“一元论”病因诊断在心率矛盾反应中的临床应用

Clinical application of "holism view" dialectical thinking in the etiological diagnosis of contradictory heart rate reaction

目的应用"一元论"病因诊断理论,辩证分析心率矛盾反应的本质,确定病因,科学治疗。方法选择2017年11月至2018年6月十堰市人民医院感染性疾病科收治的1例"肺炎、冠心病、多浆膜腔积液,心率65次/min"69岁女性患者和1例"上消化道大出血、乙型肝炎后肝硬化,心率70次/min"41岁男性患者的临床资料,辩证分析心率矛盾反应的原因。结果应用"一元论"理论辩证分析上述2例患者肺部感染、胸腔积液与相对缓慢心率的矛盾反应和上消化道出血与相对缓慢心率的矛盾反应,最后确定患者的病因分别为"甲状腺功能减退症"和"肝硬化性心肌病"。结论在细致问诊、规范体检、辅助检查的基础上,应用"一元论"病因诊断理论,辩证分析心率矛盾反应,有助于临床正确诊断,减少误诊误治,达到科学治疗。

Objective To understand the concept of holism view and to analyse the etiological diagnosis of contradictory heart rate reaction.Methods A dialectic diagnosis thinking way was performed on 2 patients with contradictory heart rate admitted to the department of infectious disease in Shiyan People′s Hospital from November 2017 to June 2018.A 69-year-old woman with a history of pneumonia,coronary heart disease,polyserositis and with heart rate 65 beats a minute.The other patient was a 41-year-old man who presented with massive hemorrhage of gastrointestinal tract,liver cirrhosis after hepatitis B,and with heart rate 70 beats a minute.Results The“holistic view”theory was applied to analyze the contradictory responses of pulmonary infection,pleural effusion and relatively slow heart rate in the first patient,as well as upper gastrointestinal hemorrhage and relatively slow heart rate in the second patient.The 2 cases were eventually diagnosed as hypothyroidism and cirrhotic cardiomyopathy respectively.Conclusion Applying“holism view”dialectical analysis to the etiological diagnosis of contradictory heart rate reaction is helpful to get a correct diagnosis and giving the patients′reasonable treatments,on the basis of detailed inquiry,standardized physical examination and auxiliary examination.