大柴胡汤治疗术后麻痹性肠梗阻病例报告
A Case Report of Postoperative Paralytic Ileus Treated by Da Chaihutang
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1.福建中医药大学附属第二人民医院中医内科,福州 350003
2.福建中医药大学研究生院,福州 350122
3.福建中医药大学中医学院,福州 350122
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张喜奎, 王婷娜, 吴起浩, 等. 大柴胡汤治疗术后麻痹性肠梗阻病例报告[DB/OL].(2022-07-21)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=28531113&Fpath=home&index=0
Xikui ZHANG, Tingna WANG, Qihao WU, et al. A Case Report of Postoperative Paralytic Ileus Treated by Da Chaihutang[DB/OL].(2022-07-21)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=28531113&Fpath=home&index=0
张喜奎, 王婷娜, 吴起浩, 等. 大柴胡汤治疗术后麻痹性肠梗阻病例报告[DB/OL].(2022-07-21)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=28531113&Fpath=home&index=0 DOI:
Xikui ZHANG, Tingna WANG, Qihao WU, et al. A Case Report of Postoperative Paralytic Ileus Treated by Da Chaihutang[DB/OL].(2022-07-21)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=28531113&Fpath=home&index=0 DOI:
病史摘要,2,施某,男,54岁,阑尾切除术后便秘、腹胀痛5 d。患者7 d前无明显诱因出现右下腹疼痛,呈持续性疼痛,阵发性加剧,伴发热,体温最高达38.5 ℃,5 d前就诊于福建中医药大学附属第二人民医院,拟“阑尾炎”收入院,行“腹腔镜下阑尾切除术”,手术过程顺利,术后予抗感染、补液、护胃等治疗。但术后患者持续大便不通,腹胀、腹痛,复查CT提示小肠梗阻,炎症指标水平升高,2020年10月20日邀请张喜奎教授会诊。张教授辨本案为少阳阳明合病,治拟和解少阳、通腑泄热,方选大柴胡汤加减治疗,药后大便得通,腹胀、腹痛缓解,炎症指标恢复正常。四诊信息 大便不通,腹胀、腹痛,口干而渴,恶热,舌质红苔黄腻,脉弦数。中医病证 便秘,少阳阳明合病。中医治法 和解少阳,通腑泄热。西医诊断 麻痹性肠梗阻。干预措施 大柴胡汤加减,用药7剂。疗效转归 大便得通,肠梗阻解除,腹胀、腹痛缓解,且感染得到控制。
Summary of case history, Shi, male, 54, constipation, abdominal distension and pain after appendectomy for 5 days. The patient had no obvious cause of right lower abdominal pain 7 days ago, showing persistent pain, paroxysmal aggravation, with fever, and the body temperature was up to 38.5 °C. Five days ago, he was admitted to the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine. 'Appendicitis' was planned to be admitted to the hospital. 'Laparoscopic appendectomy' was performed. The operation process was smooth. After operation, anti-infection, rehydration, gastric protection and other treatments were given. However, the postoperative patients continued to have bowel obstruction, abdominal distension and abdominal pain. The CT examination showed small intestinal obstruction. The inflammatory index increased on October 20, 2020. Professor Zhang Xikui was invited to consult. Professor Zhang identified this case as Shaoyang Yangming comorbidity, treatment of Shaoyang, Tongfu Xiere, prescription modified ,Dachaihu ,Decoction treatment, after defecation, abdominal distension, abdominal pain relief, inflammation returned to normal.,Symptoms and signs ,Dysuria, abdominal distension, abdominal pain, dry mouth and thirst, hot, red tongue moss yellow greasy, pulse string and fast.,TCM disease and syndrome, Constipation (shaoyang yangming disease),TCM treatment ,harmonizing and releasing shaoyang,eliminating heat by purgation.,Western medicine diagnosis ,paralytic ileus.,Diagnostic methods, belly computed tomography.,Therapeutic methods ,Modified ,Dachaihu ,Decoction for 7 days.,Clinical outcomes ,Intestinal obstruction was relieved, abdominal distension and abdominal pain were relieved, and infection was controlled.【,Dachaihu ,Decoction
麻痹性肠梗阻少阳阳明合病和解少阳通腑泄热大柴胡汤
paralytic ileusshaoyang yangming diseaseharmonizing and releasing shaoyangeliminating heat by purgation
张仲景.伤寒论[M].何丽春,校注.北京:科学技术文献出版社,2010:52-53.
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