Anjiang County is very small, and it only takes about ten minutes to drive from Lu's clinic to the county hospital.

When he got out of the car, Lu Xuan said thank you to the driver, and hurried to the nephrology department of the county hospital.

Chronic renal failure, this syndrome is said to be serious and serious, and it is not serious and not serious.

However, what he captured from Zhang Guangli's words was that the patient's condition was already relatively serious, and in this case, one more minute of delay would be dangerous.

What Lu Xuan can do is to arrive early, even if it's just for a minute, it's a good thing.

In medical matters, sometimes even if it's just a minute early, the result may be different.

A life that could have been lost may have been saved because of this early minute.

Came to a consultation room agreed with Zhang Guangli, the door of the consultation room was closed, Lu Xuan stepped forward and knocked on the door, and soon a voice came from inside: "Who?" ”

It's not Zhang Guangli, it should be other doctors in the county hospital.

The moment the voice came out, it didn't take long for the closed door to be opened.

Lu Xuming opened the door, looked at the young man standing at the door, and frowned: "Hello, who are you looking for?" ”

"Is Dean Zhang Guangli here?" Lu Xuan asked.

Hearing that he was looking for Zhang Guangli, Lu Xu was stunned for a moment, but soon thought of something, and looked at Lu Xuan with a look of surprise in his eyes: "You are Lu Xuan Doctor Lu?" ”

"Hmm."

Lu Xuan nodded and responded, "You are?" ”

Lu Xuming hurriedly held Lu Xuan's hand and introduced himself with a smile: "My name is Lu Xuming, the director of the nephrology department of the county hospital, and this is President Zhang Guangli. ”

"Director Lu, Dean Zhang."

Lu Xuan greeted the two, and then went straight to the point: "What is the patient's current situation?" ”

Looking at Lu Xuan's unimaginably young face, Zhang Guangli was a little stunned for a while, although he knew through his voice that Lu Xuan was not very old, and he might be in his twenties, but when he really saw Lu Xuan, he was still taken aback.

But at this time, he knew that he was not surprised by Lu Xuan's age, and in the face of Lu Xuan's questioning, he turned his head to look at Lu Xuming: "Director Lu, you know a little bit about the patient's situation, you can tell me." ”

Lu Xuming nodded and said in a deep voice: "Patient Li Dali, male, 65 years old. He was presented with "recurrent swelling for 1 year and worsening for 1 week". Symptoms: general edema, fatigue, fatigue, loss of appetite, chills and cold limbs, back pain, abdominal distension and lack of urine. “

Hearing this, Lu Xuan's expression was repeated, and his whole body was swollen, proving that the patient's kidney function was almost gone, and in this case, it was difficult to say how long the patient could live.

Coupled with the chain reactions that kidney failure can cause, the patient's life is in danger at all times.

Even when the news of the patient's death came the next moment, Lu Xuan was not surprised.

The most important thing is that the patient's whole body is swollen repeatedly for nearly a year, and there are too many accidents in this year.

has not yet come into contact with the patient, and Lu Xuan's heart is also sinking.

This patient, named Li Dali, is in a very bad condition.

Even he didn't dare to say that he was sure that he would be able to pull the other party back from the ghost gate.

However, Lu Xuan did not panic because the patient's condition was in danger, but continued to listen to Lu Xuming talk about the patient's other conditions.

As long as the patient's physical condition is thoroughly understood, the intervention can be better done.

The examination indicators of Western medicine can also play an auxiliary role in the syndrome differentiation treatment of traditional Chinese medicine.

This is similar to pulse checking and tongue diagnosis.

The difference is that Western medicine generally does not know how to look at the tongue coating, while Chinese medicine basically understands some examination indicators of Western medicine.

Lu Xuming continued to talk about the condition of patient Li Dali: "Signs: blood pressure: 120/80mmHg, 24-hour urine protein quantification 4.2g, abdominal distention, obvious ascites, and edema of the lower limbs.

The hospital diagnosed it with steamed nephritis and renal failure. In other cases, Dean Zhang has also seen the patient, so you can ask him to talk to Dr. Lu. ”

"The tongue is light and fat, white and greasy, and the pulse is thin." Zhang Guangli, the director of the county hospital of traditional Chinese medicine, immediately added.

"I also specialize in kidneys, but Anjiang County Hospital of Traditional Chinese Medicine has not received patients with chronic renal failure, I have no experience in this area, plus the patient Li Dali's condition is more serious, I am not sure, so I cured to find Mr. Huang Beishan, who had experience in this area back then, and was also half of my teacher, and then found Dr. Lu through the introduction of Mr. Huang Beishan."

"Doctor Lu, the patient's current situation, our county hospital has no good way, now it depends on whether there is a good plan on your side, if not, we can only let the patient handle the transfer, go to the province, we will contact him with the first or second hospital of the province." Lu Xuming also said whatever he wanted.

He definitely can't save the patient Li Dali's condition, and now the only hope is on Lu Xuan.

But Lu Xuan was so young, he was a little suspicious in his heart.

So I said it directly.

And what he said is also true, if it doesn't work, it can only be sent to the province.

Even if it is in the city, such a serious patient, the city hospital may not be able to have one in a year, speaking of experience, it is not much better than that of Anjiang County.

There is no way, good medical resources are concentrated in the provincial capital.

It's not just medical resources, it's also about other things.

Hearing this, Lu Xuan thought for a while and said, "I want to see the patient first." ”

Lu Xuming and Zhang Guangli introduced the situation, Lu Xuan probably had some ideas in his heart, but this was just the judgment of the two of them, and it had nothing to do with him, Lu Xuan still hoped that he would see the patient's situation with his own eyes and then decide how to formulate a treatment plan.

In the face of Lu Xuan's request, Lu Xuming was naturally full of response, and the four of them came to the intensive care unit, Lu Xuan checked the patient's pulse, looked at the tongue coating, and observed the patient's condition for a while before leaving the intensive care unit.

"Doctor Lu, how's the situation?"

When he got outside, Zhang Guangli, who had not spoken, asked eagerly.

Although he didn't think that Lu Xuan really had any opinions, but when he thought that the person Huang Beishan admired so much, he should always have some ability, not to mention that he was better than Huang Beishan, but it shouldn't be too bad, and he must be a lot better than his peers.

Moreover, now the hope is all on Lu Xuan.

Zhang Guangli can only hope from the bottom of his heart that Lu Xuan can really have a corresponding treatment plan for Li Dali's illness as Huang Beishan said.

And the others also cast their eyes at Lu Xuan.

Lu Xuan thought for a while and said: "Chronic renal failure does not have a corresponding disease name in traditional Chinese medicine, and according to its clinical evolution, it belongs to the categories of "drowning", "guange", "seizure", "kidney wind", "edema", "fatigue", "kidney labor" and so on.

There are two main views on the understanding of the name of chronic renal failure in modern Chinese medicine. Some believe that chronic kidney failure falls under the category of multiple diseases in Chinese medicine. For example, chronic renal failure is classified into the categories of "guange", "edema", "seizure", "fatigue", "drowning", "kidney wind", "water qi disease" and "uremia" in traditional Chinese medicine. There are also some who advocate the use of a TCM disease name to summarize chronic kidney failure, such as thinking that chronic kidney failure should be named "debilitating kidney failure", while others believe that chronic kidney failure belongs to the category of "kidney labor" in TCM.

According to the national standard "Terminology of Clinical Diagnosis and Treatment of Traditional Chinese Medicine" compiled a few years ago, the name of chronic renal failure in modern medicine is chronic renal failure.

However, I looked at the patient's condition, and based on the results of the examination, I can conclude that the patient has edema caused by spleen and kidney yang deficiency. ”

"Spleen and kidney yang deficiency ......"

Zhang Guangli kept repeating these four words.

In what Lu Xuan said, he basically knew it before, even if what he knew was not necessarily as detailed as what Lu Xuan said, but it was generally not much worse, but his memory was not enough for him to remember as clearly as Lu Xuan.

And the edema caused by spleen and kidney yang deficiency mentioned by Lu Xuan came to the point at once.

Traditional Chinese medicine (TCM) treatment focuses on a syndrome differentiation, and only when the syndrome differentiation is clearly understood, can it be better to prescribe and treat the disease.

If the dialectic is correct, the prescription will not be too bad on the whole.

It can be said that the most important thing in TCM treatment is syndrome differentiation.

If the syndrome differentiation is not accurate, the prescribed medicine will naturally have no effect.

"So spleen and kidney yang deficiency is the key to his edema?" After thinking about it, Zhang Guangli had to ask the doubts in his heart.

Although Lu Xuan said that the patient had spleen and kidney yang deficiency, Zhang Guangli didn't count it in his heart, and he didn't know whether Lu Xuan's dialectic was correct or not, so he had to use this way to determine whether Lu Xuan's medical skills were as powerful as Huang Beishan said.

After he asked this, there was also a hint of expectation on his face.

From the chat with Lu Xuan just now, he learned that Lu Xuan is from Anjiang County, if Lu Xuan is really as powerful as Huang Beishan said, then Anjiang can be regarded as a top master of traditional Chinese medicine.

This is definitely a happy thing for the Chinese medicine community in Anjiang.

In the face of Zhang Guangli's inquiry and temptation, Lu Xuan did not break it, but thought about it: "Regarding the cause of chronic renal failure, I think it can generally be divided into three aspects, the first of which is the invasion of external evils, from the surface to the inside, the condition is repeated and aggravated;

secondly, it is mental trauma or excessive thinking, uncontrolled room, and abnormal daily life;

The third element has the loss of lungs, spleen and kidneys, which is triggered by the feeling of external evils, or overwork, or improper treatment, which further imbalances the viscera, yin and yang, qi and blood, and breeds real evils such as wind, cold, damp heat, stasis, and poison.

"Su Wen: The Theory of Lifting Pain" has "labor is exhaustion"; "Su Wen: The Theory of Anger and Anger" also has "Therefore, it is strong, and kidney qi is injured." ”； The medical technique "Treatise on the Spleen and Stomach" also mentions that "physical labor leads to spleen disease";

I wonder if Dean Zhang has heard of Mr. Zheng? ”

"That old Mr. Zheng?" Zhang Guangli's eyes moved.

Seeing that Zhang Guangli had heard of it, Lu Xuan nodded slightly and said: "Mr. Zheng divides the cause of chronic renal insufficiency into the original cause, the standard cause and the inducement cause, the original reason is the deficiency of the spleen and kidney, and the standard is that the kidney disease lasts for a long time, and the function of distinguishing turbidity is lost, so that the dampness is stored in the body, diffuses the three cokes, and affects other viscera, which causes the disease.

This kind of damp and turbid old Mr. He Lianchen called it drowning, and said that "drowning poison into the blood, blood poison into the brain".

The inducement is the sudden feeling of external evil, the lack of lung qi, the dereliction of duty, the unfavorable waterway of the three cokes, the storage of dampness and turbidity, and the original spleen and kidney deficiency, and the spleen and kidney damage after sudden sensation of external evil; or poor diet, or overwork, damage the spleen and stomach, and aggravate the spleen and kidney deficiency.

Among them, whether it is an ancient medical book, or Mr. Zheng and Mr. He Lianchen, they all mention one point, that is, spleen and kidney deficiency. It can be seen that chronic renal failure is closely related to spleen and kidney deficiency, and it can even be said that it leads to edema and a series of symptoms throughout the body.

Looking at his medical books and some related remarks, most doctors believe that this disease is mainly the result of the abnormal function of the internal organs, and the turbidity is not divided and the chaos is reversed, which is the evidence of the hypocrisy and the real standard, and the disease site is mainly the spleen and kidney.

The pathogenesis is based on the deficiency of the spleen and kidney, and the retention of dampness and turbidity is the standard. There are four pathological mechanisms of "deficiency, solidity, stasis and poison", among which deficiency is the basic pathogenesis of the disease, and it is centered on kidney deficiency and affects the heart, liver, spleen and lungs over time.

In this disease, kidney yang deficiency is manifested as backache and low back pain, chills, cold limbs, and heavy pulse. Traditional Chinese medicine believes that "long-term illness enters the kidneys" and "long-term illness will lead to deficiency", and the formation of kidney disease is mostly due to insufficient congenital endowment, poor mood, and uncontrolled diet resulting in insufficient spleen and kidney, and yang deficiency and overflowing.

The disease is located in the spleen and kidney, and the water retention is in the middle focus. In short, it is the evidence of this false standard and reality, and the treatment is to use the warm yang and water method, that is, to warm and replenish the spleen and bones, and to reduce swelling with water. ”

Zhang Guangli secretly exclaimed in his heart, he originally wanted to test Lu Xuan through this method of inquiry, whether he had the ability and power as Huang Beishan said, but he didn't expect that he would test such a result because of this.

These things can't be memorized by rote memorization.

Moreover, the matter was very urgent, and it had only taken more than ten minutes for Lu Xuan to rush over from the time he answered the phone to now, and he didn't have time to read this aspect at all, but he was able to explain things involving the kidneys very thoroughly.

From childhood to adulthood, from shallow to deep, this is not explaining to him at all, but a top Chinese medicine master, Xinglin Holy Hand, is explaining the true meaning of Chinese medicine kidneys to his students.

Just now, Zhang Guangli was not sure whether Lu Xuan's dialectic was ready.

But now, his only remaining meaning suspicion has completely disappeared without a trace, without the slightest trace.

The young man in front of him, who is only in his twenties, really has great ability.

Huang Beishan said that his medical skills were not as good as Lu Xuan, and Zhang Guangli thought that he might be joking, but now, Zhang Guangli has a feeling.

What Huang Beishan said may be true.

At this moment, Zhang Guangli was really breathtaking.

I didn't care about my identity as the head of the hospital, so I showed an expression like a student, and humbly asked: "Doctor Lu, what you said about warming and replenishing the spleen and bones, diluting water and reducing swelling, this is a treatment, if you prescribe medicine, what kind of medicine do you need?" ”

"Fang Yi Wu Ling San plus Jin Heal Kidney Qi plus or minus."

Lu Xuan smiled slightly and said: "Zhu Ling 1, Poria Cocos, Ze Yuan, Atractylodes, Guixiao, Rehmannia Rehmannia, Cannon Aconite, Cornus officinalis, Peony skin, Yam." 7 doses. Water decoction. If the patient's urine output increases, the edema of the lower limbs will be reduced, and the urine protein will be reduced. You can continue to take the original prescription by adding or subtracting it. ”

(End of chapter)