食物的營養成分及保健功效 - 奇異果

奇異果

適宜：情緒低落，食欲不振，消化不良，便秘者，心血管疾病患者

不宜：脾虛便溏者，寒濕痢疾，慢性胃炎，月經過多者

營養成分：含維他命B1，維他命C，果糖，葡萄糖，氨基酸以及多種礦物質等。

保健功效：味甘酸，性寒，可止渴解熱利尿，對便秘，高血壓，心血管疾病有一定療效，還可抑制皮膚黑色素的形成，使皮膚潔白細膩。

Suppurative Otitis media (化膿性中耳炎) - Acute otitis media (急性中耳炎)

Acute otitis media (急性中耳炎)

Aetiology:
Acute infection of the middle ear cleft, common in young children. This usually occurs as part of an upper respiratory tract infection, with Haemophilus influenzae and Pneumococcus being the most common pathogens.

Clinical features:
Presents as severe otalgia and deafness. The tympanic membrane is red and bulging. Rupture may occur leading to purulent otorrhoea.

Management:
Treat with oral antibiotic therapy (amoxicillin, cotrimoxazole or erythromycin) and adequate analgeria.

食物的營養成分及保健功效 - 檸檬

檸檬

適宜：口乾煩躁，消化不良，維他命C缺乏者，胎動不安的孕婦，腎結石患者，高血壓，心肌梗塞患者

不宜：胃酸過多者，有蛀牙者，胃潰瘍，糖尿病患者

營養成分：含維他命B1，維他命B2，維他命C，鈣，磷，鐵，碳水化合物，檸檬酸等。

保健功效：味酸性寒，可生津止渴，解暑開胃，消滯安胎等，可幫助消化，清理腸胃，促進食欲，保持皮膚彈性，防止皺紋形成，抑制黑色素沉著，防止黑斑形成。

Middle ear effusion (滲出性中耳炎)

Aetiology:
Middle ear effusion is often associated with Eustachian tube obstruction, either acute during upper respiratory infections or chronic as in childhood adenoid hypertrophy. In adults middle ear effusion may result from Eustachian tube obstruction by a nasopharyngeal neoplasm. Changes in atmospheric pressure occurring during flight or diving may also result in effusions: otitic barotrauma.

Incidence:
Middle ear effusion is a common pediatric problem, particularly in the 4-7age group.

Clinical features:
On otoscopy the tympanic membrane is dull with a loss of light reflex. Small vessels are often seen radiating from the handle of the malleus and occasionally a fluid level is seen. Deafness in children may lead to poor language development and educational performance. Diagnosis may be confirmed by impedance audiometry in which the compliance of the tympanic membrane is measured in response to pressure changes in the external auditory meatus.

Management:
Medical treatment – consists of the use of topical and systemic decongestants.

Surgical treatment – consists of myringotomy and insertion of a ventilation tube into the affected tympanic membrane. Children may also require an adenoidectomy whilst in adults a nasopharyngeal tumor must be excluded.

食物的營養成分及保健功效 - 葡萄

葡萄

適宜：兒童，孕婦，神經衰弱，過度疲勞，體倦乏力，未老先衰，肺虛咳嗽，盜汗者，高血壓，水腫，貧血，四肢筋骨疼痛者

不宜：糖尿病患者，便秘者，脾胃虛寒者不宜多吃

營養成分：含葡萄糖，果糖，蔗糖，檸檬酸，蘋果酸，蛋白質，多種氨基酸，胡蘿蔔素，維他命B雜，維他命C，鈣，鉀，磷，鐵等。

保健功效：味甘酸性平，可促進消化液分泌，促進腸胃液蠕動，利尿的功效，還可滋潤皮膚，防止膚色暗沉。

Chronic sinusitis (慢性鼻竇炎)

Frontal sinusitis

Clinical features:

Presents as a persistent frontal headache or, if a mucocele develops, a unilateral proptosis. A pyocele may result from secondary infection of a mucocele. X-rays show an opaque sinus, often with hazy, indistinct edges. A CT scan will show a soft tissue mass filling the sinus.

Management:

Surgical treatment is aimed at re-establishing aeration of the frontal sinus. The area of the frontal recess leading into the frontal sinus can be approached either endoscopically through the nasal cavity or via an external incision. Obliteration of the frontal sinus via an osteoplastic flap approach is a radical procedure very rarely required.

Maxillary sinusitis

Aetiology:

Disease is commonly bilateral unless there is an underlying septal deviation, unilateral polyp or history of maxillary trauma. A past history of dental treatment may be relevant.

Clinical features:

Usually presents with chronic facial pain or upper jaw toothache. Other presentations include a purulent postnasal drip, chronic laryngitis or otitis media. Examination is often normal but paranasal sinus X-rays usually demonstrate antral disease, in the form of mucosal thickening, a persistent fluid level or total opacification.

Management:

Treatment involves the creation of intranasal antrostomies to ventilate and drain the antra. Antrostomies are now normally performed endoscopically through the middle meatus. In severe cases a Caldwell-Luc approach can be used to remove diseased antral mucosa.

食物的營養成分及保健功效 - 芒果

芒果

適宜：便秘，高血壓，食欲不振者

不宜：風濕，皮膚過敏，胃潰瘍，胃炎者

營養成分：含蛋白質，糖類，膳食纖維，胡蘿蔔素，維他命A，維他命B雜，維他命C，鈣，磷等。

保健功效：味甘酸，性涼，入肺，脾，胃經，可止嘔解渴利尿，適用於口渴咽乾，食欲不振，消化不良，眩暈嘔吐，咽痛音啞，咳嗽痰多，氣喘等症。

Acute sinusitis (急性鼻竇炎)

Aetiology:
Stasis and acute infection of sinus secretions may result from any pathological or anatomical abnormality obstructing free sinus drainage. The common cold is the most frequent cause. Acute maxillary sinusitis can also result from apical infection of an upper tooth root. The causative organism is usually Pneumococcus, Streptococcus viridans or Haemophilus influenzae.

Complications:
Left untreated, acute sinusitis can rarely lead to orbital cellulitis, cavernous sinus thrombosis or intracranial abscess formation. Chronic sinusitis is a far more common sequela.


Maxillary sinusitis

Clinical features:
Most common type overall. Facial or dental pain may occur, as may referred otalgia. Nasal obstruction and purulent rhinorrhea are also frequent. Local tenderness may be the only physical sign. An occipitomental X-ray usually shows a fluid level on one or both sides, but this investigation is increasingly being replaced by CT scanning.

Management:
Treat with antibiotics and topical nasal decongestants. An antral washout through the inferior meatus may be necessary if resolution with antibiotics does not occur, but this form of treatments is decreasing in popularity with the advent of endoscopic management of sinusitis.


Ethmoiditis

Incidence:
Most common in young children who have poorly developed maxillary sinuses.

Clinical features:
Usually presents as persistent headache and orbital cellulitis following a cold. Untreated, an orbital abscess and blindness may occur.

Management:
Treatment requires hospital admission. Antibiotics are given and the maxillary sinuses washed out if also infected. Rarely, an external ethmoidectomy may be necessary. A CT scan should be performed if there is any question of an orbital abscess.


Frontal sinusitis
Potentially the most serious acute sinusitis. The long course of the frontonasal duct makes it particularly prone to obstruction by mucosal oedema.

Clinical features:
Presents as frontal headache after an upper respiratory tract infection. Local tenderness is common, but may be the only sign. A sinus CT scan usually shows a fluid level or complete opacification in one or both sinuses.

Management:
Treatment is with antibiotics, but sinus trephine and insertion of drainage tubes is undertaken if rapid resolution does not occur.


Sphenoiditis

Clinical features:
This rare form of sinusitis may present as a deep central, reto-orbital or vertex headache. Diagnosis is confirmed by a lateral X-ray or CT scan. Sinus drainage may be necessary if there is not a quick response to antibiotic therapy.

食物的營養成分及保健功效 - 荔枝

荔枝

適宜：產婦，老人，體質虛弱者，病後調養患者，貧血，胃寒者

不宜：糖尿病患者，陰虛火旺，伴上火症狀者

營養成分：含有豐富糖分，蛋白質，脂肪，多種維他命，檸檬酸，果膠及磷，鐵等。

保健功效：味甘，酸，性溫，入心，脾，肝經，可養血健脾，行氣消腫，適用於病後體虛，津傷口渴，脾虛泄瀉，呃逆，食少，外傷出血等。

Cholesteatoma (膽脂瘤)

A ball of keratinizing stratified squamous epithelium in the middle ear cleft or mastoid which enlarges and can destroy or erode local structures. It is a feature of the unsafe type of chronic middle ear disease.

Aetiology:
The most widely accepted theory of its development is the immigration-retraction pocket theory: in response to Eustachian tube obstruction and negative middle ear pressure an inward retraction of the tympanic membrane occurs, usually in the attic region. 
Desquamated epithelium normally shed from the membrane into the meatus collects in the pocket, the continued enlargement of which results in the formation of a cholesteatoma sac. Congenital cholesteatoma is very rare and results from congenital squamous cell rests within the temporal bone.

Clinical features:
Presents as progressive conductive hearing loss with purulent, and often offensive, otorrhoea. Pain or vertigo due to bong erosion may also occur. Otoscopy reveals a retraction pocket or perforation in the attic or posterior marginal region of the tympanic membrane with flaky white debris visible in the defect. Nystagmous and other evidence of neurological involvement should be sought.

Management:
Radical mastoidectomy involves removal of the cholesteatoma, middle ear structures and bone of the bony external meatus, producing a smooth exteriorized mastoid cavity accessible for inspection. The operation may be modified in order to conserve hearing by retaining part of the ossicular chain and tympanic membrane.

食物的營養成分及保健功效 - 草莓

草莓

適宜：咽喉腫痛，聲音沙啞，夏季煩熱口乾或腹瀉如水者

不宜：尿路結石患者，腎功能不佳者

營養成分：富含氨基酸，單糖，檸檬酸，蘋果酸，果膠，維他命，鎂，磷，鐵等礦物質。

保健功效：味甘酸性涼，入肺，脾經，可解暑清熱，生津止渴，利尿止瀉，利咽，可輔助治療小便澀痛，尿色深黃，對腸胃病，貧血等有一定的滋補調理作用。

Otogenic Vertigo (耳源性眩暈)

Testing:

Otogenic vertigo is an hallucination or a false sensation of movement. Disease affecting the vestibular apparatus may produce rotatory vertigo accompanied by horizontal nystagmus.

Caloric testing:

Involves stimulating the vestibular apparatus by irrigating the external meatus with water at varying temperatures; the duration of induced nystagmus is recorded, allowing comparison between the two sides.

Positional testing:

Vertigo provoked by head movements may be a feature of inner ear disease, cervical spondylosis or disease affecting central vestibular pathways in the brainstem.

Meniere’s disease

Aetiology:

Unknown. Maybe due to imbalance between production and absorption of inner ear endolymph or disturbance of inner ear immunity.

Clinical features:

Episodic rotatory vertigo, tinnitus and sensorineural deafness may be present. Unilateral in early stages.

Management:

Vestibular sedatives for acute attacks. Surgery may be conservative (endolymphatic sac decompression) or destructive (labyrinthectomy or vestibular neurectomy). Intratympanic gentamicin is also an option.

Sudden unilateral vestibular failure

Aetiology:

Unknown aetiology. Viral infection, ischaemia and inner ear membrane rupture have been postulated.

Clinical features:

Presents with sudden onset of vertigo. Recovery takes place by central compensation.

Management:

Vestibular sedatives are useful in the acute phase.

Other causes of vertigo are syphilis, suppurative labyrinthitis, temporal fractures and ototoxic drugs.

食物的營養成分及保健功效 - 西瓜

西瓜

適宜：高血壓，急慢性腎炎，膽囊炎患者，高熱不退者

不宜：糖尿病患者，脾胃虛寒，濕盛便溏者

營養成分：含豐富糖類及氨基酸，胡蘿蔔素，維他命B雜，維他命C等。

保健功效：味甘性寒，入胃，膀胱經，可解暑清熱，生津止渴，利尿，解酒解毒，適用中暑，高血壓，腎炎，尿路感染，口瘡等。

Facial nerve palsy (面神經麻痹/面癱)

Disruption of the lower motor neurone facial nerve can occur at any point between its brainstem nucleus and the facial musculature.


Bellis (idiopathic) Palsy
Clinical features:
Most common palsy with no identifiable cause although a viral or vascular aetiology postulated. Palsy may be partial or complete.

Management:
Total recovery occurs in 90% of cases. Treatment with steroids or surgical decompression controversial.


Ramsay Hunt Syndrome
Clinical features:
Herpes zoster involvement of the facial nerve with herpetic vesicles on the tympanic membrane, pinna or palate. May present with severe otalgia alone. Auditory and trigeminal nerves may be affected.

Management:
Recovers fully in about 60% of cases. If given early, the antiviral agent aciclovir may enhance recovery. The value of steroids or surgical decompression of the nerve remains unproven.


Temporal bone fracture
Clinical features:
Longitudinal fractures (80%) are associated with a facial palsy in 20% of cases and a conductive deafness. Transverse fractures (20%) are associated with a facial palsy in 50% of cases and a sensorineural deafness. Diagnosis is confirmed by CT scan.

Management:
Exploration of the nerve may be indicated in cases of immediate, complete paralysis but is likely to be followed by deafness.

食物的營養成分及保健功效 - 哈密瓜

哈密瓜

適宜：貧血者，夏季中暑者

不宜：腳氣病，黃疸，腹脹，便溏，寒性咳喘，糖尿病患者，產後及病後休養期者

營養成分：含豐富的糖類，纖維素，蘋果酸，果膠物質，胡蘿蔔素，維他命B雜，維他命C，鈣，磷，鐵等。

保健功效：味甘性寒，入心，胃經，可清暑熱，解煩渴，利小便，適用於腎病，胃病，貧血，便秘等。

Simple Nasal Polyps (鼻息肉)

Aetiology
Simple nasal polyps are pedunculated areas of oedematous mucosa occurring in the nasal cavity and paranasal sinuses. Their aetiology is unknown although chronic sinus infection and mucosal allergy have been suggested. Most polyps arise from the ethmoid sinuses with the maxillary antrum being a less common source.

Nasal polyps can be associated with asthma and aspirin sensitivity (aspirin triad). In children, nasal polps may be a manifestation of cystic fibrosis.


Clinical features
Presents as progressive nasal obstruction and rhinorrhea. On inspection of the nasal cavity, polyps are seen as pale grey, smooth swellings, which can fill the nasal cavity. Most cases are bilateral but in unilateral cases a neoplasm must be excluded by biopsy. 

An antrochoanal polyp passes from the maxillary sinus via its ostium posteriorly into the nasal cavity to occupy the posterior choana where it can be seen on posterior rhinoscopy and its presence confirmed by lateral radiography.


Management 

Medical treatment:
Topical steroid drops or spray administered correctly can cause considerable diminution in polyp size.

Surgical treatment: 
Intranasal polypectomy may have to be repeated as recurrence after polyp removal is common. Many surgeons use endoscopic ethmoidectomy techniques to remove polyps from the ethmoid sinuses.

食物的營養成分及保健功效 - 木瓜

木瓜

適宜：慢性萎縮性胃炎，產後缺乳，風濕筋骨痛，跌打扭傷者，消化不良，肥胖者。

不宜：孕婦，過敏體質者

營養成分：含番木瓜碱，木瓜蛋白酶，木瓜凝乳酶，蛋白質，脂肪，糖類，胡蘿蔔素，維他命B雜，維他命C，維他命E等

保健功效：味甘，性平，微寒，入肝，脾經，可消食，驅蟲，清熱，袪風，適用於胃痛，消化不良，肺熱乾咳，乳汁不通，濕疹，寄生蟲病等。

食物的營養成分及保健功效 - 蜜瓜

蜜瓜

適宜：夏季煩熱口渴者，口鼻生瘡者，中暑者

不宜：脾胃虛寒，腹脹便溏者，有吐血，咳血病史者，胃潰瘍及心臟病患者

營養成分：含大量氨基酸，碳水化合物，檸檬酸，蘋果酸，葡萄糖，維他命C等。

保健功效：味甘性寒，入胃，肺，大腸經，可消暑熱，解煩渴，利小便，可用於暑熱口渴等。

一般聲線問題如何治療？

1. 聲帶休息：

聲帶因炎症或手術後引起反應性充血，腫脹時，應禁聲，使聲帶休息，以利炎症消退。

2. 糾正不正確的發聲方法：

I. 喉肌功能過強如男聲女調，男性青春期變聲異常，致語調高尖者，應引導在發聲時使喉肌放鬆，降低語調，發聲時同時作咀嚼動作訓練，可改善發聲。

II. 喉肌功能過弱者，練習屏氣動作，使聲帶緊閉，胸腔固定，並同時發聲。反覆練習，有助於增加聲帶張力。

III. 音質異常者，因運氣方法不當，致發聲效果不佳，應進行呼吸訓練，改胸式呼吸為胸腹式混合呼吸，控制呼氣能力，使呼氣慢而均勻，呼氣期延長。

3. 霧化吸入與理療：以消炎藥液，激素進行霧化吸入，以利聲帶紅腫，早期聲帶小結，息肉的消退。超短波理療等能改善局部血供，加速炎症吸收。

4. 手術治療：

I. 聲帶小結或息肉可在顯微鏡下摘除。

II. 對於單側聲帶麻痹，可酌情做聲帶內移術或I型甲狀軟骨成型，以縮小雙聲帶間縫隙，改善發聲。

III. 聲帶溝，可作聲帶注射。

IV. 男聲女調，可做II型甲狀軟骨成型，降低聲帶張力，降低音調。

V. 女聲男調則相反，可做IV型甲狀軟骨成型，增加聲帶張力，提高音調。

VI. 室帶肥厚性發聲障礙，則切除室帶肥厚部分。

VII. 痙攣性發聲障礙，則在甲杓肌注射肉毒杆菌毒素A。

5. 重視嗓音保健：

增強體質，預防呼吸道感染，對保護嗓音至關重要；不要濫用嗓音，不大聲叫喊，演唱及演講時，用聲要適當。一旦出現聲音嘶啞，應及時診治。男性青春期變聲時，適當減少練聲時間。女性月經期，聲帶輕度充血，也應注意聲帶休息。忌煙酒，避免辛辣等刺激性食物。

食物的營養成分及保健功效 - 橙

橙

適宜：胸膈滿悶，噁心嘔吐，飲酒過多，宿醉未醒者

不宜：糖尿病患者，脾胃虛，腹瀉腹痛者

營養成分：含糖類，果膠，維他命，橙皮甙，枸櫞酸，蘋果酸，琥珀酸等。

保健功效：味酸性涼，入肺，肝，胃經，可降逆和胃，理氣寬胸，消癭，醒酒，解魚蟹毒，適用於食欲不振，胸腹脹滿作痛，噁心嘔吐，癭瘤，醉酒等。

聲音檢查所見有些什麼？

1. 一般檢查 

I. 喉部檢查：間接喉鏡檢查了解聲帶的色澤，形態，運動和聲門閉合狀況，注意有無充血，水腫，肥厚，小結，息肉等病變，觀察呼吸及發聲時的聲帶情況，還可作纖維和電子喉鏡檢查。

II. 共鳴器官檢查：包括鼻腔，鼻竇，咽腔，口腔的檢查。

2. 發聲功能的主觀聽覺評價：

通過聽覺，將聲沙分成以下四型。每型分正常，輕度，中度，重度等級。

I. 粗糙型：聲帶腫脹變軟，有息肉時，振動不均勻。

II. 氣息型：聲帶癱瘓，發聲時聲帶閉合不全，呼出氣流增大。

III. 無力型：聲帶癱瘓時，聲帶變薄，質量減低，張力下降。 

IV. 緊張型：聲帶癌，聲帶異常變硬，變重，用力發聲。

3. 發聲功能客觀檢查分析

I. 聲時測定：聲時也稱時值，是深吸氣後能持續發聲的最長時間。測試時一般發 /a/ 或 /i/ 音。反覆測試3次後取其最大值。可以推測受檢者喉部的調節功能及發聲的持續能力。

正常情況下，男性的聲時約為30秒，女性約為20秒，老人則縮短，兒童的聲時隨年齡增長而增長。全身健康狀況，體形，肺活量，呼吸方法等對聲時有影響。聲帶有病變時聲時縮短。因此，聲時測定可作為治療前後效果評定的參考。

II. 氣流率測定：以每秒鐘經聲門呼出之氣流量除以聲時所得的值，為氣流率。正常時氣流率＜200ml/s。聲帶有病變時，由於聲時縮短，氣流率高於正常人。一般認為氣流率＞200ml/s時，則有診斷意義。

III. 發聲頻率範圍測定：通過發聲功能檢查裝置，測試聲音的頻率範圍。一般選單元音進行測試。聲帶有病變時，發聲功能減退，致最低頻率提高，最高頻率降低，發聲頻率範圍變窄。

IV. 喉動態鏡檢查：主要用於了解聲帶振動狀況。由於喉動態鏡具有與聲帶振動頻率一致並同步的光源，檢查時可以觀察聲帶的振動方式，幅度等。正常情況下，發低音時，聲帶振動速度慢，振幅大；發高音時，聲帶振動速度快，振幅小；兩側聲帶呈對稱性，波浪形運動，聲帶振動速度均勻。聲帶有病變時，根據病情輕重，表現為振動速度變慢，振幅減少，聲帶波浪形運動減弱或消失，兩側常不對稱。

V. 喉肌電描記法：是測試喉肌及其支配神經電活動的檢查法。主要用於喉肌功能的評定。檢查時以電極針插入喉肌（環甲肌，甲杓肌）內，經電刺激，分別觀察平靜呼吸，發高音和低音時的肌電描記的波形。正常時波形密集，聲帶麻痹等喉肌病變時，波形衝疏。喉肌電檢查對了解喉肌病變程度，病因，預後估計有一定幫助。

VI. 聲學測試：應用聲圖儀，頻譜儀或電腦等儀器，將聲波轉換成電波後，可對聲音的頻率，強度及音色（諧波數，噪音量）進行分析，客觀地評估嗓音質量，供診斷及療效比較時參考。

4. 影像學檢查：

平靜呼吸及發聲時，進行X光喉側位片，正側位胸片，食管鋇透及喉CT掃描等檢查，可用於嗓音病變的研究，查找和鑒別聲音障礙的病因和診斷。

食物的營養成分及保健功效 - 菠蘿

菠蘿

適宜：身熱煩躁，消化不良者，腎炎，高血壓，支氣管炎患者

不宜：潰瘍病，高熱，濕疹，腎病，凝血功能障礙者

營養成分：含蛋白質，氨基酸，果糖，葡萄糖，有機酸，礦物質，酶類。

保健功效：味甘微酸，性平，可生津止渴，醒酒，益氣消滯，有助治療消化不良，中暑等症。

聲音障礙典型的臨床表現有些什麼？

從音強，音調，音質方面分析，聲音障礙常有以下表現。

1. 音強反常：

• 喉肌功能過強。如發聲時過於緊張，方法不當，唱歌時選擇音域過高，聲帶及共鳴腔肌肉過度收縮使聲帶張力太大，聲門關閉過緊，共鳴腔變小，使發出的聲音尖弱且不悅耳。

根據研究，發高音時，聲帶的振動主要位於其前中1/3交界處，如喉肌收縮過強，該處摩擦過多，易引起黏膜肥厚，聲帶小結，息肉等病變。

• 喉肌功能過弱。見於聲帶麻痹，發聲方法不當或功能性病變等。由於喉肌功能減退，聲帶鬆弛，發出的聲音會如吹風樣的呼氣聲，說話時聲音沙啞低弱，漏氣狀，發聲不能持久，容易疲勞。

檢查時見聲帶閉合不全，病變如累及雙側聲帶，發聲時聲帶間有梭形或三角形的縫隙，單側性病變時，有弓形縫隙。如病程較長，可因二氧化碳呼出過多，血液中二氧化碳濃度降低，產生頭暈乏力，胸悶，手足麻痹等過度換氣的徵象。

2. 音調反常：

聲音就其固有的音域和音樂特性，可分為男低音（音域為81 - 325Hz），男中音（音域為96 - 426Hz），男高音（音域為122 - 580Hz），女低音（音域為145 - 690Hz），女中音（音域為217 - 1024Hz），女高音（音域為256 - 1300Hz）等類型。正常的語調，女性約為256Hz，男性約為128Hz。正常語調高低，雖有個體差異，但如超過或低於正常人一個音階（8度音調）時，屬音調反常。

臨床所見男聲女調為高頻反常，男性講話時音調偏高，或用假嗓音，是因男性青春期變聲時，性激素分泌不足或受精神因素影響，可帶著童聲進入成年期。也與發聲方法不當，聲帶張力過大，咽喉部肌張力增強等因素有關。偶有因喉發育不良，聲帶短小而致語調過高引起。低頻反常則較少見，女性使用男性激素治療疾病後，可發生語調過低。

3. 音質反常：

• 喉部病變所致的音質變化表現為聲音沙啞。
• 共鳴障礙引起的音質改變表現為閉塞性鼻音和開放性鼻音。
• 室帶改變也可引起聲沙。聲帶運動障礙或手術切除聲帶後，可致室帶代償性肥厚，喉部炎症也使室帶充血腫厚。由於室帶振動的頻率較低，故其發出的聲音低啞，沉悶，持續時間短，發聲費力，容易疲勞。檢查見室帶肥厚，部分或全部遮蓋了聲帶。
• 痙攣性發聲障礙是由於喉肌張力障礙，引起了喉發聲運動紊亂，而引起的發聲困難。分兩型：
• 一型是內收型，常見，特徵是發聲時，聲帶過度內收或閉合過緊，出現發聲頻繁中斷，不連貫，聲音振顫，擠壓感，發聲疲勞
• 另一型是外展型，少見，表現為發聲時聲帶外展，發聲頻繁中斷，暫時性漏氣，發聲時常有頸面部肌肉痙攣，面部出現種種怪異，頸靜脈怒張，但耳語，哭笑時發聲往往正常。喉肌電圖（EMG）檢查，見肌肉異常的肌電活動。
• 聲帶突接觸性肉芽腫或潰瘍，由濫用嗓音，胃酸反流到喉刺激了黏膜引起。臨床表現為聲沙，聲音低沉，咳嗽，不自主地清理咽喉，發高音時易走音。檢查見到聲帶突內側或上方的邊緣有肉芽或潰瘍形成。
• 聲帶溝
• 功能性失音

食物的營養成分及保健功效 - 白米

白米

適宜：一切體虛，高熱者，久病初愈，婦女產後，老年人，嬰幼兒消化力減弱者

不宜：糖尿病患者

營養成分：含蛋白質，脂肪，碳水化合物，鈣，磷，維他命B1，維他命B2等。

保健功效：味甘性平，入脾，胃經，可補中益氣，平和五臟，止煩渴，止瀉，壯筋骨，通血脈，益精養顏，適用於瀉痢，胃氣不足，口乾渴，嘔吐，諸虛百損等。

食物的營養成分及保健功效 - 糯米

糯米

適宜：體虛自汗，盜汗，多汗，血虛，頭暈眼花，脾虛腹瀉者，神經衰弱者，病後或產後調養期者

不宜：脾胃虛弱者，老人，兒童不宜食蒸糯米飯。

營養成分：含蛋白質，脂肪，糖類，鈣，磷，鐵，維他命B1，維他命B2等。

保健功效：味甘性溫，入脾，胃，肺經，可補中益氣，健脾止瀉，縮尿斂汗，適用於脾胃虛寒泄瀉，消渴尿多，自汗痔瘡等。

食物的營養成分及保健功效 - 粟米

粟米

適宜：便秘，高血壓，動脈硬化患者

不宜：腹脹，尿頻患者

營養成分：含碳水化合物，蛋白質，脂肪，胡蘿蔔素，維他命B2等。

保健功效：味甘性平，入胃，小腸經，可調中開胃，利水通淋，適用於食欲不振，水腫，尿路感染，肝炎等。

食物的營養成分及保健功效 - 赤小豆

赤小豆

適宜：各種類型水腫者，肥胖者

不宜：多尿之人，身體有傷口者

營養成分：含蛋白質，脂肪，維他命A，維他命B雜，維他命C，鋁，銅等微量元素。

保健功效：味甘性平，可健脾止瀉，利水消腫，適用於水腫脹滿，腳氣浮腫，黃疸尿赤，風濕熱痹，癰腫瘡毒，腸癰腹痛患者，特別適合各種類型水腫之人，包括腎臟性水腫，心臟性水腫，營養不良性水腫等，產後缺乳者。