I. Basic concepts
Tuberculosis: It is an infectious chronic debilitating disease.
The main clinical manifestations are cough, hemoptysis, hot flashes, night sweats and gradual weight loss.
Second, the pathogenesis of tuberculosis
The key to pathogenesis is that tuberculosis eats lung.
Qi deficiency is the basis of disease. The pathological nature is mainly yin deficiency and excessive fire, which can lead to deficiency of both qi and yin, and even damage of yang by yin.
The disease is located in the lung, but it can spread to the spleen and kidney for a long time, affecting the whole.
Third, the principle of treatment.
Because tuberculosis is caused by the consumption of lung by tuberculosis insects, the treatment should be based on the principle of tonifying deficiency and nourishing yuan, treating tuberculosis and killing insects.
Fourth, treatment based on syndrome differentiation.
1. lung yin loss
Key points of syndrome differentiation: dry cough, short cough sound, bloodshot sputum, bright red color, thin white fur, red tongue tip and rapid pulse.
Treatment: nourishing yin and moistening lung.
Representative prescription: Yuehua Pill.
2. virtual fire burns the lungs
Key points of syndrome differentiation: choking cough, shortness of breath, frequent hemoptysis, bright red blood, hot flashes in the afternoon, bone steaming, five-upset fever, red cheekbones and night sweats.
Treatment: nourishing yin and reducing fire.
Representative prescription: Baihe Gujin Decoction+Longdan Biejia Powder.
3. Deficiency of both Qi and Yin
Key points of syndrome differentiation: cough weakness, occasional expectoration or blood, shortness of breath and low voice, hot flashes in the afternoon, spontaneous sweating and night sweats can be seen at the same time.
Treatment: supplementing qi and nourishing yin.
Representative prescription: Baozhen Decoction or Shen Ling Baizhu Powder.
4. Deficiency of Yin and Yang
Key points of syndrome differentiation: cough, dyspnea, expectoration and foaming, spontaneous sweating, night sweats, pale purple tongue, rapid pulse or fatigue.
Treatment: nourishing yin and nourishing yang.
Representative prescription: Butian Jujube Pill.
example
The patient, a 34-year-old female, has been coughing for nearly a month, with shortness of breath, frequent hemoptysis, bright red blood, hot flashes in the afternoon, bone steaming, fever in five nerves, red cheekbones and night sweats. The treatment should be:
A. Nourishing yin and moistening lung B. Nourishing yin and reducing fire
C. supplementing qi and nourishing yin D.
E. Nourishing spleen and kidney
1. Answer B. Analysis: (1) According to the patient's choking cough, shortness of breath, hot flashes in the afternoon, bone steaming, feverish sensation in the five senses, red cheekbones and night sweats, the disease was diagnosed as pulmonary tuberculosis; Hemoptysis from time to time, the color of blood is bright red. Syndrome differentiation is yin deficiency and excessive fire, and treatment should be nourishing yin and reducing fire. So the answer is B.