泻心汤治愈儿童急性出血性坏死性肠炎2例报告

Xiexintang Treatment of Acute Hemorrhagic Necrotizing Enterocolitis Report Two Cases

报告2例泻心汤清化湿热、凉血止血,治疗急性出血性坏死性肠炎,便血-肠道湿热证(小肠瘅)。男,5岁,腹痛、呕吐、腹泻、便血发热2d;T39.2℃,P120次/min,R84次/min,BP85/60mm Hg;血常规:WBC24.4×109/L,中性67%,淋巴细胞20%;腹部X线:中腹小肠充气,未见液平面;便常规:高粱色,无黏液及脓血,白细胞+,蛔虫卵+,潜血++++;合并蛔虫病;泻心汤(大黄后下5g,黄连3g、黄芩各3g,地榆、愧花炒、丹皮、枳实炒各5g,木香2g,当归、甘草各5g),3剂,1剂/d,水煎400m L,早中晚温服;二诊加乌梅、使君子各6g,干姜炒黑2g,2剂,1剂/d,水煎400m L,早中晚温服;三诊上方服2剂,胃纳正常,大便成形,大便潜血3次阴转,继以健脾安蛔治疗1周,出院。男,7岁,腹痛、呕吐、腹泻、便血发热3d;T38.8℃,P115次/min,R82次/min,BP80/50mm Hg;血常规:WBC20.4×109/L,中性72%,淋巴细胞20%;腹部X线:左上腹小肠充气、膨胀,肠腔扩大,未见液平面,肠间有异常改变。便常规:大量红细胞和白细胞,培养无细菌生长,隐血试验阳性;泻心汤(大黄后下5g,黄连、黄芩各3g,地榆炒、愧花炒、丹皮、枳实炒各5g,木香2g,当归、甘草各5g),2剂,1剂/d,水煎500m L,早中晚温服;二诊以原方再服2剂;三诊香连丸加减,木香、黄连各2g,陈皮、茯苓、白术、麦冬、西洋参各6g,扁豆9g,焦三仙6g。3剂,1剂/d,水煎500m L,早中晚温服,进食米汤及牛奶;四诊血象、腹部X线检查、大便镜检、隐血试验(连续3次)等检查均已恢复正常,随即出院。

Xie Xin Tang Qing report two cases of heat, cooling blood to stop bleeding, treatment of acute hemorrhagic necrotizing enterocolitis, blood in the stool- heat Syndrome gut（intestine hate）. Male, aged 5, abdominal pain, vomiting, diarrhea, bloody diarrhea fever 2d; T39.2 ℃, P120 times / min, R84 times / min, BP85 / 60 mm Hg; blood： WBC24.4 × 109 / L, 67% neutral, Lymphocytes 20%; abdominal X-ray： the small intestine in the abdomen inflated, no liquid surface; then routine： Sorghum color, no mucus and pus and blood, white blood cells ＋, Ascaris ＋, occult blood ＋＋＋＋; merge ascariasis; Xiexintang（rhubarb under 5g, berberine 3g, skullcap 3g, Burnet, ashamed flower fried, Dan, citrus aurantium fry each 5g, woody 2g, angelica, licorice 5g）, 3 agents, a / d, decoction 400 m L, early in the evening, warm clothes; two clinics Jiawu Mei, the gentleman each 6g, ginger Chaohei 2g, 2 agents, 1 / d, decoction 400 m L, early in the evening, warm clothes; the top three clinics serving two, stomach Na normal stool forming, fecal occult blood 3 times overcast, followed by the spleen roundworm treatment one week, and discharged. Male, 7 years old, abdominal pain, vomiting, diarrhea, bloody diarrhea fever 3d; T38.8 ℃, P115 times / min, R82 times/min, BP80 / 50 mm Hg; blood： WBC20.4 × 109 / L, 72% neutral, Lymphocytes 20%; abdominal X-ray： the left upper quadrant of the small intestine inflated, swelling, expanding the intestine, no liquid surface, intestinal abnormal changes. Then routine： a large number of red blood cells and white blood cells, the culture no bacterial growth, occult blood test was positive; Xiexintang（rhubarb under 5g, berberine, baicalin 3g, Burnet fried, fried flower ashamed, Dan, citrus aurantium fry each 5g, wood Hong 2g, angelica, licorice 5g）, 2 agents, 1/d, decoction 500 m L, early in the evening, warm clothes; two clinics in the original square and then served two; three clinics Xianglian Pill, woody, berberine Each 2g, dried tangerine peel, Poria, Atractylodes, Radix, ginseng each 6g, lentils 9g, coke Sansen 6g. 3, 1/ d, decoction 500 m L, early in the evening, warm clothes, eating rice and milk; four diagnostic blood, abdominal X-ray examination, stool examination, occult blood test（for three times） and other tests have returned to normal, then discharged.