The author thinks that the pathogenesis of this disease is not only lung failure, but also closely related to blood stasis. The disease begins with coughing, and then coughing hurts the collaterals so much that blood stasis replaces the lungs, blocking the airway, preventing the rise and fall of qi, and blocking the airway, leading to coughing and dyspnea. In addition to the promotion of heart qi, the circulation of blood is closely related to the "treatment of depression" of the lungs. Long-term cough and asthma, lung qi deficiency, can not penetrate the heart, but promote blood circulation to 100 pulses to help the heart, coupled with phlegm resistance, qi disorder, heart pulse obstruction and depression leading to blood stasis, treatment should promote blood circulation and remove blood stasis, phlegm and qi can move smoothly, asthma is flat.
Therapeutic prescription: Radix Angelicae Sinensis, Radix Rehmanniae, Flos Carthami, Radix Platycodi, Radix Glycyrrhizae, Lumbricus and Cortex Mori each 65438±05g, Radix Bupleuri, Fructus Aurantii, Rhizoma Chuanxiong, Radix Paeoniae Rubra, Bulbus Fritillariae Cirrhosae and Herba Ephedrae each 65438±00g, and Semen Persicae 20g.
Qi stagnation adds fragrance 15g, Allium macrostemon10g; For patients with severe blood stasis, salvia miltiorrhiza 12g and notoginseng 3g are added (taken at the end of grinding); Inula (decocted)12g is added for patients with excessive phlegm; Constipation increases yellow 10g (waist and back); Add 40 grams of gypsum, 0/2 grams of Scutellaria baicalensis Georgi/KLOC-for fever, and increase the dosage of Bupleurum; 30 grams of Astragalus membranaceus is added after a long illness of qi deficiency; 15g Cornus officinalis is added to general older people.
It can be treated with Xuefu Zhuyu Decoction if it meets the following requirements: 1. It is difficult to breathe. If you move, you will open your mouth and lift your shoulders, even shortness of breath. After exercise, you will lose your breath and even sweat, so you can't lie flat. 2. Chest diaphragmatic distension, abdominal distension, intercostal tingling, cyanosis of mouth and lips, purplish purple, dark tongue with petechiae, swollen sublingual collaterals, and unsmooth pulse.
Typical case: Zhang, male, 15 years old. Repeated cough and asthma for eight years, aggravated in recent 1 month,1July 2, 998. The child got bronchial asthma at the age of 7, and it is easy to catch a cold in the later stage. The climate changes repeatedly in autumn and winter every year, and I was admitted to the hospital for treatment. In the past two years, no matter whether the climate change is frequent or not, the condition is getting worse and worse, and traditional Chinese and western medicine can't cure it for a long time. Cough, wheezing, white and sticky phlegm, dyspnea, shoulder lifting and mouth opening, anorexia, dry stool, yellow urine, dark red tongue, yellow and greasy fur and slippery pulse. Physical examination: Generally speaking, the patient's condition is poor, with sitting breathing, concave sign (+), barrel chest, heart rate 1 10 beats/min, wheezing in both lungs and no moist rales. Chest X-ray: The air content of both lungs is increased, the chest is slightly barrel-shaped, the texture of the right lung is obviously thickened, the edge is blurred, there are scattered punctate calcification, and the left lung is slightly enhanced. Western medicine diagnosis: bronchial asthma, emphysema. Traditional Chinese medicine diagnosis: Asthma, syndrome differentiation belongs to phlegm-heat blocking the lung, and both lung, spleen and kidney are deficient, which belongs to the syndrome of excess and deficiency. The treatment is oral Qingfei Huatan Zhike Pingchuan Decoction and intravenous drip of penicillin. After 5 days of continuous use, the condition did not improve obviously, so I asked for a consultation with Chinese medicine.
For 7 years, the long-term illness with excessive blood stasis and red and dark tongue can be treated with Xuefu Zhuyu Decoction. Formula: Radix Angelicae Sinensis 15g, Radix Rehmanniae 15g, Semen Persicae 10g, Flos Carthami 10g, Radix Paeoniae Rubra 10g, Radix Platycodi 20g, Radix Achyranthis Bidentatae 10g, Fructus Aurantii 15g. Decoct with water, daily 1 dose. After two weeks of continuous use, the patient basically did not gasp, and the auscultation breath sounds of both lungs were clear and there was no obvious wheezing sound. After reexamining the chest radiograph, the texture of both lungs was enhanced, and the rest were normal. In order to consolidate the curative effect, spleen and kidney were treated with traditional Chinese medicine.
Experience: Asthma is generally treated with pulmonary congestion or renal failure. As early as Neijing, there was a theory about asthma caused by blood stasis. In "Su Wen Jing Wei Pulse Theory", it is said that "liver disease persists for a long time, and its color is not blue. When the disease falls, people take a breath. " Su Wen's Theory of Yangming Veins says: "The syncope of Yangming will make him gasp and sigh." Modern medicine believes that asthma attacks repeatedly, because of ventilation disorder, the body is in a state of hypoxia, stimulating erythropoiesis and increasing blood viscosity, leading to increased peripheral vascular resistance and extravasation of intravascular liquid, resulting in blood concentration, increased viscosity and slow blood flow, which is consistent with the pathogenesis of blood stasis in traditional Chinese medicine. The main pathological factor of asthma is phlegm. However, phlegm retention in the lung does not exist in isolation, and it is often mutually causal with qi stagnation and blood stasis. Stagnation of phlegm and blood stasis leads to qi stagnation, abnormal ascending and descending, turbid phlegm caused by condensation of body fluid, stagnation of qi and phlegm coagulation, which leads to blocked blood circulation and blood stasis, forming a complex situation of phlegm and blood stasis. Therefore, the main pathogenesis of asthma is that "blood stasis and phlegm" block the lung and the lung loses its function. Promoting blood circulation to remove blood stasis, smoothing pulse and relieving asthma.
Xuefu Zhuyu decoction can achieve the above therapeutic purposes. Modern pharmacological research shows that this prescription has three characteristics in drug compatibility: 1. Give consideration to both qi and blood, mainly promote blood circulation and remove blood stasis, supplemented by qi-regulating drugs, and combine blood circulation and remove blood stasis. The prescription is mainly composed of Angelica sinensis, Ligusticum Chuanxiong, Radix Paeoniae Rubra, Semen Persicae and Carthami Flos. Bupleurum soothes the liver and relieves depression, and introduces drugs to the affected area. Platycodon grandiflorum opens the lungs and carries drugs on the upper side. Fructus Aurantii opens the chest and promotes qi circulation. When the three drugs are used together, they will rise and fall, recover and reduce qi, and widen the chest; Nourish yin in raw land to avoid damaging body fluid and consuming gas. Achyranthes bidentata promotes blood circulation, induces drugs to descend, promotes blood circulation and promotes qi circulation, so that blood stasis and heat disappear and liver depression is relieved. Platycodon grandiflorum carries medicine upward, which means boat weaving. Reusing earthworm to clear heat, relieve asthma and dredge collaterals has a good antiasthmatic effect on bronchial asthma and asthmatic bronchitis. 2. Nourish in life, so that promoting blood circulation does not consume blood, removing blood stasis does not hurt the body, and regulating qi does not hurt yin. 3. Use both lifting and lowering to promote the movement of qi. According to the theory of "qi stagnation and blood stasis" in traditional Chinese medicine, this prescription is matched with four drugs for promoting blood circulation and removing blood stasis, such as Radix Platycodi and Radix Achyranthis Bidentatae, which conforms to the therapeutic principle of "qi promoting blood circulation" and the theory that qi can promote blood circulation. Xuefu Zhuyu decoction is used to treat intractable asthma, and the effect is obvious when taking 10~20 doses.