Liu Lichang, a famous traditional Chinese medicine doctor in Guangdong Province, Professor and graduate supervisor of Shenzhen University, Chief expert and chief physician of traditional Chinese medicine at Shenzhen Second People's Hospital, and also serves as vice president and secretary-general of Shenzhen Society of Integrated Traditional Chinese and Western Medicine. Liu Lichang advocates classics, mainly studies typhoid fever, attaches importance to positive energy, pays attention to the spleen and stomach, and advocates the correspondence of prescriptions and syndromes. He has been engaged in clinical, teaching, and scientific research in traditional Chinese medicine for more than 40 years, edited 7 works, published more than 50 academic papers, and presided over a number of national, provincial and municipal scientific research results.
medical case is a record of traditional Chinese medicine's clinical practice, reflecting the specific use of principles, methods, prescriptions and medicines in the diagnosis and treatment process, and is a manifestation of the doctor's thinking process of diagnosis and treatment of diseases. The medical cases of famous masters of all dynasties are treasures in the treasure house of traditional Chinese medicine. We have launched the [Case-based Medical Treatment] column in order to inherit the essence, inspire us to make progress together.
Peng, female, 45 years old at the time. He came to the clinic on September 13, 2017 because he was "detected of goiter and sweating and fatigue."
disease process: 3 months ago, I found goiter in the Department of Endocrinology of the other hospital. I found abnormalities in the examination of thyroidism and diagnosed hyperthyroidism. I am now taking propylthiorui and betaxel. But I still feel sweating, panic, and often worsen, fatigue, and fear of cold. . Loose stools and poor sleep.
[First Diagnosis]
Current symptoms: neck discomfort, breath holding, sweating, palpitations, often worsen, fatigue, fear of cold, and poor appetite. Loose stools and poor sleep. physical examination : thyroid II enlarged, heart rate 90 beats per minute, the rate is equal, pale tongue, red tongue, thin white tongue coating, deep pulse thin.
[Dynamic and Treatment]
Dynamic and Treatment: strengthens the spleen and eliminates phlegm, softens hardens and disperses nodules.
prescription: Sijunzi Decoction Heyanghe Decoction plus and subtract.
bran fried Atractylodes macrocephala 15 grams, 15 grams of Codonopsis pilosula slices, 415 grams of Poria cocos 15 grams, 415 grams of white mustard 15 grams, 30 grams of calcined oyster, 430 grams of antler cream 30 grams, 410 grams of cinnamon twig 10 grams, 45 grams of licorice 5 grams, 415 grams of cooked Rehmannia husk 15 grams, 415 grams of sausage husk 10 grams, 410 grams of Zhejiang Fritillaria 10 grams, 10 grams of ginger, 415 grams of method Pinellia ternata 15 grams.
[Section process]
Review on September 27, 2017:
Sweating symptoms have been relieved, and I am still afraid of cold. Consciously, the neck goiter has decreased. is dry at night and is obvious. The edge of the tongue has red and white coating, and the pulse is stringy and thin. Add 10g above to continue taking it.
Three diagnosis:
Sweat and palpitations are significantly reduced, sweating is mainly the head, sleep improves at night, goiter in the neck is relieved, bloating in the stomach after eating, stool 2-3 times a day, loose stools , and still feel fatigue. Add Rehmannia above and add Citrus aurantium 10g. After taking the medicine for one month, the goiter subsided and all symptoms were covered.
notes:
Hyperthyroidism belongs to the category of "god disease" in traditional Chinese medicine. " Medical School Jinjian " says, "The three yang meridians of small scrotum and large scrotum are born on the front of the neck and the back of the neck. Although the names of phlegm, dampness, qi and tendons are different, they are always caused by anger, anger, depression and heat." It is believed that scrotum and should be divided into meridians. The former of the neck should belong to the Yangming meridian, and Taiyin and Yangming are the exterior and interior of each other. Goiter of goiter is born in front of the neck and should belong to the Yangming meridian. From the perspective of meridian theory, it also shows that goiter is closely related to the spleen and stomach meridians. Teacher Liu believes that people in this life have an unpredictable daily life and eat twice as much. In addition, is in internal emotions and . The spleen and stomach are affected first. If the spleen is damaged, the qi will be stagnant. If the spleen is weak, the phlegm and dampness will be produced. The phlegm and qi are blocked, and the blood flow will be poor. Qi, blood, and phlegm will be condensed and goiter disease will be caused. Therefore, in clinical practice, Teacher Liu often carries the principle of strengthening the spleen and dispersing nodules throughout the treatment. In terms of treatment, it is based on medicines to relieve liver and strengthen the spleen. If the spleen and stomach are healthy, the essence of water and grain can be distributed and the water can be qi-transformed.
The patient was goiter, sweating, fatigue, afraid of cold, poor appetite, loose stools, pale red tongue, thin white tongue, deep and thin pulse, and was diagnosed as spleen deficiency and phlegm. Therefore, Sijunzi Decoction adds Astragalus to strengthen the spleen and replenish qi, and then Yanghe Decoction is used to warm the yang qi, unblock the meridians, and eliminate phlegm and knots. For those with swelling of the thyroid gland, you can add turtle shell , Curcuma zedo , white mustard seeds, White Flower Snake Tongue , Summer Deep Grass, Half-branch Lotus, and Forsythia to enhance the effect of resolving phlegm and dispersing knots.White mustard seeds are pungent and warm, and they are connected to the lung and stomach meridians, which can help qi and disperse nodules. "Bencao Jingshu" says, "White mustard seeds are extremely pungent, and the qi is warm, which can detect internal and external phlegm knots, as well as cold phlegm in the chest and diaphragm, and those with cold saliva are blocked." Therefore, it is better for blood stasis that is difficult to dissipate.
(written by this case: Li Lifang)
solemnly stated:
Due to the different physical constitution and condition of each person, the prescriptions and dosages in this case are only applicable to the patient's condition at that time. The prescriptions and dosages in this case shall not be copied and used without diagnosis and treatment by traditional Chinese medicine. Readers should go to regular hospitals for diagnosis and treatment if necessary to avoid delaying the condition. ■
[Source: Shenzhen Second People's Hospital, Guidance Expert: Liu Lichang Chief Physician]
