Chinese medicine doctor Xu Yang

On the way, Xu Yang was looking at the cases, and Zhao Guobin was introducing the patient's condition to Xu Yang.

"Dr. Xu, Team Leader He, the patient is a female, 65 years old, with a history of chronic bronchitis and prone to coughing. The patient developed cough and sputum production on January 20, 2020."

"I went to the pharmacy to buy Chinese patent medicines and took them, and received rehydration treatment at the community hospital, but currently we cannot find out what medicines were used at that time."

"After taking it, the patient's symptoms were not significantly relieved. Then he developed shortness of breath, which gradually worsened! The patient was weak and had obvious anorexia."

"Later, the nucleic acid test was positive and it was confirmed that it was new pneumonia. However, due to the shortage of beds, it was delayed for another three days before being admitted to our hospital. After admission, conventional moxifloxacin, ribavirin and other drugs were given for antiviral treatment. "

"But the day after the patient was hospitalized, that is, the night before yesterday, the patient's condition suddenly worsened and his blood oxygen saturation dropped significantly. We had already rescued him once the night before."

Having said this, Xu Yang, who was reading the medical records, couldn't help but look up at Zhao Guobin.

Zhao Guobin said calmly: "After timely treatment such as methylprednisolone anti-inflammatory and non-invasive ventilator support, the patient's condition has improved slightly."

Xu Yang nodded and said, "But the condition is still not optimistic, right?"

Zhao Guobin's tone also softened: "Yes, the patient's condition is still very dangerous. To be honest, this is a typical critically ill patient."

"To put it harshly, it is very likely that we will have to come to rescue several times today. The patient is now on the edge of the cliff and is very dangerous. We don't have any particularly reliable plan. Therefore, we would like to ask traditional Chinese medicine to intervene."

"Yeah." Xu Yang responded softly and continued to read the patient's case report. It was the patient's laboratory report. The white blood cell count was 11.4, the absolute lymphocyte value was 0.8, the lymphocyte percentage was 7.4%, and the absolute neutrophil value was 10.3.

The last part is the patient’s lung CT report.

After Xu Yang read it, he closed the case and said, "Which room is the patient in?"

Zhao Guobin pointed forward: "Turn left ahead, the first one."

Several people quickened their pace and quickly arrived at the ward where the patient was.

The patient is now conscious and curled up in bed.

"Are you feeling better today?" Zhao Guobin came over and asked.

"Well..." The retired aunt responded weakly, her voice was very soft, and she didn't mean to say more.

Zhao Guobin said again: "I've invited two more Chinese medicine experts to come over and give you a check-up. Can you please cooperate?"

After hearing about Chinese medicine, the retired aunt rolled her eyes slightly and glanced at the two astronaut-like figures standing next to Zhao Guobin.

"Hmm..." The retired aunt responded again without saying much.

Zhao Guobin nodded towards Xu Yang and Professor He.

Professor He said: "Xu Yang, go and diagnose."

"Okay." Xu Yang went up to make a diagnosis without being polite.

The patient currently has no fever, but has shortness of breath. He maintains a nasal cannula and uses a dual-channel high-flow oxygen mask, and his blood oxygen saturation is 87%.

Cough with phlegm, sputum color and white matter are thin, and there is a slight feeling of tightness in the chest.

Afraid of the cold and tired.

It takes three days to pass stool, the amount of urine is small, and the patient sleeps restlessly at night.

Xu Yang observed the patient's face. The patient's face was pale and his eyelids were pale.

Xu Yang went to touch the patient's hands and feet again and found that the extremities of the patient's limbs were cold.

He frowned.

Then press the patient's abdomen again.

This is the abdominal diagnosis of traditional Chinese medicine.

There are four diagnostic skills in traditional Chinese medicine: looking, smelling, asking, and feeling. This diagnosis does not only refer to taking the pulse, but also includes diagnosis by pressing the abdomen.

The origin of abdominal diagnosis is also very ancient. Zhang Zhongjing has already discussed abdominal diagnosis in detail. There is a carved "Zhongjing Abdominal Examination Diagram" in the Baoding Grottoes in Sichuan.

But strangely, abdominal diagnosis is rarely mentioned in medical books written by later generations of doctors. Especially after the Tang and Song Dynasties, it became even rarer.

Some people also analyze that it is because after the Song Dynasty, feudal ethics were severely restricted, and the abdomen was also a hidden part and could not be touched at will. Especially female patients...

Therefore, many laypeople don’t know that “cut” in traditional Chinese medicine also includes abdominal examination.

Although many traditional Chinese medicine doctors no longer perform abdominal diagnosis, there are still many traditional Chinese medicine practitioners who have passed down the tradition and require their disciples to pay attention to abdominal diagnosis.

For example, the medical records of Mr. Pu Fuzhou and Mr. Pu basically record the abdominal diagnosis.

There is also Mr. Li. Abdominal diagnosis often appears in medical records. At that time, there were also Japanese encephalitis patients in Shanxi. At that time, Qingwen Baidu Drink and Angong Niuhuang Pills were of no use at all.

The patient has been in a coma for five days, and his condition is very critical. Later, Mr. Li pressed the patient's abdomen and found that the patient's upper abdomen was hard and painful, so he decisively used Dachengqi Decoction.

After one dose, the fever subsided and my mind became clear.

There was once a patient who was in shock. He used Dushen Decoction and Western medicine, but his blood pressure could not be raised and he was dying.

Later, during abdominal examination, Mr. Li found that the patient had tenderness in the epigastrium, which was due to the stagnation in the stomach. Then he used Zhishi Houpu Decoction, added Erchou and ginseng, to eliminate the stagnation, and he was saved.

If you don't do an abdominal diagnosis, it's easy to get a misdiagnosis.

Therefore, Mr. Li has always emphasized that in critical cases, abdominal pressure must be applied and abdominal examination must be performed.

As their student, Xu Yang naturally did not dare to underestimate abdominal diagnosis at will.

Xu Yang stepped forward, opened the patient's clothes, and was about to rub his hands when he realized that he was wearing gloves. Before doing abdominal examination, it is generally necessary to warm the hands first.

One is that he is afraid of freezing the patient and being impolite. The other thing is also for preparation. If you give someone ice and their abdominal muscles immediately contract, it is too hard, which can easily affect your judgment.

Xu Yang started immediately.

Follow-up visits are also divided into virtual and actual situations.

Generally speaking, if there is tenderness, it is true. Those who like pressing and pressing belong to the category of deficiency. Fullness without tenderness indicates qi stagnation. If there is tenderness in a small area under the xiphoid process, it is due to phlegm. Tenderness in the entire epigastrium is a sign of stasis in the stomach.

I won’t go into details…

After Xu Yang completed the abdominal examination, he found that the patient's abdomen was soft.

A soft abdomen indicates weakness.

The patient has been unable to defecate for three days, and the result is that his abdomen is still so soft...

Xu Yang said: "Put your tongue out and let me take a look."

The patient sticks out his tongue.

The tongue is dull and the coating is white and greasy.

Then Xu Yang checked the patient's pulse. Xu Yang adapted quickly and is now used to wearing gloves to check the pulse.

The pulse is heavy, thin and weak.

Xu Yang stood up after making the diagnosis.

Zhao Guobin hurriedly came over and asked, "How is it?"

Xu Yang walked out and said: "The evil poison invades the lungs and the vitality is severely damaged. It is necessary to return to Yang in time to save Ni and detoxify at the same time. Use Si Ni."

"Ah?" This sound came from Professor He.