{"id":9240,"date":"2024-06-06T01:51:58","date_gmt":"2024-06-06T01:51:58","guid":{"rendered":"https:\/\/tcmdrma.com\/%e3%80%90%e5%8c%bb%e6%a1%88%e3%80%91%e4%b8%ad%e8%8d%af%e6%b2%bb%e7%96%97%e5%a4%9a%e5%b9%b4%e5%92%b3%e7%97%b0%e8%83%b8%e9%97%b7\/"},"modified":"2025-05-09T10:45:33","modified_gmt":"2025-05-09T00:45:33","slug":"%e3%80%90%e5%8c%bb%e6%a1%88%e3%80%91%e4%b8%ad%e8%8d%af%e6%b2%bb%e7%96%97%e5%a4%9a%e5%b9%b4%e5%92%b3%e7%97%b0%e8%83%b8%e9%97%b7","status":"publish","type":"post","link":"https:\/\/tcmdrma.com\/zh-hans\/%e3%80%90%e5%8c%bb%e6%a1%88%e3%80%91%e4%b8%ad%e8%8d%af%e6%b2%bb%e7%96%97%e5%a4%9a%e5%b9%b4%e5%92%b3%e7%97%b0%e8%83%b8%e9%97%b7\/","title":{"rendered":"\u3010\u533b\u6848\u3011\u4e2d\u836f\u6cbb\u7597\u591a\u5e74\u54b3\u75f0\u80f8\u95f7"},"content":{"rendered":"

患者，男，亚裔，54岁，主诉为十多年的咽部不适及清嗓子，同时两年前感冒之后咳嗽一直未好，具体表现为：呼吸时可闻杂音，清嗓子一直清不干净。胸部发紧，按压则舒服，位置大概在天突与膻中穴之间。有小颗粒的白色浓痰，非常难咳出。咽喉部有砂砾样异物感。嗓子干，喜饮水，胃反酸，小便频多，平日睡眠较晚，不饥不困。另有花粉症。舌中后部苔偏厚，舌下静脉迂曲。脉整体偏沉数紧弦，右寸沉位有力，右尺略弦硬。<\/p>\n

此患者存在多个方面的问题，先解决肺的问题为主，集中在宽胸理气，化痰降肺气同时兼顾瘀血。<\/p>\n

第一周用药后，患者非常高兴，反馈哮鸣音消失，胸口紧张明显改善，小颗粒痰基本消失了，睡眠有所好转，晚上有困的感觉了。第二周用药后，患者说已经感觉跟生病前已经没有什么差别了。但摸脉虽已大好，还未彻底改善，嘱咐继续用药巩固。<\/p>\n

这里讨论几点：<\/p>\n

其一，俗话说：病来如山倒，病去如抽丝。对于慢性病的治疗，由于此患者是实证，所以获效很快，但是要想把病根完全去除，是需要患者有耐心多花些时间的。<\/strong>一般来说，对于非虚性疾病的治疗，前70%的症状改善，可能只需要花30%的时间，但后30%症状的改善，有时候需要花掉70%的时间。<\/p>\n

其二，脉证的重要性在这个案例里面也有明显的体现。虽然患者感觉如常了，但是只有通过摸脉感受脉气，才能最真实客观地反应患者改善的程度。如果忽视了脉的重要作用，只用方证相应的思维去处方，就无法准确评估已经”不体现为症状的<\/strong>“患者的病情。<\/p>\n

 <\/p>\n

 <\/p>\n

注意：中医根据个体差异所采取的治疗手段和治疗效果亦有差异，医案分享不构成治疗建议。<\/p>\n

\n

医案编号：077<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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