刘继帅

[{"body":{"content":"你好，我是京东互联网医院王医生，很高兴为你提供医学服务","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051468353},{"body":{"content":"你***","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051530229},{"body":{"content":"今天做胸部CT 右肺上叶小空腔","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051668511},{"body":{"content":"我这里是泌尿外科，挂普外科治疗。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051692645}]

男31岁

2022.05.20

[{"body":{"content":"晚上好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049626351},{"body":{"content":"多长时间了？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049633841},{"body":{"content":"一个月","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049643325},{"body":{"content":"这个是哪里问题，","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049658214},{"body":{"content":"一开始是如何引起的。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049669474},{"body":{"content":"吃东西过于寒凉吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049704110},{"body":{"content":"睡眠怎么样？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049798350},{"body":{"content":"有点少","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049803973},{"body":{"content":"睡眠不好，是引起这一类现象的主要原因。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049963782},{"body":{"content":"1）养成良好的生活习惯　如建立一天有规律的生活制度，在固定时间睡觉和起床，保持正常的睡眠－觉醒节律。白天适度的体育锻炼，尤其下午锻炼是帮助睡眠的最佳时间。有规律的体育锻炼能提高夜间睡眠的质量。2）建立科学的睡眠卫生习惯　避免睡前吃得过饱，尽量避免在睡前饮用酒、咖啡、茶、可乐等刺激性饮料（但可以喝适量牛奶），避免睡前进行体育活动。另外，应限制白天睡眠时间，避免午睡或减少午睡时间。3）创造良好的睡眠环境　保持卧室清洁、安静、远离噪声、避开光线刺激等。保持室温稍凉，卧室温度稍低有助于睡眠。好的卧具可以帮助入睡，可从选择合适的床垫开始。4）建立“睡眠仪式”　入睡前要抛开清醒时的一切烦恼。“睡眠仪式”可依据个人喜好或繁或简，可始于轻轻地舒展身体，松弛肌肉，或冲个热水澡，也可以听听音乐或者翻翻不具恐怖色彩的书。但是不管选择哪种方式，都要记住每晚睡前做同一件事，直到它成为夜间休息的一种暗示。5）保持乐观、知足的良好心态　对社会竞争、个人得失等有充分的认识，避免因为生活和工作中遇到挫折而导致心理失衡。6）服***　对于失眠较严重的病人，可在医生指导下，短期、适量地服用***或小剂量的抗焦虑、抗抑郁制剂，这样可能会取得更快、更好的治疗效果。但是需要强调的是，***不宜长期服用，否则容易变成习惯，甚至成瘾。另外，长期服用***也可能产生耐药性，使药物的效用降低。有些药品具有一定的肝毒性，并可能引起胃肠功能紊乱。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049974359},{"body":{"content":"这个问题应该吃什么中成药","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049994923},{"body":{"content":"中医讲究辨证论治，我需要再详细了解一下您的基础情况，帮您对症分析，再给您一个综合调理的方案。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050069342},{"body":{"content":"方便拍个舌头的照片（让舌头对着光线明亮的方向拍照，尽量不要使用美颜，舌体尽量自然伸出来，也可以多拍几张对比一下），传一下看看舌象。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050080618},{"body":{"content":"舌头很红。有齿痕。舌苔很厚。白，这种情况多数情况是体内湿气比较重。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050360812},{"body":{"content":"食欲怎么样？油腻的东西吃的多不多？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050385313},{"body":{"content":"用镜子看没有舌苔","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050982926},{"body":{"content":"红头红，有齿痕，无舌苔","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050997051},{"body":{"content":"好的，那就是光线的原因。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051008985},{"body":{"content":"食物正常，油腻的东西吃的不多","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051013228},{"body":{"content":"大便正常吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051100698},{"body":{"content":"正常吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051135618},{"body":{"content":"小便什么颜色的一天几次？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051167190},{"body":{"content":"小便颜色淡，一天10次吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051285560},{"body":{"content":"有没有口渴？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051320792},{"body":{"content":"没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051331257},{"body":{"content":"有没有怕冷的感觉？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051371118},{"body":{"content":"有点怕冷吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051400343}]

男31岁

2022.05.20

[{"body":{"content":"你好，我是京东妇产科梁国肖医生，非常高兴由我为您提供医疗咨询服务。请问您有什么需要咨询的医学问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965819961},{"body":{"content":"建议少喝","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965842898}]

女32岁

2022.05.20

[{"body":{"content":"请问有什么需要咨询的医学问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049954699},{"body":{"content":"嗯，您看一下我的这些报告单，然后嗯之前做了心脏搭桥手术，我后面就一直在吃药，但是医生说我有心衰，我看报告上说提示有心尖部室壁瘤形成，我需要怎么治疗呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050020642},{"body":{"content":"我这个病情目前属于严重吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050040122},{"body":{"content":"这是上次心梗遗留的后遗症","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050061677},{"body":{"content":"该如何治疗么，病情严重吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050090760},{"body":{"content":"暂时只能这样","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050101328},{"body":{"content":"室壁瘤如果要处理要找心外科开胸","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050124239},{"body":{"content":"还需要手术吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050131462},{"body":{"content":"暂时不管它","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050133777},{"body":{"content":"吃药能治好吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050141896},{"body":{"content":"不能","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050146748},{"body":{"content":"这个会有生命危险吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050150667},{"body":{"content":"那什么时候治疗呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050160175},{"body":{"content":"主要是冠心病的风险","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050174638},{"body":{"content":"如果再发心梗容易猝死","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050190727},{"body":{"content":"心脏破裂","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050197049},{"body":{"content":"怎么办呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050220520},{"body":{"content":"上一次心梗估计拖时间长了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050222607},{"body":{"content":"好好吃药","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050227338},{"body":{"content":"定期复查","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050230656},{"body":{"content":"药吃完之后没见好转","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050246090},{"body":{"content":"反而说心衰更严重了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050255989},{"body":{"content":"从图里哪个指标能判断心衰的严重程度啊","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050283348},{"body":{"content":"没看到","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050289776},{"body":{"content":"要看BNP结果","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050297937},{"body":{"content":"像我这种情况还可以上班么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050343445},{"body":{"content":"不适合体力劳动","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050380626},{"body":{"content":"看看监控室这种可以么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050400934},{"body":{"content":"不能熬夜","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050416783},{"body":{"content":"目前我比较严重的地方是在哪呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050456768},{"body":{"content":"哪些病情的描述是比较严重的啊","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050480630},{"body":{"content":"心梗后心衰，肝功能异常，血脂高","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050523187},{"body":{"content":"室壁瘤","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050526979},{"body":{"content":"医生","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050603973},{"body":{"content":"能帮我分析一下我的报告吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050623507},{"body":{"content":"分析了啊","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050637651},{"body":{"content":"心梗之后就做了心脏搭桥，没有拖着，然后一直吃药呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050646315},{"body":{"content":"室壁瘤为什么会产生呢？那这个我到底什么时候再去做手术呢？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050673337},{"body":{"content":"心梗时间长会导致并发症","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050695123},{"body":{"content":"越早效果越好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050732285},{"body":{"content":"这个估计当时时间长了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050744762},{"body":{"content":"您的意思是室壁瘤越早治疗越好？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050785739},{"body":{"content":"治疗早就不会有室壁瘤","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050817987},{"body":{"content":"可是为啥您说不用管呢先","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050820743},{"body":{"content":"现在已经有了，暂时先观察吧","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050829047},{"body":{"content":"或者你也可以咨询下心外科","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050837884},{"body":{"content":"这个很严重是么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050913400},{"body":{"content":"我看这上面的介绍很可怕啊","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050998746},{"body":{"content":"是心梗的比较严重的并发症","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051060216},{"body":{"content":"你可以咨询下心外科关于开刀方面的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051076045},{"body":{"content":"这个风险大吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051160383},{"body":{"content":"相比搭桥手术","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051168648},{"body":{"content":"大","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051176348},{"body":{"content":"你做的是支架","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051182550},{"body":{"content":"不是搭桥","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051192040},{"body":{"content":"不一样","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051194499},{"body":{"content":"这个手术要开胸的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051202670},{"body":{"content":"像你这么重的冠心病风险肯定大","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051217930},{"body":{"content":"能推荐一下**好的医院和专家吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051353404},{"body":{"content":"安贞医院和阜外医院","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051441436},{"body":{"content":"我目前保守治疗行么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051579322},{"body":{"content":"只吃药","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051584104},{"body":{"content":"观察吧，定期复查","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051599798},{"body":{"content":"这两个医院有好的专家吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051606161},{"body":{"content":"我这个部室瘤是属于哪种","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051636633},{"body":{"content":"看心外科","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051643910},{"body":{"content":"具体哪些专家我也不是很清楚","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051654703},{"body":{"content":"较小的么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051666139},{"body":{"content":"\n我这个部室瘤是属于哪种","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051688555},{"body":{"content":"麻烦回我一下","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051700215}]

男47岁

2022.05.20

[{"body":{"content":"尊敬的PLUS会员您好，我是普通外科张医生，很高兴为您提供医疗咨询。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050328707},{"body":{"content":"您好，请问您有什么不适症状？有多久了？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050330967},{"body":{"content":"哺乳期发热","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050346805},{"body":{"content":"37.5度","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050351322},{"body":{"content":"乳房疼痛，怀疑是乳腺炎","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050376910},{"body":{"content":"乳房有硬块吗？局部皮肤有发红发烫么","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050395609},{"body":{"content":"有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050411205},{"body":{"content":"怀疑急性乳腺炎","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050419774},{"body":{"content":"好的，乳房疼伴有发烧 这首先考虑是急性乳腺炎","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050481366},{"body":{"content":"给您些治疗的方法您参考一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050489713},{"body":{"content":"治疗建议前，为了用药安全，系统需要先排除药物禁忌，请问您既往是否有任何基础疾病，近期是否有发现肝肾功能异常？是否有药物过敏史？是否处于妊娠，备孕状态呢？您回答有或者没有就可以了。谢谢。（例行询问，请您配合回答，谢谢。）","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050501647},{"body":{"content":"没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050511762},{"body":{"content":"现在是哺乳期","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050518156},{"body":{"content":"用药肯定得注意","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050526472},{"body":{"content":"乳腺炎一般是由于乳汁淤积引起的，您可以局部冷敷，后由肿块向乳头方向按揉，将肿块揉散，后排出乳汁，按揉前清洗乳头，保证乳头清洁干燥，乳头处乳管通畅。平日也要保持乳头乳晕清洁干燥，哺乳和挤奶前后都要清洁乳头及乳晕周围。平日尽量保持乳房空虚，避免乳汁淤积。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050566076},{"body":{"content":"如果体温超过38.5度可以口服退热药物，**就可以。一般一次10ml，4到6小时可以重复一次。这个不影响哺乳 不到38度5 物理降温","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050578776},{"body":{"content":"药物可以口服 蒲公英颗粒 ****治疗 也不影响哺乳","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050590018},{"body":{"content":"如果自行保守治疗2天无效，乳房红肿痛加重，有脓性乳汁出现，或者高热不退，您需要到医院普外科或乳腺外科就诊，查彩超，明确具体情况，针对性治疗了。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051748495}]

女31岁

2022.05.20

[{"body":{"content":"您好，感谢您体验京东育儿师咨询服务，我您有新生儿或儿童必备药品，或有关儿童生长发育相关问题的，需要京东平台为您准备，儿科专家及一对一服务及专属福利","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050284274},{"body":{"content":"您好，在吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050292403},{"body":{"content":"多大的孩子适用","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050296393},{"body":{"content":"宝宝多大了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050308122},{"body":{"content":"1个月","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050325278},{"body":{"content":"？？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050427503},{"body":{"content":"适用6至12岁的宝宝","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050471620},{"body":{"content":"这么小不要乱吃","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050513996},{"body":{"content":"宝宝不爱吃奶吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050546407},{"body":{"content":"希望我的建议能够帮助到您，非常感谢您的信任！请对话结束后对我的服务作出评价，祝您生活愉快，祝宝宝健康快乐成长","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051703533},{"body":{"content":"您还有其他问题吗，咨询结束前，我一直都在","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051711325},{"body":{"content":"感谢您的支持，您的评价对我非常重要，麻烦您给个好评，谢谢！！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051716064}]

女

2022.05.20

[{"body":{"content":"您好，我是泌尿外科医生，非常高兴可以帮到您，为了确保本次问诊顺利进行，请您始终保持在线，谢谢配合。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050225474},{"body":{"content":"在么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050258498},{"body":{"content":"您好，请问您有什么需要咨询的医学问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050281191},{"body":{"content":"最近这段时间尿完之后总会流一点","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050307864},{"body":{"content":"就是**尿完了，但是提上裤子之后，他就会给内裤上滴点","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050346867},{"body":{"content":"尿不尽对吧","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050384915},{"body":{"content":"就是尿完之后啊，他总会有那么一点残留，过一会儿再滴几滴出来","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050414380},{"body":{"content":"还就是有时候尿黄且有点浑浊","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050484069},{"body":{"content":"请问是否还有以下症状：○1尿频○2尿急○3尿痛○5排尿困难○6小腹胀痛○7会阴胀痛○8睾丸胀痛○9尿道口滴白。回复序号即可，谢谢配合。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050501811},{"body":{"content":"9","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050533277},{"body":{"content":"就是偶尔一年可能就出现这么一次","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050569584},{"body":{"content":"尿的时候有点白色的，干了之后就跟淀粉干了之后一样","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050582133},{"body":{"content":"多久了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050605037},{"body":{"content":"有几个月了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050618089},{"body":{"content":"半年左右","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050630874},{"body":{"content":"现在收集的信息来看，您的症状初步诊断为：前列腺炎可能性大。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050700599},{"body":{"content":"可以到公立医院泌尿外科检查前列腺液常规和前列腺彩超确诊，不方便到医院，我可以根据经验，给您选择些药物治疗。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050703759},{"body":{"content":"你给推荐一下治疗药物吧！","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050722158},{"body":{"content":"为了更好更安全的为您提供用药指导，请问您是否有药物过敏史？是否有严重的肝肾功能不全？严重的心脏病、高血压、糖尿病等病史？是否备育期？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050729915},{"body":{"content":"没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050740719},{"body":{"content":"您还有早泄是吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050746002},{"body":{"content":"是的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050749879},{"body":{"content":"对于射精时间或控制射精能力是您不满意，还是伴侣不满意，还是您们两人都不满意呢？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050754053},{"body":{"content":"一般多久射精呢","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050761228},{"body":{"content":"不带**套的情况下，进去动几下就想射","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050765047},{"body":{"content":"带套的情况下，3到5分钟吧！","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050779567},{"body":{"content":"是否有使用什么药物治疗了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050781180},{"body":{"content":"没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050788488},{"body":{"content":"对于射精的时间和控制射精的能力","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050815653},{"body":{"content":"有过几年的手淫史","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050839513},{"body":{"content":"嗯，现在很少手淫了对吧","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050853069},{"body":{"content":"戒了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050893675},{"body":{"content":"现在有5，6年没有手淫了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050917408},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050920911},{"body":{"content":"根据**男科疾病诊断治疗指南，****** 对早泄这个疾病是有治疗作用的，且目前为一线治疗药物。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050926498},{"body":{"content":"****\n可以降低精囊内压，降低球海绵体肌的爆发性收缩，降低阴茎背神经敏感性而增加控精能力延长性生活时间，虽然不是每天用药，但是其实是具有治疗作用的。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050930861},{"body":{"content":"******：口服。药片应完整片吞下。建议至少用一满杯水送服药物。推荐的首次剂量为30mg（1片），需要在性生活之前约1至3小时服用。推荐的最大用药剂量使用频率为每24小时一次。推荐使用频率为1周1-2次，服药当天避免饮酒。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050950312},{"body":{"content":"这个是属于根治的还是辅助的药物","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051036275},{"body":{"content":"只是这个疾病没有根治一说，除非像阑尾炎做完手术切除了，就不会再有阑尾发炎了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051048342},{"body":{"content":"治疗作用的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051053853},{"body":{"content":"为用药安全，既往有药物过敏及肝肾损伤、慢性病史吗？请问您是否有严重心血管病史？是否在使用***、****、***、****；****；****、****、****、等药物。是否在备孕？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051064359},{"body":{"content":"没有使用这些药物","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051078684},{"body":{"content":"您这个情况是在泌尿外科非常常见的，也不用过于担心，是可以通过药物治疗的。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051147511},{"body":{"content":"针对您的情况，建议您可以使用：****+******治疗一下，可以先使用2周的看看效果，2周后线上复诊，我帮您看一下治疗的效果。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051176272},{"body":{"content":"这两个是治疗早泄和尿不尽的，是吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051200674},{"body":{"content":"是的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051205317},{"body":{"content":"****是一种选择性5-羟色胺再吸收抑制剂。早泄可能是大脑性欲中心存在着5-羟色胺和***之类的化学物质，它们传导强烈的射精冲动，而****能干扰上述化学物质，达到延时射精的目的。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051211277},{"body":{"content":"他们经常给我推荐那个*****那个","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051215428},{"body":{"content":"******适应症: **利湿，****。用于慢性前列腺炎属湿热挟瘀证，症见：小便频急、尿后余沥、尿后滴白、尿道涩痛、少腹疼痛、会阴不适、腰骶疼痛、阴囊潮湿、睾丸疼痛。一天2次 一次4粒","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051217532},{"body":{"content":"*****诊断早泄会有帮助的，但是一般建议中医辩证论治指导会更好些的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051268539},{"body":{"content":"好的好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051284809},{"body":{"content":"上面给您推荐的药物为处方药，我可以给您开一张电子处方，以供线上购买使用，或者作为线下购买及用药参考。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051291284},{"body":{"content":"还有就是每到夏天晚上的话，就是脚心发热，心悸","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051297159},{"body":{"content":"脚心发热等中医症状，建议中医科望闻问切，辩证论治，会更准确些的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051366288},{"body":{"content":"咱们京东有中医吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051389742},{"body":{"content":"我给您一个医院临床治疗反馈效果好的一线用药方案，您可以参考下，比较适合您。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051392015},{"body":{"content":"有的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051419092},{"body":{"content":"处方供您开好了，供您参考","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051463686},{"body":{"content":"已经开好了，处方内药品由京东质保，京东物流配送（保密发货，送药到家）.用量处方上帮您备注上，用药前建议您仔细阅读说明书，注意药物的不良反应，副作用及用法用量，如果用药后出现不适症状或症状得不到缓解，建议及时线上咨询或去医院就医。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051468230},{"body":{"content":"好的，到时候怎么联系您？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051577323},{"body":{"content":"您可以按照上图的这个流程找到我，建议用药一段时间后及时复诊，相对于埋头吃药来说，医生的指导更重要，减量和停药都要在医生的指导下进行；","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051594542},{"body":{"content":"给您些生活建议，希望能够帮助到您","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051735069},{"body":{"content":"这个****一盒够吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051749960},{"body":{"content":"生活建议您：保持良好的心态，减轻心理压力，多喝水，勤排尿，忌烟酒、别熬夜，不吃辛辣刺激性食物。忌久坐，避免长时间骑车，坚持运动锻炼，如提肛、深蹲锻炼，避免剧烈运动。规律性生活，不要忍精不射，避免不洁性交。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051780137},{"body":{"content":"4周6片1疗程的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051792604},{"body":{"content":"行","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051807720},{"body":{"content":"给您开一盒3片的****先试试，效果明显的话，没有啥不适症状，再继续按需服用，性生活时间达到满意度以后再停药。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051821655},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051865666},{"body":{"content":"目前很多患者除了在口服药物治疗以外，都在用***，提高性功能，连续服用效果还是非常不错的。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051904967},{"body":{"content":"***是**，**，**，**，还有**混合在一起泡出来的茶。可以起到调理身体的作用，功效有：**固精，**，补充精力，提高性能力的作用。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051921229}]

男32岁

2022.05.20

[{"body":{"content":"您好。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878499020},{"body":{"content":"请说一下具体病史，如发病时间和部位，症状，有无诱因，家族史，既往史，医院化验结果，诊断， 治疗方案，效果如何？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878849286},{"body":{"content":"后背，腋下","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878865859},{"body":{"content":"化验单刚才发的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878879511},{"body":{"content":"两大块儿，手上之前走过烧伤，感觉开始有小点点的白。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878948430},{"body":{"content":"后背腋下照片发给我看看","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879003392},{"body":{"content":"好的马上拍","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879058500},{"body":{"content":"后背","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879094766},{"body":{"content":"您看是***吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879129486},{"body":{"content":"腋下跟这个类似，然后就是手上很早年烧伤过，看着像是开始有小白点","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879251520},{"body":{"content":"有没有预防再在别处长的药或打针之类的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880142114},{"body":{"content":"是***！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652882524411},{"body":{"content":"预防发展就是用**","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652882553166},{"body":{"content":"吃药片或打针都行","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652882574311},{"body":{"content":"能直接给开药？还是要到医院？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652884765850},{"body":{"content":"您推荐吃药还是打针好？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652884795330},{"body":{"content":"**哪能瞎开啊","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652884929788},{"body":{"content":"必须去医院面诊","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652884943531},{"body":{"content":"如果开点外用药膏还可以","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652884963618},{"body":{"content":"吃药麻烦但是可以精确控制**的剂量，打针方便（一月一针）但不能精确控制剂量","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652885046821},{"body":{"content":"打扰下，打针一般需要几针，一个月到一次医院是吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652968746320},{"body":{"content":"一两针就好了，一个月到一次医院","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653002754293}]

女48岁

2022.05.20

[{"body":{"content":"你好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965730766},{"body":{"content":"有齿痕吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965743183},{"body":{"content":"舌苔怎么样？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965755735},{"body":{"content":"医生您好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965756401},{"body":{"content":"这是有齿痕吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965773900},{"body":{"content":"舌体胖大","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965784234},{"body":{"content":"湿气重吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965796076},{"body":{"content":"吃什么食物了吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965813482},{"body":{"content":"没吃啥啊","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965822785},{"body":{"content":"正常吃三餐","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965828939},{"body":{"content":"平时舌苔就这样吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965844033},{"body":{"content":"是的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965850731},{"body":{"content":"脾虚湿气重引起的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965880929},{"body":{"content":"需要怎么治疗啊","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965899460},{"body":{"content":"可以服用参苓白术散**化湿治疗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965919717},{"body":{"content":"寒凉，冷饮雪糕不要吃","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965931783},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965940527},{"body":{"content":"泡脚有用吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965946262},{"body":{"content":"可以的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965961640},{"body":{"content":"谢谢医生","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966635873}]

女20岁

2022.05.20

[{"body":{"content":"你好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050394644},{"body":{"content":"胃间质瘤，晚期","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050422226},{"body":{"content":"你发一下报告吧，你这样子拿着拍片子，我一点都看不见。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050434568},{"body":{"content":"发现半年了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050434790},{"body":{"content":"要什么样的报告","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050448111},{"body":{"content":" CT报告。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050502699},{"body":{"content":"发一下病理报告。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050518452},{"body":{"content":"没做病理，","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050546380},{"body":{"content":"大夫没让做","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050562605},{"body":{"content":"没做病理怎么知道是胃间质瘤？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050568380},{"body":{"content":"沈阳肿瘤大夫根据加强ct给的结果","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050589143},{"body":{"content":"建议你第1个是取病理明确病理诊断，只有病理诊断才能够确诊恶性肿瘤，第二如果是胃肠间质瘤，如果有CD117阳性的话，可以进行靶向治疗，效果还是挺好的。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050618619},{"body":{"content":"光影像没有办法确诊。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050626187},{"body":{"content":"之前寇有为大夫给开的****，吃了之后效果不好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050676700},{"body":{"content":"除了这个药还有别的药好用吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050689817},{"body":{"content":"因为你没明确，也不知道你到底适合不适合吃这个药。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050705748},{"body":{"content":"就是做个胃镜取一块东西就能确诊的事儿，怎么那么麻烦呢？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050719225},{"body":{"content":"你首先不明确诊断让大夫怎么跟你说怎么治疗。现在要求治疗恶性肿瘤，必须有病的诊断。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050739267},{"body":{"content":"如果确诊是恶性肿瘤，胃间质瘤，那怎么治疗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050817617},{"body":{"content":"得看CD117和CD34的表达水平。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050844452},{"body":{"content":"好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050848684},{"body":{"content":"大夫没让做病理的原因是，现在肚子里全是肿瘤，怕破裂，","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050968254},{"body":{"content":"这么这边的底线是病理","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051000334},{"body":{"content":"没有病理不能按恶性肿瘤治疗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051018839},{"body":{"content":"明白了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051045812},{"body":{"content":"因为不知道到底是间质瘤还是胃癌，怕方向错了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051051392},{"body":{"content":"希望您可以理解，都是家里人带老人去治疗的，我这边也是想多一个方向","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051105127},{"body":{"content":"嗯嗯","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051117743}]

男73岁

2022.05.20