Chronic liver failure is conditionally still needed for liver transplantation
03.07
Xu Moumou, male, 37 years old, chronic liver failure, bilirubin 221 units, PTA 35%
Tatsumi: tired, afraid of cold, dry mouth without bitterness, a small amount of warm water, nacha, recent nausea and vomiting, poor sleep, night awake in 3
dots, mushy stools, yellow urine;
Tongue vein: the tongue is dark, there are tooth marks on the sides, the moss is thin and greasy, the veins are slippery, the left pulse is weak, the right is floating, and the right is closed
obvious
TCM Analysis:
1, the tongue is dark, the fungal papilla is also dark, it can be seen that there is blood stasis inside, combined with the idea that long-term illness must be stasis, and the blood line is easy to think, but can
See to be communicative choleretic;
2. The moss is thin and greasy, there are tooth marks on the side, the right side of the pulse is floating, the close is obvious, combined with the idea of liver disease and spleen, considering the factors of spleen deficiency
3. The pulse string is slippery, the left pulse force is weak, it can be seen that the righteous qi is insufficient, and the treatment is not mainly heat and dampness, but on the basis of positive wetness
Huang;
4, tired, afraid of cold, poor, stool paste, combined with tongue vein, and according to the root of the kidney, supplemented in the spleen and stomach of the mind, can
See Spleen deficiency clear;
5, na poor, nausea and vomiting, according to the stomach disharmony is restless, visible yang does not enter the yin, so it can be seen that the sleep difference;
6. Spleen deficiency and wet connotation, wet connotation three jiao, shaoyang cardinal unfavorable, bile spillage skin, betting bladder, visible skin yellow and urine yellow;
Treatment: Replenish qi and strengthen the spleen, dampness and yellowing
Prescription medicine: Yin Chen Wuling scatter addition and subtraction
The prescriptions are as follows: Yin Chen, Gui Zhi, Poria Poria, Pig Lily, Ze Diarrhea, Bai Shu, White Peony, Windproof, Astragalus, Malt, Ginger Half Summer
Tangerine peel, chicken blood vine, dandelion, silk seed
By Word:
First, the spleen is weak and wet, so choose Yin Chen Wulingsan;
Second, the gas machine of the stomach is abnormal, and ginger half-summer orange peel is added to combine malt;
Third, wei qi is abnormal, afraid of cold, add jade screen to scatter and add silk;
Fourth, long-term illness will be stasis and long-term illness will be weak, to pass through the yellow, blood is easy to yellow, add chicken blood vine;
Fifth, wet contains heat, hot refining liquid for phlegm, phlegm wet junction, disease cementation, here the two Chen Tang plus dandelion;
Sixth, the courage is connected, the laurel branch here;
Seventh, the liver and intestines are connected, and the white art and dandelion here are missing sauce grass
03.10
Nosebleeds, poor sleep, yu all improved
Tongue purple red, thin and yellow moss, smooth veins, left off floating, right floating, left pulse weak
The prescriptions are as follows: Yin Chen, Gui Zhi, Poria Poria, Pig Lily, Ze Diarrhea, Bai Shu, Red Peony, Windproof, Astragalus, Stone Calamus, Tulip
Yuan Zhi, Chai Hu, Jiang Banxia, Skullcap, Silk Silk
According to the language: jaundice, weak pulse strength, continue to add and subtract in Chen Wuling scatter; slightly afraid of cold, continue to yuping wind scatter; prevention of hepatic encephalopathy, continue
Stone calamus Tujin Yuanzhi; Zuo Guanfu, sleep difference, suggesting Shaoyang disease, add small chai hu soup; and long-term disease liver and kidney deficiency, so added 菟
Silk tonic liver and kidney; due to nasal bleeding, combined with tongue purple red, tongue tip red, considering the blood has heat, so go to white peony to improve red peony, the same
When Xiao Chai Hu clears liver fever and achieves the purpose of purifying the heart fire;
03.15
Dry mouth, smooth veins, left off floating, right floating
The prescription is as follows: Yin Chen, GuiZhi, Poria Poria, Pig Lily, Ze Diarrhea, Bai Shu, Chicken Blood Vine, White Peony, Astragalus, Stone Calamus
Yu Jin, Yuan Zhi, Chai Hu, Jiang Banxia, Skullcap, Dogwood
03.21
Discharged, discharged bilirubin 180 units, PTA 41%
04.30
Re-admitted, did not take Chinese medicine after discharge, admitted to the hospital to check 330 units of bilirubin, PTA 18%
Tatsumi: bloating, toilet after meals, loose stools, mouth neutral, night sleep, nacha, yellow urine;
Tongue veins: tongue purple red, moss thin yellow, pulse slip number, off floating;
TCM Analysis:
1. Tongue purple red, thin yellow moss, pulse number, indicating heat inside;
2. Go to the toilet after meals, consider muwangke soil, and the left guan floating also indicates hepatobiliary depression; while the right guanfu, indicating spleen and stomach stasis;
3. Abdominal distension, combined with liver disease and spleen thoughts, there are tooth marks on the side of the tongue, indicating that the spleen is weak and does not make water, and water gathers in the abdominal cavity;
4. Wet resistance trifocal, shaoyang cardinal unfavorable, bile spillage skin and betting bladder, visible skin yellow, urine yellow;
Treatment: Liver and spleen, heat and humidity
Prescription medicine: diarrhea should be combined with the addition and subtraction of the loose powder
The prescription is as follows: tangerine peel, bai shu, white peony, windproof, large belly skin, magnolia, rotten sauce grass, angelica, chai hu, poria, cohosh
Peppermint, licorice, oysters, zephyllum
According to the language: go to the toilet after meals, loose stool, combined with liver failure basis, left off floating, consider muwangke soil, so choose the diarrhea recipe, because
Albumin is low, so the amount of white surgery is increased; because the liver body is yin and yang, and here Mu Wang, combined with the basis of liver failure, considers stasis and deficiency
On the basis of the cause of liver prosperity and ketu, so choose to add and subtract from the loose scatter, add oyster Ze diarrhea soft and firm water; and the right guan float, combined with the abdomen
Swelling, good at treating water does not cure water and cure qi, add large belly skin thick pu sauce grass to remove the swelling through the gastrointestinal stasis, and add cohosh
Spleen and yang are raised, and spleen rises and the stomach is lowered;
During the period of Western supplementation with coagulation factors and platelets, the disease was progressively aggravated, the PTA dropped to 7%, and liver migration was recommended many times
Plant, unable to perform due to economic reasons, refused rescue measures after transferring to the ICU, death was inevitable, and clinical death was declared on 5.10
Dead;
Patients with chronic liver failure who have the condition of the liver transplant or liver transplantation, do not delay the disease, if the economic conditions do not allow,
That should actively cooperate with the doctor's treatment, the patient's first hospitalization has improved, did not continue to consolidate, and the doctor's obedience is poor, and the diet is not available
control, which leads to glue and further progression of the disease;
