Big round check

The research team has been operating normally in Grassland City for more than half a month.

Today is the day of the research group's rounds. The research group stipulates that every half month, the leader or deputy leader of the research group will lead a team to comprehensively inspect all the patients in the research group, in order to let the leader or deputy group of the research group.

Learn more about the changes in all patients' condition.

Huang Su changed into a white coat and walked into the conference room, following Risong next to him, He Hui.

Since Huang Su had the idea of ​​leaving the grassland city and handing over the Chinese medicine department to them, he would now take them with him and let them learn more.

In the conference room, the leaders and deputy leaders of the three groups have arrived, namely the early group, the late group and the mixed certificate group.

Mainly, when cancer enters the late stage, the internal organs will experience varying degrees of failure. Even for other syndromes, there will be different degrees of deficiency of both qi and blood.

Among all the research groups, the symptoms of Qi and Blood deficiency are the most complex, which is also a test for flavin.

Huang Su sat in the main seat and said, "Today is the first major round check since the establishment of the research team. I would like to make a suggestion. In the future, I will check the rounds with three group leaders and deputy group leaders.

, and just a recorder, don’t bring others, what do you think?"

Dr. Sha from the mixed certificate group said: "This proposal is good. If there are too many people, it will not only delay time, but also affect other people's rest."

Dr. Sha is Professor Sun's first graduate student and has rich experience in traditional Chinese medicine in treating tumors. Professor Sun specially called him to check the research team.

Seeing that everyone nodded in agreement, Huang Su said, "Since everyone agrees, let's start today's rounds."

Huang Su did this to prevent foreign thieves from making up for the research team.

Since the last time an islander appeared in the registration clinic, Huang Su has been on guard against the islander.

The islanders will never give up easily, they will definitely have a backup plan.

Although we cannot prevent thieves for a thousand days and cannot guarantee that there will be no accidents, we can also minimize the spread of prescriptions. In the research team, including him, there are only eight people who know about prescriptions.

"Senior Brother Sha, let's start with your mixed certificate team today." Huang Su stood up and swept over everyone present and said, "The workload will be a bit big today, thank you for your hard work."

There are more than 300 patients in the three research teams. They need to check them as quickly as possible, and the workload is indeed relatively large.

The group walked out of the conference room and walked towards the ward of the mixed certificate group. The ward of the mixed certificate group was on the third floor.

The hospitalization in the new building of the city hospital has eight floors, with two research groups on the first floor, occupying the second to seven floors respectively. The wards on the eighth floor are divided into traditional Chinese medicine departments to receive tumor patients in grassland city.

The group walked into Ward 301, and Feng Su first checked the notes at the end of the bed.

It says:

Name: Cheng Dong.

Age: 69 years old.

Symptom type: internal stasis and toxicity syndrome + qi and blood deficiency syndrome.

Each bed in the research group contains basic information and syndrome classification.

Seeing a group of doctors coming in, the family members who were accompanying Cheng Dong stood up and said, "Doctor Sha, hello to everyone!"

Fei Su took out Cheng Dong's gastric lens from the information bag at the end of the hospital bed and checked it out.

On each bed, there will be a patient's file folder, which contains the patient's medical records and all gastroscopy films within half a year, which is convenient for doctors to check.

Dr. Sha introduced the patient's condition to Fei Su: "Cheng Dong had many years of gastric ulcers, and suddenly felt a tingling pain in the stomach in March today. After gastroscopic biopsy, it was gastric adenocarcinoma. The small curvature of the stomach was 1.5cm away from the cardia and the size was 6cm.

×3.5cm×1cm, cancer tissue infiltrates the fat on the serous surface."

The cardia is the mouth where food enters the stomach, while the pylorus is the mouth where digested food residues enter the intestine.

Dr. Sha pointed to the gastric lens and said, "Look, the cancer thrombus and nerves in the vascular system have cancerous tissues, and the lymph nodes in the stomach can show signs of cancer cells metastasis."

Invasive adenocarcinoma is a concept relative to in situ adenocarcinoma. It is an subtype of adenocarcinoma. When adenocarcinoma cells penetrate the basement membrane of the epithelium and infiltrate deep into the basement membrane, it is called invasive adenocarcinoma.

Different adenocarcinomas are present. If the adenocarcinoma invades, it has the opportunity to enter blood vessels and lymphatic vessels, and lymphatic tracts and blood tract metastasis may occur.

After invasive adenocarcinoma is diagnosed, active treatment is required. Early invasive adenocarcinoma can be treated with surgical resection. After the operation, postoperative adjuvant chemotherapy can also be performed based on the pathological reward results.

The patient has gastric adenocarcinoma metastasized to the gastric curvature lymph and is no longer able to remove cancer cells through surgery. He has to control the development of the disease by using systemic treatment methods such as chemotherapy.

Invasive adenocarcinoma is a more difficult cancer in traditional Chinese medicine because this cancer is easy to spread and spreads very quickly. As long as it enters the blood vessels, it can spread cancer cells throughout the body.

Looking at Cheng Dong, who was covered in color and pale lips on the bed, Huang Su frowned slightly and asked, "When can the patient arrange chemotherapy in his current physical condition?"

Dr. Sha said: "The patient's qi and blood deficiency are quite serious. We have added Bazhen Decoction on the basis of Taohong Siwu Decoction and Sei Xiao San. I guess we have to take it for another month."

After listening to Dr. Sha’s explanation, Feng Su frowned even deeper.

In one month, no one can guarantee what will happen. Patients with this type of invasive adenocarcinoma really metastasize quickly, spread quickly, and people walk faster.

Seeing Huang Su's expression, Dr. Sha also knew what Huang Su was worried about and explained: "Junior Brother Huang, don't worry, the family members have a very good mentality, as long as we try to treat it as much as possible. After the patient was diagnosed, they found many hospitals, but none of them were available.

We are the only ones who are willing to accept it.”

Huang Su nodded, walked to Cheng Dong and sat down, picked up his arm, put three fingers on the three parts of the cun Guan and Chi, and tried hard to touch the wrist bone, and there was a pulse. The pulse was beating, and the pulse was hard and thin when it came. This was heavy.

Astringent, thin and weak pulse.

Huang Sufa started to speak, "Open your mouth and I'll take a look at the tongue coating."

Cheng Dong stuck out his tongue and saw that his tongue was slightly smaller, with purple-red tongue with dark ecchymns.

Dr. Sha came over and explained: "The patient's tongue image has improved a lot now. When he first came, his tongue was dark purple."

Huang Su nodded and asked, "Does your stomach still feel stinging when you are eating?"

Cheng Dong said weakly: "Also, but it's much better. Doctor, you don't know that eating is like torture as before. Every time you eat, it seems like a blade is cutting my stomach, especially at night, it hurts.

I can't sleep all night. Now I'm stinging when I eat, and I'm very satisfied."

Qi is the blood leader, and blood follows Qi. Over time, it will cause blood stasis to stop internally. Because blood stasis is tangible, the pain and concentration are often the place where the blood stasis is often refused to press.

Where blood stasis stops, the meridians are blocked and blocked, so the pain is like acupuncture, and severely it will be like a knife cutting.

Symptoms of stomach stasis and internal obstruction, blood stasis is in the stomach, and eating often causes blood stasis, so the pain is severe and eating will be aggravated.

In traditional Chinese medicine theory, since blood belongs to yin, after nightfall, the stomach will suffer pain even if it does not press or eat.

Huang Su nodded and continued to ask, "Will there be any vomiting blood and turning black?"

"The stool is still black, but the blood vomiting has decreased."

Internal obstruction of blood congestion will lead to poor blood circulation and overflow from the pulse. When the stomach qi is upward, blood will be vomited, and when the intestines go down, it will become black.

This is the common symptoms of internal obstruction of stagnation and toxins, such as tingling pain in the stomach, vomiting blood, and dark stools.

"Take the prescription and I'll take a look."

Fei Su took the prescription handed over by Dr. Sha and checked it.

12g peach kernel, 10g safflower, 10g angelica, 10g red peony, 10g raw porridge, 10g Wuling stearum, 15g Salvia miltiorrhiza, 10g Yuanhu, 10g Chuanyizi, 10g Atractylodes, 10g Atractylodes, 12g Orchid cypress charcoal, 12g Blood surplus charcoal,

30g of Crane Grass, 30g of White Flower Snake Tonga, 30g of Knotweed, 10g of Codonopsis Pinelliae, 15g of Atractylodes macrocephala, 15g of Poria cocos, 10g of Chuanxiong, 10g of White Peony, 10g of Rehmannia glutinosa, 10g of Rehmannia glutinosa, 10g of Licorice.

In the prescription, Taohong Siwu Decoction and Hu Xiaosan promote blood circulation and remove blood stasis. With Chuan Lianzi, Yuanhu, and Aconite medicine, strengthen the circulation of qi. When Qi flows, blood flows, vomit blood. When blood flows, black stool can be cured. Then, with Orchid cypress charcoal, blood remains

Carbon removes blood stasis and stops bleeding, and uses cranes, white flower snake tongue grass, and slimming knots to soften and hard.

Finally, Bazhen Decoction is used to replenish qi and blood, so why not use Shiquan Dabu Decoction.

Because the symptoms of internal obstruction of stasis and toxins often cause heat for a long time, ginseng and cinnamon can not be used to help yang and cause dryness and heat. Even Bazhen Decoction has changed ginseng to Codonopsis, which replenishes qi without dryness.

After reading this prescription, Huang Su said: "When we were doing the project design, we didn't think it thoroughly. Patients like Cheng Dong should still be classified as a stasis and internal toxicity syndrome. The fundamental pathogenesis of the patient is still stasis and internal toxicity syndrome.

, the treatment is mainly based on Taohong Siwu Decoction and Xixiao Powder, and other prescriptions are just auxiliary effects."

Dr. Sha comforted: "It is understandable if there are occasional flaws. After all, the Institute of Traditional Chinese Medicine and five major universities are combined with the State Council, and it is impossible to think about everything in a comprehensive manner at such a large scale."

Afterwards, Feisu checked two other patients in the same ward before leaving Ward 301.

The rounds lasted until around 8 o'clock in the evening before the mixed certificate group was inspected.

Feng Su simply had supper, returned to the dormitory, had just taken a shower, and was ready to go to bed.

After going through the rounds one day today, Huang Su felt very tired, not only physically but also mentally. This would take at least two days.

Huang Su was just lying on the bed when the cell phone on the table suddenly rang. He got out of bed and picked up the cell phone. He saw that it was Professor Sun who called.

He patted his forehead gently and couldn't help but blame himself in his heart. He was so busy that he forgot to report to Professor Sun about the situation of the grand rounds today.

Huang Su hurriedly answered the phone and said, "Teacher!"

Professor Sun's voice came from his hand and asked, "Huang Su, how was the situation in the rounds today?"

"Today we only checked the mixed certificate team. I have just finished the rounds and returned to the dormitory. It is estimated that it will take two days to complete the check."

Huang Su then explained the situation of the rounds today to Professor Sun in detail, and finally said: "Teacher, I only found out after the rounds today that there were some problems in our grouping."

Professor Sun said with great interest: "Oh! What problem did you find?"

Huang Su said: "I think there are some problems with our mixed-certificate group. Today, I found that many patients in the mixed-certificate group have developed qi and blood deficiency because of the long-term illness of other syndromes.

Moreover, everyone has different conditions for both qi and blood deficiency. For mild cases, Siwu Decoction and Ginseng Jianpi Pills, and for slightly severe cases, Bazhen Decoction, and for Shiquan Dabu Decoction, there is no need to use Shiquan Dabu Decoction at all."

After a little rest, Fei Su continued to explain: "Today, I found that one-third of the patients in the mixed-certificate group should be classified into other syndrome groups, rather than hastily directly classified into our research group."

On the phone, Professor Sun said: "It's great to find these mistakes. The main purpose of our project this time is to explore a path for evidence-based medicine in traditional Chinese medicine. We should not be afraid of mistakes. As long as we find mistakes, summarize mistakes, and future
To be continued...