非洲病人消化性溃疡的治疗TCMinMuhimbiliforPepticUlcerSurname：Mu**Othername：Ma**DateofBirth：1984Sex:FJob：NotknowHospitalReg.Number:A****由于我在国内是消化科的医生，所以，内科疾病中的消化系统的疾病更加关注。这是治疗的第三例消化性溃疡的疾病，效果都不错，对于消化系统疾病的烧心泛酸，胃痛，呃逆，泄泻，腹胀便秘等疾病，积累了不少的经验，大部分疾病可以起到比较显著的效果。这是一例典型的十二指肠溃疡的病人，从症状以及后来的钡餐造影显示都是这样的。从治疗来看也是比较典型和常规的思路。初诊：2009年10月9日主诉：胃脘灼痛烧心泛酸2年余，加重2个月。病史：患者从2年前无明显原因开始出现胃脘灼痛，泛酸烧心，没有经过任何检查，服用当地铝制剂药物中和胃酸，效果不理想，后反复发作。2月前无明显诱因病情加重。刻下：胃脘疼痛，以灼痛为主，泛酸，食道有烧灼感，空腹时加重，进食后好转，食欲差，大便正常，颜色为赭黄色，睡眠正常，容易着急生气，平素喜欢吃热，不太敢吃凉。查体：胃脘部轻压痛，剑突下尤重。建议：查HP（幽门螺旋杆菌），明确病因，X-ray钡餐胃肠造影，最好是胃镜。实验室检查：未查舌脉：舌体正常，舌红，苔黄白相间，脉位中，脉弦滑。诊断：消化性溃疡？HP感染？胃炎？中医诊断：胃痛辨证：肝郁化火，脾寒胃热，寒热错杂治疗：清肝和胃，辛开苦降处方：半夏泻心汤和连茱六一丸半夏6黄连6黄芩10干姜4（自备）党参10吴茱萸6乌贼骨10桂枝6白芍10炒谷芽10炙甘草6六剂颗粒剂冲服每天一剂，每日两次医嘱：清淡饮食，减少油炸食品的摄入。2009年10月16日复诊Muhimbili医院钡餐造影示：十二指肠溃疡，胃炎。服上方诸症减轻，泛酸烧心减轻一半，舌脉同前，继服上方一周。2009年10月22日三诊服上方烧心泛酸已经消失，胃脘灼痛减轻一半，舌淡苔白，脉滑。继续服用上方，加胃苏颗粒12盒/6gTid以巩固治疗。Surname：Mu**Othername：Mar**DateofBirth：1984Sex:FJob：NotknowHospitalReg.Number:A****Firstvisit：9thOctober2009Chiefcomplaint:Thereweretheburningpain,heartburnandwaterbrashinthegastriccavityfor2years.Itwasreallyworsefor2months.Shecomplainedthattheburningpain,heartburnandwaterbrashinthegastriccavitycome2yearsago.Shewasnotreceivedanyexaminationandtreatmentbefore.Afterhadtooksomemedicineofaluminiumforbalanceoutthegastricacidhimself,hedidnotfellbetter.Thesametroublerecurrentattacksmanytimes.Itwasreallyworse2monthsago.Nowthestomachacheisburningpain.Therewerethewaterbrashandburningsensationintheesophagus.Itgetworseifthestomachwasempty.Itfeelsbetterifhavethesomefoods.Hisappetitewasbedalso,urineandstoolwerenormal.Thecolourofstoolwasyellow.Thesleepingwasnormal.Shelikesthewarmfoodandwater.Shewaseasytogetangryonherlive.Physicalexamination:Therearelighttendernessinthemiddleregionoftheupperabdomen.Itfeelworseonthelowerappendixensiformis.Laboratoryexamination:None.TCMexamination:Tongue:Thebodyoftonguewasnormal.Redwithwhiteandyellowcoatingtongue.Pulse:HuaandXian（Slideandlikechord）Diagnosis:PepticUlcer?HPinfection?Gastritis?TCMdiagnosis:GastralgiaDifferentiationofsymptomsandsigns：Pathogenicfirederivedfromstagnationofliver-QI；Spleniccoldandgastricheat；coldheatcomplex.Therapy:Cleantheliverfireandmakeharmonyinstomach；MakeYin-Yangbalancetothespleenandstomach.Prescription:PinelliaeDecoctionforPurgingStomach-FireandLian-ZhuSix-OneWan.NameofherbinChineseNameofherbinEnglishNameofherbinLatinPronounceinTCMWeight（g）半夏PinelliaTuberRhizomaPinelliaeBanxia10黄连GoldenThreadRhizomaCoptidisHuanglian10黄芩RadixScutellariaeRadixScutellariaeHuangqin10干姜DriedGingerRhizomaZingiberisGanjiang5党参PiloseAsiabellRoot/ModerateAsiabellRoot/SzechwonTangshenRootRadixCodonopsisDangshen10吴茱萸MedcinalEvodiaFruitFructusEvodiaeWuzhuyu3桂枝CassiaTwigRamulusCinnamomiGuizhi5白芍WhitePaeonyRootRadixPaeoniaeAlbaBaishao10炒谷芽Rice-grainSproutFructusOryzaeGerminatusGuya15炙甘草LiquoricRootRadixGlycyrrhizaeGancao66dosesgiven.1doseperdaytakenorallytwiceaday.Adviceforthepatient:Diet.Paymuchattentiontothefoodyoutakeeachtime.1、Takeaking’sbreakfast,havingasmanydifferentkindsoffoodasyoucan;richman’slunch,havingasmuchasyoucan;bagger’sdinner;thatistakingaslittleasyoucan.Therighttimetohavebreakfast:8:00a.m.;righttimetohavelunch:before1:00p.m.;righttimetohavedinner:7:00p.m.;2、Itisbetterforyoutotakealightexercises..3、WewillgettheX-rayforyouralimentarysystem.ItisbetterforyoutogetGastroscopy4、Blanddiet.havingaslessfriedfoodasyoucanSecondvisit:16thOctober,2009TheresultsofthebariummealinMuhimbiliis:duodenalulcerandgastritis.Afterthatmedicine,thesymptomsgetlessandthepatientfeelsbetter.Thetongueandpulseweresametobefore.Continuethattreatmenttherapyforoneweek.Thirdvisit:16thOctober,2009Theheartburnandwaterbrashinthegastriccavityhavedisappeared.Theburningpaingetlesshalfthanbefore.Redwithwhitecoatingtongue.PulsewasHua（Slide）.Continuethattreatmenttherapyforoneweek.AddtheWeisuGranula12boxes/6gTid.
标签：TCM,Muhimbili,Peptic
