刘继帅

[{"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":1653049822923},{"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":1653049836642},{"body":{"content":"静脉曲张","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049843563},{"body":{"content":"腿麻","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049851228},{"body":{"content":"目前没有图片","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049864504},{"body":{"content":"您可以站立位，发一张下肢的照片吗？我来判断一下严重程度。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049864585},{"body":{"content":"因为是帮家人问的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049901913},{"body":{"content":"就想看一下有什么可以缓解一下","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049921011},{"body":{"content":"好的，患者多大年纪 确诊是下肢静脉曲张了么？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049930976},{"body":{"content":"腿部的筋和**差不多","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049957662},{"body":{"content":"下肢静脉曲张 一般引起的是下肢酸胀不适 特别是站久了 酸胀明显 麻木的症状，要除外是腰椎问题引起的不适症状","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049974460},{"body":{"content":"63岁","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049974894},{"body":{"content":"确诊了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049988149},{"body":{"content":"暂时可以给您些静脉曲张的治疗建议 和方法 帮患者缓解下肢 酸胀不适的症状，但是彻底治疗下肢静脉曲张 是需要手术的，另外 下肢麻木的情况 需要排除是腰椎问题 压迫神经引起的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050027005},{"body":{"content":"治疗建议前，为了用药安全，系统需要先排除用药禁忌，请问您既往是否有基础疾病？近期是否有发现肝肾功能异常？是否有药物过敏史？您回答有或者没有就可以了。谢谢。（例行询问，请您配合 谢谢）","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050038945},{"body":{"content":"家里人也没有拍过腰椎片子","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050088917},{"body":{"content":"但是静脉曲张是有的，也是那条腿麻","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050123140},{"body":{"content":"小腿","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050129764},{"body":{"content":"没有药物过敏","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050144619},{"body":{"content":"嗯，可以先用药缓解症状的。药物建议前，需要您配合回答一下上边问题。我给您建议","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050149205},{"body":{"content":"好的，感谢配合","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050154238},{"body":{"content":"可以用药膏或者喷雾那些药吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050185214},{"body":{"content":"建议您注意下肢保暖，避免过久站立，和久坐，平躺休息是尽量抬高下肢，促进血液回流，可以外用*******涂抹下肢 涂抹后轻轻按揉有助于药物吸收 同时可以口服 ****一次2片一天2次，治疗静脉曲张 口服****营养神经 缓解麻木症状","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050189224},{"body":{"content":"这种涂抹的效果比较好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050213207},{"body":{"content":"为了方便您用药，您可以点击“药品名称带有购物车标志”进入链接购买。有些药品为“处方药”，必须要由有医师开处方才能购买。稍后我再帮您开具一张电子处方，并注明用法用量，您作为参考，按照处方用药","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050418267},{"body":{"content":"用药前请您仔细阅读药品说明书中禁忌，注意事项，如无禁忌可使用我为您开具的药品，如您在用药过程中出现不适，请您及时上线咨询或去医院就诊。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050419545},{"body":{"content":"处方已经开好，您可以点击处方，预约购买，药师审核通过后，即可发药,京东物流会配送到您指定的**。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050451727},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050579271},{"body":{"content":"祝患者早日康复，身体健康，生活愉快","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050617136},{"body":{"content":"别忘了方便时候 带患者做过彩超检查一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050946037},{"body":{"content":"你***这个药膏可以吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051060220},{"body":{"content":"因为你说的药膏，我那地区发不了货","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051087636},{"body":{"content":"也是可以的，效果也是不错的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051096133},{"body":{"content":"哦哦好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051112937},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051169477},{"body":{"content":"哪个***是一次两片是吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051311777},{"body":{"content":"另一个就是一次一粒","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051329844},{"body":{"content":"是的 ***一次2片 另外一个一次一个","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051406775},{"body":{"content":"***一天2次，另外一个一天一次","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051413408},{"body":{"content":"我看另一个处方上写的是一天3次","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051491899},{"body":{"content":"***对痔疮也有用对吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051538715},{"body":{"content":"另外一个一天3次","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051542879},{"body":{"content":"这个打错字了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051546555},{"body":{"content":"哦哦","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051551089},{"body":{"content":"对的，对痔疮也是管用的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051551617},{"body":{"content":"哦哦好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051559037},{"body":{"content":"祝早日康复","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051702209}]

女30岁

2022.05.20

[{"body":{"content":"您好，非常高兴由我为您提供医疗咨询服务，请稍等，我正在详细阅读您的病情描述。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051114312},{"body":{"content":"目前主要有哪些不适症状？什么时候开始的？持续多长时间了？有没有加重或缓解的因素？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051123002},{"body":{"content":"大夫，您好！我母亲68岁，膝盖疼的厉害，医生建议膝关节置换手术，想让您看看是不是必须手术治疗，母亲年龄大了，害怕手术。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051134834},{"body":{"content":"膝关节炎很严重","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051152531},{"body":{"content":"关节间隙没有了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051159051},{"body":{"content":"疼痛估计也很厉害","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051163965},{"body":{"content":"活动受限吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051171568},{"body":{"content":"她这个5岁时被砸了，是伤腿，一直疼，最近一周影响走路了，疼痛厉害","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051200657},{"body":{"content":"必须手术吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051221517},{"body":{"content":"建议手术","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051240693},{"body":{"content":"保守治疗，注射****效果怎么样？她听说周围有人手术恢复不好后来拄拐了，害怕手术","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051293929},{"body":{"content":"保守治疗，也只是拖延时间","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051333861},{"body":{"content":"我觉得早做手术，康复更好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051362579},{"body":{"content":"手术风险大吗？她有高血压，血糖的话前两天测的8点多","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051426521},{"body":{"content":"可以这样子，先****注射保守治疗三个月看看","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051435001},{"body":{"content":"如果没有缓解，还是痛的厉害","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051443066},{"body":{"content":"再考虑手术也不迟","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051447803},{"body":{"content":"手术风险还可以，这些术前会调整到正常水平","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051469539},{"body":{"content":"好的，谢谢您！","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051487403},{"body":{"content":"希望我的建议能够帮助到您！\n如果您对我的回答表示满意，请在对话结束后给出推荐评语和五星好评～\n祝您早日康复，生活愉快！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051534285}]

女67岁

2022.05.20

[{"body":{"content":"您好，我是妇产科医生王轩，非常高兴由我为您提供医疗咨询服务","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051384394},{"body":{"content":"我有阴道炎和宫颈炎，医生让我提高免疫力，给我开**********","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051543508},{"body":{"content":"是您的医生给您的用药建议对吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051562252},{"body":{"content":"对","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051570112},{"body":{"content":"是*************栓 50万IU*3枚这个是吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051592845},{"body":{"content":"3盒是吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051627956},{"body":{"content":"嗯","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051647919},{"body":{"content":"您是需要帮您开一下是吗/","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051652686},{"body":{"content":"对，帮我开一下","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051682440},{"body":{"content":"请问您有药物过敏史，肝肾功能异常及其他高血压、糖尿病等慢性病史、或血栓、乳腺病史吗？是否孕期、哺乳期、备孕期？以便我给您建议","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051684986},{"body":{"content":"血压吃药正常，乳腺增生","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051761670},{"body":{"content":"您之前的检查是有发现有HPV的情况是吗？因为帮您开处方需要写上诊断，这个用药是治疗HPV的情况的，所以跟您核实一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051766139},{"body":{"content":"您稍等，后续关注一下处方的信息","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051828726},{"body":{"content":"您看一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051894109},{"body":{"content":"用药前请您仔细阅读药品说明书中禁忌，注意事项，如无禁忌可使用我为您开具的药品，如您在用药过程中出现不适，请您及时上线咨询或去医院就诊。注意按时复诊。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051897494}]

女51岁

2022.05.20

[{"body":{"content":"您好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965025702},{"body":{"content":"能拍个照片看一下吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965047862},{"body":{"content":"身体右侧肿","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965053284},{"body":{"content":"颜面部肿吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965055421},{"body":{"content":"右侧是上肢和下肢吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965072607},{"body":{"content":"既往有什么基础疾病吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965083725},{"body":{"content":"上肢不肿对吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965143453},{"body":{"content":"按压肿得地方有凹陷吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965163733},{"body":{"content":"从图上看您左侧下肢及脚面是肿的，而不是右侧","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965225387},{"body":{"content":"整个右边都是肿的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965257392},{"body":{"content":"没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965272777},{"body":{"content":"心脏和肾脏都查过","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965285570},{"body":{"content":"没有问题","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965292020},{"body":{"content":"我自己拍不到全身","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965311743},{"body":{"content":"单侧水肿考虑血管的问题","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965318746},{"body":{"content":"哪的血管呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965364390},{"body":{"content":"建议您查下腔静脉及下肢动静脉超声或血管核磁","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965384820},{"body":{"content":"都查过","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965401080},{"body":{"content":"血管核磁可能更清楚一些","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965409087},{"body":{"content":"有问题吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965420435},{"body":{"content":"有点静脉曲张。但不足以导致整个右侧的肿","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965429488},{"body":{"content":"脸的肿","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965459714},{"body":{"content":"如果水肿部位比较的应该考虑上面血管的问题。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965459845},{"body":{"content":"胳膊没法拍","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965468281},{"body":{"content":"自身免疫抗体谱有没有查过？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965476117},{"body":{"content":"没","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965488092},{"body":{"content":"属于内分泌么？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965498738},{"body":{"content":"主要考虑血管的问题，就是全身血管的问题。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965501139},{"body":{"content":"属于风湿免疫科。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965509879},{"body":{"content":"腰脱或颈椎问题会导致这种问题么？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965534492},{"body":{"content":"需要做个全身的血管检查么？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965569183},{"body":{"content":"ct或核磁么？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965592431},{"body":{"content":"不会的，颈椎和腰椎的问题，它不会引起单侧的颜面的问题，除非是脑神经脑血管堵塞，但是会伴行运动障碍。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965614130},{"body":{"content":"核磁看血管比较清楚。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965625364},{"body":{"content":"需要挂什么科室呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965659792},{"body":{"content":"风湿免疫科么？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965671643},{"body":{"content":"可以的，可以挂风湿免疫科，考虑全身血管病变。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965682508},{"body":{"content":"早晨起来手抓不严","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965712402},{"body":{"content":"这就是晨僵现象。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965728966},{"body":{"content":"活动一会才会好一些","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965729784},{"body":{"content":"建议到上级比较好的风湿免疫专科就诊。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965746669},{"body":{"content":"就是血管的病变引起的是么","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965766140},{"body":{"content":"对血管病变引起的。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965788618},{"body":{"content":"好的。我去查查","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965807547},{"body":{"content":"一定要到上级最好的风湿免疫专科就诊，这样的话查的比较全面，不延误您的病情。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965838817},{"body":{"content":"之前做了心脏肾脏。。。。好多检查。。都没有解决问题","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965844364},{"body":{"content":"这种能治不","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965855891},{"body":{"content":"目前考虑大血管的病变，具体还要等检查结果。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965862258},{"body":{"content":"不要紧张，根据病情制定方案就行了。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965874445},{"body":{"content":"一般情况会是做手术还是吃药调理呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965902348},{"body":{"content":"嗯，不会做手术的，主要是内科治疗。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965918896},{"body":{"content":"哦哦","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965935466},{"body":{"content":"等下。我拍个手和胳膊","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965999057},{"body":{"content":"手指没有变形，但是皮肤颜色有变化，所以仍考虑风湿免疫类问题","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966146725},{"body":{"content":"感谢您的回复","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966159379},{"body":{"content":"不客气","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966167409},{"body":{"content":"最近会安排做个检查","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966172223},{"body":{"content":"因为已经折磨我几年了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966186522},{"body":{"content":"找不到病因","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966198089},{"body":{"content":"放宽心情，积极面对，尽早的明确病情","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966288526},{"body":{"content":"应该是手机镜像的原因你看着是左边。其实是右边","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966360372},{"body":{"content":"哦哦","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966380243},{"body":{"content":"有凹陷","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966382190},{"body":{"content":"按下去不回来","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966406626},{"body":{"content":"静脉的水肿一般就为凹陷性水肿，血管炎会有这样的表现，血管炎呢，它一般情况下属于也是属于风湿免疫结缔组织病的一种，所以建议您尽快的行，专科检查，专科治疗。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966444186},{"body":{"content":"但不回弹的地方只在膝盖以下","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966459709},{"body":{"content":"我是做整身的血管检查么？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966495949},{"body":{"content":"还是只做右侧呢？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966515102},{"body":{"content":"我建议您不要只做单项检查，我建议您先走风湿免疫科的专科医院，然后由专科医生给您开一系列的检查，您再去做，检查结果，方便医生进行总体病情评估。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966555759},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966570901},{"body":{"content":"您自己不要再去单独的开检查了，必须让专科医生进行专科治疗。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966574409},{"body":{"content":"我明白了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966577447},{"body":{"content":"感谢您的帮助","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966585320},{"body":{"content":"这就是所谓的一叶障目不见泰山，所以不要自作主张，及时的进行专科诊疗。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966627887},{"body":{"content":"明白了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966643652},{"body":{"content":"不客气","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966676573},{"body":{"content":"您早点休息。我尽快安排检查","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652966736986},{"body":{"content":"嗯嗯，加油","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652966760292}]

女40岁

2022.05.20

[{"body":{"content":"你好，我是三级甲等医院神经内科中级医师，***，请问您有什么需要咨询的医学问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050400673},{"body":{"content":"血糖高多长时间了？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050409326},{"body":{"content":"好长时间了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050439010},{"body":{"content":"有10年了吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050520345},{"body":{"content":"你这种情况预防和早期诊断是防止糖尿病神经病变造成严重后悔的基本措施。\n\n1、严格控制血糖，戒烟，纠正血脂异常，控制高血压。\n\n2、加强足部**：选择透气性良好质软的合脚的鞋袜，经常检查并取出鞋内异物。患者应每日洗脚，水温不宜过高。秋冬季节足部易干裂，可用中性润肤霜均匀涂擦，汗脚可撒些***。\n\n3、定期进行筛查及病情评价：\n\n","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050533052},{"body":{"content":"差不多吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050590876},{"body":{"content":"**，那你需要注意一下了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050615418},{"body":{"content":"我把上面的注意事项也发给你了，预防非常关键。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050623422},{"body":{"content":"预防糖尿病周围神经病变。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050630880},{"body":{"content":"这吃什么药，好的快点","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050683754},{"body":{"content":"可以试试****，早中晚各一粒。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050805140},{"body":{"content":"那个厂家的药会好些","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050946956},{"body":{"content":"***","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050956406},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050977650},{"body":{"content":"试试吧","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051024582}]

男33岁

2022.05.20

[{"body":{"content":"您好，我是皮肤科副主任医师刘立红医生，非常高兴由我为您提供医疗咨询服务","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050806963},{"body":{"content":"请问医生在吗?","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050903303},{"body":{"content":"在的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050913454},{"body":{"content":"方便上传清晰的患处图片吗？以便更好地为您分析病情","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050917115},{"body":{"content":"发际线吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050928378},{"body":{"content":"对的，或者发量比较稀疏的部位","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050945827},{"body":{"content":"您看我都快秃了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050986862},{"body":{"content":"主要是前面","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051007730},{"body":{"content":"收到","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051008188},{"body":{"content":"您家里有遗传的情况吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051011148},{"body":{"content":"有的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051016910},{"body":{"content":"根据您的图片及描述考虑是脂溢性脱发","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051036030},{"body":{"content":"我爷爷是秃顶","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051037530},{"body":{"content":"那是遗传问题可以治疗吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051070591},{"body":{"content":"目前考虑是脂溢性脱发的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051072776},{"body":{"content":"遗传基因是改变不了的，但是可以用药控制和缓解症状","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051084087},{"body":{"content":"应该怎么治疗啊","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051117557},{"body":{"content":"根据您的情况可以给您用药建议，为用药安全，请问您是否有严重药物过敏史或者药物严重不良反应？近期肝肾功能是否正常？是否有慢性疾病？ 如没有，可以直接回复“否”。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051131286},{"body":{"content":"否","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051137625},{"body":{"content":"建议您口服*****，外用******治疗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051199561},{"body":{"content":"平时的***可以换成*****吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051254933},{"body":{"content":"用药前请您仔细阅读药品说明书中禁忌，注意事项，如无禁忌可使用我为您开具的药品，如您在用药过程中出现不适，请您及时上线咨询或去医院就诊。建议您定期复诊。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051267574},{"body":{"content":"稍后可以给您推荐一种***","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051280416},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051354247},{"body":{"content":"谢谢医生！","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051359453},{"body":{"content":"不客气的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051376322},{"body":{"content":"可以给您开具处方方便您线上购药，如果需要稍后可以直接点击处方单预约购买","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051380747},{"body":{"content":"上面给您开具了处方单，您往上翻看一下，如果需要可以点击处方单按照提示线上预约购买。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051445699},{"body":{"content":"******是是非处方药，您可以自己购买","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051457350},{"body":{"content":"建议您避免辛辣刺激油腻饮食，均衡饮食，多吃高蛋白的食物，蔬菜和水果，适当锻炼身体，避免头皮长时间暴露在阳光下，避免熬夜，焦虑，精神紧张等。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051569208},{"body":{"content":"请问您还有其他问题需要咨询吗?","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051744111},{"body":{"content":"如果您没有其他问题，我将结束问诊，希望我的建议能够帮助到您。请您在对话结束后给予五星好评，您的好评是对我工作最好的肯定和鼓励，欢迎您有问题随时上线咨询。祝您及家人身体健康。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051832312}]

男21岁

2022.05.20

[{"body":{"content":"您好，非常高兴由我为您提供医疗咨询服务，请稍等，我正在详细阅读您的病情描述。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965432936},{"body":{"content":"HPV病毒可以导致湿疣，有传染性，正常人没有不洁性接触史不会得的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965516151}]

男24岁

2022.05.20

[{"body":{"content":"您好，一天的体重变化没有意义的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652964981124},{"body":{"content":"要一周以上变化才有意义","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652964990367},{"body":{"content":"哦哦，好的，我知道了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965020351},{"body":{"content":"体脂较高怎么办","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965052880},{"body":{"content":"采用调整饮食结构，增加运动量的方式。调整饮食不是控制饮食，而是调整为高蛋白（鸡胸，**，鱼，虾，豆制品等）低碳水（粗粮为主）低脂肪（少食肥肉，烧菜时少放油等）这种饮食模式。另外运动是为了增加基础代谢率的，这样减肥才能持续，不容易反弹。运动方式比较多，跑步，跳绳，仰卧起坐，爬楼梯，游泳等都是可以的，可以根据自己平时的生活习惯选择。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965234553}]

女21岁

2022.05.20

[{"body":{"content":"您好，我是京东互联网医院医生，非常高兴由我为您提供医疗咨询服务，请稍等，我正在详细阅读您的病情描述。\n什么情况？是否有其他疾病？\n近期有没有什么用药史，\n或药物过敏史？\n请说","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049650314},{"body":{"content":"你好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049663735},{"body":{"content":"宝宝老是长这个痘痘","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049680636},{"body":{"content":"这样多久","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049683104},{"body":{"content":"有啥不舒服表现","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049685733},{"body":{"content":"别的没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049694229},{"body":{"content":"就是长痘","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049698586},{"body":{"content":"过几天好了","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049708727},{"body":{"content":"过了几天又长","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049716121},{"body":{"content":"怎么好的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049721025},{"body":{"content":"自然好 偶尔抹点药膏","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049738267},{"body":{"content":"痒蹭？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049759153},{"body":{"content":"被啥咬？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049763259},{"body":{"content":"背上头上脚上都有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049771101},{"body":{"content":"不痒","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049774310},{"body":{"content":"线下皮肤镜检查过？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049791393},{"body":{"content":"没有","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049795828},{"body":{"content":"涂啥药？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049824861},{"body":{"content":"*****","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049873159},{"body":{"content":"哦，有*****","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049919441},{"body":{"content":"需要去医院检查吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049938163},{"body":{"content":"建议需要的，反复发作，而且自己好。多是自身免疫因素","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050017827},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050140134},{"body":{"content":"谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050142382},{"body":{"content":"客气了","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050161385}]

男3岁

2022.05.20

[{"body":{"content":"我是中医内科主任医师张玲军医生，请问您有什么需要咨询的医学问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965571258},{"body":{"content":"你好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965579051},{"body":{"content":"你好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965596256},{"body":{"content":"指甲发生这种情况是啥原因","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965624189},{"body":{"content":"需不需要去医院挂科看","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965644714},{"body":{"content":"去医院看看吧","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965680552},{"body":{"content":"应该挂啥科室","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965694530},{"body":{"content":"皮肤科","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965702052},{"body":{"content":"好的谢谢您","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965804374},{"body":{"content":"不客气","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965813884}]

女24岁

2022.05.20