褥瘡 Bedsores (pressure sores)

褥瘡  Bedsores (pressure sores)

姓名name:XXXX
性別sex:女F
年齡age:87

現病史 (Present i11ness):
出血性中風 久病臥床 臀部薦椎骨褥瘡二個月
She got bedsore on her hip for two months due to prolonged bed rest.

望診Looking Examination:
舌紅無苔
褥瘡性潰瘍已經侵犯皮下筋膜組織
Red tongue without tongue coating.
The bedsore ulcer get into the subcutaneous fascia tissue

中醫診斷TCM Diagnosis
褥瘡
Pressure ulcers

治療方法Treatment method:
外敷紫雲膏一個半月
Apply Zi yun gao for one and half month

使用方法Directions:
一天敷兩次
Apply on it twice a day.
先以以生理時鹽水洗淨傷口 再敷上紫雲膏
Washing the wound with physiological saline before apply zhi yun gao

追蹤follow up:
治療後痊癒未再復發
recovered.

備註note:
成分 Ingredients:
紫草根zi cao gen 60g
當歸dang gui 60g
麻油 sesame oil 600g
豬油 pork lard 600g
黃蜂蠟 yellow beeswax

最佳的製作方法the best making method:
1.將當歸及紫草冷浸於麻油3-7天
2.慢火搾取豬油
3.七天後 豬油與麻油混在一起
4.以非常小的火煮到當歸變脆
5.過濾去渣後 再放入黃蠟
6.蠟的份量 會因天氣寒熱而異

1. Soaking dang gui and zi czo in sesame oil for 7 days
2. Getting pig lard by slowly fried.
3. The sesame oil needs to be mixed with pig lard after 7 days
4 Cooking it with very low fire till the dang gui become crispy.
5. Filtering the dregs away, and then put the yellow beeswax into the oil.
6.The amount of wax is depend on the weather condition.

失音Hoarseness

失音Hoarseness

沙啞的原因很多
我經驗的cases 有：

急性聲帶炎
大多是感冒引起的
很容易治癒

聲帶結節
大多是
話說太多太大聲
引起聲帶上皮角質增生而沙啞
此案例就是屬於這型的

聲帶息肉　
通常是單側發聲
它是聲帶長期充血不退引起的
所以中醫治療時
應在主方中加入
大量的玄參與蒲公英

聲帶萎縮　
大多是聲帶退化引起的
只能補腎水 與腎氣
臨床治療效果緩慢

聲帶麻痺　
大多是外科手術造成的傷害
中醫治療效果不佳

聲帶肉芽腫
大多是聲帶長期受刺激後引起的
如經常插管或長期胃酸逆流至咽喉或嘶吼
需要移除病因才能治癒

註記:
訶子是聲帶結節失聲沙啞的特效藥
但它很特殊
只能用含的
用沖泡開水煎劑就是無效
它的味道苦又澀
這是比較讓人難接受之處
但是臨床效果非常好
只要沙啞是因為話講太多或長期咳嗽引起的
非它莫屬
但初期感冒引起的沙啞 不宜使用

案例:

聲帶結節Vocal Fold Nodules (VFNs)
姓名name:XXXX
性別sex:女 F
年齡age:68
現病史 (Present i11ness):
聲音沙啞已經持續1個多月
咽喉不適 咽喉緊緊的感覺
西醫檢查 診斷為聲帶結節
Hoarseness has lasted more than one month
Throat tightness all the time
Western doctor diagnosed her with vocal cord nodule.
望診observation
舌紅苔黃
舌下瘀脈明顯
Red tonguewith yellow coating.
sublingual veins stasis obviously
問診inquiry:
食慾和大便正常
無過敏、飲酒、抽煙及.胃酸逆流等問題
但發病前有感冒咳嗽
Normal appetite and bowel movement
No allergies,and acid reflux problem
She got severe cough before hoarseness onset
切診Palpation::
脈弦
無頸部淋巴腫大
wiry pulse
No abnormal neck lymph nodes
中醫診斷TCM Diagnosis
血瘀型聲帶慢性的發炎
Chronic inflammation of the vocal cords due to blood stasis
治療原則Treatment principles:
養陰清熱，活血化瘀
Nurish yin and clear internal heat
Promoting blood circulation to move away blood stasis

中藥處方Chinese medicine prescription::
A.
木蝴蝶mu hu die 4g克
會厭逐瘀湯hui yan zhu yu tanng 10g
組成 composition of formula:
桃仁tao ren1 g
紅花huong hua1 g
甘草gan cao0.5g
桔梗jie geng0.5g
生地黃sheng di huang 1g
當歸dang gui1g
玄參xuan shen3g
柴胡cai hu0.5g
枳殼zhi ke0.5g
赤芍ci shao1g
14克分成四包 連續服用二周
total 14g Divided into four packets
take two weeks in a row
B.
另外 訶子打破 整顆口含 至無味 吐掉渣
藥量不限制
the other method is break the he zi into pieces and put in the mouth till tasteless and then spit out.
No limit for dosages
醫囑Instructions:
1. 避免大聲地說話
2. 多喝開水，忌吃刺激性和冰冷的食物
3. 勿吃太飽以防胃酸逆流
1. Avoid talking loudly.
2. Drink plenty of water, avoid eating spicy and icy food
3. Do not over eat to prevent acid regurgitation
1個月後追蹤follow up after30 days:
治療後痊癒未再復發
recovered.

註記note:
He Zi 最好的使用方法是整顆打破 含到嘴中 直到無味道才吐掉
它用沖泡開水煎劑就是無效
口噙的臨床效果非常好
但初期感冒引起的沙啞 不適合使用
The best way to take He Zi is break it into pieces and then put it in your mouth until tasteless then spit it out.
It is no effective by the decoction method.
The clinical effect is very good for the vocal fold nodules
However , it's not recommend for the exterior pathogen attacking stage.