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报告2例泻心汤清化湿热、凉血止血,治疗急性出血性坏死性肠炎,便血-肠道湿热证(小肠瘅)。男,5岁,腹痛、呕吐、腹泻、便血发热2d;T39.2℃,P120次/min,R84次/min,BP85/60mm Hg;血常规:WBC24.4×109/L,中性67%,淋巴细胞20%;腹部X线:中腹小肠充气,未见液平面;便常规:高粱色,无黏液及脓血,白细胞+,蛔虫卵+,潜血++++;合并蛔虫病;泻心汤(大黄后下5g,黄连3g、黄芩各3g,地榆、愧花炒、丹皮、枳实炒各5g,木香2g,当归、甘草各5g),3剂,1剂/d,水煎400m L,早中晚温服;二诊加乌梅、使君子各6g,干姜炒黑2g,2剂,1剂/d,水煎400m L,早中晚温服;三诊上方服2剂,胃纳正常,大便成形,大便潜血3次阴转,继以健脾安蛔治疗1周,出院。男,7岁,腹痛、呕吐、腹泻、便血发热3d;T38.8℃,P115次/min,R82次/min,BP80/50mm Hg;血常规:WBC20.4×109/L,中性72%,淋巴细胞20%;腹部X线:左上腹小肠充气、膨胀,肠腔扩大,未见液平面,肠间有异常改变。便常规:大量红细胞和白细胞,培养无细菌生长,隐血试验阳性;泻心汤(大黄后下5g,黄连、黄芩各3g,地榆炒、愧花炒、丹皮、枳实炒各5g,木香2g,当归、甘草各5g),2剂,1剂/d,水煎500m L,早中晚温服;二诊以原方再服2剂;三诊香连丸加减,木香、黄连各2g,陈皮、茯苓、白术、麦冬、西洋参各6g,扁豆9g,焦三仙6g。3剂,1剂/d,水煎500m L,早中晚温服,进食米汤及牛奶;四诊血象、腹部X线检查、大便镜检、隐血试验(连续3次)等检查均已恢复正常,随即出院。
Report 2 cases Xiexin Tang Qinghua dampness, cooling blood to stop bleeding, treatment of acute hemorrhagic necrotizing enterocolitis, blood in the stool - intestinal damp heat syndrome (small intestine 瘅). Male, 5 years old, abdominal pain, vomiting, diarrhea, blood in the stool 2d; T39.2 ℃, P120 beats / min, R84 beats / min, BP85 / 60mm Hg; blood routine: WBC24.4 × 109 / , Lymphocytes 20%; abdomen X-ray: abdominal small intestine inflatable, no liquid level; conventional: sorghum, mucus and pus and blood, leukocytes +, roundworm eggs +, occult blood +++ +; merge ascariasis; Soup (Rhubarb 5g, Coptis 3g, Scutellaria 3g, Burnet, Absinthe fried, Dan Pi, Citrus aurantium fried 5g, woody 2g, Angelica, licorice 5g), 3, 1 / d, water Fried 400m L, morning and evening warm clothes; second diagnosis plus ebony, gentleman each 6g, dry ginger fried black 2g, 2, 1 / d, decoction 400m L, early and late warm clothing; Agent, normal appetite, stool formation, fecal occult blood three times, followed by spleen acupuncture treatment for 1 week, discharged. Male, 7 years old, abdominal pain, vomiting, diarrhea, fecal blood fever 3d; T38.8 ℃, P115 times / min, R82 times / min, BP80 / 50mm Hg; blood: WBC20.4 × 109 / L, , Lymphocytes 20%; abdomen X-ray: left upper quadrant of the small intestine inflatable, swelling, enlargement of the intestine, no liquid level, abnormal bowel changes. Conventional: a large number of red blood cells and white blood cells, bacterial growth without culture, occult blood test was positive; Xiexin soup (rhubarb 5g, berberine, skullcap the 3g, Burnet fried, 2g, Angelica, licorice each 5g), 2, 1 / d, decoction 500m L, morning and evening warm clothes; Coptis 2g, dried tangerine peel, Poria, Atractylodes, Radix, American ginseng 6g, lentils 9g, coke Sanxian 6g. 3 doses, 1 dose / d, decoction 500m L, morning and evening warm clothes, eating rice soup and milk; four diagnostic blood, abdomen X-ray examination, stool microscopy, occult blood test (3 times) and other tests have returned to normal , Then discharged.