Qi is a subtle substance, which is constantly moving and has strong vitality. Blood is a red viscous liquid substance running in blood vessels. But both of them are the most basic substances that constitute the body and maintain the life activities of the body. Therefore, both in physiological and pathological conditions, qi and blood have a very close relationship. Generally speaking, it means "Qi is handsome with blood" and "Blood is the mother of Qi". W Dan JM= me, Qi is a handsome man? "Qi is handsome for blood" means that Qi plays an extremely important role in the generation, promotion and control of blood. It is embodied in three aspects: qi can produce blood, qi can promote blood circulation and qi can suck blood. This theory has been fully reflected in clinical syndrome differentiation and treatment, and treating blood and worrying about qi has become a basic principle in the practice of syndrome differentiation and treatment. Many prescriptions of veterinary drugs in past dynasties can prove this theory. I {丨丨 > c? 1, Qi can generate blood: Qi can generate blood in two aspects: First, from the composition of blood, blood is composed of Qi Ying and body fluid, Qi Ying is the main component of blood, and Qi Ying's main physiological function is to generate blood, such as Lingshu? 6? 1 When discussing the function of invigorating qi and generating blood, the evil guest said: "Those who invigorate qi secrete body fluid, inject it into the pulse and turn it into blood." It can be seen that as long as body fluid exists, there will be blood when there is Qi Ying. Full of Qi Ying leads to vigorous blood, and Qi Ying can produce blood. Secondly, judging from the process of blood formation, the formation of nourishing qi and blood depends on the gasification of some viscera. All come from the subtle Shui Gu of spleen and stomach. Diet is transformed into Shui Gu essence, Shui Gu essence into nourishing qi and body fluid, and then into red blood. All these transformation processes are inseparable from the movement and change of qi. Therefore, when qi can produce blood, the functional activities of viscera are also strong, and the function of transforming blood is also strong, so blood is enriched. Qi deficiency leads to low activity of zang-fu organs and weakened function of transforming blood, which leads to blood deficiency. Therefore, in the clinical treatment of blood deficiency, qi-invigorating drugs are often used in combination to improve the curative effect. For example, Xie Ming, a graduate student of Beijing College of Traditional Chinese Medicine, studied the methods of enriching blood in traditional Chinese medicine. The results showed that the first choice drugs in the prescription were tonifying qi except blood, and blood and qi were often used in combination. The top 25 drugs used are Angelica sinensis, Radix Paeoniae Alba, Glycyrrhrizae Radix, Ginseng Radix, Radix Rehmanniae Preparata, Radix Astragali, Radix Rehmanniae and Radix Codonopsis. At the same time, these 25 drugs can form classic prescriptions with simple structure and excellent curative effect, such as Sijunzi Decoction, Siwu Decoction and Shaoyao Glycyrrhiza Decoction, and these prescriptions are often an important part of the blood-enriching method. For another example, after discussing the academic thought of gynecology, the graduate students of China Academy of Traditional Chinese Medicine found that Fu advocated tonifying qi and blood for blood deficiency and other syndromes, and prevented replenishing blood first and then replenishing qi. Blood deficiency syndrome nourishes blood, tonifies spleen and kidney and produces blood. For example, "Songzidan" (Radix Astragali, Radix Angelicae Sinensis, Rhizoma Chuanxiong, Radix Rehmanniae Preparata and Radix Ophiopogonis) selected by Fu's treatment of dystocia due to blood deficiency is a good example. Adding astragalus to dystocia due to blood deficiency is, in Fu's own words, "the principle of benefiting qi and enriching blood". Dystocia due to blood deficiency "for example, when a ship encounters shallow water, it is difficult to carry out it." Suddenly, the spring water overflows and the boat leaves in a hurry, so it must be sent with the wind. Are there any swift travelers who don't sail? " Another example is Funing Decoction (Radix Angelicae Sinensis, Radix Rehmanniae Preparata, Radix Ophiopogonis, Colla Corii Asini, Radix Codonopsis, Rhizoma Dioscoreae, Glycyrrhrizae Radix, Radix Dipsaci, and Cortex Cinnamomi), which is used to treat postpartum abdominal pain due to blood deficiency. Because "only the pain due to blood deficiency can be supplemented with blood-enriching drugs". However, this prescription is also a medicine for invigorating qi and blood, and there is no worry about depression. All the above prescriptions are the products of clinical practice under the guidance of the theory of "Qi generating blood". I2 1？ V 2。 Qi can promote blood circulation: if yin and yang are divided according to the relative properties of qi and blood, then blood belongs to yin, which governs quietness, and blood cannot move by itself, so blood is zero. The circulation of meridians, the penetration of viscera and the filling of skin, such as endless circulation, all depend on the promotion of qi (the promotion of heart qi, the declaration of lung qi and the release of liver qi). Activating qi promotes blood circulation, while stagnation of qi leads to blood stasis. Therefore, qi deficiency promotes weak blood circulation; Qi stagnation leads to poor blood circulation, blood stasis and even blood stasis; Qi is disordered, and the movement of qi and blood is also disordered with the abnormal movement of qi. Therefore, in the clinical treatment of blood circulation disorders, drugs such as invigorating qi, promoting qi circulation and lowering qi are often used in combination as appropriate in order to achieve good results. For example, Buyanghuanwu Decoction (Radix Astragali, Radix Angelicae Sinensis, Lumbricus, Rhizoma Chuanxiong, Flos Carthami, and Semen Persicae) is used to treat hemiplegia, mouth-eye deviation, speech disorder, salivation, etc. caused by poor blood circulation, and it is a famous prescription for invigorating qi and promoting blood circulation. The above symptoms are all due to the lack of vital qi, which leads to stagnation of veins and dystrophy of tendons and veins. For this syndrome of "blood stasis due to deficiency", the treatment should be based on invigorating qi, promoting blood circulation and dredging collaterals. The use of Astragalus membranaceus (20 times that of Angelica sinensis) in the prescription can greatly supplement the qi of the spleen and stomach, make it full of qi, promote blood circulation and remove blood stasis without hurting vital qi, and help other drugs. Combined with angelica to promote blood circulation, it has the effect of removing blood stasis without hurting yin and blood. The combination of the above drugs can promote qi and blood circulation, remove blood stasis and dredge collaterals, and the symptoms can be gradually eliminated. It can be said that Astragalus membranaceus is an ideal drug for treating qi deficiency and blood stasis syndrome. Another example is the "Xuefu Zhuyu Decoction" in Yilin Gaicuo (peach kernel, safflower, angelica, radix rehmanniae, rhizoma Chuanxiong, radix Paeoniae Rubra, Achyranthes bidentata, platycodon grandiflorum, radix bupleuri, fructus Aurantii, licorice), which is used to treat chest obstruction and poor blood circulation. It is a prescription that mainly promotes blood circulation, removes blood stasis and relieves pain, and gives consideration to both qi and blood, supplemented by products that soothe the liver, open the chest and regulate qi. This is because the treatment of blood stasis is to "dredge its qi and blood, make it unobstructed, and achieve peace" (Su Wen? 6? 1 truth theory "). The "Honghua Powder" used in the classic veterinary work "Yuan Heng Therapeutic Horse Collection" to treat the five stagnation of material injury is composed of 13 drugs, among which, except some drugs for promoting blood circulation and removing blood stasis, four drugs have the functions of regulating qi and activating blood circulation and removing blood stasis, which can be said to be a typical application of the theory of promoting blood circulation. For hematemesis, bleeding, irregular menstruation and other diseases, the treatment principle is also "dredging collaterals and eliminating evil". Regulating Qi-flowing and conforming to the law of Qi-flowing up and down in human body is the fundamental method to treat these diseases, such as "Jin Lingzi" in Su Wen's Pathogenesis Collection, and to treat pains such as heart, abdomen, hypochondrium and ribs caused by poor qi and blood, and to nourish qi. The reason is that as long as the qi is smooth, the blood circulation will be smooth, and the pain will stop. Under the guidance of the theory of promoting qi and blood circulation, these prescriptions are widely used in clinic. Shame and disease iii. Qi can suck blood: it means that blood circulates in the pulse without escaping from the pulse, mainly relying on the fixation of blood by qi. If qi is deficient, this fixation will be weakened, which will lead to various bleeding symptoms. Therefore, in the clinical treatment of bleeding, hemostatic drugs are never used alone, but based on the etiology, combined with the bleeding site, and drugs are used to replenish qi. Only by starting with the method of invigorating qi and enriching blood can we really stop bleeding. For example, the "Huang Tu Decoction" (Radix Glycyrrhizae, Radix Rehmanniae, Rhizoma Atractylodis Macrocephalae, Radix Aconiti Lateralis Lateralis, Colla Corii Asini, Scutellariae Radix, and Jujube Seed Loess) used to treat women's hematochezia, hematemesis, hemorrhage and metrorrhagia in Synopsis of the Golden Chamber is a typical example of invigorating qi and nourishing blood. Looking at this prescription, it can be said that it is a direct hemostatic, but it has achieved the purpose of hemostasis. Qing? 6? 1 Tang Rongchuan pointed out when analyzing this prescription: blood is the unity of the spleen, and defecation first followed by blood. This is because the spleen is exhausted and blood follows, so the spleen soil should be supplemented with kitchen soil, grass and surgery, which is the basis of taking blood. Xu Zigong, a famous veterinarian in China, used Radix Rehmanniae, Radix Aconiti Lateralis Preparata, spiced Radix Aconiti Lateralis Preparata and dried ginger charcoal to make a prescription for treating bloody cow dung. It can be seen that both Chinese medicine practitioners and veterinarians realize that blood "depends on the spleen as the host to control the whole body and walk around the pulse." Deficiency of spleen and soil leads to loss of the right to control, so heat leads to rashness, and cold leads to obstruction, and all of them can be separated from menstruation and blood fails to keep "(Easy to read). Another example is Lizhong decoction in Treatise on Febrile Diseases (Ginseng, Atractylodes macrocephala, Radix Glycyrrhizae Preparata and Zingiberis Rhizoma), which has a good effect on vomiting blood, hematochezia or blood caused by qi deficiency and yang weakness. Therefore, for bleeding, you must not use hemostatic products to stop bleeding. If it is so simple, the curative effect will definitely be poor. When the prescription mainly focuses on invigorating qi and spleen, inducing blood to dredge collaterals, and warming meridians to suck blood, its mechanism lies in "more damage is due to qi, while injury is due to blood storage" (Jing Yue Quan Shu). c？ Second, blood is the mother of qi. Sj is the mother of Qi, which means that blood is the carrier of Qi, giving Qi sufficient nutrition. Blood has the function of bearing Shui Gu's essence and clearing natural qi, so blood bears qi. In addition to innate qi, the generation and maintenance of qi in zang-fu organs and meridians mainly depend on the continuous nourishment of acquired qi, while the distribution of acquired qi in zang-fu organs and meridians mainly depends on the transportation of blood, which often leads to the loss of qi when a large amount of blood is lost. Therefore, in the clinical treatment of qi deficiency and blood deficiency, we should use the method of invigorating qi and removing stagnation for first aid, and at the same time cooperate with the method of stopping bleeding and enriching blood. For example, postpartum hemorrhage in women (sudden bleeding in the birth canal shortly after the placenta is delivered) results in "postpartum blood halo" due to a large amount of blood loss in a short period of time. Symptoms include dizziness, dark eyes, cold hands and feet, coma, pale face, cold sweat, palpitation, shortness of breath, slight or floating pulse (shock). This disease is more common in two hours after delivery, and it is a critical syndrome of postpartum diseases. The treatment should be invigorating primordial qi and stopping bleeding (not enriching blood), and the prescription should be Yiqi Jiejing Decoction (Ginseng, Sanqi) (TCM syndrome differentiation). After the bleeding stops, it should be changed to the prescription for invigorating the spleen and regulating the week (Radix Codonopsis, Atractylodis Rhizoma, Radix Astragali, Radix Angelicae Sinensis, Radix Paeoniae Alba, Polygonum Multiflori Radix, Rhizoma Cyperi, Placenta Hominis and Polygonum Multiflori Radix) or Yunhua Shengdan (Ginseng, Atractylodis Rhizoma, Angelica, Chuanxiong Radix Rehmanniae Preparata, Zingiberis Rhizoma) (secret records in stone room) or Cynanchum atratum (Cynanchum atratum, Ginseng, Angelica, Glycyrrhiza) (Pu These series of prescriptions not only reuse qi-invigorating drugs (ginseng, Atractylodes macrocephala and Astragalus membranaceus) to save collapse, but also do not forget to find a home for qi (some people call it "blood is the home of qi") and roots, so that qi can be effectively supplemented and attached for a long time. As for stopping bleeding first and then replenishing blood, it is a concrete embodiment of the treatment principle of "treating symptoms urgently and curing the root cause slowly". Another example is Buzhong Yiqi Decoction (Radix Codonopsis, Radix Astragali, Rhizoma Atractylodis Macrocephalae, Radix Glycyrrhizae Preparata, Radix Angelicae Sinensis, Pericarpium Citri Tangerinae, Cimicifuga Rhizoma, and Radix Bupleuri) for treating three lost Syndrome of Qi Stagnation, and Radix Angelicae Sinensis is only used for replenishing blood. There is no intention to correct the clinical manifestations by creating a site for invigorating qi drugs, because the symptoms of qi stagnation are: three-deficiency syndrome, chronic diarrhea, chronic dysentery and physical symptoms. Hey? vⅳ3。 Qi is heavier than blood? +Blame ap As we all know, qi is yang and blood is yin. They are interdependent, mutually educated, mutually utilized and mutually restricted, but in the relationship of unity of opposites between them, qi plays a leading role, "the right of yang is granted, and the yin is the master" (Su Wen? 6? 1 theory of yin-yang clutch). This feature can be reflected in both physiological functions and pathological changes. Therefore, in the practice of TCM syndrome differentiation and treatment of qi and blood diseases, when adopting the method of regulating qi and blood, qi should be the main principle and treatment of qi should be the basic principle. For example, Danggui Buxue Decoction (Radix Astragali and Radix Angelicae Sinensis) is used to treat internal injuries, weakness of qi and blood, yang floating outside, and women's menstrual and postpartum blood deficiency, that is, the qi of Radix Astragali (five times that of Radix Angelicae Sinensis) is reused to enrich the blood source, and the blood is nourished by Radix Angelicae Sinensis, so that Yang is longer than Yin and blood is flourishing. Wu Shuo, "Tangible blood cannot be born by itself, but by invisible qi. "Guiqi Mu Yi Decoction" in Niujingbei Prescription is composed of Danggui Buxue Decoction and Leonurus japonicus. It can be seen that their theoretical views are consistent, and they all think that deficiency of both qi and blood should be based on invigorating qi, and qi is their main aspect. Another example is "Guben Zhiben Decoction" (Radix Rehmanniae Preparata, Ginseng, Radix Astragali, Atractylodis Rhizoma, Ginger and Angelica), which is used to treat asthenia of dark blood in gynecology in Fu Qingzhu. Of the six drugs, three are tonics, and the other two are blood tonics. Tonics are more important than blood tonics and hemostatics, and the curative effect is "one dose stops the collapse, and ten doses are no longer given". 6? 1? 6? 1? 6? 1? 6? 1? 6? 1? 6? 1"。 Guipi Decoction (Ginseng, Atractylodes macrocephala, Astragalus, Angelica, Radix Glycyrrhizae Preparata, Poria, Cortex et Radix Polygalae, Semen Ziziphi Spinosae, Radix Aucklandiae, Arillus Longan, Ginger and Jujube) for treating deficiency of both heart and spleen and deficiency of both qi and blood. Although it is a prescription for invigorating qi and blood, the medicine for invigorating qi is far superior to the medicine for enriching blood in both taste and dosage. In Treatise on Febrile Diseases, other "roasted licorice soup" (roasted licorice, ginseng, jujube, rehmannia root, cassia twig, donkey-hide gelatin, Ophiopogon japonicus, hemp seed, ginger) for treating deficiency of both qi and blood and palpitation pulse, also use roasted licorice to turn qi into blood and restore pulse, and ginseng and jujube are assisted in invigorating qi, strengthening spleen and nourishing heart. The "prescription" for treating postpartum deficiency of both qi and blood (Radix Codonopsis, Atractylodis Macrocephalae, Poria, Radix Glycyrrhizae Preparata, Radix Angelicae Sinensis, Rhizoma Chuanxiong, Radix Paeoniae Alba, Radix Rehmanniae Preparata, Fructus Amomi, Rhizoma Cyperi and Rhizoma Corydalis) is also a prescription that does not forget to replenish qi and focuses on regulating qi. And "Ginseng Nourishing Soup" in Taiping Huimin Hejiju Prescription and "Taishan Panshi Powder" in Jingyue Quanshu. To sum up, we can see that in the treatment of hemorrhagic diseases, we should pay attention to the effect of qi on blood, and adjust qi, or adjust qi first, or adjust qi first. Inspired by the above theories and classic prescriptions, and guided by "those who are good at nourishing yin must seek yin in yang" (Jing Yue Quan Shu) and "blood deficiency is supplemented by ginseng, and Wang Yang can produce yin and blood" (spleen and stomach theory), so the syndrome of deficiency of both qi and blood should be mainly based on invigorating qi, and the traditional Chinese medicine used in our clinical treatment of severe production paralysis of dairy cows is "Shiquan Dabu Decoction". This is because postpartum qi and blood are inherently weak, milking is too much, and nutrition can't keep up in time, which leads to passive biochemistry of blood, and qi and blood are even weaker. Weak qi is nourished by blood loss, and there is no blood attachment, which leads to failure. Qi failure leads to mental fatigue, severe coma, mental fatigue and weakness, severe inability to lie on the ground, vigorous body, stiff limbs, and backward head. It can be seen that the main cause of the disease at this time is qi failure, so the treatment should be based on benefiting qi and helping yang first, while enriching blood and stopping bleeding, nourishing liver and tonifying kidney can cure the disease. As "Fu Qingzhu Gynecology" said in the treatment of bloody collapse: "If you cover a bloody collapse and faint in the dark, the blood will be exhausted, leaving only a glimmer of gas to protect it. If you don't make up the qi to produce blood, but make up the blood first and keep it, the tangible blood may not be born, and the intangible gas will be exhausted. Therefore, it is advisable to replenish qi first instead of replenishing blood first. "