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Calculus in the Gall Bladder   膽囊砂石  (in English and Chinese 中英文)

Translated by: Joe Hing kwok Chu          按此看中文

Diagnosis

  1. The three symptoms, commonly known as Charcot's triad, abdominal pain, jaundice, and fever and/or chills suggest cholangitis, (inflammation of bile duct) which requires emergency treatment.

  2. Using ultrasonic equipment: simple operation, high accuracy.

  3. Xray: I.V.C or P.T.C

  4. Four "F": female, fat, forty years over, fertile (high offspring production)

  5. Liver tests indicating obstruction : elevated serum bilirubin and alkaline phosphatase, usually accompany the symptoms.

I. Simple obstruction with Chronic symptoms:

 Prescription:

wei ling xian 30 to 60 g. Make into 2 servings per day.

Result: 120 patients. Total effectiveness: 87%.

It was especially effective for the mud- and sand-like kind of calculus. Among the 120 patients, 26 were with mud-and sand-like kind of calculus and 23 were clinically healed and 3 were better. The rate of being healed was 88.5% and total effectiveness was 100%. [4]

II. Damp heat syndrome (main duct obstruction with acute infection)

Symptoms: Sudden acute pain at right upper abdomen, nausea, vomiting, lack of appetite, high fever and chill, jaundice, fullness of right upper abdomen and avoiding pressure, pain when sudden release of pressure, enlargement of liver and gallbladder, yellow or scanty urine, constipation, grey color stool, white oil or yellow fur on the tongue, stringy or strong pulse.

Prescription: da chai hu tang with adjustment or long dan xie gan tang with mu xiang , jie ke , yu jin, dda huang, yin chen hao

慢性膽管梗阻

威靈仙 30 ~ 60 克。水煎分二次服。每天一劑。

效果﹕120 病例。總有效率﹕87%。

此方對泥沙樣膽結石尤其有效。120病例﹐ 26 例為泥沙樣結石﹔ 23例痊癒﹔3例較好。治癒率為88.5%。總有效率為100%。

陸煥清等,河南中醫,1987 (6) 22

 

濕熱型(相當於膽總管急性梗阻合併急性感染) 
  1.主證:起病急劇,右上腹劇痛,噁心嘔吐,不思飲食,口渴喜飲,高熱,惡寒,身面目黃似橘色。右上腹硬滿拒按(壓痛,反跳痛,肝及膽囊腫大)小便黃濁或短少,大便秘結,糞便灰白色。舌苔黃膩或白膩。脈象弦漓或洪數。
  2.治法:疏清肝理氣,清熱利濕,佐以通里攻下。         
  3.方例:大柴胡湯加減或
龍膽瀉肝湯木 香桔 實鬱金大黃 茵陳蒿.。 
 

I.V.CIntravenous Cholangiography: X-ray examination of the bile ducts following administration of a radiopaque contrast medium.

P.T.C.Percutaneous transhepatic cholangiography

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