基于“半阴半阳”理论探讨薏苡附子败酱散治疗溃疡型淋巴结核案例1则
A Case Study on the Treatment of Ulcerative Lymphatic Tuberculosis with Yiyi Fuzi Baijiang Powder Based on the Theory of "Half Yin and Half Yang"
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成都中医药大学附属医院皮肤科,四川 成都 610072
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.基于“半阴半阳”理论探讨薏苡附子败酱散治疗溃疡型淋巴结核案例1则[DB/OL].(2023-12-26)[2023-12-26].https://cccl-tcm.cacm.org.cn/thesisDetails?columnId=46791888&Fpath=home&index=0&lang=zh
WANG Ping,HAN Bingying,CHEN Mingling.A Case Study on the Treatment of Ulcerative Lymphatic Tuberculosis with Yiyi Fuzi Baijiang Powder Based on the Theory of "Half Yin and Half Yang"[J].,
.基于“半阴半阳”理论探讨薏苡附子败酱散治疗溃疡型淋巴结核案例1则[DB/OL].(2023-12-26)[2023-12-26].https://cccl-tcm.cacm.org.cn/thesisDetails?columnId=46791888&Fpath=home&index=0&lang=zh DOI:
WANG Ping,HAN Bingying,CHEN Mingling.A Case Study on the Treatment of Ulcerative Lymphatic Tuberculosis with Yiyi Fuzi Baijiang Powder Based on the Theory of "Half Yin and Half Yang"[J]., DOI:.
病史摘要,2,患者2+年前无明显诱因出现左侧腹股沟、左侧腋窝淋巴结肿大、疼痛,继而破溃流脓,于四川大学华西医院就诊,行左侧腹股沟淋巴结切除活检术,经病理检查诊断为淋巴结核。治疗上予毗嗪酰胺片、利福平、盐酸乙胺丁醇片、异烟肼口服(具体剂量、频次不详),外用药物具体不详。经治疗后切口愈合良好,1年后停用所有药物,症状未反复。2022年9月患者无明显诱因出现左侧腹股沟切口部位瘙痒,破溃,流清稀脓液,再次于四川大学华西医院就诊,给予西药口服(具体不详),外用碘伏消毒,破溃处反复结痂流脓,久不愈合,病情反复。1+月前溃疡面逐渐扩大,创面稍红肿,表面不平,皮损中心稍凹陷,伴大量清稀灰白色脓液。今为求治疗,遂来诊,刻下症见:左侧大腿内侧见一2 cm×2 cm 的溃疡,皮损处稍红肿,表面不平,触之稍硬,皮损中心稍凹陷,伴清稀灰白色脓液。周围覆有黑褐色痂壳,时瘙痒疼痛。口干、口苦,精神倦怠,纳差,眠可,大便溏,2~3次/日,小便调,舌质红,苔白腻,脉数。既往史:否认“高血压、糖尿病、冠心病”等慢性病病史。否认传染病及特殊疾病史。家族史:否认家族遗传病史,家族中无类似患者。中医诊断 瘰疬(湿热蕴肤,半阴半阳证)西医诊断 溃疡型淋巴结核干预措施 中药口服(先后予化坚二陈汤、薏苡附子败酱散等加味),外治以庆大霉素注射液160000 u及硫酸镁注射液40 mL加入生理盐水500 mL中局部湿敷;复方多粘菌素B软膏外涂。疗效转归 共治疗2个月,患者局部疮面完全愈合,随访3月未复发。
Summary of case history, The patient had no obvious cause of swelling or pain in the left inguinal and axillary lymph nodes 2 years ago, followed by ulceration and pus discharge. They were treated at West China Hospital of Sichuan University and underwent left inguinal lymph node resection biopsy. After pathological examination, they were diagnosed as lymphotuberculosis. In terms of treatment, "piperazamide tablets, rifampicin, ethambutol hydrochloride tablets, and isoniazid orally (specific dosage and frequency are unknown)" are given, and specific topical drugs are not available. After treatment, the incision healed well. After 1 year, all medications were discontinued, and the symptoms did not recur. In September 2022, the patient had no obvious cause of itching, ulceration, and clear pus at the left inguinal incision site. They sought medical attention again at the West China Hospital of Sichuan University and were given oral Western medicine (specific information is not available). External use of iodophor disinfection resulted in repeated scabbing and pus discharge at the site of the ulcer, which did not heal for a long time and the condition recurred. More than 1 month ago, the ulcer gradually expanded, with a slightly red and swollen wound surface, uneven surface, and a slight depression in the center of the skin lesion, accompanied by a large amount of clear and dilute gray white pus. In order to seek treatment,Current symptom: An ulcer with a size of about 2 cm×2 cm can be seen on the inner side of the left thigh. The skin lesion is slightly red and swollen, with an uneven surface and a slightly hard touch. The center of the lesion is slightly concave, accompanied by clear and thin gray white pus.Surrounded by black brown scabs, sometimes itching and pain. Dry mouth, bitter mouth, mental fatigue, poor appetite, good sleep, loose stools, 2-3 times per day, moderate urination, red tongue, white and greasy fur, and pulse count. Past history: deny the history of chronic diseases such as "hypertension, diabetes, coronary heart disease". Deny a history of infectious diseases and special illnesses. Family history: Deny family genetic history, and there are no similar patients in the family.,TCM diagnosis, scrofula (dampness heat accumulation on the skin, half yin and half yang syndrome),Western medicine diagnosis, ulcerative lymphoid tuberculosis,Therapeutic methods, Oral administration of traditional Chinese medicine (including Hua Jian Er Chen Tang and Yi Yi Fu Zi Bai Jiang San), external treatment with gentamicin injection 160000 u and magnesium sulfate injection 40ml added to 500ml of physiological saline for local wet compress; Compound polymyxin B ointment for external application.,Clinical outcomes, After a total of 2 months of treatment, the patient's local ulcer surface completely healed, and there was no recurrence after a 3-month follow-up.
淋巴结核溃疡半阴半阳透阴转阳
lymphatic tuberculosisulcerhalf yin and half yangtransitioning yin to yang【Suitable majors】 ulcerskin
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