犀角地黄汤+参苓白术散+大补元煎鼻饲联合西药临床治愈呼吸机相关腹胀1例报告

One Case Reporting of Xijiao Dihung Decoction(犀角地黄汤)Shenling Baizhu Powder(参苓白术散) and Dabuyuan Jian(大补元煎) combined Western Medicine Therapy for Long-term Use Breathing Machine Lead to Abdominal Distension

报告1例犀角地黄汤＋参苓白术散＋大补元煎鼻饲联合西药临床治愈长期使用呼吸机导致相关性腹胀,出院后腹胀症状消失,大便1-2日一行。男,68岁。肢体活动不利,意识欠清1天。腹部膨隆、皮肤绷急,大便2-3日一行,脉沉细;白细胞15.06×10^9/L,中性粒细胞百分比88%,血红蛋白84g/L;C反应蛋白58.5mg/L,降钙素原0.43ng/m L,D二聚体2ug/m L;生化、凝血、肿瘤系列、心肌酶等未见明显异常;CT：双下肺炎症;颅脑左侧丘脑可见新发梗塞灶,放射冠可见陈旧性梗塞灶。西医诊断：1.脑梗塞,2.肺炎;中医诊断：1.中风（肝肾亏虚）,2.喘嗽。抗感染、营养支持等治疗,犀角地黄汤加减,水牛角、生地各30g,赤芍、丹皮、丹参、玄参各15g,麦冬20g,茯苓30g,白术15g,1剂/d,水煎200m L,早晚鼻饲,5d为1疗程。二诊以参苓白术散合大补元煎加减以健脾补肾,党参30g,茯苓20g,白术、山药各15g,薏苡仁30g,砂仁、桔梗各12g,生地、熟地各30g,杜仲、枸杞各15g,鹿角胶烊化10g,丹参15g,地龙12g,桃仁、红花各9g,甘草炙6g,1剂/d,水煎200m L,早晚鼻饲。此后每7d在此方基础上加减,服药2月,腹胀明显减轻,大便1-2日一行,服药4月,腹胀症状消失,大便1-2日一行,临床治愈。

Report one case reporting of Xijiao Dihung decoction（犀角地黄汤） Shenling Baizhu Powder（参苓白术散） and Dabuyuan Jian（大补元煎） combined western medicine therapy for long-term use breathing machine lead to abdominal distension, bloating symptoms disappeared after discharge, defecate 1-2 time a day. Patient is 68 years old, male. Physical activity was dad and Consciousness owe 1 day. Abdomen became distension, skin became shiny, defecate 2-3 time a day, heavy fine of arteries and veins; Auxiliary examination played： white blood cell 15.06 ×10^9/L, neutrophil percentage 88%, hemoglobin 84 g/L; C-reactive protein 58.5 rag/L, calcitonin original 0.43 ng/mL, dimer 2 ug/mL; Series of biochemistry, blood coagulation, tumor and myocardial enzyme were not seen obvious abnormity; Lung CT： double pneumonia disease; craniocerebral CT： new infarct at the left thalamus, corona radiata visible pulmonary infarction ; therapeutic schedule ： Anti-infection and nutrition support, ligustrazine injection to promote blood circulation by removing blood stasis, Xijiao Dihung decoction： each 30 g buffalo horn and radix rehmanniae, each 15 g radix paeoniae rubra, cortex moutan, salvia mihiorrhiza and radix scrophulariae, radix ophiopogonis 20 g, poria cocos 30 g, atractylodes15 g, one dose a day, which was fried 200 mL water, morning and evening nasal feedding, 5d to one course of treatment. Second clinical gave Shenling Baizhu Powder and Dabuyuan Jian add and subtract to spleen and kidney, Dangshen 30 g, poria cocos 20 g, each 15 g atractylodes and yam, semen coicis 30 g, amomum villosum and platycodon grandiflornm each 12 g, radix rehmanniae and prepared rhizome of rehmannia each 30 g, eucommia bark and Chinese wolfberry each 15 g, antler glue Yang 10 g, salvia miltiorrhiza 15 g, 12 g earthworm, peach kernel and safflower each 9 g, licorice main 6 g, one dose a day, which was fried 200 ml water, morning and evening nasal feedding. Since every 7 d on the basis of the party to add and subtract, After 2 months, abdominal distension was lighten, defecate 1-2 time a day, just 4 month, abdominal distension symptoms disappeared, defecate 1-2 time a day.