徐春军治疗臌胀验案一则
A Case of Professor XU Chunjun's Diagnosis and Treatment of Tympanites
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1.首都医科大学附属北京中医医院肝病科,北京 100010
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闫语, 徐春军, 武璇, 等. 徐春军治疗臌胀验案一则[DB/OL].(2022-07-25)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=28589142&Fpath=home&index=0
Yu YAN, Chunjun XU, Xuan WU, et al. A Case of Professor XU Chunjun's Diagnosis and Treatment of Tympanites[DB/OL].(2022-07-25)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=28589142&Fpath=home&index=0
闫语, 徐春军, 武璇, 等. 徐春军治疗臌胀验案一则[DB/OL].(2022-07-25)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=28589142&Fpath=home&index=0 DOI:
Yu YAN, Chunjun XU, Xuan WU, et al. A Case of Professor XU Chunjun's Diagnosis and Treatment of Tympanites[DB/OL].(2022-07-25)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=28589142&Fpath=home&index=0 DOI:
病史摘要,2,患者卢某,男,67岁,主因“腹胀、双下肢水肿1月”于2020年12月16日就诊于首都医科大学附属北京中医医院门诊;患者既往高血压、糖尿病、高尿酸血症、胆囊结石病史,长期大量饮酒史;1月前出现腹胀、双下肢水肿,伴少尿,乏力,反复低热,于外院诊断“酒精性肝硬化失代偿期、门脉高压、食管胃底静脉曲张、脾大、腹水、胸腔积液”,多次静脉输注人血白蛋白、穿刺抽取腹腔积液、口服利尿药物、预防上消化道出血等对症治疗,腹胀等症状缓解不明显,为求进一步治疗就诊于本院。四诊信息 腹胀如鼓,胁肋部隐痛,胸闷短气,语声低微,神疲乏力,间断发热,纳呆,眠差,大便稀溏,每日1~2次,小便不利,色黄,舌淡暗,苔黄厚腻,脉沉细无力。中医病证 气虚血滞、湿热内蕴证。中医治法 补气活血、清热利湿。西医诊断 酒精性肝硬化失代偿期、门脉高压、食管胃底静脉曲张、脾大、腹水、胸腔积液。干预措施 中药处方以防己黄芪汤合五苓散加减:生黄芪80 g、茵陈10 g、藿香10 g、当归10 g、白芍10 g、赤芍10 g、大腹皮10 g、炒白术20 g、黄芩10 g、泽兰30 g、炒酸枣仁15 g、泽泻10 g、防己10 g、二丑10 g、猪苓10 g、茯苓15 g、阿胶珠10 g、青蒿10 g、水红花子10 g。7剂,每日1剂,浓煎分2~3次温服。停服利尿剂。畅情志,节饮食,慎起居,戒酒。复诊用药随证加减。疗效转归 经治疗患者腹胀、双下肢水肿、乏力明显缓解,腹水消退,肝功能得到恢复,未严格戒酒,随访半年病情平稳,未见复发。
Summary of case history ,LU, male, 67 years old, went to our hospital on December 16,th, 2020 for "abdominal distention and edema of lower limbs for 1 month". He had a medical history of hypertension, diabetes, hyperuricemia, gallstone, and long-term alcohol consumption. He developed abdominal distension, leg swelling with oliguria, asthenia and low fever 1 month ago. He was diagnosed with "alcoholic cirrhosis, portal hypertension, esophagogastric varices, splenomegaly, ascites and pleural effusion" by a local hospital, and was treated with infusion of human albumin, aspiration of abdominal fluid, taking diuretics and prevention of gastrointestinal bleeding. However, his abdominal distension and other symptoms were not significantly relieved, thus he came here for further treatment.,Symptoms and signs ,The patient had a problem of abdominal distension, vague pain in the hypochondrium, chest tightness and shortness of breath, speaking low, fatigue, leg swelling, low fever. He had poor appetite and couldn't sleep well. He also had less urine in deep yellow and diarrhea. His tongue was dark with yellow and thick and greasy fur on it, and his pulse was thin and weak.,TCM treatment ,The treating method is to tonify Qi, promote blood flow, clear heat and remove dampness using Fangji Huangqitang and Wulingsan.,TCM disease and syndrome ,He was diagnosed as tympanites, Qi deficiency and blood stasis, damp-heat syndrome.,Western medicine diagnosis ,He was diagnosed with alcoholic cirrhosis, portal hypertension, esophagogastric varices, splenomegaly, ascites and pleural effusion.,Clinical outcomes ,After treatment, his symptoms were significantly relieved, ascites decreased, the bilirubin and albumin returned to normal level. He still drinks a little. We followed up for 6 months and found out he was in stable condition.
肝硬化腹水臌胀经验徐春军【适合阅读专业】 中医内科学中西医结合医学
hepatic ascitestympanitesexperienceXU Chunjun【Suitable majors】 medical department of traditional Chinese medicine(TCM)combination of TCM with western medicine
徐小元,丁惠国,李文刚,等.肝硬化腹水及相关并发症的诊疗指南[J].实用肝脏病杂志,2018,21(1):21-31.
孔祥琳,吕琴,李运伦,等.黄芪甲苷对心脑血管疾病的现代药理作用研究进展[J].中国实验方剂学杂志,2021,27(2):218-223.
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