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Treatment experience of common clinical spleen and stomach diseases
Among Zhang Zhongjing's prescriptions for treating spleen and stomach diseases in Han Dynasty, except Sanchengqi decoction for treating Yangming stomach excess and Lizhong decoction for treating Taiyin spleen deficiency, all the other prescriptions take both spleen and stomach into consideration. Such as cinnamon twig soup, ginger and jujube caramel in Xiaojianzhong soup, jujube in Zhao Shi soup, sipping hot porridge after taking cinnamon twig soup and so on. After the industry lived here, it developed from generation to generation, and it was more prosperous in the Jin and Yuan Dynasties. Su Zhang Garden doesn't need an ancient prescription to form its own family, but mainly nourishes stomach qi and regulates the rise and fall of qi. Li Dongyuan's Treatise on Spleen and Stomach and Debate on Internal and External Injuries emphasized the treatment of spleen and health, and created a famous prescription "Buzhong Yiqi Decoction". Although Xue Lizhai, Zhou Shenzhai and Li Zhongzi are attached to Dongyuan, they focus on the acquired spleen and stomach. Ye invented the method of moistening stomach and nourishing yin and improved the method of treating spleen and stomach. In clinical practice, the author also advocates the theory of spleen and stomach and uses it to guide clinical practice, which has achieved remarkable results. I want to talk about my superficial understanding and experience in the treatment of spleen and stomach diseases.

1 spleen transports the stomach and intestines, and the treatment should achieve its ascending and descending mechanism.

Su Wen's Theory of Differentiation of Classics points out: "If you drink in the stomach, you will overflow the essence; if you drink in the spleen, you will disperse the essence; if you drink in the lungs, you will transfer the water to the bladder, and the water and essence will be distributed in all directions, and the five internal organs will be parallel". Spleen and stomach, one dirty and one fu-organ, one deficiency and one solid. The spleen and stomach live in Zhongzhou, and the spleen governs transportation and transformation, the stomach governs reception, the spleen governs ascending, and the stomach governs descending and ascending, which is the hub of human qi. Ascension is transmitted to the heart and lungs, while descent is attributed to the liver and kidneys. Its function in the human body is like the exchange of heaven and earth. Therefore, Su Wen's Theory of Five Zang-organs says: "The five zang-organs store essence without diarrhea, so they are full but not real. Those who have six internal organs pass on chemicals without hiding them, so they can't be full. " "Lingshu Jade Edition" said: "Those who suffer from anger are also concerned. What was injected in the valley is also in the stomach. Stomach, the blood sea of Shui Gu. " If the function of ascending and descending the spleen and stomach is abnormal, the qi of clearing Yang can't be used, the acquired essence can't be absorbed, the essence of diet can't be absorbed, and phlegm can't be discharged. Healthy spleen and stomach and normal exercise can be maintained. The normal physiological functions of "clearing yang out of the upper orifices, turbid yin out of the lower orifices, clearing yang in the furuncle, clearing yang in the five internal organs, clearing yang in the limbs and turbid yin in the six fu organs" make people full of vitality. Therefore, in the clinical treatment of spleen and stomach diseases, we should give consideration to their physiological functions and pay attention to the timing of smooth lifting. The yang of the spleen and stomach should rise, and the bitterness should fall, but it should not fall too much to prevent yin injury. Clinically, rising yang has a good effect on some digestive system diseases. For example, Buzhong Yiqi Decoction, Guipi Decoction and Huangqi Jianzhong Decoction all have good curative effects on gastroptosis and peptic ulcer, all because of the rise of spleen yang. Acute gastritis vomiting must be caused by bitterness, and Qin Lianfang of Xiexin Decoction is specially designed for bitterness, and it is used exactly like a drum. Maimendong Decoction and Guan Yi Decoction in Synopsis of the Golden Chamber can benefit qi and nourish stomach yin, and have certain curative effects on atrophic gastritis and peptic ulcer with yang deficiency.

2 Spleen and stomach are full of qi and blood, which should be nourished and beneficial rather than cut.

Both qi and blood are important substances that constitute the human body and maintain human life activities. Qi governs temperature, and blood governs moistening, which are mutually used, and their sources are related to the function of spleen and stomach. Spleen is a dirty organ with excessive qi and blood, which likes dryness and hates dampness; The stomach is a viscera full of qi and blood. It likes to be moist, but hates to be dry. If the spleen is injured by fatigue and the yang is insufficient, the ascending and descending of the spleen is out of control. Therefore, Li Dongyuan's treatment of spleen is mainly to promote spleen yang. Although the stomach is a sea of water and grain, if you eat safely and feel uncomfortable with cold and temperature, your stomach will be damaged, and some diseases will occur that damage Yin, especially Yang, because there is little blood in your stomach. Li Dongyuan Buzhong Yiqi Decoction for the treatment of internal injury and fatigue is a product made of Sijunzi Decoction, which mainly strengthens the spleen. Xue Lizhai said: "Anyone who wants to produce yin and blood should take Liujunzi Decoction as the main prescription." Zhang Jingyue Zhixue Tuochuang Shen Du Decoction, Li Dongyuan Danggui Yangxue Decoction, and Huangqi are five times as much as Danggui, all of which are aimed at invigorating the spleen and stomach, benefiting qi and removing blood stasis, invigorating qi and generating blood, generating tangible blood with invisible qi, and taking the meaning that yang generates yin and grows long. It can be seen that the treatment of spleen and stomach diseases should be based on invigorating qi and nourishing dampness. However, if the disease lasts for a long time, it will be mixed with excess and deficiency, and if the spleen and stomach are stagnant at the beginning of the disease, it is said that the initial disease governs qi. Adjust the qi first, and the disease will self-heal; After a long illness, it is necessary to nourish the blood and regulate the collaterals. If the veins are harmonious, the pain will go away. Injury to the spleen and stomach, dereliction of duty in transportation. At this time, Zhongzhou has no burden, and it is too necessary to adjust the air. We should choose Radix Aucklandiae, Fructus Amomi, Fructus Aurantii Immaturus and Cortex Magnolia Officinalis as appropriate. Because too much gas is broken, Xiang is discouraged, warm and dry, which can prolong the illness. It is advisable to take all kinds of flowers, such as roses, Bai Meihua, camellia, etc., which are light in nature, so as to regulate qi without hurting healthy qi.

The three zang-organs are affected by the disease, and the spleen and stomach are regulated.

Spleen is the acquired foundation, the source of qi and blood biochemistry, and irrigates the five internal organs. In the past, there was a saying: "A strong stomach is strong, a weak stomach is weak, and a stomach born is dead." The pathological changes of the spleen and stomach will inevitably affect his viscera. If the spleen and stomach are weak, biochemical passive, blood deficiency and heart fire are strong, then heart disease will occur; Weak spleen and stomach, poor soil and poor lungs can cause lung disease; Weakness of the spleen and stomach, inability to concentrate on the liver, or stagnation of soil can all cause liver disease; Spleen and stomach are weak, and kidney disease can be caused without water injection. Therefore, in Spleen and Stomach Theory, Li Dongyuan emphasized that "the deficiency of stomach leads to diseases of viscera and meridians" and put forward the argument that spleen can regulate five internal organs in treatment. Zhang Jingyue developed the theory of spleen and stomach, and put forward the viewpoint that regulating the five internal organs can also treat the spleen and stomach, pointing out that "if liver evil invades the spleen, both liver and spleen will be consolidated, which can inhibit the liver; The liver is strong and the spleen is weak, and it is also possible to save the liver and spleen; If the heart evil attacks the spleen, the heart is inflamed and the fire is clear. Insufficient heart fire, replenishing fire and generating spleen; If the lung pathogen invades the spleen, the lung qi will be blocked, and the lung will be sparse and the spleen will be depressed; Lung qi deficiency, when the lung prevents lung deficiency; If kidney evil invades spleen, spleen deficiency can neutralize gram, mainly to save spleen; Kidney deficiency has no right to open and close, and tonifying kidney is the first. "Adhering to the teacher's clinical guidance, using Jianpi Yin and Qingpi Yin in empirical research, and using different formulas such as Yidongli Powder, Qiwei Baizhu Powder, Buzhong Yiqi Decoction, Shen Ling Baizhu Powder and Guipi Decoction for patients with deficiency syndrome and deficiency in the middle are really effective.

4 insufficient gas and fire, the treatment must be warm and clear; There is a dry fire in the stomach, so you should raise it.

Li Dongyuan also advocated the theory that fire and qi are incompatible in the theory of spleen and stomach. He believes that lack of vitality will lead to vigorous yin fire, which will consume vitality. Therefore, Dongyuan often uses drugs to clear fire when nourishing spleen yang. Although this statement was denied by Zhang Jingyue, the author realized that adding some herbs such as Rhizoma Coptidis, Fructus Gardeniae, and Cortex Phellodendri to the drugs for invigorating spleen and benefiting qi has a certain curative effect on treating epigastric pain of spleen deficiency with fire. If the spleen-qi is not empty and the stomach has dry fire, the theory of nourishing stomach yin by Ye should be used, and those with stomach yin deficiency and heat should be treated with Radix Adenophorae, Radix Rehmanniae and Dendrobium. If heat is insufficient to eliminate stomach yin, it can be moistened with Radix Scrophulariae, Radix Ophiopogonis, Radix Asparagi, Rhizoma Imperatae, Rhizoma Polygonati Odorati, pear juice, sugarcane juice, etc. Slightly acidic products should be used to astringe the liver. If it is inhibited by Radix Paeoniae Alba, Mume Fructus, Fructus Chaenomelis and Fructus Schisandrae Chinensis, the stomach will fill itself. Calm, fluid, with jujube kernels, poria cocos, wheat and the like. If you supplement me, the stomach yin will recover on its own, and ginseng, astragalus and Buzhong will be used to promote fluid production. In short, the scale of drug selection should be warm but not dry, moist but not cold, nourishing but not stagnant.

5. the deficiency syndrome caused by long illness should be observed and the illness should be refined.

To treat chronic diseases, we should follow the law, grasp the main contradictions, take care of physiology, act according to local conditions, and adjust slowly; If it is more unpredictable, it will be difficult to collect all the works. When taking medicine, we should distinguish the characteristics of spleen and stomach and choose the best medicine. If the middle qi is insufficient, make up the flavors of ginseng, surgery, astragalus and grass, and make up yam, chicken gizzard-membrane and rice buds without delay; Deficiency of cold in middle energizer, warm ginger and cinnamon, and taking cold; For those who are full of dampness, the second operation is dryness, and dampness will remove spleen, and excessive dampness will hurt yin; For those who clear yang and sink, the amount of firewood should be increased, and the amount should not be heavy, so as not to make the medicine pass the disease; For people with qi stagnation, tangerine peel and Lindera root should be treated rationally, but if they stagnate, they should be treated. If they are too fragrant and dry, they will get hurt. When you are in the clinic, you should carefully check the certificate and use it correctly. Regardless of trauma and internal injuries, it is not appropriate to be bitter or tired on the premise of caring for the spleen and stomach. However, tonic cannot be blindly supplemented. The tonic, the tone, or the spleen first, or after the stomach. In addition, in the process of treating spleen and stomach diseases, we should pay attention to health care according to "those who hurt the spleen, adjust diet, and be suitable for cold and warm" to make the breath suitable. Never fast whole grains at will, but patients should be properly fed to help stomach qi reach evil for external use.