nguyn nhn: Phong nhit
1.4. Chn on tng ph, kinh lc: Ph v
1.5. Php iu tr: Tn lng gii biu
1.6. iu tr bng thuc: Kinh phong phng
Kinh gii 10g Thuyn thoi 04g
Phng phong 08g Ngu bng t 12g
Bch cng tm 08g an b 12g
Kim ngn hoa 12g Ph bnh 12g
Sinh a 16g Hong cm 16g
Cam tho 06g Sc ung ngy 1 thang, chia 2 ln
2. Th phong hn:
2.1. Triu chng: Mu ca my ay nh mu da bnh thng, gp gi, lnh th nng thm. Ming khng kht, cht li bu nht, ru trng,
mch khn.
2.2. Chn on bt cng: Biu thc hn
2.3. Chn on nguyn nhn: Phong hn
2.4. Chn on tng ph, kinh lc: Ph v
2.5. Php iu tr: Tn n gii biu, tuyn ph tn hn
2.6. iu tr bng thuc: Ma hong gia gim
Ma hong 04g Ph bnh 12g

Hnh nhn 10g Xch thc 12g
Can khng b 04g Bch cng tm 10g Sc ung ngy 1 thang, chia 2 ln
3. Th m huyt bt tc:
3.1. Triu chng: My ay hay ti pht, ko di khng khi, bnh hay ti pht v chiu v m. Tm phin, hi hp, hay cu, ming kh, li
, kh, mch trm t. Chng ny thuc v m huyt bt tc, phong t thc biu.
3.2. Chn on bt cng: Biu l tng kim, thin h nhit
3.3. Chn on nguyn nhn: Bt ni ngoi nhn, phong t
3.4. Chn on tng ph, kinh lc: Huyt phn, biu
3.5. Php iu tr: T m, nhun huyt, s tn phong t
3.6. iu tr bng thuc: Lc v gia kinh gii phng phong
Thc a 16g Sn th 08g
Hoi sn 16g Bch linh 12g
Trch t 10g Kinh gii 12g
an b 16g Phng phong 08g Sc ung ngy 1 thang, chia 2 ln
4. Phng bnh:
- C gng tm nguyn nhn trnh tip xc.
- Ch iu tr cc ri lon d dy, rut, bnh k sinh trng, cc ri lon ni tit, cc nhim trng mn tnh.
- Trnh n thc n d gy d ng.
- King ru, ch c, cafe, cay.
- Lun gi cho i tin thng.
Quy trinh 84: PHU THUT TR BNG MY ZZIID KT HP IU TR YHCT
I/ i cng: Tr l nhng cu trc bnh thng ng hu mn. Bnh tr l do nhng cu trc ny b chuyn i sang trng thi bnh l do yu
t c hc lm gin, lng lo h thng nng gy sa bi tr v yu t mch mu lm gin mch gy chy mu. Bnh tr kh thng gp, trung
bnh cc tc gi c tnh khong 50% dn s, nhng ch 10-15% s ngi c tr cn c phu thut v trong s ny cng ch 5-10% l phi
phu thut. Bnh tr nh hng rt nhiu ti cht lng cuc sng ca ngi bnh l: - Gy chy mu khi i tin. - Gy cm gic kh chu
cho ngi bnh vng hu mn trc trng do s tn ti ca bi tr sa ra ngoi.
Hin nay c nhiu phng php iu tr bnh tr nh:
- Ni khoa: Thuc ung, thuc t hu mn
- YHCT: Thuc sc ung, ngm ti ch, p, xng, bi, chm cu,
- Th thut: Tht bi tr, tim s bi tr, nong bi tr
- Phu thut:
Trong phu thut l phng php iu tr c hiu qu v trit nht. Nhng ngi bnh thng rt ngi phu thut m nguyn nhn c bn
nht vn l au sau m. au sau m l vn m phu thut vin rt quan tm trong phu thut. C rt nhiu phng php phu thut tr:
Milligan, Parks, Ferguson, Whitehead, Longo v Longo ci tin.
Dng c phu thut c rt nhiu loi dao in (1 cc, 2 cc), Plasma, Laser, My ZZIID (K thut HCPT), HCPT vit tt ca High frequency-
Capacity- Pile- Treatment (iu tr tr bng dng in cao tn) c p dng m tr Trung quc t 1995 do Phng Ngc Cn- Dalishen thc
hin. Vit Nam PGS.TS. Nguyn Mnh Nhm thc hin m tr bng my ZZIID ti Bnh vin a khoa Trng An t 2004 cho thy m
tr bng my ZZIID c nhiu u im: au t, t chy mu, t nhim khun, mau lin vt thng. Ti khoa Ngoi Bnh vin YHCT TW p
dng m tr bng my ZZIID t 23 thng 9 nm 2005 cho ti nay hn 100 bnh nhn cng cho kt qu tt.
II/ Ch nh: + Tr I,II,III
+ Tr vim nght.
III/ Chng ch nh:
+ Tr III, tr vnh khn.
+ Tr c bnh tim mch, gan, thn mn tnh phi hp.
IV/ Chun b:
1/ V cn b: kp m gm 5 cn b:
- Bc s phu thut: Nm vng k thut ZZIID v bnh l hu mn trc trng.
- Bc s ph m: C kin thc ngoi khoa.
- K thut vin: S dng h thng vi tnh v bm cc chc nng khi thao tc.
- Bc s gy m
- K thut vin ph m.
2/ Phng tin:
+ My ZZIID
+ B kim kp, cm mu, dao in.
+ Thuc gy t ti ch trc v sau khi phu thut (Bubicain v Xanh metilen).
3/ Ngi bnh:
+ c qun trit lm th thut bng phng php ZZIID.
+ c tho tht trc v sau m.
+ c ung thuc an thn.
+ c th test: SAT, khng sinh, thuc gim au.
V/ Cc bc tin hnh:
- Bnh nhn c a ln nh m.
- Theo di mch, HA.
- Nm t th sn khoa
- V sinh vng m (hu mn trc trng).
- Th kim in, kp in, dao in.
- Gy t bng Bubicain vo cc v tr 3,6,9,12.
- Bc l ng hu mn.
- Chp hnh nh cc bi tr trc khi lm th thut.
- Dng kp t cc bi tr.
- Nu chy mu th kp cm mu.
- Chp li hnh ng hu mn sau khi phu thut.
- Tim dung dch 2B18 vo quanh ng m tr.
- Bng p, cm mu.
VII/ Tai bin v d phng:
1/ Tai bin: cng hay gp nh cc trng hp phu thut, th thut khc v vng hu mn trc trng nh:
+ Chy mu: Rm, hoc nh git ngy u, ngy th 5 sau m.
+ au: Thng trng hp tr ngoi nhiu hoc bnh nhn c nhiu bi tr.
+ Tc, rt hu mn: t thuc s ht.
+ Kh tiu tin: nht l khi lm cc bi tr v tr 1,2,3. V cm bng t tu sng.
+ Kh i tin: i tin thng to, au rt hu mn, i tin ra mu.
+ Sng n hu mn: sng n tim dung dch 2B18
2/ Cch d phng
Tu trng hp c th m c cch khc phc.
+ Chy mu: Ngm hu mn (bt ngm tr): t n hu mn, thuc cm mu Vn nam bch dc.
+ au chm t gim au, ngm hu mn nu au do rom ph n, thuc gim au YHCT.
+ Kh tiu tin: chm t b i, chm m vng bng quang, thng tiu
+ Kh i tin: Ngm bt ngm trc khi i tin, ung lc v hon, lc v gia i hong, tht nc m.
Quy trinh 85: XNG HI THUC Y HC C TRUYN
I. i cng: Thng qua hi nng bc ln ca nc thuc YHCT vo da lm ra m hi, lm thng ng th v lm v sinh da ngi
bnh c tc dng phng v cha mt s bnh l c hiu qu cao nhng t tn km.
II. Ch nh, chng ch nh:
1. Ch nh:
+ Cm phong hn (st, s gi lnh, ngt mi, khng c m hi, au u, chn tay thn mnh au mi kh chu, mch ph khn)
+ Mt s bnh l: Ng quan, bnh ngoi da.
2. Chng ch nh:
Ngi b st do nhit (st, s nng, c m hi, kht, mch nhanh) st do m h, tn dch h, ngi suy yu.
III. Chun b:
1. Dng c:
+ 5 n 7 loi l xng: Hng nhu, Cc tn, Ta t, L chanh, L bi, L tre, S, L du, Cy ct ln, mi th 50-100g.
+ Mt ni (xoong) c np, nc va nu nc xng.
+ Chn n, ng chp mt chic bnh nhn trm hoc chp khi xng.
+ Khn kh sch bnh nhn lau kh ngi sau khi xng.
+ Qun o sch bnh nhn thay sau khi kh ngi
+ Bung xng kn gi.
2. Bnh nhn:
+ c hng dn cch xng t lm.
+ Thc hin ng quy trnh t hiu qu v trnh b bng.
3. Thy thuc:
+ Hng dn cho bnh nhn cch xng.
+ Chun b ni nc xng cho bnh nhn.
+ Chun b ch xng cho bnh nhn.
+ Chun b khn, qun o cho bnh nhn.
4. H s bnh n: Theo mu quy nh.
IV. Cc bc tin hnh:
1. Thy thuc:
+ Cho thuc vo ni, nc ngp gn y, y vung kn.
+ t ln bp un si, si 5- 10 pht.
+ Bc ni nc xng si t vo v tr xng.
+ khn kh v qun o sch bn phi bnh nhn.
2. Bnh nhn:
+ B qun o ngoi, ngi trc ni xng ri chm khn kn ngi, u.
+ M h np vung ni, cho hi thuc bc ra t t va vi sc chu ng ca c th.
+ Va ht th su hi nc thuc, va t t m rng ming ni, va quy thuc cho hi thuc ln tng dn to vo mt. Thi gian khong
trn di 5-10 pht.
+ Sau khi thy m hi u, mt, c, ngc, lng tot ra v ngi cm thy d chu, bt au u, th b ni xng ra khi chn, vn ngi nh
trc.
+ Ly khn kh lau sch u, mt, c, thn th.
+ Thay qun o kh sch.
+ B chn trm ngi, song ch gi m, trnh gi lnh t ngt.
+ Ty theo tnh trng sc kho ngi bnh xng 2 ln ngy u tin, sau c th xng mt ln vo cc ngy tip theo cho n khi lnh bnh.
V. Tai bin:
+ Bng do hi nng.
+ Ra m hi khng ngng.
VI. Cch x l:
+ Ra m hi khng ngng.
- Trnh gi la, gi m.
- Nguyn nhn: Thi gian xng lu, v kh b hao tn nn m hi tip tc ra.
- Php iu tr: B nguyn kh.
- Thuc: Ngm 1 lt Sm lt, hoc ung Ch sm.
+ X l bng theo cc phng php thng dng cho bng I, II.
uy trinh 86: IU TR BNG NGM THUC V XNG HI

I i cng: Ngm thuc v xng hi l hai phng php nm trong php cha ngoi ca ng y, thng dng cc thuc c tinh du tc dng
khu phong, tn hn, tr thp, hot huyt, tiu vim, lu thng kinh lc,tc ng ln b phn pha ngoi c th nh da, nim mc, gn c
cha bnh.
T xa xa nhiu s sch ng y vit nam ghi nhn vic s dng nc gi gn, nng cao sc kho v cha bnh nh: Ngm mnh trong
sui nc khong m gim au khp, nhc mi c th, cha mt ng, iu tr cc bnh ngoi da. un nng hn ri cho vo ni nc c
sn mt s cy l thuc to hi thuc xng cha cm, cm, au nhc xng khp. Nhiu bi thuc, cy thuc c nhn dn ta s dng
p, ra bi, tm ngm, xng, hun, cha cc bnh ngoi da, tr, c xng khp, thn kinh,c tc dng tt nh: Nh diu tn, Kh tr tn,
Khi tr thang, Thanh i tn, Ho c tn, Kh sm thang,
Theo Dc in Vit nam III nhiu v thuc dng ngoi c ghi nhn nh: M tin, Huyt gic, u, Long no, i hi, a lin, inh
hng, Qu, Gng hay Ring m, Thin nin kin, Huyt gic, Thng trut,..
Y hc phng ty t nhiu th k p dng tnh cht c hc v nhit hc ca nc tc ng ln mt ngoi c th tr liu, l phng
php Thu tr liu (Hydrotherapy) bao gm nhiu k thut a dng tc ng ton thn hay cc b nh: p, ngm, xng hi, tia nc tr liu,
kh dung,
Theo y hc hin i khi c th c ngm, xng nc nng th xy ra cc tc dng sau:
+ M hi tit ra nhiu, tng cng s bi tit nc tiu do gin mch ngoi vi.
+ Nhp tim tng ln thng qua s kch thch cc c quan th cm da lm tng cng lu thng mu trong c th.
+ Huyt p gim, nhp th tng ln.
+ Gim hng phn ca h thn kinh.
Ngm thuc v xng hi c tc dng kch thch h tun hon, tiu ho, thn kinh, tng cng h thng min dch, tng chuyn ho, chng
vim, chng stress v iu ho c th. c bit ngm thuc gii phng cho c th khi nhng cn au do co gn c, cng khp.
II Ch nh:
1/ Ch nh chung trong ngm thuc:
1.1. Ngm thuc ton thn:
- Vim khp v vim a khp dng thp mn.
- au v vim dy thn kinh mn.
- au lng, au dy thn kinh to cp, mn.
- au do co tht c quan tiu ho v tit niu, sinh dc.
- So co ko, mm ct au.
- Chng stress, an thn, iu tr mt ng.
- Gim bo, gii c.
1.2. Ngm thuc cc b:
- Bong gn, cng khp, teo c, hn ch vn ng.
- Chn thng chi giai on cp, mn, so co cng.
- au dy thn kinh.
- Vim khp: Vim a khp dng thp, bnh Goutte,..
- Mt s bnh ri lon vn mch.
- Tng huyt p, mt ng
- Bnh ngoi da: vim da d ng, t a, nm, chm,
2/ Ch nh trong tm hi:
2.1. Xng hi ton thn:
- Cm mo, au nhc mi ton thn.
- Vim da d ng, trng c, chm,..
- Thp khp, au cng khp.
- au cc dy thn kinh ngoi bin.
2.2. Xng hi cc b:
- au cng khp mn tnh, au lng, au c gy do co cng c,
- au dy thn kinh, t b, gim dinh dng vng chi,
- Chn thng lu ngy gy co cng gy co cng gn c, so co ko,
- Mt s bnh ngoi da: Chm, vim da d ng, nm, trng c,
- Chm sc da, chng lo ho,
Mi mt ch nh c th c c phi tu theo tng phng php, nhit , tnh cht ca dc liu c p dng c cc ch nh tht c th.
III Chng ch nh:
1/ Chng ch nh tuyt i:
- Vim cp v cc chn thng cp tnh.
- Vt thng nhim khun, vt thng h.
- Tc ng mch hay tnh mch bnh nhn i tho ng.
- Cc khi u c tnh, lao tin trin.
- Bnh nhn say ru, tm thn.
2/ Chng ch nh tng i:
- Cc trng hp gim cm gic nng lnh.
- Tr em, bnh nhn tm thn.
- Cc bnh tim mch, h hp, thn (khng iu tr ton thn).
IV Chun b:
1/ Cn b y t:
- C cu t chc: (1-2-2) 1 Bc s, 2 k thut vin, 2 iu dng vin cho 1 c s c 2 n 4 phng xng kh, t, 2 n 4 bn ngm thuc.
- Cn b y t phi c hc chuyn su v thu tr liu ni chung v tm ngm- xng thuc ni ring.
2/ Ngi bnh:
- Bnh nhn phi c khm v chn on ng bnh c ch nh iu tr bng tm xng thuc.
- Bnh nhn trc 1 t iu tr phi c kim tra mch, huyt p, cn nng. c hng dn hiu cch iu tr.
- Trc khi iu tr bnh nhn phi c tm ra sch s, tun th tuyt i thi gian v cch thc iu tr.
3/ Phng tin:
- H thng ni hi vi ng dn hi t tiu chun an ton y t.
- Phng xng hi ton thn m bo kn, c ca bng knh m, p g hoc .Trang b ni tht c gh di bnh nhn c th ngi,
nm. C h thng ci n bo ng, ng h v o nhit phng.
- H thng xng hi cc b t tiu chun quy nh ca B y t.
- Bn ngm thuc ton thn t 150 n 300 lt, cc b t 1 n 50 lt theo tiu chun quy nh ca B y t, c h thng dy ai gi, ng
h bo gi v chung bo ng.
- H thng ging ngh, khn, o tm, dng v sinh c nhn cho mi ln iu tr.
4/ H s bnh n: (H s bnh n c trnh by phn ph lc).
V Cc bc tin hnh:
- Chun b phng, bn ngm (trc khi bnh nhn vo):
+ Nhit phng xng hi t 40 n 650C tu bnh nhn. Thuc dng xng phi thch hp cho tng loi bnh.
+ Nhit bn ngm t 25- 390C tu tng th trng bnh nhn v ch nh iu tr. Thuc phi c sc trc v ho tan u vi nc
trc khi tip xc vi bnh nhn.
- Chun b cho bnh nhn: Bnh nhn phi c tm ra sch s v bc l phn cn c iu tr bng ngm thuc, xng thuc.
- K thut vin hng dn, gii thch, gip bnh nhn bt u quy trnh iu tr vi nhit , thuc, thi gian iu tr thch hp.
- Sau ngm, xng ton thn bnh nhn phi c ngh ngi, th gin v chun b cho qu trnh iu tr tip theo.
VI Tai bin v cc cch x tr:
- Bng do nc qu nng
- Cn phi o nhit trc khi iu tr cho bnh nhn.
- Kit sc do ngm nc qu lu,c th b tru tim mch do gin mch qu mc v tng tit m hi. Khi ngm tm xng xong bnh nhn
phi c nm ngh trong vng 15 n 20 pht trc khi ra v.
- D ng vi thuc ngm
- Bnh nhn phi c khm k v kim tra trc thuc s dng cho c t iu tr.
uy trinh 87: QUY TRNH CHM NGI CU
I. i cng: S dng ngi cu nng p ln vng c th cn iu tr. Tc dng chnh l tc dng nhit. II. Ch nh: + Gim au + Gin c. +
Chun b cho ko gin, tp vn ng, xoa bp.
III. Chng ch nh:
+ Vng mt cm gic.
+ Da b tn thng h.
+ St cao, nhim trng, nhim c.
IV. Chun b:
1. Cn b chuyn khoa: Bc s chuyn khoa phc hi chc nng, k thut vin vt l tr liu.
2. Phng tin:
- Ngi cu l, cnh kh hoc ti.
- Ni nu v cc dng c km theo.
- Cn 70o-90o
- Bn hoc ging nm.
- Khn bng, nilon v cc dng c cn thit khc.
3. Ngi bnh:
Gii thch cho ngi bnh an tm.
ngi bnh t th thoi mi, ph hp vi iu tr.
4. H s bnh n:
V. Cc bc tin hnh:
- Bc l vng iu tr.
- Chm ngi cu: ly ngi cu nng bc li bng ti nilon, t ln vng cn iu tr, dng khn bng qun kn gi trong 20-30 pht.
- C th kt hp xng hi ngi cu hoc p trc tip khi ngi cu khng nng lm.
- Ht thi gian chm: ly ngi cu ra, lau sch vng iu tr, kim tra, ghi bnh n.
VI. Theo di:
Phn ng ca ngi bnh trong khi iu tr phng nga bng.
VII. Tai bin v x l:
Bng: Ngng chm, x l nh bng nhit.
Quy trinh 88: QUY TRNH CT TR BNG LASER CO2
I. i cng: Tr l bnh thng gp chim ti 40% dn s v c cc phng php iu tr t rt sm theo y hc c truyn cng nh y hc
hin i. S pht trin ca khoa hc k thut, c bit l s ng dng laser trong y hc ni chung v c th l ng dng ca laser trong phu
thut tr c p dng v em li nhiu kt qu tt cho ngi bnh.
II. Ch nh:
+ Bnh nhn tr III-IV.
+ Cc bnh nhn tr I-II c iu tr bng cc phng php khc khng kt qu.
III. Chng ch nh:
+ Tr triu chng: x gan,...
+ Cc trng hp mc bnh phi hp c chng ch nh phu thut.
IV.Chun b:
1/ Nhn vin y t:
- Phu thut vin chnh: 01 bc s.
- Phu thut vin ph: 02.
- Dng c vin: 01.
- Bc s gy m: 01.
- Ph m.
2/ Bnh nhn:
- c gii thch k v phng php iu tr.
- Nhn n ung trc phu thut 8 ting.
- K giy m, v sinh thn th.
- Tht tho trc m 24 ting.
3/ Phng tin:
- My Laser CO2 45W.
- Cc dng c ph tr.
- Dng c phu thut chung.
4/ V cm: Tu theo tng trng hp c th:
- Chm t.
- T ti ch.
- T khoang cng.
- T tu sng.
- M tnh mch.
- Ni kh qun.
5/ H s bnh n: y cc mc theo quy nh. Thuc sau m: khng sinh, thuc y hc c truyn, chm t gim au.
V.K thut m:
- T th bnh nhn: nm nga, hai i gp dng.
- Nong hu mn.
- Bc l cc bi tr.
- Gii phng cc bi tr bng laser CO2. Tu theo mc ch cm mu bng hiu ng quang ng hoc ct t chc, phu thut vin iu chnh
tiu c thch hp.
- Khu gc bi tr, ct bng laser CO2.
VI. Tai bin v cch x tr:
1/ V laser CO2:
- Kim tra cc u ni.
- H thng iu khin.
2/ V bnh nhn:
2.1. Trong m:
- Cc trng hp laser CO2 khng cm mu c, c th khu cm mu hoc cm mu bng dao in.
2.2. Sau m:
+ Sm:
- B i: in chm, thng i.
- Chy mu: m cm mu.
+ Mun:
- Chy mu: m cm mu.
- Mnh da tha: ct li.
- Hp hu mn: Phu thut to hnh c tht.
Quy trinh 89: IU TR AU DY THN KINH HNG
I i cng: au dy thn kinh hng l mt hi chng au r thn kinh tht lng V v cng I, au lan t tht lng xung hng dc theo mt
sau i xung cng chn, lan ra ngn ci hoc t (tu theo r b au). Nguyn nhn do thot v a m l hay gp nht, ngoi ra cn do cng
ho tht lng V hay cng I, gai i ct sng, thoi ho ct sng hoc do chn thng ct sng, vim ct sng dnh khp, Theo Y hc c
truyn au dy thn kinh hng cn gi l yu cc thng, to ct phong, to in phong, thuc phm vi chng t. Nguyn nhn do
phong hn, phong thp, phong nhit tha c tu l s h xm ln vo kinh tc Thi dng Bng quang v tc Thiu dng m, hoc do chnh
kh h yu, ri lon chc nng tng ph nht l tng can, thn hoc do lao ng qu sc, trng thng gy huyt , kh lm b tc kinh kh
ca kinh Bng quang, kinh m gy au.
II Ch nh:
au dy thn kinh hng:
- au dc theo ng i ca dy thn kinh hng
- C im au cnh sng
- Du hiu Lasegue (+) 700
- Du hiu Valleix (+).
- Nghim php Bonnet (+).
- Ri lon cm gic c hoc khng.
- Teo c c hoc khng.
III Chng ch nh:
- au dy thn kinh hng do thot v a m c ch nh iu tr ngoi khoa.
- au dy thn kinh hng do bnh ct sng khc: Lao, ung th c chn p tu, bnh ng tu, ang tng huyt p c chn thng ct sng, gy
xng v bin dng.
- au dy thn kinh hng km theo: X gan, suy tim, hen suyn, ung th, tm thn, suy thn, HIV/AIDS.
IV Chun b:
1/ Cn b y t:
- Mc y phc.
- St trng tay.
- ng bn au bnh nhn, gii thch s qua tnh hnh bnh tt, phng php iu tr s p dng, gip ngi bnh yn tm, tin tng.
2/ Ngi bnh:
- Nm sp bc l bn au, c th co nh khp gi hoc k c chn bng gi mm nu bnh nhn au nhiu khng nm thng chn c.
3/ Phng tin:
- Khay inox ng: Hp bng cn, panh, kim chm cm ring tng ngi.
- Kim chm cu: Di 5-6 cm v 10cm.
- My in chm.
- iu ngi hoc n hng ngoi.
V Quy trnh iu tr cc th theo YHCT:
1/ Th phong hn (au thn kinh hng do lnh).
- Chn on bt cng: Biu thc hn
- Php iu tr: Khu phong, tn hn, thng kinh hot lc.
- iu tr:
+ Chm cu: n in chm (dng mi ngi hay n hng ngoi).
+ au theo kinh Bng quang: Huyt dng: Gip tch t L4- S1, Thn du, i trng du, Trt bin, n mn, U trung, Tha sn, Cn ln, Tc
lm khp.
+ au theo hai kinh: Chm kt hp cc huyt trn.
+ Xoa bp: Day, ln, pht, bp bm huyt, vn ng ct sng, vn ng chn.
- Bi thuc: Theo i php lp phng hoc bi Can khng, Thng trut, Ph linh thang gia Qu chi, Xuyn khung.
2/ Th phong hn thp:
(Thoi ho ct sng, cng ho L5-S1 gai i L5-S1).
- Chn on bt cng: Biu thc hn hoc biu l tng kim.
- Php iu tr: Khu phong, tn hn, tr thp, thng kinh hot lc hay khu phong, kin t, tr thp, b can thn.
- iu tr:
+ Chm cu: n in chm, chm cc huyt theo kinh b bnh ging th phong hn. Nu nh hng n can t thn th thm huyt Can du, T
du, Thn du (chm b).
+ Xoa bp ging th phong hn.
- Bi thuc: Dng i php lp phng hay c hot tang k sinh thang.
3/ Th phong thp nhit (vim ct sng, vim khp cng chu,):
- Chn on bt cng: Biu thc nhit.
- Php iu tr: Khu phong, tr thp, thanh nhit gii c, thng kinh hot lc.
- iu tr:
+ Chm cu: in chm nh th phong hn thm: Phong tr, Hp cc.
+ Xoa bp: Nh th phong hn.
- Bi thuc: i php lp phng hoc d thang vi Nh diu thang.
4/ Th huyt (thot v a m, chn thng):
- Chn on bt cng: Thc chng.
- Php iu tr: Hnh kh, hot huyt, thng .
- iu tr:
+ Chm cu: in chm cc huyt nh th phong hn thm: Huyt hi, Cch du.
+ Xoa bp: Ging th phong hn thp thm ng tc ko gin ct sng, xoa bp xong nm bt ng trn ging cng.
- Bi thuc: i php lp phng hoc T vt o hng.
VI Phng php kt hp YHH-YHCT:
* Ch nh:
- Cc trng hp iu tr Y hc c truyn t.
- Cc trng hp au cp, hn ch vn ng nhiu.
* Y hc hin i:
- Giai on khng vim (NSAID): Diclofenac, Voltaren, Feldendng ung hoc tim (khng dng trong cc trung hp c tin s lot d dy
hnh t trng) ch tim bp su, khng nn thu chm cc huyt vng cng chn, tim dng t 1-3 ng (ngy 1 ng).
- Thuc gin c: Mydocalm, Alaxan
- Hoc Vitamin B liu cao, thu chm cc huyt theo kinh b bnh.
- Vt l tr liu: Chiu n hng ngoi, sng ngn, ko gin ct sng nht l trng hp au do thot v a m.
* Y hc c truyn:
- in chm, n in chm, xoa bp bm huyt.
VII Tiu chun nh gi kt qu iu tr:
- Tt: Ht au, i li bnh thng.
- Kh: Cn au khi vn ng, ngh ngi .
- Trung bnh: Cn au c khi vn ng, ngh ngi.
- Km: Khng hoc au tng ln.
Quy trinh 90: IU TR DI CHNG TAI BIN MCH MU NO BNG YHCT
.
I. I CNG: 1. Quan im ca YHH - nh ngha: TBMMN hay t qu (stroke) l du hiu pht trin nhanh trn lm sng ca mt ri
lon khu tr chc nng ca no ko di trn 24 gi v thng do nguyn nhn mch mu. - Hnh thnh t qu t mt trong hai th bnh l
mch mu no; thiu mu no cc b hoc xut huyt. Thiu mu no cc b l nguyn nhn thng gp nht t qu do tc mch mu ti
ch hoc do lp mch t ni khc a n. - Thiu mu no thong qua v t qu cp tnh l nhng bnh cp cu ni khoa i hi phi chn
on ngay do c th iu tr hiu qu khi s dng sm cc thuc. Giai on phc hi v di chng cn c phi hp iu tr nguyn nhn, phc
hi chc nng.
2. Quan im ca YHCT
- TBMMN c YHCT gi l Trng phong, bnh thng gp trung nin ang c xu hng gia tng. Bnh pht sinh trn c s kh huyt ni
h nhn khi ni thng km m pht sinh thnh bnh. Bnh khi pht cp tnh v bin ha mau l.
- Bnh c chia thnh 3 giai on:
* Giai on cp tnh: trong vng 4 tun k t khi pht bnh.
* Giai on phc hi t tun th 5 n na nm.
* Giai on di chng: sau na nm k t khi pht bnh.
II. CH NH:
Trng phong kinh lc hoc Trng phong tng ph giai on phc hi v di chng. i vi YHH bnh nhn t qu giai on bn cp khi
ton trng tng i n nh, tinh thn tnh to.
III.CHNG CH NH:
Trng phong tng ph giai on cp bnh nhn cn trong tnh trng hn m phi iu tr bng YHH.
IV.CHUN B:
1. Cn b y t: Bc s chuyn khoa y hc c truyn
iu dng hoc k thut vin v YHCT, nhn vin phc v.
2. Ngi bnh: c thm khm k v YHH v YHCT
3. Phng tin: Thuc YHCT, my in chm, kim chm cu v mt s y dng c khc phc v cho chm cu. Mt s thuc YHH cn thit (
thuc h p huyt, chng i tho ng). C s cho bnh nhn iu tr ni tr.
4. H s bnh n theo mu ca B y t.
V. QUY TRNH IU TR CC TH BNH THEO YHCT:

Cn phn bit trng phong kinh lc, trng phong tng ph (chng b, chng thot) la chn cc php iu tr thch hp. Trong giai on
phc hi v di chng, phn nhiu bnh nhn l h thc hip tp, Tr liu nn nng cao chnh kh, tr t kh.
1. iu tr bng thuc:
a. Kh h huyt tr, mch lc tr:
- Triu chng: bn thn bt toi, chi mm v lc, sc mt vng nht, hay t tay chn, li nht ta hoc c ban huyt, ru trng, mch t sp
hoc h nhc.
- Phng php iu tr: ch kh, hot huyt thng lc.
- Bi thuc: B dng hon ng thang
Quy v 12g a long 12g
Xuyn khung 12g Xch thc 12g
Sinh hong k 60g Hng hoa 9g
o nhn 9g Thch xng b 9g Sc ung mi ngy mt thang
- Gia gim: Tr m gia Bn h, Xng B, Vin ch.
m h dng cang, mch lc tr:
- Triu chng: Bn thn bt toi, lit cng co rt, ni kh, nhn khu oa t, au u chng mt, tai , li ru vng, mch huyt sc hu lc.
- Phng php iu tr: T m tim dng, hot huyt thng lc
- Bi thuc: H tim hon gia gim:
Thc a 18g Thch hc 9g
Quy bn 13g Ngu tt 12g
Hong b 9g ng quy 12g
Tri mu 12g Sinh mu l 12g
Bch thc 12g o nhn 9g
Ta dng 12g Hng hoa 9g
Trn b 12g
Sc ung ngy mt thang.

Phong m tr khiu, lc mch tr
Triu chng: Li cng, ni kh, chi th t b, nhn khu oa t, li nht ti, ru nhn, mch huyn hot
Phng php iu tr: Tc phong ha m, hot huyt thng lc.
Bi thuc: Gii ng n gia gim
Bch ph t 9g Cam tho 6g
Thch xng b 9g an sm 15g
Vin ch 6g ng quy 12g
Thin ma 12g Xch thc 9g
Ton yt 6g a long 10g Sc ung ngy 1 thang
* Liu php chm cu
Chm cu liu php bao gm c 2 b phn: chm v cu. i vi trng phong u c hiu qu r rt. Giai on no ca bnh cng c th s
dng chm cu.
a. Ho chm
1. Nhn khu oa t (lit mt trung ng)
Tr php: ch ty sung no, s iu kinh cn
Huyt: Phong tr, Thi dng, H quan, a thng, Gip xa, Hp cc bn lnh.
Thao tc: Phong tr chm b, cc huyt chm t, Thi Dng xuyn Gip xa.
2.Tht ngn:
Tr php: iu thn khai khiu
Huyt: Thng tinh, Bch hi, Phong tr, n ng, Kim tn, Ngc dch, Thin tr, Lim tuyn, Thng l
Thao tc: Thng tinh xuyn Bch hi, chch huyt bng kim tam lng huyt Kim tn v Ngc dch, chm t Lim tuyn v Thng l.
3. Lit chi trn:
Tr php: S thng kinh lc
Huyt: Phong tr, Cc tuyn, Xch trch, Hp cc, Bt t, Kin ngung, Khc tr, Ngoi quan.
Thao tc: Hp cc chm hng ti ngn tay ci; Bt t, Ngoi quan, Kin Ngung, Khc tr chm t.
Lit chi di:
Tr php: S kinh thng lc, bi nguyn b thn.
Huyt: Hon khiu, Phong th, Dng lng tuyn, y trung, Tam m giao, Cn ln.
Thao tc: Tam m giao chm b, cc huyt khc chm t
au khp vai:
Tr php: S cn thng t
Huyt: Kin ngung, Nhn trung, Kin trinh, Kin trung du, Kin ngoi du, in khu, a th huyt.
Thao tc: Cc huyt u chm t.
Si ngc (sa st tr tu)
Tr php: Ha m tuyn khiu, kin no sinh ty
Huyt: Bch hi, Thi dng, n ng, Hp cc, Tm du, Thn du, Thn mn, Tc tam l, Ni quan.
Thao tc: cc huyt u chm b.
in chng (ri lon tm thn)
Tr php: L kh gii ut, ch m khai khiu.
Huyt: Thn mn, Phong long, Bch hi, Tm du, Hnh gian, Tam m giao, Tc tam l.
Thao tc: Phong long, Hnh gian chm t; cc huyt khc chm b.
b. Cc bin php chm cu khc:

1. in chm: thng dng cc huyt nh Kin ngung, Khc tr, Ngoi quan, Hp cc, Hon khiu, Phong th, Dng lng tuyn, Tc tam l,
Huyt hi, Thi xung. V ng kinh nn ly th tc dng mnh lm kinh ch. Mi ln chn 2-3 cp huyt, chm c kh ri cho thng in.
Ty theo bnh trng h thc m iu chnh tn s, cng v thi gian kch thch cho ph hp.
2. Thy chm: Thng dng cc huyt nh Gip tch tng ng vi chi lit , Kin ngung, Th tam l, Tha sn, Dng lng tuyn, Gii kh.
Thuc thy chm l sinh t nhm B, ATP.
3. u chm: la chn v tr chm da u tng ng vi vng vn ng, vng cm gic, vng ngn ng.. trn v no bn i din vi chi lit.
V d chn phi lit chm 1/5 trn vng vn ng bn tri, tay tri ri lon cm gic chm 2/5 gia vng cm gic bn phi
4. Nh chm: Chn cc huyt trn loa tai nh tuyn thng thn, tm, can, no, di v, thn mn, h chng th gi kim, thc chng th dng
kch thch mnh nh xung in khng xuyn qua da, in chm, thy chm, chch huyt
5. Cy ch: Thng chn cc huyt nh Tc tam l, Dng lng tuyn, Tha sn, Tam m giao Mi ln cy 1-3 huyt bng ch Catgut. Ch
yu ch nh trong giai on di chng.
c. Xoa bp bm huyt v tp luyn:

C cng dng thc y kh huyt vn hnh, iu ha kinh mch v cng nng cc tng ph rt c li cho s phc hi chc nng ca chi c th
b lit.
B v cn xoa bp l vng u mt lng v cc chi, trng tm l bn lit. Cc huyt nn ch day khi xoa bp l Phong tr, Kin tnh, Kin
ngung, Khc tr, Hp cc, Th tam l (chi trn), Hon khiu, Dng lng tuyn, Tc tam l, Huyt hi, Phong th, y trung, Tha sn, Cn
ln, Gii kh (chi di), Thi dng, Ton trc, phong, Gip xa, a thng ( mt).
Tin hnh cho bnh nhn tp sm t th ng n ch ng ty theo tnh trng ca bnh nhn.
d. D phng:
Vn ng v tp luyn kh cng dng sinh
Lm vic v ngh ngi hp l, trnh lao lc qu .
Ch phng trnh nhng yu t bt li ca thi tit kh hu
+ Khi pht hin cc tin triu trng phong th phi kp thi v tch cc trnh pht trin thnh trng phong thc th.
VI. PHNG PHP KT HP YHCT - YHH:

Giai on cp tnh
Ngoi vic thc hin cc bin php chung ca ty y nh bt ng, m bo h hp, khng ch huyt p, chng ph no, bi ph nc in gii,
chng tc mch (NMN), chng chy mu (XHN), ci thin tun hon c th phi hp thm thuc YHCT: thuc sc, thuc hon (An cung
ngu hong hon)
Giai on phc hi: Ngoi bin php ca ty y nh ci thin tun hon no, phc hi chc nng thn kinh, l liu php nn kt hp chm
cu. xoa bp, tp dng sinh v dng thuc ng y ty iu kin c th.
Giai on di chng: Cc bin php ng y thch hp hn.
VII. TIU CHUN NH GI KT QU:

Tt: Cc chc nng phc hi hon ton c th tr li bnh thng.
Kh: Cc chc nng phc hi di chng t v vn ng, bnh nhn t lm sinh hot c nhn v c th tham gia cng vic.
Trung bnh: Cc chc nng phc hi mt phn cn t di chng v vn ng thn kinh, bnh nhn t lm sinh hot c nhn hoc cn c h tr
t.
Km: iu tr khng c kt qu hoc bnh nhn t vong hoc li nhiu di chng khng t lm c sinh hot c nhn v phi c ngi khc
h tr.
Quy trinh 91: VIM TC NG MCH CHI
I I CNG: Quan nim ca y hc hin i: L mt hi chng bnh gy tn thng thnh ng mch. Bnh c th cp tnh hoc mn tnh.
Hu qu l thnh ng mch b cht hp (gy thiu mu ngoi vi) hoc tc hon ton lng mch (gy hoi t chi) C nhiu nguyn nhn gy tc
ng mch chi. Nhng hay gp l vim tc ng mch chi do x va ng mch (artrio sclro oblitrant) v vim mch gy huyt khi
(thrombo-angite- oblitrant) hay cn gi l bnh Buerge. Quan nim ca YHCT: gi chng thot th nguyn nhn bnh do c t xm phm
hoc do n ung khng iu lm kinh mch b tc kh huyt khng thng t dn ti tm lnh chi, hoi t u chi.
II. CH NH IU TR YHCT:
Tt c cc biu hin ca bnh: tm lnh chi, au nhc, sng n, lot hoi t u chi u c ch nh iu tr.
Nhng tt hn c l iu tr giai on sm (giai on cha c lot hoi t) th t hiu qu tt. Nu giai on mun th kt qu hn ch v
c nhiu bin chng.
III.CHNG CH NH IU TR YHCT:
Hu nh khng c chng ch nh.
IV. CHUN B:
1.Cn b y t:
+ Thy thuc c trnh chuyn mn su. Nm vng l lun YHCT; hiu bit v YHH, c tp hun y c th phn loi th bnh, giai
on bnh ( khi no nn iu tr n thun YHCT, khi no nn iu tr kt hp YHH, khi no nn iu tr ngoi khoa).
+ iu dng: C kin thc, su st ngi bnh, quan st mu sc u chi ( tm, nht) bt mch ngoi vi, theo di th trng ngi bnh, cn
au nhc thng bo kp thi din bin bt thng vi thy thuc. Thc hin y lnh ca thy thuc nht l trn nhng bnh nhn c lot hoi
th, v sinh vt lot hng ngy.
Ngi bnh
+ Tin tng chuyn mn
+ Tun th hng dn ca thy thuc, dng ng thuc ch nh, b thuc l, thuc lo, trnh lnh, ch n ung, vn ng, ngh ngi hp l.
Phng tin:
Cn c nh nhng chuyn ngnh khc.
Ngoi ra cn trang b b my siu m mu c u d mch mu gip thy thuc lm sng trong chn on v iu tr.
Cn c 1 phng tiu phu rng v sinh vt lot hng ngy cho ngi bnh. Khi cn c th ct lc tiu phu ti ch.
Yu cu ca phng tiu phu:
+ Cc dng c panh, kp phu tch, dao m, ko, khay ng dng c, bng, cn 700, nc mui sinh l. Oxy gi, dung dch st khun
Betadine, bng dnh, gng tay, khu trang
+ Mt t hp dng c ngay ti ch
+ C h thng chu ra, ng nc sch v nc thi ra dng c ti ch.
+ n tng sng.
+ n hng ngoi tit trng sau cc th thut.
H s bnh n:
Gm 2 phn YHCT v YHH
V h s bnh n YHH: c in sn m hnh m t hnh nh tn thng ngoi vi,
V.QUY TNH IU TR THEO CC TH YHCT:
Trn lm sng chia 2 th chnh:
Th thp nhit.
Th hn thp.
Th thp nhit:
Tc nhn gy bnh ch yu l thp, nhit. Thp nhit gy cn tr tun hon kh huyt lu thng trong kinh mch. Lu ngy kh huyt b tc
khng nui dng c u chi gy lot hoc hoi t u chi.
Triu chng ch yu gm:
+ au nhc lin lc trong nhiu ngy.
+ Da u chi tm ti, sng n ngn hoc phn bn tay hoc bn chn.
+ Ton thn c st hoc khng st.
+ Mi kh kht nc hoc thch ung nc mt.
+ Li ru vng dy, kh, dnh, thn li bu vi cht li tm.
+ Mch 3 b hot sc.
+ Ti ch: - Lot hoi th rng, r dch m vng c, dnh, hi.
- Mch vng chi b bnh p yu hay khng s thy.
Phng php iu tr: Thanh nhit, tr thp, hot huyt ha .
Bi thuc 1:
Kim ngn hoa 12g o nhn 12g
Hong cm 12g Hng hoa 8g
Th phc linh 12g Huyn sm 12g
T gii 12g Sinh a 12g
Quy v 12g Trn b 6g
Ngu tt 12g Cam tho 6g
Sc ung mi ngy 1 thang
Bi thuc 2:
T diu dng an thang gia gim:
Kim ngn hoa 12g Huyn sm 12g
ng quy 12g Cam tho 6g
Sc ung mi ngy 1 thang.
Tc dng ca bi thuc: Thanh nhit, gii c, hot huyt, ch thng.
Bi ny dng tt cho bnh thot th c l lot, nhit thnh. Nu hn ngng th khng dng bi ny.
Gia gim: Nu huyt nhiu (da tm, li tm) th gia thm cc v: Hng hoa 8g, o nhn 12g, Huyt gic 12g, T mc 12g.
Nu au nhiu gia thm: dc 10g, Nh hng 8g, Mc hng 8g.
Th hn thp: Tc nhn gy bnh ch yu l hn th tr lu ngy lm kh huyt khng thng dn n b tc m pht sinh ra bnh.
Triu chng ch yu gm:
+ au nhc m , tng nhiu v m, gn sng.
+ u chi gi lnh, tri lnh au tng.
+ Da u chi trng nht hay trng tot.
+ Lot cht nng, r dch t, long.
+ S lnh, thch m nng, thin n.
+ Li ru trng dnh, c im huyt.
+ Mch trm sc, mch vng chi b bnh p yu hoc khng s thy.
Phng php iu tr:
Tn hn, tr thp, hnh kh, hot huyt.
Bi thuc 1:
Kim ngn hoa 12g o nhn 12g
Xuyn khung 12g dc 10g
Qu chi 6g Mc hng 8g
o nhn 12g Cam khng 8g
Bch ch 8g Thc a 12g
i to 12g
Bi thuc 2:
T vt o hng gia gim:
ng quy 12g o nhn 10g
Xuyn khung 12g Hng hoa 8g
Thc a 12g Xch thc 12g
Nu huyt nhiu gia thm: an sm 12g, Huyt gic 12g
Nu lnh chi nhiu: gia thm Ph t ch 8-10g, Qu chi 6-8g, Mc hng 8g
*Bi thuc dng chung cho c 2 th bnh
1. Bi Cao thng u (dng cao lng)
Thnh phn:
Kim ngn hoa Phng sm
Th phc linh Qu chi
T gii Hong tinh
Binh lang Thc a
o nhn Cam tho
Thng ma Thch xng b
H th ng knh
Hng hoa Ru 400
Tam lng
+ Tc dng:
Tiu vim, thanh nhit.
Hot huyt, trc huyt .
B kh huyt.
Ch thng (gim au)
Dng tm, an thn.
Tr thp, li tiu.
Tuyn thng kinh lc.
+ Ch nh dng:
Huyt , huyt tr.
Kh tr km huyt .
Cc chn thng c t huyt.
Chng t (au nhc xng khp).
au thn kinh ngoi bin.
+ Chng ch nh:
St cao trn 390 C.
Tng huyt p, huyt p ti a >= 180mmHg
Vin lot d dy, t trng.
Rong huyt, xut huyt.
Ri lon ng mu.
Bnh i tho ng.
Ri lon chc nng gan thn.
Ph n c thai trong 3 thng u.
+ Cch dng:
Ngy ung 40-80 ml chia 2 ln: bui sng trc hoc sau ba n, ti 1 gi trc khi i ng.
2.Bi 2: B huyt mch (dng vin t)
+ Thnh phn:
Thc a Xuyn khung
Ngu tt Lin nhc
Hoi sn Cam tho
Phng sm Mc hng
+ Tc dng: B kh, dng huyt, thng mch.

Cch dng: Ngy ung 20g; chia 2 ln sng, chiu.
+ Ch : Cn phi hp cc thuc trn vi thuc thang trong vng 3-4 thng
VI.PHNG PHP KT HP YHH VI YHCT:
giai on III, IV c l lot, hoi th rm r cn kt hp thm thuc YHH.
Cc thuc kt hp:
1.Khng sinh: S dng khi c vim lot, sng n, r dch nhiu
Gm:
Cefazolin l 1g
Cefotaxim l 1g
Ceftriaxon l 1g
Dng 1 trong 3 loi trn, liu lng 2g 1 ngy x 10 ngy, tim tnh mch chia 2 ln sng, chiu (th phn ng trc khi tim).
2.Cocticoid:
Presnisonlon 5mg
4 ngy u mi ngy ung 4 vin chia 2 ln sng, chiu (sau ba n).
4 ngy tip theo mi ngy ung 3 vin, 2 vin sng, 1 vin chiu.
4 ngy tip theo ung 2 vin chia 2 ln sng chiu.
2 ngy cui mi ngy ung 1 vin vo bui sng.
3. Cc thuc ci thin tun hon ngoi vi:
Fonzylane ng 50mg/5ml x 4-6 ng pha vi 500ml dung dch 5% hoc mui Nacl 90/00.
Truyn tnh mch (tun truyn 2-3 ln).
4. Chng kt tp tiu cu:
Aspecgic 100mg x 2 gi/ngy ung sng, chiu sau ba n.
Hoc Dipyridamol 75mg/ngy (vin 25,50, 75mg).
5. Gim au:
Aspirin pH8 0,5g x 2-4 vin/ngy.
Efferalgan Codein 500mg x 2-4 vin/ngy.
Ch v sinh lot hng ngy.
Nu vt lot hoi th c nhiu m.
Ra oxy gi cho sch m.
Ra li bng nc mui sinh l.
Thm kh.
Nh Betadine st khun ln b mt vt lot.
p gc tm m khng sinh ln vt lot bng li.
C th thay m khng sinh bng l M qu ti (ra sch, b cung, gi nt ri ly tht l nhuyn p vo vt lot, ln 1 ngy)
VII.TIU CHUN NH GI KT QU IU TR:
Loi A: Kt qu tt.
Lm sng:
+ Ht cc triu chng ri lon cm gic u chi (ht au rt, gi lnh chi).
+ Ht tm ti, ht sng n (da chi hng).
+ Ht au cch hi chi.
+ Th c lot th vt lot lin so.
+ Vn ng chi ht au, gim teo c.
+ i b c trn 1000m.
+ Cn lm sng: S lng bch cu gim, bch cu a nhn trung tnh gim, tc mu lng gim.
+ Siu m mch: Tn thng hp lng mch c ci thin tt, tun hon lu thng tt hn.
Loi B: Kt qu kh.
+ Lm sng:
Th cha lot: gim tm ti, gim au nhc, gim gi lnh chi, da chi m hng hn, vn ng chi cho au nhc (i b c trn 500m).
Th c lot: Vt lot gn lnh, cn au t, cc ri lon dinh dng v cm gic ri lon u chi gim.
+ Cn lm sng: S lng bch cu gim t, t l bch cu a nhn trung tnh gim.
+ Doppler mch c tin b hn.
Loi C: Kt qu khng ng k hay khng c kt qu.
Cn lm sng: s lng bch cu v mu lng khng gim.
Siu m mch: Nh c.
Loi D: Bnh nng thm phi chuyn phng php iu tr.
Quy trinh 92: HEN PH QUN
I. i cng: 1. Quan nim ca YHH: Hen ph qun l trng thi lm sng ca s phn ng cao ph qun do nhiu kch thch khc nhau.
Biu hin lm sng c trng l kh th, ting c c, ph n nim mc ph qun v tng tit nhy ph qun. Hin nay ti Vit Nam t l hen
ph qun khong 2-6% dn s v >10% tr em.
Ngh n hen ph qun khi c mt trong cc du hiu sau:
+ Cn hen vi c im: c tin triu ht hi s mi, kh th chm th th ra.
+ Ting th rt (tr em c vim ph qun co tht > 3 ln)
+ Tin s c mt trong cc triu chng sau:
Ho v m > 3 ln
Ting rt ti pht
Kh th ti pht
Nng ngc nhiu ln
+ Khm thc th: Trong cn hen ting ran rt, ran ngy 2 bn phi, r ro ph nang gim. Ngoi cn khng nghe thy g
Thm d chc nng h hp c ri lon thng kh tc nghn vi FEV1 <80%, FEV1/VC <70%, FEV1 tng > 15% sau khi dng salbutanul
400mg.
2. Quan nim ca YHCT
+ Hen ph qun thuc phm vi chng ho suyn, m m
+ Nguyn nhn do nhim phi ngoi t, n ung, tnh ch bt thng nh hng n cng nng ca tng ph v thn: Ph tuyn ging, thn np
kh khi ph kh nghch, thn khng np kh dn n kh th tc ngc
Ngoi ra cn do t h khng vn ho thu cc, thn (+) h khng n t dng lm m m tr gy m nghch, kh th, tc ngc.
+ YHCT quan nim trong cn hen ph qun l chng thc; ngoi cn hen l chng h.
II. Ch nh:
Trong cn hen ph qun phi hp YHH vi YHCT (Thuc thang, chm cu, xoa bp).
Ngoi cn dng cc thuc YHCT tng cng chc nng ca tng ph, t, thn.
III. Chng ch nh:
Phi iu tr bng YHH khi bnh nhn c cn hen ph qun nng cp vi cc biu hin:
+ Kh th khi ngh ngi, ngi ci v pha trc (tr em b b) kch thch n, ln ln, th chm hoc tn s th >30 ln/1pht.
+ Ran rt gim hoc mt.
+ Mch > 120 ln /pht (>160 ln/ 1 pht tr s sinh).
+ LL < 60% gi tr l thuyt, ngay sau khi iu tr ban u.
+ p ng thuc gin ph qun chm v duy tr < 3gi.
+ Khng ci thin triu chng 2-6 gi sau khi dng Coticoid ton thn.
+ Din bin nng dn ln.
IV. Chun b:
1. Cn b y t: Cn 01 bc s v 01 y t
2. Ngi bnh: t th bnh nhn thy d chu.
+ Ngi ci v pha trc.
+ T th 1/2 nm 1/2 ngi.
+ ng vin ngi bnh an tm iu tr.
3. Phng tin:
* Theo YHH:
+ Thit b cung cp oxy.
+ Bnh xt Ventoline hoc Terbutalin.
+ Thuc kh dung: Fulmi CH 500mg.
Bricanyl 2,5mg 5mg.
Atrovent nang gin ph qun.
+ Coticoid: solumedrol .
+ Thuc bi ph nc in gii: NaCL 90/00, Glucoza 5%
+ Thuc Diaphylin, Theophylin
+ B dy truyn, bng, cn, panh
* Theo YHCT:
+ Thuc thang.
+ Kim chm cu, mi ngi.
4. H s bnh n: B h s bnh n theo ng quy ch ca B Y t.
V. Quy trnh iu tr cc th theo YHCT:
Trong cn hen: Cn hen xut hin t ngt, kh th ra km ting c c, ngc y tc, khng nm c v m hi, sc xanh nht chia 2 th:
* Hen hn: Ngi lnh, sc mt trng bch, ho m trng long d khc, khng kht, i tin nt, ru li trng nht, ru mng, mch huyn t.
Php iu tr: n ph, tn hn, tr m, bnh suyn.
Bi thuc: T t ging kh thang.
T t 12g Hu phc 8g
Qut b 8g Qu chi 12g
Bn h ch 8g Ngi cu 12g
ng quy 10g Gng 4g
Tin h 10g i to 12g
Sc ung ngy 1 thang
Chm b cc huyt: Thin t, Chin trung, Phong mn
nh suyn, Lit khuyt, Tam m giao
Phong long, Tc tam l
Cu: Ph du, Cao hoang, Thn du.
* Hen nhit: Ngi bt rt, s nng, mt mi , m dnh vng, ming kht, i tin to, li , ru vng dy, mch hot sc.
Php iu tr: Thanh nhit tuyn ph, ho m nh suyn.
Bi thuc: Kin t gia bn h gia thang.
Ma hong 8g Hnh nhn 10g
Thch cao 20g T t 8g
Bn h ch 6g Gng ti 4g
X can 10g i to 12g
nh lch t 8g
Sc ung ngy 1 thang
Chm t cc huyt: Trung ph, Thin t, Chin trung, nh suyn, Ph du, Xch trch, Thi uyn, Phong long, Hp cc.
VI. Phng php kt hp YHH vi YHCT:

- Ti cc c s YHCT ch nn iu tr cc cn hen nh v trung bnh. Cc cn hen ph qun nng nn chuyn n cc c s YHH.
- Trong iu tr lc cn hen ang xy ra nn s dng cc phng php iu tr bng YHH sau mi s dng cc phng php YHCT.
* Vi cn hen trung bnh.
YHH: Salthitamil (Ventolin MD) 2 nht 1 ln lc bnh nhn ht vo su, sau 15 pht bm tip 2 nht nu bnh nhn cha . C th bm xt
2-3 ln/1gi u.
Dng Pretnisolon 5mg x 4-6 vin/24h ung sng lc no (ch trng hp bnh nhn c bnh l d dy t trng).
Th oxy 2-4 lt/1 pht nu ngi bnh thiu oxy.
C th dng Theophylin nu khng c thuc cng b2 dng xt (thn trng trong nhng trng hp dng Theophylin thng xuyn).
YHCT: Phn loi th: Hen hn hay hen nhit s dng bi thuc cho ph hp, cng nh s dng cc cng thc chm cu, xoa bp.
* Vi cn hen nng - cp: Chuyn cc c s YHH iu tr, trc khi chuyn c th phi s dng cc thuc sau:
+ t ng truyn TM NaCL 90/00; Glucoza 5%: 2 lt/24h.
+ Th oxy 2-6 lt/1pht.
+ Kh dung Bricanyl 2,5-5mg + 4ml NaCl 90/00 lc u 15 pht/1ln sau 1h/1 ln. Fulmicor 500mg x 4 nang/24h cch 6h/1ln.
+ Solumedrol 40mg x 3 ln/24h tim tnh mch.
+ Thuc gin ph qun Atrovent x 4 nang/24h.
+ Diaphylin 0,6mg/kg/24h truyn tnh mch lin tc.
+ Sau khi cn hen dt mi s dng cc thuc YHCT b ph, thn, t, b tr.
VII. Tiu chun nh gi kt qu iu tr:
Da vo bng phn loi mc nng nh ca cn hen phn loi kt qu iu tr nh sau:
+ Tt:
Bnh nhn ht kh th.
Tn s th tr v bnh thng 18-20 ln/pht.
Bnh nhn c th ni chuyn bnh thng tnh to.
PaO2 > 99% lu lng nh bnh thng.
+ Kh:
Bnh nhn cn kh th khi i li c th nm nga c.
Tn s th 23 ln/pht.
Bnh nhn c th i thoi c.
Tri gic kch thch nh.
Lu lng nh 80% gi tr bnh thng dao ng < 20%.
+ Trung bnh:
Ngi bnh thch ngi.
Ni tr li tng cu, khng lin tc.
Tn s th > 23 n 30 ln/pht.
Tri gic kch thch, bn chn.
Lu lng nh > 60%; < 80% gi tr l thuyt giao ng > 30%.
+ Km:
Khng p ng vi iu tr.
Kh th lin tc, bnh nhn ngi ci v pha trc.
Tn s th > 30 ln/pht.
Din t t ng kh khn tr li tng t mt.
Tri gic kch thch: ng g, l ln.
Lu lng nh < 60% gi tr l thuyt dao ng > 30%.
Quy trinh 93: IU TR VIM QUANH KHP VAI BNG PHNG PHP YHCT KT HP YHH
I. i cng: Vim quanh khp vai (VQKV) thuc nhm bnh thp ngoi khp, theo phn loi ca YHH. VQKV thng l mt cm t ch
tt c nhng trng hp au v hn ch vn ng khp vai do tn thng phn mm quanh khp, ch yu l gin c, dy chng v bao khp.
Theo nh ngha ny, VQKV khng bao gm nhng bnh c tn thng ca u xng, sn khp v mng hot dch (chn thng, vim khp
nhim khun, vim khp dng thp, vim ct sng dnh khp). Da vo triu chng lm sng bnh c phn lm 3 th: VQKV th n
thun, VQKV th nghn tc v VQKV c hi chng vai tay. Chn on VQKV da theo tiu chun lm sng chn on ca Boissier MC 1992.
Theo YHCT, bnh thuc phm vi chng Kin t. Gm ba th l kin thng, kin ngng v hu kin phong, tng ng vi ba th ca YHH.
Do chng ny thuc phm vi chng t, nn nguyn nhn cng do phong, hn, thp kt hp vi nhau lm b tc kinh lc gy ra. Giai on u
phong hn thng, bnh nhn au l ch yu (kin thng): giai on sau hn thp thng, hn ch vn ng l ch yu (kin ngng). Lu ngy cc
t kh ny lm tc ng lu thng kh huyt, kh huyt khng nui dng cn c, gy ra th hu kin phong.
II. Ch nh:
Nhn chung: iu tr VQKV bng phng php YHCT c ch nh rng ri cho hu ht cc trng hp bao gm cc nguyn nhn gy VQKV
c th nh sau:
1. Ti ch:
- Chn thng: Thng l vi chn thng do ngh nghip, thi quen, ng tc th thao i khi c th do chn thng mnh vo vng vai.
- Vim gn, thoi ho hoc vi ho phn mm quanh khp.
- Thi tit: lnh, m.
2. xa:
- Cc tn thng thn kinh: Lit na ngi do di chng ca tai bin mch mu no, chn thng s no, vim no-mng no y l tn
thng th pht do ri lon vn ng gy ra. Chn p cc r thn kinh cng t sng c do thoi ho, vim, u cc t sng c.
- Chn thng bn ngn tay, c tay.
3. Khng r nguyn nhn: Chim khong 15% bnh nhn.
III. Chng ch nh:
iu tr VQKV bng phng php YHCT an ton v hiu qu, ch cn lu nhng chng ch nh chung ca phng php chm cu.
- Cc trng hp bnh l thuc din cp cu.
- Ngi c sc kho yu, thiu mu, ngi c tin s nhi mu c tim, bnh ng mch vnh, vim mng ngoi tim, ph n c thai.
- C th trng thi khng bnh thng nh: va lao ng xong, mt mi, i
IV. Chun b:
1. Cn b y t:
- Thm khm ton din, hi bnh, a ra chn on v ch nh phng php iu tr cho ngi bnh.
- Nn chn t th thun li nht c th thc hin th thut chm, cu, xoa bp, thu chm c d dng.
2. Bnh nhn:
* Lm mt s xt nghim: Xt nghim thng quy, Xquang khp vai, siu m khp vai.
* La chn t th sao cho thoi mi nht, chu c lu v phi bc l c r vng cn chm. Thng c mt s t th nh sau:
- Ngi nga da gh.
- Ngi thng lng.
- Ngi co khuu tay trn bn.
- Nm nghing.
3. Phng tin:
- Kim chm cu, my in chm, iu ngi cu.
- Bm tim, bng, panh, cn 700 st trng.
- Khay ng dng c.
- Phng tin sc thuc.
4. H s bnh n: Theo mu bnh n quy nh.
V. Quy trnh iu tr cc th bnh VQKV bng phng php YHCT kt hp YHH:
1. Th Kin thng: tng ng vi VQKV n thun

- Php iu tr: Khu phong, tn hn, tr thp, n thng kinh lc.
- Bi thuc:
Khng hot 8g Ngh vng 12g
Qu chi 6g Trn b 8g
Phng phong 8g Th phc linh 12g
Bch ch 12g Sinh khng 6g
Hong k 16g Cam tho 6g
Xch thc 12g
Sc ung ngy mt thang
- Phng php khng dng thuc:
+ Chm cu:
Th thut: Chm t.
Huyt: Kin tnh, Kin ngung, Kin trinh, Thin tng, Trung ph, T nhu, C ct, Vn mn, A th
C th ho chm, n chm, in chm, nh chm, trng chm Nhng in chm c kh nng gim au tt nht.
+ Xoa bp bm huyt:
Th thut: Xt, day, ln, bp, vn, vn ng, bm huyt (cc huyt chm cu).
ng tc cn lm nh nhng, khng gy au tng cho bnh nhn.
+ Thu chm:
Thuc: Vitamin B1, B6, B12, thuc gim au chng vim khng cha Corticoid.
Huyt: Thin tng, Kin trinh, T nhu, i chu
Vi th ny chm cu l chnh, xoa bp l ph, nu xoa bp phi lm nh nhng.
2. Th Kin ngung: tng ng vi VQKV th nghn tc

- Php iu tr: Tr thp, tn hn, khu phong, th cn hot lc
- Bi thuc:
Khng hot 8g Xuyn sn gip 8g
Phng phong 8g Qu chi 6g
Xch thc 12g Bch ch 12g
Ngh vng 12g Sinh khng 6g
ng sm 16g Bch trut 12g
Trn b 8g Cam tho 6g
Sc ung ngy 1 thang.
- Phng php khng dng thuc
+ Chm cu: Chm b cc huyt nh th kin thng.
+ Xoa bp: rt c tc dng vi th ny.
- Th thut: Xt, day, ln, bp, vn, bm huyt, rung, vn ng. Trong vn ng m khp vai l ng tc quan trng nht. Tng dn
cng , bin vn ng khp vai ph hp vi sc chu ng ti a ca bnh nhn.
- Bnh nhn cn phi hp tp luyn tch cc, kin tr, nht l cc ng tc m khp s c kt qu tt.
3. Th Hu kin phong: tng ng vi VQKV th c hi chng vai tay

- Php iu tr : B kh huyt, hot huyt tiu
- Bi thuc:
Thc a 16g o nhn 10g
ng quy 10g Hng hoa 10g
Bch thc 12g Xuyn khung 16g
ng sm 10g Hong k 16g
Sc ung ngy mt thang
Bn tay ph n nhiu, au nhc gia Khng hot 16g, Uy linh tin 12g tng sc tr phong thp, ch thng.
Bn tay bm tm, li tm c im huyt gia T mc 10g, Ngh vng 8g tng sc hot huyt tiu .
- Phng php khng dng thuc:
+ Chm cu: l bin php kt hp, dng khi au nhiu.
Th thut: Chm b
Huyt: nh th kin ngng, thm: Khc tr, Th tam l, Ngoi quan, Dng tr, Hp cc bn au.
Xoa bp: L ch yu
Th thut: nh th kin ngng, c xoa bp thm bn tay.
Ch nn lm sau khi bn tay ht bm tm, ph n trnh cc tn thng th pht nh teo c, cng khp.
Bnh nhn cn kt hp t xoa bp, tp vn ng bn tay, khp vai.
th ny nn kt hp cc vitamin nhm B, thuc gim au chng vim khng cha Corticoid ng ung cho bnh nhn.
VI. Tiu chun nh gi kt qu:
Nm 1987, Constant v Murley cng b phng php lm sng nh gi chc nng vai v c hi ngh khp hc ca SECEC chp
nhn v cn c gi l tiu chun Constant. Tiu chun ny ngy nay c cc tc gi trn th gii v Vit Nam cng nhn p dng.
Constant v Murley nh gi chc nng vai da trn 4 tiu chun chnh l: au, hot ng cuc sng hng ngy, tm vn ng khp vai,
lc vai vi tng s im l 100. Tiu chun ny c nh gi trc v sau iu tr vim quanh khp vai v phn loi kt qu iu tr 5 mc
:
- Rt tt: 95 - 100 im
- Tt: 85 - 94 im
- Kh 75 - 84 im
- Trung bnh 60 - 74 im
- Km < 60 im

DANH MỤC QUY TRÌNH KỸ THUẬT Y HỌC CỔ TRUYỀN

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DANH MỤC QUY TRÌNH KỸ THUẬT Y HỌC CỔ TRUYỀN

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DANH MC QUY TRNH K THUT Y HC C TRUYN

( Ban hnh km theo Quyt nh s: 26/2008/Q-BYT

STT Quy trnh Trang

Quy trinh 02: VNG CHN

Quy trinh 03: VN CHN

Quy trinh 04: VN CHN

1. L do i khm bnh v hon cnh xut hin bnh:

- L do chnh lm ngi bnh lo lng v phi i khm bnh, mc bnh ca l do ny

2. Din bin bnh:

o Din bin ca triu chng chnh:

- Xut hin t bao gi, trong hon cnh no?

o Din bin ca triu chng km theo:

o Cc phng php iu tr s dng v kt qu:

- i tin kh thuc thc.

Phn to hay lng:

- Kh (to) hn bnh thng l nhit va, nu bn li tng hn l nhit nng.

Tnh cht phn:

- Nc tiu trong, i nhiu: hn

Thi gian i tiu: i tiu nhiu v m, hay i dm... l thn h

o Hi v gic ng: tm hiu v mt ng, ng d hoc ng hay m

- Ngi lun mt mi, ng nhiu l kh h.

- Khi no bt u c kinh, sch kinh cha, khi no?

o Kh h (i h): mi v mu sc, tnh cht ca kh h ?...

- Trong long, tanh l h hn,

- Tnh hnh sinh : s ln c mang, ln ? C hay khng c kh ? S ln sy, no ht thai ?

Quy trinh 05: THIT CHN

- Tng khn: xem chung c 3 b nhn nh tnh hnh chung

o nng su ca mch: mch ph v mch trm

o Tn s mch: mch tr v mch sc

- Mch tr: l mt hi th c 3 mch p (khong di 60 ln/pht), thuc v hn chng

o Cng mch: mch h v mch thc

o cng mm ca mch: mch huyn v mch khn :

Quy trinh 06: CHN ON BNG Y HC C TRUYN

Quy trinh 07: K N THUC Y HC C TRUYN

ca cc v thuc trnh tai bin v thuc.

YHH nh iu tr ung th, iu tr sau phu thut

III. CHNG CH NH:

- Cc bnh khng ung c c th dng tim.

- Bnh nhn d ng thuc.

- Bnh nhn s ung thuc YHCT.

4.2. Phng tin

- Phng khm, gi bt mch

4.3. Bnh nhn

- C h s bnh n Y hc hin i v Y hc c truyn.

- Phi c n lu ghi y liu lng.

th dng mt trong cc cch k n sau:

5.1. Cch k n theo toa cn bn

5.1.1. Cu to bi thuc: gm hai phn:

- Phn iu ho c th l phn c bn gm 6 tc dng

- Phn tn cng bnh

5.1.2. Cch s dng:

5.2. Cch k n theo nghim phng

5.3. Cch k n theo gia truyn

5.4. Cch k n theo c phng

Cc bi thuc ny c qun thn t s r rng.

dng bi Lc v, nhng nu mt ng th thm Vin ch hoc To nhn, nu di tinh th b Trch t ho c gi m li u, cc bi thu c c ph ng c th

bn ra th trng khng phi th c tnh cp v bn trng din.

5.5. Cch k n thuc theo i php lp phng

tin phn nt v sng, tay chn lnh, mch trm t.

+ Chn on tng ph: T v h

- Php iu tr: n trung, kin t, tiu thc v an thn

va l Qun do tc dng n trung.

5.6. Cch k n thuc theo kt hp YHCT vi YHH