A Case Report on the Treatment of Postoperative Retention of Urine Using a Thoughtful Approach that Incorporates TCM Theory, Diagnosis, Treatment, Acupuncture Points, and Acupuncture Methods
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1.Internal medicine department of traditional Chinese medicine, The Second Affiliated Hospital of Fujian Traditional Chinese Medical University, Fuzhou 350003, China
2.General surgery department, The Second Affiliated Hospital of Fujian Traditional Chinese Medical University, Fuzhou 350003, China
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WU Qihao, WANG Jun, LI Qiang. A Case Report on the Treatment of Postoperative Retention of Urine Using a Thoughtful Approach that Incorporates TCM Theory, Diagnosis, Treatment, Acupuncture Points, and Acupuncture Methods[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=34745909&Fpath=home&index=0
WU Qihao, WANG Jun, LI Qiang. A Case Report on the Treatment of Postoperative Retention of Urine Using a Thoughtful Approach that Incorporates TCM Theory, Diagnosis, Treatment, Acupuncture Points, and Acupuncture Methods[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=34745909&Fpath=home&index=0 DOI:
病史摘要,2,陈某某,男,84岁,2020年1月13日以“便血5天”为主诉入院,因直肠恶性肿瘤、急性肠梗阻住院急诊行腹-会阴联合直肠癌根治术,手术过程顺利,术后导尿管留置状态,予止血、补液扩容、制酸保胃、补充蛋白质、去甲肾上腺素升压等治疗。但患者术后12小时尿量偏少,约300 mL,经利尿处理后,患者后续仍无明显尿液引出,并进展至无尿状态。2020年1月14日10时30分,吴起浩医师接诊患者后,见患者小便点滴未出,舌质淡,苔白腻,脉大兼弦疾而无力、尺脉沉。吴起浩医师辨本案为心气不足、肾虚肝郁之癃闭,主治以益心气、补肾、疏肝之法,急予针刺治疗,针刺后排出大量尿液。中医诊断 癃闭,心气不足、肾虚肝郁西医诊断 少尿干预措施 1.在充分补充血容量基础上,①去甲肾上腺素16 mg,间续微量泵入4 mL/h,控制收缩压110~120 mmHg左右;②予人血白蛋白40 g bid 静脉滴注,2 d;③予去乙酰毛花苷注射液0.4 mg qd 静脉注射;④予呋塞米 20 mg qd 静脉注射。2.针刺双侧神门(补法)、双侧太溪(补法)、双侧阳陵泉(泻法),留针2 min。疗效转归 患者排出约700 mL尿液。
Summary of case history ,Mr. CHEN, male, 84 years old, was admitted to hospital on January 13, 2020 with the complaint of "five days of hematochezia". He was hospitalized for rectal cancer and acute intestinal obstruction and underwent abdominal-perineal combined radical resection of rectal cancer. The operation process was smooth, and the catheter was retained after operation. He was treated with hemostasis, fluid infusion and volume expansion, acid production and stomach preservation, protein supplementation, noradrenaline booster, etc. However, the patient ' s urine volume was relatively small at 12 h after operation, about 300 mL. After diuretic treatment, the patient still had no obvious urine extraction and progressed to a urine-free state. At 1030 hours on January 14, 2020, after receiving the patient, Dr. Wu Qihao saw that the patient 's urine was not dripping, the tongue was light, the moss was white and greasy, the pulse was large and stringy, and the pulse was weak and the ulnar pulse was deep. Doctor Wu Qihao identified this case as deficiency of heart qi and stagnation of liver qi due to kidney deficiency. He mainly treated with tonifying heart qi, tonifying kidney and soothing liver. He was given acupuncture treatment urgently and discharged a large number of urine after acupuncture.,TCM diagnosis ,uroschesis (syndrome of heart qi insufficiency,kidney deficiency and liver depression),Western medicine diagnosis ,oliguria.,Therapeutic methods ,1. On the basis of fully replenishing blood volume, ①Giving norepinephrine 16 mg, intermittent micropumping 4ml/h, controlling the systolic pressure at about 110~120 mmHg ;②Intravenous drip of human albumin 40 g bid for 2 days ;③Intravenous injection of deacetyloside 0.4 mg qd ;④Intravenous injection of furosemide 20 mg qd.2. Acupuncture bilateral Shenmen ( reinforcing method ), bilateral Taixi ( reinforcing method ), bilateral Yanglingquan ( reducing method ), needle retention 2 min.,Clinical outcomes, Patients discharged about 700 mL urine.
癃闭加速康复外科理法穴针凭脉取经原穴
uroschesisfast track surgeryTCM theory diagnosis treatment acupuncture points and acupuncture methodsTaking meridians by pulse of traditional Chinese medicineyuan acupoints
吴勉华,石岩.中医内科学[M].北京:中国中医药出版社,2021:290-297.
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