问题 问答题

患者,女,47岁。患奔豚数日。患者平素偶有心悸,但发作轻微,自不在意,未予治疗。数日前突觉脐下动悸,继之有气上冲,日日复作。自诉每次发作时先觉脐下不适,如鼠奔突,继之自觉一股气流,从少腹往上冲逆,至心胸则心悸且烦躁不安,胸满憋气,呼吸不利,头身出汗,每日可发作3~5次,精神极度紧张,有死的恐怖感,小便量少,舌质淡、苔水滑,脉沉弦无力。 要求分析:中医诊断、证型、证候分析、治法、方药。

答案

参考答案:

解析:中医诊断:奔豚。 证型:苓桂甘枣汤证。 证候分析:是案为奔豚证,与论中桂枝加桂汤证颇为相似,但本案有两点与之不符。一为小便不利,苔白滑,二是患者脐下悸明显,乃与《伤寒论》6条“发汗后,其人脐下悸者,欲作奔豚,茯苓桂枝甘草大枣汤主之。”证机相当,俱为心阳不足,下焦寒水之气上逆之证。有所小异者,65条为奔豚欲作而尚未作,而本案之奔豚已作,然无论作之与否,只要主证一致,病机相同,皆可依之而辨。正常情况下心阳下蛰于肾,使肾水温暖,且能蒸腾化气,水气上升,以调心火,则心火不亢,故水火既济。今观患者素有心悸,则知其心阳素虚,久久不复,而致心肾失交。心阳不足,无心下蛰暖肾,肾水无以蒸化而停于下,故见小便不利,脐下悸动,苔水滑,舌质淡,脉沉弦无力。寒水蓄于下焦,复因心阳虚而上乘之,故见先有脐下悸动,如鼠奔突,继之气从少腹向上冲逆,至心胸则心悸且烦躁不安,胸满憋气,呼吸不利,头身汗出等等皆为寒水逆上之征。 治法:温通心阳,化气利水。 方药:茯苓桂枝甘草大枣汤.茯苓、桂枝、甘草、大枣。

单项选择题
阅读理解
Harry’s father bought a magazine which gave its readers information about all kinds of products and helped them make the best choice while buying.
Harry borrowed his father’s magazine when he needed a new computer. “I’ll read it and choose the best one.” He said.
The magazine described these computers.
The DGT PC450
The BNK 975XF: AT $3,200
The CGP 8PT

This computer comes with lots of good software. However it does not have much memory and is rather slow. At $2,850 it’s not very good value for money.

This is the most expensive computer we tested. However it is also the most reliable (可靠的). It is very fast and has lots of memory. It is worth the extra money if you can afford it.

At only $1,900. It has lots of memory and is quite fast. However it broke down twice while we were testing it and we cannot recommend (建议) it for reliability.
     Harry chose the BNK 975XF. “I know it’s expensive,” he said, “but it will be with me for a long time and do everything I want it to do.”
小题1: Harry wants to buy a computer, so he borrowed ___________ from his father.
A.a magazine about all kinds of productsB.a computer magazine
C.a shopping bookD.a book about all kinds of computers
小题2: ____________ doesn’t have much memory and is rather slow.
A.The BNK 975XFB.The DGT PC450
C.The CGP 8PTD.Harry’s computer
小题3: The CGP 8PT is _____________ among the three kinds of computers.
A.the fastestB.the most expensive C.the cheapestD.the slowest
小题4:Harry chose the BNK 975XF because _________.
A.it is the most expensiveB.it has lots of good software
C.it has much memoryD.it would work for him for a long time