李七一汤膏结合辨治黑汗一例
Sucessful Treatment of Chromatic Sweat with Traditional Chinese Medicine: A Case Report
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1.南京市建邺区莲花社区卫生服务中心康复医学科,南京 210000
2.江苏省中医院心血管科,南京 210000
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李笑, 李七一. 李七一汤膏结合辨治黑汗一例[DB/OL].(2022-08-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=29347829&Fpath=home&index=0
Xiao LI, Qiyi LI. Sucessful Treatment of Chromatic Sweat with Traditional Chinese Medicine: A Case Report[DB/OL].(2022-08-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=29347829&Fpath=home&index=0
李笑, 李七一. 李七一汤膏结合辨治黑汗一例[DB/OL].(2022-08-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=29347829&Fpath=home&index=0 DOI:
Xiao LI, Qiyi LI. Sucessful Treatment of Chromatic Sweat with Traditional Chinese Medicine: A Case Report[DB/OL].(2022-08-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=29347829&Fpath=home&index=0 DOI:
病史摘要,2,蒋某,女,46岁,2017年12月12日因“多汗,黑汗3年”就诊。患者3年来自汗、盗汗,汗出量大湿衣,染衣色黑。曾多次服中药而少效。为求进一步治疗,来江苏省中医院名医堂就诊,中医病证:多汗,量大湿衣,表现为盗汗,动辄汗出,汗量与活动量正相关,汗染内衣、胸罩为黑斑、黑点,洗之难褪,皮肤易起黑痣,多发生于出汗部位,寐差,胃脘胀痛,喜暖怕冷,经时口腔溃疡,牙痛,腰酸软,尿频,白日8~9次,夜尿4~5次,或阴道发痒,平素月经1月行2次,量少色紫黑。脉细滑数,舌淡红,中有裂纹,苔薄黄。中医诊断 汗证-黑汗。辨为阴虚内热并阳明经热证。西医诊断 色汗症。干预措施 ①治以滋阴清热,清泻阳明,佐补肾固涩,温中散寒,清热燥湿法。方选当归六黄汤合白虎汤加减:生炙黄芪各10 g、菟丝子15 g、生熟地黄各10 g、知母15 g、黄柏15 g、生石膏30 g,(先煎),、寒水石30 g,(先煎),、肉桂10 g,(后下),、炮干姜各10 g、黄连6 g、吴茱萸5 g、牡丹皮10 g、徐长卿15 g。7剂。日1剂。水煎,或用煎药机按规范煎煮,或自己按要求煎煮两次后混合,早、晚饭后15~30 min各温服1次,每次约200 mL。②嘱咐患者生活规律,按时起睡;每天活动0.5~1 h,建议跳广场舞。疗效转归 分别于患者第1、2、3、4次就诊时,第1次随访和最近一次随访时进行的中医症候积分评定,值分别为38分、30分、20分、7分、4分和1分。并于患者第2、3、4次就诊时和第一次随访时进行疗效指数计算,值分别为21.05%、47.37%、81.58%和89.47%。患者主要症状消失,次要症状减轻,治疗取得显效。且于2021年6月1日进行最后一次随访,患者病情没有反复。
Summary of case history ,Patient JIANG X, female, 46 years old. The patient's chief complaint was "excessive sweating with blackish color for 3 years". She presented to us with spontaneous sweating, night-sweating, making her clothes wet,also staining underwear and brassiere with dark spots and black spots since 3 years. The patient has taken traditional Chinese medicine many times,responding poorly. For further treatment, She first visited the outpatient department at our hospital on December12, 2017. At this visit, spontaneous sweating, night-sweating, making her clothes wet, also staining underwear and brassiere with dark spots and black spots, which are difficult to fade after washing. Skin moles are easy to develop, mostly occur in sweating areas, poor sleep, stomach cavity distending pain, happy to warm and fear of cold, soreness and weakness of waist, frequent urination, about 8-9 times, vaginal itching sometimes, episodes of bleeding occurring twice a month, diminished menstrual flow with color of blueberry. oral ulcers and toothache started last month. her pulse was thready and slippery also rapid. her tongue was pink, with fissures on its surface, also a thin and yellow coating.,TCM diagnosis ,Perspiration syndrome-blackish sweating; deficiency-heat syndrome and Yangming meridian heat syndrome.,Western medicine diagnosis, Chromhidrosis,.Therapeutic methods, Nourishing Yin and clearing heat, Clearing heat-fire of Yangming meridian. Assisting with Tonifying the kidney and supplying essence,warming spleen and stomach for dispelling cold, clearing heat and dry dampness. The Chinese medical formula was combined by Danggui Liuhuangtang and Baihutang. The patient's Traditional Chinese Medicine prescription included the following: Shenghuangqi (Radix astragali) 10 g; Zhihuangqi (Honey-fried Radix astragali) 10 g, Tusizi (Cuscuta Chinensis) 15 g, Shengdihuang (Radix Rehmanniae) 10 g, Shudihuang (Radix Rehmanniae Praeparata) 10 g, Zhimu (Anemarrhena Asphodeloides) 15 g, Huangbo (Phellodendron Chinense) 15 g, Shengshigao (Gypsum Fibrosum) 30 g, Hanshuishi (Calcitum) 30 g, Rougui (Cinnamomum Cassia) 10 g, Paojiang (Rhizoma Zingiberis Praeparatum) 10 g, Ganjiang (Rhizoma Zingiberis) 10 g, Huanglian (Coptis Chinensis) 6 g, Wuzhuyu (Fructus Evodiae) 5 g, Mudanpi (Cortex Moutan) 10 g, Xuchangqing (Cynanchum Paniculatum) 15 g, (7dose). A dose of Chinese medicinal herbs is decocted twice, and the juice is mixed. The herbs were taken twice a day. ,Clinical outcomes ,the Traditional Chinese Medicine symptom scores were evaluated at the 1,st, 2,nd, 3,rd, and 4,th, visits, also at the first follow-up and the latest follow-up, with values of 38, 30, 20, 7, 4 and 1 respectively. The efficacy index was calculated at the 2,nd, 3,rd, and 4,th, visits and at the first follow-up, with values of 21.05%, 47.37%, 81.58% and 89.47% respectively. The main symptoms disappeared, the secondary symptoms tended to diminish, and the treatment was effective. The last follow-up was carried out on June 01, 2021, no recurrence of symptoms was noted.
李七一汤膏结合黑汗
professor LI Qiyicombination of decoction and unguentumchromatic sweat
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