The tongue is dark and pale, and there are generally three reasons for this tongue sign, such as food accumulation, liver stagnation and blood stasis, and internal arrest of dampness.

The so-called food accumulation, uncontrolled diet or abnormal spleen and stomach acceptance and decay, resulting in food stagnation in the stomach and intestines after eating, which can cause symptoms such as swelling and pain, belching and acid swallowing, vomiting and sour and rotten food, thus causing the tongue to be purple and dark and white and greasy.

If you have food accumulation, you can take drugs such as Baohe Pill and Citrus Citrus Pills to eliminate food and reduce the accumulation and relieve the symptoms.

The liver stagnation and blood stasis are due to the lack of liver qi and blood flow, which can be manifested as purple and dark tongue and white greasy on the tongue.

As for the internal stagnation of dampness, it is a deficiency of righteous qi in the body, resulting in the obstruction of muscles, joints, meridians, and paralysis.

Li Yuquan's situation is more serious, and there are all three reasons above.

"Look at it."

Lu Xuan gave up his position to Su Kenan.

In this regard, Li Yuquan was not surprised, but Li Jueying frowned, but opened her mouth and still didn't say anything.

After all, it is essential for new doctors to accumulate clinical experience, but it is the first time she has seen it in the health center.

Su Kenan nodded obediently, changed positions with Lu Xuan, checked the pulse, and looked at Li Yuquan's tongue again, thinking secretly.

And Lu Xuan was there listening to his heart, comparing whether his judgment was accurate.

After a while, Lu Xuan came back to his senses and asked, "How is it?" ”

Su Kenan blinked: "His pulse seems to be a little complicated. ”

Lu Xuan smiled, his pulse was heavy and thin, could it not be complicated?

"There are three kinds of pulses for this old man." Lu Xuan reminded.

"Three ......"

Su Kenan thought for a while and said, "The pulse is fine......"

After groaning, Su Kenan looked at Lu Xuan as if asking for help.

Lu Xuan also knew that it was really a little difficult for Su Kenan to judge Li Yuquan's pulse, so he said directly: "The pulse is heavy and astringent, and the judgment of the fine pulse is relatively simple, and the Shen pulse and the astringent pulse do not have a certain amount of experience, so it is relatively difficult to judge." ”

Su Kenan looked lost.

"In fact, if it is a single pulse, whether it is a thin vein, a Shen vein or an astringent vein, it is not too difficult to judge, but Old Man Li's pulse is three, and it is normal for you to not be able to judge."

Lu Xuan comforted, if anyone can easily judge such a complex pulse, then Chinese medicine does not need any clinical experience, and can become a generation of famous doctors by self-study.

The reason why Chinese medicine is more difficult to learn than Western medicine is that it is difficult in these places.

Without a certain amount of experience, it is simply impossible to be prepared to judge.

The reason why Lu Xuan was able to judge it was mainly because he had been exposed to these three pulses during this time, otherwise he would probably not be much better than Su Kenan half a month ago.

Hearing this, Su Kenan nodded slightly.

Lu Xuan continued: "If you know the pulse, you can judge a lot of things, I believe you should understand, but before talking about Old Man Li's situation, I will first talk about how to distinguish and treat bile reflux gastritis after gastrectomy." ”

As he spoke, Lu Xuan looked at Li Yuquan: "Old man, I may have to delay you a little time." ”

If you want to talk about it, you have to ask for the patient's opinion.

If the patient is in a hurry, then he will not talk about it, and mention it to Su Kenan when he is free.

Fortunately, the old man Li Yuquan didn't care about this, not only did he not object, but he also showed a strong interest in it: "It's okay, I just want to listen to it too." ”

"Thank you, old man."

Lu Xuan thanked him, immediately sorted out his words, and continued: "Generally speaking, after gastrectomy and gastrointestinal anastomosis, the probability of patients developing acid bile reflux gastritis is very high. Among them, the incidence of gastrectomy after Billlroth II is two to three times higher than that of Billlroth I.

Bile reflux occurs mainly due to the loss of pyloric function or incomplete pyloric closure after the above surgery. ”

Speaking of this, Li Yuquan thought for a while and asked, "Doctor Lu, when I was in the hospital, I heard that some people have not had these surgeries, and they will have bile reflux, why is this?" ”

Lu Xuan didn't expect Li Yuquan to ask about this matter, but the other party was curious, and he also knew everything: "In fact, the reason is very simple, some patients have no history of surgery, but if the pylorus is not closed, the contents of the duodenum can still reflux into the stomach, causing reflux gastritis."

If the gallbladder is removed, the function of storing bile is lost, and bile continues to flow into the duodenum. After gastrectomy, bile reflux into the stomach is the most common postoperative complication. ”

"I see."

Li Yuquan suddenly realized, and then looked at Lu Xuan: "I have been taught." ”

If it were another doctor, they wouldn't have told him so much.

At most, he will tell him what would happen if he did not have this surgery, and rarely tell the patient what kind of postoperative complications would occur after this surgery.

Lu Xuan nodded slightly and continued: "Generally speaking, patients with bile reflux gastritis will have symptoms such as abdominal and stomach billing, burning, and pain, and the swelling pain is aggravated after eating. ”

"For example, after eating greasy, it will be disgusted, vomit bile, and after vomiting, the stomach will be slightly moderate, due to gastric emptying disorders, vomiting mostly occurs after eating or in the second half of the night, and the vomit can be accompanied by undigested food, or occasionally a small amount of blood.

For fear of aggravation of symptoms after eating, many patients will reduce their diet, resulting in weight loss, diarrhoea, malnutrition, and even anemia, head volume, fatigue and weakness of the whole body and limbs, sweating, etc. ”

"But ......"

"But what?"

Lu Xuan changed his words and looked at a few people in the eye examination room: "There is no such thing as reflux gastritis in the concept of traditional Chinese medicine, but this kind of disease is included in traditional Chinese medicine "stomach pain", "vomiting acid", "noisy" and the like.

The pathogenesis is mostly related to the liver loss and discharge, the transverse reversal of the soil and the stomach, and the reversal of bile qi with the liver qi is big, dry and bitter.

However, gastrectomy complicated by gastric cautery and vomiting of bitter acid water is only formed after surgery due to loss of pyloric function or incomplete pyloric closure. Of course, there is also stomach distension and stomach pain due to inflammatory changes in the local anastomosis, and bile reflux. ”

Speaking of this, Lu Xuan thought for a while, and said: "There are ancient medical books, and there is a saying in "Su Wen • Meteorological Theory of Ordinary People": "The normal qi of ordinary people is in the stomach, and the stomach is the normal qi of ordinary people.

The so-called people who have no stomach gas, but they have their real visceral veins, and they can't have stomach gas.

For example, it is also said in the "Lingshu Accounting" that there are five entrances and exits that are connected with the stomach qi: pharyngeal gate, cardia gate, pyloric gate, valve valve, and soul gate.

The ancients believed that food and drink entered from the mouth, through the pharynx, esophagus, cardia, stomach, pylorus, small intestine, large intestine and anus, and any problem in any of these links would affect digestion and excretion.

It has been recorded in some ancient books that when the ancients dealt with these diseases, they first used surgery to cut the skin, dissolve the muscles, trick the veins, knot the tendons, the marrow brain, the famine, the claw curtain, the decoction of the stomach and intestines, and the technique of rinsing and cleansing the five victories. ”

Speaking of this, Lu Xuan couldn't help but sigh.

The reason why traditional Chinese medicine has declined in modern times is that on the one hand, it is because Western medicine has risen too fast, and on the other hand, the loss of many of its own medical skills is also the key, especially when it comes to the content of traditional Chinese medicine surgery, which has lost the most, which has also led to the fact that traditional Chinese medicine cannot be comparable to Western medicine in terms of surgery.

Li Yuquan was stunned for a moment, and then sighed: "It's a pity, otherwise, if it exists, it should be a blessing for many patients." ”

Speaking of this, Li Yuquan couldn't help but look at Lu Xuan again: "However, I didn't expect Doctor Lu to know so much, no wonder his medical skills are so good." ”

"The old man praises it."

Lu Xuan subconsciously hugged his fists and thanked him.

Li Yuquan thought for a while and asked, "Doctor Lu, what does my illness seem to you to be?" ”

Hearing this, Su Kenan also pricked up her delicate little ears and looked serious.

Lu Xuan groaned and said, "From the perspective of traditional Chinese medicine, bile reflux gastritis after gastrectomy can be divided into four types.

The first is the weakness of the spleen and stomach, people with weak spleen and stomach often can't rise in temper, stomach turbidity can not fall, and the turbid juice of the gallbladder refluxes in the stomach and causes the upper abdomen to be swollen, burning, painful, nausea, vomiting, and acidic water.

People with weak spleen and stomach should first consider strengthening the spleen and invigorating qi, the spleen is mainly transported, and the stomach is mainly accepted.

If the stomach turbidity is blocked, the bile turbidity cannot descend and will inevitably go up to the stomach, and the turbidity and decay will cause burning and pain.

Therefore, such patients need to replenish qi and strengthen the spleen, so that the lifting machine can be restored, and the rotten things in the stomach will naturally decline smoothly, so as to treat the root cause and the symptoms. ”

After Li Yuquan heard this, his brows furrowed slightly, obviously not quite understanding.

After all, he is not a medical student, and he doesn't know much about Chinese medicine, and he can probably understand what Lu Xuan says, but it is impossible to say that he can fully understand it.

On the other hand, Su Kenan, while frowning lightly, a trace of joy appeared on her delicate face.

She has learned a lot of what Lu Xuan said, but no one has explained it in such a systematic and detailed way.

All-in-one.

Su Kenan quickly understood the meaning.

"What about the second one?" Although Li Yuquan couldn't fully understand, he knew that the first thing Lu Xuan said should have nothing to do with him, so he continued to ask.

"Phlegm and dampness block the stomach."

Lu Xuan recalled and continued: "Su Wen Linglan Secret Classics Yun: The stomach, the official of the warehouse, the five flavors are out.

Today's stomach is completely removed, so the cangological inspection is missing, and the five grains can not be accepted normally, because the pyloric closed function is out of appointment, the pyloric portal is relaxed, and the bile is naturally easy to reflux into the stomach, and the gastric capacity is too small, and there is local traumatic inflammation, so the spleen and stomach function is greatly reduced and it is easy to damp and obstruct Zhongzhou.

If it is wet for a long time, it is easy to concentrate phlegm, and if it is damp and turbid for a long time, it will turn into heat, so such patients often have burning, nausea and vomiting, and the bile contains food residues with a fishy smell and bad smell.

The reason is very simple, the gall master hides the soul, and the gall is weak and cannot hide the spirit, so the heart is upset, dreamy, and unhappy.

Dampness obstruction in Zhongzhou, liver and spleen lifting dysfunction, dereliction of duty, so upper abdominal distension and discomfort.

Although the stool is formed, it can be too hot and humid, and the stool is naturally fishy and smelly.

The treatment is to strengthen the spleen, remove dampness and clear heat, so that the spleen is healthy and turbid.

The gall is the fire of the young yang, so that the gall qi descends, the heat is self-removed, the humidified heat removes phlegm and self-dissipates, and the turbidity is divided.

For the treatment of patients with phlegm-damp obstructive gastric bile reflux gastritis, the first choice is Huanglian warm bile decoction with flavor.

Coptis chinensis, Zhuru clear heat and gallbladder and stomach, Atractylodes macrocephalus, Poria cocos, Banxia, Koren, Jishi strengthens the spleen and invigorates qi, and self-removal of dampness, which can also adjust the intestinal activity, increase the tension of the intestinal tract and affect the flow of bile, and can promote gastrointestinal peristalsis and enhance the ability of gastric emptying.

The combination of angelica, white peony, baiqi and licorice can not only protect the wound mucosa, but also reduce the excitability of the vagus nerve, improve the tension of the pyloric sphincter, and control bile reflux. This formula has a miraculous effect on phlegm-dampness obstruction of the stomach and the postoperative symptoms of gastric cancer. ”

Li Yuquan is more and more interesting to listen, sighed: "I didn't expect our Chinese medicine to be so broad and profound, I used to hear that Chinese medicine looks at sick people, and treats people as a whole, I still don't believe it, now it seems that I underestimated the treasure of my country." ”

Li Yuquan may just think that Lu Xuan is rich and rich, after all, he is just shocked to listen to too much content, but most of them are not too comprehensible.

But Su Kenan is different, she is a medical student, and she is also a student of the University of Chinese Medicine, so she naturally knows how important what Lu Xuan said is to a Chinese medicine practitioner.

This kind of opportunity is simply not possible in school.

The tutor will not speak in such detail, or in other words, the tutor may not be as knowledgeable as Lu Xuan, and I am afraid that he does not know as much as Lu Xuan, so he can't say it if he wants to.

She quickly typed these contents into the computer file, and where she didn't have time, she memorized it in her head, and even turned on the phone recording a long time ago, planning to go back and digest it well.

These experiences are invaluable.

To put it mildly, today's class alone is enough for any Chinese medicine practitioner to use for a lifetime.

How many people have stomach cancer today?

There are too many to count.

For patients with gastric cancer, not to mention all of them, most of them have undergone gastrectomy in the end, and there are definitely many cases of bile reflux after surgery.

If you can integrate what Lu Xuan said, this skill alone is enough to lay a territory of your own in the field of traditional Chinese medicine.

You can't learn these things in school.

Even if you go to a big Chinese medicine hospital, if anyone understands it, even if someone really understands, it may not necessarily be mentioned.

Learning to apprentice and starving to death of a master, there are too many such things in the field of Chinese medicine.

Of course, this is true not only in the field of Chinese medicine, but also in other fields, and the same is true in Western medicine.

There will always be some people who are reluctant to pass on what they have learned to others, resulting in a lot of technology being lost.

But this is also a helpless thing, after all, people are egoists.

To some extent, Lu Xuan is really generous.

Not only did he say it, but he said it very clearly, without a trace of reservation.

There are Chinese medicine practitioners like Lu Xuan who are willing to teach them, but there are definitely not many.

At this moment, Su Kenan looked at Lu Xuan's pupils, and a light became brighter and brighter.

What else will he do?