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笔者在门诊遇到一些病人,由于问诊上的失误,治疗时往往效果不好,给病人带来不必要的损失。但反面教训可以借鉴,故总结有关病案三则,供同行参考。一、治疗肾病综合征蛋白尿不可只知调补还应辩证施治病案:王××,男,6岁,病历号0093。患儿曾以肾病综合征在宁夏医学院附属医院住院治疗8月余。住院期间,经用强的松、环磷酰胺等药后,病情基本得到控制,尿蛋白由住院初期的++++减少为±,由于家长惧怕强的松和环磷酰胺的副作用,故出院后不再给患儿服用以上两药。1987年6月7日来我处初诊时,小便少,大便溏,食少倦怠,面色萎黄,面目四肢轻度浮肿,脉细略数,苔黄白相间、稍厚,尿常规化验蛋白+++。辨证为肾脾阳虚,治拟温补脾肾:熟地6克、山药12克、山萸肉9克、仙茅9克、仙灵脾9克、菟丝子9克、五味子
The author encountered some patients in the clinic, due to errors in the interview, the treatment is often not effective, causing unnecessary loss to the patient. However, the negative lessons can be used for reference. Therefore, the relevant medical records are summed up for reference by peers. First, the treatment of nephrotic syndrome proteinuria can not be only known to make up the case should be dialectical treatment: Wang × ×, male, 6 years old, medical record number 0093. The child had been treated with nephrotic syndrome for more than eight months in the affiliated hospital of Ningxia Medical College. During hospitalization, after the use of prednisone, cyclophosphamide and other drugs, the disease was basically controlled, urinary protein decreased from ++++ in the initial period of hospitalization to ±, because parents fear the side effects of prednisone and cyclophosphamide, so discharged After the children are no longer taking the above two drugs. When I first came to our office on June 7, 1987, I had little urine, loose stools, little food, and tiredness. My face was chlorosis. My face was slightly swollen, my pulse was slightly thin, and my yellow and white moss was slightly thicker. Urine was routinely tested for protein +++. . Syndrome is kidney-spleen yang deficiency, governance proposed warming spleen and kidney: Rehmannia 6 grams, 12 grams of yam, hawthorn meat 9 grams, Curculigo 9 grams, 9 grams of epimedium, Dodder 9 grams, Schisandra