至阴

患者年龄35岁，男性。主诉阳痿4年余。病史示性欲澹漠，难以起阳或举而不坚，头昏耳鸣，畏寒肢冷，腰膝痠软，夜尿频。面色无华，神情倦怠，舌澹红，苔少而滑，脉沉细弱。中医病名为阳痿，证型属肾阳不足，命门火衰，宗筋弛纵。病因病机为肾藏精，主生殖，肾阳不足导致阳痿不举。

患者男性，46岁。主诉左侧偏头痛15年，发作时间数分钟至数小时，精神紧张时加剧，近2年发作频率增加。舌象未提及，脉象未提及。中医病名偏头痛，证型未明确，病因病机未详细描述。

患者61岁，女性。主诉入睡困难20年，加重5天。主要症状包括入睡困难、睡后易醒、多梦、胸闷胁痛、心烦、口干渴喜饮、眼干、不思饮食、小便黄赤、大便秘结。中医诊断为不寐，证型为肝郁气滞。病因病机为肝气郁结，气机不畅。望诊见眼干，舌象未提及。闻诊无特殊描述。问诊包括睡眠障碍、情绪烦躁、口干、饮食及二便情况。切诊未提脉象。

患者男性，40岁。全身水肿10个月，腰以下为甚，按之凹陷不易恢复，脘腹胀闷，纳减乏力，面色无华，神疲少尿。舌质澹，苔白滑，脉沉弱。中医诊断水肿，辨证脾阳虚损，土不制水。病因病机为脾阳虚损，水液运化失常。望诊面色无华，舌质澹，苔白滑。闻诊未提及。问诊有水肿、脘腹胀闷、纳减乏力、神疲少尿。切诊脉沉弱。

患者40岁，男性。主诉阳事不举3年。病程3年。中医病名阳痿。证型肾阳亏虚、肾气虚衰。病因病机劳神过度、心阴亏耗、恣情纵欲、命门火衰、精气亏虚。体胖，精神萎靡，面色暗而无光，舌质澹红，双尺脉细弱。

8岁男性，眼睑、颜面及四肢浮肿，食欲不振，精神倦怠，四肢乏力，病程约1个月。中医诊断水肿（风水），证型肺气不宣，肃降失常。面色㿠白，舌苔薄白，脉浮。

女，29岁，月经前乳房、乳头胀痛，少腹胀痛，阴中抽痛，胸闷胁胀，烦躁易怒，精神抑郁，时有叹息。舌边尖红，苔薄白，脉弦。证属肝气郁结。

头痛，少年不慎酒色，兼气恼而得。遇劳遇寒遇热皆发，色欲则头岑岑而欲卧。肾劳，肾水不足，肝木燥，龙雷之火上冲巅顶。舌象未提，脉象未提，面色未提，声音气味未提，病程未提。中医病名头痛，证型肾水不足，肝木生火，病因病机肾劳，气恼，酒色过度。

患者男性，44岁。反复水肿、腰痛四年余。面色皖白，舌尖红，苔薄白，脉细数兼滑弦。主症为水肿、腰酸、四肢疲倦、懒言、乏力、心烦、发热、咽干、手足心热、小便短少色黄有泡沫。中医病名水肿，证型气阴两虚，病机为阳损及阴，三脏见虚，阴虚内热。

患者男性，38岁。主诉小腹剧痛，阴缩半天。现病史示昨日下半夜突发小腹痛欲死，阴囊、睾丸及阴茎全缩入腹，口鼻气凉。面色唇甲青紫，四肢逆冷，舌青苔白，脉沉细而伏。诊断为阴缩证，病因系房事后卧于阴冷之处，寒邪直中至阴。

患者，女，眼疮（麦粒肿），反复发作，月发一次，病程6个月。眼睑浮肿，与经期相关。风热之邪客于眼睑，脾胃内热，循经上攻于目，经气郁滞，化火腐肉。舌尖红赤溃烂，午时疼痛加剧，小便黄，心烦，舌苔黄。背部有赤点如粟，合谷穴、太阳穴压痛，至阴穴、关冲穴、足窍阴穴、内庭穴、厉兑穴相关。灵道穴、少海穴、厥阴俞穴压痛。

患者73岁，男性，主诉右侧胁肋部疼痛2月余。右侧胁肋部疼痛，局部皮肤色红，疼痛放散至腹部及背部。舌淡，苔薄白，脉细弦。中医诊断胁痛，辨证为热邪滞留、孙络不通。

患者36岁，男性，主诉脐下至阴囊部胀痛麻木，痛势剧烈，小便频急，日夜三、四十次，量少不爽，阳痿不举，食欲不振，头晕不寐。脉小弦，舌苔薄滑。诊断为气淋，病因病机为忧思郁怒，厥阴之气失于疏泄。病程四天。

患者年龄4岁，纳差2周。厌食，脾阴不足。食欲差，饮水少，进食则腹胀，脐周偶痛，口唇干裂，腹软，脐周轻压痛，手心热。舌澹红，少津，苔薄。脉未提。

患者34岁，男性。体倦乏力、心悸失眠10年，工作能力减退，易出虚汗，下午精神萎靡，面色灰黑，指甲干枯凹陷，眼球有黑色粒子影群。苔薄白，脉沉细无力。辨证为久劳伤损，气血不足，精气不能濡头目，外润肌肤爪甲。

女性，30岁，失眠1年，难入睡，早醒，醒后难再睡，心烦，易激动，易怒，日间精神不佳，皮肤红疹，月经量少，腰酸痛，胸闷胸痛，晨起黄痰，咽部不适，口腔溃疡，尿黄，夜尿频，大便不爽，口干口苦，头后枕部痛，目胀发热。舌边尖红，苔少，脉滑小弦。诊断为失眠，证属阴虚阳亢。

患者年龄未提及，性别未提及，主诉腹满肿胀，病程百日有余。中医病名腹满，证型脾肾功能失调，病因病机脾损不能散精于肺，胃损不能司肾之关钥，水湿泛滥。望诊未提及，闻诊未提及，问诊描述喘咳、肿胀、经百日有余，切诊脉来微弱无神，右脉尤甚。

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3岁男性，头面部皮肤潮红，红色丘疹，奇痒，破后流黄水，起脓疱，气味腥臭，病程入夏至秋加剧，面浮肢肿，阴囊肿大透明，小便点滴难出，大便闭结，发热，口渴喜饮。面色苍白，舌澹苔白，脉沉细而缓。水肿，病因属邪气侵袭，肺脾肾功能失调，水湿内停，正气亏虚。

4岁5月男童，周身水肿2个月，倦怠乏力，易出汗，腹胀，睡眠差，大便每日3次，小便泡沫多，尿量少，面色萎黄，周身水肿，腹胀大如鼓，下肢按之如泥，肌肤甲错，舌澹红有瘀斑、苔白腻，脉细数，诊断为水肿，证属脾肾亏虚，水湿泛滥，瘀血阻滞。