Under, Chinese medicine flavin

Chapter 195

The research team has been operating normally in Grassland City for more than half a month.

Today is the day of the research team's big rounds. The research group stipulates that every half a month, the team leader or deputy team leader of the research team will lead a team to conduct a comprehensive inspection of all patients in the research group, in order to let the research team leader or deputy team Long-term understanding of changes in the condition of all patients.

Huang Su put on a white coat and walked into the conference room, followed by Na Risong and He Hui.

Since Huang Su has the idea of ​​leaving Grassland City and handing over the Department of Traditional Chinese Medicine to the two, she will bring the two with her now so that they can learn more.

In the conference room, the leaders and deputy leaders of the three groups have arrived. The three groups are the early group, the late group and the mixed syndrome group.

The main reason is that when the cancer enters the advanced stage, the functions of the viscera will fail to varying degrees. Even in other syndrome types, there will also be varying degrees of qi and blood deficiency.

Among all the research groups, the Qi and blood deficiency syndrome is the most complicated, which is also a test for flavin.

Huang Su sat on the main seat and said: "Today is the first big ward round since the establishment of the research group. I would like to make a suggestion. In the future big ward rounds, I, the three team leaders and the deputy team leaders will do the ward rounds together. , and a recorder, don’t bring other people, what do you think?”

Dr. Sha from the mixed syndrome group said: "This proposal is good. Too many people will not only waste time, but also affect other people's rest."

Dr. Sha is Professor Sun's first graduate student and has rich experience in treating tumors with traditional Chinese medicine. Professor Sun specially called him to check in on the research group.

Seeing that everyone nodded in agreement, Huang Su said: "Since everyone agrees, let's start today's rounds."

Huang Su did this to prevent outside thieves from attacking the research group.

Since the last time an islander appeared in the registration clinic, Huang Su has been wary of the islander.

The islanders will never give up easily, they must have a backup.

Although it is impossible to prevent thieves for a thousand days, and it cannot be guaranteed to be foolproof, it can also minimize the spread of the prescription. In the research team, including him, there are only eight people who know the prescription.

"Senior Brother Sha, today we will start with your mixed certificate team." Huang Su got up and swept all the people present: "Today's workload will be a bit heavy, everyone work hard."

There are more than 300 patients in the three research groups, and it is necessary to check them as quickly as possible, and the workload is indeed relatively heavy.

A group of people walked out of the meeting room and walked to the ward of the mixed certificate group, which was on the third floor.

The new building of the city hospital has a total of eight floors. Each of the two research groups occupies one floor, occupying the second to seventh floors respectively. The wards on the eighth floor are assigned to the Department of Traditional Chinese Medicine to receive tumor patients in Grassland City.

A group of people walked into Ward 301, Huang Su first checked the sticky note at the end of the bed.

It says:

Name: Cheng Dong.

Age: 69 years old.

Syndrome type: stasis toxin internal resistance syndrome + Qi and blood deficiency syndrome.

The basic information and syndrome types of the patients are written on each bed in the research group.

Seeing a group of doctors walking in, the family members accompanied by Cheng Dong stood up and said hello, "Doctor Sha, hello to all the doctors!"

Huang Su took out Cheng Dong's gastroscope from the information bag at the end of the hospital bed to check it out.

On each hospital bed, there will be a patient folder, which contains the patient's medical records and all the films of gastroscopy within half a year, which is convenient for doctors to check.

Dr. Sha introduced the patient's condition to Huang Su: "Cheng Dong has suffered from gastric ulcer for many years. He suddenly felt a sharp pain in the epigastric cavity in March today. After gastroscopic biopsy, it was gastric adenocarcinoma. The distance from the lesser curvature of the stomach to the cardia was 1.5cm. Infiltrating adenocarcinoma, the size was 6cm. ×3.5cm×1cm, the cancer tissue infiltrates in the serosa fat.”

The cardia is the mouth through which food enters the stomach, and the pylorus is the mouth through which digested food residue enters the intestine.

Dr. Sha pointed to the gastroscope and said, "Look, there are cancerous tissues in the vessels and nerves, and the lymph nodes in the lesser curvature of the stomach can be signs of cancer cell metastasis."

Invasive adenocarcinoma is a concept relative to adenocarcinoma in situ. It is a subtype of adenocarcinoma. When adenocarcinoma cells penetrate the basement membrane of the epithelium and infiltrate into the deep layer of the basement membrane, it is called invasive adenocarcinoma.Different from adenocarcinoma in situ, if adenocarcinoma infiltrates, it may enter blood vessels and lymphatic vessels, and metastasis to lymphatic and blood vessels may occur.

When invasive adenocarcinoma is diagnosed, aggressive treatment is required, and early invasive adenocarcinoma can be treated with surgical resection.After surgery, postoperative adjuvant chemotherapy can also be carried out according to the results of pathological reports.

The patient's gastric adenocarcinoma has metastasized to the lymph nodes of the lesser curvature of the stomach, and it is no longer possible to remove the cancer cells through surgery. Chemotherapy and other systemic treatments must be used to control the development of the disease.

Infiltrating adenocarcinoma is a difficult type of cancer in traditional Chinese medicine, because it is easy to spread, and the speed of spreading is very fast. As long as it enters the blood vessels, it can spread the cancer cells throughout the body.

Seeing Cheng Dong with pale lips and pale complexion on the bed, Huang Su frowned slightly and asked, "When can chemotherapy be arranged for the patient's current physical condition?"

Dr. Sha said: "The patient's qi and blood deficiency is quite serious. We have added Bazhen Decoction to Taohong Siwu Decoction and Shixiaosan. It is estimated that we will continue to take it for another month."

After hearing Dr. Sha's explanation, Huang Su's frown deepened.

One month, no one can guarantee what will happen. Patients with this kind of invasive adenocarcinoma really metastasize quickly, spread fast, and people walk faster.

Seeing Huang Su's expression, Dr. Sha also knew what Huang Su was worried about and explained: "Junior Brother Huang, don't worry, the mentality of the family members is very good, as long as we try our best to treat it, after the patient was diagnosed, they went to many hospitals, but none of them We are the only ones who are willing to receive treatment.”

Huang Su nodded, walked up to Cheng Dong and sat down, took his arm, put three fingers on the three parts of the Cunguan ruler, and touched the wrist bone hard to see the pulse, the pulse was beating, and the pulse was difficult and weak when it came. Astringent and weak pulse.

Huang Sufa started and said: "Open your mouth, let me take a look at the coating on your tongue."

Cheng Dong stuck out his tongue, only to see that the body of the tongue was slightly smaller, and the tongue was purplish red with dark ecchymosis.

Dr. Sha came over and explained: "The patient's tongue has improved a lot now. When he first came here, his tongue was all dark purple."

Huang Su nodded and asked, "When you eat now, do you still feel a tingling pain in your stomach?"

Cheng Dong said weakly: "Also, but it's much better. Doctor, you don't know. Eating is like torture. Every time I eat, it feels like a blade is cutting my stomach. Especially at night, my stomach hurts." Couldn't sleep all night. Now it's tingling when I eat, and I'm very satisfied."

Qi is the commander of blood, and blood moves along with Qi, and if Qi stagnates for a long time, it will lead to internal stagnation of blood stasis. Because blood stasis is tangible, the pain can be localized, and often the place where the blood stasis is located is refused to press.

Where the stagnant blood stops internally, the veins are blocked and blocked, so the pain is like a needle prick, and if it is severe, it will be like a knife cut.

Stomach stasis toxin internal resistance syndrome, blood stasis in the stomach, often eating will touch the blood stasis, so pressing the pain is severe, and eating will aggravate it.

In TCM theory, because blood belongs to yin, after nightfall, even if the stomach is not pressed or eaten, pain will occur.

Huang Su nodded, and continued to ask: "Will there still be vomiting of blood and blackening?"

"The stool is still black, but the vomiting of blood has become less."

Congestion and internal resistance will lead to poor blood flow, and overflow to the outside of the veins, vomiting blood when the stomach qi goes up, and turns black when the intestines go down.

This is the pathogenesis of common symptoms of stasis and internal resistance, tingling in the stomach, vomiting blood, and black stools.

"Bring me the prescription and let me have a look."

Huang Su took the prescription handed over by Dr. Sha and checked it.

桃仁12g、红花10g、当归10g、赤芍10g、生蒲黄10g、五灵脂10g、丹参15g、元胡10g、川楝子10g、乌药10g、侧柏炭12g、血余炭12g、仙鹤草30g、白花蛇舌草30g、虎杖30g、党参10g、白术15g、茯苓15g、川芎10g、白芍10g、熟地黄10g、甘草10g。

In the prescription, Taohong Siwu Decoction and Shixiaosan are used to promote blood circulation and remove blood stasis, and use Toosendan, Yuanhu, and black medicine to strengthen Qi circulation. Charcoal removes blood stasis to stop bleeding, and uses Crane, Hedyotis diffusa, Polygonum cuspidatum to soften and resolve stagnation.

Finally, Bazhen Decoction is used to invigorate Qi and blood. As for why not use Shiquan Dabu Decoction.

Because of the syndrome of stasis and toxin internal resistance, stasis often generates heat for a long time, so ginseng and cinnamon can not be used to help yang to generate dryness and severe heat. Even Bazhen Decoction changes ginseng into Codonopsis ginseng to nourish qi and not dryness.

Huang Su looked at this and said: "When we were designing the project, we didn't consider it thoroughly. Patients like Cheng Dong should be included in the research group of blood stasis and internal resistance syndrome. , the treatment is still based on Taohong Siwu Decoction plus Shixiao San, and the other prescriptions are just auxiliary."

Dr. Sha comforted: "Occasional flaws are understandable. After all, the Academy of Traditional Chinese Medicine unites the five major colleges and universities. With such a large scale, it is impossible to think about everything comprehensively."

Later, Huang Su checked the other two patients in the same ward before leaving Ward 301.

The ward rounds lasted until about [-]:[-] pm before the mixed certificate team completed the inspection.

Huang Su simply ate dinner, returned to the dormitory, just took a shower, and was ready to go to bed.

Huang Su felt very tired after a day of ward rounds today, not only physically, but more importantly mentally, and this kind of day would last at least two days.

Just as Huang Su was lying on the bed, the mobile phone on the table rang suddenly. She got out of bed and picked up the mobile phone. It was Professor Sun calling.

He patted his forehead lightly, and couldn't help blaming himself in his heart. He was so busy that he forgot to report to Professor Sun about today's ward rounds.

Huang Su hurriedly connected the phone and said, "Teacher!"

Professor Sun's voice came from his hand and asked, "Huang Su, how is the ward round going today?"

"Today we only finished the inspection of the mixed certificate group. I have just finished the ward inspection. When I return to the dormitory, it will take two days to complete the inspection."

Huang Su then explained the situation of today's ward rounds to Professor Sun in detail, and finally said: "Teacher, I only found out after today's ward rounds that there are some problems with our grouping."

Professor Sun said with great interest: "Oh! What problem did you find?"

Huang Su said: "I think there is something wrong with the grouping of our mixed-syndrome group. During today's ward rounds, I found that many patients in the mixed-syndrome group suffered from Qi and blood deficiency because of other syndrome types. Moreover, each person’s deficiency of Qi and blood is also different, if it is mild, you can use Siwu Decoction and Renshen Jianpi Pills, if it is slightly severe, you can use Bazhen Decoction, and there is no need to use Shiquan Dabu Decoction at all.”

After a short break, Huang Su continued to explain: "Today's ward round, I found that in the mixed syndrome group, one-third of the patients should be classified into other syndrome groups, instead of hastily and directly classified into our research group."

On the phone, Professor Sun said: "It's very good that you can find these mistakes. The main purpose of our project this time is to explore a path for evidence-based medicine in traditional Chinese medicine. We don't have to be afraid of making mistakes. We only need to find mistakes and summarize them. TCM evidence-based medicine experiments can avoid detours."

Huang Su nodded silently and said: "I see, teacher! I will learn from today's mistake experience, and I will never make similar mistakes again when I am doing the subject."

Afterwards, Huang Su chatted with Professor Sun about the research group, and after sitting in the clinic with himself to start the diagnosis and treatment of tumor patients, the two hung up the phone.

The next day, Huang Su and his party started another round of the research team.

Huang Su asked Wei Lai beside him, "Wei Lai, have any patients in your research group started chemotherapy?"

Wei Lai replied: "Yes, the three patients have already completed chemotherapy, and today is the second chemotherapy."

After helping Professor Sun complete the communication work of the large research group, Wei Lai also came to Grassland City and served as the leader of the early research group.

Huang Su said: "Then start from the early research group today."

The three of them walked into the ward, and saw that the chemotherapy team had already begun to prepare intravenous chemotherapy for the patient.

Seeing Huang Su coming in, Dr. Liu from the chemotherapy group put down his work and said, "Dr. Huang, you are here. Are you going to check the early stage group today?"

"Today is the investigation of the early stage group. Didn't you hear Wei Lai say how many patients are going to receive chemotherapy today? Come over and have a look?"

Huang Su asked the patient who was undergoing chemotherapy: "Did you feel uncomfortable during the last chemotherapy?"

The patient smiled and said: "Doctor Huang, our traditional Chinese medicine's chemotherapy is better. After the last chemotherapy, I neither felt weak, nor vomited, anorexia, or oily. It’s so fragrant. It’s the first time that chemotherapy is so easy, and now I’m not afraid of chemotherapy.”

At the beginning of the century, chemotherapy was no different from going to hell. When it comes to chemotherapy, patients are actually afraid in their hearts. Even now, patients who die suddenly during chemotherapy often happen.

As he said that, the patient asked the big plastic jug beside him and said, "I heard from Dr. Wei that it's all thanks to the water and the breakfast before chemotherapy."

Since Huang Su carefully prepared breakfast and hydration water for Zou Wenzhi, the effect was very good, this time the research group also used this method in the research group's chemotherapy.

And according to the deficiency syndrome of Qi and blood, treat Poria cocos, red dates and astragalus porridge and Poria cocos, red dates and astragalus water.

Poria cocos, red dates and astragalus water are the toxic and side effects of hydration chemotherapy. Drinking a lot of water during chemotherapy can reduce the toxic and side effects of chemotherapy.

While Huang Su was chatting with the patient, Li Yan hurried into the ward.

(End of this chapter)