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脑出血这么严重都能救回来,小续命汤不愧是治脑出血的金方-
脑出血这么严重都能救回来,小续命汤不愧是治脑出血的金方

脑出血这么严重都能救回来,小续命汤不愧是治脑出血的金方

患者秦某,男,35岁,山西人,平时高血压140~160/90~110mmHg,并有头痛、恶心等症,1999年1月28日因所牵毛驴受惊,头部着地面,突发神志不清,右半身不遂,左肢发抖,急送某院,查血压140/100mmHg,右侧瞳孔散大,意识不清,呼之不应,牙关紧闭,膝肘僵硬,四肢缩成背弓状,全身寒战,发抖。CT提示:基底节出血约20毫升,诊为脑破裂伤伴重度昏迷。

小续命汤——治脑出血金方

经专家会诊,施止血、脱水、抗炎、降颅压。每天大约输液2500毫升左右,吸氧、鼻饲、导尿,经治八天,昏迷加重,咳嗽气促,通知家属,病危出院,准备后事。无奈之中,于2月9日急诊收入我院。

病人昏迷欲死,舌僵肢瘫,神昏失语,四肢痉挛,身屈背弓,肌无弹性,骨瘦如柴,入院诊断:脑中风,属中脏腑闭证。追述病史,平素血压偏高,后因抢救时大量液体输入,阴长阳消,阴寒收引,肺失宣化,脑窍郁闭。

急用古今录验小续命汤:麻黄10克,防己10克,人参10克,黄芩10克,制附子60克,肉桂15克,白芍15克,川芎20克,杏仁10克,甘草10克,防风20克。

用法:①药氧吸入;②药液热敷前后胸腹;③鼻饲或灌肠,每日6次,每次60毫升,间隔4小时。连用3日后,双眼睁开,患体肢软,抽搐停止,排出尿液,全身汗出。做头部核磁共振,结果与1月28日CT片对比,出血面积缩小,脑破裂伤密度减低,仍用药氧吸入、鼻饲小续命汤。前后治疗120天痊愈出院,一年后随访,仍和常人无异,可以驾驶汽车。

思考本病案,主要是重用麻黄、肉桂、附子,此大温大热之药,可发汗消瘀,通畅五窍,使出血得以吸收,受损的脑组织恢复。

此案使笔者认识到孙思邈把“古今大小续命汤”录入到《千金方》之中,对治疗中风昏迷欲死者的奇效推崇备至,曰“大良”,曰“甚良”,曰“必佳”,曰“诸风服之皆验”,评价如此之高,绝非偶然,此案例使笔者真正体会到了小续命汤的确是治疗脑出血的金方,方中强调“录验”二字,说明古人用此方即应验,所谓“续命”乃指在生命断续的情况下可续命而生之意,故该患者瘫痪肢体逐渐得以恢复。

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