FuWeiMin: reuse of rhubarb to treat acute pancreatitis

Time: the 2015-08-29

source: China's traditional Chinese medicine the author: Gu Xi town

FuWeiMin, born in 1940, male, han ethnic group, jiangyin, jiangsu province. Director of TCM doctor, professor, doctoral supervisor, the old Chinese medicine expert academic experience inheritance work instruction in the country teacher. From Meng He YiPa jiangyin Xia Ren name old doctor of traditional Chinese medicine, in 1961, graduated from nanjing college of traditional Chinese medicine, traditional Chinese medicine in jiangsu province after work.

Served the member of the standing committee of the national Chinese medicine medical professional committee of China federation of Chinese medicine fever, deputy director of professional committee members, blood stasis, director of the professional committee of China association of Chinese medicine, director of the disease of traditional Chinese medicine professional committee of jiangsu province, jiangsu province, the emergency professional committee of academic leaders, encephalopathy, director of the center, deputy director of the hospital emergency department of jiangsu province, director of the national emergency center of traditional Chinese medicine, Chinese medicine hospital of jiangsu province. Served as the state administration of traditional Chinese medicine of TCM for emergency medicine evaluation experts, the state drug administration drug evaluation experts, national essential drugs state evaluation experts, the state protection of varieties of new drug of TCM evaluation experts.

Editor, published 168 academic theses, 6 works and participated in 12 units. Presided over several national and provincial subject. "Study on traditional Chinese medicine in the treatment of epidemic hemorrhagic fever" hosted by science and technology progress award, the state administration of traditional Chinese medicine "stomach blood ning granule in the treatment of peptic ulcer research" won third prize in jiangsu province scientific and technological progress, "pancreatitis the spirit pellet in the treatment of acute pancreatitis research" won third prize in jiangsu province scientific and technological progress, "tong spirit of mixture in the treatment of acute phase of cerebral hemorrhage brain research" by jiangsu province scientific and technological progress second prize, "the brain granule in the treatment of vascular dementia in the elderly" won third prize in jiangsu province scientific and technological progress, "exogenous high fever syndrome differentiation standardization of clinical research" by jiangsu province scientific and technological progress second prize, won the state administration of traditional Chinese medicine of traditional Chinese medicine emergency work special contribution and advanced individual.

Pony, already belongs to the liver depression and qi stagnation, damp and hot dirty blood stasis resistance, relieving gas, application of poison and blood stasis in alternating knot, cure of ZongZhongSheng, party choose big radix bupleuri decoction and bearing gas tonga subtraction.

Bin medical record first diagnosis, professor FuWeiMin use raw rhubarb moves is 20 grams, it is more than pharmacopoeia prescribed dosage, and after the next. Rhubarb kill three birds with one stone here -- "inner parts, the blood circulation, detoxifying", serious illness must use remedies, I say, visible differentiation of quasi, incompetent and guts.

XXL one, male, 38 years old. Because of "abdominal pain, fever, vomiting 1 day" to the hospital. Patients in the 2 days ago with the family quarrel with his wife, the next day at noon to drink, drunk, in the afternoon sudden abdominal pain, vomiting, restlessness, body heat, thought drunk, neglected, at noon to 2 days to hospital emergency department. Physical examination: temperature 38.7 ℃, heart rate 82 times/min, the blood pressure 130/84 MMHG. Conscious, listlessness, buckling postures, acute pain ill, sclera mild yellow dye, petechiae skin no yellowing and ecchymosis, smell and cardiopulmonary anomaly, abdomen, liver and spleen untouched under the ribs, full abdomen tenderness (+), muscular tension and rebound tenderness, ammonites and lump, reduce bowel sounds, without shifting dullness, Grey - Turner sign (-), Cullen (-). Laboratory examination: routine blood: the WBC 11.21 x 109 / L, N 80%, 20%. Urine amylase 702.1 U/L, blood amylase 134.6 U/L. CRP is 20.16 mg/L. Fasting glucose tendency for 6.72 / L, 19.00 U/L aspertate aminotransferase, alanine aminotransferase 45.00 U/L, 142.00 U/L lactic acid dehydrogenase and creatine kinase 84.00 U/L, 17.00 U/L GGTP (gamma glutamyl transpeptidase), alkaline phosphatase (54.00 U/L, total bilirubin tendency for 46.34 / L, direct bilirubin tendency for 12.67 / L, total protein 80.12 g/L, 49.23 g/L of albumin, abdominal ultrasound tip: pancreas swelling, abnormal echo around the pancreas and pancreas. Routine after admission to fasting, gastrointestinal decompression, antibiotics, maintain water and electrolyte balance, parenteral nutrition support treatment.

TCM diagnosis: abdominal pain.

Western medicine diagnosis: acute pancreatitis (edema).

Syndrome differentiation and treatment: patients with young strong, body fat, paunchy, often abdominal distension full, buckling in bed, such as drill nail sample blunt inverse pain, violent, moaning shout pain, vomiting, much sputum for water stripping, belching, stroke the burning of the skin, not shit 2 lines, view its tongue, quality of a material is red, yellow greasy moss on jin is little, the lingual faint blue stripe area, according to its veins, go again now, such as the pearl of the straight chord length, "string" as also.

Syndrome differentiation: liver depression and qi stagnation, damp and hot dirty blood stasis resistance, relieving gas.

Treatment: liver qi, heat-clearing and detoxicating, relieving blood.

Prescription: big radix bupleuri decoction and bearing gas tonga subtraction. 10 grams 15 grams of radix bupleuri, radix scutellariae, rhizoma coptidis hu 10 grams, 15 grams of radix paeoniae alba, 15 grams of cortex moutan, rhizoma corydalis 10 grams, raw rhubarb (after) 20 grams, glauber's salt (rushed) 10 grams, 10 grams, magnolia bark hovenia dulcis 10 grams, 10 grams of flos lonicerae. 2 doses. Decoction, daily 1 agent, because of vomiting could not enter the medicine, told to the stomach tube nasal feeding, enema each 100 ml.

General solution 2 clinical medicine into 2 doses, shit, stop vomiting, abdominal distension, abdominal pain significantly reduce, but still fever, belch, thirsty urine yellow. Tongue red moss yellow greasy, pulse string and smooth. Dirty, a lot of stomach and gas, but hot and humid thanh hoa, liver depression qi activity without chang show. Through relieving still cure liver and qi, blood, after application of the pathogenesis of liver, where the hot and humid in tonghua poison and blood stasis. Above to glauber's salt, rhizoma coptidis hu, rhizoma coptidis 6 grams, 10 grams of salvia miltiorrhiza. 3 agent, water decoction, daily 1 agent, points in the morning and evening.

Three diagnosis: abdominal pain relief, hot and cool, has been able to eat, still thirsty to drink, Sou short color yellow, languid, tongue from scarlet, yellow greasy moss has to go, now show thin jin less dry, pulse string and smooth. Hot and dirty and failure of the seven or eight, like the beginning. Cure to liver and spleen, through inner parts without harming the Yin.

Prescription: above to rhizoma coptidis, rhizoma corydalis, red sage root, honeysuckle, radix paeoniae rubra 10 grams, yuan and 10 grams, 10 grams radix trichosanthis, radix curcumae 10 grams, 10 grams of semen coicis. Water decoction, daily 1 agent, morning and evening.

The above modulation 5 days, the disease, normal appetite, spirit is a bit tired. Review of laboratory indicators: urine amylase 46.2 U/L, blood amylase 66.7 U/L. Routine blood: the WBC 6.8 x 109 / L, N 68%, 32%. Abdominal ultrasound: pancreas no swelling, no abnormal echo around the pancreas and pancreas. Sequel to the liver spleen, qi and nourishing Yin agent after two days, fine out of the hospital.

【 in 】 : in this case the cause is clear, "snow" in petty arguments, stroke depressive mood, "add cream" in sorrows-drowning, overeating. "Anger hurt liver", "food from times, intestines and stomach is hurt", anger hurt liver, liver hydrophobic, qi activity stasis; These hot and humid in im into the stomach, resistance Yu Zhongjiao, relieving stasis in the bowel, lifting up and down as the smothering, or so fluently as the resistance, so often the original shows womb, abdominal distension, abdominal pain, fever, vomiting, constipation, red tongue moss yellow greasy, is the sign of "hot and humid dirty" indicates product, pulse string is wood subjugates earth and abdominal pain, slide, hot and damp stasis resistance and abdominal distention, lingual blue stripe faint, moss yellow greasy, though not a brown or black yellow, and a short course of disease, know the disease is not to "hemorrhage, necrosis, Jude hope to have treatment.

The case already distinguishes the genus liver depression and qi stagnation, damp and hot, dirty blood stasis resistance relieving gas, application of poison and blood stasis in each knot of machine, cure of ZongZhongSheng, party choose big radix bupleuri decoction and bearing gas tonga subtraction. Party in the reuse of bupleurum through table release heat, liver qi, radix scutellariae and clear heat, apart from the evil of shaoyang, with radix paeoniae alba diarrhea spleen heat and liver pain. Flos lonicerae, radix scutellariae, rhizoma coptidis hu, qingrejiedu, wet and heat resistance in the stagnant, each to a poor person, so with orange, magnolia bark, fights, qi and eliminating the new in addition to the full. And hovenia dulcis paired with radix bupleuri, a liter of a fall, and inverse lifting without help, discharge reduction which can cut. And easy to cause blood stasis, poison stasis knot in the stomach, cortex moutan, XuanHu qi huoxue pain. Di catharsis, bowel relieving drop disorder, to the raw rhubarb xie purgation, cleaning intestines and stomach, supplemented by glauber's salt salt cold purging heat, soft firm dryness. Here, rhubarb kill three birds with one stone, "tong relieving, blood circulation, detoxifying," choose the essence of medicine. The medicine altogether plays by liver qi and blood detoxification, capturing the inner parts of the work.

The medical record was professor FuWeiMin use raw rhubarb moves is 20 grams, it is more than pharmacopoeia prescribed dosage, and after the long (raw rhubarb decoction on the force of less), serious illness must use remedies, I say, visible FuWeiMin differentiation of quasi, failing and guts.

Real problem in medicine, a good beginning, two diagnosis is seen through the stomach and inner parts, but didn't get a hot and damp stasis poison cleansing, tottering foe appropriate chase, so, effect is not more, but a prescription medicine take a discrepancy, give evil is a way out. Three clinical evil to seven or eight, virtual image, added to the side of yuan and two flavor, pollen, and rhubarb are wu, combine ZhongJingZeng liquid bearing gas, capturing on relieving without injury and Yin, eliminate pathogenic centralizer, two don't hinder. Throughout the treatment to the case, all the "poison stasis mutual knot" stick to acute pancreatitis pathological center, the blood through relieving always carry out treatment, fully embodies the "from" poison stasis treatment of acute pancreatitis of academic ideas, therefore received satisfactory curative effect.