One Case Report of Treatment of Bentun Disease Result from Abortion in Department of Emergency
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1.Emergency department of First Teaching Hospital of Tianjin University of Traditional Chinese Midicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381
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PANG Shuchao. One Case Report of Treatment of Bentun Disease Result from Abortion in Department of Emergency[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=30676269&Fpath=home&index=0
病史摘要,2,患者,女,32岁,2021年3月13日主因“纳差,伴恶心、呕吐半月,并气从少腹上冲心2天”就诊。患者于2021年2月堕胎后即返岗工作。半月前贪食寒凉并劳累后出现纳差、恶心、呕吐,呕吐物为胃内容物,自服奥美拉唑、马来酸曲美布汀等药物无明显缓解,后就诊于当地医院。自诉于当地医院就诊时理化检查无明显异常,辨证给予益气健脾、化湿和胃中药治疗未见好转。2天前患者出现食入即吐,腹胀,自觉气从少腹上冲心,乏力,畏寒,四肢不温等症。今到我院消化科就诊,因患者刻诊之时面色苍白,极度虚弱,行走站立困难,遂直接由消化科门诊转入急诊。刻下症:患者神清,精神差,纳差,胃脘痛,食入即吐,自觉气从少腹上冲心,腹胀,极度乏力,行走站立不能,畏寒,小便可,大便2~3日一行。四诊信息:面色苍白无华,四肢不温,舌体胖大,质暗苔白,边有齿痕,脉寸关尺三部俱沉。中医诊断 奔豚病,脾肾阳虚兼肝血亏虚证。西医诊断 神经官能症。干预措施 奔豚汤加减,联合参附注射液静脉滴注。疗效转归 患者1剂药小量频服并输液治疗后,胃脘痛消失,进食稀粥一碗而无呕吐,余症较前减轻。后予中药汤剂持续治疗,不断好转,至六诊(2021年5月8日),未再发冲气上逆之症,腹胀已解,夜寐尚安,唯平素遇寒腹痛,大便里急后重,时有稀便,月经量少色红伴少量血块。急症已去,沉疴仍在,嘱其节饮食,避寒凉,慎起居,以丸散徐图。随诊半年,起居如常。
Summary of case history ,Patient, female, 32 years old. On March 13, 2021, she went to see a doctor because of "anorexia, accompanied by nausea and vomiting for half a month, and qi from the abdomen to the heart for 2 days". The patient returned to work after an abortion in February 2021. Half a month ago, she felt anorexia, nausea and vomiting due to gluttony, cold and fatigue. The vomitus was stomach contents, but there was no significant relief after taking omeprazole, trimebutine maleate and other drugs, and then she received treatment in in a local hospital. The routine examination showed no obvious abnormalities. The treatment of TCM "invigorating Qi and strengthening spleen, removing dampness and restoring stomach" did not improve the state of patient at that time. Two days ago, the patient developed vomiting after eating, abdominal distension, self-conscious qi rushing from the abdomen to the heart, fatigue, chills, and cold limbs. When to seek treatment in the Department of Gastroenterology of our hospital, the patient was extremely weak, difficult to walk and stand, so he was directly transferred from the outpatient department of gastroenterology to the emergency department. The patient had clear mind, poor spirit, poor appetite, epigastric pain, vomiting when eating, conscious qi flushing from the abdomen, abdominal distension, extreme fatigue, unable to walk and stand, chills, normal urination, stool 2-3 days once, when in the emergency department. Four diagnosis information: pale face, cold limbs, fat tongue, dark moss, edge tooth marks, heavy pulse.,TCM diagnosis ,Bentun disease, Deficiency of spleen-kidney yang and Deficiency of Liver Blood.,Western medicine diagnosis ,Psychoneurosis.,Therapeutic methods ,Add or subtract the Bentun decoction, combined with Shenfu injection intravenously.,Clinical outcomes, After taking 1 dose of medicine frequently and infusion treatment, the epigastric pain disappeared, and there was no vomiting after eating a bowl of gruel, and the remaining symptoms were relieved. Afterwards, she continued to treat with traditional Chinese medicine decoction, and it continued to improve. In the sixth consultation (May 8, 2021), she did not have the symptoms of rushing qi and upward reversal. The abdominal distension has been resolved, and the night is still sound. , Occasionally loose stools, light red menstrual flow with a small amount of blood clots. The emergency has passed, but the sputum is still there. He is instructed to eat and drink, avoid cold and cold, live with caution, and continue to treat with pills. Follow-up for half a year, daily life as usual.
奔豚奔豚汤脾肾阳虚肝血亏虚
BentunBentun DecoctionDeficiency of Spleen-kidney YangDeficiency of Liver Blood
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张秀, 樊蔚. 奔豚病证治[J]. 中国中医基础杂志, 2006, 12(6): 477, 480.
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