Zhang Jingcai pushed the door in.

Hearing the movement behind him, Gu Huahua turned off the screen, put his phone aside, looked at the computer screen in front of him, and sat upright.

Zhang Jingcai walked behind Gu Huahua with a smile, patted him lightly on the shoulder, and said kindly: "Xiao Gu, don't be nervous, this is not a hospital, there are not so many rules, as long as you don't delay things, it doesn't matter if you play with your mobile phone when you're bored."

If there is anything you don't understand, you can write it down, and ask when you have time, and when you see a doctor, I will also say some special situations.

I probably also understand your situation, hard work is hard work, but the foundation is still a little not solid enough, many things that should be remembered have not been remembered, this should not be done, it must be changed. ”

Zhang Jingcai's palm suddenly fell on Gu Huahua, Gu Huahua's body trembled, and he turned his head a little nervously, but he saw a scene that he would never forget in this life.

Behind Zhang Jingcai, isn't the young man standing his old classmate Lu Xuan?

Gu Huahua was stunned, but quickly reacted, he didn't say anything, but subconsciously turned his head to look at Zhang Jingcai, and hurriedly said, "Doctor Zhang, I will definitely change." ”

"It's good to change."

Zhang Jingcai smiled slightly: "Let's sit down first." ”

Gu Huahua sat down, but after sitting down, he glanced at Lu Xuan suspiciously.

Why did he come in with Zhang Lao, could it be that he came to see Zhang Lao?

Gu Huahua glanced at the computer screen with his spare eyes, but did not find Lu Xuan's name, so he looked back at Lu Xuan.

Lu Xuan had long known that Gu Huahua was here to be an assistant to Zhang Lao, so naturally there was no accident, he greeted Gu Huahua with a smile, and at this moment, Zhang Jingcai suddenly looked at Lu Xuan and said, "Doctor Xiao Lu, let me tell you about the patient's situation first." ”

Lu Xuan turned his head to look at Zhang Jingcai: "Okay, then it's troublesome for Old Zhang." ”

"It's all said that it's okay to call Lao Zhang, what's the matter, Doctor Xiao Lu looks down on me Lao Zhang?" Zhang Jingcai pretended to be angry.

Lu Xuan had no choice but to shout Lao Zhang, Zhang Jingcai didn't say anything, but handed some of the examinations provided by the patient to Lu Xuan: "These are some of the examinations that the patient did before, you sit here and take a look at it first, while watching, I will tell you about some of his conditions, and then talk about how to treat it." ”

Lu Xuan nodded, did not speak, but took some of the checklists handed over by Zhang Jingcai, came to the side and sat down, and looked at them quietly.

Gu Huahua, who was still thinking about how Lu Xuan could come to Zhang's old clinic, heard the conversation between the two, and the expression on his face instantly froze.

"Lao Zhang?"

It is almost impossible for this to appear in Lu Xuan's mouth, and when it came to Gu Huahua's ears at this moment, it was no less than a thunderbolt on a sunny day, which made Gu Huahua's originally somewhat nervous face directly become stunned at this moment, this strange scene made him feel like he was listening to a fantasy story.

Swallowing his saliva fiercely, it took a while for Gu Huahua to react from this strange situation and murmured in a low voice: "What the hell is going on?" ”

Lu Xuan, does he know Zhang Lao?

And......

Gu Huahua could see that the two should not have known each other for a long time, but it gave him the illusion that the two were forgetful friends.

The key is that this scene of peer discussion made him really a little puzzled when Lu Xuan had a relationship with Zhang Lao.

If Lu Xuan has this relationship, when he graduates, he can just come to Liannan Traditional Chinese Medicine Hall to be an assistant to Zhang Lao, why do you still go to the District Hospital of Traditional Chinese Medicine?

He even heard that Lu Xuan had only been in the district hospital for half a year, as if he had been driven away because of some things, but he didn't know where he went.

However, if Lu Xuan knew Zhang Lao, he wouldn't be driven away, right?

Not to mention the district hospital, there is no problem even if you go to the city hospital!

For a while, Gu Huahua's brain was a little mushy.

The situation in front of me is really amazing.

If it weren't for Zhang Jingcai's presence, he would have wanted to take out his mobile phone and ask Ji Xiuwen what was going on, or he would have pulled Lu Xuan out of the consultation room to figure this matter out.

Just when Gu Huahua was full of thoughts, Zhang Jingcai was already introducing the patient's situation to Lu Xuan.

Hearing the elder's voice, Gu Huahua came back to his senses and looked up at the two who were talking.

"The patient had liver discomfort at the beginning of last year, but because it was not serious, he did not go for an examination, and it was not until August that he went to the hospital for abdominal ultrasound and CT, and you can see the results of the examination.

The right lobe of the liver occupies a mass of 2.9 cm x 2.5 cm, portal vein cancer thrombus x 0.8 cm, ascites is moderate, splenomegaly, and alpha-fetoprotein is abnormally elevated. ”

Lu Xuan glanced at the B-ultrasound and CT results one by one, looked up and asked, "Does the patient have any past history?" ”

"Yes."

Zhang Jingcai hurriedly said: "I have a history of hepatitis B cirrhosis in the past, and Xiao Sanyang has listened to the patient's self-report for more than 30 years.

I had undergone 2 interventional treatments for right lobe tumors in the hospital before, but because the side effects were too great, the patient refused to undergo further Western medical treatment, and immediately sought help from traditional Chinese medicine.

I've made some notes on other symptoms, so you can look at them. ”

After Zhang Jingcai finished speaking, he handed the patient's medical record to Lu Xuan.

Lu Xuan took it and looked at it.

Symptoms: emaciation, malaise, dry mouth, rash, bloating, joint pain, sluggishness, diarrhea, yellow urine, red tongue, yellow moss, heavy pulse.

However, even though the elder had already made a judgment, Lu Xuan still turned his head to look at the patient: "I'll take your pulse." ”

The patient looked at Lu Xuan for some reason, but did not stretch out his hand, but turned his head to look at Zhang Jingcai: "Doctor Zhang, this ......"

Zhang Jingcai said with a smile: "This is Doctor Xiao Lu, and he is also the attending doctor of the Liannan Traditional Chinese Medicine Association, but on the first day of today, I will ask him to come over and help you take a look." ”

Hearing this, the patient stretched out his arm.

Lu Xuan took the pulse, looked at the patient's tongue, and after a while, he took his hand back.

"How?"

Seeing this, Zhang Jingcai hurriedly asked.

Lu Xuan groaned and said: "Combined with the results of the examination, it should be primary liver cancer, but it has been delayed for a long time, if you come to see it when the symptoms first appear, the treatment effect will be much better, and now, you can only control the non-proliferation and try to maintain the patient's life." ”

Saying this, he is not alarmist.

Primary liver cancer generally has an insidious onset, and the early diagnosis rate is very low, and most of them are already in the middle and advanced stages when they are diagnosed.

The degree of malignancy is very high, and the disease develops rapidly, Western medical treatment measures such as radiotherapy and chemotherapy are insensitive, the treatment effect is poor, and the survival time of patients is only 3 ~ 6 months, which is regarded as the "king of cancer".

The patient in front of me is lucky to be able to maintain such a good condition.

If it were someone else, they might have passed away at this time.

"I'm giving you a similar opinion."

Zhang Jingcai nodded approvingly and continued: "The etiology and pathogenesis of liver cancer attach importance to liver depression and blood stasis, and the liver, spleen and kidney are the same disease.

The occurrence of liver cancer is first responsible for the stagnation of liver qi, the liver stores blood and is used for drainage, the liver qi is regulated, the qi is smooth, the five organs are harmonious, and the six organs are safe.

If the external sensation of six lewdness or seven emotions and internal injuries cause the liver qi to stagnate, and there is no right to discharge, then the internal organs and meridians are out of balance, and the qi is not smooth, resulting in qi stagnation and blood stasis, and the evil poison accumulates into lumps, which accumulates over time.

The spleen is the foundation of the day after tomorrow, the spleen is healthy, the liver qi needs to be regulated, the liver is depressed and the fire is turned into fire, and the wood is strong and the spleen and stomach are offended, which will lead to spleen deficiency;

The liver and kidney are also homologous, the yin of the liver and kidney breeds each other, the liver blood is insufficient, the liver yang is delusional, and the kidney yin is robbed, which will also lead to kidney deficiency.

It begins with stagnation of liver qi and ends with spleen deficiency and liver and kidney yin deficiency.

Therefore, although liver cancer is to blame the liver, it is usually treated with the same disease of the liver, spleen and kidney.

Liver stagnation and blood stasis are the leading factors in the pathogenesis of liver cancer, which runs through the whole syndrome of liver cancer. ”

Lu Xuan looked at Zhang Lao with admiration, a little unimaginable that Zhang Lao, who mainly studies kidney diseases, actually has such high attainments in the liver.

Think about it, though.

Any Chinese medicine practitioner who has a high level of attainment in one aspect will not be bad in other aspects.

Traditional Chinese medicine treats the human body as a whole, and does not say that where the pain is cured, it needs to consider where it is fundamentally willing to come out and prescribe the right medicine.

Just like liver cancer, although the main cause is liver qi stagnation, liver cancer patients, the problem is not only the liver, but also the spleen and kidneys will be implicated because of the liver.

During treatment, it is necessary not only to treat the liver, but also to take into account the spleen and kidney.

"Doctor Xiao Lu, what do you think?"

Lu Xuan's expression did not change, but Gu Huahua's eyes were as wide as copper bells at the moment, and he looked at Zhang Jingcai in disbelief.

Zhang Lao is asking Lu Xuan's opinion?

Really?

Gu Huahua pinched his thigh fiercely, and the huge pain made him know that this was not a dream at all.

For a while, Gu Huahua's eyes when he looked at Lu Xuan were full of surprise and at the same time, he was also more and more puzzled.

He couldn't figure out why Elder Zhang asked Lu Xuan's opinion on this matter.

This is liver cancer!

Among their group, there are very few who have touched the patient's pulse so far, how can they have the ability to treat the patient's syndrome differentiation and treatment!

Isn't this a joke?

When Gu Huahua thought of this, Lu Xuan sighed and responded: "In the concept of traditional Chinese medicine, there is no name for "primary liver cancer", according to the clinical manifestations of patients, it should belong to the categories of "accumulation", "accumulation", "liver accumulation", "fatness" and so on. ”

Zhang Jingcai nodded slightly, and there was no problem with including primary liver cancer in these.

Lu Xuan's voice continued to ring in his ears: "For this kind of disease, there is a relevant introduction in the "Su Wen: Treatise on Lifting Pain": "The cold qi is between the small intestinal membranes, and in the blood, blood crying cannot be injected into the major meridians, and blood and qi are not allowed to be retained, so the old days have become accumulated." ”

In addition, "Su Wen: The Treatise on the Abdomen" also said: "Fu Liang is wrapped in large pus and blood, and lives outside the stomach. ”

Both believe that both accumulation and fugit are related to blood stasis.

The "Jingyue Quanshu" also has the saying that "blood accumulation is tangible and immovable, or hard and refuses to press", indicating that stasis can lead to accumulation.

In "Surgical Authenticity: Ruffianism", there are also some related records: "Ruffians are all caused by excessive internal injuries, qi and blood are reversed, and they are born from agglomeration." At first, there is a small movement in the abdomen, and the traction is painful, and after a long time, it gradually grows and takes shape, and even moves inside. It is undoubtedly also pointed out that ruffians are related to the accumulation of qi and blood.

There is also "Finger Mystery Quanfang Sheng: Zhuji Chapter": "A lump is formed in the abdomen, and it is not moved, and it is not moved." And "Danxi Heart Method: Accumulating Ruffian Blocks" said: "Blocks are tangible things, and they are made of dead blood." And "The Accumulation of Rope and Ink in the Medical Forest" says: "Those who accumulate are also the accumulation of blood." ”

All of these believe that the production of lumps is closely related to blood stasis. Qing Dynasty medical scientist Wang Qingren Lao Zhang may have also heard it, and he believed that "if the abdomen is lumped, there must be visible blood", "Qi is invisible and cannot be lumped, and those who are clumped must have tangible blood, and the blood will coagulate into a lump when it is cold, and the blood will be tormented into a lump when it is heated", which is undoubtedly a step deeper than the understanding of the predecessors.

Tang Zonghai learned Confucianism less, Guangxu fifteen years to raise the jinshi, the director of the Ministry of Rites, middle-aged medical scientist Tang Rongchuan, who only began to contact traditional Chinese medicine, clearly pointed out in the "Blood Evidence Theory and Blood Stasis": "Blood stasis between the meridians and viscera, it is a scum." ”

It can be seen that blood stasis is an important pathological basis for primary liver cancer, and the occurrence of liver cancer is closely related to qi and blood stagnation and vein blockage. ”

After speaking, the consultation room was unusually quiet.

"Before, Lao Zhou told us that Dr. Xiao Lu's understanding of medical books is extremely terrifying, it can be called a mobile hard drive full of medical books, and his understanding of the content is also different from ordinary people, at first we didn't believe it, but now, I really have to believe it."

Zhang Jingcai was really a little frightened.

Although the content of what Lu Xuan said was not much, only a few hundred words, there were as many as seven medical books involved, which did not mean that he could memorize them.

To put it mildly, these medical books, just put them here for others to read, I don't know how long it will take to find some discussions about primary liver cancer.

can't come like Lu Xuan with his mouth open.

To be honest, Zhang Jingcai was also a little shocked.

Compared with Gu Huahua, Zhang Jing is good.

After all, I had heard Lao Zhou introduce Lu Xuan before, and I knew that Lu Xuan's ability was not small, but in Gu Huahua's eyes, Lu Xuan should be in a similar situation to him, even if he was working as an assistant to a Chinese medicine practitioner, he didn't know anything about syndrome differentiation and medical treatment, and it was even more nonsense to take the pulse or something.

But the scene in front of him completely subverted Gu Huahua's cognition.

It's like, the junior brother who originally came out of the same division as him, he still holds a secret book but is not proficient in the little person, but Lu Xuan has become the leader of the martial arts alliance, and his martial arts are world-renowned.

This terrifying gap made Gu Huahua's eyes when he looked at Lu Xuan for a while, full of shock.

Lu Xuan didn't answer this, but just smiled subconsciously.

Zhang Jingcai didn't care about these either, and said with a smile: "This unforgettable ability is really terrifying!" Now it seems that Dr. Xiao Lu was really invited. ”

"That's all I'll do."

"I'm a little envious."

Zhang Jingcai did not hide the envy on his face at all, he never forgot it, he could achieve twice the result with half the effort after learning anything, who could not be envious?

Anyway, he was really envious.

"Since Dr. Xiao Lu has said this, what about this treatment?" Zhang Jingcai was also not polite at all, everyone was invited, it would not be enough for anyone to make the best use of it, otherwise it would be too much of a waste of Lu Xuan's terrible talent.

Speaking of this, Lu Xuan was not pretentious, but pondered for a while, and said: "Su Wen: The Great Treatise on the True Truth" expounds the treatment method of "the strong eliminate it" and "the strong one is soft".

The function of the turtle nail decoction pill is to invigorate qi and blood, dispel dampness and dispel stasis, reduce softening and hardness, and treat hypochondria.

Wang Qingren also mentioned in "Medical Forest Correction of Errors" that the diaphragm Zhuyu Tang and Xuefu Zhuyu Tang are representative prescriptions for blood circulation and blood stasis. For this primary liver cancer, the basic treatment should be to promote blood circulation and eliminate blood stasis, and you can choose Xuefu Zhuyu Soup, Guizhi Poria Pill or Big Yellow Worm Pill and Chai Hu Shu Liver Powder or Xiaoyaosan.

However, according to the different stages of the course of primary liver cancer, the choice of drugs to promote blood circulation and eliminate blood stasis is also different.

For postoperative patients, due to the local vascular and lymphatic reflux disorders, blood stasis and pulse obstruction, and qi and blood deficiency, it is advisable to choose drugs with slightly stronger blood circulation and blood stasis;

However, some patients undergoing chemotherapy should not use strong blood-invigorating drugs to improve the body's tolerance to chemotherapy if they are deficient in positive qi, spleen deficiency and dampness, internal dampness and stasis, and blood stasis syndrome is further aggravated.

If the patient is undergoing radiotherapy, due to the heat evil (radiation) is blazing, the qi and yin are consumed, the fluid is insufficient, the blood is sticky, and the blood stasis syndrome is aggravated, at this time, it is advisable to use cool blood and invigorate the blood to reduce the damage of the heat evil to normal tissues and increase the sensitivity of radiotherapy.

However, if the disease progresses to the stage of coagulation disorder, that is, the stage of yin deficiency and blood stasis, early intervention should be taken to nourish yin and nourish the body, cool the blood and activate the blood, and use the soup to promote the repair and proliferation of liver cells, maintain the normal coagulation state, prevent the occurrence of bleeding events, and prolong the survival time of the patient as much as possible.

However, the general liver cancer patients can basically be divided into four syndrome types, namely liver depression and spleen deficiency, qi stagnation and blood stasis, liver and gallbladder dampness and heat, and liver and kidney yin deficiency.

If I come for treatment, it should be treated to strengthen the spleen and liver, clear away heat and dampness. ”

As Lu Xuan spoke, he subconsciously took a pen and wrote down the prescription in the patient's medical record book: Bupleurum 8g, Dashengdi 15g, White Moss Peel 10g, Zhu Ling 10g, Poria Cocos 10g, Dihu Seed 10g, Danpi 10g, Early Lotus Grass 10g, Lingxiao Flower 10g, Pavilion Dangzi 10g, Crane Grass 15g, Dandelion 10g, Lily 20g, Iwami Piercing 10g, Pomegranate Peel 15g, Half Lotus 10g.

"However, while taking these medicines, taking into account the unbearable pain of liver cancer renewal, you can supplement a prescription composed of incense, Chuanxiong, Atractylodes, Divine Comedy, Gardenia, Codonopsis, Poria cocos, chrysanthemum, rose, liporice, white peony, and white flower snake tongue to delay the occurrence and further aggravation of cancer pain."

Before Lu Xuan could speak, Zhang Jingcai had already taken the medical record book from Lu Xuan's hand, and looked at it carefully against the prescription prescribed by Lu Xuan, and after a long time, while his face showed surprise, he couldn't help frowning:

"You also mentioned a point just now, "Su Wen: The Great Treatise on the Truth" said that the strong will disappear and the strong will be soft, doesn't his situation need to add pangolins, turtle shells, tortoise shells, keels, oysters, sea pumice, sea clam shells, seaweed, kelp and other soft and hard medicines?"

(End of chapter)