If there is a list of "small and annoying diseases", recurrent oral ulcers must be on the list. A small ulcer can bring a painful background to every bite of food. Professor Nie Huimin, a famous typhoid doctor, often treats this disease with the prescription of clearing heat and harmonizing stomach, benefiting qi and promoting fluid production, and with gargle prescription, the effect is very good. Let's see which side Nie Lao uses-
Composition of prescriptions and drugs
Two handfuls of bamboo leaves, one catty of gypsum, half a liter of Pinellia ternata (washed), one liter of Ophiopogon japonicus (pitted), two ounces of ginseng, two ounces of licorice (fried) and half a liter of japonica rice.
decoct medical herbs
Seven flavors are served, water bucket, six liters are boiled, rice is removed, rice is cooked until cooked, and rice is removed to make 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 typhoid fever is relieved, qi deficiency and qi inversion will cause vomiting. 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 recipe are sweet and cool, clearing away heat and removing troubles; Gypsum is sweet in taste, cold in nature, and removes 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, tonify the middle warmer and stomach, and cultivate Zhongzhou; Side effects of Pinellia ternata on reducing stomach qi.
The combination of all kinds of drugs, full body fluid, deficiency-heat relieving exterior syndrome and vomiting are the methods to strengthen the body resistance and eliminate evil spirits, treating both the symptoms and root causes. This prescription is a prescription for conditioning after illness. It is not only used to treat the syndrome of gas-liquid injury and unclear residual heat after typhoid fever, but also commonly 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 the residual heat, but also make up for its physical weakness, stimulate appetite and increase food intake, with all the functions.
Typical medical record
Zheng, female, adult. 2001aug 2 1 first time to see a doctor.
The patient has recurrent oral ulcer, pain, anorexia, dry stool, red tongue, thin yellow fur and thin and thin pulse.
Western medicine diagnosis: recurrent oral ulcer.
Traditional Chinese medicine diagnosis: aphtha.
Syndrome differentiation: yin deficiency and heat excess.
Treatment: clearing heat and relaxing bowels.
Add and subtract with bamboo leaf gypsum soup. Prescription 1: gypsum 15g (fried first), lophatherum gracile 10g, gardenia 12g, Ophiopogon japonicus 15g, Pseudostellaria heterophylla 15g, Anemarrhena asphodeloides 10g and imperata rhizome/kloc-. 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.
Secondary diagnosis: August 28th, 2006, 5438+0. After taking the medicine, the pain of the patient's oral ulcer was relieved, with loose stool, red tongue, thin yellow fur and thin and weak pulse. Prescription ①: Newly diagnosed 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 the symptoms have been alleviated. The stool is thin, the tongue is red, the fur is thin and yellow, and the pulse is thin and weak. According to the former method, the second diagnosis method 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, The Theory of the Alternation of Su Wen and Qi said that "the golden age is not as good as the fire age ... people got aphtha." People think that the onset of aphtha is related to climate. Later, doctors divided it into two categories: excess and deficiency. Most of the 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 heat depression and often recurs due to improper diet. Stomach heat damages body fluids and then dries for a few days. The spleen and stomach are not harmonious, and the lifting is not normal, so I see a bad diet and indigestion. Combined with the comprehensive analysis of the patient's tongue and pulse, the syndrome belongs to yin deficiency and heat excess. The treatment is mainly to relieve depression, clear heat and dredge fu-organs, and add and subtract 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, with a curative effect like a fork drum.
Nie Huimin's clinical thinking
This book was carefully selected, sorted out and written by Professor Nie Huimin and his disciples about his clinical cases 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 prescriptions is introduced. Professor Nie selected more than 300 cases of flexible use of prescriptions to diagnose and treat difficult clinical diseases, covering internal medicine, surgery, gynecology, pediatrics and other disciplines. In particular, according to the main points of each case, the key points of Professor Nie's syndrome differentiation and treatment, prescription scheduling and prescription addition and subtraction were emphatically commented, and his clinical experience and academic thoughts were deeply analyzed, which comprehensively presented his academic thoughts 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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