北沙参+血瘀

刘某，男，76岁。间断发热伴咳嗽、咳黄痰、周身乏力9个月。双肺CT提示间质性肺炎改变。风热犯肺，肺失肃降。营卫不和。肺气不足，气滞血瘀。面色无华，舌质红，苔黄腻。声音低微，气息短促。脉浮数，脉细弱。

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患者26岁，女性，主诉烦渴引饮，日饮水多时达10暖瓶，病程3年。中医诊断消渴，证型未明确提及，病因病机为情志不舒，气机郁结，化火伤阴。望诊见舌黄厚腻，晦暗，苔薄质暗灰。闻诊未提及。问诊见烦躁、头痛、尿清长有气味、月经不调。切诊见脉细数（104次）、濡细（84次）。

患者26岁，女性，右侧胁肋胀痛1月余，伴心烦急躁，小腹胀痛，腰部酸楚。病史有药物流产后阴道出血淋漓，未行经，有刮宫流产史。舌质偏暗，边有齿痕，苔薄黄，脉细弦。中医诊断胁痛，证属气血不足、肝气郁结、心肝火盛。

46岁女性，双上肢白斑1年余，颜面双颊、双上肢散在色素脱失斑，无自觉症状，倦怠乏力，夜寐不安，易于感冒，腰部酸痛。舌红少苔，脉沉。中医诊断白驳风，证属血虚生风，肝肾不足。

42岁女性，主诉口、眼、鼻、咽喉干燥、阴道干涩3年余，加重2个月。现症见双目干涩、无泪，口干咽燥，声音嘶哑，鼻干无涕，吞咽困难，皮肤干燥，手足心热，心烦易怒，疲乏无力，睡眠不佳，纳差，小便涩赤，大便干结。中医诊断为干燥综合征。证属阴虚内热、气虚血瘀。病因病机为气虚失运，瘀血内阻，耗损津液，致燥证。舌象未详，脉象未提。

女，76岁，发热，口干，食欲不振，右侧肝区、肾区疼痛，舌红、少苔，脉弦细，肝痈、肾痈（阴虚热毒血瘀型），肝肾阴虚，热毒内蕴，血瘀阻络，舌红少苔，脉弦细

女，33岁，月经先后不定期，量多有块，少腹疼痛1年余。子宫肌瘤，属瘕、积聚。证属肝气郁结，冲任失调，气滞血瘀。舌澹体胖有齿痕，苔黄腻，脉滑。

68岁男性，咳嗽频作，痰多白黏，胸痛胁满，咯血，纳食不佳。舌质红，苔黄腻，脉弦细。辨证为痰毒阻肺，痰阻气滞，血不归经。诊断为息积，痰毒蕴肺，肃降失司证，原发性中心型肺鳞癌。

男性，66岁，阵发性压迫性胸痛2年余，加重1个月。胸闷心悸，偶有胸胁胀痛，劳累、情绪激动后加重，心烦失眠。舌质紫暗、苔红，脉弦。胸痹，气滞血瘀。肝气郁结，血虚瘀阻，心失所养。

患者56岁，男性，胃脘胀痛加重，食后尤著，有时呈刺痛，食欲减退，四肢乏力，大便溏软，体重明显下降。胃镜检查示重度萎缩性胃炎，病理切片示慢性萎缩性胃炎（重度）、鳞状上皮轻度增生。证属气虚血瘀，胃络阻滞。面色萎黄，舌淡苔薄，脉细弱。

患者男性，70岁。吞咽困难，伴胸骨后痛。病程自1981年11月至1994年1月，共12年又3个月。中医病名食道癌。证型脾虚失运，气滞、血瘀、痰凝。病因病机脾虚失运，气滞血瘀，痰凝结而成症，留阻胸膈。望诊未提及。闻诊未提及。问诊吞咽困难，胸骨后痛，乏力消瘦，呕血。切诊脉象小弦，舌苔薄润。

女，60岁，失眠头昏，健忘多梦心悸，胸闷气短，腿软，出汗怕冷，乏力。高血压动脉硬化冠心病。心阴亏虚，心血瘀阻，心神失养。面色苍白，舌淡苔薄，脉细弱。心前区不适，胸闷气短，怕冷出汗，乏力。脉细弱。

患者年龄87岁，男性。主诉腹部胀满、双下肢水肿、胸闷、气喘1月余。中医病名鼓胀，证型气滞血瘀，水饮停滞。面色晦暗，舌质紫暗，脉弦涩。胸闷、气喘，不能平卧，腹部胀满，双下肢水肿明显，纳眠差，小便量少。病史有肺心病10余年。

患者年龄10岁，女性。主诉腹痛4年，好发早晨，偏右腹为甚，时有包块。面色萎黄，舌红苔薄，脉细涩。二便尚调。病程较长，症状持续4年。中医病名腹痛，证型气滞瘕聚，病因病机久病成瘀，脉络瘀阻，不通则痛。舌象舌红苔薄，脉象脉细涩。

患者男性，41岁。主诉心慌、胸闷2年余，伴阵发口干、气短、胸痛，乏力、腹胀、胃脘不适。西医诊断为心肌缺血（红血性心脏病）。中医辨证为血热、血瘀、心络不通。舌质紫黯，苔黄厚腻，脉细数而涩。口唇紫黯，眼球充血稍突出，钩状指阳性。红细胞7.24×10¹²/L，Hb22.2g/L。

患者23岁，女性。主诉为颜面暗红斑块、关节疼痛、发热、口腔糜烂、头昏乏力、咽干口渴、胸闷纳差。病程数年，急性期高热持续。颜面蝶形红斑，舌质红少苔，脉细数。辨证为毒热炽盛，气血两燔。后期出现气阴两伤，血脉瘀阻，脾肾不足，气血瘀滞。

患者55岁，男性，主诉心悸胸闷20年，加重4年。主要症状包括心悸、气急、胸闷、双下肢水肿、纳差、乏力、咳嗽痰多、口干、口唇指甲紫绀。舌质紫黯少津，舌苔微黄腻，脉细涩。中医诊断为心悸，证型为气阴两虚，痰瘀互阻。病机为气阴两虚，痰瘀互阻，心血瘀阻，脾虚失运。

61岁男性，胸闷痛频发，活动、情绪波动及冷水刺激可诱发，病程8年，高血压病史20余年。舌质暗紫舌尖赤，苔白，舌根白腻，脉沉弦细。中医诊断为胸痹，证型为气阴两虚兼痰浊血瘀。面色晦暗，舌象暗紫，脉沉细弦。胸痛与气滞血瘀、痰浊内阻有关，气虚则气滞，气滞则血瘀，痰浊血瘀互结，血脉瘀阻。

57岁 乏力 气短 纳差 肝区不适 两胁胀痛 睡眠差 大便软 面色晦暗无光泽 蜘蛛痣 肝郁脾虚 气虚血瘀 面色晦暗无光泽 舌淡红 苔薄白 脉平缓