运用经方治疗尿毒症继发顽固性呃逆验案1则
增强出版One Case of Refractory Hiccup Secondary to Uremia Treated by Classical Prescription
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1.北京中医医院顺义医院肾病科,北京 101300
2.河北北方学院中医学院,张家口 075000
3.首都医科大学&北京中医医院科研处,北京 100010
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刘先利, 修悦颖, 刘宝利. 运用经方治疗尿毒症继发顽固性呃逆验案1则[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=30038898&Fpath=home&index=0
LIU Xianli, XIU Yueying, LIU Baoli. One Case of Refractory Hiccup Secondary to Uremia Treated by Classical Prescription[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=30038898&Fpath=home&index=0
刘先利, 修悦颖, 刘宝利. 运用经方治疗尿毒症继发顽固性呃逆验案1则[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=30038898&Fpath=home&index=0 DOI:
LIU Xianli, XIU Yueying, LIU Baoli. One Case of Refractory Hiccup Secondary to Uremia Treated by Classical Prescription[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=30038898&Fpath=home&index=0 DOI:
病史摘要,2,高某,男,66岁,住院号:00082977,门诊号:114891322,2022年1月24日初诊。主因呃逆反复发作3年就诊。患者3年前因2型糖尿病进展至慢性肾功能不全尿毒症期,就诊于北京中医医院顺义医院肾病科,服用脾肾双补等中药保守治疗,2019年2月出现呃逆,呃逆昼夜不停,伴有乏力干呕,纳一般,夜间呃逆严重时有明显窒息感,需家属用力捶打后背方可缓解,曾就诊于多家医院,考虑膈肌痉挛,予对症治疗。2020年7月开始血液透析治疗,血液透析治疗后呃逆未见缓解,由于不间断呃逆,血液透析上机时常出现窒息样不适,需护士密切观察,出现不适反复捶打背部方能缓解。发病后病情逐步加重,长期服用多潘立酮、胃复安、地西泮片等西药治疗,也根据呃逆证型服用旋覆代赭汤、橘皮竹茹汤、丁香柿蒂汤、健脾和胃等中药治疗以及针刺治疗,均未能缓解。中医诊断 呃逆、痰实气壅脾虚风动证。西医诊断 膈肌痉挛。干预措施 予橘皮竹茹汤合止痉散,方药组成:陈皮100 g、竹茹45 g、太子参20 g、炙甘草30 g、生姜50 g、大枣50 g、蜈蚣3 g,(后下),、全蝎3 g,(后下),,7剂,水煎服,一日一剂。疗效转归 用上法治疗3 d,呃逆消失。1月后因饮食不节复发,上方续服1周,呃逆再次消失。随访至今未作。
Summary of case history ,GAO, male, 66 years old, inpatient number:00082977, Outpatient number: 114891322, initial diagnosis on January 24, 2022. The main cause is hiccups recurrent attacks for three years. Three years ago, due to type 2 diabetes progressing to chronic renal insufficiency uremia phase, the patient was treated in the Department of Nephrology of Shunyi Hospital, Beijing Hospital of Traditional Chinese Medicine(TCM), taking spleen and kidney double supplements and other TCM for treatment. In February 2019, there were hiccups, which were non-stop around the clock, with fatigue and vomiting, and food volume is general. At night, when the hiccup is severe, there is a significant feeling of suffocation. So the patient needed family members to beat the back hard to alleviate it. The patient has been treated in several hospitals, treatment with traditional Chinese and Western medicine, but he has not been alleviated. Hemodialysis treatment began in July 2020, and hiccups did not relieve after hemodialysis treatment. Due to continuous hiccups, asphyxia-like discomfort often occurs on hemodialysis machines. Nurses should closely observe the discomfort and repeatedly beat the back to alleviate it. After the onset of the disease,the disease was gradually aggravated. The patient was treated with domperidone, metoclopramide, Diazepam tablets, and other western medicine for a long time. According to the syndrome type of hiccup, he was also treated with Xuanzao Daizhetang, Jupi Zhurutang, Dingxiang Shiditang, methods of strengthening the spleen and regulating the stomach, as well as acupuncture treatment, which failed to alleviate.,TCM diagnosis ,hiccup; Syndrome of Phlegm and gas in the interior, and wind stirring up.,Western medicine diagnosis ,diaphragmatic spasms.,Therapeutic methods ,To Jupi Zhuru decoction and Anti Spasm powder.Composition of the drug: Citri Reticulatae Pericarpium, 100 g, Bambusae Caulis in Taenias 45 g, Pseudostellariae Radix 20 g, Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle30 g, Zingiberis Rhizoma Recens 50 g, Jujubae Fructus 50 g, Scolopendra 3 g (to be decocted later), Scorpio 3 g(to be decocted later). All the above drugs were to be decocted in the water for oral taking.7 doses were prescribed.He was told to take 1 dose a day.,Clinical outcomes ,After using the upper method of treatment for 3 days,the hiccups disappeared.After one month,due to the irregular diet relapse, the upper diet continued for one week,and the hiccups disappeared again. There were no episodes since a follow-up.
尿毒症顽固性呃逆橘皮竹茹汤止痉散医案
uremiastubborn hiccupJupi ZhurutangAnti Spasm powdermedical cases
吴勉华,王新月.中医内科学[M].北京:中国中医药出版社,2012.
王贝,姜淑君.顽固性呃逆的中医治疗进展[J].中西医结合研究,2019,11(6):316-318.
李秋河,赵敏.急性脑卒中后呃逆治疗进展[J].医学综述,2019,25(15):3050-3053,3058.
金杰.穴位注射联合和胃降逆中药治疗重型颅脑损伤继发顽固性呃逆的疗效观察[J].中国中医急症,2018,27(1):142-144.
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