[Identification and typing].
Liver and gallbladder damp-heat, Qi stagnation and blood stasis: Symptoms: right hypochondriac pain or colic, nausea, vomiting, dizziness, bitter mouth and dry throat, loss of appetite, dyspareunia, yellow urine, red tongue with yellowish coating and stringiness of pulse.
Analysis: Liver and gallbladder are mutually exclusive.
The location of the disease is in the liver and gallbladder, and the nature of the disease is heat and real. The cause of the disease is damp-heat.
Liver depression, spleen deficiency, damp-heat internalization: symptoms: loss of appetite, nausea, aversion to grease, prolonged right hypochondriac pain, with fatigue and weakness, low fever in the afternoon, irritability, light tongue with white or yellowish greasy coating, sunken and thin pulse.
Analysis: Liver stagnation, spleen failure, damp-heat endogenous, dampness is sticky, then the disease is prolonged and prolonged; liver stagnation is associated with vague pain in the right hypochondrium and irritability; spleen failure is associated with loss of appetite, nausea and greasiness; no source of chemistry is associated with fatigue and weakness; damp-heat injury to yin is associated with low fever in the afternoon; light tongue, white or yellowish greasy coating, sunken and thin pulse, all signs of spleen deficiency, liver stagnation and damp-heat endogenous. The disease is located in the liver and spleen, and the nature of the disease is to contain the real in the deficiency; its origin is liver-depression and spleen-deficiency, and its symptom is damp-heat internalization.
[Treatment plan]
I. Treatment principles
For gallbladder stones and acute cholecystitis, broad-spectrum antibiotics are used to control infection, together with Chinese herbal medicine to clear heat and dampness, regulate Qi and activate Blood. After the inflammation is controlled and the spontaneous symptoms are relieved or alleviated, surgical treatment can be used, and the preoperative and postoperative treatments are combined with Chinese medicine. For those with obvious contraindications to surgery, TCM evidence-based treatment can be used to increase the dosage of lithotripsy herbs.
Second, dialectical treatment
1.Treatment by identification
①Damp-heat in liver and gallbladder, stagnant qi and blood stasis: clear heat and dampness, regulate qi and activate blood.
Name of formula: Self-designed formula (gallstone decoction)
Prescription.
Jun: Yin Chen 30g, Gentiana 30g, Jin Yin Hua 30g
Subordinate herbs: Yu Jin 15g, Chai Hu 10g, Scutellaria baicalensis 10g, Rhubarb 10g, Pericarpium chenopodium 10g, Fructus septicum 30g
Adjuvant: Hesperidin 30g Money Grass 30g
Conjugate: Glycyrrhiza glabra 6g
Dosage: Decoction in water, 200ml bottle, 100ml per dose, 2 times daily.
② liver depression, spleen deficiency, dampness and heat within the evidence
Treatment: Soothing the liver and strengthening the spleen, clearing heat and relieving dampness
Name of formula: Self-designed formula (Jinsha Heshi Wan)
Prescription.
Conjugate herb: Astragalus membranaceus 15g, Yu Jin 15g
Subordinate medicine: Yin Chen 15g Ze Di 10g Chai Hu 10g Angelica 12g Bai Shao 15g Poria 15g Atractylodes 15g Gardenia 15g
Adjuvant: Money Grass 60g Sea Gold 60g Chicken Nei Jin 10g
Medicines: Glycyrrhiza glabra 6g
Usage and dosage: dry all the medicines, crushed into powder, water pan for pills such as mung bean large, each serving 60 pills, 2 times a day.
2.Auxiliary treatment
With electro-acupuncture therapy as appropriate: foot three miles, sun and moon, Liangmen (or Taichong).