Hepatology of the internship diary

Now in the hepatitis section, this is the first internal medicine department of my internship. The liver department of Shuguang Hospital is second to none in the country, so I have a slight income for an internship here for me.

On the second day of entering the department, I met Professor Wang Lingtai to teach the rounds. I was sent to report the medical history. To be honest, I was the first to experience such a formal teaching rounds. In front of the former director, Teacher Wang, I have just entered the department. The patient's condition is not clear. The people in the whole department are standing behind Wang teacher with respect and respect, and I have to face the teacher to explain the ins and outs of the patient's condition face to face. At that time, my brain It’s like bleaching. The original few pieces of the sentence have been squandered. I’m nervous at first, I can’t grasp the key points, and I’m so innocent, like a thorn, my thoughts are tangled and cut. Still chaos, fortunately, Mr. Wang is sympathetic to me as a newcomer, with encouragement as the mainstay, and helps me sort out my ideas so that I can no longer report so indiscriminately. The patient's condition turned out to be very complicated. He checked the liver function several times and found out that the result was good or bad, and it was repeated. However, before the teaching rounds, he went to the patient and understood the situation and found that he had ignored one before. The situation is that the patient has taken non-steroidal drugs before each onset, and the tests during the hospitalization basically ruled out viral hepatitis, autoimmune hepatitis, etc., and were basically identified as drug-induced hepatitis after the analysis. Although this case did not let me experience the TCM syndrome of sputum stripping, the experience of reporting the medical history made me memorable.

Although the hepatitis department here is said to be very characteristic of traditional Chinese medicine, it is far less powerful than imagined. It is probably that the research here is more famous than the clinical one. Traditional Chinese medicine is still in the position of conditioning and auxiliary, and for various reasons, the use of traditional Chinese medicine prescriptions is extremely narrowly controlled. It is necessary to strictly follow the regulations and what is the norm? It is an extremely standard type and symptomatic medication similar to those in TCM internal medicine textbooks. So how is the effect, and what kind of criteria should be used to evaluate the efficacy? I can't say it.

We are still here to observe patients, and patients are the most valuable resources. Generally speaking, patients who come here for hospitalization are definitely because of abnormalities in liver function or B-and-half, etc. From the symptoms, most of them are fatigued. This kind of patient is a typical liver disease and spleen. There is a bad stomach, even bloating discomfort; there is a typical body yellow, yellow eyes, urine yellow, and even ascites bulging, these patients, if it is acute, it is good, if it is chronic, liver damage It is more serious. In the end, there are no symptoms. It is purely a patient with poor test results.

The principle of treatment is still based on laboratory indicators. Recently, because the end of the year, the department has to use the amount of traditional Chinese medicine to reach the standard, so the Chinese medicine is also frequently used, but it has been said before, because the tube is very strict, so the medicine is not creative, but No work.

Many of our classmates have chosen the teacher of the liver department as a mentor. Here, the previous brothers and sisters of the class have been busy making progress. I have been thinking about whether to choose a school teacher or a clinical teacher. I certainly know Whether learning Chinese medicine or Western medicine is inseparable from clinical practice, but if I stay here for a year, my Chinese medicine will come to an end. With the model of Western medicine, the prognosis will not be good. I suddenly remembered that a teacher at the seminar in the country said that "the best way to let Chinese medicine die is to combine Chinese and Western medicine." If you want to know what happened, can you have a predecessor to break it down?