If there is a list of "small and annoying diseases", recurrent oral ulcers must be on the list. A small ulcer will bring a painful background color to every bite of food. Professor Nie Huimin, a famous doctor of typhoid fever, often treats this disease with modified prescriptions of clearing heat and harmonizing stomach, benefiting qi and promoting fluid production, and with gargle prescription, the effect is very good. Let's take a look at which side Nie Lao used-
Composition of prescriptions and drugs
Two handfuls of bamboo leaves, a catty of gypsum, half a liter of Pinellia ternata (washed), one liter of Ophiopogon japonicus (pitted), two ounces of ginseng, two ounces of licorice (baked) and half a liter of japonica rice.
Decoct drugs
Serve seven flavors, fight with water, boil six liters, remove rice, cook rice until cooked, and take the rice out of the soup. Take one liter of warm clothes three times a day.
Prescription efficacy
Clearing heat and harmonizing stomach, benefiting qi and promoting fluid production.
Original prescription certificate
After the typhoid fever is relieved, it is qi deficiency, and when the qi is reversed, it will vomit. Mainly bamboo leaf gypsum soup. (article 397 of Treatise on Febrile Diseases)
Analysis of prescription and syndrome
Bamboo Leaf Gypsum Decoction is made of Baihu Decoction and ginseng soup, which is a medicine for clearing away heat, promoting fluid production, benefiting qi and regulating stomach. The light bamboo leaves in the prescription are sweet and cold, clearing away heat and removing troubles; Gypsum is sweet and cold, clearing the evil of residual heat; Ophiopogon japonicus is sweet and cold, nourishing yin and moistening dryness, clearing lung and stomach heat; Ginseng, licorice and japonica rice nourish yin, replenish qi and promote fluid production, and tonify the middle and stomach to cultivate Zhongzhou; Side effects of Pinellia ternata on reducing stomach qi.
The combination of all kinds of drugs, body fluid and qi, deficiency heat and vomiting are the methods of strengthening the body resistance and eliminating evil, treating both the symptoms and root causes. This prescription is a post-illness conditioning prescription, which not only treats the syndrome of gas-liquid injury and unclear residual heat after typhoid fever, but also is often used for those who see gas-liquid injury and inexhaustible residual heat in the late stage of epidemic febrile disease. This prescription can not only clear away heat, but also make up for its physical weakness, stimulate appetite and increase food intake, with various effects.
Typical medical record
Zheng, female, adult. First visit on 2001August 2 1 day.
The patient has recurrent oral ulcers, pain, loss of appetite, dry stool, red tongue, thin yellow fur and rapid pulse.
Western medicine diagnosis: recurrent oral ulcer.
Traditional Chinese medicine diagnosis: aphtha.
Syndrome Differentiation: Yin deficiency with heat.
Treatment: clearing heat and clearing intestines.
Add and subtract with bamboo leaf gypsum soup. Formula 1: gypsum15g (fried first), lophatherum gracile10g, gardenia12g, Ophiopogon japonicus15g, Pseudostellaria heterophylla15g, Anemarrhena asphodeloides10g and imperata rhizome. 7 doses, decoction, daily 1 dose, 2 doses per day. Prescription ②: Cortex Dictamni Radicis 15g, Radix et Rhizoma Rhei 15g, Fructus Perillae 15g. Decoct with water, and gargle for external use.
Second diagnosis: August 28th, 2006, 5438+0. After taking the medicine, the patient's pain of oral ulcer is relieved, and his stool is moving day by day, his tongue is red, his fur is thin and yellow, and his pulse is thin and weak. Prescription ①: First diagnosis prescription ①: Radix Astragali and Radix Glycyrrhizae are added. 7 doses, decoction, daily 1 dose, 2 doses per day. Prescription ②: rhubarb 15g, licorice 6g, astragalus 15g, cortex Dictamni Radicis 15g, Pulsatilla chinensis 15g. Decoct with water, and gargle for external use.
Third diagnosis: September 4th, 2006, 5438+0. The patient's oral ulcer has healed, and all symptoms have been alleviated. The stool is thin, the tongue is red, the fur is thin and yellow, and the pulse is weak. According to the former method, the second diagnosis prescription ① removes gypsum, Lophatherum gracile, Anemarrhena asphodeloides and raw coix seed, and adds bamboo shavings and coptis root. 7 doses, decoction, daily 1 dose, 2 doses per day.
Essentials of medical records
The name of aphtha first appeared in Huangdi Neijing. For example, Su Wen's theory of alternating qi and qi said: "The golden age is not as good as the age of fire ... people will get aphtha." People think that the onset of aphtha is related to climate. Later doctors divided it into two categories: excess and deficiency. Most positive cases were caused by rising heart fire or stomach fire or damp-heat fumigation. Deficiency syndrome is mostly caused by deficiency of kidney yin and deficiency of fire.
This case is recurrent oral ulcer. The patient's constitution belongs to yin deficiency, which is called stagnation of heat, and it often recurs due to improper diet. Stomach heat damages body fluid, and then it will dry for a few days. The spleen and stomach are not harmonious, and the ascending and descending are abnormal, so the diet is poor and indigestion occurs. Combined with the comprehensive analysis of the patient's tongue and pulse, this syndrome belongs to yin deficiency and heat excess. The treatment is mainly to relieve depression, clear heat and dredge fu-organs, plus modified Zhuye Gypsum Decoction. Adding Flos Lonicerae and Fructus Forsythiae to absorb heat; Pseudostellaria heterophylla, Ophiopogon japonicus and Anemarrhena asphodeloides have the functions of benefiting qi and nourishing yin, clearing away heat and promoting fluid production; Cogongrass rhizome and scutellaria baicalensis Georgi cool serum and heat.
In addition, while taking the decoction orally, use Cortex Dictamni Radicis, Radix et Rhizoma Rhei, Fructus Perillae, Radix Glycyrrhizae, Radix Pulsatillae, and Rhizoma Imperatae to decoct and gargle, and treat both internal and external aspects, which is as effective as a fork drum.
Nie Huimin's clinical speculation
This book was carefully selected, sorted and written by Professor Nie Huimin and his disciples for more than 50 years. According to the classification of prescriptions in Treatise on Febrile Diseases and Synopsis of the Golden Chamber, they are divided into fourteen categories, and the clinical application of some prescriptions is introduced. Professor Nie selected more than 300 cases of flexible use of prescriptions to diagnose and treat clinical intractable diseases, including internal medicine, surgery, gynecology, pediatrics and other disciplines. Especially, according to the main points of each case, this paper focuses on the key points of Professor Nie's syndrome differentiation and treatment, prescription and drug use, prescription and drug addition and subtraction, deeply analyzes Professor Nie's clinical experience and academic thoughts, and comprehensively presents his academic ideas of mastering Zhongjing meridians, innovating dialectical thinking of six meridians, flexibly tailoring prescriptions and "covering all subjects with one typhoid fever".
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