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- 第69章 中医药调理口渴症一（第1页）
第69章 中医药调理口渴症一（第1页）
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口渴症（一）[病案]吴某，男性，年龄32岁。自发病以来，一直感到口渴难耐，想要饮水，同时胸部也感觉胀满不适已有四月之久。该症状起因于一次长时间的体力劳动：忍饥负重行走二十华里后，身体极度疲劳。第二天开始出现胸闷症状，并逐渐加重，口渴感随之而来，但每次饮水量并不多，夜间常因口渴而醒来数次。经过一系列医学检查，包括尿糖检测、血常规和胸透钡餐等项目，结果均显示正常。曾经尝试过服用清热生津的药物，但未见明显疗效。患者舌质偏暗，脉象弦而不数。[治则]理气活血化瘀。[方药]郁金9克，桃仁9克，丹皮9克，赤芍9克，乌药9克，柴胡9克，川芎9克，当归9克，五灵脂9克，香附6克，黄芪24克，全瓜蒌12克，穿山甲18克。患者在服用了这个方剂之后，经过三剂药物的调理，所出现的各种症状都得到了明显缓解。过去困扰患者的夜间频繁起床口渴饮水的状况也得到了改善。患者对这一疗效感到十分满意，于是继续按照原方服用了六剂。经过这连续的九剂药物调理，患者的身体状况得到了显着改善，原先的各种症状都已经消失，达到了痊愈的状态。在痊愈的一年之后，患者进行了回访，期间未见病症复发，表明此方剂在治疗该病症方面具有较高的疗效和持久性。[评析]《金匮要略·惊悸吐衄下血胸满瘀血脉证治第十六》记载：病人表现出好像发热的症状，但实际上却没有发热，同时伴有烦躁、烦闷和口渴等不适。这种情况表明体内有淤血积聚，应当采取攻下的治疗方法来消除淤血。这一论述强调了通过脉象判断病情并确定相应治疗方案的重要性。当患者出现类似发热的症状时，比如身体发烫、面色发红等，但脉象却没有显示出真正的热度，即脉象浮大而数，重按则空，这时候就需要考虑是否是因为淤血导致的。因为淤血会阻碍气血运行，导致身体局部发热，所以此时需要用攻下法来治疗。所谓攻下法，就是使用大黄、芒硝等苦寒泻下的药物，以消除体内的淤血和实热。当然，具体的用药还需要根据病情的轻重缓急和个体差异来决定。总之，医生可以通过脉象来诊断疾病，并选择合适的治疗方法。然而，具体的治疗方法需要根据个体情况进行调整，以确保安全有效。总之，这体现了中医理论中对脉象与病症之间关系的重视，以及通过观察脉象来指导治疗决策的独特理念。它提醒我们在诊断和治疗过程中要综合考虑各种因素，以实现准确的诊断和恰当的治疗。这起病案，起源于一次负重努力挣扎后，胸部之气郁结不畅，导致了气滞血瘀的病症。因此，医生对症下药，投以活血化瘀之药物，竟然收到了药到病除的功效。：（）每日医案
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