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href='/'>醫(yī)學(xué)教育網(wǎng)</a> > <a href='/zhongyiyishi/shicheng/'>中醫(yī)師承</a> > <a href='/zhongyiyishi/shicheng/sichuan/'>四川</a></div> </div> <div id="nr8ed3s" class="layout clearfix msf new-wrap"> <div id="z3trtuy" class="new_left fl"> <div id="zbyfa83" class="news_mian"> <div id="bkoilki" class="tit"> <h1>請(qǐng)敘述產(chǎn)后小便不通的問診——四川省2021年傳統(tǒng)師承考試?？?/h1> <div id="l85ooqp" class="mark clearfix"> <div id="jp0e5pr" class="fl"> <span id="tzdlij8" class="time">2021-04-26 15:42</span> <a href="http://thedailypurge.net" title="醫(yī)學(xué)教育網(wǎng)" class="a1">醫(yī)學(xué)教育網(wǎng)</a> </div> <a href="javascript:void(0)" onclick="window.external.AddFavorite(location.href,document.title);" target="_self" class="collection ico fr"></a>  <div id="chlp3gb" class="fen fr">|</div> <div id="sxxucdz" class="font_size fr ico"><a href="javascript:void(0);" target="_self" class="big lan ico">大</a><a href="javascript:void(0);" target="_self" class="small ico">小</a></div> </div> </div> </div>  <div style="width: 800px;text-align: left;margin: 0 auto;margin-bottom: 20px;"> <div style="width:800px; height:90px;"> <a href="http://thedailypurge.net/zhiyeyishikaoshi/shichengzhuanchang2019.htm?gg=news_tb"target="_blank"> <img title="傳統(tǒng)師承/確有專長(zhǎng)備考培訓(xùn)課程" src="http://thedailypurge.net/upload/resources/image/2021/04/02/253636.png" width="800" height="90" style="border:0px;"></a> </div> </div>  <div id="r0hf3tv" class="news_con"> <div id="ptaaw3q" class="jxbox clearfix"> <p style="text-align: left;"> 請(qǐng)敘述產(chǎn)后小便不通的問診——四川省2021年傳統(tǒng)師承考試?？挤窒斫o大家，中醫(yī)四診是2021年傳統(tǒng)師承和確有專長(zhǎng)考試臨床實(shí)踐技能考察的必要內(nèi)容，醫(yī)學(xué)教育網(wǎng)編輯為您整理中醫(yī)四診知識(shí)點(diǎn)如下，建議大家直接購(gòu)課學(xué)習(xí)，<a href="http://thedailypurge.net/zhiyeyishikaoshi/shichengzhuanchang2019.htm" target="_blank">跟師學(xué)習(xí)備考省時(shí)省力>></a> </p> <p style="text-align: left;"> <strong>查看匯總：</strong> </p> <p style="text-align: left;"> <a href="/zhongyiyishi/shicheng/fudao/su2104189342.shtml" articlerela="4422442" target="_blank">中醫(yī)婦科學(xué)常見病癥問診——傳統(tǒng)師承出師/確有專長(zhǎng)考試技能考點(diǎn)</a> </p> <p style="text-align: center;"> <strong>產(chǎn)后小便不通的問診</strong> </p> <p style="text-align: left;"> 根據(jù)問診，產(chǎn)婦在產(chǎn)后8小時(shí)仍未小便，或在產(chǎn)褥期間，排尿困難，或小便點(diǎn)滴而下，伴小腹脹滿急痛者，即可診為產(chǎn)后小便不通。 </p> <p style="text-align: left;"> 新產(chǎn)后產(chǎn)婦出現(xiàn)排尿困難，小便點(diǎn)滴而下，甚或完全無尿，伴小腹脹滿急痛者，稱為產(chǎn)后小便不通，亦稱“產(chǎn)后小便難”“產(chǎn)后癃閉”?！吨T病源候論》說：“因產(chǎn)動(dòng)氣，氣沖于胞，胞轉(zhuǎn)屈辟，不得小便故也。亦有小腸本夾于熱，因產(chǎn)水血俱下，津液竭燥，胞內(nèi)熱結(jié)，則小便不通也?！薄爱a(chǎn)則津液空竭，血?dú)饨蕴?，有熱客于胞者，熱停積，故小便否澀，而難出。”所以發(fā)生本病的病因病機(jī)主要為產(chǎn)后脾肺氣虛，通調(diào)不利；腎虛氣化失職；氣滯水道不利；或密熱內(nèi)藴膀胱，以致膀胱氣化功能失職而發(fā)生小便不通。本病以通利小便為主要治療原則，但應(yīng)根據(jù)其虛實(shí)寒熱不同而分證治之。 </p> <p style="text-align: left;"> 西醫(yī)的產(chǎn)后尿潴留相當(dāng)于本病。 </p> <p style="text-align: left;"> （一）問診要點(diǎn) </p> <p style="text-align: left;"> 根據(jù)問診，產(chǎn)婦在產(chǎn)后8小時(shí)仍未小便，或在產(chǎn)褥期間，排尿困難，或小便點(diǎn)滴而下，伴小腹脹滿急痛者，即可診為產(chǎn)后小便不通。同時(shí)應(yīng)詢問排尿時(shí)有無尿頻、尿急、灼熱、澀痛等癥狀，以與產(chǎn)后小便淋痛鑒別，還應(yīng)與無小腹脹滿急痛，因小便生成障礙導(dǎo)致的少尿、無尿相鑒別。 </p> <p style="text-align: left;"> 本病辨證應(yīng)了解發(fā)病緩急，小便的色質(zhì)，小便時(shí)有無不適，分娩時(shí)有無失血過多史，并結(jié)合全身癥狀、舌脈進(jìn)行辨證分型。一般來說，發(fā)病緩者多為虛證，發(fā)病急者多為實(shí)證。產(chǎn)時(shí)失血多，小便清、色白為虛；小便色黃、赤、渾濁屬瘀熱。 </p> <p style="text-align: left;"> （二）分型問診 </p> <p style="text-align: left;"> 1.氣虛 </p> <p style="text-align: left;"> 問診：產(chǎn)后小便不通，欲解不得，小腹脹急，小便清、色白。伴精神倦怠，少氣懶言，四肢無力。 </p> <p style="text-align: left;"> 治法：補(bǔ)氣升清，化氣行水。方用補(bǔ)氣通脬飲。 </p> <p style="text-align: left;"> 2.腎虛 </p> <p style="text-align: left;"> 問診：產(chǎn)后小便不通，小便清、色白，小腹脹滿。伴腰膝酸軟，面色晦暗，畏寒肢冷。 </p> <p style="text-align: left;"> 治法：補(bǔ)腎溫陽，化氣行水。方用腎氣丸。 </p> <p style="text-align: left;"> 3.氣滯 </p> <p style="text-align: left;"> 問診：產(chǎn)后小便不通，小腹脹滿疼痛。伴精神抑郁或煩躁不安，胸脅亦脹滿疼痛。 </p> <p style="text-align: left;"> 治法：理氣行滯，佐以利尿。方用木通散。 </p> <p style="text-align: left;"> 4.膀胱瘢熱 </p> <p style="text-align: left;"> 問診：產(chǎn)后小便不通，或點(diǎn)滴而下，尿黃而渾濁，小便時(shí)灼熱不適，小腹脹滿。伴口干口渴，心煩不寧。 </p> <p style="text-align: left;"> 治法：清熱化瘀，佐以利尿。方用化陰煎。 </p> <p style="text-align:center"> <a href="http://thedailypurge.net/upload/resources/image/2021/04/01/251929.gif?1617240845334" target="_blank" style="text-decoration-line: none; color: rgb(0, 0, 255); outline: none;"><img src="/upload/resources/image/2021/04/18/263184_1000x2000.gif" title="小手動(dòng)圖" alt="小手動(dòng)圖" suffix="gif"/></a> </p> <p style="text-align:center"> <a href="http://thedailypurge.net/upload/resources/image/2021/04/09/257056.png?1617937066324" target="_blank" style="text-decoration-line: none; color: rgb(0, 0, 255); outline: none;"><img src="/upload/resources/image/2021/04/18/263185_1000x2000.png" class="huoma" data-actid="100" data-actpid="11" data-actsourceid="32" title="dianxiao：2021師承報(bào)名指導(dǎo)微信群" alt="dianxiao：2021師承報(bào)名指導(dǎo)微信群" suffix="png" style="max-width: 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