Topic: Syndrome Differentiation and Treatment of Senile Constipation
Etiology and pathogenesis of 1
1. 1 Deficiency of qi and blood leads to senile constipation, weakness of spleen and stomach, passive biochemistry of qi and blood, weakness of large intestine conduction due to qi deficiency, exhaustion of body fluid due to blood deficiency, and loss of moisture in large intestine.
1.2 yang deficiency leads to high health and weakness, while yang deficiency leads to endogenous yin cold and gastrointestinal stagnation, leading to yang deficiency, body fluid failure, intestinal conduction weakness and constipation.
1.3 The elderly who are weak or ill for a long time due to insufficient vaginal fluid, or who take too many laxatives, lead to serious bodily fluid damage, dry intestines and difficulty in defecation.
1.4 The elderly with depressed qi are worried or sedentary, which leads to stagnation of qi, obstruction of viscera, stagnation of dregs and constipation.
1.5 Excessive heat accumulation in the gastrointestinal tract, or excessive drinking, or overeating spicy and thick taste, which leads to heat accumulation in the gastrointestinal tract, or residual heat after fever, which consumes body fluids, makes the intestines lose water and causes constipation.
2 treatment
2. 1 Non-drug therapy should develop the habit of regular defecation, pay attention to diet conditioning and physical exercise, especially functional constipation. Food should be rich in fiber and drink plenty of water.
2.2 Drug treatment of constipation is clinically divided into secret of qi, secret of deficiency, secret of cold and secret of heat. Deficiency and secret are divided into qi deficiency and blood deficiency.
2.2. 1 Qi-deficiency constipation is characterized by diarrhea, facial fatigue, thin stool, mental fatigue, timidity, pale tongue with thin fur and weak pulse. Medicinal Radix Astragali, Poria, Fructus Crataegi, Radix Aucklandiae, Fructus Citri Sarcodactylis, Fructus Citri Sarcodactylis, Fructus Cannabis, white honey, etc.
2.2.2 Constipation due to blood deficiency is characterized by constipation, pale complexion, pale tongue and thready pulse. Medicinal Angelica sinensis, Fructus Cannabis, Polygonatum odoratum, Radix Rehmanniae, Radix Rehmanniae Preparata, Radix Scrophulariae, Fructus Citri Sarcodactylis, Radix Astragali, white honey, etc.
2.2.3 Cold secret is characterized by difficulty in defecation, cold pain in epigastric cavity, aversion to heat, pale tongue with white fur and delayed pulse. Medicinal Angelica sinensis, Epimedium, Cistanche deserticola, Radix Aucklandiae, Fructus Aurantii, Fructus Cannabis, Radix Astragali etc.
2.2.4 The secret manifestations of qi are constipation, frequent wheezing, abdominal distension and pain, fullness in the chest and hypochondrium, thin and greasy fur and thready pulse. Medicinal Radix Aucklandiae, Areca catechu, Fructus Citri Sarcodactylis, Radix Curcumae, Fructus Aurantii Immaturus, Fructus Cannabis, Bupleuri Radix, Endothelium Corneum Gigeriae Galli, etc.
2.2.5 The secret of heat is dry stool, liking cold drinks, yellow and dry fur, and rapid pulse. Medicinal rhubarb, fried Fructus Aurantii Immaturus, Radix Paeoniae Alba, Radix Rehmanniae, Radix Scrophulariae, Radix Astragali, etc.
Three typical cases
3. 1 female patient, 65 years old. Long-term constipation, accompanied by low back pain, cold waist, abdominal distension and poor appetite. The tongue is pale, the coating is thin and white, and the pulse is heavy. This syndrome belongs to the deficiency of spleen and kidney yang, and the treatment is to warm and tonify the kidney and spleen. Prescription: Herba Epimedii 10g, Herba Cistanches 20g, Radix Astragali 15g, Fructus Citri Sarcodactylis 10g, Fructus Crataegi 15g, Radix Angelicae Sinensis 15g, and Achyranthis Radix1.
The patient is weak, spleen and kidney yang deficiency, cold endogenous, weak intestinal conduction, so constipation occurs. Deficiency of kidney yang leads to low back pain and cold waist. Weak transport of spleen deficiency leads to abdominal distension and anorexia. Epimedium and Achyranthes bidentata warm kidney and help yang, Cistanche deserticola warm kidney and help yang, moisten intestines and relieve constipation, bergamot and fragrant rafters regulate qi, Polygonum Multiflori Radix and Angelica sinensis nourish blood and promote qi, moisten intestines and relieve constipation. After 5 doses, defecate every day 1 time. After the defensive side conditioned.
3.2 Male patient, 92 years old. He underwent subtotal gastrectomy for gastric cancer and had 1 stool in the next few days or every week. I have used products for purging fire and relaxing bowels, and I have loose bowels. Sometimes abdominal distension, fatigue, pallor, sometimes cough, excessive phlegm, thin Huang Lue greasy fur, and rapid pulse. Syndrome differentiation belongs to deficiency of both qi and blood, and the treatment is to tonify qi and blood, moisten intestines and relieve constipation. Prescription: Radix Astragali 15g, Poria 15g, Radix Pseudostellariae 15g, Fructus Trichosanthis 20g, Fructus Citri Sarcodactylis 15g, Radix Aucklandiae 10g, and Yuxiang 10g.
Patients with deficiency of both qi and blood and spleen deficiency are unlucky, which becomes constipation and abdominal distension. Water can't be transported, and it gathers into phlegm. Spleen deficiency, passive qi and blood biochemistry, pale and weak face. Radix Astragali, Poria, Radix Pseudostellariae, Radix Angelicae Sinensis, Radix Paeoniae Alba nourish blood and moisten dryness, Fructus Citri Sarcodactylis, Radix Aucklandiae, and Radix Curcumae regulate qi, help to transport spleen, strengthen stomach, promote digestion, eliminate phlegm and clear heat, and moisten intestines to relieve constipation. After 5 doses, normal stool 1 ~ 2 days/time. Observe the prescription, focusing on invigorating spleen and qi, nourishing blood and moistening dryness.
4 discussion
The elderly's visceral function is weakened and intestinal transmission is weakened, which becomes constipation. It is dominated by virtual secrets, cold secrets and gas secrets. In the treatment, we can't use drugs for purging fire and relaxing bowels, mainly for moistening intestines and relaxing bowels, and at the same time add products for regulating qi and strengthening spleen. Although diet and diseases, such as drinking or overeating, can also appear hot secrets, most of them are mixed with reality. Therefore, drugs for purging fire, relaxing bowels and breaking qi should be used with caution. If laxatives are used for a long time or used in large amounts, they will interfere with normal conditioned reflex, form drug dependence, and at the same time make qi, blood and body fluid more damaged, resulting in dryness of intestinal body fluid and aggravating constipation. The application of cathartic drugs should stop the middle disease, and the cathartic drugs should be removed after constipation is relieved. According to the etiology, we should continue to treat both the symptoms and root causes by strengthening the spleen and replenishing qi, warming yang and nourishing blood, and moistening dryness to prevent constipation from recurring.
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Title: Analysis and Research on Market Trend of Chinese Herbal Medicine
First, the large-scale shock adjustment changes are unusual.
Affected by the SARS epidemic, the trade of Chinese herbal medicines in 2003 was ups and downs, with abnormal changes, and the overall trend was obviously better than in previous years. The trade of Chinese herbal medicines has developed vigorously, the sales volume has continued to climb, and the varieties have risen more and fallen less, showing a rare active trend in recent years. From the time point of view, it is roughly as follows: from June to March, 2003, the SARS epidemic appeared, the Chinese herbal medicine market turned from fatigue to smoothness, the transaction volume increased significantly compared with the winter of 2002, the prices of most varieties rose steadily, and the market began to recover; From April to the beginning of June, the SARS epidemic intensified, the purchase and sale of medicinal materials flourished, the batch transactions accelerated, the prices of many varieties soared, and the market prices of popular medicinal materials reached a record high; After June, on the one hand, the SARS epidemic was effectively controlled, on the other hand, the state began to carry out special rectification of the professional market of Chinese herbal medicines, prohibiting the sale of Chinese herbal pieces, and the trade of Chinese herbal medicines quickly fell back and fell into a trough; In September, the trade of medicinal materials recovered and the market became more and more active. During this period, the amplitude and speed of vibration are rare in the past years.
Second, the sales volume continued to rise, and the varieties rose more and fell less.
Throughout the trade of medicinal materials in 2003, both the sales volume and the sales volume have increased significantly compared with previous years. The sales volume and sales volume of nearly 300 commonly used bulk medicinal materials in the national 17 Chinese herbal medicine professional market increased by 25% ~ 48% and 33% ~ 42% respectively compared with 2002. Among them, varieties with rising prices account for 48.5% ~ 54.3% of the statistical caliber, varieties with stable prices account for 28% ~ 33%, and varieties with falling prices account for 12.7% ~ 23.5%.
In recent years, China's agricultural planting structure has been constantly adjusted, especially after China's accession to the WTO, the competition in the agricultural product market is fierce, and various places have sprung up. Drug fever? , leading to oversupply of many medicinal materials, unsalable market and low price. In particular, some commonly used Chinese herbal medicines with annual sales of more than 1000 tons and 10000 tons have been running in the trough since 1998, such as Radix Isatidis, Radix Salviae Miltiorrhizae, Radix Astragali, Radix Paeoniae Alba, Cortex Magnolia Officinalis, Poria and so on. However, SARS revived the trade of traditional Chinese medicine after years of silence. The prices of Radix Saposhnikoviae, Rhizoma Osmundae and Flos Lonicerae have increased by dozens of times, and even over-listed varieties such as Radix Isatidis, Radix Astragali and Radix Paeoniae Alba have been snapped up.
Three, five major incentives give birth to the fever of medicinal materials trading.
In 2003, the trade of medicinal materials was booming, although there were fluctuations in the middle, but the overall trade was obviously better than before, which was a rare harvest year. The reasons for this positive situation are as follows:
1, stimulated by the SARS epidemic, the sales of medicinal materials are hot. Chinese medicine has played an important role in the fight against SARS. For a time, there was a rush to buy Chinese herbal medicines, which injected vitality into the weak trade of Chinese herbal medicines and pulled most Chinese herbal medicines out of the trough.
2. Affected by drought and flood, the output of medicinal materials decreased. Drought and flood disasters have occurred in the south and north of China, which has led to a serious decline in the market supply of major medicinal materials producing areas such as Hunan, Guangxi, Guangdong, Anhui, Heilongjiang and Jilin. The prices of Radix Isatidis, Radix Platycodi, Rhizoma Atractylodis Macrocephalae, Radix Angelicae Dahuricae, Radix Rehmanniae, Radix Gentianae, and seed medicinal materials such as Fructus Schisandrae Chinensis, Semen Plantaginis, Fructus Gardeniae, Semen Ziziphi Spinosae, Semen Platycladi and Fructus Amomi have all increased to varying degrees.
3. Restricted by policy factors such as banning hunting and gathering wild animals and plants, returning farmland to forests and environmental protection. In particular, the excessive exploitation and utilization of wild medicinal materials for decades has caused the scarcity of resources and the decreasing market supply, which has led to rising prices. Wild medicinal materials have become a hot spot in the market in recent years. Cordyceps sinensis, Saposhnikovia divaricata, Gentiana macrophylla, wild ginseng, Dioscorea nipponica, tabanus, Ma Bao, Rana chensinensis oil and other wild medicinal materials have always been very expensive. In 2002, the price of wild medicinal materials rose the most, from 16000 yuan at the beginning of the year to 26750 yuan, and the king of extra-large cordyceps has risen to the peak of 4 1000 yuan.
4. Export demand increased. In 2003, the export of Chinese herbal medicines showed a recovery growth, and the overall situation developed in a good direction. Especially after China's entry into WTO, the export channels and sales scope of Chinese herbal medicines have been broadened. Platycodon grandiflorum, Glehnia littoralis, Chinese yam, Scutellaria baicalensis, Pseudostellaria heterophylla and Siraitia grosvenorii were successfully exported.
5. Affected by the price increase of agricultural products such as grain, cotton and oil after autumn, some domestic varieties invariably follow the price increase of agricultural products.
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