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1 一般资料 本组收治胆道蛔虫病38例,其中男24例,女14例,年龄在7～39岁,其中12～24岁25例,平均18岁。多见于儿童、青年。 胆道蛔虫病人由于高热、胃酸降低,导致胃肠功能紊乱,或服不足量祛蛔虫药物,影响了蛔虫的生活环境,因蛔虫有喜碱恶酸和钻孔的癖性,于是,向上窜动入胃、入胆道。虫动则痛虫静则止,如此反复发作。久之引起感染、化脓、出血导致肝脓肿、胰腺炎、化脓性胆管炎、胆道出血等并发症。虫入胆道伏死而不动,不影响肝胆疏泄功能,称之为“隐型”。 辨证分型;①气滞血瘀型:右上腹“钻顶”绞痛,阵发性发作,腹软喜按。病因病机:脾胃虚寒蛔虫上窜入膈。②肝胆湿热:发热、黄疸、腹痛拒按。肝胆气滞血瘀,郁而化热。⑧脓毒败血型,中毒休克,肝胆湿热,伴高热,吐血便血,神志恍惚,亡阴、亡阳。病因病机:蛔虫入膈,气滞血瘀化热,湿热壅结,热腐酿脓,毒入营血或热伤血络。④隐型:蛔虫伏死胆道,不影响肝胆疏泄。
1 General Information The group received 38 cases of biliary ascariasis, including 24 males and 14 females, aged 7 to 39 years, of which 25 cases of 12 to 24 years old, with an average of 18 years. More common in children, youth. Biliary ascariasis patients due to high fever, gastric acid decreased, leading to gastrointestinal disorders, or lack of administration of roundworm drugs, affecting the living environment of roundworms, because of roundworm hi caustic soda and drilling habit, so up ran into the stomach, Into the biliary. Insect pest movement is static, so repeated attacks. A long time caused by infection, suppuration, bleeding led to liver abscess, pancreatitis, suppurative cholangitis, biliary bleeding and other complications. Insects into the biliary flushes and does not move, does not affect the function of liver and gallbladder catharsis, called “invisible.” Syndrome differentiation; ① qi stagnation type: right upper quadrant “drill top” colic, paroxysmal attack, abdominal soft hi press. Etiology and pathogenesis: Deficiency of spleen and stomach worms on the channeling into the diaphragm. ② hepatobiliary fever: fever, jaundice, abdominal pain refused to press. Hepatobiliary Qi stagnation, Yu and heat. Septic sepsis type, poisoning shock, liver and gallbladder heat, accompanied by fever, vomiting and blood in the stool, trance, death yin, Yang. Etiology and pathogenesis: roundworm into the diaphragm, qi stagnation of blood stasis, dampness knot, hot rot of brewing, poisoning into the camp blood or hot wounds. ④ invisible: roundworm lazy biliary, does not affect the liver and gallbladder catharsis.