Patient: Li, female 58 years old
Main complaint: more dreams and easy to wake up for 2 years
History of present illness: difficulty falling asleep, dreaming and waking up for more than 2 years, waking up in the morning, unconsciousness during the day, dullness, fatigue and sometimes bitter mouth, unsatisfactory diet, and able to eat, stool color sometimes turns black, usually Afraid of heat, bad thoughts, irritable and irritable, in the past two months I have always felt aggrieved and depressed, my tongue is pale and the fur is white, my pulse is thin, and my pulse is heavy.
Chronic symptoms: dreamy and easy to wake up, fatigue in the morning, dizzy and unclear during the day, sometimes bitter mouth, poor diet, irritability, low mood, fine pulse, heavy pulse.
Pathogenesis: evil spirits pervade the triple burn, restlessness, and deficiency of yin and yang.
Fang Zheng dialectic: According to Article 107 of “Treatise on Febrile Diseases”: Eight or nine days of typhoid fever, the next one is full of anxiety, trouble urinating, delirium, heavy all over, and those who cannot turn are the master of Bupleurum and keel.
According to the outline of the six classics taught by the master: Shaoyin is a disease, and the pulse is subtle, but it is also for sleep.
Diagnosis: Chaihu plus Longgumuli Decoction Syndrome and Mahuang Fuzi Gancao Decoction Syndrome
Therapeutic Principles: Reconciliation of Shaoyang, Calm and Soothe the nerves, Warm and sweat slightly
Recipe: Bupleurum plus Longgu Oyster and Mahuang Fuzi Gancao Decoction
North Bupleurum 20g Scutellaria 10g Codonopsis 10g Qing Pinellia 10g Ginger 10g Jujube 10g Cassia twig 10g Raw keel 15g Section oyster 20g Raw magnet 10g Poria cocos 10g Cyperus rotundus 10g Turmeric 10g Ephedra 12g Heishun slice 15g Qianghuo 10g Licorice 15g
Granules 5 doses of water
According to the patient’s dreaminess, easy awakening, and lack of relief in the morning, sometimes the mouth is bitter, the diet is not fragrant, and irritable. It belongs to the syndrome of Chaihu and Longgu and Oyster Soup, and because of the book written by Master Huang Huang mentioned: Chaihujia Dragonbone oyster may be a common remedy for the treatment of phobias and depression in ancient times. Can be seen as a mental tranquilizer. And because the patient considered elderly depression from the perspective of Western medicine, this prescription was chosen.
From the patient’s irritability, irritability, feelings of grievance, Ganmai Dazao Decoction should be used, but the patient still has trouble thinking and drowsiness during the day, the pulse string is thin, the foot pulse is heavy, and the feeling is in the category of Shaoyin disease. The ephedra and aconite licorice soup. However, at the moment when the patient took the medicine, he still had no confidence in his heart. He was worried that the patient would not be able to rest well at night. There is ephedra in this prescription. I am afraid that she will worsen insomnia at night. What should I do? We can’t let the patient bring it to her and then change her prescription. This will reduce the patient’s trust in us. Wait for the effect!
Five days later, the patient didn’t come again after taking the medicine, and I didn’t call back for a visit. I slowly forgot about it. A few days ago, an older man brought his daughter-in-law to see his grandson, and he said you when he came in. It looked good, so I came with my grandson again. After the patient left, our staff told me that this is the old lady who was depressed that time. She is now much better. It depends on the situation. If she is not good, she He won’t take his grandson to see a doctor again.
Author: Zhu Hongxia
患者：李 女 58岁
北柴胡20g 黄芩10g 党参10g 清半夏10g 生姜10g 大枣10g 桂枝10g 生龙骨15g 段牡蛎20g 生磁石10g 茯苓10g 香附10g 郁金10g 麻黄12g 黑顺片15g 羌活10g 甘草15g