Xi Jianzhong looked up, and four people rushed into the outpatient clinic at once. At the front is an old lady about sixty years old, with a panicked look: "Okay, it's finally here!".”
You may be seated, **uncomfortable?Xi Jianzhong asked.
It's not me, it's my daughter-in-law!The old lady hurriedly got out of the way. Only then did Xi Jianzhong notice the three people behind the old lady: a man and a woman on the left and right, with a very weak young woman in the middle. The young woman was sluggish, her face was pale, her forehead was full of sweat, and the hair on her forehead was already soaked with sweat, and strands were sticking to the **. Despite this, she was dressed very thickly, and in addition to the down cotton coat inside, she also covered a fat military coat outside.
Why is the patient dressed so much?It's all hot. Xi Jianzhong muttered in a low voice.
You can't take it off!The old lady took over the conversation, "My daughter-in-law has just given birth to a baby, and according to the rules of my hometown, I have to stay in the room honestly for confinement, but now young people have to pay attention to the trendy, go for a walk outside, and breathe some fresh air." No, if you're not careful, you'll catch a cold. ”
I felt a little hot last night, my back was a little cold, and my nose was a little stuffy, so I took a Tylenol cold tablet and a packet of cold powder because I might have a cold," the young woman whispered. But in the middle of the night, my body began to sweat non-stop, and my clothes and quilts were all wet, and my body still kept coming out until now. ”
Do you sweat at night when you're asleep, or when you're awake?Zhong Xiaoyi felt that the patient's condition was related to sweating, and wanted to confirm whether the patient was sweating spontaneously or night sweats.
When I was awake, I came out, and when I fell asleep, I woke up and found that my body was still out. In short, the sweat pores are like a faucet being unscrewed, and they are constantly sweating. ”
At this time, Zhong Xiaoyi began to be a little confused, and originally wanted to find clues for diagnosis and treatment from sweating, but now she is in a predicament. "So what else is uncomfortable with you besides sweating?Zhong Xiaoyi wanted to find another way, so he asked further.
I was still a little afraid of cold, especially the joints of my limbs, and I felt as if I was coming out with cold air and some pain and cramps," the patient continued, "and my head was still a little painful. ”
Oh, the patient has chills and headaches, which means that the symptoms have not been completely resolved. Zhong Xiaoyi couldn't hide the joy in her heart, and began to observe the patient's tongue and pulse: the tongue was pale red, the moss was thin and white, and the pulse was thin and thin.
Zhong Xiaoyi wrote the outpatient medical record and cast a look for help from Professor Guo.
Professor Guo seemed to be intent on exercising his two **, but said without hurrying, "You two will analyze the patient's condition first." ”
The patient is weak after childbirth, and takes excessive sweating medicine after catching a cold, resulting in continuous sweating, and should be treated with fluid in time to avoid water and electrolyte disorders. Xi Jianzhong first expressed his views.
I think the most important thing at the moment is to stop the patient's sweat first, only in this way can we avoid further damage to the yin fluid. Currently, patients can eat and drink on their own, and should not have to rush to rehydrate first. Zhong Xiaoyi put forward a different point of view, "But the patient's sweating is both self-sweating and night sweats, and it is difficult to distinguish whether it is qi deficiency or yin deficiency." Moreover, at present, the patient still has manifest manifestations, suggesting that sweating may also be related to external sensation, but there is a significant difference between the patient's continuous sweating and the intermittent small amount of sweating in Guizhi Tang syndrome. ”
Excellent!Professor Guo cast an approving glance at the two young **, "You have all grasped the main symptom of the patient's 'sweating' this time, and conducted a corresponding analysis around it, which shows that you have a preliminary understanding of the diagnosis and treatment characteristics of traditional Chinese medicine." The patient's sweating was not only related to external cold, but also closely related to improper medication, and also inseparable from her physical weakness after giving birth. ”
For sweating, it was recorded as early as in the "Yellow Emperor's Neijing", which was mentioned in the "Lingshu Camp Health Association".
The Yellow Emperor said: People have heat, eat and drink in the stomach, their qi is undetermined, sweat comes out, or from the face, or from the back, or out of the body, it does not follow the way of guarding the qi, why not?Qi Bo said: In addition, it hurts the wind, the inner body is opened, the hair is steamed and discharged, and the guard qi goes, and it is not allowed to follow its path. In the Neijing, this symptom is called 'leakage', which is very vivid, pointing out that sweating does not stop as leaking. Of course, the most important pathogenesis of leakage here is that the patient is injured by the wind and re-enters the hot diet, which causes the intestines to open and sweat like leakage. Our patient today is also traumatized by the wind, but the difference is that the patient's sweating is not caused by hot food, but due to excessive sweating and damage to the yang qi, resulting in the inability of the guard qi to fix the surface, because the sweating is like leakage. Professor Guo paused, "So, think about it again, how should you ** this patient?"”
As we have just discussed, if the external syndrome of sun disease is unsolved, accompanied by physical weakness, you can still use cinnamon branch soup to sweat. Moreover, the guizhi soup itself can stop the "sick sweat" by producing "medicinal sweat". Therefore, this patient should be able to consider using cinnamon branch decoction to **. Xi Jianzhong was quick to think and put into practice, but after a while of silence, he said: "The main symptom of the patient is that he sweats incessantly, and is accompanied by symptoms such as thin pulse and cold pain in the joints, and it seems that he can't simply use Guizhi soup." ”
So how do you adjust it?Professor Guo looked at Zhong Xiaoyi kindly.
I remember!Zhong Jing recorded the following case in the "Treatise on Typhoid Fever": "Those who are sick with the sun, sweating, and leakage do not stop, and those who have bad wind, difficulty urinating, and limbs are slightly anxious, and it is difficult to bend and stretch, and the cinnamon branch and aconite soup are the main ones (20)." Therefore, we can add aconite to the Guizhi soup to warm the yang and fix the surface. Zhong Xiaoyi said excitedly.
Very good!Professor Guo nodded with satisfaction, he was very satisfied with his performance: "Considering the great loss of qi and blood in the postpartum period of this patient, if you add a little qi and blood nourishing drugs, such as astragalus, angelica, etc., it will be more suitable for the pathogenesis." ”
I don't understand a question," Xi Jianzhong looked at Professor Guo, "This patient is sweating nonstop, obviously hurting yin, but why does Chinese medicine start with Wenyang." ”
I'll answer this," Zhong Xiaoyi hurriedly said, "Although the patient's performance is that he is sweating, the patient's sweating is caused by excessive sweating and damage to Weiyang, so from the perspective of treating the disease and seeking the roots, it is necessary to warm and replenish the yang qi. If you don't understand this truth, blindly replenishing yin will be consumed even if it is temporarily replenished. ”
In TCM theory, the theory of yin and yang is the core. It believes that the yin and yang in the human body must be relatively balanced in order to maintain the abundance of righteousness and not be violated by external evils. Just like the words of "Su Wen: The Theory of Vitality and Vitality": "The yin person hides the essence and rises urgently, and the yang person guards the outside and is solid." For example, if the sky and the sun lose their place, they will lose their longevity. Therefore, the fortune of heaven should be bright. It is the old yang that is therefore on the top, and the defenders are also. ''The essence of yin and yang, the yang is dense, the two are not in harmony, if there is no spring and autumn, if there is no summer in winter, ...... is not in summerTherefore, the yang is strong and cannot be dense, and the yin qi is absolute. In yin and yang, because yang energy bears the body's defensive and anti-evil role, in "Treatise on Typhoid Fever", Zhongjing attaches great importance to the maintenance of yang energy, and pays attention to the yang energy in the body everywhere. This patient wants to use cinnamon sticks and aconite soup to **, which actually embodies Zhongjing's idea of helping yang qi. Of course," Professor Guo suddenly changed his words, "since the lack of yang qi in this patient is closely related to the lack of yin blood, it is necessary to add or subtract certain changes when using cinnamon and aconite decoction, which is why it is necessary to increase qi and blood nourishing medicine." ”
Xi Jianzhong and Zhong Xiaoyi were deeply impressed by Professor Guo's explanation, and strengthened their belief in learning Chinese medicine well.