托里消毒法协同治疗肝脓肿促进病灶液化吸收案例

黄凯舟; 蒋开平

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托里消毒法协同治疗肝脓肿促进病灶液化吸收案例

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托里消毒法协同治疗肝脓肿促进病灶液化吸收案例
A case of synergetic treatment of liver abscess with strengthened interior-expel toxins method to promote liquefaction and absorption of lesions
1.广州中医药大学附属佛山中医院肝病科，佛山市 528000
DOI：

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黄凯舟, 蒋开平. 托里消毒法协同治疗肝脓肿促进病灶液化吸收案例[DB/OL].（2023-10-28）[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43200000&Fpath=home&index=0

HUANG Kaizhou, JIANG Kaiping. A case of synergetic treatment of liver abscess with strengthened interior-expel toxins method to promote liquefaction and absorption of lesions[DB/OL].（2023-10-28）[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43200000&Fpath=home&index=0
黄凯舟, 蒋开平. 托里消毒法协同治疗肝脓肿促进病灶液化吸收案例[DB/OL].（2023-10-28）[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43200000&Fpath=home&index=0 DOI：

HUANG Kaizhou, JIANG Kaiping. A case of synergetic treatment of liver abscess with strengthened interior-expel toxins method to promote liquefaction and absorption of lesions[DB/OL].（2023-10-28）[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43200000&Fpath=home&index=0 DOI：

摘要

病史摘要,2,患者青年男性，急性起病，因“腰痛伴左下肢放射痛1周，发热3天”就诊。3天前无明显诱因下出现发热，伴头痛，右胁疼痛，胃纳差，予抗感染对症治疗后无缓解。遂拟“发热查因”收治。症见：神清，精神疲倦，发热畏寒，无寒战，右胁疼痛拒按，牵涉至右侧肩背部疼痛，呼吸时右胁疼痛明显，无咳嗽咯痰，无尿频尿急尿痛，无腹胀腹痛，大便未解，小便通调，纳差，寐差，舌红苔黄腻，舌下脉络迂曲，脉弦细。否认饮酒史及药物过敏史。辅助检查：2022年12月20日查全腹CT：肝左内叶内见斑片状低密度影，密度不均匀，CT值约26~40HU，大小约50 mm×65mm，边缘模糊不清。肝左叶肿块性质待定。肝胆胰脾彩色多普勒超声：肝S4见64mm×62 mm混合回声结节，境界欠清晰，内部回声分布不均匀，内似见范围约35 mm×18 mm稠性液区，血供丰富度：1级。建议超声造影增强检查。为进一步治疗，超声引导下行肝脓肿穿刺引流术，引流出红色絮状液体300 ml。引流后患者高热不退、临床症状改善不明显，遂及时加入中医中药辨证治疗。中医诊断　肝痈热聚毒蕴，气血亏虚西医诊断　1.肝脓肿；2.腰椎间盘突出症干预措施　西医治疗抗感染、护肝、抑酸护胃、营养支持；中医治则益气补血，托里消毒疗效转归　痊愈

Abstract

Summary of case history,　The patient, a young male with acute onset, was presented with "low back pain with radiating pain in the left lower extremity for 1 week and fever for 3 days". Three days ago, he developed a fever with a headache, right hypochondriac pain, and gastric anorexia without obvious inducement, which was not relieved after anti-infective symptomatic treatment. Therefore, it was planned to be admitted for "fever investigation". symptoms: Clear mind, tired spirit, fever, chills, no chills, right flank pain refused to press, involved in the right shoulder back pain, breathing right flank pain is obvious, no cough expectoration, no frequent urination acute urine pain, no abdominal distension abdominal pain, undissolved stool, urine, poor appetite, poor sleep, red tongue moss yellow greasy, fine pulse string, sublingual vein circuitous. He denied having a history of drinking and drug allergies. Auxiliary examination: On December 20, 2022, the whole abdomen CT examination report showed: patchy low-density shadows with uneven density in the left inner lobe of the liver, with a CT value of 26~40HU and a CT size of 50 mm ×65mm and with blurred edges. The nature of the mass in the left liver lobe is pending. Color Doppler ultrasound of the liver, gallbladder, pancreas, and spleen showed: 64 mm×62 mm mixed echo nodules could be seen in S4 of the liver with unclear boundary and uneven internal echo distribution,a thick liquid area with a range of about 35mm×18 mm could be seen, and the blood supply richness was grade 1. It was recommended to perform contrast-enhanced ultrasonography. For further treatment, ultrasound-guided puncture drainage of the liver abscess was performed, and 300 ml of red flocculent liquid was introduced. After drainage, the patient's high fever did not return and the clinical symptoms were not improved. So the dialectical treatment of TCM was adopted in time.,TCM diagnosis,　Liver abscess (Heat accumulation poison accumulation, qi and blood deficiency),Western medicine diagnosis,　1. Hepatic abscess 2. Lumbar disc herniation,Therapeutic methods,　Western medical treatment: anti-infection、liver protection、Acid suppression and stomach protection、nutrition support,Principles of TCM treatment,　Interior-expel toxins method, Replenish Qi and nourish blood,Clinical outcomes,　get well

关键词

中西医结合辨证施治肝脓肿

Keywords

Integrative Chinese and Western MedicineTreatment based on syndrome differentiationliver abscess

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