Thoughts on the Selection of Shaoyang Prescriptions in Shu Da
Xiaochaihu decoction in Treatise on Febrile Diseases is a classic prescription for treating shaoyang in Shu Da, but there are not many drugs to help yang in Xiaochaihu decoction. In general, cassia twig is used instead of aconite, so I thought of Chaihu Guizhi Decoction. It consists of Xiaochaihu decoction and Guizhi decoction, each taking half dose, and has the functions of shaoyang in Shu Da and harmonizing ying and wei. Xiaochaihu decoction can reconcile cardinals and relieve depression, but it is not enough to help shaoyang, so cassia twig and licorice are used to help heart and gallbladder yang; Paeonia lactiflora nourishes liver blood and helps to stop diarrhea, thus enhancing the development of wood gas. There are only Pinellia ternata and ginger in Xiaochaihu decoction, which can eliminate phlegm and turbidity, eliminate phlegm and drink, and smooth triple energizer. Obviously, the strength is insufficient, what's more, Chaihu Guizhi Decoction has no calming power, so Wendan Decoction is chosen.
There are records of Wendan decoction in Qian Jin and Wai Tai, which shows that Wendan decoction first appeared in Ji Jian Fang and has been lost. It is composed of ginger, Pinellia ternata, orange peel, bamboo shavings, immature bitter orange and licorice. It can treat insomnia due to fatigue after a serious illness, which is also due to fear of cold. Poria cocos and jujube were added to this recipe in the Song Dynasty, and it is still called Wendan Decoction, which is used to treat "heart and gallbladder are weak and timid, things are easy to shock, dreams are ominous, or hallucinations are confused, resulting in fright, qi stagnation, salivation, qi stagnation and various syndromes." Or shortness of breath, or spontaneous sweating, edema of limbs, tasteless diet, guilty conscience and fidgeting. "These symptoms are all manifestations of anxiety and depression, so when the patient complains of many symptoms and gushes, and the doctor can't grasp the main points, you can consider using Chaihu Guizhi Decoction and Wendan Decoction. But the strength of mind is not enough, so I chose Xiaozhi Pill from Sun Simiao.
Zhi Ding Pill, from Volume 14 of Thousand Women, treats "restless mind", that is, trance, boredom, inattention and decreased efficiency; "Deficiency of five internal organs", that is, the whole body is boring; "What's more, people suddenly like to forget when they are sad and unhappy", that is, the clinical manifestations of depression and mental depression such as unhappiness and inattention. At the same time, it is recorded that "the drama in the morning and evening, or the drama in the morning and evening", which is the first time in the history of Chinese medicine literature that there are different records on the severity of illness, which is in line with the clinical characteristics of patients with anxiety and depression. Dingzhi Xiaowan has four medicines: Ginseng, Poria, Acorus calamus and Polygalae. Ginseng in Chaihu Guizhi Decoction and Poria in Wendan Decoction, that is, adding Acorus calamus and Polygalae in Chaihu Guizhi Decoction and Wendan Decoction, can achieve the purposes of resolving phlegm, inducing resuscitation, tonifying heart yang, improving intelligence and waking up. Chaihu Guizhi Decoction, Wendan Decoction and Zhi Ding Pill are combined into one, and Hao Wanshan calls it Chaihu Wendan Zhi Ding Decoction.
Chaigui Wendan Zhi Ding Decoction Basic Formula
Bupleuri Radix, Scutellariae Radix, Ramulus Cinnamomi, Radix Paeoniae Alba, Pericarpium Citri Tangerinae, Rhizoma Pinelliae, Poria, Caulis Bambusae, Fructus Aurantii Immaturus, Rhizoma Acori Graminei, Radix Polygalae, Radix Codonopsis and Radix Glycyrrhizae Preparata. This prescription is beneficial to shaoyang, smoothing qi, resolving phlegm and reducing turbidity, calming the heart and calming the nerves, and then activating the whole body's vitality. It can be widely used in many mental diseases and psychosomatic diseases through addition and subtraction. Depression, anxiety, obsessive-compulsive disorder, phobia, difficulty in getting up, difficulty in choosing, hoarding and other mental diseases. Psychosomatic diseases such as hypertension, hyperlipidemia, arteriosclerosis, coronary heart disease, tension headache, migraine, and inexplicable physical pain. Various diseases of digestive system from top to bottom, anorexia in children, enuresis, night terrors, Tourette's syndrome, rheumatoid arthritis, tumors, diabetes, hyperthyroidism, various skin diseases and respiratory diseases, male sexual dysfunction, menstrual disorders in women, and some infertility, dysmenorrhea, amenorrhea, hysteria and so on.
Medical records
Li, male, 32 years old, was first diagnosed on May 20 14 16. Low fever, bitter taste, abdominal distension, scanty urine, fatigue, pale complexion, emaciation and fatigue, defecation once every 3-5 days, difficulty in defecation, dark tongue, thick and greasy fur and slippery pulse.
History of hepatitis B 10 years, 201May 7, 6 AFP 989.8 ng/ml. Considering liver cancer, the size is about 15cm 13.2cm, and radiotherapy, chemotherapy and interventional therapy were not performed. Treatment: soothing shaoyang, dispersing stagnation, strengthening spleen and stomach, clearing damp heat, calming the heart and calming the nerves.
Prescription: Radix Bupleuri, Fructus Citri, Fructus Citri Sarcodactylis, Herba Artemisiae Scopariae, Herba Hedyotidis Diffusae, Herba Scutellariae Barbatae, Herba Taraxaci, Fructus Aurantii, Poria, Rhizoma Curcumae, fried atractylodes, Atractylodis Rhizoma, Radix Codonopsis, Radix Polygalae, Rhizoma Acori Graminei and Radix Glycyrrhizae. 14 dose, the effect can be taken again.
1 year later, the patient returned to the clinic and said that after taking this prescription for nearly half a year, many symptoms gradually disappeared. At present, the abdomen is easy to catch cold, the stool is soft, the pulse is slippery, the tongue is red, and the coating is thin and white. Treatment: soothing the liver and relieving yang, invigorating the spleen and regulating the stomach, eliminating dampness and turbidity, dispersing stagnation and gathering collaterals, calming the heart and calming the nerves.
Prescription: Radix Bupleuri, Fructus Citri, Herba Artemisiae Scopariae, Pericarpium Citri Tangerinae, Rhizoma Pinelliae, Poria, Charcoal Ginger, fried atractylodes, Rhizoma Curcumae, Radix Codonopsis, Radix Polygalae, Rhizoma Acori Graminei, Radix Glycyrrhizae Preparata, 14 dose.
2065 438+07. 7. 29 Third diagnosis: normal liver function, abdominal distension, slippery pulse, red tongue, thin and white fur. Treatment: soothing the liver and relieving depression, regulating the spleen and stomach, calming the heart and calming the nerves.
June 20 1 65438+1October1AFP 1027 ng/ml, indicating that the tumor did not disappear, but the lesion site decreased.
On 20th17th165438+10th month18th, patients reported drinking and staying up late, which led to slight increase of transaminase. Patients are required to take the original prescription for more than 3 months.
On March 30th, 2008, 2065438, the examination showed a space-occupying lesion of the liver, and liver cancer was considered. The tumor size was 53.4 mm 465438 0.8 mm.
Treatment review: male, 32 years old, with a history of hepatitis B 10 years, 2065438+May 7, 2006, a huge space occupying lesion in the right lobe of the liver,15 cm13.2 cm; After the treatment of soothing the liver and relieving depression, invigorating the spleen and regulating the stomach, calming the heart and calming the nerves, on March 30, 20 18, it was found that there was hydronephrosis at the top of the liver, and irregular masses were seen in the right posterior lobe of the liver, with blurred edges, with a maximum of 5.34cm 4. 18cm. After being treated with pure Chinese medicine, the tumor volume is reduced, the tumor survives and the quality of life is good.
Visit 20 19 on the morning of April 3rd: No discomfort, just hope to consolidate the curative effect. The prescription comprises Bupleuri Radix, Herba Artemisiae Scopariae, Herba Taraxaci, Rhizoma Sparganii, Rhizoma Curcumae, fried atractylodes, Pericarpium Citri Tangerinae, Poria, Radix Codonopsis, Radix Polygalae, Rhizoma Acori Graminei and Radix Glycyrrhizae Preparata. I have been living and working normally since I took it intermittently.
This method also has a good effect on the treatment of tumor surgery and problems left over after radiotherapy and chemotherapy. For liver cancer, in addition to using Chai Gui Wen Dan Zhi Ding Decoction as the basic prescription to relax the three exchanges and help Shaoyang, we should also add and subtract according to the specific situation. Clearing away heat, toxic materials and dampness, selecting Herba Hedyotidis Diffusae, Herba Scutellariae Barbatae, Herba Taraxaci, Fructus Gardeniae and Herba Artemisiae Scopariae; Rhizoma Sparganii and Rhizoma Curcumae are selected for dispersing stagnation, and Atractylodis Rhizoma is used for breaking qi. Prunella vulgaris and Fritillaria thunbergii can also be selected. Ningxin is combined with fried jujube kernels and albizzia bark; Schisandra chinensis reduces transaminase; Use Wuling powder or Zhu Ling decoction to eliminate ascites. This kind of addition and subtraction can improve the quality of life of patients and prolong the survival time of patients appropriately.