File size: 120,793 Bytes
39e92cd
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
501
502
503
504
505
506
507
508
509
510
511
512
513
514
515
516
517
518
519
520
521
522
523
524
525
526
527
528
529
530
531
532
533
534
535
536
537
538
539
540
541
542
543
544
545
546
547
548
549
550
551
552
553
554
555
556
557
558
559
560
561
562
563
564
565
566
567
568
569
570
571
572
573
574
575
576
577
578
579
580
581
582
583
584
585
586
587
588
589
590
591
592
593
594
595
596
597
598
599
600
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616
617
618
619
620
621
622
623
624
625
626
627
628
629
630
631
632
633
634
635
636
637
638
639
640
641
642
643
644
645
646
647
648
649
650
651
652
653
654
655
656
657
658
659
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
685
686
687
688
689
690
691
692
693
694
695
696
697
698
699
700
701
702
703
704
705
706
707
708
709
710
711
712
713
714
715
716
717
718
719
720
721
722
723
724
725
726
727
728
729
730
731
732
733
734
735
736
737
738
739
740
741
742
743
744
745
746
747
748
749
750
751
752
753
754
755
756
757
758
759
760
761
762
763
764
765
766
767
768
769
770
771
772
773
774
775
776
777
778
779
780
781
782
783
784
785
786
787
788
789
790
791
792
793
794
795
796
797
798
799
800
801
802
803
804
805
806
807
808
809
810
811
812
813
814
815
816
817
818
819
820
821
822
823
824
825
826
827
828
829
830
831
832
833
834
835
836
837
838
839
840
841
842
843
844
845
846
847
848
849
850
851
852
853
854
855
856
857
858
859
860
861
862
863
864
865
866
867
868
869
870
871
872
873
874
875
876
877
878
879
880
881
882
883
884
885
886
887
888
889
890
891
892
893
894
895
896
897
898
899
900
901
902
903
904
905
906
907
908
909
910
911
912
913
914
915
916
917
918
919
920
921
922
923
924
925
926
927
928
929
930
931
932
933
934
935
936
937
938
939
940
941
942
943
944
945
946
947
948
949
950
951
952
953
954
955
956
957
958
959
960
961
962
963
964
965
966
967
968
969
970
971
972
973
974
975
976
977
978
979
980
981
982
983
984
985
986
987
988
989
990
991
992
993
994
995
996
997
998
999
1000
1001
1002
1003
1004
1005
1006
1007
1008
1009
1010
1011
1012
1013
1014
1015
1016
1017
1018
1019
1020
1021
1022
1023
1024
1025
1026
1027
1028
1029
1030
1031
1032
1033
1034
1035
1036
1037
1038
1039
1040
1041
1042
1043
1044
1045
1046
1047
1048
1049
1050
1051
1052
1053
1054
1055
1056
1057
1058
1059
1060
1061
1062
1063
1064
1065
1066
1067
1068
1069
1070
1071
1072
1073
1074
1075
1076
1077
1078
1079
1080
1081
1082
1083
1084
1085
1086
1087
1088
1089
1090
1091
1092
1093
1094
1095
1096
1097
1098
1099
1100
1101
1102
1103
1104
1105
1106
1107
1108
1109
1110
1111
1112
1113
1114
1115
1116
1117
1118
1119
1120
1121
1122
1123
1124
1125
1126
1127
1128
1129
1130
1131
1132
1133
1134
1135
1136
1137
1138
1139
1140
1141
1142
1143
1144
1145
1146
1147
1148
1149
1150
1151
1152
1153
1154
1155
1156
1157
1158
1159
1160
1161
1162
1163
1164
1165
1166
1167
1168
1169
1170
1171
1172
1173
1174
1175
1176
1177
1178
1179
1180
1181
1182
1183
1184
1185
1186
1187
1188
1189
1190
1191
1192
1193
1194
1195
1196
1197
1198
1199
1200
1201
1202
1203
1204
1205
1206
1207
1208
1209
1210
1211
1212
1213
1214
1215
1216
1217
1218
1219
1220
1221
1222
1223
1224
1225
1226
1227
1228
1229
1230
1231
1232
1233
1234
1235
1236
1237
1238
1239
1240
1241
1242
1243
1244
1245
1246
1247
1248
1249
1250
1251
1252
1253
1254
1255
1256
1257
1258
1259
1260
1261
1262
1263
1264
1265
1266
1267
1268
1269
1270
1271
1272
1273
1274
1275
1276
1277
1278
1279
1280
1281
1282
1283
1284
1285
1286
1287
1288
1289
1290
1291
1292
1293
1294
1295
1296
1297
1298
1299
1300
1301
1302
1303
1304
1305
1306
1307
1308
1309
1310
1311
1312
1313
1314
1315
1316
1317
1318
1319
1320
1321
1322
1323
1324
1325
1326
1327
1328
1329
1330
1331
1332
1333
1334
1335
1336
1337
1338
1339
1340
1341
1342
1343
1344
1345
1346
1347
1348
1349
1350
1351
1352
1353
1354
1355
1356
1357
1358
1359
1360
1361
1362
1363
1364
1365
1366
1367
1368
1369
1370
1371
1372
1373
1374
1375
1376
1377
1378
1379
1380
1381
1382
1383
1384
1385
1386
1387
1388
1389
1390
1391
1392
1393
1394
1395
1396
1397
1398
1399
1400
1401
1402
1403
1404
1405
1406
1407
1408
1409
1410
1411
1412
1413
1414
1415
1416
1417
1418
1419
1420
1421
1422
1423
1424
1425
1426
1427
1428
1429
1430
1431
1432
1433
1434
1435
1436
1437
1438
1439
1440
1441
1442
1443
1444
1445
1446
1447
1448
1449
1450
1451
1452
1453
1454
1455
1456
1457
1458
1459
1460
1461
1462
1463
1464
1465
1466
1467
1468
1469
1470
1471
1472
1473
1474
1475
1476
1477
1478
1479
1480
1481
1482
1483
1484
1485
1486
1487
1488
1489
1490
1491
1492
1493
1494
1495
1496
1497
1498
1499
1500
1501
1502
1503
1504
1505
1506
1507
1508
1509
1510
1511
1512
1513
1514
1515
1516
1517
1518
1519
1520
1521
1522
1523
1524
1525
1526
1527
1528
1529
1530
1531
1532
1533
1534
1535
1536
1537
1538
1539
1540
1541
1542
1543
1544
1545
1546
1547
1548
1549
1550
1551
1552
1553
1554
1555
1556
1557
1558
1559
1560
1561
1562
1563
1564
1565
1566
1567
1568
1569
1570
1571
1572
1573
1574
1575
1576
1577
1578
1579
1580
1581
1582
1583
1584
1585
1586
1587
1588
1589
1590
1591
1592
1593
1594
1595
1596
1597
1598
1599
1600
1601
1602
1603
1604
1605
1606
1607
1608
1609
1610
1611
1612
1613
1614
1615
1616
1617
1618
1619
1620
1621
1622
1623
1624
1625
1626
1627
1628
1629
1630
1631
1632
1633
1634
1635
1636
1637
1638
1639
1640
1641
1642
1643
1644
1645
1646
1647
1648
1649
1650
1651
1652
1653
1654
1655
1656
1657
1658
1659
1660
1661
1662
1663
1664
1665
1666
1667
1668
1669
1670
1671
1672
1673
1674
1675
1676
1677
1678
1679
1680
1681
1682
1683
1684
1685
1686
1687
1688
1689
1690
1691
1692
1693
1694
1695
1696
1697
1698
1699
1700
1701
1702
1703
1704
1705
1706
1707
1708
1709
1710
1711
1712
1713
1714
1715
1716
1717
1718
1719
1720
1721
1722
1723
1724
1725
1726
1727
1728
1729
1730
1731
1732
1733
1734
1735
1736
1737
1738
1739
1740
1741
1742
1743
1744
1745
1746
1747
1748
1749
1750
1751
1752
1753
1754
1755
1756
1757
1758
1759
1760
1761
1762
1763
1764
1765
1766
1767
1768
1769
1770
1771
1772
1773
1774
1775
1776
1777
1778
1779
1780
1781
1782
1783
1784
1785
1786
1787
1788
1789
1790
1791
1792
1793
1794
1795
1796
1797
1798
1799
1800
1801
1802
1803
1804
1805
1806
1807
1808
1809
1810
1811
1812
1813
1814
1815
1816
1817
1818
1819
1820
1821
1822
1823
1824
1825
1826
1827
1828
1829
1830
1831
1832
1833
1834
1835
1836
1837
1838
1839
1840
1841
1842
1843
1844
1845
1846
1847
1848
1849
1850
1851
1852
1853
1854
1855
1856
1857
1858
1859
1860
1861
1862
1863
1864
1865
1866
1867
1868
1869
1870
1871
1872
1873
1874
1875
1876
1877
1878
1879
1880
1881
1882
1883
1884
1885
1886
1887
1888
1889
1890
1891
1892
1893
1894
1895
1896
1897
1898
1899
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
2047
2048
2049
2050
2051
2052
2053
2054
2055
2056
2057
2058
2059
2060
2061
2062
2063
2064
2065
2066
2067
2068
2069
2070
2071
2072
2073
2074
2075
2076
2077
2078
2079
2080
2081
2082
2083
2084
2085
2086
2087
2088
2089
2090
2091
2092
2093
2094
2095
2096
2097
2098
2099
2100
2101
2102
2103
2104
2105
2106
2107
2108
2109
2110
2111
2112
2113
2114
2115
2116
2117
2118
2119
2120
2121
2122
2123
2124
2125
2126
2127
2128
2129
2130
2131
2132
2133
2134
2135
2136
2137
2138
2139
2140
2141
2142
2143
2144
2145
2146
2147
2148
2149
2150
2151
2152
2153
2154
2155
2156
2157
2158
2159
2160
2161
2162
2163
2164
2165
2166
2167
2168
2169
2170
2171
2172
2173
2174
2175
2176
2177
2178
2179
2180
2181
2182
2183
2184
2185
2186
2187
2188
2189
2190
2191
2192
2193
2194
2195
2196
2197
2198
2199
2200
2201
2202
2203
2204
2205
2206
2207
2208
2209
2210
2211
2212
2213
2214
2215
2216
2217
2218
2219
2220
2221
2222
2223
2224
2225
2226
2227
2228
2229
2230
2231
2232
2233
2234
2235
2236
2237
2238
2239
2240
2241
2242
2243
2244
2245
2246
2247
2248
2249
2250
2251
2252
2253
2254
2255
2256
2257
2258
2259
2260
2261
2262
2263
2264
2265
2266
2267
2268
2269
2270
2271
2272
2273
2274
2275
2276
2277
2278
2279
2280
2281
2282
2283
2284
2285
2286
2287
2288
2289
2290
2291
2292
2293
2294
2295
2296
2297
2298
2299
2300
2301
2302
2303
2304
2305
2306
2307
2308
2309
2310
2311
2312
2313
2314
2315
2316
2317
2318
2319
2320
2321
2322
2323
2324
2325
2326
2327
2328
2329
2330
2331
2332
2333
2334
2335
2336
2337
2338
2339
2340
2341
2342
2343
2344
2345
2346
2347
2348
2349
2350
2351
2352
2353
2354
2355
2356
2357
2358
2359
2360
2361
2362
2363
2364
2365
2366
2367
2368
2369
2370
2371
2372
2373
2374
2375
2376
2377
2378
2379
2380
2381
2382
2383
2384
2385
2386
2387
2388
2389
2390
2391
2392
2393
2394
2395
2396
2397
2398
2399
2400
2401
2402
2403
2404
2405
2406
2407
2408
2409
2410
2411
2412
2413
2414
2415
2416
2417
2418
2419
2420
2421
2422
2423
2424
2425
2426
2427
2428
2429
2430
2431
2432
2433
2434
2435
2436
2437
2438
2439
2440
2441
2442
2443
2444
2445
2446
2447
2448
2449
2450
2451
2452
2453
2454
2455
2456
2457
2458
2459
2460
2461
2462
2463
2464
2465
2466
2467
2468
2469
2470
2471
2472
2473
2474
2475
2476
2477
2478
2479
2480
2481
2482
2483
2484
2485
2486
2487
2488
2489
2490
2491
2492
2493
2494
2495
2496
2497
2498
2499
2500
2501
2502
2503
2504
2505
2506
2507
2508
2509
2510
2511
2512
2513
2514
2515
2516
2517
2518
2519
2520
2521
2522
2523
2524
2525
2526
2527
2528
2529
2530
2531
2532
2533
2534
2535
2536
2537
2538
2539
2540
2541
2542
2543
2544
2545
2546
2547
2548
2549
2550
2551
2552
2553
2554
2555
2556
2557
2558
2559
2560
2561
2562
2563
2564
2565
2566
2567
2568
2569
2570
2571
2572
2573
2574
2575
2576
2577
2578
2579
2580
2581
2582
2583
2584
2585
2586
2587
2588
2589
2590
2591
2592
2593
2594
2595
2596
2597
2598
2599
2600
2601
2602
2603
2604
2605
2606
2607
2608
2609
2610
2611
2612
2613
2614
2615
2616
2617
2618
2619
2620
2621
2622
2623
2624
2625
2626
2627
2628
2629
2630
2631
2632
2633
2634
2635
2636
2637
2638
2639
2640
2641
2642
2643
2644
2645
2646
2647
2648
2649
2650
2651
2652
2653
2654
2655
2656
2657
2658
2659
2660
2661
2662
2663
2664
2665
2666
2667
2668
2669
2670
2671
2672
2673
2674
2675
2676
2677
2678
2679
2680
2681
2682
2683
2684
2685
2686
2687
2688
2689
2690
2691
2692
2693
2694
2695
2696
2697
2698
2699
2700
2701
2702
2703
2704
2705
2706
2707
2708
2709
2710
2711
2712
2713
2714
2715
2716
2717
2718
2719
2720
2721
2722
2723
2724
2725
2726
2727
2728
2729
2730
2731
2732
2733
2734
2735
2736
2737
2738
2739
2740
2741
2742
2743
2744
2745
2746
2747
2748
2749
2750
2751
2752
2753
2754
2755
2756
2757
2758
2759
2760
2761
2762
2763
2764
2765
2766
2767
2768
2769
2770
2771
2772
2773
2774
2775
2776
2777
2778
2779
2780
2781
2782
2783
2784
2785
2786
2787
2788
2789
2790
2791
2792
2793
2794
2795
2796
2797
2798
2799
2800
2801
2802
2803
2804
2805
2806
2807
2808
2809
2810
2811
2812
2813
2814
2815
2816
2817
2818
2819
2820
2821
2822
2823
2824
2825
2826
2827
2828
2829
2830
2831
2832
2833
2834
2835
2836
[
  {
    "question_num": 1,
    "query": "下列各项,具有化神作用的是",
    "options": {
      "A": "脉",
      "B": "气",
      "C": "血",
      "D": "津",
      "E": "液"
    },
    "answer": "C",
    "reason": "血由水谷之精、肾精化生,与心、脾、肺肾关系密切,具有濡养、化神作用。"
  },
  {
    "question_num": 2,
    "query": "患者,女,24岁,已婚。停经49天时诊为早孕,近3天少量阴道流血,无腰痛,尿妊娠试验(+),既往曾2次流产,其诊断是",
    "options": {
      "A": "妊娠腹痛",
      "B": "胎动不安",
      "C": "胎漏",
      "D": "堕胎",
      "E": "滑胎"
    },
    "answer": "C",
    "reason": "胎漏是指妊娠期间,阴道不时有少量出血,时出时止,或淋漓不断,而无腰酸、腹痛、小腹下坠。胎动不安有腰酸、腹痛下坠,或伴有少量的阴道出血、脉滑。妊娠疬是妊娠期因胞脉阻滞或失养,发生小腹疼痛。堕胎是凡妊娠12周内,胚胎自然殒堕。滑胎是凡堕胎或小产连续发生3次或3次以上。故本题选C项。"
  },
  {
    "question_num": 3,
    "query": "分布于上肢内侧中线的是",
    "options": {
      "A": "手厥阴经",
      "B": "手太阳经",
      "C": "手阳明经",
      "D": "足少阳经",
      "E": "足阳明经"
    },
    "answer": "A",
    "reason": "十二经脉在上肢的分布:上肢内侧由前到后为太阴一厥阴一少阴,上肢外侧由前到后为阳明一少阳一太阳。"
  },
  {
    "question_num": 4,
    "query": "八脉交会穴中,主治目内眦、颈项、耳、肩疾患的是",
    "options": {
      "A": "照海、阳陵泉",
      "B": "后溪、申脉",
      "C": "列缺、照海",
      "D": "外关、足临泣",
      "E": "内关、公孙"
    },
    "answer": "B",
    "reason": ""
  },
  {
    "question_num": 5,
    "query": "寒邪伤人,导致毛发腠理闭塞,筋脉挛急收缩的理论依据是",
    "options": {
      "A": "寒性收引",
      "B": "寒性主痛",
      "C": "寒易伤气",
      "D": "寒性凝滞",
      "E": "寒易伤阳"
    },
    "answer": "A",
    "reason": "寒邪致病特点:①寒为阴邪,易伤阳气;②寒性凝滞,易致经脉血气运行不畅;③寒性收引,可致气机收敛,腠理、经络、筋脉挛急收缩。"
  },
  {
    "question_num": 6,
    "query": "呃逆的基本治法是",
    "options": {
      "A": "疏肝解郁降逆",
      "B": "和胃降逆止呃",
      "C": "理气化瘀降逆",
      "D": "健脾温中止呃",
      "E": "清热和胃止呃"
    },
    "answer": "B",
    "reason": "呃逆的病机为胃气上逆,治法宜和胃降逆止呃。"
  },
  {
    "question_num": 7,
    "query": "多重情志交织,易伤的脏是",
    "options": {
      "A": "肺脾肾",
      "B": "心肝肾",
      "C": "心肝脾",
      "D": "肝脾肾",
      "E": "心肺脾"
    },
    "answer": "C",
    "reason": "七情内伤致病,数情交织,易伤心肝脾,是因心肝脾三脏在人体生理和情志活动中发挥重要作用。"
  },
  {
    "question_num": 8,
    "query": "患者,男,22岁。发热恶寒,寒重热轻。头痛身痛,鼻塞流涕,咳嗽,咳痰清稀,舌苔薄白,脉浮紧。治疗应首选",
    "options": {
      "A": "手太阴、手阳明、足太阳经穴",
      "B": "手少阴、手太阳、手太阴经穴",
      "C": "手太阴、足太阳、手少阳经穴",
      "D": "手太阴、手少阳、足少阳经穴",
      "E": "手阳明、足阳明、手太阴经穴"
    },
    "answer": "A",
    "reason": "由患者的症状可知本病为感冒之风寒感冒,所以应首选手太阴肺经疏风散寒;手阳明大肠经与肺经相表里,所以其经穴能协助肺经经穴疏风散寒;外感风寒首先犯太阳而伤肺卫,故选足太阳膀胱经的腧穴以解表宣肺。故本题选A项。"
  },
  {
    "question_num": 9,
    "query": "下列各项,不属于瘀血致病特点的是",
    "options": {
      "A": "易于阻滞气机",
      "B": "影响血脉运行",
      "C": "影响新血生成",
      "D": "病位相对固定",
      "E": "易于蒙蔽心神"
    },
    "answer": "E",
    "reason": "瘀血致病特点:易于阻滞气机,影响血脉运行,影响新血生成,病位相对固定,病证繁多。E项为痰饮的致病特点。"
  },
  {
    "question_num": 10,
    "query": "治疗鹅口疮虚火上浮证,应首选的方剂是",
    "options": {
      "A": "益黄散",
      "B": "知柏地黄丸",
      "C": "六味地黄丸",
      "D": "沙参麦冬汤",
      "E": "养胃增液汤"
    },
    "answer": "B",
    "reason": "鹅口疮虚火上浮证,冶且滋阴降火,方剂选知柏地黄丸。"
  },
  {
    "question_num": 11,
    "query": "破伤风、狂犬病的发病类型是",
    "options": {
      "A": "徐发",
      "B": "继发",
      "C": "复发",
      "D": "感邪即发",
      "E": "伏而后发"
    },
    "answer": "E",
    "reason": "伏而后发:感受邪气后,并不立即发病,病邪在机体内潜伏一段时间,,或在诱因的作用下,过时而发病,多见于外感性疾病和某些外伤,如伏气温病、破伤风.狂犬病等。"
  },
  {
    "question_num": 12,
    "query": "疮疡的半阴半阳证应选用的外用药物是",
    "options": {
      "A": "冲和膏",
      "B": "太乙膏",
      "C": "阳和解凝膏",
      "D": "咬头膏",
      "E": "玉露膏"
    },
    "answer": "A",
    "reason": "疮形肿而不高,痛而不甚,微红微热,属半阴半阳证者,可用冲和膏。"
  },
  {
    "question_num": 13,
    "query": "肺、肝、脾、胃等脏腑功能失调,易导致气失常的病机是",
    "options": {
      "A": "气虚",
      "B": "气脱",
      "C": "气陷",
      "D": "气滞",
      "E": "气逆"
    },
    "answer": "D",
    "reason": "由于肝升肺降、脾升胃降。在调整全身气机中起着极其重要的作用,故脏腑气滞以肺、肝、脾、胃多见。气逆多见于肺、肝、胃。"
  },
  {
    "question_num": 14,
    "query": "治疗瘾疹的主穴是",
    "options": {
      "A": "血海、曲池、合谷、膈俞、三阴交",
      "B": "大椎、曲池、太冲、风池、中脘",
      "C": "大椎、太冲、三阴交、血海、内庭",
      "D": "血海、内庭、足三里、气海、天枢",
      "E": "外关、风池、三阴交、大椎、膈俞"
    },
    "answer": "A",
    "reason": "瘾疹主穴:膈俞、曲池、合谷、血海、三阴交。曲池、合谷属手阳明经穴,与肺经相表里,可通经络、行气血、疏风清热;血海、膈俞合用意在“治风先治血,血行风自灭”两组穴位相配能疏风、活血、止痒;三阴交属足太阴经,乃足三阴经之交会穴,可养血活血、润燥祛风止痒。"
  },
  {
    "question_num": 15,
    "query": "下列各项,其功能失常易致水湿停滞发生的是",
    "options": {
      "A": "脾肾",
      "B": "肝肾",
      "C": "脾胃",
      "D": "心肾",
      "E": "脾肺"
    },
    "answer": "A",
    "reason": "脾主运化水液,肾为主水之脏,二者协同主司水液代谢的平衡协调。若二者功能失常,则津液输布障碍,水湿痰饮停留,气机阻滞,形成水湿停滞。"
  },
  {
    "question_num": 16,
    "query": "丹毒总的病因病机是",
    "options": {
      "A": "湿热蕴结",
      "B": "血热火毒",
      "C": "气血瘀滞",
      "D": "气血不和",
      "E": "肝郁脾虚"
    },
    "answer": "B",
    "reason": "丹毒总的病因病机为血热火毒。"
  },
  {
    "question_num": 17,
    "query": "下列各项,可用“阴中求阳”治疗的是",
    "options": {
      "A": "实寒证",
      "B": "实热证",
      "C": "虚寒证",
      "D": "虚热证",
      "E": "真热假寒证"
    },
    "answer": "C",
    "reason": "阳偏衰产生“阳虚则寒\"的虚寒证,治宜“阴中求阳”。"
  },
  {
    "question_num": 18,
    "query": "下列各项中,不属于期门穴主治病证的是",
    "options": {
      "A": "胸胁胀痛",
      "B": "呕吐、腹胀",
      "C": "奔豚气",
      "D": "乳痈",
      "E": "癃闭、遗尿"
    },
    "answer": "E",
    "reason": "期门穴主治:①胸胁胀痛、呕吐、吞酸、呃逆、腹胀、腹泻等肝胃病证;②奔豚气;③乳痈。数本题选E项。"
  },
  {
    "question_num": 19,
    "query": "下列各项,临床表现为忽然昏倒,口吐涎沫,两目上视,四肢抽搐,醒后如常的是",
    "options": {
      "A": "狂病",
      "B": "脏躁",
      "C": "痴呆",
      "D": "痫病",
      "E": "癫病"
    },
    "answer": "D",
    "reason": "突然昏倒,口吐白沫,目睛上视,四肢抽搐,移时苏醒,醒后如常,其多由脏气失调,肝风挟痰上逆、蒙蔽清窍所致,属痫病。"
  },
  {
    "question_num": 20,
    "query": "痰肿的临床表现是",
    "options": {
      "A": "肿势高突,根盘收束",
      "B": "坚硬如石,皮色不变",
      "C": "肿势软如棉或硬如馒",
      "D": "皮紧内软,喜怒有变",
      "E": "皮肤漫肿,其色青紫"
    },
    "answer": "C",
    "reason": "痰肿、肿势软如棉,或硬如馒,大小不一,形态各异,无处不生,不红不热,皮色不变,见于脂瘤等。"
  },
  {
    "question_num": 21,
    "query": "患者肥而食少的临床意义是",
    "options": {
      "A": "形气有余",
      "B": "形盛气虚",
      "C": "形气不足",
      "D": "中焦有火",
      "E": "阴虚火旺"
    },
    "answer": "B",
    "reason": "形体肥胖,肉松皮缓,食少懒动,动则乏力气短,为形盛气虚。形体肥胖,肌肉坚实,食欲旺盛,为形气有余。形瘦食多为中焦有火,形瘦食少为中气虚弱。"
  },
  {
    "question_num": 22,
    "query": "下列关于中风辨证要点的叙述,正确的是",
    "options": {
      "A": "首辨闭证与脱证",
      "B": "中经络者辨闭证与脱证",
      "C": "中经络者仅出现肢体不用,无口眼歪斜",
      "D": "中经络者意识清楚,中脏腑者神志昏迷",
      "E": "脱证常骤然起病"
    },
    "answer": "D",
    "reason": ""
  },
  {
    "question_num": 23,
    "query": "在目的脏腑分属中,白睛所属的是",
    "options": {
      "A": "心",
      "B": "肺",
      "C": "肝",
      "D": "肾",
      "E": "脾"
    },
    "answer": "B",
    "reason": "目的脏腑分属:瞳仁属肾一一水轮;目内眦及外毗的血络属心一一血轮;黑睛属肝一一风轮;白睛属肺一一气轮#;眼胞属脾一一肉轮。"
  },
  {
    "question_num": 24,
    "query": "胁痛的治疗原则是",
    "options": {
      "A": "疏肝理气止痛",
      "B": "活血化瘀止痛",
      "C": "清热化湿利胆",
      "D": "养血柔肝止痛",
      "E": "疏肝和络止痛"
    },
    "answer": "E",
    "reason": "胁病之治疗原则根据“通则不痛\"的理论,以疏肝和络止痛为基本治则,结合肝胆的生理特点,灵活运用。"
  },
  {
    "question_num": 25,
    "query": "下列各项,属于斑的临床表现的是",
    "options": {
      "A": "色淡红",
      "B": "点小如粟",
      "C": "高出皮肤",
      "D": "抚之碍手",
      "E": "压之不褪色"
    },
    "answer": "E",
    "reason": "斑:深红或青紫色+片状斑块+平摊于皮肤+摸之不应手,压之不褪色。疹:深红或紫红色+高出皮肤+抚之碍手,压之褪色+粟粒状疹点。"
  },
  {
    "question_num": 26,
    "query": "下列各项,哪项不是阴户的功能",
    "options": {
      "A": "排月经之出口",
      "B": "排恶露之出口",
      "C": "防御外邪入侵的第一道门户",
      "D": "阴阳交合的入口",
      "E": "孕育胎儿"
    },
    "answer": "E",
    "reason": "阴户是防御外邪入侵的第一道门户,是排月经、泌带下、排恶露之出口,是合阴阳之入口,又是娩出胎儿、胎盘之产门。"
  },
  {
    "question_num": 27,
    "query": "小儿指纹淡白者,其临床意义是",
    "options": {
      "A": "外感表证",
      "B": "里实热证",
      "C": "疼痛,惊风",
      "D": "血络郁闭",
      "E": "脾虚,疳积"
    },
    "answer": "E",
    "reason": "小儿指纹颜色代表的临床意义:①鲜红,外感表证、寒证;②紫红,里热证;③色青,疼痛、惊风;④紫黑,血络郁闭,病危重;⑤淡白,脾虚、疳积。"
  },
  {
    "question_num": 28,
    "query": "肛管直肠癌的早期症状除便血外,还可见",
    "options": {
      "A": "大便变形",
      "B": "腹胀肠鸣",
      "C": "脱出不纳",
      "D": "排便习惯改变",
      "E": "肛门潮湿"
    },
    "answer": "D",
    "reason": "初期直肠黏膜上或肛门皮肤上有一无痛性突起的硬结,无明显症状,以后可出现排便习惯改变,排便次数较多,便意频数,但无粪便排出;或便秘,有肛门内不适或下坠感。大便带血,血色鲜红或暗红,量不多,常伴有黏液便,往往被误诊为痔疮。因此肛管直肠癌的早期症状除便血外,还可见排便习惯改变。"
  },
  {
    "question_num": 29,
    "query": "热盛又兼见血瘀的舌象是",
    "options": {
      "A": "淡红舌",
      "B": "红舌",
      "C": "青紫舌",
      "D": "绛紫舌",
      "E": "青舌"
    },
    "answer": "D",
    "reason": "舌紫红或绛紫而干枯少津为热盛伤津,气血壅滞。"
  },
  {
    "question_num": 30,
    "query": "下列不属于慢性盆腔炎常见病因的是",
    "options": {
      "A": "湿热瘀结",
      "B": "气滞血瘀",
      "C": "寒湿凝滞",
      "D": "气虚血瘀",
      "E": "热毒炽盛"
    },
    "answer": "E",
    "reason": "慢性盆腔炎常见病因有湿热瘀结、气滞血瘀、寒湿凝滞、气虚血瘀。"
  },
  {
    "question_num": 31,
    "query": "自言自语、喃喃不休、见人语止、首尾不续者,称之为",
    "options": {
      "A": "谵语",
      "B": "独语",
      "C": "郑声",
      "D": "错语",
      "E": "言謇"
    },
    "answer": "B",
    "reason": "独语:自言自语,喃喃不休,见人语止,首尾不续。谵语:神识不清,语无伦次,声高有力。郑声:神识不清,语言重复,时断时续,语声低弱模糊。错语:神识清楚,语言错乱,语后自知。狂言:精神错乱,语无伦次,狂叫骂詈,登高而歌。言謇:神志清楚,思维正常而吐字困难,或吐字不清。"
  },
  {
    "question_num": 32,
    "query": "中医外科内治法中,温阳托毒法的代表方剂是",
    "options": {
      "A": "透脓散",
      "B": "托里消毒散",
      "C": "神功内托散",
      "D": "右归丸",
      "E": "桂附八味丸"
    },
    "answer": "C",
    "reason": "内托法中,透托法的代表方剂是透脓散。益气托毒法的代表方剂是托里消毒放;温阳托毒法的代表方剂是神功内托散;补益助阳法的代表方剂是右归丸和桂附八味丸。故本题选C项,"
  },
  {
    "question_num": 33,
    "query": "恶寒发热的临床意义是",
    "options": {
      "A": "外邪袭表,卫阳被遏,肌表失煦",
      "B": "外邪侵袭,阳热炽盛,腠理开泄",
      "C": "邪正相争,相持不下,枢机不利",
      "D": "邪气侵袭,阳气损伤,机体失温",
      "E": "邪气侵袭,腠理疏松,阳气郁遏"
    },
    "answer": "A",
    "reason": "】恶寒发热:表证的特征性症状,提示外邪袭表,卫阳被遏,肌表失煦。"
  },
  {
    "question_num": 34,
    "query": "伤食、积滞、疳证三者因果关系是",
    "options": {
      "A": "积滞→伤食→疳证",
      "B": "伤食→积滞→疳证",
      "C": "伤食→疳证→积滞",
      "D": "积滞→疳证→伤食",
      "E": "疳证→伤食→积滞"
    },
    "answer": "B",
    "reason": ""
  },
  {
    "question_num": 35,
    "query": "睡眠时时惊醒,不易安卧的临床意义是",
    "options": {
      "A": "心肾不交",
      "B": "胆郁痰扰",
      "C": "食滞胃脘",
      "D": "营血亏虚",
      "E": "心脾两虚"
    },
    "answer": "B",
    "reason": "失眠:①不易入睡,彻夜不眠,心烦不寐,心肾不交;②睡后易醒,不易再睡,心脾两虚;③时时惊醒,不易安卧,胆郁痰扰;④夜卧不安,腹胀嗳气酸腐,食滞内停。"
  },
  {
    "question_num": 36,
    "query": "膏淋的治疗原则是",
    "options": {
      "A": "补脾益肾固涩",
      "B": "补中益气,升阳举陷",
      "C": "清热利湿,分清泄浊",
      "D": "益气养血通淋",
      "E": "清热利湿通淋"
    },
    "answer": "C",
    "reason": "膏淋证候:小便浑浊,乳白或如米泔水,上有浮油,置之沉淀,或伴有絮状凝块物,或混有血液、血块,尿道热涩疼痛,尿时阻塞不畅,口干,苔黄腻,舌质红,脉濡数。治法:清热利湿,分清泄浊。代表方剂:程氏萆薢分清饮加减。"
  },
  {
    "question_num": 37,
    "query": "下列各项,属月经先后不定期的临床意义是",
    "options": {
      "A": "脾气亏虚,生血不足",
      "B": "肝脾郁滞、冲任失调",
      "C": "阳盛血热,热扰冲任",
      "D": "寒凝血瘀,冲任受阻",
      "E": "痰湿阻滞,冲任不调"
    },
    "answer": "B",
    "reason": "月经先后不定期:肝气郁滞或脾肾虚损,冲任失调。月经先期(提前>7天):脾气亏虚、肾气不足、冲任不固;或阳盛血热、肝郁化热、阴虚火旺,热扰冲任。月经后期(延后>7天):营血亏损、肾精不足,或阳气虚衰,生血不足;或气滞、寒凝血瘀,痰湿阻滞,冲任受阻。"
  },
  {
    "question_num": 38,
    "query": "耻骨联合上缘至股骨内上髁上缘的骨度分寸是",
    "options": {
      "A": "13寸",
      "B": "14寸",
      "C": "16寸",
      "D": "18寸",
      "E": "19寸"
    },
    "answer": "D",
    "reason": "耻骨联合上缘至股骨内上髁上缘的骨度分寸是18寸。"
  },
  {
    "question_num": 39,
    "query": "脉诊指法中,指力最轻的运指指法是",
    "options": {
      "A": "举法",
      "B": "摸法",
      "C": "循法",
      "D": "寻法",
      "E": "按法"
    },
    "answer": "A",
    "reason": "举法,较轻的指力。按法:较重的指力。寻法:指力从轻到重或从重到轻,左右推寻。"
  },
  {
    "question_num": 40,
    "query": "妊娠恶阻脾胃虚弱证的中医治法是",
    "options": {
      "A": "健脾养阴,和胃止呕",
      "B": "健脾祛湿,豁痰止呕",
      "C": "清肝和胃,降逆止呕",
      "D": "健脾益气,降逆止呕",
      "E": "健脾和胃,降逆止呕"
    },
    "answer": "E",
    "reason": "妊娠恶阻脾胃虚弱证主要证候:妊娠早期,恶心呕吐不食,甚则食入即吐;口淡,呕吐清涎,头晕体倦,脘痞腹胀;舌淡,苔白,脉缓滑无力。治法:健脾和胃,降逆止呕。代表方剂:香砂六君子汤。"
  },
  {
    "question_num": 41,
    "query": "龟甲的正确用法是",
    "options": {
      "A": "另煎",
      "B": "后下",
      "C": "包煎",
      "D": "先煎",
      "E": "冲服"
    },
    "answer": "D",
    "reason": "先煎:①有效成分难溶于水的金石、矿物.介壳类药物,如磁石,代赭石、生石膏、龙骨、牡蛎、石决明、龟甲、鳖甲等;②附子、乌头等毒副作用强的也应先煎,久煎能降低毒性。"
  },
  {
    "question_num": 42,
    "query": "治疗滑胎气血虚弱证的代表方剂是",
    "options": {
      "A": "泰山磐石散",
      "B": "补肾固冲汤",
      "C": "育阴汤",
      "D": "安奠二天汤",
      "E": "桂枝茯苓丸合寿胎丸"
    },
    "answer": "A",
    "reason": "滑胎气血虚弱证主要证侯:屡孕屡堕;头晕目眩,神疲乏力,面色㿠白、心悸气短;舌质淡,苔薄白,脉细弱。治法:益气养血,固冲安胎。代表方剂:泰山磐石散。"
  },
  {
    "question_num": 43,
    "query": "治疗心悸、失眠、多梦,宜选用的药物是",
    "options": {
      "A": "山茱萸",
      "B": "金樱子",
      "C": "五味子",
      "D": "覆盆子",
      "E": "枸杞子"
    },
    "answer": "C",
    "reason": "五味子:收敛固涩,益气生津,补肾宁心。可用于:①久咳虚喘;②自汗、盗汗;③遗精、滑精;④久泻不止;⑤津伤口渴、消渴;⑥心悸、失眠、多梦。"
  },
  {
    "question_num": 44,
    "query": "下列有关预产期的计算,正确的是",
    "options": {
      "A": "以末次月经结束后的第一天起计算",
      "B": "以末次月经的最后一天起计算",
      "C": "以尿检阳性的第一天起计算",
      "D": "以末次月经的第一天起计算",
      "E": "月数加9(或减3),日数加14"
    },
    "answer": "D",
    "reason": "预产期的计算:从末次月经的第一天算起,月数加9(或减3),日数加7(阴历则加14)"
  },
  {
    "question_num": 45,
    "query": "小青龙汤中具有温肺化饮作用的药物是",
    "options": {
      "A": "麻黄、桂枝",
      "B": "桂枝、细辛",
      "C": "干姜、细辛",
      "D": "半夏、麻黄",
      "E": "细辛、麻黄"
    },
    "answer": "C",
    "reason": "小青龙汤主治外寒里饮证。方中麻黄、桂枝相须为君药,发汗散寒解表,麻黄宣肺平喘,桂枝化气行水;干姜、细辛为臣药,温肺化饮,兼助麻、桂解表祛邪。"
  },
  {
    "question_num": 46,
    "query": "循行“起于中焦,下络大肠”的经络是",
    "options": {
      "A": "手阳明大肠经",
      "B": "足阳明胃经",
      "C": "手厥阴心包经",
      "D": "手太阳小肠经",
      "E": "手太阴肺经"
    },
    "answer": "E",
    "reason": "《灵枢·经脉》原文指出:“肺手太阴之脉,起于中焦,下络大肠,还循胃口,上膈属肺。”故本题选E项。"
  },
  {
    "question_num": 47,
    "query": "治疗妇人伤寒(中风),经水适断,寒热发作有时,应选用的方剂是",
    "options": {
      "A": "逍遥散",
      "B": "小柴胡汤",
      "C": "大柴胡汤",
      "D": "柴胡疏肝散",
      "E": "蒿芩清胆汤"
    },
    "answer": "B",
    "reason": "小柴胡汤和解少阳,主治;①伤寒少阳证;②热入血宣证(妇人中风,经水适断,寒热发作有时);③黄疸、疟疾,内伤杂病见少阳证者。大柴胡汤,和解少阳,内泻热结,用于少阳阳明合病。"
  },
  {
    "question_num": 48,
    "query": "下列各项,不属生理性闭经的是",
    "options": {
      "A": "育龄期闭经",
      "B": "妊娠期闭经",
      "C": "哺乳期闭经",
      "D": "围绝经期闭经",
      "E": "绝经期闭经"
    },
    "answer": "A",
    "reason": "对于青春期前、妊娠期、哺乳期、绝经前后的月经停闭不行,或月经初潮后1年内月经不行,又无其他不适者,均属于生理性闭经,需要注意鉴别。"
  },
  {
    "question_num": 49,
    "query": "参苓白术散的病机是",
    "options": {
      "A": "脾失健运,湿无以化,湿聚成痰",
      "B": "脾胃气虚,运化乏力",
      "C": "脾胃气虚,运化失司,湿浊内盛",
      "D": "脾胃虚弱,运化失常,饮食停滞",
      "E": "脾胃气虚,清阳下陷"
    },
    "answer": "C",
    "reason": "参苓白术散为补益剂,益气健脾、渗湿止泻,用于脾胃气虚.运化失司、湿浊内盛所致的脾虚湿盛证。"
  },
  {
    "question_num": 50,
    "query": "治疗久痹风、寒、湿偏盛不明显者,可选用的方剂是",
    "options": {
      "A": "薏苡仁汤",
      "B": "宣痹汤",
      "C": "防风汤",
      "D": "祛痹汤",
      "E": "乌头汤"
    },
    "answer": "D",
    "reason": "久痹风、寒、湿偏盛不明显者,可选用祛痹汤,为治疗风寒湿痹基本方剂,有益气和营,祛风胜湿,通络止痛之功,可根据感受外邪偏盛情况随证加减。"
  },
  {
    "question_num": 51,
    "query": "天王补心丹的君药是",
    "options": {
      "A": "麦门冬",
      "B": "天门冬",
      "C": "生地黄",
      "D": "酸枣仁",
      "E": "柏子仁"
    },
    "answer": "C",
    "reason": "天王补心丹:滋阴清热,养血安神;用于阴虚血少,神志不安证。方中重用甘寒之生地黄,入心养血,入肾滋阴,滋阴养血,壮水以制虚火,是为君药。"
  },
  {
    "question_num": 52,
    "query": "艾灸矫正胎位宜选",
    "options": {
      "A": "任脉的关元穴",
      "B": "足太阴脾经的隐白穴",
      "C": "足太阳膀胱经至阴穴",
      "D": "督脉命门穴",
      "E": "足少阴肾经涌泉穴"
    },
    "answer": "C",
    "reason": ""
  },
  {
    "question_num": 53,
    "query": "具有行气散结,降逆化痰功用的方剂是",
    "options": {
      "A": "越鞠丸",
      "B": "瓜蒌薤白白酒汤",
      "C": "半夏厚朴汤",
      "D": "苏子降气汤",
      "E": "柴胡疏肝散"
    },
    "answer": "C",
    "reason": "半夏厚朴汤:行气散结、降逆化痰,用于梅核气。越鞠丸:行气解郁,用于六郁证。瓜蒌薤白白酒汤:通阳散结、行气祛痰,用于胸阳不振、痰气互结之胸痹轻证。苏子降气汤,降气平喘、祛痰止咳,用于上实下虚喘咳证。柴胡疏肝散:疏肝行气、活血止痛,用于肝气郁滞证。"
  },
  {
    "question_num": 54,
    "query": "下列哪项不是内伤发热的病机",
    "options": {
      "A": "瘀血阻滞,壅遏不通",
      "B": "中气不足,阴火内生",
      "C": "肝气不舒,气郁化火",
      "D": "邪气在表,卫表失和",
      "E": "阴精亏虚,阳气偏盛"
    },
    "answer": "D",
    "reason": "内伤发热的基本病机是气血阴阳亏虚,脏腑功能失调,其且体包括气都化火、瘀血阻滞、痰湿停聚、气血阴阳虚损等。"
  },
  {
    "question_num": 55,
    "query": "血府逐瘀汤的配伍特点是",
    "options": {
      "A": "既活血又行气",
      "B": "既活血又补气",
      "C": "既活血又温阳",
      "D": "既活血又通阳",
      "E": "既活血又泻热"
    },
    "answer": "A",
    "reason": "血府逐瘀汤;活血化瘀、行气止痛,用于胸中血瘀证。气血并调,既行血分瘀滞,又解气分郁结;养活同施,活血而无耗血之虑,行气又无伤阴之弊;升降兼顾,既能升达清阳,又佐降泄下行,使气血调和。"
  },
  {
    "question_num": 56,
    "query": "发于躯干部的丹毒称为",
    "options": {
      "A": "缠腰火丹",
      "B": "抱头火丹",
      "C": "流火",
      "D": "赤游丹",
      "E": "内发丹毒"
    },
    "answer": "E",
    "reason": "丹毒的分类:生于躯干部者,称内发丹毒;发于头面部者,称抱头火丹;发于小腿足部者,称流火;新生儿多生于臀部:称赤游丹毒。"
  },
  {
    "question_num": 57,
    "query": "补阳还五汤中用以通经活络的药物是",
    "options": {
      "A": "地龙",
      "B": "黄芪",
      "C": "当归尾",
      "D": "川芎",
      "E": "桃仁"
    },
    "answer": "A",
    "reason": "补阳还五汤:补气、活血、通络,用于中风之气虚血瘀证。黄芪为君大补脾胃之气;当归尾活血通络不伤血;桃仁、红花、赤芍、川芎活血祛瘀;地龙通经活络。"
  },
  {
    "question_num": 58,
    "query": "下列各项,属带下过多脾虚证临床表现的是",
    "options": {
      "A": "腰酸如折,畏寒肢冷",
      "B": "带下赤白相兼,有气味",
      "C": "烘热汗出,失眠多梦",
      "D": "四肢倦怠,纳少便溏",
      "E": "烦热头晕,口苦咽干"
    },
    "answer": "D",
    "reason": ""
  },
  {
    "question_num": 59,
    "query": "下列各项、不属旋覆代赭汤临床表现的是",
    "options": {
      "A": "胀满",
      "B": "嗳气",
      "C": "呕吐",
      "D": "下利",
      "E": "苔白腻"
    },
    "answer": "D",
    "reason": "旋覆代赭汤:降逆化痰、益气和胃,用于胃虚痰阻气逆证。症见胃脘痞闷或涨满,按之不痛,频频嗳气;或见纳差,呃逆、恶心,甚或呕吐,舌苦白腻,脉缓或滑。"
  },
  {
    "question_num": 60,
    "query": "十二经脉之海是指",
    "options": {
      "A": "任脉",
      "B": "冲脉",
      "C": "督脉",
      "D": "带脉",
      "E": "阴维脉"
    },
    "answer": "B",
    "reason": "冲脉上至头,下至足,通贯全身,可涵蓄调节十二经气血,故有“十二经脉之海”之称。"
  },
  {
    "question_num": 61,
    "query": "主治肝热生风的方剂是",
    "options": {
      "A": "一贯煎",
      "B": "羚角钩藤汤",
      "C": "镇肝息风汤",
      "D": "龙胆泻肝汤",
      "E": "天麻钩藤饮"
    },
    "answer": "B",
    "reason": "羚角钩藤汤:凉肝息风、增液舒筋,用于肝热生风证。一贯煎:滋阴疏肝,用于肝肾阴虚、肝气郁滞证。镇肝息风汤:镇肝息风、滋阴潜阳,用于类中凤。龙胆泻肝汤:清泄肝胆实火、清利肝经湿热,用于肝胆实火上炎证、肝经湿热下注证。天麻钓藤饮;平肝息风、清热活血、补益肝肾,用于肝阳偏亢、肝风上扰证。"
  },
  {
    "question_num": 62,
    "query": "针刺治疗太阳头痛应选取腧穴是",
    "options": {
      "A": "天柱、后溪、昆仑",
      "B": "印堂、合谷、内庭",
      "C": "率谷、外关、足临泣",
      "D": "四神聪、太冲、内关",
      "E": "风门、列缺、足三里"
    },
    "answer": "A",
    "reason": "头痛治疗宜疏调经脉、通络止痛,按局部穴位和远端循经取穴为主,太阳经头痛为后枕部疼痛,天柱位于后枕部,属局部取穴、疏导头部经气、后谈、昆仑为远端循经取穴。故本题选A项。"
  },
  {
    "question_num": 63,
    "query": "桃核承气汤中配伍桂枝的作用是",
    "options": {
      "A": "解肌发表",
      "B": "温阳散寒",
      "C": "通行血脉",
      "D": "调和营卫",
      "E": "降逆平冲"
    },
    "answer": "C",
    "reason": "桃核承气汤:逐瘀泻热,用于下焦蓄血证。方中桂枝通行血脉,助桃仁活血化瘀,防芒硝、大黄寒凉凝血之弊。"
  },
  {
    "question_num": 64,
    "query": "治疗风热型目赤肿痛除主穴外还应配用",
    "options": {
      "A": "鱼腰、四白",
      "B": "行间、侠溪",
      "C": "少商、外关",
      "D": "肾俞、光明",
      "E": "太溪、侠溪"
    },
    "answer": "C",
    "reason": "目赤肿病的治法:疏风散热,消肿止痛、以局部腧穴及手阳明、足厥阴经穴为主。主穴:晴明、太阳、风池、合谷、太冲;配穴:外感风热配少商、外关;肝胆火盛配行间、侠溪。"
  },
  {
    "question_num": 65,
    "query": "体现“培土生金”治法的是",
    "options": {
      "A": "黄土汤",
      "B": "理中丸",
      "C": "补中益气汤",
      "D": "麦门冬汤",
      "E": "小建中汤"
    },
    "answer": "D",
    "reason": "麦门冬汤:清养肺胃,降逆下气。方中粳米、大枣益脾胃,人参益气生津,寓“培土生金\"之意。"
  },
  {
    "question_num": 66,
    "query": "下述哪项是崩漏和经行泄泻所共有的病机",
    "options": {
      "A": "脾虚,肾虚",
      "B": "肝郁,脾虚",
      "C": "血热,血瘀",
      "D": "肝虚,肾虚",
      "E": "气虚,血虚"
    },
    "answer": "A",
    "reason": "崩漏的常见病因有脾虚、肾虚、血热和血瘀。与经行泄泻的发生所共有的病机为脾肾虚弱。"
  },
  {
    "question_num": 67,
    "query": "组成中含有黄芪,白术的方剂是",
    "options": {
      "A": "理中丸",
      "B": "健脾丸",
      "C": "参苓白术散",
      "D": "防己黄芪汤",
      "E": "四君子汤"
    },
    "answer": "D",
    "reason": "防己黄芪汤;防已、黄英、甘草、白术、生姜、大枣。理中丸:人参、干姜、白术、炙甘草。健脾丸:白术、木香、酒炒黄连、甘草、茯苓、人参、神曲、陈皮、砂仁、炒麦芽、山楂、山药、肉豆蔻。参苓白术散:莲子肉、山药、薏苡仁、白扁豆、人参、炒甘草、白术、茯苓、砂仁、桔梗、大枣。四君子汤:人参、白术、茯苓、炙甘草。"
  },
  {
    "question_num": 68,
    "query": "治疗腹痛中脏虚寒证,首选的方剂是",
    "options": {
      "A": "枳实导滞丸",
      "B": "吴茱萸汤",
      "C": "小建中汤",
      "D": "少腹逐瘀汤",
      "E": "理中丸"
    },
    "answer": "C",
    "reason": "腹痛中脏虚寒证,治当温中补虚、缓急止痛、方剂选小建中汤加减。积实导滞丸适用于饮食积滞证,少腹逐瘀汤适用于瘀血内停证,理中丸适用于脾胃虚寒证,吴茱萸汤适用于胃寒呕吐证。故本题选C项。"
  },
  {
    "question_num": 69,
    "query": "具有温阳健脾,行气利水作用的方剂是",
    "options": {
      "A": "五苓散",
      "B": "实脾散",
      "C": "真武汤",
      "D": "苓甘五味姜辛汤",
      "E": "半夏厚朴汤"
    },
    "answer": "B",
    "reason": "实脾散:温阳健脾、行气利水,用于脾肾阳虚、水气内停之阴水(身半以下肿甚)。五苓散:利水渗湿、温阳化气,用于膀胱气化不利之蓄水证。真武汤:温阳利水,用于阳虚水泛证。苓甘五味姜辛汤:温肺化饮,用于寒饮咳嗽。半夏厚朴汤:行气散结,降逆化痰,用于梅核气。"
  },
  {
    "question_num": 70,
    "query": "“痔、疟、狂、癫疾”是哪个经病候",
    "options": {
      "A": "足少阳胆经",
      "B": "足阳明胃经",
      "C": "足太阳膀胱经",
      "D": "手太阳小肠经",
      "E": "手少阳三焦经"
    },
    "answer": "C",
    "reason": "足太阳膀胱经主治脏腑病证;神志病证疯、狂、痫;头面五官病证,头痛、鼻塞等;经脉循行部位的其他病证,项、背、腰、下肢痹痛等。"
  },
  {
    "question_num": 71,
    "query": "体现寒热并用、辛开苦降、补泻兼施配伍特点的方剂是",
    "options": {
      "A": "旋覆代赭汤",
      "B": "半夏泻心汤",
      "C": "枳实导滞丸",
      "D": "木香槟榔丸",
      "E": "厚朴温中汤"
    },
    "answer": "B",
    "reason": "半夏渴心汤:寒热平调,消痞散结,用于寒热错杂之痞证。特点:寒热并用,辛开苦降,补泄兼施。"
  },
  {
    "question_num": 72,
    "query": "最典型的神经毒类毒蛇有",
    "options": {
      "A": "眼镜蛇",
      "B": "眼镜王蛇",
      "C": "蝮蛇",
      "D": "烙铁头蛇",
      "E": "银环蛇"
    },
    "answer": "E",
    "reason": "神经毒者有银环蛇、金环蛇、海蛇;血循毒者有蛙蛇、尖吻蝮蛇、竹叶青蛇和烙铁头蛇;混合毒者有眼镜蛇、眼镜王蛇和蝮蛇。"
  },
  {
    "question_num": 73,
    "query": "治疗寒热夹杂,气血不足的久泻久痢,首选",
    "options": {
      "A": "补中益气汤",
      "B": "真人养脏汤",
      "C": "参苓白术散",
      "D": "乌梅丸",
      "E": "黄土汤"
    },
    "answer": "D",
    "reason": "乌梅丸:温脏安蛔,用于脏寒蛔厥证。症见脘腹阵痛,烦闷呕吐,时发时止,得食则吐,甚则吐蛔,手足厥冷;或久泻久痢(气血不足,湿热积滞未去之寒热虚实错杂证候)。"
  },
  {
    "question_num": 74,
    "query": "深Ⅱ度烧伤的临床表现是",
    "options": {
      "A": "局部红肿,有疼痛和烧灼感,皮肤温度增高",
      "B": "水疱较饱满,有剧痛,皮温增高",
      "C": "水疱饱满,感觉迟钝,皮温低",
      "D": "水疱较小或偏薄,感觉较迟钝,皮温稍低",
      "E": "创面无水疱,感觉消失,皮温低"
    },
    "answer": "D",
    "reason": "深Ⅱ度烧伤临床表现:伤及皮肤的真皮深层,深浅不尽一致,尚残留皮肤附件;也可有水疱,但去疱皮后创面微湿,红白相间,痛觉较迟钝,如不发生感染,3~4周可愈合,常有瘢痕形成。"
  },
  {
    "question_num": 75,
    "query": "下列各项,抗原-抗体反应发热的是",
    "options": {
      "A": "白血病",
      "B": "甲状腺功能亢进症",
      "C": "鱼鳞病",
      "D": "药物热",
      "E": "安眠药中毒"
    },
    "answer": "D",
    "reason": "抗原一抗体反应发热:风湿热、血清病、药物热、结缔组织病等。A项为无菌性坏死物质吸收发热;B项为内分泌代谢障碍发热;C项为皮肤散热减少的发热;E项为体温调节中枢功能失常发热。"
  },
  {
    "question_num": 76,
    "query": "关于切开法切开方向的叙述,错误的是",
    "options": {
      "A": "一般疮疡,宜循经直开,刀头向上",
      "B": "乳部宜放射形切开",
      "C": "面部脓肿沿皮肤纹理切开",
      "D": "手指脓肿,最好从正面切开,以免伤及屈伸功能",
      "E": "关节附近宜用横切口"
    },
    "answer": "D",
    "reason": "切开法适用于一切外疡。确已成脓者,操作时宜选择脓腔最低点或最薄弱处进刀。一般疮疡宜循经直切;乳房部应以乳头为中心,放射状切开;面部脓肿应尽量沿皮肤自然纹理切开;手指脓肿,应从侧方切开;关节区附近的脓肿,切口尽量避免越过关节;关节区脓肿,一般施行横切口、弧形切口“S”形切口;肛旁低位脓肿,应以肛管为中心作放射状切开。"
  },
  {
    "question_num": 77,
    "query": "典型心绞痛的疼痛性质是",
    "options": {
      "A": "刀割样痛",
      "B": "刺痛",
      "C": "压榨样痛",
      "D": "灼痛",
      "E": "闷痛"
    },
    "answer": "C",
    "reason": "心绞痛星压榨样痛,可伴有室息感。"
  },
  {
    "question_num": 78,
    "query": "水肿属风水相搏者,最佳选用的方剂是",
    "options": {
      "A": "越婢加术汤",
      "B": "五苓散",
      "C": "五皮饮",
      "D": "桂枝汤",
      "E": "麻黄连翘赤小豆汤"
    },
    "answer": "A",
    "reason": "水肿风水相搏证。治法:疏风清热,宣肺行水。代表方剂:越婢加术汤加减。"
  },
  {
    "question_num": 79,
    "query": "表现为吸气性呼吸困难的疾病是",
    "options": {
      "A": "支气管哮喘",
      "B": "慢性支气管炎",
      "C": "重症肺结核",
      "D": "气管异物",
      "E": "气胸"
    },
    "answer": "D",
    "reason": "吸气性呼吸困难;三凹征,伴干咳及喘鸣音,见于急性喉炎、喉水肿、喉痉挛、白喉、气管异物,支气管肿瘤、气管受压(喉管肿压)等。呼气性呼吸困难:广泛哮鸣音,见于支气管哮喘,喘息性慢性支气管炎.慢性阻塞性肺疾病等。重症肺结核、气胸为混合性呼吸困难。"
  },
  {
    "question_num": 80,
    "query": "下列不符合十二经脉循行流注次序的是",
    "options": {
      "A": "胆、肝、肺经",
      "B": "大肠、胃、脾经",
      "C": "心、小肠、肾经",
      "D": "肾、心包、三焦经",
      "E": "三焦、胆、肝经"
    },
    "answer": "C",
    "reason": "十二经脉循行流注次序为肺大胃脾心小肠,膀肾包焦胆肝藏。"
  },
  {
    "question_num": 81,
    "query": "下列各项,出现水肿伴颈静脉怒张的是",
    "options": {
      "A": "心源性水肿",
      "B": "肝源性水肿",
      "C": "肾源性水肿",
      "D": "营养不良性水肿",
      "E": "内分泌水肿"
    },
    "answer": "A",
    "reason": "心源性水肿的特点:下垂性水肿,常伴呼吸困难,心脏扩大,心率加快、颈静脉怒张、肝颈静脉回流征为阳性。"
  },
  {
    "question_num": 82,
    "query": "水痘邪伤肺卫证的治法是",
    "options": {
      "A": "宣肺解毒,利湿清热",
      "B": "辛凉解表,清热渗湿",
      "C": "疏风清热,利湿解毒",
      "D": "清热渗湿,解毒凉营",
      "E": "宣肺解表,清热化湿"
    },
    "answer": "C",
    "reason": "水痘邪伤肺卫证:发热轻微,或无发热,鼻塞流涕,喷嚏,咳嗽,起病后1~2天出皮疹,疹色红润,疱浆清亮,根盘红晕,皮疹瘙痒,分布稀疏,此起彼伏,以躯干为多,舌苔薄白,脉浮数。治法:疏风清热,利湿解毒。代表方剂:银翘散。"
  },
  {
    "question_num": 83,
    "query": "表现为面色晦暗、双颊紫红、口唇轻度发绀的面容是",
    "options": {
      "A": "慢性病容",
      "B": "甲亢面容",
      "C": "二尖瓣面容",
      "D": "伤寒面容",
      "E": "贫血面容"
    },
    "answer": "C",
    "reason": ""
  },
  {
    "question_num": 84,
    "query": "下列腧穴在五行配属中属金的是",
    "options": {
      "A": "后溪",
      "B": "经渠",
      "C": "少府",
      "D": "大陵",
      "E": "阳溪"
    },
    "answer": "B",
    "reason": "十二经脉中每条经各有5个穴位属于五输穴;五输穴不仅有经脉归属,而且具有自身的五行属性,少府为手少阴心经之荣穴,属火;大陵为手厥阴心包经之输穴,属土;阳溪为手阳明大肠经之经穴,属火;后溪为手太阳小肠经之输穴,属木;经渠为手太阴肺经之经穴,属金。"
  },
  {
    "question_num": 85,
    "query": "引起全身淋巴结肿大的疾病是",
    "options": {
      "A": "化脓性扁桃体炎",
      "B": "淋巴结结核",
      "C": "胃癌",
      "D": "系统性红斑狼疮",
      "E": "乳腺癌"
    },
    "answer": "D",
    "reason": "全身淋巴结肿大常见于传染性单核细胞增多症.状巴细胞白血病.淋巴瘤、系统性红班狼疮。"
  },
  {
    "question_num": 86,
    "query": "下列关于虚体感冒治疗的叙述,错误的是",
    "options": {
      "A": "忌用大剂量发汗之品",
      "B": "忌用大剂量寒凉药物",
      "C": "忌用辛温重剂",
      "D": "疗程宜长",
      "E": "解表药物用量宜轻宜少"
    },
    "answer": "D",
    "reason": "体虚之人,卫外不固,感受外邪,常缠绵难愈,或反复不已。治疗当扶正达邪,在疏散药中酌加补正之品。对气虚感冒者,用药忌大剂量发汗之品,如麻黄、桂枝,解表药物用量宜轻宜少,疗程宜短,以免出汗过多、气随津脱。对阳虚感冒者,忌用大剂量寒虚感冒者,忌用辛湿重剂,以防损伤阴血之弊。"
  },
  {
    "question_num": 87,
    "query": "引起触觉语颤增强的病变是",
    "options": {
      "A": "肺气肿",
      "B": "气胸",
      "C": "肺实变",
      "D": "胸膜肥厚",
      "E": "胸腔积液"
    },
    "answer": "C",
    "reason": "语颤增强,肺实变、压迫性肺不张、较浅而大的肺空洞。语颤减弱:肺气肿、支气管哮喘发作、气胸、阻塞性肺不张、气管内分泌物增多、胸腔积液、胸膜肥厚、胸膜粘连、体质衰弱。"
  },
  {
    "question_num": 88,
    "query": "主客原络配穴是指",
    "options": {
      "A": "先病经脉的原穴与后病的相表里经脉的络穴相配合",
      "B": "后病经脉的原穴与先病的相表里经脉的络穴相配合",
      "C": "阴经的原穴与后病的相表里阳经的络穴相配合",
      "D": "阳经的原穴与后病的相表里阴经的络穴相配合",
      "E": "同一条经脉的原穴与络穴相配合"
    },
    "answer": "A",
    "reason": "临床上把先病经脉的原穴与后病的相表里经脉的络穴相配合,称为原络配穴法或主客原络配穴法。"
  },
  {
    "question_num": 89,
    "query": "胸骨左缘第三、四肋间听到响亮粗糙的收缩期杂音,应考虑的疾病是",
    "options": {
      "A": "二尖瓣狭窄",
      "B": "室间隔缺损",
      "C": "肺动脉瓣狭窄",
      "D": "二尖瓣关闭不全",
      "E": "肺动脉瓣关闭不全"
    },
    "answer": "B",
    "reason": "胸骨左缘第三、四肋间听到响亮粗糙的收缩期杂音,可能为室间隔缺损。杂音在心尖部最响,病变在二尖瓣。在主动脉瓣区或肺动脉瓣区最响,病变在主动脉瓣或肺动脉瓣。在胸骨下端近剑突偏左或偏右最响,病变在三尖瓣。"
  },
  {
    "question_num": 90,
    "query": "治疗经期延长血瘀证,应首选的方剂是",
    "options": {
      "A": "失笑散加味",
      "B": "桂枝茯苓丸合失笑散加味",
      "C": "逐瘀止血汤合失笑散加味",
      "D": "桃红四物汤合失笑散加味",
      "E": "血府逐瘀汤合失笑散加味"
    },
    "answer": "D",
    "reason": "血瘀证方药为桃红四物汤含失笑散加味或桂枝茯苓丸加味"
  },
  {
    "question_num": 91,
    "query": "触诊肝脏呈弥漫性肿大,应首先考虑的是",
    "options": {
      "A": "肝囊肿",
      "B": "肝癌",
      "C": "肝包虫病",
      "D": "脂肪肝",
      "E": "肝脓肿"
    },
    "answer": "D",
    "reason": "肝脏弥漫性肿大:肝炎、脂肪肝、肝淤血、早期肝硬化、白血病、血吸虫病等。局限性肝肿大:肝肪肿、肝囊肿(包括肝包虫病)、肝肿瘤等。"
  },
  {
    "question_num": 92,
    "query": "分布于胸腹第二侧线的经脉是",
    "options": {
      "A": "足太阴脾经",
      "B": "足少阴肾经",
      "C": "足阳明胃经",
      "D": "足厥阴肝经",
      "E": "足少阳胆经"
    },
    "answer": "C",
    "reason": "胸腹部第一侧线为足少阴肾经,第二侧线为足阳明胃经,第三侧线为足太阴脾经,第四侧线为足厥阴肝经。"
  },
  {
    "question_num": 93,
    "query": "肢体远端对称性完全感觉缺失,呈手套状、袜子状分布,其感觉障碍的类型是",
    "options": {
      "A": "末梢型",
      "B": "神经根型",
      "C": "脊髓型",
      "D": "内囊型",
      "E": "脑干型"
    },
    "answer": "A",
    "reason": "感党障碍末梢型:肢体远端对称性完全感觉缺失,呈手套状.袜子状分布。"
  },
  {
    "question_num": 94,
    "query": "下列各项,不属于产后发热感染邪毒证临床表现的是",
    "options": {
      "A": "小腹疼痛拒按",
      "B": "产后高热寒战,热势不退",
      "C": "肢体酸痛,无汗",
      "D": "恶露量或多或少,色紫暗如败酱,气臭秽",
      "E": "心烦口渴,尿少色黄,大便燥结"
    },
    "answer": "C",
    "reason": "产后发热感染邪毒证主要证候:产后高热寒战,热势不退,小腹疼痛拒按,恶露量或多或少,色紫暗如败酱,气臭秽;心烦口涡,尿少色黄,大便燥结:舌红苔黄,脉数有力。治法:清热解康,凉血化瘀。代表方剂:五味消毒饮合失笑散加减或解毒活血汤加减。"
  },
  {
    "question_num": 95,
    "query": "缺铁性贫血给予铁剂治疗后,网织红细胞计数达到的高峰时间是",
    "options": {
      "A": "3~5天",
      "B": "5~7天",
      "C": "7~10天",
      "D": "11~13天",
      "E": "14天以后"
    },
    "answer": "C",
    "reason": "网织红细胞为红细胞的“前身”,缺铁性贫血铁剂治疗有效,最先升高的是网织红细胞,常于7~10天达到高峰。2周后血红蛋白开始上升,一般2个月恢复正常。"
  },
  {
    "question_num": 96,
    "query": "药毒气阴两虚证的治疗方剂首选",
    "options": {
      "A": "萆薢渗湿汤",
      "B": "清营汤",
      "C": "增液汤合益胃汤",
      "D": "消风散",
      "E": "五神汤"
    },
    "answer": "C",
    "reason": "药毒分三型,湿毒蕴肤证方刑用草薢渗湿汤加减,热毒入营证方剂用清营汤、气阴两虚证方剂用增液汤合益胃汤。"
  },
  {
    "question_num": 97,
    "query": "溶血性黄疸时,实验室检查结果为阴性的指标是",
    "options": {
      "A": "血清总胆红素",
      "B": "结合胆红素",
      "C": "非结合胆红素",
      "D": "尿胆原",
      "E": "尿胆红素"
    },
    "answer": "E",
    "reason": ""
  },
  {
    "question_num": 98,
    "query": "烧伤面积的计算按中国九分法,双上肢面积占",
    "options": {
      "A": "9%",
      "B": "18%",
      "C": "27%",
      "D": "36%",
      "E": "45%"
    },
    "answer": "B",
    "reason": "中国九分法将全身体表面积分为11个9等份。成人头、面、颈部为9%;双上肢为2x9%;躯干前后包括外阴部为3X9%;双下肢包括臀部为5x9%+1%=46%。"
  },
  {
    "question_num": 99,
    "query": "内生肌酐清除率(Ccr)为48ml/min,肾功能的分期是",
    "options": {
      "A": "肾功能正常",
      "B": "肾衰竭代偿期",
      "C": "背衰竭失代偿期",
      "D": "肾衰竭期",
      "E": "肾衰竭终末期"
    },
    "answer": "C",
    "reason": "评估肾功能损害的程度,根据Ccr一般可将肾功能分为4期:①肾衰竭代偿期,Ccr50~80ml/min;②肾衰竭失代偿期,Ccr20~50ml/min;③肾衰竭期(尿毒症早期),Ccr10~19ml/min;④肾衰竭终末期(尿毒症晚期),Ccr<10ml/min。"
  },
  {
    "question_num": 100,
    "query": "妊娠期痹阻胎元、使用活血化瘀药的原则是",
    "options": {
      "A": "治病与安胎并举",
      "B": "衰其大半而止",
      "C": "禁止使用",
      "D": "病去即止",
      "E": "慎用"
    },
    "answer": "B",
    "reason": ""
  },
  {
    "question_num": 101,
    "query": "出现空腹血糖(FBG)增高的疾病是",
    "options": {
      "A": "糖尿病",
      "B": "重型肝炎",
      "C": "胰岛β细胞瘤",
      "D": "甲状腺功能减退症",
      "E": "急性酒精中毒"
    },
    "answer": "A",
    "reason": "]空腹血糖(FBG)增高:①生理性增高,见于餐后1一2小时、高糖饮食、剧烈运动、情绪激动等;②病理性增高,见于各型糖尿病;内分关疾沉,如甲状腺功能亢进症、嗜铬细胞瘤、胰高血糖素瘤等;应激性因素,如颅脑外伤、心肌梗死、大面积烧伤;肝脏和胰腺疾病,如严重肝损害、环死性胰腺炎、胰腺癌等;呕吐、脱水、缺氧、麻醉等。"
  },
  {
    "question_num": 102,
    "query": "痄腮热毒壅盛证,宜选用的方剂是",
    "options": {
      "A": "柴胡葛根汤",
      "B": "银翘散",
      "C": "普济消毒饮",
      "D": "清瘟败毒饮",
      "E": "龙胆泻肝汤"
    },
    "answer": "C",
    "reason": "炸腮热毒壅盛证:高热,一侧或两侧耳下腮部肿胀疼痛,坚硬拒按,张口咀嚼困难,或有烦躁不安,口渴欲饮,头痛,咽红肿痛,颌下肿块胀痛,纳少,大便秘结,尿少而黄,舌质红,舌苔黄,脉滑数。治宜清热解毒,软坚散结。方剂宜选用普济消毒饮。"
  },
  {
    "question_num": 103,
    "query": "下列各项,反映左、右心室除极过程的电位与时间变化的是",
    "options": {
      "A": "P波",
      "B": "QRS波群",
      "C": "U波",
      "D": "Ta波",
      "E": "T波"
    },
    "answer": "B",
    "reason": "A项为心房除极波,反映左、右心房除极过程的电位和时间变化。B项为心宝除极波,反映左、右心室除极过程的电位和时间变化。C项为T波后的小波,机制不明。D项代表心房复极,方向与P波相反。E项为心室复极波,反映心室晚期快速复极的电位和时间变化。"
  },
  {
    "question_num": 104,
    "query": "肺炎喘嗽的病机主要是",
    "options": {
      "A": "肺卫失宣",
      "B": "肺失宣肃",
      "C": "肺气郁闭",
      "D": "痰饮内伏",
      "E": "痰阻气道"
    },
    "answer": "C",
    "reason": "肺炎喘嗽外因感受风邪,或由其它疾病传变而来。内因小儿肺脏娇嫩,卫外不固。病变部位主要在肺,病机关键是肺气郁闭。痰热是其病理产物。"
  },
  {
    "question_num": 105,
    "query": "下壁心肌梗死时,病理性Q波出现的导联是",
    "options": {
      "A": "V1、V2、V3",
      "B": "V4、V5、V6",
      "C": "Ⅱ、Ⅲ、aVF",
      "D": "Ⅰ、aVL、V6",
      "E": "V7、V8、V9"
    },
    "answer": "C",
    "reason": "心肌梗死部位:①前间壁,V1~V3:②前壁,V3~V5;③广泛前壁,V1一V6;④下壁,II、III、aVF;⑤高侧壁,I、aVL;⑥正后壁,V7一V8;⑦右心室,V3R一V7R。"
  },
  {
    "question_num": 106,
    "query": "治疗疳积,应首选",
    "options": {
      "A": "印堂",
      "B": "二白",
      "C": "太阳",
      "D": "四缝",
      "E": "八风"
    },
    "answer": "D",
    "reason": "四缝穴主治小儿疳积、百日咳。故选择D。"
  },
  {
    "question_num": 107,
    "query": "下列各项,不属于慢性支气管炎X线特点的是",
    "options": {
      "A": "两肺纹理增多",
      "B": "支气管充气征",
      "C": "两肺纹理紊乱",
      "D": "两肺纹理增粗",
      "E": "肺纹理延伸到肺野外带"
    },
    "answer": "B",
    "reason": "慢性支气管炎的早期X线无异常。典型慢性支气管炎表现为两肺纹理增多、增粗、紊乱,肺纹理延伸至肺野外带。"
  },
  {
    "question_num": 108,
    "query": "确认成脓的方法,错误的是",
    "options": {
      "A": "按触法",
      "B": "透光法",
      "C": "点压法",
      "D": "穿刺法",
      "E": "切开法"
    },
    "answer": "E",
    "reason": "确认成脓的方法:接触法、透光法、点压法、穿刺法、B超。"
  },
  {
    "question_num": 109,
    "query": "CT见脑内圆形均匀密度增高影,边界清楚、周围有环形密度减低影。应首先考虑的诊断是",
    "options": {
      "A": "脑出血",
      "B": "蛛网膜下隙出血",
      "C": "脑梗死",
      "D": "脑肿瘤",
      "E": "颅脑外伤"
    },
    "answer": "A",
    "reason": "脑出血急性期CT表现:圆形、椭圆形或不规则形均匀密度增高影,边界清楚,周围有环形密度减低影。脑梗死:①缺血性,可见三角形或扇形大范围低密度区②出血性,可见不规则斑点状或片状高密度出血灶影,有占位效应;③腔隙性,可见小片状密度减低影,边缘模糊,无占位效应。"
  },
  {
    "question_num": 110,
    "query": "治疗哮病缓解期肺肾两虚证,应首选的方剂是",
    "options": {
      "A": "平喘固本汤",
      "B": "六君子汤",
      "C": "定喘汤",
      "D": "三子养亲汤",
      "E": "生脉地黄汤合金水六君煎"
    },
    "answer": "E",
    "reason": "哮病缓解期肺肾两虚证证候:脑转耳鸣,腰酸腿软,心慌,不耐劳累;或五心烦热,颧红,口干,舌质红少苔,脉细数;或畏寒肢冷,面色苍白,舌苔淡白,质胖,脉沉细。治法:补肺益肾。代表方剂:生脉地黄汤合金水六君煎加减。"
  },
  {
    "question_num": 111,
    "query": "既是西方医学的创始人,也是西方传统医德的奠基人,指的是",
    "options": {
      "A": "希波克拉底",
      "B": "亚里士多德",
      "C": "盖伦",
      "D": "迈蒙尼提斯",
      "E": "帕茨瓦尔"
    },
    "answer": "A",
    "reason": "希波克拉底是西方传统医德奠基人,其著名的《希波克拉底誓言》提出不伤害原则.为患者利益原则和保密原则,成为西方的医德传统和规范,也成为后来学医者宣誓的誓词。"
  },
  {
    "question_num": 112,
    "query": "头空痛,眉棱骨痛,出血后痛重,属头痛血虚型,其治法为",
    "options": {
      "A": "养阴补肾,填精生髓",
      "B": "养血滋阴,和络止痛",
      "C": "健脾益气升清",
      "D": "活血化瘀,通窍止痛",
      "E": "补益气血,调养心脾"
    },
    "answer": "B",
    "reason": "血虚头痛证候:头痛隐隐,时时昏晕,心悸失眠,面色少华,神疲乏力,遇劳加重,舌质淡,苔薄白;脉细弱。治法:养血滋阴,和络止痛。代表方剂:加味四物汤加减。"
  },
  {
    "question_num": 113,
    "query": "下列不符合无伤原则的是",
    "options": {
      "A": "对症下药,合理配伍",
      "B": "避免操作失误造成医疗伤害",
      "C": "对孕妇行X线检查且未告知可能的风险",
      "D": "适当地限制约束精神病患者的自由",
      "E": "选择受益最大、伤害最小的治疗方案"
    },
    "answer": "C",
    "reason": "无伤原则(底线原则):①努力避免不应有的医疗伤害;②杜绝有意和责任伤害,若不能有利于,至少不伤害。"
  },
  {
    "question_num": 114,
    "query": "治疗热结型便秘,除取主穴外,还应加",
    "options": {
      "A": "气海、神阙",
      "B": "关元、命门",
      "C": "脾俞、胃俞",
      "D": "合谷、曲池",
      "E": "中脘、行间"
    },
    "answer": "D",
    "reason": "便秘治宜理肠通便,取大肠的背俞穴及下合穴为主。主穴:天枢、大肠俞、上巨虚;配穴:热秘配合谷、曲池;气秘配太冲、中脘;冷秘配神阙、吴元;虚秘配足三里、脾俞、气海,兼阴伤津亏者加照海、太溪。故木题选D项。"
  },
  {
    "question_num": 115,
    "query": "临床诊疗道德中,最优化原则是指",
    "options": {
      "A": "积极充分利用现实条件,严肃认真做出符合病情实际的判断",
      "B": "认真实施有效治疗",
      "C": "疗效最佳,安全无害,痛苦最小,耗费最少",
      "D": "尊重患者的生命价值,不随意泄露患者的隐私",
      "E": "力争尽快地对疾病做出诊断,主动迅速地治疗"
    },
    "answer": "C",
    "reason": "最优化原则;以最小的代价获得最大效益的决策。内容:疗效最佳,安全无害,痛苦最小,耗费最少。是最普通、最基本的治疗原则。"
  },
  {
    "question_num": 116,
    "query": "治疗扭伤取穴原则是",
    "options": {
      "A": "以循经取穴为主",
      "B": "以远端取穴为主",
      "C": "以受伤局部取穴为主",
      "D": "以受伤局部阳经取穴为主",
      "E": "以受伤局部阴经取穴为主"
    },
    "answer": "C",
    "reason": "扭伤多发于腰、踝、膝、腕、肘、髋等部住,病住在经筋。扭伤的治法:祛瘀消肿,舒筋通络。扭伤以局部取穴为主。"
  },
  {
    "question_num": 117,
    "query": "在医德评价标准中、医疗行为是否有利于人类生存环境的保护和改善、属于",
    "options": {
      "A": "疗效标准",
      "B": "社会标准",
      "C": "科学标准",
      "D": "质量标准",
      "E": "操作标准"
    },
    "answer": "B",
    "reason": "社会标准,医疗行为是否有利于人类生存环境的保护和改善."
  },
  {
    "question_num": 118,
    "query": "“痛无定处,忽彼忽此,走注甚速”,其疼痛的原因是",
    "options": {
      "A": "风痛",
      "B": "湿痛",
      "C": "痰痛",
      "D": "热痛",
      "E": "化脓痛"
    },
    "answer": "A",
    "reason": "风善行而数变,故其病无定处,忽彼忽此,走注其速,遇风则剧。湿病痛而我成,火原光流滋。痰痛疼痛轻微,或隐隐作病,皮色不变,压之酸痛。热痛皮色炊热疼痛,遇冷则减。化脓痛痛势急胀,痛无止时,如同鸡啄,按之中软应指。故本题选A项。"
  },
  {
    "question_num": 119,
    "query": "法律效力仅次于《宪法》的卫生法渊源是",
    "options": {
      "A": "卫生自治条例",
      "B": "卫生法律",
      "C": "国际卫生条约",
      "D": "卫生部门规章",
      "E": "卫生行政法规"
    },
    "answer": "B",
    "reason": "法律作为卫生法的渊源,其决律效力仅次于《中华人民共和国宪法》。"
  },
  {
    "question_num": 120,
    "query": "月经先后无定期的主要发病机制是",
    "options": {
      "A": "寒凝血瘀,冲任不畅",
      "B": "气虚统摄无权",
      "C": "水亏火旺,热扰冲任",
      "D": "痰阻经脉,血行不畅",
      "E": "气血失于调节,血海蓄溢失常"
    },
    "answer": "E",
    "reason": "月经先后无定期,其病机为脏腑受损,气血失调,冲任功能紊乱,血海蓄溢失常所致。"
  },
  {
    "question_num": 121,
    "query": "下列各项,属于《中华人民共和国医师法》规定执业医师义务的是",
    "options": {
      "A": "依法参与所在机构的民主管理",
      "B": "人格尊严、人身安全不受侵犯",
      "C": "接受继续医学教育",
      "D": "宣传健康科普知识,对患者进行健康教育",
      "E": "参加专业学术团体"
    },
    "answer": "D",
    "reason": "D项为医师的义务,"
  },
  {
    "question_num": 122,
    "query": "瘢痕灸治疗的病证是",
    "options": {
      "A": "肺痨、瘰疬",
      "B": "虚寒病证",
      "C": "风寒痹痛",
      "D": "阳痿早泄",
      "E": "疮疡久溃不敛"
    },
    "answer": "A",
    "reason": ""
  },
  {
    "question_num": 123,
    "query": "突发公共卫生事件检测机构发现传染病菌种丢失,向有关部门报告的时限要求是",
    "options": {
      "A": "2小时内",
      "B": "24小时内",
      "C": "30日内",
      "D": "6个月内",
      "E": "1年内"
    },
    "answer": "A",
    "reason": "发生或可能发生传染病暴发、流行的,发生或发现不明原因群体性疾病的,发生传染病菌种、毒物丢失的、发生或可能发生重大食物和职业中毒事件的,2小时内上报。"
  },
  {
    "question_num": 124,
    "query": "不寐的病机总属",
    "options": {
      "A": "阴虚火旺,心肾不交",
      "B": "脾虚不运,心神失养",
      "C": "阳盛阴衰,阴阳失交",
      "D": "邪扰心神,心神不宁",
      "E": "气血阴阳亏虚,心失所养"
    },
    "answer": "C",
    "reason": "不寐的病因虽多,但其病理变化,总属阳盛阴衰,阴阳失交。一为阴虚不能纳阳、一为阳盛不得入于阴,其病位主要在心,与肝、脾、肾密切相关。故本题选C项。"
  },
  {
    "question_num": 125,
    "query": "造成患者中度残疾的医疗事故,所属的医疗事故级别是",
    "options": {
      "A": "一级",
      "B": "二级",
      "C": "三级",
      "D": "四级",
      "E": "五级"
    },
    "answer": "B",
    "reason": "一级:死亡、重度残疾;二级:中度残疾、严重功能障碍;三级,轻度残疾、一般功能障碍;四级:明显人身损害。"
  },
  {
    "question_num": 126,
    "query": "患儿,10个月。高热烦躁,气急鼻煽,张口抬肩,喉中痰鸣,声如拽锯,口唇紫绀,其治法是",
    "options": {
      "A": "清热宣肺,涤痰定喘",
      "B": "清热解毒,止咳化痰",
      "C": "辛凉开肺,清热化痰",
      "D": "清热活血,泻肺化痰",
      "E": "泻肺镇咳,清热化痰"
    },
    "answer": "A",
    "reason": "本证多见于肺炎喘嗽的中期,痰热俱甚,郁闭于肺,而见上述诸症。临床以发热、咳嗽、痰壅、气急、鼻煽为特征,治疗宜清热宣肺,涤痰定喘。故本题选A项。"
  },
  {
    "question_num": 127,
    "query": "能杀灭细菌芽孢的消毒方法是",
    "options": {
      "A": "超声波消毒法",
      "B": "酒精浸泡法",
      "C": "碘伏浸泡法",
      "D": "环氧乙烷灭菌法",
      "E": "氯己定消毒法"
    },
    "answer": "E",
    "reason": "高效消毒法杀灭一切细菌繁殖体(包括分枝杆菌)、病毒、真菌及其孢子,并对细菌芽胞有显著杀灭作用;主要有紫外线消毒法和奥氧、含氮消毒剂.过氧化氢等。中效消毒法杀灭除细菌芽胞以外的各种微生物;主要有超声波消毒法和中效消毒剂如醇类、碘类、酚类消毒剂等。"
  },
  {
    "question_num": 128,
    "query": "患者,女性,28岁,已婚。月经50天一次,量少、色淡、质稀,小腹隐痛,喜热喜按,腰酸无力,大便溏薄,小便清长,舌淡苔白,脉沉细而迟。治疗应首选",
    "options": {
      "A": "乌药汤",
      "B": "艾附暖宫丸",
      "C": "温胞饮",
      "D": "大补元煎",
      "E": "人参养荣汤"
    },
    "answer": "B",
    "reason": "根据月经50天一次可诊断为月经后期量少、色淡、质稀,小腹隐痛,喜热喜按,腰酸无力,大便溏薄,小便清长,舌淡苔白,脉沉细而迟,为血寒之虚寒证的典型表现,此证为月经后期之虚寒证。治法:扶阳祛寒调经。代表方剂:温经汤(《金匮要略》)或艾附暖宫丸。"
  },
  {
    "question_num": 129,
    "query": "脏腑关系中,“燥湿相济”指的是哪种关系",
    "options": {
      "A": "心与小肠",
      "B": "肝与胆",
      "C": "脾与胃",
      "D": "肺与大肠",
      "E": "肾与膀胱"
    },
    "answer": "C",
    "reason": "脾为阴脏,喜燥而恶湿;胃为阳腑,喜润而恶燥。脾胃阴阳燥湿相济。"
  },
  {
    "question_num": 130,
    "query": "患者,女,40岁。平素善惊易恐,因受惊而心悸1月余,坐卧不安,少寐多梦,舌苔薄白,脉虚弦。治疗应首选",
    "options": {
      "A": "炙甘草汤",
      "B": "朱砂安神丸",
      "C": "归脾汤",
      "D": "天王补心丹",
      "E": "安神定志丸"
    },
    "answer": "E",
    "reason": "善惊易恐,因受惊而心悸为心悸心虚胆怯证,治以镇惊定志,养心安神为法。代表方剂:安神定志丸。"
  },
  {
    "question_num": 131,
    "query": "巴豆内服的用量是",
    "options": {
      "A": "0.1~0.3g",
      "B": "0.5~1g",
      "C": "1.5~3g",
      "D": "3~5g",
      "E": "5~10g"
    },
    "answer": "A",
    "reason": "巴豆入丸散,每次0.1~0.3g。大多制成巴豆霜用,以减低毒性。外用适量。"
  },
  {
    "question_num": 132,
    "query": "患者,64岁。眼睑浮肿,延及全身,皮肤光亮,尿少色赤,身发疮痍,甚则溃烂,恶风发热,舌质红,苔薄黄,脉浮数或滑数。治疗应首选的方剂是",
    "options": {
      "A": "麻黄连翘赤小豆汤合五味消毒饮加减",
      "B": "五味消毒饮合小蓟饮子",
      "C": "龙胆泻肝汤合羚角钩藤汤",
      "D": "龙胆泻肝汤合小蓟饮子",
      "E": "甘露消毒丹合羚角钩藤汤"
    },
    "answer": "A",
    "reason": "根据题干描述,可以明确诊断为水肿、证型为湿毒浸淫证。治法:宣肺解毒、利湿消肿。代表方刑:麻黄连翘赤小豆汤合五味消毒饮加浊,"
  },
  {
    "question_num": 133,
    "query": "湿热和热毒导致的带下过多的治则是",
    "options": {
      "A": "宜消,宜利",
      "B": "宜消,宜升",
      "C": "宜消,宜泻",
      "D": "宜清,宜利",
      "E": "宜散,宜补"
    },
    "answer": "D",
    "reason": "带下过多者,治疗以除湿为主。一般治脾宜运、宜升、宜燥;治肾宜补、宜固、宜涩;湿热和热毒宜清、宜利;阴虚夹湿则补清兼施。虚实夹杂证及实证治疗还需配合外治法。"
  },
  {
    "question_num": 134,
    "query": "某女,23岁。2年前经期淋雨后出现痛经。经期腹痛拒按,经色紫红有块,得温痛减,舌淡苔白,脉沉。针灸取穴为",
    "options": {
      "A": "肾俞、大赫、命门、关元、血海、三阴交",
      "B": "肾俞、肝俞、太溪、太冲、血海、三阴交",
      "C": "中极、地机、次髎、三阴交、关元、归来",
      "D": "中极、地机、太冲、三阴交、期门、关元",
      "E": "肾俞、肝俞、太冲、三阴交、关元、命门"
    },
    "answer": "C",
    "reason": "痛经实证主穴为中极、次髎、地机、三阴交。气滞血瘀配太冲、血海;寒凝血鼎配关元、归来。"
  },
  {
    "question_num": 135,
    "query": "下列妇科病证不适宜选用直肠导入法的是",
    "options": {
      "A": "慢性盆腔炎",
      "B": "盆腔淤血综合征",
      "C": "癥瘕",
      "D": "产后发热",
      "E": "异位妊娠"
    },
    "answer": "E",
    "reason": "直肠导入法有利于盆腔、胞中癓积,慢性盆腔炎、盆腔淤血综合征,以及产后发热、大便秘结等病证的治疗。月经期、阴道出血时及妊娠期需甚用。"
  },
  {
    "question_num": 136,
    "query": "患者大便秘结、胸胁痞满、甚则腹中胀痛,嗳气,食少,苔薄腻、脉弦。治疗上应首选",
    "options": {
      "A": "柴胡疏肝散",
      "B": "黄芪汤",
      "C": "润肠丸",
      "D": "保和丸",
      "E": "六磨汤"
    },
    "answer": "E",
    "reason": "本患者出现症状为情志失和、肝气都结所致的便秘、即气秘。治疗宜顺气导滞。代表方剂:六磨汤。"
  },
  {
    "question_num": 137,
    "query": "治疗产后身痛风寒证,应首选的方剂是",
    "options": {
      "A": "独活寄生汤",
      "B": "身痛逐瘀汤",
      "C": "生化汤",
      "D": "养荣壮肾汤",
      "E": "黄芪桂枝五物汤"
    },
    "answer": "A",
    "reason": "产后身痛风寒证治法:养血祛风,散寒除湿。代表方剂:独活寄生汤或趁痛散、防风汤。"
  },
  {
    "question_num": 138,
    "query": "患者,女性,26岁,已婚。月经错后半个月,量少、色淡、质稀,少腹空痛,头晕眼花,心悸失眠,面色萎黄,舌淡苔少,脉细弱。治疗应首选",
    "options": {
      "A": "十全大补汤",
      "B": "人参养营汤",
      "C": "大营煎",
      "D": "大补元煎",
      "E": "滋血汤"
    },
    "answer": "D",
    "reason": "根据题干可诊断为月经后期、辨证为血虚证。治法:补血益气调经。代表方剂:大补元煎。"
  },
  {
    "question_num": 139,
    "query": "月经过少肾虚证的治法是",
    "options": {
      "A": "补肾益精、养血调经",
      "B": "补肾益精,活血调经",
      "C": "温肾健脾,养血调经",
      "D": "温肾健脾,活血调经",
      "E": "温肾健脾,疏肝调经"
    },
    "answer": "A",
    "reason": "月经过少肾虚证治法;补肾益精,养血调经。代表方剂;归肾丸或当归地黄饮。"
  },
  {
    "question_num": 140,
    "query": "患者,男性,25岁。晨起跑步时遇风后全身泛发风团,色白,伴瘙痒,发无定处,成批发生,用温水清洗后皮损很快消退,口不渴,舌淡,苔白,脉浮紧。治疗应首选的方剂是",
    "options": {
      "A": "消风散",
      "B": "麻黄桂枝各半汤",
      "C": "麻黄附子细辛汤",
      "D": "当归饮子",
      "E": "四物消风散"
    },
    "answer": "B",
    "reason": "患者晨起跑步时遇风后全身泛发风团,应考虑为风寒束表而发为瘾疹,治法应以疏风散寒为主,方剂用麻黄桂枝各半汤最为妥当。消风散和当归饮子亦可用于瘾疹的治疗,前者主治风热犯表,后者主治血虚风燥证。"
  },
  {
    "question_num": 141,
    "query": "下列各项,不属于药物流产适应证的是",
    "options": {
      "A": "正常宫内妊娠7周之内者",
      "B": "自愿要求药物终止妊娠的健康孕妇",
      "C": "高危人流对象",
      "D": "对手术流产有恐惧心理者",
      "E": "带器妊娠或可疑宫外孕者"
    },
    "answer": "E",
    "reason": "药物流产适应证:正常宫内妊娠7周以内:自愿要求药物终止妊娠的健康妇女:高危人流对象;对手术流产有恐惧心理者。带器姓娠或可疑宫外孕者属于禁忌证。"
  },
  {
    "question_num": 142,
    "query": "李某,女,82岁。平素时常头晕,沉默寡言。近年来智力衰退,终日无语,呆若木鸡,不思饮食,胃痞不适,头重如裹,舌质淡,苔白腻,脉滑,其诊断为",
    "options": {
      "A": "癫证痰气郁结证",
      "B": "郁证痰气郁结证",
      "C": "痴呆痰浊蒙窍证",
      "D": "癫证心脾两虚证",
      "E": "痴呆髓海不足证"
    },
    "answer": "C",
    "reason": "痴呆痰浊蒙窍证证候:表情呆钝,智力衰退,或哭笑无常,喃喃自语,或终日无语,呆若木鸡,伴不思饮食,脘腹胀痛,胃痞不适,口多诞沫,头重如裹,舌质淡,苔白腻,脉滑。"
  },
  {
    "question_num": 143,
    "query": "按公式推算,2周岁幼儿正常的身长(cm)是",
    "options": {
      "A": "75",
      "B": "80",
      "C": "89",
      "D": "90",
      "E": "95"
    },
    "answer": "C",
    "reason": "2岁至6岁儿童的身高计算公式:身高(cm)=75+7*年龄。经计算,2周岁幼儿正常的身长应为89cm。"
  },
  {
    "question_num": 144,
    "query": "患者呕吐多为清水痰涎,脘闷不食,头晕心悸,舌苔白腻,脉滑,其证候为",
    "options": {
      "A": "饮食积滞",
      "B": "痰饮内阻",
      "C": "脾胃虚弱",
      "D": "脾阳虚衰",
      "E": "气滞痰阻"
    },
    "answer": "B",
    "reason": "根据题干所述,可以明确诊断为呕吐,证型为痰饮内阻。痰饮内停,中阳不振,胃气上逆,故可出现上述症状。饮食积滞证表现为呕吐酸腐,脘腹胀满,嗳气厌食,大便溏或结,苔厚腻,脉滑实。脾胃虚弱表现为食欲缺乏,食入难化,恶心呕吐,脘部痞闷,大便不畅,苔白腻,脉虚弦。脾阳虚衰证表现为饮食稍多即吐,时作时止,兼有虚寒证,如面色白,恶寒喜暖,四肢不温,口干而不欲饮,舌质淡,脉濡弱。气滞痰阻表现为恶心呕吐痰涎,不思饮食,食入即吐,胸胁胀痛,嗳气,脘腹胀满,苔滑腻,脉滑数。"
  },
  {
    "question_num": 145,
    "query": "下列小儿疾病,不宜用推拿手法治疗的是",
    "options": {
      "A": "厌食",
      "B": "紫癜",
      "C": "咳嗽",
      "D": "腹痛",
      "E": "遗尿"
    },
    "answer": "B",
    "reason": "推拿疗法禁忌证:急性出血性疾病、急性外伤、脊背皮肤感染等。"
  },
  {
    "question_num": 146,
    "query": "患者,女性,45岁。头痛多年,后头部疼痛固定不移,痛如锥刺,舌暗,脉细涩,针灸治疗除百会、风池、足三里外,宜取",
    "options": {
      "A": "太阳、列缺、曲池",
      "B": "后溪、申脉、悬钟",
      "C": "三阴交、肝俞、脾俞",
      "D": "太冲、太溪、侠溪",
      "E": "阿是穴、血海、膈俞"
    },
    "answer": "E",
    "reason": "患者头痛多年,应为内伤头痛。疼痛部位固定不移、痛如锥刺、舌暗,应考虑为瘀血头痛。故取主穴百会、风池、足三里,配以阿是穴、血海、膈俞、内关等。"
  },
  {
    "question_num": 147,
    "query": "下列各项,不属于急惊风病因的是",
    "options": {
      "A": "外感风热",
      "B": "外感暑热",
      "C": "感受疫疠",
      "D": "暴受惊恐",
      "E": "久病体虚"
    },
    "answer": "E",
    "reason": "急惊风为痰、热、惊、风四证俱备,临床以高热、抽凤、神昏为主要表现,多由外感时邪(风寒、风热、暑湿)、内蕴湿热和暴受惊控而引发。"
  },
  {
    "question_num": 148,
    "query": "患者牙痛,隐隐而痛,时作时止,口不臭,有齿浮动,脉细。应选穴",
    "options": {
      "A": "合谷、颊车、外关",
      "B": "合谷、下关、风池",
      "C": "合谷、颊车、内庭、二间",
      "D": "合谷、颊车、太溪、行间",
      "E": "合谷、下关、内庭、外关"
    },
    "answer": "D",
    "reason": "牙痛祛风泻火,通络止痛。取手、足阳明经穴为主。主穴:合谷、颊车、下关;虚火牙痛配太溪、行间。"
  },
  {
    "question_num": 149,
    "query": "治疗鹅口疮心脾积热证,应首选的方剂是",
    "options": {
      "A": "银翘散",
      "B": "泻白散",
      "C": "泻心导赤散",
      "D": "清热泻脾散",
      "E": "知柏地黄丸"
    },
    "answer": "D",
    "reason": "鹅口疮治法:清心泻脾。代表方剂:清热泻脾散。"
  },
  {
    "question_num": 150,
    "query": "患者,女,45岁。3天来尿频急,尿色深红,尿痛,心烦,舌尖红,苔黄腻,脉滑数。治疗应首选的方剂是",
    "options": {
      "A": "八正散",
      "B": "小蓟饮子",
      "C": "六味地黄丸",
      "D": "知柏地黄丸",
      "E": "无比山药丸"
    },
    "answer": "B",
    "reason": "血淋证候:小便热涩刺痛,尿色深红,或夹有血块,疼痛满急加剧,或见心烦,舌尖红,苔黄,脉滑数。治法为清热通淋,凉血止血。代表方为小蓟饮子加减。"
  },
  {
    "question_num": 151,
    "query": "下列各项,属于传染性单核细胞增多症临床特点的是",
    "options": {
      "A": "白细胞明显升高",
      "B": "白细胞明显降低",
      "C": "单核细胞明显升高",
      "D": "淋巴细胞明显降低",
      "E": "异形淋巴细胞增多"
    },
    "answer": "E",
    "reason": "传染性单核细胞增多症(简称传单)临床表现多样,以发热、咽峡炎、淋巴结肿大、肝脾大、外周血中淋巴细胞增多并出现异型淋巴细胞增多为特征。"
  },
  {
    "question_num": 152,
    "query": "患儿持续发热4天,口渴多饮,目赤流泪流涕,耳后发际可见红色疹点,继之全身都可见到,疹点细小,触之碍手,先红后暗,舌红苔黄,脉浮数。治疗首选",
    "options": {
      "A": "柴葛解肌汤",
      "B": "透疹凉解汤",
      "C": "清解透表汤",
      "D": "解肌透痧汤",
      "E": "宣毒发表汤"
    },
    "answer": "C",
    "reason": "根据题干可辨证为麻疹邪入肺胃证(出疹期),证候:壮热持续,起伏如潮,肤有微汗,烦躁不安,目赤眵多,咳嗽阵作,皮疹布发,疹点由细小稀少而逐渐稠密,疹色先红后暗,皮疹凸起,触之碍手,压之褪色,大便干结,小便短少,舌质红赤,舌黄腻,脉数有力。治法:清凉解毒,透疹达邪。代表方剂:清解透表汤。"
  },
  {
    "question_num": 153,
    "query": "治疗蛔厥证,应首选的方剂是",
    "options": {
      "A": "使君子散",
      "B": "驱蛔承气汤",
      "C": "乌梅丸",
      "D": "芍药甘草汤",
      "E": "人参五味子汤"
    },
    "answer": "C",
    "reason": "蛔厥证治法:安蛔定痛,继则驱虫。代表方剂:乌梅丸。"
  },
  {
    "question_num": 154,
    "query": "患者表情淡漠,神志痴呆,喃喃独语,精神抑郁,不思饮食,舌苔白腻,脉弦滑,其治法是",
    "options": {
      "A": "养心健脾,益气安神",
      "B": "理气化痰,活血通络",
      "C": "豁痰开窍,健脾化浊",
      "D": "镇心涤痰,安神定志",
      "E": "化痰健脾,养心宁神"
    },
    "answer": "C",
    "reason": "辨证为痴呆痰浊蒙窍证。治法:豁痰开窍,健脾化浊。代表方剂:涤痰汤加减。"
  },
  {
    "question_num": 155,
    "query": "菟丝子散治疗小儿遗尿的证型是",
    "options": {
      "A": "肺脾气虚证",
      "B": "肾气不足证",
      "C": "肝经湿热证",
      "D": "心肾失交证",
      "E": "脾虚肝亢证"
    },
    "answer": "B",
    "reason": "遗尿治法:温补肾阳,固涩膀胱。代表方剂:菟丝子散。肺脾气虚证用补中益气汤合缩泉丸。肝经湿热证用龙胆泻肝汤。心肾失交证用交泰丸合导赤散。"
  },
  {
    "question_num": 156,
    "query": "患者,男,45岁。近1年来心悸头晕,倦怠无力,面色无华,舌淡红,脉象细弱,其治法是",
    "options": {
      "A": "镇惊定志,养心安神",
      "B": "补血养心,益气安神",
      "C": "滋阴降火,养心安神",
      "D": "温补心阳,安神定志",
      "E": "振奋心阳,化气行水"
    },
    "answer": "B",
    "reason": "从症状描述可知,此为心血不足之心悸,治以补血养心,益气安神,方剂用归脾汤。故本题选B项。"
  },
  {
    "question_num": 157,
    "query": "下列各项,不属于疳气证临床表现的是",
    "options": {
      "A": "精神欠佳",
      "B": "形体略瘦",
      "C": "不思伙食",
      "D": "大便干稀不调",
      "E": "面貌如老人"
    },
    "answer": "E",
    "reason": "疳气证临床表现:形体略瘦,面色少华,毛发稀疏,不思饮食,精神欠佳,性急易怒,大便干稀不调,舌质略淡,苦薄微腻,脉细有力。面貌如老人是干疳证的临床表现。"
  },
  {
    "question_num": 158,
    "query": "患儿,5岁。发热1天,颜面、躯干见丘疹及水疱疹,低热,恶寒,鼻塞流涕,疹色红润,疱浆清亮,疹粒稀疏,舌质红,苔薄白,脉浮数,其病证诊断为",
    "options": {
      "A": "幼儿急疹,邪郁肌表证",
      "B": "风疹,邪犯肺卫证",
      "C": "麻疹,邪犯肺卫证",
      "D": "水痘,毒炽气营证",
      "E": "水痘,邪伤肺卫证"
    },
    "answer": "E",
    "reason": "水痘之邪伤肺卫证。"
  },
  {
    "question_num": 159,
    "query": "根据腧穴主治规律、足三阳经腧穴主治相同的病证是",
    "options": {
      "A": "胃肠病",
      "B": "咽喉病",
      "C": "头面病",
      "D": "神志病",
      "E": "耳病"
    },
    "answer": "D",
    "reason": "足三阳经相同的主治病征是神志病、热病。"
  },
  {
    "question_num": 160,
    "query": "患者王某,心痛憋闷,心悸盗汗,虚烦不寐,腰酸膝软,头晕耳鸣,口干便秘,舌红少津,苔剥,脉细数。中医辨病为胸痹。治法宜选用",
    "options": {
      "A": "滋阴清火,养心和络",
      "B": "益气养阴,活血通脉",
      "C": "温补阳气,振奋心阳",
      "D": "辛温散寒,宣通心阳",
      "E": "通阳泄浊,豁痰宣痹"
    },
    "answer": "A",
    "reason": "胸痹之心肾阴虚证。证候主症:心痛憋闷,心悸盗汗,虚烦不寐,腰酸膝软,头晕耳鸣,口干便秘,舌红少津,苔薄或剥,脉细数或促代。治法:滋阴清火,养心和络。"
  },
  {
    "question_num": 161,
    "query": "流行性脑脊髓膜炎带菌者细菌在体内寄生的部位是",
    "options": {
      "A": "汗腺",
      "B": "血管内皮",
      "C": "蛛网膜",
      "D": "肺部",
      "E": "鼻咽部"
    },
    "answer": "E",
    "reason": "脑膜炎奈瑟菌存在于带菌者鼻咽部及患者的血液、脑背液,皮肤瘀点中。"
  },
  {
    "question_num": 162,
    "query": "患者,25岁。3天前与人吵架后,今日出现鼻衄,头痛,目眩,口苦,目赤耳鸣,烦躁易怒,其诊断与治法为",
    "options": {
      "A": "血证;清肝泻火,凉血止血",
      "B": "血证;清胃泻火,凉血止血",
      "C": "血证;清泻肺热,凉血止血",
      "D": "血证;滋肾阴泻肾火",
      "E": "血证;清心泻火,凉血止血"
    },
    "answer": "A",
    "reason": "血证肝火上炎证证候:鼻衄,头痛,目眩,耳鸣,烦踩易怒,两目红赤,口苦,舌红,脉弦数。治法:清肝泻火,凉血止血。代表方剂:龙胆泻肝汤加减。"
  },
  {
    "question_num": 163,
    "query": "流行性出血热判断少尿的标准为24小时尿量少于",
    "options": {
      "A": "400ml",
      "B": "300ml",
      "C": "200ml",
      "D": "100ml",
      "E": "50ml"
    },
    "answer": "A",
    "reason": "24小时尿量少于400ml为少尿,少于50ml为无尿。"
  },
  {
    "question_num": 164,
    "query": "患儿,2岁4个月。发热恶风,喷嚏流涕,轻微咳嗽,皮疹分布均匀,疹点稀疏细小,疹色淡红,肌肤轻度瘙痒,耳后及枕部臖核肿大触痛,舌质偏红,舌苔薄黄,指纹浮紫。治疗应首选的方剂是",
    "options": {
      "A": "银翘散",
      "B": "桑菊饮",
      "C": "桑杏汤",
      "D": "香苏散",
      "E": "麻杏石甘汤"
    },
    "answer": "A",
    "reason": "风痧邪犯肺卫证:发热恶风,喷嚏流涕,轻微咳嗽,精神倦急,饮食欠佳皮疹先起于头面、躯干,随即遍及四肢,分布均匀,疹点稀疏细小,疹色淡红,一般2~3日渐见消退,肌肤轻度瘙痒、耳后及枕部界核肿大触痛、舌质偏红、苔薄白或薄黄、脉浮数。治宜疏风清热透疹,方剂选银翘散、故本题选A项。"
  },
  {
    "question_num": 165,
    "query": "霍乱剧烈腹泻的主要致病因素是",
    "options": {
      "A": "神经氨酸酶",
      "B": "血凝素",
      "C": "霍乱内毒素",
      "D": "霍乱肠毒素",
      "E": "菌体裂解"
    },
    "answer": "D",
    "reason": "霍乱肠毒素是霍乱的主要致病物质,可导致剧烈水样腹泻。"
  },
  {
    "question_num": 166,
    "query": "患者,女,44岁。咳喘较甚,伴有胸中烦热,呼吸气涌,胸中胀痛,痰多色黄黏稠,渴喜冷饮,面红咽干,尿赤,便秘,或痰中夹血,苔黄腻,脉滑数,其诊断与治法为",
    "options": {
      "A": "痰浊壅肺;化痰降气,二陈汤合三子养亲汤",
      "B": "痰热郁肺;清热化痰,桑白皮汤加减",
      "C": "风热犯肺;清热解表,宣肺平喘,麻杏石甘汤",
      "D": "痰热郁肺;清热化痰,白虎汤合五磨饮子",
      "E": "肝火犯肺;清肝泻肺,百合固金汤"
    },
    "answer": "B",
    "reason": "喘证痰热郁肺证证候:喘促气涌,胸部胀痛,咳嗽痰多,质黏色黄,或兼有血色、伴胸中烦闷、身热、有汗、口渴而喜冷饮,面赤、咽干、小便赤涩、大便或秘、舌质红,苔薄黄或腻,脉滑数。治法:清热化痰,宣肺平喘。代表方剂:桑白皮汤加减。"
  },
  {
    "question_num": 167,
    "query": "鉴别中毒型菌痢与流行性乙型脑炎的重要依据是",
    "options": {
      "A": "高热、昏迷、惊厥",
      "B": "肠道症状",
      "C": "血清抗体检测",
      "D": "脑脊液常规检查",
      "E": "血常规检查"
    },
    "answer": "D",
    "reason": "中毒型细菌性痢疾与流行性乙型脑炎鉴别:流行性乙型脑炎起病及进展相对缓慢;循环衰竭少见;意识障碍及脑膜刺激征明显;脑脊液可有蛋白及白细胞增高,粪便检查多无异常;乙脑病毒特异性抗体IgM阳性可资鉴别。"
  },
  {
    "question_num": 168,
    "query": "患者,男,50岁。颜面部红肿疼痛伴发热2天,皮色鲜红,色如涂丹,压之褪色,扪之灼手,边界清楚,触痛明显。大便2日未行。治疗应首选",
    "options": {
      "A": "五味消毒饮加减",
      "B": "萆薢渗湿汤加减",
      "C": "普济消毒饮加减",
      "D": "黄连解毒汤加减",
      "E": "犀角地黄汤加减"
    },
    "answer": "C",
    "reason": "该患者诊断为丹毒风热毒蕴证。治法:疏风清热解毒。方药:普济消毒饮加减。故本题选C项"
  },
  {
    "question_num": 169,
    "query": "化脓灸所属的灸法是",
    "options": {
      "A": "直接灸",
      "B": "间接灸",
      "C": "悬起灸",
      "D": "实按灸",
      "E": "天灸"
    },
    "answer": "A",
    "reason": "化脓炙又名瘢痕灸,属于直接炙。"
  },
  {
    "question_num": 170,
    "query": "一患者非经期阴道突然大量出血,淋沥日久不净,血色深红,质地黏稠,口干欲饮,烦躁面赤。应诊断为",
    "options": {
      "A": "血热型,月经过多",
      "B": "血热型,崩中漏下",
      "C": "血虚型,月经过多",
      "D": "血瘀型,崩中漏下",
      "E": "血虚型,崩中漏下"
    },
    "answer": "B",
    "reason": "根据题干描述,可以明确诊断为崩漏,证型为血热证—实热证。治法:清热凉血,固冲止血。代表方剂:清热固经汤。"
  },
  {
    "question_num": 171,
    "query": "黄疸进行性加重并伴有明显神经、精神症状的肝炎是",
    "options": {
      "A": "急性黄疸型肝炎",
      "B": "重度慢性肝炎",
      "C": "急性重型肝炎",
      "D": "淤胆型肝炎",
      "E": "中度慢性肝炎"
    },
    "answer": "C",
    "reason": "急性重型肝炎亦称暴发型肝炎,其以急性黄疸型肝炎起病,病程2周内出现极度乏力,明显消化道症状(无食欲、恶心、频繁呕吐等),常有高热,迅速出现神经精神症状(如性格改变、行为反常、嗜睡、烦踩不安,甚至昏迷等),肝浊音界进行性缩小,黄疸急剧加深,血白细胞计数及中性粒细胞增高,血小板减少,凝血酶原时间延长,PTA≤40%。"
  },
  {
    "question_num": 172,
    "query": "患者,男性,28岁。左肩部可扪及5cm×3cm×3cm的肿物,质地软,呈分叶状,推之可移,无明显压痛,局部皮色正常,病史已有5年。应首先考虑的是",
    "options": {
      "A": "肉瘤",
      "B": "气瘤",
      "C": "脂瘤",
      "D": "血瘤",
      "E": "骨瘤"
    },
    "answer": "A",
    "reason": "肉瘤好发于四肢、躯干,多单发。局部表现:肿块生长缓慢,质地柔软,或有囊性感,不伴有疼痛,皮色不变,界限清楚,呈分叶状。"
  },
  {
    "question_num": 173,
    "query": "下列不属于流行性乙型脑炎流行病学特征的是",
    "options": {
      "A": "人畜共患疾病",
      "B": "人是本病的主要传染源",
      "C": "东南亚是主要的流行区",
      "D": "人群对流行性乙型脑炎普遍易感",
      "E": "流行性乙型脑炎经蚊虫叮咬传播"
    },
    "answer": "B",
    "reason": "流行性乙型脑炎是人畜共患的自然疫源性疾病,人不是主要的传染源,猪是本病主要的传染源。东南亚和西太平洋地区是主要流行区。人和群对流行性乙型脑类病毒普遍易感。流行性乙型脑炎主要通过蚊虫叮咬而传播。"
  },
  {
    "question_num": 174,
    "query": "患者,男,27岁。左眉上出现一坚硬肿块约1cm×1cm,中有一粟粒样脓头,坚硬根深,如钉之状,疼痛剧烈,左上眼睑肿胀明显,不能睁眼,伴发热头痛,其诊断是",
    "options": {
      "A": "痈",
      "B": "发",
      "C": "疖",
      "D": "疔疮",
      "E": "有头疽"
    },
    "answer": "D",
    "reason": "疔疮是常见的外科急症,好发于面部和指端。因其初起形小根深,底脚坚硬如钉,故名疔疮。本病初起状如粟粒,色或黄或紫,或起脓水疱、脓疱,根结坚硬如钉,自觉麻痒而疼痛轻微,继则红肿灼热,疼痛增剧,多有寒热。"
  },
  {
    "question_num": 175,
    "query": "归来穴归属的经脉是",
    "options": {
      "A": "手太阴肺经",
      "B": "手阳明大肠经",
      "C": "足阳明胃经",
      "D": "足太阴脾经",
      "E": "手太阴心经"
    },
    "answer": "C",
    "reason": "归来穴归属足阳明胃经。主治小腹痛,疝气,月经不调、带下、阴挺、闭经等妇科病证。"
  },
  {
    "question_num": 176,
    "query": "患者,女性,28岁,已婚。妊娠3个半月,头晕胀痛,面目肢体肿胀,但皮色不变,压痕不明显,舌苔薄腻,脉弦滑。治疗应首选",
    "options": {
      "A": "羚角钩藤汤",
      "B": "半夏白术天麻汤",
      "C": "镇肝熄风汤",
      "D": "杞菊地黄丸",
      "E": "天仙藤散"
    },
    "answer": "E",
    "reason": "妊娠肿胀气滞证,主要证候:妊娠3~4月后,肢体肿胀,始于两足,渐延于腿,皮色不变,随按随起,胸闷胁胀,头晕胀痛;苔薄腻,脉弦滑。治法:理气行滞,除湿消肿。代表方剂:天仙藤散或正气天香散。"
  },
  {
    "question_num": 177,
    "query": "患者、女,66岁。头晕,耳鸣15天。伴头目胀痛、两侧为重,心烦易怒,夜寐不宁,口苦面红,伴有肢体麻木,舌红苔黄,脉弦。治疗应首选的方剂是",
    "options": {
      "A": "芎芷石膏汤",
      "B": "天麻钩藤饮",
      "C": "银翘散",
      "D": "龙胆泻肝汤",
      "E": "镇肝息风汤"
    },
    "answer": "B",
    "reason": "患者头晕,耳鸣15天,诊为眩晕。头目胀痛,两侧为重,心烦易怒,夜寐不宁,口苦面红,伴有肢体麻木,舌红苔黄,脉弦,为肝阳上亢的表现。故诊为眩晕肝阳上亢证。治法:平肝潜阳,清火息风。代表方剂:天麻钩藤饮。"
  },
  {
    "question_num": 178,
    "query": "患儿,6岁。因左腮部肿痛3天,抽搐1次就诊。现症见发热,耳下腮部漫肿,神昏,嗜睡,项强,呕吐,舌红,苔黄,脉弦数。治疗应首选的方剂是",
    "options": {
      "A": "仙方活命饮",
      "B": "普济消毒饮",
      "C": "黄连解毒汤",
      "D": "羚角钩藤汤",
      "E": "清瘟败毒饮"
    },
    "answer": "E",
    "reason": "痄腮以发热、耳下腮部肿胀疼痛为主要特征。根据题干描述可知,本病证型为炸腮之变证邪陷心肝证。治法:清热解毒,熄风开窍。代表方剂:清瘟败毒饮。"
  },
  {
    "question_num": 179,
    "query": "患者,女,17岁。昨晚进食火锅后出现呕吐酸腐,脘腹胀满,嗳气厌食,大便溏,舌苔厚腻,脉滑实。治疗应首选的方剂是",
    "options": {
      "A": "藿香正气散",
      "B": "理中丸",
      "C": "竹茹汤",
      "D": "保和丸",
      "E": "平胃散"
    },
    "answer": "D",
    "reason": "昨晚进食火锅后出现呕吐酸腐,脘腹胀满,嗳气厌食,大便溏,舌苔厚腻,脉滑实,为饮食内停的表现。故诊为呕吐饮食内停证。治法:消食和胃,行气消痞。代表方剂;保和丸加减。"
  },
  {
    "question_num": 180,
    "query": "患者,心痛彻背,气短心悸,感寒痛甚,四肢不温,冷汗出,舌苔薄白,脉紧,其证候是",
    "options": {
      "A": "寒凝心脉",
      "B": "心肾阳虚",
      "C": "气阴两虚",
      "D": "痰浊痹阻",
      "E": "心肾阴虚"
    },
    "answer": "A",
    "reason": "根据题干描述,可以明确诊断为胸痹,证型为寒凝心脉证。"
  },
  {
    "question_num": 181,
    "query": "患者,女,5岁。大便干结7天。腹胀腹痛,面红身热,口干口臭,心烦不安,小便短赤,舌红苔黄燥,脉滑数,其治法是",
    "options": {
      "A": "清热通腑,健脾和胃",
      "B": "清肠化湿,调气和血",
      "C": "清热解毒,通腑止痛",
      "D": "泻热通腑,化瘀导滞",
      "E": "泻热导滞,润肠通便"
    },
    "answer": "E",
    "reason": "患者大使干结7天,诊为便秘。腹胀腹痛,面红身热,口干口臭,心烦不安,小便短赤,舌红苔黄燥,脉滑数,为热秘的典型表现。治法:泻热导滞,润肠通便。代表方剂:麻子仁丸。"
  },
  {
    "question_num": 182,
    "query": "李某,男,49岁。头晕头痛,手足麻木,突然发生口舌歪斜,口角流涎,舌强语謇,半身不遂,舌质紫暗有瘀斑,苔薄白,脉弦涩,其诊断是",
    "options": {
      "A": "中经络,风阳上扰证",
      "B": "中经络,风痰瘀阻证",
      "C": "中经络,阴虚风动证",
      "D": "中脏腑,阳闭证",
      "E": "恢复期,气虚络瘀证"
    },
    "answer": "B",
    "reason": "根据题干描述,可以明确诊断为中风,患者无神志异常,故可明确为中经络、舌质紫暗有瘀斑、苔薄白,脉弦涩、证为风痰瘀阻证。故本题选B项。"
  },
  {
    "question_num": 183,
    "query": "患者,女,56岁。反复发热半年,为低热。发热而欲近衣,形寒怯冷,四肢不温,少气懒言,头晕嗜卧,腰膝酸软,纳少便溏,舌质淡胖,苔白润,脉沉细无力,其治法是",
    "options": {
      "A": "温补阳气,引火归原",
      "B": "补中益气,甘温除热",
      "C": "滋补肾阴,清火泄热",
      "D": "滋补肝肾,清退虚热",
      "E": "补气养阴,清退虚热"
    },
    "answer": "A",
    "reason": "患者反复低热半年,诊为内伤发热。发热而欲近衣,形寒怯冷,四肢不温,少气懒言,头晕嗜卧,腰膝酸软,纳少便溏。舌质淡胖,苔白润,脉沉细无力,为阳虚发热的典型表现。治法:温补阳气,引火归原。代表方剂:金匮肾气丸加减。"
  },
  {
    "question_num": 184,
    "query": "患儿,2岁。形体极度消瘦,面呈老人貌,皮包骨头,腹凹如舟,精神萎靡,大便溏薄,舌淡苔薄腻,其证候是",
    "options": {
      "A": "疳肿胀",
      "B": "疳气",
      "C": "疳积",
      "D": "干疳",
      "E": "心疳"
    },
    "answer": "D",
    "reason": "患儿形休极度消瘦,面呈老人貌,皮包骨头,腹凹如舟,精神萎靡,大便溏薄,舌淡苔薄腻,属干疳。"
  },
  {
    "question_num": 185,
    "query": "患者,男,39岁。反复鼻衄3个月。伴头痛,目眩,烦躁易怒,两目红赤,口苦,舌红,脉弦数,其治法是",
    "options": {
      "A": "疏肝理气,活血化瘀",
      "B": "疏肝理气,凉血止血",
      "C": "清肝泻火,凉血止血",
      "D": "清泻肝胆,活血化瘀",
      "E": "清热解毒,宁络止血"
    },
    "answer": "C",
    "reason": "患者反复鼻衄3个月,诊为鼻衄。头痛,目眩,烦躁易怒,两目红赤,口苦,舌红,脉弦数,为肝火上炎的典型表现。治法,清肝泻火,凉血止血。代表方剂;龙胆泻肝汤加减。"
  },
  {
    "question_num": 186,
    "query": "患者,女性,32岁,已婚。孕后腰酸腹痛,胎动下坠,伴阴道少量出血,头晕耳鸣,小便频数,舌淡苔白,脉沉细滑。治疗应首选",
    "options": {
      "A": "加味圣愈汤",
      "B": "胎元饮",
      "C": "举元煎",
      "D": "补肾安胎饮",
      "E": "寿胎丸"
    },
    "answer": "E",
    "reason": "妊娠期由现腰酸腹病,胎动下坠,或阴道少最出血者,称为胎动不安,又称胎气不安。根据题干描述可明确证型为肾虚证,治宜补贤健脾、益肾安胎。代表方剂:寿胎九。"
  },
  {
    "question_num": 187,
    "query": "患者,男,78岁。表情呆钝,智力衰退,哭笑无常,喃喃自语,不思饮食,脘腹胀痛,痞满不适,口多涎沬,头重如包裹,舌质淡,苔白腻,脉滑,其病证诊断是",
    "options": {
      "A": "癫证心脾两虚证",
      "B": "癫证痰气郁结证",
      "C": "痴呆痰浊蒙窍证",
      "D": "痴呆脾肾两虚证",
      "E": "痫病风痰闭阻证"
    },
    "answer": "C",
    "reason": "患者表情呆钝,智力衰退,诊为痴呆。哭笑无常,喃喃自语。不思饮食,脘腹胀痛,痞满不适,口多涎沫,头重如包裹,舌质淡,苔白腻,脉滑,为痰浊上蒙,清窍被阻的典型表现,故诊为痴呆痰浊蒙窍证。治法:豁痰开窍,健脾化浊。代表方剂:涤痰汤加减。"
  },
  {
    "question_num": 188,
    "query": "患儿,6岁。发热2天,出现淡红色小丘疹,根盘红晕,丘疹上部可见疱疹,形态椭圆,疱浆清亮,皮疹以躯干为多,苔薄白,脉浮数,其治法是",
    "options": {
      "A": "疏风清热,利湿解毒",
      "B": "清气凉营,解毒化湿",
      "C": "发散风寒,清热利湿",
      "D": "芳香化湿,兼以健脾",
      "E": "清解郁热,活血化瘀"
    },
    "answer": "A",
    "reason": "发热,丘疹、疱疹并见,皮疹以躯干为多,所以诊断为水痘。“苔薄白,脉浮数”,表明是水痘的风热轻症,邪伤肺卫证,治当疏风清热,利湿解毒。故本题选A项。"
  },
  {
    "question_num": 189,
    "query": "患者,女,35岁。胁痛反复发作5年,加重3天。现症见:胁肋胀痛,走窜不定,胸闷腹胀,苦苔薄白,脉弦,其证型是",
    "options": {
      "A": "肝郁脾虚证",
      "B": "肝胃不和证",
      "C": "肝郁气滞证",
      "D": "肝胆湿热证",
      "E": "肝络失养证"
    },
    "answer": "C",
    "reason": "胁肋胀病,走窜不定,胸闷腹胀,脉弦,为肝郁气滞的典型表现。患者无脾胃方面的症状,可排除A.B项,无湿热的表现,可排除D项,无阴虚的表现,可排除E项。"
  },
  {
    "question_num": 190,
    "query": "患者,女性,26岁,已婚。妊娠3个月,尿少色黄,尿时艰涩而痛,心烦,口舌生疮,舌红少苔,脉数。治疗应首选",
    "options": {
      "A": "导赤散",
      "B": "加味五淋散",
      "C": "知柏地黄汤",
      "D": "清热通淋汤",
      "E": "龙胆泻肝汤"
    },
    "answer": "A",
    "reason": "妊娠小便淋痛以小便频数淋沥涩痛,量少色黄,面赤心烦,甚者口舌生疮,舌红,苔薄黄,脉细滑数为主要表现,其为心火偏亢,热移小肠所致,治宜清心泻火解毒:方剂用导赤散。"
  },
  {
    "question_num": 191,
    "query": "患者,男,58岁。口渴多饮,尿频量多,口苦舌燥6个月,伴烦热多汗,舌边尖红,苔薄黄,脉洪数,其证型是",
    "options": {
      "A": "上消肺阴亏虚证",
      "B": "下消气阴两虚证",
      "C": "上消肺气不足证",
      "D": "中消肺胃郁热证",
      "E": "上消肺热津伤证"
    },
    "answer": "E",
    "reason": "该患者以口渴多饮为主要表现,诊为上消。口苦舌燥,烦热多汗,脉洪数,为肺热津伤的典型表现,故诊为上消肺热津伤证。"
  },
  {
    "question_num": 192,
    "query": "患者,心烦不寐,心悸不安,头晕,耳鸣健忘,腰酸梦遗,五心烦热,口干津少,舌红,脉细数,其治法是",
    "options": {
      "A": "清心宁神,养阴除烦",
      "B": "养阴生津,除烦宁神",
      "C": "清火除烦,宁心安神",
      "D": "滋阴降火,养心安神",
      "E": "滋阴宁心,镇惊安神"
    },
    "answer": "D",
    "reason": "根据题干所述,可以明确诊断为不寐,证型为心肾不交证。肾水亏虚,不能上济于心,心火炽盛,不能下交于肾,故可出现上述症状,治疗宜选用滋阴降火,养心安神之法。"
  },
  {
    "question_num": 193,
    "query": "患者、男、34岁。全身泛发疖肿10天。成脓收口时间长、脓水稀薄。伴面色萎黄,纳少便溏,舌质淡,边有齿痕,脉濡。治疗应首选的方剂是",
    "options": {
      "A": "补中益气汤合五味消毒饮",
      "B": "黄芪建中汤合萆薢渗湿汤",
      "C": "仙方活命饮合五味消毒饮",
      "D": "五味消毒饮合四物汤",
      "E": "参苓白术散合五神汤"
    },
    "answer": "E",
    "reason": "患者全身泛发疖肿10天,故诊为疖。面色萎黄,纳少便溏。舌质淡,边有齿痕,,脉濡,为脾虚的表现,故诊为疖体虚毒恋,脾胃虚弱证。治法:健脾和胃,清化湿热。代表方剂:参苓白术散合五神汤,"
  },
  {
    "question_num": 194,
    "query": "患者,女性,27岁。已婚。近几个月来带下量多、黏稠、色黄,胸闷心烦,纳少便溏,舌淡红,苔黄略腻,脉细滑,其治法是",
    "options": {
      "A": "清热利湿止带",
      "B": "健脾利湿止带",
      "C": "健脾益气止带",
      "D": "清热解毒止带",
      "E": "补肾健脾止带"
    },
    "answer": "A",
    "reason": "患者带下量多、黏稠、色黄是有湿热之象,胸闷心烦,纳少便溏,舌淡红苔黄略腻,脉细滑是湿热内阻,治当清热利湿止带。"
  },
  {
    "question_num": 195,
    "query": "患者臀部湿烂溃脓,伴恶寒发热,头痛骨楚,食欲不振,舌红苔黄,脉数,其治法是",
    "options": {
      "A": "清热利湿,活血化瘀",
      "B": "清热解毒,和营化湿",
      "C": "清热解毒,散风通络",
      "D": "清肝泻火,活血化瘀",
      "E": "凉血清热,解毒通络"
    },
    "answer": "B",
    "reason": "患者臀部湿烂溃脓,伴恶寒发热,头痛骨楚,食欲不振,舌红苔黄,脉数,为臀痈湿火蕴结证。治法:清热解毒,和营化湿。代表方剂;黄连解毒汤合仙方活命饮加减。"
  },
  {
    "question_num": 196,
    "query": "某男,65岁。糖尿病10余年,半年来项部近发际处,经常出现红肿块,灼热疼痛,出脓后即愈合,触之突起根浅,服用消炎药,无明显效果,常口渴唇燥,舌红苔薄,脉细数。中医诊断",
    "options": {
      "A": "有头疖",
      "B": "无头疖",
      "C": "蝼蛄疖",
      "D": "疖病",
      "E": "粉刺"
    },
    "answer": "D",
    "reason": "疖病好发于项后发际、背部、臀部;几个到几十个,反复发作,缠绵不愈;也可在身体各处散发疖肿,一处将愈,他处续发,或间隔周余、月余再发;患消渴病、习惯性便秘或营养不良者易患本病;突起根浅,易脓、易溃、易敛。"
  },
  {
    "question_num": 197,
    "query": "患者,男,25岁。头发干枯脱落,头皮瘙痒,头屑多,头面部皮肤干燥脱屑,并见淡红色斑片,伴口干便秘,舌红,苔薄白,脉细数,其证型是",
    "options": {
      "A": "肠胃湿热证",
      "B": "热毒蕴结证",
      "C": "气血两虚证",
      "D": "气滞血瘀证",
      "E": "风热血燥证"
    },
    "answer": "E",
    "reason": "患者头发干枯脱落,头皮瘙痒,头屑多,头面部皮肤千燥脱屑,并见淡红色斑片,为脂溢性皮炎的典型表现。伴口千便秘,舌红,苔薄白,脉细数,为风热血燥证。治法:祛风清热,养血润燥。代表方剂:消风散合当归饮子加减。"
  },
  {
    "question_num": 198,
    "query": "患者,男,34岁。身目黄色鲜明如橘皮,发热口渴,心中懊侬,恶心欲吐,小便短少,色黄赤,大便秘结,舌苔黄腻,脉弦数。治疗应首选的方剂是",
    "options": {
      "A": "茵陈五苓散",
      "B": "麻黄连翘赤小豆汤",
      "C": "茵陈蒿汤",
      "D": "茵陈术附汤",
      "E": "大柴胡汤"
    },
    "answer": "C",
    "reason": "黄疸的辨证论治。患者由于湿热熏蒸,爽滞肝胆,胆汁泛滥导致黄疸阳黄由现、经辨证分析为热重于湿,治宜清热通腑,利湿退黄。代表方剂:茵陈蒿汤加减。"
  },
  {
    "question_num": 199,
    "query": "患者急性子痈2天,恶寒发热。睾丸肿大疼痛,疼痛引及子系,舌红,苔黄腻,脉滑数。外治应首选",
    "options": {
      "A": "红油膏外敷",
      "B": "苦参汤熏洗",
      "C": "冲和膏外敷",
      "D": "葱归溻肿汤坐浴",
      "E": "金黄散水调冷敷"
    },
    "answer": "E",
    "reason": "急性子痈:未成脓者,可用金黄散或玉露散水调匀,冷敷。病灶有波动感,穿刺有脓者,应及时切开引流。脓稠、腐肉较多时,可选用九一丹或八二丹药线引流,脓液已净,外用生肌白玉膏。"
  },
  {
    "question_num": 200,
    "query": "王某,女,55岁。进行性吞咽困难伴消瘦1年,现症:食人格拒不,入而复出,心烦口干,胃脘灼热,大便干结如羊屎,形体消瘦,皮肤干枯,小便短赤,舌质光红,干裂少津,脉细数,其治法是",
    "options": {
      "A": "滋养津液,泻热散结",
      "B": "滋阴养血,破血行瘀",
      "C": "开郁化痰,润燥降气",
      "D": "温补脾肾",
      "E": "清热凉血"
    },
    "answer": "A",
    "reason": "噎膈津亏热结证证候:吞咽粳涩而痛,食入而复出,甚则水饮难进、心烦口干,胃脘灼热、大便干结如羊屎,形体消瘦,皮肤干枯、小便短赤,舌质光红,干裂少津,脉细数。治法:滋养津液,泻热散结。代表方剂:沙参麦冬汤加减。"
  },
  {
    "question_num": 201,
    "query": "脱疽患者,患趾坠胀疼痛,夜难人眠,步履艰难,患趾皮色暗红,下垂更甚,皮肤发凉干燥,肌肉萎缩,趺阳脉搏动消失,舌暗红,苔薄白,脉弦涩,其证型是",
    "options": {
      "A": "寒湿阻络证",
      "B": "血脉瘀阻证",
      "C": "湿热毒盛证",
      "D": "热毒伤阴证",
      "E": "气阴两虚证"
    },
    "answer": "B",
    "reason": "脱疽血脉瘀阻证证候:患趾(指)酸胀疼痛加重,夜难入寐,步履艰难,患趾(指)皮色暗红或紫暗,下垂更甚,皮肤发凉干燥,肌肉萎缩,跌阳脉搏动消失;舌暗红或有瘀斑,苔薄白,脉弦涩。该患者临床表现符合脱疽血脉瘀阻证。"
  },
  {
    "question_num": 202,
    "query": "患者,男,30岁。便后肛门部疼痛、出血反复发作10年。检查:肛门外观截石位6点有结缔组织外痔,并有梭形裂口通向肛内,边缘不齐,创面较深。术中见肛管狭窄明显。应首选的治疗措施是",
    "options": {
      "A": "注射疗法",
      "B": "扩肛疗法",
      "C": "切除疗法",
      "D": "纵切横缝",
      "E": "肛裂切开"
    },
    "answer": "D",
    "reason": "本病属于陈旧性肛裂伴有肛管狭窄者,应选择纵切横缝。扩肛法适应证为早期肛裂,陈旧性肛裂且无结缔组织外痔,肛乳头肥大者,切除疗法适应证为陈旧性肛裂伴有结缔组织外痔或肛乳头肥大者"
  },
  {
    "question_num": 203,
    "query": "患者,女,38岁,已婚。近半年月经时而提前10天,时而延后2周,经量时多时少,色黯红,经行不畅,经行乳房胀痛,脘闷不舒,时叹息,苔薄白,脉弦,其证型是",
    "options": {
      "A": "肝郁证",
      "B": "肝郁肾虚证",
      "C": "血瘀证",
      "D": "肝郁脾虚证",
      "E": "气滞血瘀证"
    },
    "answer": "A",
    "reason": "患者近半年月经时而提前10天,时而延后2周,经量时多时少,诊为月经先后无定期。经行不畅,经行乳房胀病,脘闷不舒,时叹息,脉弦,为肝气郁结的典型表现,故该患者为月经先后无定期肝郁证。"
  },
  {
    "question_num": 204,
    "query": "王某,男,75岁。反复咳喘22年多。胸部膨满,喘息气粗,烦躁,目胀睛突,痰黄,黏稠难咯。身热微恶寒,有汗不多,口渴欲饮,溲赤,便干,舌边尖红,苔黄腻,脉滑数,其治疗应首选的方剂是",
    "options": {
      "A": "苏子降气汤",
      "B": "越婢加半夏汤",
      "C": "三子养亲汤",
      "D": "二陈平胃散",
      "E": "清金化痰汤"
    },
    "answer": "B",
    "reason": "患者胸部膨满,喘息气粗辨病为肺胀,烦躁,痰黄,黏稠难略。身热微恶寒,有汗不多,口渴欲饮,溲赤,便干,舌边尖红,苔黄腻,脉滑数,辨证为痰热郁肺证。治法:清肺化痰,降逆平喘。代表方剂:越婢加半夏汤或桑白皮汤加减。"
  },
  {
    "question_num": 205,
    "query": "患者,哮喘多年,喘促气短,动则喘甚,汗出肢冷,舌淡,脉沉细。治疗除手太阴经穴外,还应选取的是",
    "options": {
      "A": "足太阴、任脉穴",
      "B": "足太阴、足少阴经穴",
      "C": "足厥阴、督脉穴",
      "D": "足少阴、背俞穴",
      "E": "足少阴、督脉穴"
    },
    "answer": "D",
    "reason": "患者哮喘多年,气息短促,动则喘甚,舌淡,脉沉细者为虚证(肾气虚)。治宜补益肺肾,止哮平喘,治取相应背俞穴及手太阴、足少阴经穴为主。"
  },
  {
    "question_num": 206,
    "query": "患者,男,36岁。饮酒后出现便血,呈喷射状,色鲜红,无疼痛,便时肛门内无物脱出,该患者最可能的诊断是",
    "options": {
      "A": "直肠息肉",
      "B": "肛裂",
      "C": "内痔",
      "D": "肛管直肠癌",
      "E": "肛瘘"
    },
    "answer": "C",
    "reason": ""
  },
  {
    "question_num": 207,
    "query": "患者,女,21岁。带下量多,质稀,腰膝酸软,小便频数,大便溏,舌淡,苔白,脉沉迟。最佳的方剂是",
    "options": {
      "A": "完带汤",
      "B": "易黄汤",
      "C": "内补丸",
      "D": "止带方",
      "E": "龙胆泻肝汤"
    },
    "answer": "C",
    "reason": "患者带下量多,质稀,腰膝酸软,小便频数,大便溏,舌淡,苔白,脉沉迟,诊断为带下过多肾阳虚证,治宜温肾培元,固涩止带。代表方剂;内补丸。"
  },
  {
    "question_num": 208,
    "query": "患者,女,32岁。平素嗜食生冷。近期心下坚满,自利,利后反快,虽利,心下续坚满,肠间沥沥有声,腹满,便秘,口舌干燥,舌苔黄腻,脉沉弦。本病的证候诊断是",
    "options": {
      "A": "痰饮脾阳虚弱证",
      "B": "痰饮饮留胃肠证",
      "C": "悬饮邪犯胸肺证",
      "D": "悬饮饮停胸胁证",
      "E": "支饮脾肾阳虚证"
    },
    "answer": "B",
    "reason": "根据题干所述,可以明确珍断为痰饮,心下坚满或痛,自利,利后反快,虽利,心下续坚满,或水走肠间,沥沥有声,腹满,便秘,口舌干燥,舌苔腻,色白或黄,脉沉弦或伏。治法:攻下逐饮。代表方剂:甘遂半夏汤或已椒苈黄丸加减。"
  },
  {
    "question_num": 209,
    "query": "患者,女,32岁。身起皮疹为大小不等风团,色鲜红,灼热剧痒,遇热加重,得冷则减;伴有发热,恶寒,咽喉肿痛;舌质红,苔薄白或薄黄,脉浮数。治疗可选用",
    "options": {
      "A": "桑菊饮",
      "B": "银翘散",
      "C": "龙胆泻肝汤",
      "D": "防风通圣散",
      "E": "消风散"
    },
    "answer": "E",
    "reason": "瘾疹,风热犯表证,证候:凤团鲜红,灼热剧痒,遇热加重,得冷则减;伴有发热,恶寒,咽喉肿痛;舌质红,苔薄白或薄黄,脉浮数。治法:疏风清热止痒。代表方剂:消风散加减。"
  },
  {
    "question_num": 210,
    "query": "患者,女性,48岁。颈前肿物,生长迅速,质地较硬,轻度疼痛,表面不平,推之不动,声音嘶哑,随吞咽活动减弱,放射性核素131I扫描显示为冷结节。应首选的治疗措施是",
    "options": {
      "A": "中药外敷",
      "B": "中药内服",
      "C": "中药内服、外敷",
      "D": "内服、外敷、熏洗",
      "E": "手术治疗"
    },
    "answer": "E",
    "reason": "石瘿是甲状腺的恶性肿瘤,因肿块坚硬如石,故称之,其多因情志不畅,肝气郁滞,气痰、血郁结于颈前结喉侧而成,也可由气瘿、肉瘿恶变而来。石瘿是恶性肿瘤,一旦确诊,宜早期行手术治疗,"
  },
  {
    "question_num": 211,
    "query": "患者,男,38岁。胸闷反复发作3年。近日来,胸闷重而心痛微,痰多气短,肢体沉重,倦怠乏力,纳呆便溏。舌体胖大且边有齿痕,苔白滑,脉滑。治疗应首选",
    "options": {
      "A": "半夏厚朴汤合黄连温胆汤",
      "B": "参苓白术散合二陈汤",
      "C": "枳实薤白桂枝汤合当归四逆汤",
      "D": "栝蒌薤白半夏汤合涤痰汤",
      "E": "生脉散合人参养荣汤"
    },
    "answer": "D",
    "reason": "胸痹痰浊闭阻证证候:胸闷重而心痛微,痰多气短,肢体沉重,形体肥胖,遇阴雨天而易发作或加重,伴有心悸眩晕,纳呆便溏,咯吐痰延,舌体胖大且边有齿痕,苔浊腻或白滑,脉滑。治法:通阳泄浊,豁痰宣痹。代表方剂:栝蒌薤白半夏汤合涤痰汤加减。"
  },
  {
    "question_num": 212,
    "query": "患儿,男,8岁。症见多动多语,冲动任性,难于制约,注意力不集中,胸中烦热,懊侬不眠,便秘尿赤,舌质红,苔黄腻,脉滑数。治疗应首选的方剂是",
    "options": {
      "A": "龙胆泻肝汤",
      "B": "泻心导赤散",
      "C": "泻心汤",
      "D": "清心涤痰汤",
      "E": "黄连温胆汤"
    },
    "answer": "E",
    "reason": "辨病为注意力缺陷多动症,证型为痰火内扰证,临床见多动多语,烦躁不宁,冲动任性,难以制约,兴趣多变,注意力不集中,胸中烦热,懊侬不眠,纳少口苦,便秘尿赤,舌质红,苔黄腻,脉滑数。治法:清热泻火,化痰宁心。代表方剂:黄连温胆汤。"
  },
  {
    "question_num": 213,
    "query": "患者钱某,年过16周岁尚未行经,体质虚弱,全身发育欠佳,第二性征发育不良,腰腿酸软,头晕耳鸣,倦怠乏力,夜尿频多;舌淡黯,苔薄白,脉沉细。辩证为",
    "options": {
      "A": "闭经气滞血瘀证",
      "B": "闭经肾气亏损证",
      "C": "闭经肝肾不足证",
      "D": "痛经痰瘀阻滞证",
      "E": "月经后期气虚血瘀证"
    },
    "answer": "B",
    "reason": "闭经肾气亏损证,主要证候:年逾16岁尚未行经,或月经初潮偏迟,时有月经停闭,或月经周期建立后,由月经周期延后、经量减少渐至月经停闭;或体质虚弱,全身发育欠佳,第二性征发育不良,或腰腿酸软,头晕耳鸣,倦怠乏力,夜尿频多;舌淡黯,苔薄白,脉沉细。"
  },
  {
    "question_num": 214,
    "query": "患者胁部皮肤灼热疼痛,2天后患部皮肤出现簇集粟粒大小丘状疱疹,呈带状排列,疱壁紧张,口苦,心烦,脉弦数。治疗本病除局部阿是穴、夹脊穴外,宜选取",
    "options": {
      "A": "神门、大陵",
      "B": "合谷、列缺",
      "C": "血海、三阴交",
      "D": "阴陵泉、内庭",
      "E": "行间、侠溪"
    },
    "answer": "E",
    "reason": "由簇集粟粒大小丘状疱疹,呈带状排列,可辨病为蛇串疮,患者口苦,心烦,脉弦效偶肝胆火盛,除主穴外,应配合:行间、侠溪进行治疗,故本题选E项。"
  },
  {
    "question_num": 215,
    "query": "患者,男,62岁。咳喘病史20年,近1月来咳喘促,时有神志恍惚,谵妄,烦躁不安,或有嗜睡,下肢水肿,舌淡胖,苔白腻,脉沉细。诊断为肺胀,其证候是",
    "options": {
      "A": "肺肾气虚",
      "B": "阳虚水泛",
      "C": "痰浊壅肺",
      "D": "痰热郁肺",
      "E": "痰蒙神窍"
    },
    "answer": "E",
    "reason": "患者有神志恍惚,谵妄,烦躁不安,或有嗜睡的表现,为神志异常,属于痰蒙神窍。故本题选E项。"
  },
  {
    "question_num": 216,
    "query": "患儿,女,4岁。患心肌炎5个月,面黄少华,形瘦倦怠,气短乏力,动则汗出,烦热口渴,夜寐不安,纳差便溏,舌光红少苔。治疗应首选的方剂是",
    "options": {
      "A": "失笑散",
      "B": "栝蒌薤白半夏汤",
      "C": "葛根黄芩黄连汤",
      "D": "炙甘草汤合生脉散",
      "E": "桂枝甘草龙骨牡蛎汤"
    },
    "answer": "D",
    "reason": "患者为病毒性心肌炎,形瘦倦怠,气短乏力,动则汗出,烦热口渴,夜寐不安,纳差便溏,舌光红少苔可诊断为气阴亏虚证。治法:益气养阴,宁心复脉。代表方剂。炙甘草沥合生脉散。"
  },
  {
    "question_num": 217,
    "query": "患者,男,65岁。耳中如蝉鸣,时作时止,拨之鸣声减弱,听力亦下降,同时伴神疲乏力,食少腹胀,便溏,脉细弱。治疗宜在听宫、翳风、太溪、肾俞基础上,加用",
    "options": {
      "A": "行间、丘墟",
      "B": "外关、合谷",
      "C": "丰隆、阴陵泉",
      "D": "气海、足三里",
      "E": "肾俞、肝俞"
    },
    "answer": "D",
    "reason": "耳聋虚证主穴:听宫、翳风、太溪、肾俞;配:、脾胃虚弱配气海、足三里。"
  },
  {
    "question_num": 218,
    "query": "患者,女,35岁,已婚。产后半个月余,全身关节疼痛,肢体酸楚麻木,头晕心悸,舌淡红,少苔,脉细无力。治疗应首选",
    "options": {
      "A": "黄芪桂枝五物汤",
      "B": "养荣壮肾汤",
      "C": "独活寄生汤",
      "D": "八珍汤",
      "E": "黄芪汤"
    },
    "answer": "A",
    "reason": "产后身病血虚证,方选黄芪桂枝五物汤。故本题选A项。"
  }
]