HS Chinese Medicine Clinic

28/04/2024

11/02/2023

这还是我在学生门诊时候的事情。 第一次遇到时，他的太太陪他来看诊，华人面孔，矮小精干，衣着随性，光脚吸个拖鞋。他是马来西亚人，听不懂也不会说中文。听他太太说他虽然70多岁了，一辈子忙碌，风风火火，平常做Uber司机，闲暇也一定要找点事情做。只是一次饭后突然跌倒发病，救护车送到医院呆了几周。出院后寻求针灸治疗，但外面诊所比较贵，所以来学生诊所试试。 他的症状不算太严重，基本可以自主活动，但右侧肢体和面部麻木，血压偏高，脉浮弦紧硬。 只针灸了一次，就发现我们很合得来。当时我还是学生，一直在钻研各种针灸技术，每种针法他都乐意尝试。所以，我经常在指导老师走后，关起门来，全然按自己的想法去扎。他积极、乐观，全然配合着。这好像画师得了一张好的画布，挥洒起来酣畅淋漓，而潇洒自如。 他每周固定来治疗一两次，几个月下来，从未迟到过一次。他也是唯一一个会在治疗结束后，偶尔给我一点小费的病人。他有时候还免费载一位80多岁的老太太过来治疗，因为对方腿脚不便。我不会想到那个风风火火的性格下面藏着一颗温暖而坚定的心。 治疗效果出奇地好。一个月的时间，麻木感消失，甚至有一天他指着他的头很兴奋地说：你看看，这里没有头发的地方，居然长出了黑头发。周围的人也都啧啧称奇。后来，我又凭脉用针把他的血压降到了100mmHg。我说：您要不要咨询家医看看，血压药可以减量或停用了。第二次来，他说他自己已经停了。之后，血压完全恢复正常数值。 很快我毕业了，再没遇到他，但又常常不经意间会想起他。我不是要回想我帮了他的那个部分，而是点点滴滴当中，我所看到的我所赞叹的那个深藏在这个平凡躯体下的“光芒”。他的思维和决策动机是基于他七十多年人生的阅历，基于他对待别人的感恩与信任，基于他智慧的坚持与决断。 我们似乎遇到疾病时，习以为常地要么先去网络胡乱搜索一番，要么迷信什么专家教授或者神医，似乎总期待找到了那么一个人就可以被治愈。这个患者却分明让我觉得，是他的光芒，让我在那一刻变成了“神医”，并心甘情愿的为其化去灾痛的痕迹。 是的，就是这么一个不起眼儿的、72岁的、时刻忙个不停的、Uber司机做到了。

这还是我在学生门诊时候的事情。 第一次遇到时，他的太太陪他来看诊，华人面孔，矮小精干，衣着随性，光脚吸个拖鞋。 [...]

10/02/2023

女儿幼儿园的老师很爱跟我聊天，她来自英国，有个很优雅的姓“Swan”，马上就65岁了。老太太每天都精神头十足，动作麻利，说话爽朗。今天送女儿上学，因为最近女儿有点咳嗽，话题自然扯到健康。老太太忽然跟我说，她这辈子从来没有生过病，没有吃过一片西药，也没有看过医生。她还喜欢抽烟。

这自然很引起我的兴趣。她说看到现在的年轻人太喜欢吃药片、吃各类维生素，她觉得完全没有必要。连这边大人小孩必备的退烧药Pamol，她说她也从来没有碰过。 我开玩笑说，那是因为你有强大的 NDA。我说从中医来看，身心是一体的，你的心境一定很好，现在年轻人各种焦虑、紧张，当然身体会有问题。她说，紧张和焦虑可以杀死一个人。对她而言，任何事情她统统放得下，所以，她的心情每天都好，一切都看得开、放得下。

“放下”其实是一个极难的修炼。我们绝大部分人常常觉得自己放下了，但事实上99%的人都没有，我们的身体和意识只是把不好的情绪隐藏到某个角落，表面上它被和解了或遗忘了，但它们并没有消失，一定会在某一天转变成疾病的样子或某种偏执的形态在生命中跟我们反复相遇。

所以，我跟老太太说：这一点，最知易行难了。这种性格是一种天赋，它真的是上天的一份厚礼。后天无论如何修炼都是难事。所以，我常听到在寺院修行的出家人不少人身体不好的消息。想来不少出家人的机缘本在于社会中受了不少挫折磨难，即使换上僧衣、专注修行，潜意识中的难放下，依然在侵蚀他们的身体。

“可以号一下您的脉吗？” ，我难以抑制地希望从脉象上一探究竟。 “当然”， 老太太把手伸给我。

这是一种很柔和的脉象。跟她看起来风风火火、大大咧咧的外在完全不符。非常柔和，是只要稍微减哪怕一点点都会转为弱脉。没有任何虚弱与不足，亦无显山露水的充盈之气，能想到最准确的描述，便只有“轻柔和缓”四字。

所以，一个好的脉，应该是偏于含蓄、收敛的。像中国的水墨山水，它不凸显生机，但生机就在那里。

女儿幼儿园的老师很爱跟我聊天，她来自英国，有个很优雅的姓“Swan”，马上就65岁了。老太太每天都精神头十足， [...]

31/01/2023

In modern times, people are used to seeing doctors according to the Western medical system, so that if you have a disease, you go to a specialist in the corresponding department. But what if you have eight medical conditions at the same time?
Let’s take a look at the following case.

In modern times, people are used to seeing doctors according to the Western medical system, so that if you have a disease, you go to a specialist in the corresponding department. But what if you have eight medical conditions at the same time? Let's take a look at the following case.

26/01/2023

一位三十多岁的印度裔女士出现崩漏而下血不止三个月有余，家医给她做了所有的检查就是查不出任何原因，幸运的是有人推荐她服用了我们的妇科圣药之一的乌鸡白凤丸，效果很好，血止住了。但是，她发现这个药不能停，一停就各种“副作用”出现了，月经不调，头痛头晕等各种不舒服就回来了，所以一吃就吃了10个多月。因为她不想长期依赖一个药物，所以想找中医专家看诊帮她解决这个问题。

她没有表达太多的主诉。但我上手搭她的脉，她的主要问题比较清晰地显现了出来：阴血虚挟血瘀，肾气不足，同时身上有水湿。可见，这是一个较为复杂的病机。

服药一两次之后效果就开始显现了，原来的不舒服感极大减轻，头痛和头晕减少很多，同时，还增加了不少“福作用”：睡眠明显改善（以前半夜被小孩吵醒后很难入睡），干枯的头发柔顺了很多，精神大好。后因回国，暂停看诊。

这个案例主要想探讨一下为什么用了乌鸡白凤丸起效但又没有完全解决问题。

其一，乌鸡白凤丸补血作用明显，但祛瘀血的力量明显不足。虽然它止了流血问题，只要病因还在，一定会以其他症状形式显现，对应到这个患者就是月经不调以及引发的一系列不适。

其二，乌鸡白凤丸有补益作用，可以补气补血，但在补肾气方面明显不足。这个患者尺脉空虚，用乌鸡白凤丸是补不起来的，必须用专方。

总的来说，乌鸡白凤丸是一个比较温和的方子，确实对症的情况下是可以较长期服用，但也正是因为其比较温和，对特定病理状态的针对性不强，所以面对一个复杂病机的作用非常有限。

这其实对患者也是具有重要的启发意义：当你必须长期依赖一种药物来缓解或压制症状的时候，这个药物必然不对症，至少是不完全对症的。切记啊，任何对证的治疗是无需依赖于长期用药的。

患者在回去之前给我发信息，能否把我的诊断和治疗思路告诉她，转告给她印度当地的医生，同时她想再复查一下究竟是什么问题。我说阴虚、血瘀还有肾气虚都是中医独有的概念，是超越了任何西医的知识范畴的。

估计这就是她之前怎么找西医查都查不出来问题的原因吧。

注意：中医根据个体差异所采取的治疗手段和治疗效果亦有差异，医案分享不构成治疗建议。

医案编号：086

一位三十多岁的印度裔女士出现崩漏而下血不止三个月有余，家医给她做了所有的检查就是发现不了任何原因，幸运的是有人推荐她服用了我们的妇科圣药之一的乌鸡白凤丸，效果很好，血止住了。但是，她发现这个药不能停，...

14/01/2023

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07/12/2022

“新冠”没有预防方

随着中国防疫政策的逐渐放开，感染风险提升，现在国内又开始讨论新冠预防方的问题。我的观点很明确，根据在新西兰的疫情观察，我认为新冠没有什么放之四海而皆准的有效预防方。换句话说，根据瘟疫的特点，最好的预防就是“避疫”，但是避不开了，那只能大概率被感染。这绝对不是吃几天预防方就能不被感染的。从临床观察来看，全家一起被感染新冠是非常常见的，只是感染的早晚和症状的轻重的区别。

一般来讲，体质好、没有什么基础疾病的症状比较轻，或者无症状感染。但所谓体质好，不代表看起来壮实。壮实的人也有火气大，痰湿等各种问题，只是自己不自知而言。这类人症状也不见得轻微，只是不会发展为重症而已。

比较需要注意的人群是年龄高、体弱、基础疾病复杂的人群。但这类人群本来就是容易被各类流感收割的人群，而预防的办法只有把功夫花在平时，找个好的中医，把身体调理好。而这都是要花大功夫的，也绝非简单预防方可以解决的。

另外，预防方只要是药，都有一定的偏性，如果吃错了方向，跟自身身体状况不符，多有害无益。盲目预防是对自己身体不负责任的。

总结一句话，新冠感染几乎等同于一场流感，危害极小，服用预防方是没用的，也不必服用。如果真的爱惜和注意自己的身体，要把功夫花在平时，愿意花时间花精力解决好身体的基础问题，这样就算老了也不容易被各类瘟疫收割。

随着中国防疫政策的逐渐放开，感染风险提升，现在国内又开始讨论新冠预防方的问题。我的观点很明确，根据在新西兰的疫 [...]

12/10/2022

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05/09/2022

患者，女，55岁，主诉为腰部两侧疼痛（以左腰为主），大腿前侧、外侧疼痛以及左侧臀部底部固定位置的疼痛。患者说要用东西抵住臀底部疼痛的那个点才会舒服一些。臀部该疼痛始于患者子宫内膜异位的肿物切片检查后，每逢经期则疼痛显著。患者自述做过西医检查，没有腰间盘突出，右侧发现椎管狭窄，西医建议局部打封闭针。也曾找过理疗师、针灸师治疗，效果有限。疼痛指数最高可到8/10，就诊时为6/10，疼痛伴随少量的麻木。 因疼痛问题，患者走路不敢用力。患者长年怕冷怕风，到了冬天就浑身难受，腰部发冷发沉。大小便基本正常，精神佳，睡眠一般，习惯晚睡，嗓子干，有痰，月经量少。舌淡胖大，苔薄白，舌中有所凹陷。脉细弦数。中医诊断为血虚血瘀及阳虚。采用针药结合的方式，经过6次针灸及4次中药治疗后，患者感觉明显改善，患者因感染新冠病毒未继续治疗，过两个月后反馈已无大碍。

这个医案为什么要针药并用呢？

其一，患者的致病因素比较复杂，疼痛可能的因素比较多，比如阳虚疼痛，气血虚疼痛以及血瘀的疼痛。从疼痛的分布来看，包含了少阳经，太阳经以及阳明经所过。针药并有可以较好的覆盖这些因素；

其二，虚症的疼痛，尤其是气血虚弱，首先要做的是补足气血，否则疼痛治疗的效果大受影响。针药结合可以加速治疗进度。

另外，还有个有趣的现象。第一次检查时，我们发现患者左腿委阳穴附近有紫色怒张的静脉，符合放血条件。我们本来打算建议患者在第二次治疗时予以放血处理，没想到只经过一周的药物活血化瘀，该处的怒张的静脉已经明显好转，故而未做处理。在治疗的尾声，局部皮肤已经看不到明显的静脉曲张。这也说明经方对于改善络脉的血液循环作用立竿见影。





注意：中医根据个体差异所采取的治疗手段和治疗效果亦有差异，医案分享不构成治疗建议。

医案编号：081

患者，女，55岁，主诉为腰部两侧疼痛（以左腰为主），大腿前侧、外侧疼痛以及左侧臀部底部固定位置的疼痛。患者说要用东西抵住臀底部疼痛的那个点才会舒服一些。臀部该疼痛始于患者子宫内膜异位的肿物切片检查后，每....

05/09/2022

A 55-year-old female patient complained of pain on both sides of the waist (mainly on the left waist), pain on the front and lateral sides of the thigh, and pain in the fixed position of the bottom of the left buttock. The patient said that it would be more comfortable to use something against the pain point on the bottom of the buttocks. The pain in the buttocks started after the patient’s endometriosis tumor biopsy, and the pain became more pronounced during menstruation. The patient reported that she had undergone a Western medical examination, and there was no lumbar disc herniation, and spinal stenosis was found on the right side. She has also sought physiotherapists and acupuncturists for treatment, but the effect was limited. The pain level can be as high as 8/10 and 6/10 at the time of presentation, and the pain is accompanied by a small amount of numbness. Due to the pain, the patient did not dare to walk as usual. The patient has been afraid of the cold and the wind for many years. In winter, her whole body is uncomfortable, and her waist becomes cold and heavy. The urine is basically normal, the spirit is good, the sleep is normal, the habit of going to bed late, the throat is dry with phlegm, and the menstrual amount is small. The tongue is pale and enlarged, with a thin white coating. Pulse is thin/taut/fast. The diagnosis of TCM was blood deficiency, blood stasis and yang deficiency. Treated with the combination of acupuncture and medicine, after 6 times of acupuncture and 4 times of traditional Chinese medicine treatment, the patient’s feeling improved significantly. The patient did not continue the treatment due to the infection of the Covid. After two months, the feedback was all good.

Why is the combination treatment of acupuncture and medicine used in this medical case?

First, the pathogenic factors of patients are much more complex, and there are many possible factors for pain, such as pain due to yang deficiency, pain due to qi and blood deficiency, and pain due to blood stasis. From the distribution of pain, it includes the Shaoyang meridian, the Taiyang meridian and the Yangming meridian. Acupuncture and medicine can better cover these factors;

Second, for the pain of deficiency syndrome, especially the weakness of qi and blood, the first thing to do is to supplement the qi and blood, otherwise, the effect of pain treatment will be greatly affected. The combination of acupuncture and medicine can significantly speed up the progress of treatment.

Case NO.081

A 55-year-old female patient complained of pain on both sides of the waist (mainly on the left waist), pain on the front and lateral sides of the thigh, and pain in the fixed position of the bottom of the left buttock. The patient reported that she had undergone a Western medical examination, and th...

21/08/2022

One patient, in his 40s, suffered from carpal tunnel syndrome for around 2 weeks. He felt quite sore and a bit painful in his right wrist. The cause might be too much use of his right hand for smartphone and mouse. He felt the weakness in the local area. No much numbness, but the sore feeling in the middle of the wrist can radiate to his forearm and hand.

It is diagnosed as the overuse of his right hand causing the deficient Shaoyang meridian. The treatment should focus on the supplement of his Shaoyang meridian. After 2 treatments with acupuncture, the patient felt much better.

Carpal tunnel syndrome is quite common when people use more and more smartphones and laptops with mouse or touchpads. Acupuncture is a quite effective way to release the symptoms. However, the only effective way for prevention is that the patients can reduce their use of smartphones and laptops.



Case NO.079



Note: TCM doesn’t ‘treat’ any certain WM disease name. TCM has its own system and method to rebalance the human body, release the symptoms and help the body truly recover on its own. TCM treatment methods and effects are different according to individual differences, and the sharing of the case study does NOT constitute treatment recommendations.

One patient, in his 40s, suffered from carpal tunnel syndrome for around 2 weeks. He felt quite sore and a bit painful in his right wrist. The cause might be too much use of his right hand for smartphone and mouse. He felt the weakness in the local area. No much numbness, but the sore feeling in the...

21/08/2022

一名 40 多岁的患者患有腕管综合症约 2 周。 他的右手腕感觉酸痛不适。 原因可能是他的右手过多地使用智能手机和鼠标。 他感觉局部手腕无力，喜按摩。 没有太大的麻木感，但手腕中间的酸痛不适感可以辐射到他的前臂和手掌。

诊断为右手腕因过度使用而导致手少阳经的虚弱。 治疗以补局部少阳经为重点。 针灸2次后，患者感觉不适感基本缓解，未再巩固治疗。

当人们越来越多地长时间使用带有鼠标或触摸板的笔记本电脑和智能手机时，腕管综合症变得越来越常见了。 针灸是一种非常有效的缓解症状的方法。 然而，唯一有效的预防方法是患者可以减少使用智能手机和笔记本电脑的时间，减少右手腕关节的持续疲劳。

一名 40 多岁的患者患有腕管综合症约 2 周。 他的右手腕感觉酸痛不适。 原因可能是他的右手过多地使用智能手机和鼠标。 他感觉局部手腕无力，喜按摩。 没有太大的麻木感，但手腕中间的酸痛不适感可以辐射到他的前臂和手....

04/08/2022

The patient is a female, 35+ years old, Asian. Two days ago, her throat became sore and itchy, and she felt her body hot and cold alternatively. Since yesterday afternoon, she has felt weak in her legs. At night, she got high fever to above 39 degrees, accompanied by nasal congestion, headache, no sweat, and vomited a lot of white sticky phlegm. Covid-19 self-tested positive. No shortness of breath, no dizziness and nausea, no thirst, good appetite, and no bowel movement yesterday. No cold hands and feet, no rash. The tongue is thin, white with a red tongue body. The patient is diagnosed by online video consultation, so there is no pulse diagnosis information. The combination of Jing Fang(classic formula) and Wen Bing Fang(warm disease formula) was used for treatment, and the dose of herbal medicine was given for five days.

On the second day, the patient’s son, 4 and a half years old, started to have a high fever of over 39 degrees the night before, headache, sore throat, cough, and sore legs. He had taken preventive herbal medicines three times, and his body was sweating, and it was 38 degrees in the morning. No phlegm. it was hard for him to have the stool out, and the urine is yellow. He did not want to drink water. Eating normally. His lips were dry, and his throat was not too red. Light tongue coating, with red tongue body. No pulse diagnosis information. The combination of Jing Fang and Wen Bing Fang was used for treatment, and herbal medicine was given for three days.

On the third day, the patient’s husband began to develop symptoms, with a very strong headache and high fever. The daughter has been taking preventive medicine but has also developed mid-low fever, sore throat and headache. Prescribed the medicine to them accordingly.
Judging from the feedback, the family’s Covid symptoms, including high fever, sore throat, headache, etc., were quickly and effectively relieved after taking the medicine, and the high fever was basically relieved in one day. Some family members still have some cough symptoms left. Generally, if the cough cannot be relieved on its own after the Covid, it will take a period of treatment and it will disappear.

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The patient is a female, 35+ years old, Asian. Two days ago, her throat became sore and itchy, and she felt her body hot and cold alternatively. Since yesterday afternoon, she has felt weak in her legs. At night, she got high fever to above 39 degrees, accompanied by nasal congestion, headache, no s...

04/08/2022

患者女，35岁+，亚裔，两天前开始嗓子不适，发痒，身上忽冷忽热。从昨天下午开始感觉腿软，晚上开始高热至39度以上，伴有鼻塞，头痛，无汗，吐了很多白粘痰。新冠自测为阳性。没有气短，没有头晕恶心，没有觉得特别口渴，食欲不错，昨天没有排便。没有手脚凉，没有出疹。舌苔薄白，舌质红。网诊病人，故而无脉诊信息。采用经方与温病方合方治疗，予中药五日量，发热则增量服用。

第二日，患者儿子，4岁半，于前夜开始发高烧39度以上，头痛，嗓子疼，咳嗽，腿酸痛，吃过三次预防性的辛凉轻剂，身上有汗，早上38度。没有痰。大便拉不出来，小便黄。不想喝水。吃饭正常。嘴唇干，身上潮乎乎的，嗓子不太红。舌苔浅淡，舌质红。无脉诊信息。采用经方与温病方合方治疗，予中药三日量，发热增量使用。

第三日，患者丈夫开始出现症状，头痛欲裂，高热。女儿一直在吃预防方，但也出现了发热，嗓子痛和头痛的症状。继续予以中药服用。

从之后的反馈来看，这一家人的新冠症状，包括高热，嗓子痛，头痛等都在服药后迅速得到了有效缓解，基本都是一日退了高热。个别家庭成员还余留一些咳嗽症状。一般新冠后咳嗽如果无法自行缓解的话，还需要一段时间的治疗，也会消失。

讨论几点：

其一，实践证明，中医的古方（包括伤寒方和温病方）可以有效对付新冠病毒，且治疗效果显著。现代人拼凑出来的方子，不见得有古方这么好的效果；

其二，新冠病毒的传播力强，全家人一起得病的情况非常普遍。大部分情况下，可以全家人用一样的方，但是如果可以在大方向一致的情况下，根据不同人的特征、不同治疗阶段的特征进行调整，则效果更好。此病例中女患者和她儿子用了并不全相同的方组，而到了后期到女儿再生病的时候，由于前期预防方起到的作用，组方已经基本简化到只用到温病方了。



注意：中医根据个体差异所采取的治疗手段和治疗效果亦有差异，医案分享不构成治疗建议。

医案编号：078

患者女，35岁+，亚裔，两天前开始嗓子不适，发痒，身上忽冷忽热。从昨天下午开始感觉腿软，晚上开始高热至39度以上，伴有鼻塞，头痛，无汗，吐了很多白粘痰。新冠自测为阳性。没有气短，没有头晕恶心，没有觉得特别口....

31/07/2022

One patient, male, Asian, 54 years old, complained of pharyngeal discomfort and throat clearing for more than ten years. At the same time, the cough has not been relieved after a cold two years ago. The specific manifestations include: rales can be heard when breathing, and frequent throat clearing, a very tight chest slight releasing with the pressing, and the position is probably between Tiantu and Tanzhong points. Thick white and clear phlegm in green bean size, very difficult to cough up. A gritty foreign body sensation in the throat. Dry throat, like to drink a large amount of water, acid reflux, frequent urination, late sleep, not hungry or sleepy. Hay fever. The middle and rear part of the tongue is thick and the sublingual vein is tortuous. The whole pulse is deep, taut, fast, and tight overall, the right Cun sinking position is strong, and the right Chi is slightly stiff.

There are many health issues in this patient. We solve the main complaint first- the lung problem. The principals are focusing on opening up the chest and regulating qi, reducing phlegm and descending lung qi, and taking into account blood stasis as well.

After the first week of medication, the patient was very happy with the effect and reported that the rales disappeared, the chest tension was significantly improved, the phlegm basically disappeared, the sleep was improved, and he started to feel more sleepy at night. After the second week of medication, the patient said that he felt no different from before the illness. However, although the pulse has been better, it has not been completely improved, and he is instructed to continue to take medicine to consolidate.

A few points to discuss here:

First, as the Chinese saying goes: sickness comes like a mountain falling down, sickness goes like a thread pulling out. For the treatment of chronic diseases in the excess situation like this patient, the effect can be very fast, but in order to completely remove the root of the disease, the patient needs to be more patient and spend more time removing all the root issues. Generally speaking, for the treatment of non-deficiency diseases, it may only take 30% of the time to improve the first 70% of symptoms, but it takes 70% of the time to improve the symptoms of the last 30%.

Second, the importance of pulse syndrome is also clearly reflected in this case. Although the patient feels normal, only by feeling the qi with pulse check, the patient’s degree of improvement can be truly and objectively reflected. If the important role of the pulse is ignored, and only the formula-symptom corresponding method in TCM is used to formulate the prescription, it is impossible to accurately evaluate the condition of the patient who has “no manifested symptoms”.

Case NO.077



Note: TCM doesn’t ‘treat’ any certain WM disease name. TCM has its own system and method to rebalance the human body, release the symptoms and help the body truly recover on its own. TCM treatment methods and effects are different according to individual differences, and the sharing of the case study does NOT constitute treatment recommendations.

One patient, male, Asian, 54 years old, complained of pharyngeal discomfort and throat clearing for more than ten years. At the same time, the cough has not been relieved after a cold two years ago. The specific manifestations include: rales can be heard when breathing, and frequent throat clearing,...

31/07/2022

患者，男，亚裔，54岁，主诉为十多年的咽部不适及清嗓子，同时两年前感冒之后咳嗽一直未好，具体表现为：呼吸时可闻杂音，清嗓子一直清不干净。胸部发紧，按压则舒服，位置大概在天突与膻中穴之间。有小颗粒的白色浓痰，非常难咳出。咽喉部有砂砾样异物感。嗓子干，喜饮水，胃反酸，小便频多，平日睡眠较晚，不饥不困。另有花粉症。舌中后部苔偏厚，舌下静脉迂曲。脉整体偏沉数紧弦，右寸沉位有力，右尺略弦硬。

此患者存在多个方面的问题，先解决肺的问题为主，集中在宽胸理气，化痰降肺气同时兼顾瘀血。

第一周用药后，患者非常高兴，反馈哮鸣音消失，胸口紧张明显改善，小颗粒痰基本消失了，睡眠有所好转，晚上有困的感觉了。第二周用药后，患者说已经感觉跟生病前已经没有什么差别了。但摸脉虽已大好，还未彻底改善，嘱咐继续用药巩固。

这里讨论几点：

其一，俗话说：病来如山倒，病去如抽丝。对于慢性病的治疗，由于此患者是实证，所以获效很快，但是要想把病根完全去除，是需要患者有耐心多花些时间的。一般来说，对于非虚性疾病的治疗，前70%的症状改善，可能只需要花30%的时间，但后30%症状的改善，有时候需要花掉70%的时间。

其二，脉证的重要性在这个案例里面也有明显的体现。虽然患者感觉如常了，但是只有通过摸脉感受脉气，才能最真实客观地反应患者改善的程度。如果忽视了脉的重要作用，只用方证相应的思维去处方，就无法准确评估已经”不体现为症状的“患者的病情。





注意：中医根据个体差异所采取的治疗手段和治疗效果亦有差异，医案分享不构成治疗建议。

医案编号：077

患者，男，亚裔，54岁，主诉为十多年的咽部不适及清嗓子，同时两年前感冒之后咳嗽一直未好，具体表现为：呼吸时可闻杂音，清嗓子一直清不干净。胸部发紧，按压则舒服，位置大概在天突与膻中穴之间。有小颗粒的白色浓....