Song Meilian hurried towards the consultation room.

"Mom, wait for me."

Shi Guanlan shouted behind her, but when she shouted, Song Meilian's figure had disappeared in front of her and entered the TCM clinic.

Seeing this, Shi Guanlan had no choice but to trot and follow.

When she entered the consultation room, she saw that her mother had already sat down and chatted with Dr. Lu.

When she got closer, she heard Song Meilian say in detail: "Doctor Lu, my name is Song Meilian, and I am 61 years old this year......

Shi Guanlan couldn't help but cover her face, your introduction, people who know know that you are here to see a doctor, and those who don't know think that you are here for a blind date.

However, she didn't say anything, just stood behind her mother, quietly listening to her mother talk about her symptoms, but her eyes fell on Lu Xuan, staring at each other curiously.

She was curious, how could such a young man, who was a few years younger than her, have such great ability?

Even diseases such as bile reflux after gastrectomy for gastric cancer can be easily dealt with, and an old man who said that he may not be alive for a year and a half is forced back from the ghost gate.

Moreover, Lu Xuan's delicate appearance also made her can't help but look at it twice.

Lu Xuan is not the kind of handsome to scum, but very delicate, and the more you look at it, the more attractive it becomes, coupled with the attribute aura that comes with his own ability, Lu Xuan naturally seems to have an extremely attractive temperament.

And just when Shi Guanlan was staring at Lu Xuan, Song Meilian's voice was already ringing in her ears: "Three years ago, my stomach had a faint pain because of a cold, this position was very full, and I couldn't take any medicine, I kept having repeated attacks, and then I couldn't bear it, so I went to the hospital for a gastroscopy, and the results of the gastroscopy showed ......"

Speaking of this, Song Meilian was stunned and smiled awkwardly: "The name is a little too long, I can't remember it when I'm old." ”

"It's okay, Auntie, did you bring me with you for the check-up you did at that time?" Lu Xuan asked.

"No, I've been checking for a long time, I thought it was useless and didn't bring it, where do I know I'll forget."

Song Meilian was talking, and Shi Guanlan, who was behind her, heard this and said: "Chronic atrophic gastritis with intestinal gland metaplasia, accompanied by bile reflux gastritis. ”

"Intestinal gland metaplasia?"

Lu Xuan was slightly stunned, this was already a sign before the lesion.

In the introduction of Western medicine, intestinal metaplasia refers to intestinal metaplasia, which refers to the replacement of gastric mucosal epithelial cells by intestinal mucosal epithelial cells, and the appearance of intestinal mucosal epithelial cells similar to intestinal or large intestine epithelial metaplasia in the gastric mucosa.

This is a common lesion of the gastric mucosa, and it is more common in various chronic gastric diseases.

Lu Xuan nodded, motioned for Song Meilian to place her hand on the pulse diagnosis, and felt the other party's pulse and tongue signs.

When diagnosing the pulse, Lu Xuan was not idle, asked about some of the things he needed to know, and recorded them all in the medical record.

Symptoms: stomach fullness, vague pain and discomfort, noisy, phlegm is thin and white, cold and warm, cold limbs, hiccups in the morning, improvement after meals, abdominal pain after spicy food in the afternoon, diarrhea, loose stools 2~3 times a day.

Check that the tongue is dull, there are tooth marks on the side, there is no moss, and its pulse is thin.

After writing, Lu Xuan did not write down the prescription, but signaled Ji Xiuwen to also check the pulse and see the situation, this guy is now mainly focusing on digestive diseases, and Song Meilian's situation obviously has to be clear to him.

"How?"

Lu Xuan asked.

Ji Xiuwen thought for a while and said: "The tongue is dull, there are tooth marks on the edges, there is no moss, and the pulse is thin. ”

"Yes, what about dialectics?"

Ji Xiuwen thought about it for a long time, there were too many situations involved in the patient, and he couldn't say it for a while, but the pulse was clearer, but it was difficult to accurately distinguish the syndrome just by taking the pulse, so he didn't say anything.

Seeing this, Lu Xuan didn't ask more, but said: "Aunt Song's situation seems complicated, but in fact, everything is changing. ”

Ji Xiuwen sat down and listened carefully.

He's decided to focus on the digestive system, so he'll have to listen to it.

Although Su Kenan on the side decided to go in the direction of gynecology, he had already turned on the recording and prepared his notes at the same time.

As soon as the two of them were ready for everything, they heard Lu Xuan's voice ringing in their ears: "Light tongue is more common in internal injuries and miscellaneous diseases, and it is generally more of a deficiency syndrome, and the course of the disease is long in daily performance, and it is not easy to cure quickly. The cause of pale tongue is usually caused by qi and blood deficiency and spleen deficiency and cold and dampness.

The tooth marks on the side are mostly caused by the pressure of the tooth edge due to the fat tongue, so the tooth marks are often seen with the fat tongue, which is mostly spleen deficiency and the main deficiency syndrome. If the tongue is pale and moist, the spleen is weak and cold and damp.

On the other hand, due to the relaxation of the tongue muscles and the lack of mouth opening, it is a deficiency of spleen qi.

If it is pale white and moist with tooth marks, it is cold and damp; Pale red and tooth marks, spleen deficiency or qi deficiency; Red and swollen mouth, with tooth marks on the side, mostly damp and hot phlegm turbidity and stagnation;

And this is divided into two types: qi deficiency and yang deficiency:

Qi deficiency type: weak spleen, main evidence: shallow tongue, thin white tongue coating, fat and tender tongue, tooth marks on the side of the tongue, pale or yellow complexion, shortness of breath and lazy speech, heavy head and swollen body, fatigue and fatigue, self-sweating, reduced diet, abdominal distension after eating, pannaïve vomiting, loose stool, weak pulse. Rule: Replenish the middle and invigorate the qi.

Yang deficiency type: the main sorrow: the tongue is pale white, the tongue surface is moist and rich, or the tongue surface is slippery, the tongue is round, fat and tender, and there are tooth marks on the edges. Pale or blue-black, tired, tired and sleeping, light mouth and not thirsty, lack of food, cold pain in the abdomen, warm and comfortable, cold stomach and cold limbs, clear urine and stool, or edema, and a weak pulse. Rule: Xinwen replenishes yang.

The absence of lichen, which is called mirror tongue in traditional Chinese medicine, is a sign caused by yin deficiency, which can have the deficiency of stomach yin, the depletion of stomach yin, as well as the weakness of qi and blood, the deficiency of spleen yin, and the deficiency of kidney yin.

The main thing is that the yin fluid is damaged, which can cause the symptoms of no lichen, and the normal tongue coating should be light red tongue and thin white lichen.

There should also be a faint, very thin layer of lichen on the tongue, which is normal, and if the lichen is thick, it is a sign of a disease.

If there is no moss, there is no moss at all, it can only be that the stomach yin has been greatly damaged, but it is not only to look at the tongue coating, but also to see if there are other syndromes.

As for the thin pulse, the thin pulse is also the main false evidence.

It mainly refers to yin deficiency and blood deficiency, and the yin blood is insufficient and the vasculature is not full, so the pulse is small.

If yin and yang qi and blood are insufficient, the pulse will also be small.

When the simple yang deficiency and qi deficiency are simple, the pulse is now subtle, and the yang deficiency and qi deficiency are heavier and appear in the dangerous stage of yang death and qi loss, the pulse will appear to be floating and weak.

In patients with heavy dampness, the vasculature appears small but soft when it is squeezed due to the dampness of the skin.

Contrary to the fine vein, it is the Hongda pulse, which feels wide and fluctuating under the finger, such as turbulent waves, the pulse beats and beats strongly, and when it falls, it is deeper and undulating, and this pulse is more common in patients with high fever, and it is often accompanied by several pulses at the same time.

Judging from the results of looking and hearing and asking, as well as some of the situations reported by Aunt Song, the treatment should strengthen the spleen and invigorate qi, but Aunt Song had stomach pain caused by a cold at that time, and she had to warm and neutralize the stomach. ”

"Medium Jiao Xuhan?" Ji Xiuwen showed an expression as if he had heard this word for the first time.

Although Su Kenan seemed to have heard it from somewhere, he didn't remember it very clearly, and he didn't say anything, but looked at Lu Xuan quietly.

"Haven't heard of it?" Lu Xuan glanced at Ji Xiuwen in surprise.

It's normal that Su Kenan hasn't heard of it, after all, she is only an undergraduate, and she won't be exposed to too many things, and Ji Xiuwen hasn't heard of it, so it's really a little undeserved.

He had heard this word when he was an undergraduate, but the situation at that time was similar to that of Ji Xiuwen now, he saw it, and he knew it, but he also knew a little, but he also knew it limitedly.

Ji Xiuwen shook his head: "No, this should be the first time I've heard it, I heard the most about Sanjiao before, and it is still the sentence that there is fire in the upper coke and cold in the lower coke." ”

"Since you have mentioned the upper and lower coke, then I just take this opportunity to talk about the three cokes of the human body."

Lu Xuan recalled and continued: "Sanjiao is a Tibetan elephant, the first time I saw it with the "Yellow Emperor's Neijing", it is the largest of the five internal organs and six internal organs, and it is connected with the pericardial meridian, including upper coke, middle coke, and lower coke.

According to the general law of the occurrence and development of warm disease and the characteristics of symptom changes, TCM comprehensively analyzes and summarizes the various clinical manifestations in the process of warm disease according to the general law of the occurrence and development of warm disease and the characteristics of symptom changes, so as to distinguish the stage of the course of the disease, identify the transmission of the disease, clarify the location of the lesion, summarize the type of syndrome, analyze the characteristics of the pathogenesis, establish the treatment principle and predict the prognosis and prognosis.

As for the upper coke has fire, the lower coke has cold, it is precisely because the middle coke is blocked, so there will be fire in the upper coke and cold in the lower coke. ”

You have been familiar with acupuncture during this time, and you should know the Hand Shaoyang Sanjiao Sutra. ”

Ji Xiuwen nodded, he naturally knew this, otherwise wouldn't the past few days of study be in vain, if you really don't know, you will have to be criticized by Lu Xuan again.

When he sees Lu Xuan now, he has the kind of stunned feeling he felt when he saw a teacher when he was a student.

Seeing that Ji Xiuwen knew, Lu Xuan continued: "And among the five organs of the heart, liver, spleen, lungs, and kidneys, as well as the small intestine, gall bladder, stomach, large intestine, bladder, and three focal and six intestines, the three focal points are also mentioned, so how to divide the three focal points?"

Sanjiao is one of the six internal organs, which is the collective name of the upper, middle and lower three jiao.

Above the diaphragm is the upper coke, that is, the heart and lungs are the upper coke, the spleen and stomach are the middle coke, and the liver, kidney, large and small intestines, and bladder are the lower coke.

Sanjiao has the function of circulating vitality, water valley and water liquid in the human body, and the function is based on a certain shape.

However, this shape is not a specific and definite organ tissue, but a generalization of some organ tissues and their functions.

Therefore, the three focal points are invisible, figuratively speaking, the "three focal points" are actually a large channel of the human torso.

The meridians mainly walk on the limbs, and they walk in both directions and two lanes; In contrast, the three-focus is to walk on the torso of the human body in both directions and eight lanes.

And when it comes to Sanjiao, we have to mention the vitality of Sanjiao's peers. ”

Speaking of this, Lu Xuan paused before continuing: "

The theory of Sanjiao's vitality was first seen in the "Difficult Scripture". For example, "The Thirty-one Difficulties" says: "The three cokes, the road of the water valley, and the end of the qi." ”

"The Thirty-Eight Difficulties" also says: "Therefore, there are six people in the intestines, which are called three Jiao, and there is a difference between the original qi and the presiding over all qi." "The Sixty-six Difficulties" says: "The three cokes are the difference between the original qi, and the master passes the three qi and experiences the five internal organs." ”

What do you mean?

This passage undoubtedly shows that the three jiao is the way for the human body's vitality to rise and fall, and the human body's vitality reaches the five internal organs and all parts of the body through the three jiao.

Yuanqi, in the concept of traditional Chinese medicine, belongs to the most fundamental qi of the human body, and is the driving force of life activities. The vitality is rooted in the kidneys, and it reaches the five internal organs and six organs through the three jiao into the twelve meridians, so it is called the three jiao as the different envoys of the vitality.

Because Sanjiao passes the vitality in the whole body, it is the channel for the rise and fall of the body's qi, and it is also the place of gasification, so it is said that Sanjiao has the function of presiding over all qi and the whole body qi and gasification. If the vitality is weakened, the trifocal channel does not function smoothly or declines, it will lead to qi deficiency in the whole body or some parts. ”

Hearing this, Ji Xiuwen's eyes lit up, and he hurriedly said: "Speaking of this, I thought of something, in addition to the vitality of Sanjiao, it seems that it also has the ability to run water valleys and run water liquids. ”

"Yes, it does." Lu Xuan nodded.

"Do you remember a lot of related remarks in "Su Wen"?"

"Su Wen?"

Ji Xiuwen thought about it and was not impressed, so he could only shake his head and smile bitterly.

Lu Xuan also knew that not everyone had the ability to memorize, and it was indeed a little difficult for Ji Xiuwen to memorize the content of so many medical books, so he explained with a smile: "Su Wen Jin Kuizhen's Speech called Sanjiao one of the six internal organs, and 'Su Wen Wu Zang Bei' called Sanjiao the house of Chuanhua, which has the function of Chuanhua Water Valley.

"Su Wen: Six Verses of Tibetan Elephants" says: "Sanjiao...... The foundation of the warehouse, the residence of the camp, the name of the device, can turn the dross, and the person who changes the taste and enters and exits. ”

The meaning of this sentence undoubtedly points out that Sanjiao has the effect of subtly changing the water valley into camp qi and transmitting the dross.

The water valley begins with the path of the human body and the end of qi, including the digestion of food, the absorption of subtle substances, and the excretion of dross, which can be summarized by "the three cokes, the path of the water valley".

And according to the different parts of the upper, middle and lower three cokes, the role of the water valley in the operation process is also different, and there are specific descriptions of the upper coke, the middle coke, and the lower coke.

This is to summarize the digestion, absorption and excretion functions of food and beverages in the three-coke running water valley.

As for the operation of water, this is discussed in many places in the "Neijing", such as the "Suwen Linglan Secret Classics" says: "The three cokes, the officials who decide the blasphemy, the waterway is out of the waterway." ”

"Lingshu Ben Lose" said: "The three cokes are the middle and the desecration of the intestines, the waterways are out, they belong to the bladder, and they are the lonely intestines." This just shows that Sanjiao is the organ of the human body to manage water, which has the function of dredging waterways and running water.

Water metabolism is a complex physiological process, and it is also a comprehensive effect of a series of physiological functions of multiple viscera.

This point is mentioned in the "Su Wen Meridian Treatise": "Drinking into the stomach, overflowing essence, up to the spleen, spleen qi to disperse essence, up to the lungs, through the waterway, down to the bladder, water essence four cloth, five meridians in parallel." ”

Therefore, whether the Sanjiao waterway is beneficial or not not not only affects the operation of water, but also inevitably affects the distribution and excretion of water by the relevant viscera.

If the Sanjiao waterway is unfavorable, it will be difficult to realize the function of regulating water and fluid in the spleen, lungs, kidneys and other viscera, causing abnormal water metabolism, impaired water infusion and excretion, and producing sputum drinking, edema and other lesions.

As the "Neijing: Tibetan Elephants" said: "If the upper focus is not cured, the water will flood the plateau; If the middle coke is not treated, the water will remain in the middle navel; If the lower coke is not cured, the water will be messy. ””

(End of chapter)