刘继帅

[{"body":{"content":"您好，感谢信任，接到您的问题，我先根据您提供的情况仔细分析一下，然后给您答复。我这条内容您不用回复，请稍等几分钟，我会详细解答。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879268155},{"body":{"content":"他现在在做靶免治疗，这边医生说肿瘤控制的还可以，就是肝硬化有点严重。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879324502},{"body":{"content":"你好，看结果，肝功能异常，与肝硬化，肝癌，以及肝癌靶免治疗都有关系，目前具体用的那几个药物？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879402729},{"body":{"content":"\n他现在吃 *******，*****，当***，*******","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879443546},{"body":{"content":"嗯，靶免治疗用的什么？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879536304},{"body":{"content":"而且靶免治疗多久了？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879664881},{"body":{"content":"用的*****联合*****","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879722424},{"body":{"content":"嗯，目前看肝功能指标，黄疸转氨酶都比较高，靶免治疗需要注意风险","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879795185},{"body":{"content":"21天一次用了5次","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879798590},{"body":{"content":"嗯嗯，因为靶免治疗也有肝损害风险","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879817120},{"body":{"content":"那您能给一个治疗建议，治疗方案吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652879889341},{"body":{"content":"一般我们的患者靶免治疗期间如果肝功能指标持续升高，就要先暂停一次，加强***物治疗，等肝功能改善，尤其是胆红素水平最好降低到40以下再恢复","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652879957265},{"body":{"content":"谢谢医生 那现在有没有用药建议。他吃的药需不需要换。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880150636},{"body":{"content":"如果乙肝病毒DNA阴性，*****就不用换，***物也可以先维持目前几个，观察一周左右复查肝功能看变化，再决定下一步方案","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880220951},{"body":{"content":"那等一周后肝功能结果出来了我再联系你吧医生。他之前吃**，后来换的这个","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880358250},{"body":{"content":"可以，方案是否有效，关键看复查结果","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880385869},{"body":{"content":"那就先维持治疗，靶免停一停吧。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880445830},{"body":{"content":"对的，治疗安全第一，其次是效果","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880477356},{"body":{"content":"他现在还会偶尔发烧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880587846},{"body":{"content":"如果没有明确细菌感染，发烧考虑肿瘤有关，可以对症治疗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880636479},{"body":{"content":"这边医生考虑是腹水引起的腹膜炎","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880672486},{"body":{"content":"那就要用***","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880684305},{"body":{"content":"嗯 输着***，到时候看看效果吧。","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652880706907},{"body":{"content":"嗯嗯一般至少3-5天","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652880725506},{"body":{"content":"好 等结果出来我再联系您吧","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652881425055},{"body":{"content":"好的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652881434381}]

男54岁

2022.05.20

[{"body":{"content":"您好，这里是京东互联网医生，请问您有什么需要解决的医学问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965804059},{"body":{"content":"请问你们医院有没有3mg的**卖","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965825924},{"body":{"content":"请问您是咸阳中心医院的吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965858717},{"body":{"content":"这里是洛阳市精神卫生中心","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965910084},{"body":{"content":"哦，不好意思","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965922705},{"body":{"content":"谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965926555},{"body":{"content":"不客气","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965939740}]

男29岁

2022.05.20

[{"body":{"content":"您好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965313398},{"body":{"content":"有什么可以帮助到您的吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965396944}]

女24岁

2022.05.20

[{"body":{"content":"你好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965414453},{"body":{"content":"这里是京东医生平台","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965881387}]

男58岁

2022.05.20

[{"body":{"content":"你好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965669409},{"body":{"content":"宝宝这样的情况有多长时间了？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965680363},{"body":{"content":"就今天早晨","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965701026},{"body":{"content":"好的，看不出有蚊虫叮咬的痕迹吧","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965852017},{"body":{"content":"暂时看不出来","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965894996},{"body":{"content":"好像也有一个小红点点，","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652965908714},{"body":{"content":"哦，可以先用**消毒，在涂上***看看","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965948058},{"body":{"content":"出现红肿还是考虑炎症","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652965963503}]

男1岁7个月

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":1653049657759},{"body":{"content":"请问您有什么需要咨询的医学问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049725112},{"body":{"content":"您能帮我看看过敏源结果吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049743731},{"body":{"content":"总IGE浓度高是怎么回事儿","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049761513},{"body":{"content":"发下结果","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049769640},{"body":{"content":"你好","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049819142},{"body":{"content":"平时有什么过敏吗","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049826542},{"body":{"content":"前阵子去检查哮喘","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049899416},{"body":{"content":"IgE多与过敏性的反应有关，总IgE升高最常见于过敏体质的人，或者有过敏性疾病的患者。另外，寄生虫感染引起的变态免疫反应，也会引起总IgE升高，部分的血液系统疾病例如部分的骨髓瘤，还有霍奇金淋巴瘤等疾病，也可能会出现总IgE的升高。真菌感染、病毒感染或者结核病等少部分特异性的感染性疾病，患者也可能会出现总IgE的升高，与免疫功能相关的疾病包括类风湿性关节炎、格林-巴利综合征或者高IgE综合征、肾病综合征等疾病都有可能会出现总IgE的升高。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049935421},{"body":{"content":"血常规还有****检查都显示是过敏","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653049944973},{"body":{"content":"建议进一步检查","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049951764},{"body":{"content":"好的，谢谢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050021673},{"body":{"content":"不客气，建议进一步检查。不适随诊","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050103691}]

男39岁

2022.05.20

[{"body":{"content":"您好，我是住院医师狄华，很高兴由我为您提供咨询服务。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049850568},{"body":{"content":"请问您有什么需要咨询的医学问题？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049853742},{"body":{"content":"近日期生产的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653049859313}]

女

2022.05.20

[{"body":{"content":"而且很痛","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878654689},{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878784166},{"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":1652878790736},{"body":{"content":"好","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652878831734},{"body":{"content":"您好！脸上红印，红血丝较多，形成敏感肌，痘痘为结节囊肿型","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878897261},{"body":{"content":"平时常用洗面奶洗脸的频率如何？都使用哪些类型的洗面奶？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652878981247},{"body":{"content":"***","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652881169301},{"body":{"content":"晚上早上洗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652881195080},{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652881492821},{"body":{"content":"敏感肌建议您精简护肤，平时用温水洗脸即可。使用洗面奶。尽量避免使用清洁型或磨砂型，使用频率每周不超过两次为宜。每次洗脸之后需涂***。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652881539035},{"body":{"content":"同时平时注意防晒。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652881546353},{"body":{"content":"痘痘之所以反复发作跟体内激素水平高有关，会导致毛囊皮脂腺分泌旺盛，堵塞毛管，痤疮丙酸杆菌，细菌灰尘，等会定植毛囊引发炎症。痘痘有硬结是炎症比较深，深达真皮层。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652881614316},{"body":{"content":"您都用过哪些药物治疗？效果如何？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652881640524},{"body":{"content":"没有用其他药物","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652919276830},{"body":{"content":"根据您的情况，建议您：\n1、中药口服内调体质，增加皮肤修复能力；局部外用药膏改善炎症，减少痘印；\n2、配合使用药妆品和肌肤屏障修复剂；有助于皮肤修复，改善敏感肌，减少痘痘复发；\n3、日常精简护肤，用温水洗脸，尽量避免使用深度清洁型洗面奶及磨砂型洗面奶，选择比较温和的保湿产品，避免选用***类产品。使用洗面奶的频率，每周两次左右。要特别注意防晒、保湿。这些措施要贯彻在你治疗的全过程。\n4、另外一个是饮食注意少食辛辣油炸刺激之品。避免食用奶茶，奶酪，牛奶，奶油等奶制品以及巧克力冰淇淋等甜食甜品。这些都是造成痘痘反复不愈的原因。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652926585887},{"body":{"content":"什么中药呢","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1652934819750},{"body":{"content":"您好,感谢您的信任!!!","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652937215777},{"body":{"content":"需要根据您的舌开具中药方，中药免煎颗粒，开水冲服那种","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652937252364},{"body":{"content":"您发个舌苔图片看看","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1652937260673}]

女31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":1653050384421},{"body":{"content":"摸下什么感觉","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050404051},{"body":{"content":"皮肤下面有一粒","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050433657},{"body":{"content":"腱鞘囊肿？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050531141}]

男3岁

2022.05.20

[{"body":{"content":"您好，京东大药房药师工号0089，很高兴为您服务！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050857239},{"body":{"content":"为了您的用药安全，方便药师指导用药，请问患者的性别和年龄？特殊情况请提前告知，如：（糖尿病、肝肾等其他病史、备孕期、孕期、哺乳期、是否有过敏史）","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050871627},{"body":{"content":"我脚的第三个指甲盖上有白色的点 这个是灰指甲吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050884376},{"body":{"content":"可以用的。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050891047},{"body":{"content":"请问有图片看一下吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050904444},{"body":{"content":"我这个属于灰指甲吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050904910},{"body":{"content":"可以上面图片看一下","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050918505},{"body":{"content":"如果有图片看更好。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050941699},{"body":{"content":"是灰指甲的一种。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050972913},{"body":{"content":"坚持用药两个月以上。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653050978108},{"body":{"content":"严重吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653050995325},{"body":{"content":"中等的。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051001623},{"body":{"content":"饮食上不要吃辣的冷的食物和鱼虾，海鲜等发物。日常多喝温水，排出身上的毒素。晚上不能熬夜，22点之后要入睡。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051006699},{"body":{"content":"为了您的用药安全，请您在用药前仔细阅读说明书注意事项、禁忌等内容，严格按照说明书或药师指导的用法用量使用，若用药7天无效果或病情加重，请及时咨询医生师或立即线下就医。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051052515},{"body":{"content":"我这个用上面那个连接的要药就可以吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051063068},{"body":{"content":"可以用的。是对症这样的。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051082541},{"body":{"content":"这个怎么用？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051107147},{"body":{"content":"一天几次?","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051114152},{"body":{"content":"我这个会传染给孩子吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051123125},{"body":{"content":"早晚一次。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051128622},{"body":{"content":"会有传染性。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051134189},{"body":{"content":"不要让别人穿自己的鞋子。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051141256},{"body":{"content":"直接涂在指甲盖上吗？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051149654},{"body":{"content":"是的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051158130},{"body":{"content":"要用多久？","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051158331},{"body":{"content":"两个月以上。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051163850},{"body":{"content":"这个是膏状的吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051175568},{"body":{"content":"是的","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051193069},{"body":{"content":"您看还有**药理问题需要咨询药师吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051224145},{"body":{"content":"这个药只能治灰指甲吗脚气管用吗","type":"text"},"from":{"app":"jd.dyf"},"timestamp":1653051254429},{"body":{"content":"吸收好，就是效果快。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051274038},{"body":{"content":"也治脚气。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051302428},{"body":{"content":"坚持用药就可以。","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051393673},{"body":{"content":"您看还有**药理问题需要咨询药师吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051409916},{"body":{"content":"您好，请问您咨询的是这个药品吗？","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051474898},{"body":{"content":"很高兴为您服务，请对我本次服务做出评价，感谢您对京东大药房的支持，祝您生活愉快，谢谢！","type":"text"},"from":{"app":"jd.doctor"},"timestamp":1653051512387}]

女

2022.05.20