睡眠差+纳差

患者男性，48岁。主诉胸闷胁痛，腹胀4小时。舌红，苔薄黄。脉弦。辨证为瘀血闭肺型。病机为外伤致瘀血闭阻肺络，病位在胸胁、胸肺。

谭某，女，28岁。渐进性痛经，腰腹和肛门坠痛，剧痛时呕吐，出冷汗，经量增多，经期延长，血块多，块出痛减，大便溏，每日3次，婚后未孕。舌澹黯，边有小瘀点，苔薄白，脉弦细数。中医诊断为痛经，证型为血瘀气滞。妇科检查见子宫后倾，活动受限，宫后壁有硬实结节，左侧附件增厚压痛，右侧附件索状物压痛。

患者59岁，男性，主诉腰椎术后腰痛5天，发热伴乏力3天。腰痛，神疲，乏力，纳差，睡眠差，大便未排。舌红，少苔，脉弦细。中医诊断内伤发热，属气虚血瘀。

女，77岁，发热月余，双下肢发冷，纳差，口干口苦，双胁胀，易惊恐，睡眠差，轻度贫血貌，舌红苔黄厚腻，脉弦数，湿热之邪伏膜原，太阳、阳明、少阳合病，痰湿困脾，阳气郁闭，肝脾不和。

57岁，乏力、气短、纳差、肝区不适、两胁胀痛、睡眠差、大便软，病程30余年。肝郁脾虚，气虚血瘀。面色晦暗无光泽，舌淡红，苔薄白，脉平缓。蜘蛛痣，血清谷草转氨酶升高，血红蛋白降低，血小板减少。

李某，38岁，男性。反复胃脘疼痛6年。隐痛，有时胀痛，偶有反酸、嗳气，口干不苦，纳差，睡眠差，大便不畅，尚成形。舌淡暗，苔薄黄，脉细数。证属脾胃虚弱，湿热内蕴。

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患者纳差1月余，伴心慌心悸，耳鸣，喜叹息，口干，大便不爽。舌澹红，苔白干，脉沉细。辨证为气阴虚衰，内有积滞。病机为脾气亏虚，运化失司，积滞内停，心气亏虚，津液亏虚，肝阴亏虚。二诊见舌澹红胖大，苔薄黄腻，脉沉滑。三诊见舌澹暗，苔白，脉沉细弦。

女，39岁，乏力6个月。倦怠乏力，气少懒言，睡眠差，纳差。舌澹苔薄白，脉缓。紫癜病，气虚。病程6个月。

13岁男性，右眼视物不清2个月，右眼被土块击伤后视力下降。右眼胀痛，眼眶疼痛，纳差，周身倦怠，睡眠差。右眼瞳孔散大，对光反应迟缓，玻璃体混浊，眼底不清。舌淡暗，苔薄白，脉沉细。中医诊断雀盲，病机为瘀血阻络，目睛失养。

患者40岁女性，反复腹泻2年余，加重6月，消瘦，面色无华，水样便日十余次，眼冒金花，怕冷，纳差，胃痛，心慌，手抖，夜尿频，睡眠差。舌暗澹，脉虚弦。中医诊断腹泻，证属脾肾阳虚，湿困中焦。

男，49岁，腹胀、乏力1a余，烦躁易怒，胸中时堵，饮食纳差，睡眠差，面黄，小便色黄，大便干燥，苔黄腻，脉弦、右小于左。中医病名未明确，证型为气血不足，肝郁痰凝，脾虚气滞。望诊见面黄，舌苔黄腻。闻诊未提。问诊见烦躁易怒、胸中不适、饮食纳差、睡眠差。切诊见脉弦，右小于左。

女，38岁。主诉为听到他人议论、监视、语言控制，病程一月余。中医病名未明确提及，证型为心神失养、肝气郁结、脾虚湿盛。望诊见舌淡红苔白腻，舌下静脉迂曲增粗。闻诊见说话声音低。问诊见纳差、睡眠差、怕冷、喜叹息、情绪低落。切诊见脉左关沉弦，尺弦细，寸略滑；右关洪滑，尺虚大无力。

罗某，45岁。胃脘隐痛15年，反复便血4年。胃脘痛，脾胃虚寒证，久痛入络，络脉损伤。舌质澹，苔薄白，脉弦细。上腹部隐隐作痛，有冷感，腹胀嗳气，睡眠差，精神不振，食纳差，大便时溏。

64岁男性，劳累后左侧胸前区疼痛、憋闷，活动后气短，精神不佳，睡眠差，周身乏力，纳差，素腹胀，大便偏干。胸痹，心脾气虚，痰瘀互阻。舌暗，苔白，脉细弦。

患者男性，32岁。主诉右上腹疼痛不适，持续半个月。胁痛、纳差、乏力、腹胀、厌油腻、睡眠差、大便溏薄。舌暗澹，舌体胖大，边有齿痕，苔厚腻，脉弦细滑。中医诊断胁痛，证型为肝郁脾虚兼湿热。

患者64岁，男性。主诉胸骨后不适、伴口糜1周。病程2月前因咳嗽、咯痰就诊，诊断为肺炎，治疗无效。后确诊为恶性胸腺瘤，行手术治疗，术后放疗后出现胸骨后不适、口疮舌糜、纳差、口干、神疲乏力、睡眠差多梦、大便干结、小便黄。舌干红少苔，脉细数。证属气阴两伤。望诊见舌干红少苔，切诊见脉细数。问诊见纳差、口干、神疲乏力、睡眠差多梦、大便干结、小便黄。闻诊未提及。

患者36岁，女性。主诉胃脘部胀满2年，加重1月。病程2年，症状包括胃脘部胀满、两胁胀痛、口干、嗳气频繁、纳差、善太息、心烦、睡眠差、大便干燥。舌淡红，苔白，脉弦。中医诊断为痞满，证型为肝胃不和证。病因病机为情志不遂致肝气郁滞，横逆犯胃，胃失和降。

李某，女，58岁，遍身出黄汗，色黄量多，质粘，目黄，语言低微，疲乏无力，纳差，脉细弱，舌体胖。中医病名：黄汗，证型：脾虚湿热证。病因病机：脾虚湿热夹杂。望诊：面色萎黄，舌体胖。闻诊：语言低微。问诊：疲乏无力，纳差，发热，睡眠不佳。切诊：脉细弱。

患者年龄成年，男性。主要症状包括咳嗽气紧、胸满心烦、心跳加快、昼夜出汗、胃纳不佳、干咳少痰、口干不思饮。中医诊断为肺胀，证型为心肺阴亏，兼挟湿热，湿热熏蒸。望诊见舌苔黄腻、厚腻，闻诊无特殊描述，问诊提示口干不欲饮、纳差，切诊见脉数、脉涩。