world famous doctor

Chapter 172 Facial Paralysis
Doctor Zhang Jian smiled, took a sip from the teacup, and then spit the excess tea dregs into the trash can.

At this time, a female patient in her 40s who just went for an examination came in at the door.

She held several checklists, large and small, and handed them to Zhang Jian.

Zhang Jian took the checklist and first looked at her blood routine. Among the 24 items, basophils and average red blood cell values ​​were slightly increased, and the others were normal.

Hemagglutination tests were also normal.

Looking at her brain CT examination sheet, it was suggested that this patient had cerebral blood vessel compression.

According to the patient's description, she had also undergone microvascular decompression before.

But the effect doesn't seem to be very good.

Seeing Zhang Jian frowned, Zhou Chen got up and stood beside him, and also looked at the results of the checklist.

"Xiao Zhou, I want to hear your opinion." Zhang Jian asked.

Zhou Chen turned his gaze to the female patient, and asked about his condition as a routine.

Female patient’s main complaint:
In the past six months, I felt that my left eye was beating intermittently, but I didn't pay attention to it.

In the past half month, the beating has become more and more frequent, and the entire facial muscle that has extended to the left side will twitch abnormally.

Based on his own experience, Zhou Chen first stated his diagnosis.

"In my opinion, this patient is most likely suffering from facial paralysis!"

This diagnosis result is exactly the same as Zhang Jian's diagnosis.

Zhang Jian nodded:

"It seems that we want to go together!"

Now that Zhou Chen said so, Zhang Jian secretly confirmed his diagnosis.

This can also prove from the side that the possibility of misdiagnosis is very small.

Zhou Chen has become an authoritative expert in Zhang Jian's heart.

Every word he said can be used as a textbook reference for differential diagnosis of diseases.

Then, Zhou Chen talked about his treatment ideas:

"In the acute phase, the purpose of treatment is to control infection, improve local blood circulation, and reduce facial nerve edema."

"Prednisone, dexamethasone and other adrenal corticosteroids are often used."

"In addition, galantamine, B vitamins, niacin, ATP, creatinine, cytochrome C and other drugs can also be used for treatment."

According to the treatment experience given by the famous doctor system, these drugs can only play a palliative role.

If the disease is to be cured radically, the traditional Chinese medicine acupuncture treatment method can have the advantages of good curative effect and no toxic side effects on idiopathic facial paralysis.

With this in mind, Zhou Chen turned to the female patient:
"Have you ever done acupuncture in traditional Chinese medicine?"

The female patient shook her head, looking a bit puzzled.

This is the emergency department of the municipal hospital, right?

Why do doctors recommend TCM acupuncture?

she thinks.

Doctor Zhang Jian also looked at Zhou Chen, not quite understanding what he meant.

So he asked, "Xiao Zhou, do you mean that the acupuncture therapy of traditional Chinese medicine has a more accurate curative effect?"

Zhou Chen nodded, with a confident light in his eyes.

At present, the etiology of facial paralysis is unknown.

It is generally believed that viral infection, autonomic nervous instability, etc. can lead to local neurotrophic vascular pain, neural ischemia, edema, and facial paralysis.

Therefore, most of the treatments focus on improving local blood circulation, reducing facial nerve edema, relieving nerve compression, and promoting the recovery of nerve function.

Hormones and B vitamins are the drugs of choice for the treatment of idiopathic facial paralysis.

To reduce nerve edema and promote nerve myelin recovery.

If accompanied by viral infection at the same time, acyclovir is often used orally for antiviral treatment.

Patients with refractory conditions can also be treated surgically.

This is the general idea of ​​Western medicine treatment.

It is also the most doctor-approved treatment method for treating this disease in western medicine.

Then, Zhou Chen explained the etiology of the disease in traditional Chinese medicine.

"Facial paralysis" is also known as "slanted mouth, eyes and mouth, slanted mouth, partial wind mouth and mouth" in traditional Chinese medicine.

The earliest records are found in the "Nei Jing", which refers to the disease with the mouth and eyes skewed to one side as the main symptom.

Physicians of all dynasties have discussed this disease quite a lot. As far as the cause of disease is concerned, it is nothing more than internal and external causes.

Ancient doctors mostly classified this disease as "wind syndrome", and believed that this disease was mostly caused by the invasion of deficiency, evil and thief wind.

For example, the "Neijing Lingshu" says: "The tendons of the foot Yangming... If the cheek tendons are hot, the tendons will gallop and slow down, and if there is cold, the cheeks will be moved quickly, so it is secluded."

"On the Causes and Symptoms of Various Diseases Pianfeng Koukou Houhou" says, "Pifengkoukoukou is the body weak and windy, and the wind enters the tendons of the mouth. The tendons of the foot Yangming are caught in the mouth, and the tendons are weak, and the wind Because of taking advantage of it, it makes the muscles of the meridian tense and not adjusted, so now the mouth is quiet."

Doctor Zhang Jian just stared helplessly at Zhou Chen after he finished speaking these words word by word, he was at a loss.

After all, this is the professional knowledge and terminology of Chinese medicine.

Zhang Jian, who was born in Western medicine, naturally didn't understand.

Not to mention the female patient standing by.

It was as if she was listening to a book from heaven, with her face covered in circles.

But when she looked at Zhou Chen, she couldn't help showing admiration.

The medical knowledge in the famous doctor system is vast.

Zhou Chen was able to do it at his fingertips, and in the eyes of others, he thought he was taking this opportunity to show off what he had learned.

At this moment, Zhou Chen continued to talk endlessly:

In addition to the above-mentioned external causes of disease, some other doctors believe that the disease is caused by internal factors.

For example, in "Treatment of Class Syndrome", it is believed that drinking out of mouth and eyes is due to the decline of blood and alcohol, which cannot nourish the muscles and arteries.

"Medical Law" says: "If the mouth and eyes are slanted, the Qi of the face is not smooth."

To sum up, the disease is mainly caused by overwork, excessive consumption of qi and blood, or lack of qi in the body, emptiness of veins, weak defenses, exogenous evils taking advantage of the deficiency and entering the Zhongyangming and Shaoyang meridians, so that the flow of qi and blood is blocked. Block the meridians, the meridian tendons lose their nourishment in turmoil, and the muscles are slow and not retracted to cause the disease.

During this period, Zhang Jian had no chance to interrupt at all.

Of course he didn't know what to say?

It wasn't until Zhou Chen stopped that Zhang Jian opened his mouth and said:

"Then Xiao Zhou, after talking so much, what is your thinking and method of Chinese medicine treatment?"

"For different diseases, we should treat them based on syndrome differentiation." Zhou Chen replied loudly.

Traditional Chinese medicine has always paid attention to syndrome differentiation and treatment.

According to the classification of the famous doctor system, the disease is mainly divided into the following syndrome types:
The wind-cold type is more common when the face is exposed to cold or attacked by wind-cold, with sudden facial paralysis, facial muscle relaxation on the affected side, cold feeling, painless, and aversion to wind-cold, no sweating, headache, limb tightness, and tenderness under the ear.

Treatment should be based on prescriptions that dispel wind and cold, warm meridians and unblock meridians.

Wind-heat type, with a history of exogenous febrile disease in the early stage, flabby facial muscles on the affected side, crooked mouth and eyes, burning sensation, sweating, thirst, red face and red eyes, five upset and hot stools, dry stool, yellow and red urine, tongue quality Red, thin yellow fur, floating pulse.

The treatment should be based on the exterior-relieving drugs that clear away heat and the prescriptions that unblock meridians and activate blood circulation.

Rheumatic type, mostly occurs in middle-aged and obese people, with thick skin and eyelids, and a feeling of edema in the skin. After the face is exposed to cold or wind-cold, sudden facial pain occurs, and the facial muscles on the affected side are loose. Tightening, tenderness under the ear.It is caused by the upward invasion of the facial muscles by the air of rheumatism.

The treatment should pay equal attention to dispelling wind and dredging collaterals and warming and transforming cold and dampness.

(End of this chapter)