Liu XX, female, 44 years old, elementary school teacher, field Jingyuan Initial diagnosis (April 2, 2011): 2 months ago, after eating beef and mutton, the throat discomfort, pain, swallowing aggravated, accompanied by low fever, body temperature 37.8 ℃, to the local mine hospital respiratory outpatient treatment, the diagnosis is not known, to be “penicillin”, treatment, 3 After 3 days, the body temperature was normal, but the sore throat did not decrease, and then changed to a variety of “antibiotics”, the symptoms are sometimes good and sometimes bad, and in case of exertion or spicy products, it is easy to relapse, in serious cases, affecting sleep and work, and seek local Chinese medicine treatment, the effect is not good, so today to our hospital, the symptoms are: sore throat, dry throat, do not dare to swallow, pain when swallowing The pain is aggravated when swallowing, no fever, no headache, poor sleep, dry mouth and desire to drink, nasal, dry stool, one line for two days, urine regulation, red tongue, especially the tip, thin white moss, floating pulse. Physical examination: T36.9℃, P80 times/min, R20 times/min, BP110/70mmHg, pharynx red, no congestion, no enlarged tonsils, both sides of the pharyngeal-palatal arch: 3 rice-sized ulcers visible on the left, 2 rice-sized ulcers visible on the right, bright red after the surrounding mucosa, heart and lungs (-), Western medicine diagnosis: herpetic pharyngitis, Chinese medicine diagnosis. The treatment is to clear the heat and detoxify the lung, to reduce the swelling of the pharynx, and to reduce the swelling of the lung by combining Yin Qiao San with Mandarin Tang. Prescription: Morus alba 12g forsythia 12g honeysuckle 10g (later) orris 12g licorice 10g ginger 10g shepherd’s purse 10g rhizome 12g hyssop 10g thorny root 10g burdock 10g xuan shen 10g maitong 12g mab 10g (decoction) fried hen’s inner gold 10g yam 15g silkworm 10g decoction in water, one dose a day, 4 doses. Second consultation (April 7, 2011): Complained of slight relief of sore throat, increased insomnia, dry mouth and desire to drink, and regulated bowel movement, physical examination: no significant improvement of pharyngeal herpes, red tongue tip, thin yellow moss, little fluid, floating and slippery pulse, this heat and toxicity, lung and stomach yin injury, treatment is to clear heat and detoxify the throat, with products to produce muscle and nourish yin, the formula is self-designed. Prescription: Morus alba 12g, Radix Platycodon 15g, Glycyrrhiza glabra 10g, Rhizoma rehmannia 15g, Radix Bupleurum 10g, Radix Panax Ginseng 12g, Radix Codonopsis 10g, Radix yam 20g, Radix maitake 20g, Gumbo 10 (melted), Psidium guajava 10g, Radix Chuanbeiji 10g, Radix Rehmanniae 15g, Radix Ziziphiopogon 30g, decoction, one dose a day, 7 doses. Third consultation (April 12, 2011): Self-complaint of pharyngeal pain significantly reduced, sleep improved, dry mouth reduced, stool regulated, check: pharyngeal herpes subsided, switch to dietary therapy. Raw yam 50g lily of the valley 50g pear 100g Chuanbei mother 20g with rice cooked into porridge once a day, avoid taking spicy stimulation, beef and mutton and other products and healed. This case belongs to the category of breast moth in Chinese medicine. When I first saw the patient, I observed his tongue, pulse and symptoms, and according to the conventional medical identification, I identified it as a warm-heat offense to the lung, and the treatment was to clear the heat and detoxify the lung, and to reduce the swelling of the pharynx, based on the theory of “treating the upper jiao like a feather, not light but not lifting”, and used pungent and cool cleansing products, but the effect was not good, instead, the sore throat increased, dry mouth, insomnia Therefore, in addition to the use of heat-clearing and detoxifying products, the treatment should also apply sweet and cold products that nourish Yin and promote the growth of muscle, in order to be compatible with the disease. After recovering from the disease, it is also necessary to protect the lung and stomach yin and fluids from time to time, just as Ye Tianshi’s “Warming and Fever Article of Discernment” says: “If the heat evil offends the lung and is not treated, it is most likely to consume yin and injure fluids, so the best policy is to protect the fluids of the body from time to time.
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