三组内分泌课件完整版

,MadeBy3thgroup2013.11.11,MadeBy3thgroup2013.11.11,Newwords,Newwords,BackgroundoftheEndocrineSystem,Theendocrinesystemisoneofthemostimportantaccommodationsystemofthebody.Itconsistsoftheendocrineglandsandtheendocrinetissuesfromdifferentpartsofthebody.Foralongtime,ithasbeenrecognizedthatthissystemofductless（无导管的）glandsexertsprofoundinfluenceonthebody.Itincludinggrowthanddevelopment,breedingactivitiesandmetabolicprocesses.Thefunctionorpowerofthissystemisexpressedbythesubstance-TheHormone.,Gland,releasetheirsecretionsintoaductthatcarriesthemtotheoutsidethebody,Theendocrinesystemofvertebrate（脊椎动物）,Hypophysis垂体Thyroid甲状腺Parathyroid甲状旁腺Adrenalgland肾上腺Pancreas胰岛Sexualgland/gonad性腺,Endocrineorgan,Endocrineorgan,Endocrineorgan,epiphysis松果体,AboutHormones,Theseendocrineorgansortissuescansecretesomesubstancescalledhormones,whichgetintothebloodcirculationandregulatetheactivitiesoftheorgansinthebody.,Hypophysis垂体,1.Hormonessecretedbyneurohypophysis神经垂体释放的激素Vasopressin，VP血管加压素oxytocin，OT催产素2.Hormonessecretedbyadenohypophysis腺垂体释放的激素adrenocorticotropichormone,ATCH促肾上腺皮质激素；thyroid-stimulationhormone,TSH促甲状腺素；follicle-stimulationhormone，FSH卵泡刺激素Luteinizinghormone,LH黄体生成素Prolactin,PRL催乳素growthhormone，GH生长素melanocyte-stimulatinghormone,MSH黑素细胞刺激素,Thyroid甲状腺,regulatesbasalmetabolism调节基础代谢stimulatesthecatabolismofglucoseandlipid.促进葡萄糖和脂类的分解代谢stimulatesgrowthanddevelopment促进生长发育,Parathyroid甲状旁腺,parathyroidhormone,PTH甲状旁腺激素ThefunctionofPTH:effectonthebones,kidneyandintestine影响骨、肾和小肠的作用,Adrenalgland肾上腺,Adrenalcorticalhormone肾上腺皮质激素Mineralocorticoid盐皮质激素Glucocorticoid糖皮质激素Adrenalmedulla肾上腺髓质,Pancreas胰岛,胰腺,Insulin胰岛素-BcellsecretionItisthepancreatichormonethatstimulatetheanabolismandstorenutrientcontents为促进合成代谢，储存营养物质的激素。,Sexualgland性腺,Thefunctionofsexualgland：Producesgamete产生配子Endocrinefunction内分泌机能：threekindsofhormonessecretedandrogen雄激素promotethegrowthandmaturityofsperm促进精子的生成与成熟；stimulatetheappearanceofaccessorysexualcharacteristicsandmaintainthem刺激男性副性征的出现与维持；promotethesynthesisofprotein促进蛋白质的合成.,Sexualgland性腺,Estrogen雌激素stimulatethegrowthanddevelopmentoffemalesexualorgans促进雌性性器官的发育与生长；stimulatetheappearanceoffemaleaccessory（副的；配件，附件）sexualcharacteristics促进雌性副性征的出现；promotetheconstrictionofoviductanduterinesmoothmuscle增强输卵管和子宫平滑肌的收缩。,Sexualgland性腺,progestogen孕激素mainlyeffectonendometriumanduterusmuscle主要作用于子宫内膜与子宫肌maintaingravidityandprotectsembryo维持妊娠与保胎,Pathology,Hyperfunctionofglandsendocrinetumorsectopic(异位、移位)endocrinesyndrome(异位内分泌综合征)autoimmunity（自身免疫）HypofunctionofglandsEndocrineglanddisrupting（内分泌腺破坏）endocrineglandhormonesynthesisdefect（内分泌腺激素合成缺陷）Thereceptorislackofsensitivitytohormones.,缺乏激素敏感性,Hyper-高于、超过、上Hypo-低于、次于,Diagnosis,1.FunctionaldiagnosisClinicalManifestation(临床表现)Laboratorytests（实验室检查）2.PathologicaldiagnosisA.Evidenceofmetabolicdisturbance:（新陈代谢障碍）Evidenceofinappropriatehormone:（荷尔蒙分泌不当）Endocrinefunctiontest:（内分泌功能检测）Immunology（免疫学检测）B.Imageology（影像学）Xray,CT,Bultrasound,（B超）Isotope.（同位素检测）Histologyandcytology.（组织细胞学检测）,Commondiseasesofendocrinesystem,DiabetesMellitushyperthyroidism（甲亢）hypothyroidism（甲减）thyroiditis（甲状腺炎）cushingssyndrome（库欣综合征）diabetesinsipidus（尿崩症）primaryaldosteronism（原发性醛固酮增多症）chronicadrenocorticalhypofunction(Addison)慢性肾上腺皮质功能减退症dyslipidemia（血脂异常症）obesity（肥胖症)Gigantism（巨人症）osteoporosis（骨质疏松症）acromegaly（肢端肥大症）,Typicalfeatureinendocrine,Acromegaly肢端肥大症,cretinism呆小症,Gigantism,hyperthyroidism,Exophthalmos突眼症,沈殿霞肥姐,包大人仪铭,83版射雕郭靖他妈苏杏璇,Whatisthemostcommomdiseaseinendocrinesysterm?,Whatisthemostcommomdiseaseinendocrinesystem？,DiabetesMellitus,DMisagroupcharacterizedbyhyperglycemiaandmetabolicdiseases.Itisadiseaseinwhichapersonhashighbloodsugar,eitherbecausethepancreasdoesnotproduceenoughinsulin,orbecausecellsdonotrespondtotheinsulinthatisproduced.thereare2maintypesofDM,Classificationofdiabetes(ADA-1997),Type1(beta-celldestruction,usuallyleadingtoabsoluteinsulindeficiency)AutoimmuneIdiopathic（先天的；自发的，特发的）Type2(predominantlyinsulinresistancewithrelativeinsulindeficiency，predominantlysecretorydefect（缺陷）SomespecifictypesofDM：secondarypancreasdisease、endocrinopathies（内分泌病）、geneticdiabetes.Gestationaldiabetes(妊娠糖尿病),Themostcommonformofdiabetes-Type2DM,Nearly95%belongstotype2DM,itoftenassociatedwitholderage,obesity,familyhistoryofdiabetese.t.c.Intype2diabetes,thepancreasisusuallyproducingenoughinsulin,butforunknownreasonsthebodycannotusetheinsulineffectively,whichcalledinsulinresistance.Afterseveralyears,insulinproductiondecreases.Sothusglucosebuildsupinthebloodandthebodycannotmakeefficientuseofitsmainsourceoffuel.,producinginsulin,notineffectiveuseoftheproducedinsulin,But,Riskfactorsfordiabetes,Obesity/overweightFamilyhistoryofdiabetesHavinghighbloodpressureLackofphysicalactivityToomuchsweetfoodintakeOverstressInfectionHyperlipidemia（血脂过高）,TypicalSymptoms,Polyuria（多尿）Polydipsia（多饮）Polyphagia（多食）Loseweight（体重下降）,ComplicationsofDiabetes,视网膜病,冠状动脉,截肢，切断术,StandardofDiagnosis,FPGRandomplasmaglucoseOGTT2hPGmmol/Lmmol/Lmmol/LDM7.0OR11.1OR11.1IFG6.1FPG7.0OR7.8IGT7.0OR7.82hPG11.1Nor3.9FPG5.67.8FPG（FastingPlasmaGlucose）OGTT(OralGlucoseToleranceTest)IFG(ImpairedFastingglucose)（空腹血糖受损）IGT(ImpairedGlucoseTolerance)（糖耐量降低）IFG+IGT=IGR(ImpairedGlucoseRegulation)(葡萄糖调节受损),（空腹血糖）,（随机血糖）,（餐后两小时血糖）,Treatmentprinciples-FiveCarriages,Earlysynthesis（综合）individuallife-long,HealthEducation,Exercise,NutritionTherapy,DiseaseSurveillance监督，监视,OralAnti-diabeticAgent,NutritionTherapy,Reasonablecontroltotalquantityofheat(合理控制总热量）Manymealsandlessfood（少食多餐）regularlyandquantitatively（定时定量）Diversityandblance(多样平衡),DiabetesHealthEducation,Healtheducationisconsideredthekeytothesuccessoftreatment.,Exercise,Beforediabeticpatientsengageinexerciseprogram,theyshouldconsultwiththeirhealthcareprovider（保健服务人员）becausetheyneedtohaveacompletehistory（历史记录）andphysicalexamination.Exerciseincludesanythingthatkeepsthemmove.Exercise(totalofabout30minutesaday,atleast5daysaweek)lowersbloodsugarlevelsbyimprovingcelluptake（摄取，举起）ofglucose,causingthebodytoprocessglucosefaster.,Exercise,Regularmonitoring,Regularmonitoringofbloodglucoseisrecommendedtouseaportablebloodglucosemeter（便携式血糖测量仪）,Drugtherapy,Biguanides-Metformin(Glucophage)双胍类decreasingliverglucose（肝糖原）releaseandcellularinsulinresistance.Alpha-GlucoseInhibitors:-糖苷酶抑制剂Slowsdigestionandabsorption（吸收）ofcarbohydrates（糖类，碳水化合物）tomaintainnormalbloodglucoselevels.SulfonylureasandMeglitinides:(Prandin)磺脲类和格列奈类Stimulatespancreastosecreteinsulin.Thiazolidinediones:(Avandia,Actos)噻唑烷二酮类Increasesinsulinsensitivityatreceptorsitesonliver,muscle,andfatcells.Themedicationworksbyhelpingmakeyourcellsmoresensitivetoinsulin.Theinsulincanthenmoveglucosefromyourbloodintoyourcellsforenergy.,Indicationsofinsulin,Type2DMAcutecomplicationsSeverechroniccomplicationsofdiabetesEmergencySeveredysfunctionofliverorkidneyGestationandbleedingwomenWithouttoleranceOHA(OralHypoglycemicAgents口服降糖药)，OHA、SU（磺脲类）invalidationDistinct（明显的；独特的；清楚的；有区别的）lean（依赖）Withdiseasestreatedbyglucocorticoid（糖皮质激素）,TCMpathogenesis,DiabetesMellitusinwesternmedcineis“xiaoke”areasinTCM.AccordingtothetheoryofTCM,thebasicpathogenesisof“xiaoke”（consumptivethirst）isyinscorching（灼热）ontherootwhilefirepreponderance(优势，多数)onthebranch,Besides,itcouldinvolvedifferentorgansandparts,andcouldalsocausethedisorderingofqi,blood,jin,yinandyang.Xiaokeisusuallyclassifiedintofourtypesofsyndrome：1.Typeo