试一下这一段<针刺结束后，立即服用中药星蒌承气汤加减：竹茹 10g 甘草 6g 黄芩 10g 瓜蒌 8g 川牛膝 10g石膏 6g 法夏 10g 桅子 6g 白芍 10g 天竺黄（先煎） 6g茯苓 10g 生地 6g 玄参 10g 麦冬 10g 陈皮 10g苍术 15g 天麻 5g 赤芍 10g 泽泻 10g川贝（打碎另煎） 10g 胆南星 20g上述治疗过程结束后， Pm2:30约发病后4个小时，再次检查时，患者失语症状减轻，可间断说清3-4句话，右腿肌力恢复1级，感觉逐渐恢复，Pm3:00又再度重复了一次治疗，期间选穴主穴不变，辅穴有些微改变。晚7时，患者右手肌力恢复1级，感觉开始恢复，出现痛觉右腿肌力介于2-3级间。同时，患者咯大量白粘痰，自晚7时起，患者约4小时起床一次，在家人扶助下解决小便问题，无大便。发病第2日，治疗方法与第1日相比基本不变，同时加服西药VitC（1片/次，Tid）、复合VitB（2片/次，Tid）、VitE（1粒/次，Qd）、双嘧达莫（2片/次，Tid）、卡托普利（2片/次，Tid）。另外针灸2次，上午1次，下午1次，选取穴位基本不变，中药上、下午各1次。针刺治疗中，患者出现痛感。针刺治疗后，患者吐字可基本听清，右手肌力恢复至1级，右下肢出现较明显的痛感，肌力恢复至2级。针灸治疗后，为加强疗效，立即按照推拿按摩的方法，于患者右侧瘫痪肢体施用滚法、揉法、拿法、指推法、搓法、拨法、一指禅推法等推拿手法，以助患者气血流通，加速经气运行。实施手法时，需时时注意患者面部表情的变化，避免使用刺激强度过大的手法。第2日治疗全部结束后，患者已恢复明显痛觉，右手肌力1级，右下肢肌力2-3级。同时患者咯大量白粘痰，小便一日6-7次。小解前，病患可清楚地喊出家人名字帮其解决生理问题。第3日的治疗与第2日基本无异，治疗前，患者吐字可基本听清，但词与词之间，无法连贯，需停顿15-30秒时间，右上肢肌力1级，右下肢肌力2-3级。右侧肢体肌张力无异常改变，生命体征平稳。在针灸治疗中，患者自诉疼痛难忍。所有治疗结束后，患者吐词已可连贯，但一句话不超过4个词，且句与句之间仍需停顿15-25秒的时间，右上肢肌力1-2级，右下肢肌力3级，其余无明显改变。>
參考答案:Grandma’s Daily Progress in Recovery
Day 1
After the whole procedure of acupuncture therapy was completed, Grandma was instantly offered a bowl of herbal tea, ”Xinglou Chengqi Tonic”, consisting of the following ingredients suitably blended and boiled :
Latin Name; English Name; Quantity
Caulis Bambusae in Taenia; bamboo shavings 10g
Radix Glycyrrhizae; liquorice root 6g
Radix Scutellariae; baical skullcap root 10g
Fructus Trichosanthis; snakegourd fruit 8g
Radix Cyathulae; medicinal cyathula toot 10g
Gypsum Fibrosum; gypsum 6g
Rhizoma Pinelliae Preparatum; prepared pinellia tuber 10g
Fructus Gardeniae; cape jasmine fruit 6g
Radix Paeoniae Alba; white peony root 10g
Concretio Silicea Bambusae*; tabasheer 6g
Poria; indian bread 10g
Radix Rehmaniae Recens; fresh rehmannia [root] 6g
Radix Scrophulariae; figwort root 10g
Radix Ophiopogonis; dwarf lilyturf tuber 10g
Pericarpium Citri Reticulatae; dried tangerine peel 10g
Rhizoma Atractylodis; atractylodes rhizome 15g
Rhizoma Gastrodiae; tall gastrodia tuber 5g
Radix Paeoniae Rubra; red peony root 10g
Rhizoma Alismatis; oriental waterplantain rhizome 10g
Bulbus Fritillariae Cirrhosae; tendrilleaf fritillary bulb 10g
Rhizoma Arisaematis Cum bile; bile arisaema 20g
*pre-boiled
**crushed and then boiled
Thus the initial treatment drew to an end. At PM14:30, or about four hours after the attack, I made another check-up and discovered that (a) the aphasia suffered by Grandma was further relieved and she could clearly utter three to four words intermittently, and (b) the myodynamia of her right leg was restored to level 1, with its sensitivity gradually restored as well. At PM15:00, the whole procedure of treatment as described in the previous section was executed once more, and this time the main acupoints remained unchanged while the minor acupoints were shifted to new ones.
At PM19:00, the following results were observed: (a) the myodynamia of her right arm was restored to level 1, with its sensitivity slightly restored as well, and it became pain-sensitive, (b) the myodynamia of her right leg was restored to level 2-3, and (c) she began to spit out a large quantity of thick white sputum. After that, with our help, she got up every four hours to excrete urine, but without any feces.
Day 2
The procedure of treatment was basically the same as that of Day 1. Besides, such western medications as vitamin C (one tablet a time, three times a day), compound vitamin B (two tablets a time, three times a day), vitamin E (one tablet a time, once a day), dipyridamole (two tablets a time, three times a day), and captopril (two tablets a time, three times a day) were taken by Grandma. As for acupuncture therapy, it was routinely administered twice a day, with one in the morning and the other in the afternoon; also, the main acupoints activated remained unaltered. In addition, the herbal tea mentioned in this section was taken twice a day, in the morning and in the afternoon respectively.
In the process of acupuncture therapy, Grandma started to feel pain in the corresponding acupoints. After the therapy, it was discovered that (a) she could articulate some commonly-used words, (b) the myodynamia of her right arm was restored to level 1, and (c) pain was more clearly sensed in her right leg, with its myodynamia restored to level 2. Moreover, with the view to enhancing the healing effect, a series of acupressure massages was administered on her right paralytic side, including such techniques as rolling, kneading, grasping, squeezing, rubbing, twisting, and index-pressing, so that they might facilitate her blood circulation as well as speed up the movement of vital energy through the meridians. However, when administering acupressure, the therapist should always pay attention to the change of the patient’s expressions lest too strong stimulations should be given to the latter.
As the whole set of treatment came to a close at the end of Day 2, the following effects were observed: (a) Grandma evidently restored her sensitivity to pain, (b) the myodynamia of her right arm stayed at level 1, and that of her right leg at level 2-3, (c) she continued to spit out a large quantity of thick white sputum, and (d) she produced urinary excretions six to seven times a day. Every time when she had the need to excrete, she was heard to call one of our family clearly for assistance.
Day 3
The whole procedure of treatment as described on Day 2 was repeated. Prior to the treatment, Grandma was able to utter a word distinctly, but there was no fluent flow of words, with an interval of fifteen to thirty seconds. Besides, the myodynamia of her right arm continued to be at level 1, and that of her right leg at level 2-3. The myotonus of her right side remained unchanged, and her signs of life were stable.
In the course of acupuncture therapy, she told me that she found the pain unbearable.
After the whole round of treatment was put to an end, the following results were observed: (a) she was able to produce a fluent flow of phrase composed of less than four words, but there was still an interval of fifteen to twenty-five seconds between sentences, (b) the myodynamia of her right arm was upgraded to level 1-2, and that of her right leg to level 3, and (C) no significant change happened to the rest of the affected parts.
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