七三丹联合金黄散治愈对口疮病案报告1例

A Case Report of Treating Carbuncle of the Nape with Qisan Dan Combined with Jin Huang San

摘要: 病史摘要：老年男性，平素喜冷饮，有饮酒和吸烟病史，精元不足，正气不固，容易感染外邪，正气内虚，外邪炽盛，病邪生于枕骨之下，风府穴处，颈后正中，前与口相对，故名“对口疮”。颈后可见一12 cm × 4 cm的创面，局部可见脓性渗出，有结痂，创面周围可见紫褐色肿胀，高于周围皮肤，局部皮温不高。无心悸胸闷、头昏头疼等不适，精神矍铄，食欲尚可，偏食冷饮，大便如常，有夜尿，睡眠欠佳，易醒梦多。舌质淡苔薄白、脉沉弦。对局部进行常规消毒后，将按照比例混合均匀配制好的七三丹和金黄散外擦局部，并专门对创面使用七三丹喷洒，每天2次换药，保持创面湿润，经过治疗后疮面痊愈。中医诊断：对口疮、正虚邪实。西医诊断：蜂窝组织炎。干预措施：1) 采用七三丹联合金黄散以拔毒提脓，化腐生肌，扶正祛邪。2) 原本计划配合内调中药，但患者拒绝内服中药，故而未开汤剂。3) 少吃生冷刺激的食物，保持好心情，少吃盒装牛奶，治疗期间不吃发物。保持大便通畅。疗效转归：治愈。

Abstract: Summary of Case History: An elderly male, who usually prefers cold drinks, has a history of alcohol consumption and smoking. He has insufficient essence and qi deficiency, making him prone to external pathogenic factors. With internal qi deficiency and external pathogenic factors being excessive, the disease originated beneath the occipital bone, at the Fengfu acupoint, at the posterior midline of the neck, facing the mouth, hence the name “Carbuncle of the Nape”. A 12 cm × 4 cm ulcer can be seen at the back of the neck, with local purulent exudate and scab formation. There is purple-brown swelling around the ulcer, higher than the surrounding skin, and the local skin temperature is not elevated. There are no symptoms such as palpitations, chest tightness, dizziness, or headache. He is in good spirits, has a fair appetite, prefers cold drinks, has normal bowel movements, has nocturia, and has poor sleep with frequent awakenings and many dreams. His tongue is pale with a thin white coating, and his pulse is deep and taut. After routine disinfection of the local area, a mixture of Qisan Dan and Jin Huang San, prepared in the correct proportion and thoroughly mixed, was applied externally to the affected area. Additionally, Qisan Dan was specifically sprayed onto the ulcer surface. The dressing was changed twice a day to keep the ulcer moist. After treatment, the carbuncle of the nape healed. TCM Diagnosis: Carbuncle of the nape, deficiency of the body and excess of pathogenic factors. Western Medicine Diagnosis: Cellulitis. Intervention Measures: 1) Applied Qisan Dan combined with Jin Huang San to draw out toxins, promote pus discharge, remove necrotic tissue and promote new tissue growth, and to strengthen the body and eliminate pathogenic factors. 2) Originally planned to combine with internal traditional Chinese herbal medicine, but the patient refused to take it internally, so no decoction was prescribed. 3) Avoid eating raw, cold and irritating foods, maintain a good mood, reduce consumption of boxed milk, and avoid eating foods that may cause allergic reactions during the treatment period. Keep the bowels moving smoothly. Clinical Outcomes: Cured.