Song Qian picked up a pack of cotton swabs, glanced at Uncle Li's throat again, and found that the latter's tongue texture had changed slightly, it was more ruddy than before, and the tongue coating was not so white.

After the examination, Song Qian asked Uncle Li again about his urine and bowel movements.

Uncle Li smiled with satisfaction: "The constipation is much better than before, and it is much smoother when I go to the toilet." ”

"What about the diet?"

"It's still not good, I can't eat much." Uncle Li stretched out his fist as he spoke, and said with a bitter face: "I can only eat fist-sized meals at every meal, and if I eat too much, my stomach will be swollen terribly, and I will burp at every turn, and a smell will rush out of my stomach." ”

"Huh?"

"Alas, I can only eat so little, I can't eat it." Uncle Li nodded and said, "Before I got a stomach ulcer, my appetite was always good, but then it slowly stopped." People also begin to lose weight day by day. ”

"Uncle Li, are you having indigestion?" After thinking about it for a while, Song Qian came to his own judgment.

"Well, I think so, the doctor prescribed me probiotics, but the effect is not great, and I still can't eat more."

After Song Gan empathized with "sigh", he suddenly remembered that Uncle Li had been taking "omeprazole", and said seriously: "Uncle Li, do you usually have acid reflux symptoms?" Omeprazole is still eating, right? How long have you been eating? ”

"I didn't have acid reflux symptoms. That omeprazole I've been taking. As for how long I ate it, I can't remember it. Anyway, I'm eating it intermittently. ”

"Oh." Song Qian pondered for a moment and said, "Uncle Li, have you had a gastroscopy?" ”

Without waiting for Uncle Li to answer, Li Shengli stepped forward and said, "I've done it, I've done it, I did it once last year." ”

"Is the result still there?"

"Well, it turned out in my phone."

"Show me."

"Okay." Li Shengli unlocked the phone as he spoke, and then rummaged for a while before handing the phone to Song Qian.

Song Qian took the mobile phone and quickly browsed the examination results, and already had a plan in his heart, but for the sake of safety, he ordered Uncle Li to lie flat on the bed, and pressed it in several key positions on the stomach, and when he saw that there was no abnormal reaction, he immediately relaxed.

After the examination, Song Qian sorted out Uncle Li's basic condition in his heart, and Western medicine diagnosed him with gastric ulcer bleeding and atrophic gastritis.

In terms of traditional Chinese medicine, Uncle Li temporarily suffered from stomach pain and did not show symptoms of bleeding. At present, it should be mainly stomach pain, spleen and stomach deficiency and cold syndrome combined with qi deficiency and blood stasis syndrome, and the treatment should be mainly to strengthen the spleen in warmth, promote blood circulation and eliminate blood stasis, but because Uncle Li has had many ulcer bleeding, it is very likely to cause bleeding again, so he can only choose traditional Chinese medicine to dispel blood stasis and stop bleeding.

After sorting out his thoughts, Song Qian chose Astragalus Jianzhong Tang as the main recipe, and then added people to strengthen the spleen and invigorate qi, and then according to the idea of dissolving blood stasis and stopping bleeding, he chose Panax notoginseng, Baiji, Puhuang and other blood stasis and hemostatic drugs.

In addition, Uncle Li has very serious symptoms of indigestion and bloating, which also need to be dealt with, and it is necessary to add some Chinese medicine to promote digestion, such as Jiao Sanxian and Muxiang.

As soon as he considered the indigestion, Song Qian instantly remembered "omeprazole", and immediately reminded: "Uncle Li, your omeprazole, I suggest you can stop using it." ”

"Stop omeprazole?" I don't know if I didn't hear it clearly, or I couldn't believe what Song Gan said, Li Shengli looked at Song Gan with wide eyes and said, "But the doctor told me that omeprazole can't be stopped." ”

Zhu Na on the side heard that Song Gan was going to stop using omeprazole, and she also felt incredible, and asked, "Doctor Song, isn't omeprazole for stomach protection, why are you ......?"

Song Qian smiled when he heard this, and said undeniably: "Omeprazole is a stomach protector, but do you know what its effect is?" ”

Although Zhu Na is a nurse, she still knows a lot about some commonly used drugs in clinical practice, and said confidently: "Omeprazole is a proton pump inhibitor that inhibits gastric acid secretion. ”

"Yes, that's right, omeprazole's gastric function is accomplished by acid suppression. But have you learned about Uncle Li's condition? ”

"What's wrong with Uncle Li's condition, isn't he bleeding from a stomach ulcer? For gastric ulcers, you have to use omeprazole to protect the stomach. ”

Hearing this, Song Qian glanced at the father and son of the Li family on the side, and said unhurriedly: "You are right, but you look at the problem a little too one-sidedly, Uncle Li not only has a stomach ulcer, but after so many years, the stomach has begun to shrink, the gastroscope shows atrophic gastritis, the secretion function of gastric acid is significantly reduced, and there are obvious symptoms of indigestion. ”

Zhu Na was confused by Song Gan's question, and said a little stunned: "What do you mean to kill them all?" ”

"I mean Uncle Li's condition has reached the point of atrophic gastritis, the secretion of gastric acid has declined, and the secreted gastric acid is not enough to digest food.

How can Zhu Na have such eloquence as Song Gan, besides, she studied nursing, and she only has a general understanding of clinical medicine, and now she can hear Song Gan's merciless rebuttal, which can be said to be useless, but out of face, she asked herself: "Then according to what you say, what kind of medicine do gastric ulcer patients use without omeprazole?" ”

Song Qian smiled when he heard this: "Stomach ulcer has reached the point of Uncle Li, of course, you can only use medicine that promotes gastrointestinal motility." However, I kindly remind you that patients with cardiovascular and cerebrovascular diseases like Uncle Li should try to avoid the use of domperidone and choose drugs such as itopride, which has less impact on the cardiovascular system. ”

What medicine is used for indigestion, Zhu Na is naturally clear, except for the probiotics that Li Shengli said in his mouth, that is gastrointestinal motility medicine. Therefore, she is indisputable for Song Gan's remarks, and even thanks Song Gan for his kind reminder, otherwise how would she know that domperidone has an impact on cardiovascular disease!

Therefore, at this moment, Zhu Na's mood towards Song Qian is very complicated, if you want to say hate, today's controversy was caused by herself, and she really can't blame the other party. If you want to admire his knowledge, both his father and grandfather said that he was an absurd fellow, and he didn't seem to be as well-informed.

Li Shengli's father and son opened their eyes wide, and watched the doctors and nurses in a daze, and in their hearts, 10,000 grass and mud horses galloped by, and the opinions between the doctors and nurses were not unanimous! Who does this make me believe what he said?!

Although Li Shengli was a little wavering in his heart, he still had basic judgment, he didn't understand the words of the young nurse at all, he didn't understand what proton pump inhibitors were, and he still knew a little bit about stomach acid, and the human digestive function was to rely on stomach acid to digest food.

However, when I heard Song Qian say that his father's indigestion and weakened digestive function were caused by too little gastric acid secretion, it was definitely impossible to suppress gastric acid secretion.

Li Shengli doesn't understand medical things, but he still has a basic judgment. After self-analysis, he still felt that what Dr. Song said made sense.

Seeing that Zhu Na was silent, Song Qian wrote the name of the Chinese medicine that was not available in his medicine cabinet on a slip of paper and asked him to go to the pharmacy to grab the medicine.

Zhu Na took the note, and left the clinic as if she had been pardoned.

After Zhu Na left, Song Gan said to the Li father and son with an apologetic face: "Two, I'm really sorry to let you laugh." ”

Li Shengli smiled a little unnaturally when he heard this: "It's not in the way, the medical problems are already very complicated, and it is still necessary to discuss them with each other." ”

Song Gan quickly looked at Li Shengli when he heard this, he didn't expect this guy to have a reasonable side, before he was reborn, he was miserable enough, a chameleon who was alive.

When you can't cure your illness, they will speak ill of you everywhere, and they can't wait to put you to death. Now I see the hope of treatment, but I am smiling and reasonable.

This is the naked reality.

Therefore, if doctors want to gain the respect of patients, the best way is to improve their self-ability and self-cultivation. Only self-improvement, it is difficult for patients to disrespect you.

Song Qian smiled faintly, he didn't care too much about Li Shengli's words, and he didn't get carried away because of this, and even put on a posture of not letting anyone enter.

Song Qian is very clear about his position, no matter how many patients come to see him in the future, no matter how many people praise him, he can never forget that he is just a little-known little doctor, a little doctor rooted in the clinic and the grassroots.