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(一)胆道蛔虫病李某某,男,23岁。1976年6月17日初诊。患者原有肠蛔虫病史。昨日突然起病,右上腹部阵发性绞痛,并向右肩、背放射,伴有恶心呕吐,吐出蛔虫,不能进食,大便未解。检查:上腹部剑突右下方按之痛,但无“极状”感,1‰肾上腺素滴眼试验(-),舌红苔黄,脉象弦数。此乃蛔虫钴入胆道,使肝气郁闭,胆气不行所致。治当疏肝利胆,通降止痛。方用大柴胡汤化裁:柴胡10克炒黄芩10克姜半夏10克大黄15克炒枳实10克白芍15克炙甘草6克郁金10克广木香10克川楝子15克乌梅15克,水煎服。服2剂后,大便通畅,排出蛔虫13条,腹痛缓解,余症消失,病告痊愈。随访半年,病未再发。按:胆道蛔虫病,类似中医之“蛔
(a) Biliary tsutsugamushi disease Lee Mou, male, 23 years old. Newly diagnosed on June 17, 1976. The patient had a history of intestinal worm disease. Sudden onset yesterday, paroxysmal colic in the right upper abdomen, radiation to the right shoulder, back, accompanied by nausea and vomiting, vomiting of worms, inability to eat, unsolved stool. Examination: The pain in the right lower part of the xiphoid process in the upper abdomen was not painful, but there was no “polar” feeling, a 1-adrenergic eye drop test (-), red tongue yellow coating, and pulsed string numbers. This is due to the locust cobalt entering the biliary tract, causing liver qi to close and gall bladder not working. Governance when liver and gallbladder gallbladder, pass down to relieve pain. Side with large Chai Hu Tang : Rhubarb 10 grams fried Astragalus 10 grams ginger Pinellia 10 grams rhubarb 15 grams fried Gorgon 10 grams Acacia 15 grams Baked Licorice 6 grams Yujin 10 grams Guang Mu Xiang 10 grams Chuan Qi Zi 15 grams Wu Mei 15 grams, Shuijianbi. After taking 2 doses, the stool was open, 13 worms were discharged, abdominal pain eased, the remaining symptoms disappeared, and the patient was cured. Follow-up for six months, the disease did not recur. By: biliary tsutsugamushi disease, similar to traditional Chinese medicine