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第68章 快速到来的考验(2 / 2)

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病人:李婷,32岁,因咽喉疼痛来诊。

症状:

李婷是一位年轻女性,近来出现了持续的咽喉疼痛和吞咽困难。她告诉林婉儿,症状起初不太明显,但逐渐加重,尤其是早晨起床后,感觉喉咙干燥,有异物感,时常伴随轻微咳嗽和声音沙哑。她还提到,最近天气骤冷,她晚上喜欢开窗通风,睡觉时裸露脖部,尤其是凌晨时分感觉特别冷,早上醒来时喉咙疼痛更加明显。

林婉儿的诊断过程:

林婉儿在问诊时,李婷提到的咽喉症状和习惯,立即让她联想到风热上火所致的喉部不适。她回忆起之前从文老那里学到的关于“风热犯肺”的症状,认为李婷可能是由于外界的风热侵袭所致,导致了喉部炎症。

脉诊:

林婉儿把脉时发现,病人的脉象略浮且偏数,尤其在浮脉上感觉有些微热,手指轻触脉搏时有明显的跳动。根据这些脉象,林婉儿判断出李婷属于风热犯肺的类型。

诊断和开方:

基于这些症状和脉象,林婉儿诊断为“风热犯肺”,认为是因为外邪侵袭引起的喉部炎症。于是她开了一副清热解毒、宣肺散风的药方,里面有薄荷、菊花、金银花、连翘等典型清热解毒的药材,并加上了甘草、桔梗来缓解咽喉的疼痛。

她自信满满地看向文老等待师父的诊断。

然而,文老看出了一些端倪。当他仔细诊脉以及观察李婷的症状和表现后,便知道了问题出在哪里。

文老的指正:

文老仔细询问了李婷一些生活习惯后,得知她最近频繁受凉,晚上睡觉时喜欢开窗,尤其是下半身盖得不够,受了寒气。文老点了点头,明白了问题所在:李婷的咽喉疼痛并不是风热所引起,而是寒邪入侵,导致咽喉部的气滞血瘀和体寒所致。

文老通过脉诊和辨证,将“风寒袭肺”作为诊断,认为寒气入侵会导致气机不畅,产生喉咙疼痛、咳嗽等症状,且脉象表现为沉紧而非浮数。

正确的治疗方案:

文老为李婷改了方子,这次他开了一副温肺散寒的药方,里面包含了干姜、肉桂、细辛、苏叶等温补寒气的药材,并加入了杏仁、枳壳来疏通气机,帮助解除咳嗽和喉咙痛的症状。

同时,文老告诫李婷在睡觉时要保持温暖,避免受凉,尤其是脖部要好好保护,不要再开窗吹冷风。要避免寒凉的食物和饮料,多喝温水,保持身体的温暖。

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