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小儿脾常不足,外邪入侵,往往伤及运化,故外感高热多见夹滞。治疗中笔者常于辨证的同时重用大黄,其效甚佳,兹举验案2则,以示说明。 一、上呼吸道感染 王××,男,1 5/12岁,1990年8月16日诊。患儿5天前高热、咳嗽流涕。经肌注青霉素等药后咳嗽好转,但高热不退,日晡尤甚。伴腹胀食少,咽红唇赤,大便干臭,2日一行,小便黄少,舌红苔薄黄腻。T39.4℃,血象:WBC10.8×10~9/L,N0.72,L0.24。胸透无异常。诊为上呼吸道感染。中医辨证为外感风热、滞热里结。治予疏风解表、通腑泻热。处方:蝉蜕、银花、连翘、薄荷(后下)、柴胡各6g,黄芩、葛根各8g,槟榔、陈皮、生甘草各4g,滑石10g。水煎服。另以生大黄15g,开水浸泡30分钟,再以武火煎5分钟,取汁分2次,分别于第1、2次服中药时兑入同服。一剂后共解大便4次,先干硬、后稀溏,量多臭秽。随之热退。再予上方去大黄、槟榔,加茯苓、山楂、麦芽、桔梗,2剂而愈。
Pediatric spleen often inadequate, evils invading, often hurt the transporter, so exogenous heat more common folder stagnation. Treatment of the author often dialectics reuse rhubarb, the effect is very good, hereby test case 2, to show that. First, the upper respiratory tract infection Wang × ×, male, 1 5/12 years old, August 16, 1990 diagnosis. Children with fever five days ago, cough runny nose. After the injection of penicillin and other drugs cough improved, but high fever, sundial especially. With less bloating food, redness lips, dry stool stool, on the 2nd line, yellow less yellow, red tongue, thin yellow greasy. T39.4 ℃, blood: WBC10.8 × 10 ~ 9 / L, N0.72, L0.24. No abnormal chest through. Diagnosis of upper respiratory tract infection. Syndrome differentiation of traditional Chinese medicine wind heat, stagnation in the knot. Treatment of Shufeng solution table, Tongfu diarrhea. Prescription: cicada slough, Yinhua, forsythia, mint (later), Bupleurum each 6g, skullcap, Pueraria each 8g, betel nut, tangerine peel, raw licorice each 4g, talc 10g. Shuijianbi. Another Rhubarb rhubarb 15g, soaked in boiling water for 30 minutes, then Wuhuo Jian 5 minutes, take juice 2 times, respectively, in the first and second serving of Chinese medicine into the same service. After a solution of stool 4 times, first hard and dry, thin after scrumptious, the amount of more stinky. Followed by hot retreat. Then to the top to rhubarb, areca, plus Poria, hawthorn, malt, Campanulaceae, 2 and more.