How to prescribe ointment in clinic
Xie Yingbiao of Nanjing Hospital of Traditional Chinese Medicine should not make up too much. In order to avoid making up too much, he should first take "road-opening medicine" and observe the patient's reaction after taking it. Secondly, syndrome differentiation should be meticulous, carefully selected, reasonably compatible, and prescriptions should focus on statutes. There are many dialectical views in ancient prescriptions, which are often tonic and diarrhea, ascending and descending, closing and opening. For example, in Liuwei Dihuang Pill, there is a tonic of Radix Rehmanniae Preparata, accompanied by the diarrhea of Alisma orientalis; There is a combination of dogwood and peony bark; With the solidity of yam and the connection of poria cocos. Open and close the diarrhea without deviation, so that it can be replenished without stagnation, nourished without greasy, kept without staying, and circulated freely. For another example, Shenqi Pill not only uses Fuguichun to tonify kidney and yang, but also uses Liuwei Dihuang Pill to nourish yin according to the principle of yin and yang, so that yin grows and yang grows. This is what Zhang Jingyue said: "Those who are good at tonifying Yang must seek Yang in the yin, and then Yang will be helped by Yin, which is endless in biochemistry;" Those who are good at nourishing yin must seek yin in the yang, and then yin is born in the yang and the source is endless. " Most prescriptions of miscellaneous ointments should not only aim at the main symptoms, but also take into account the complexity of the disease, so it is inevitable to use miscellaneous drugs. Each dose of ointment tastes as many as thirty or forty or more. However, this diversity is not pieced together and piled up at will, but should be based on syndrome differentiation and guided by certain laws. It is necessary to distinguish between primary and secondary, combine them organically and reasonably, and make them coordinate with each other or complement each other, so as to achieve the expected therapeutic purpose. Therefore, Ding Kai must also be compatible according to the principle of monarch, minister, assistant and ambassador, so as to ensure that the primary and secondary are clear and the structure is rigorous, and each medicine can not only play its own advantages, but also play a synergistic role and increase the curative effect. It varies from person to person, and the clinical prescription of ointment depends on the specific situation of patients. Everyone's physique, etiology, symptoms and other specific circumstances are different, even if it is the same deficiency syndrome, the cream is not necessarily exactly the same. Traditional Chinese medicine has the guiding ideology of "different treatment for the same disease" and "different treatment for the same disease", so it is forbidden to use the same cream to make up indiscriminately. Because the role of ointment is reflected by the comprehensive performance of drugs, all drugs have certain bias. The purpose of tonic is to correct the bias of human body through the bias of drugs, so as to achieve the purpose of balancing yin and yang and harmonizing qi and blood. For example, ginseng is not only the "king of invigorating qi", but also the "ginseng abuse syndrome" caused by improper use. Excess syndrome is a symptom of weakness caused by excess syndrome, which is called excess syndrome in Chinese medicine. At this time, it is definitely not suitable for nourishing. If the ointment nourishes and is not properly used, it will often "build a car behind closed doors" and "encourage evil spirits". Some diseases are mixed with excess and deficiency, or there is little excess and deficiency, so Jun Fang ointment should not be used blindly to supplement them. We should put evil spirits in the first place, nourishing behind, or strengthening the body to eliminate evil spirits. When applying nourishing ointment prescription based on syndrome differentiation, we should carefully observe the condition, strictly observe the pathogenesis, distinguish between qi and blood, cold and heat, know how to open and close, prioritize and distinguish between viscera. Qi deficiency is used to replenish qi, blood deficiency is used to nourish blood, yin deficiency is used to nourish yin, and yang deficiency is used to help yang. Qi is the handsome of blood, blood is the mother of qi, and yin and yang are mutually rooted. Therefore, when invigorating qi, adding blood-enriching drugs will keep the source of qi. Supplementing blood with tonics can replenish qi and produce blood, and make yin seek yang, and Yang Can seek yin, which complement each other. Tonifying according to syndrome differentiation is the key to the curative effect of clinical ointment. Most of the prescriptions I prescribe in clinic are based on the effective treatment of decoction, which is closer to "tonifying deficiency based on syndrome differentiation" after the condition is stable. The prescription of protecting spleen and stomach ointment should pay attention to protecting spleen and stomach qi. Excessive nourishment and filling will hinder the rise and fall of the spleen and stomach, resulting in obstruction of the middle energizer. Therefore, when prescribing ointment, it must be in the case that the patient's tongue coating is not thick and the spleen and stomach are normal. For phlegm-dampness constitution, those who eat less and stay more should avoid nourishing or postpone tonic, and even if necessary, they should be supplemented with products that wake up the stomach and strengthen the spleen. When I prescribe ointment, as long as there are drugs such as Radix Rehmanniae Preparata, Colla Corii Asini, Rhizoma Polygonati Odorati and Radix Scrophulariae, I must use products such as Fructus Amomi and Pericarpium Citri Tangerinae to regulate qi and stomach. Patients can only insist on taking ointment if they always regulate their spleen and stomach. Otherwise, even with good medicine, it is not conducive to the recovery of the disease. Paying attention to food supplement can prevent diseases and cooperate with treatment, and it also has the advantages of convenient materials, delicious taste and relative safety. The main functions of food supplement are: preserving health before illness and strengthening the body. Traditional Chinese medicine believes that the attenuation of human viscera function and imbalance of yin and yang are the main causes of disease. Moreover, food supplement can adjust the balance of yin and yang and correct deficiency and excess, so it can play a role in treatment or adjuvant treatment. However, food supplements should also be used flexibly according to people's physique, and it is necessary to distinguish between cooked heat and cooked cold, and virtual reality. For example, people with yin deficiency and internal heat should eat more cold food, such as tremella; People with yang deficiency and cold should eat more hot foods, such as walnuts and venison. People who cough due to lung heat should eat more pears, lilies and gingko. People with insomnia due to blood deficiency should eat more longan and red dates. People with diarrhea due to spleen deficiency should eat more lotus seeds, lentils and coix seed. People who have been ill and make up for their efforts to promote rehabilitation are not only weak, but also have low digestion and absorption function, which often leads to nutritional deficiency and is difficult to recover. The application of food tonic method can not only regulate the function of spleen and stomach, but also supplement nutrition, so as to achieve the purpose of treatment, nourishing and rehabilitation. Therefore, while taking ointment and tonic, I also emphasize the importance of food supplement, food supplement and diet therapy.