Nasalhemorrhage鼻出血【诊断要点】【辨证论治】

Nasalhemorrhage

鼻出血

Main points for diagnosis   

【诊断要点】

1. If nasal hemorrhage is mild,the nasal blood drops; if it is severe, nasal bleeding is very profuse. Somepatients may have the accompanying symptoms os dizziness, fatigue, andpalpitation, etc. In severe cases, hemorrhagic shock may occur.

   鼻腔出血，轻者点滴而下，重者鼻衄如涌。有的患者可伴头昏、乏力、心慌等症状。严重者可出现失血性休克。

2. Examination of the nasal cavitymay discover blood spots. For juveniles, bleeding mostly occurs on theanteroinferior part of the nasal septum; for middle-aged and old people,hemorrhage largely happens in the naso-nasopharyngeal plexus of the posteriornasal part.

   鼻腔检查可以发现出血点，青少年出血多发生在鼻中隔前下方，中老年出血则以鼻腔后部的鼻-鼻咽静脉丛为多见。

3. While examining the nasalcavity to look for blood spots, check whether there exist deviation of nasalseptum, tumour of the nasal cavity and nasopharynx or not.

   检查鼻腔在寻找出血点的同时，可检查有无鼻中隔偏曲、鼻腔和鼻咽肿瘤等情况。

4. The discovery of the cause ofbleeding may be assisted by blood routine examination, platelet count test,bleeding time test, coagulation time test, electrocardiogram, liver functiontest, kidney function test as well as X-ray film of the nasal part.

   检查血常规、血小板计数、出血和凝血时间、心电图、肝、肾功能及鼻部X线摄片等，有助于明确出血原因。

Differentiating syndrome to decide treatment

【辨证论治】

The commonly-seen syndromes of nasal hemorrhage include excessive heat oflung meridian, excessive fire of the stomach, liver fire stirring the upper,yin deficiency of the liver and kidney, failure of qi to keep blood circulatingwithin blood vessess, etc. The first three types belong to acute onset, andtreatment should be purging the lung heat, stomach fire and liver firerespectively; the last two types mostly pertain to chronic bleeding, andnourishing yin and clearing away heat should be used for yin deficiency of theliver and kidney, while invigorating qi should be adopted for failure of qi tokeep blood circulating within blood vesels.

鼻出血的常见证型有肺经热盛、胃火炽盛、肝火上扰、肝肾阴虚和气不摄血证等，前三型为急性发病过程，治疗应分别清泄肺、胃、肝火；后两型多为慢性出血，肝肾阴虚者应滋阴清热，气不摄血者应补气摄血。

TO BE CONTINUED。。。

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