病态窦房结综合征反复心衰,严重低血糖症.doc

病态窦房结综合征、反复心衰、严重低血糖症 ——垂体前叶功能减退症1例病例分析及中医诊疗体会 专 业：中医内科学 研究生：蓝元隆 导 师：周国英 主任医师 副教授 中文摘要 本院1例分娩时出现产程延长但没有产后大出血的患者，由于发病原因隐匿，临床表现不明显，20年中相继出现病态窦房结综合征、反复心衰发作、严重低血糖症及昏迷，在本院医生努力下明确了病因，并通过中西医结合治疗使病情得到明显缓解。本文通过对此病例诊疗过程的分析，主要探讨成人低血糖症的诊断要点，并结合导师经验，着重阐述中医对虚劳（垂体前叶功能减退症）的认识，在治疗虚劳中的特点及优势，以及温补脾肾、益气养血法在治疗虚劳中的具体运用。 主题词： 垂体功能减退症/诊断 虚劳/诊断 低血糖症/诊断 垂体，前叶/病理生理学 垂体功能减退症/中医药疗法 虚劳/中医药疗法 温补脾肾/方法 益气活血/方法 Sick Sinus Syndrome,Heart Failure with High Frequency, Severe Hypoglycemia ——Case Analysis of Hypopituitarism，Viewpoints on Diagonisis and Therapy by TCM Major:clinic internal medicine of tradition chinese medicine Postgraduate:Lan Yuanlong Tutor:chief physician,adjunct-professor Zhou Guoying ABSTRACT In our hospital, a patient whose parturition had been prolonged but not flooding,with obscure pathogeny and unconspicuous clinical representation,suffered from sick sinus syndrome,heart failure with high frequency and severe hypoglycemia even coma one after the other in 20 years after she birthed.Being diagnosed and treated carefully with methods of combining traditional Chinese and Western medicine,she came back with greatly improved health.Analyzing the process of diagnosis and treatment of the case,the essay discusses the key points of adult hypoglycemia,combined with experience of tutor,underlines the feature and superiority by TCM in treating vacuity taxation（hypopituitarism）,and the mathods that warm and invigorate spleen-kidney,reinforce qi and nourish blood use concretly in treating vacuity taxation. MeSH term: hypopituitarism/diag vacuity taxation/diag hypoglycemia/diag pituitary gland, anterior/physiopathol hypopituitarism/tcm ther vacuity taxation/tcm ther warming and invigorating spleen-kidney/methods reinforcing qi and nourishing blood/methods 病态窦房结综合征、反复心衰、严重低血糖症 ——垂体前叶功能减退症1例病例分析及中医诊疗体会 专 业：中医内科学 研究生：蓝元隆 导 师：周国英 主任医师 副教授 临床资料 患者郑某某（病案号：43615，74343），女性，53岁，已婚。患者于33岁产后3年始出现心率减慢曾经就诊于外地医院，当时查阿托品试验呈阳性，诊断为病态窦房结综合征，由于拒绝安装心脏起搏器，仅口服药物治疗，具体不详。调动工作后，未能坚持服药，仍旧坚持上班，劳动强度较大。此期间反复出现胸闷、心慌