Introduction: Zhongjing's sentence "Seeing the disease of the liver, knowing the liver and dispersing the spleen" is deeply rooted in the hearts of the people, and it also creates a precedent for treating spleen and stomach diseases with liver-dispersing wood. So, in clinic, how can we send prescriptions and drugs accurately and achieve excellent results? Learn from the experience of Mr. Tung Chee-hwa, a famous Chinese medicine practitioner!
Soothing the liver and soothing the wood is one of the widely used therapeutic principles in traditional Chinese medicine. Dong Lao has achieved remarkable results in regulating the fluctuation of spleen and stomach qi, which is summarized as follows.
The stomach is the sea of water valley, and the main organ is Shui Gu, so it can be reduced to be smooth and used as smooth. If you don't fall, you will be sluggish, and if you rise, you will be reversed. Spleen is the ambassador of the stomach, which is the main transport, so that it can be promoted smoothly and transported expensively. If you don't rise, you will lag, and if you fall, you will sink.
In a word, the spleen and stomach are the hinge of human qi. If the lifting is appropriate, the medium coke machine is stable and orderly, and the biochemistry is active; If the lifting is not normal, the transmission will be lost and disaster will come.
"On Su Wen Liu Weizhi" says: "If you don't advance, you will get out, and if you can't grow up, you will be old; If you don't rise, you will fall, and if you don't rise, you will receive it. " And "if the clear gas is next, it will be vented; Turbid gas on the top, then health? Expansion. "
Hua said: "The diseases of the spleen and stomach are cold and hot, which should be dry and wet, and should be distinguished in detail, especially the rise and fall of the second house."
The liver is the dirty of wind and wood, and it is happy to achieve the goal and control the discharge; Spleen is the viscera of yin, which is good and quiet in nature, but it must depend on the release of liver to transport it; The gallbladder meridian is attached to the liver, and the liver overflows into the gallbladder and is concentrated into essence; Soothes the liver and regulates qi, essence enters the stomach, and helps the stomach to decompose Shui Gu; Therefore, soothing the liver can increase the temper, and the subtle temper can be attributed to the lung, reducing the stomach qi, so that the decomposed water grains can smoothly enter the small intestine.
This is "wood pneumatic, angry, soil drainage."
The pulse of Jueyin is connected with the stomach, belonging to the liver, dredging the diaphragm, stretching the tendons, and rushing the pulse from Yangming, so the liver dominates the pulse, so the qi of the liver and stomach is connected, the liver meridian is smooth, and the stomach qi is smooth.
There is a saying in Neijing that if the liver fails to disperse qi, the temper will not rise, and the stomach qi will not fall, the qi stagnation will become a disease, or the spleen and stomach will be slapped and lifted excessively, or the spleen and stomach will be weak, and the liver will multiply it, and the qi disorder will become a disease. Therefore, Neijing is also called Neijing.
Liver-wood imbalance affects the spleen and stomach. Although the clinical symptoms are concentrated in the spleen and stomach, its pathogenesis is in the liver. Use the method of dispersing and regulating liver wood to make the qi harmonious and smooth, and the spleen and stomach calm.
For example, Zhang Jingyue said: "Those who treat the spleen can regulate the five internal organs, that is, treat the spleen and stomach ... If the spleen is invaded by liver evil, the liver and spleen are solid and the liver qi can be suppressed."
In the treatment of spleen and stomach diseases, Dong Lao attaches great importance to those who suffer from liver depression, starting with regulating the liver and regulating the rise and fall of spleen and stomach qi.
First, the key points of syndrome differentiation
(1) Emotional changes
In the long-term medical practice, the ancients observed that people's emotional activities are closely related to the catharsis function of the liver, and they are frustrated, angry and deliberate, which easily leads to liver-wood imbalance; If the wood can't reach the goal, depression will lead to excitement, which will lead to horizontal and horizontal disharmony, which will easily lead to depression or upset.
(2) Abdominal distension and bilateral pain.
The liver is the pulse of Jueyin, which passes through vagina, reaches abdomen, passes through diaphragm and covers ribs. Liver qi is horizontal and has no right to disperse, and it is depressed in this meridian. Flatulence or pain in both sides of the lower abdomen is common, manifested as flatulence, which is caused by qi stagnation, and flatulence and pain are caused by qi stagnation.
(3) Women with irregular menstruation and poor qi and blood.
The liver stores blood, which governs the drainage. Jueyin communicates with the uterus through ren meridian, regulating the blood sea, regulating the pulse of the uterus, and the liver governs the pulse, so "a woman is born with a liver". Stagnation of liver-qi, stagnation of qi and blood stasis, or hyperactivity of liver-qi and hyperactivity of qi and blood can all lead to irregular menstruation in women.
Second, the classification of treatment principles
"The big branch of the fish" is a great way to regulate the liver, regulate qi and regulate the spleen and stomach. However, there are various methods for stagnation of liver-qi, stagnation of liver-qi, excess or deficiency, or relieving depression or calming hyperactivity, so it is necessary to adjust the examination according to the time.
For example, Li Zhongzi said, "Dispelling blood is not attacking, not supplementing, not warming blood, not clearing blood, not regulating blood. We must improvise and not stick to certain laws to cope with endless changes."
This paper expounds Dong Lao's experience and specific application of regulating spleen and stomach qi by regulating liver and wood from ten aspects.
(1) soothing the liver, relieving depression and regulating the stomach.
Suitable for abdominal distension, attack and even pain. Press it and you will be relieved. Eating less and not hungry is often related to emotional changes. Red tongue, white fur, and thready pulse.
Stagnation of liver qi, stagnation of wood, stagnation of spleen and stomach, stagnation of qi, stagnation of middle qi and abdominal distension. It is advisable to soothe the liver and regulate qi, relax its depression, guide its stagnation, make the middle energizer unobstructed, and there is no obstruction up and down, then abdominal distension can be eliminated and food can be eaten.
"The liver wants to disperse, and it is urgent to eat spicy food to disperse it." Pungent taste products are often used to soothe the liver, which can not only regulate liver qi, soothe the liver and relieve depression, but also regulate spleen and stomach qi, and assist acid drugs to make them disperse and merge.
The prescription is Sini Powder: Radix Paeoniae Alba, Radix Bupleuri, Rhizoma Cyperi, Radix Curcumae, Fructus Aurantii, Pericarpium Citri Tangerinae, Caulis Perillae and Radix Glycyrrhizae.
Very painful, plus Jin Lingzi and Yuanhu; If it is cold, add Litsea cubeba and Alpinia officinarum; Depressed heat, add Cortex Moutan and Fructus Gardeniae.
(2) calming the liver, lowering the adverse flow and stopping vomiting
Suitable for liver-qi invading the stomach.
Symptoms include nausea and vomiting, frequent hiccups, hiccups, anorexia, chest tightness, dry stool, red tongue with greasy fur and slippery pulse.
Nausea and nausea are mostly caused by liver qi against the stomach and stomach loss. Liver-qi goes against the stomach, so the clear qi does not rise, and the turbid qi does not fall against the stomach. Therefore, the method of lowering the stomach and lowering the qi of the liver and wood will stop vomiting.
However, the reason why the liver-qi goes against the flow is that the yin-cold guest is attacked in the liver meridian and the stomach fu-organs of Yangming, resulting in retching and spitting; Some people vomit because of depression, liver-qi disorder and diaphragmatic movement, so the treatment methods are the same, and the prescriptions are different.
The prescription is modified by Fu Xuandai Zhetang: Inula, Ochre, Ginger, Jujube, Radix Paeoniae Alba, Bupleuri Radix, Rhizoma Cyperi and Fructus Aurantii.
Evodia rutaecarpa is added for cold patients; Due to heat, add Qin and Lian; Do people, join the wine army.
(3) nourishing yin, soothing liver and regulating stomach
It is suitable for patients with deficiency of liver yin and disharmony between liver and stomach.
Symptoms include fullness and discomfort in chest and hypochondrium, loss of appetite, abdominal distension, dysphoria, dry mouth and throat, uncomfortable stool, insomnia and dreaminess, red tongue with little fur and thready pulse.
The liver takes blood as the body and qi as the use; Blood governs moistening, qi governs warmth, and * * * plays the role of nutrition and hair growth. If the liver yin is insufficient, the liver will lose nutrition, become soft and hard, and the stomach will bear the brunt. Only by nourishing the liver blood can the liver qi recover smoothly and the spleen and stomach rise and fall.
If you only use soothing the liver and calming the liver, you will make a deficiency. Proper combination of acid and sweetness can nourish the liver and strengthen the spleen and soften the liver. It is a wonderful method to nourish the liver, use less products to soothe the liver and achieve the purpose of soothing the liver and relieving depression.
The prescription is Yiguanjian: Radix Paeoniae Alba, Radix Angelicae Sinensis, Radix Adenophorae, Radix Rehmanniae, Fructus Toosendan, Radix Curcumae, Pericarpium Citri Tangerinae and Radix Glycyrrhizae.
Insomnia, add fried jujube kernels; Fire due to yin deficiency is flourishing, and Cortex Moutan is added.
(4) benefiting qi, soothing the liver and strengthening the spleen
It is suitable for patients with qi deficiency and liver depression and disharmony between liver and spleen.
Symptoms include fullness in the chest and hypochondrium, abdominal distension, abdominal distension after eating, fatigue of limbs, shortness of breath, less menstrual delay, pale tongue with white fur, heavy and thin pulse or weak string.
The liver is just dirty, and the body yin uses yang. The yang of the liver is mainly caused by rising and dispersing, and the yang of the liver is weak, so it is difficult to play the role of the liver. If ascending and dispersing have no right, it will lose its appearance and then spread to the spleen.
Tang Rongchuan said: "Liver qi deficiency, water flooding spleen meridian." The combination of Xin and Gan can produce Yang Qi, which is full of liver qi and effective in drainage. Use less blood-enriching products to nourish and help the liver. This belongs to depression caused by deficiency, which is different from simple liver depression.
The prescription is modified with Huangqi Jianzhong Decoction: Huangqi, Guizhi, Radix Paeoniae Alba, Bupleuri Radix, Poria, Radix Glycyrrhizae Preparata, Rhizoma Cyperi and Pericarpium Citri Tangerinae.
(5) Suppressing liver and supporting spleen to relieve pain.
It is suitable for diarrhea caused by liver-qi invasion and spleen-soil invasion.
Symptoms include fullness in the chest and hypochondrium, discomfort under the heart, abdominal distension and pain, which leads to diarrhea, and the pain is relieved after diarrhea. Every attack is caused by depression, anger or emotional tension. The tongue is red, yellow and coated, and the pulse is rapid.
Adverse qi movement, liver failure, cross-attack on spleen, loss of health, failure to clear yang, failure to decrease turbid yin, continuous turbidity, impassable tunnel, abdominal distension and pain, decline of essence and qi combined with pollution, and diarrhea. Only by calming down the lodging of the liver wood can the spleen soil be restored to the ascending position.
The prescription is composed of Radix Paeoniae Alba, Radix Saposhnikoviae, Bupleuri Radix, Poria, Atractylodis Rhizoma, Fructus Aurantii, Pericarpium Citri Tangerinae and Glycyrrhrizae Radix.
(6) Consolidating soil, restraining wood and stopping diarrhea
It is suitable for diarrhea due to spleen deficiency and diarrhea due to liver syndrome.
Symptoms include thin stool, indigestion, frequent bowel sounds, abdominal distension and pain, no definite position, long course of disease, accompanied by less yellow face, fatigue, pale tongue with white fur and weak pulse.
Spleen and stomach are weak, and liver qi can be used. Treatment should be based on supporting the soil, supplemented by suppressing the liver. If only supporting the soil is a matter, it is difficult to give full play to it. It is another way to help Tu by pacifying his thief and relieving his liver anxiety.
This is mainly related to the inhibition of liver by the upper method, and the pathogenesis is different successively, and the deficiency and excess are different, so we should compare and distinguish them.
The prescription is Chai Shao Liujunzi Decoction: Bupleurum Radix, Radix Paeoniae Alba, Radix Codonopsis, Poria, Atractylodis Rhizoma, Pinellia ternata, Pericarpium Citri Tangerinae, Rhizoma Cyperi and Glycyrrhrizae Radix.
(7) Soothing the liver, regulating qi and resolving phlegm
It is suitable for meihe qi of liver depression and phlegm-dampness.
Symptoms include throat discomfort, obstruction of something, chest tightness, hyperventilation, red tongue with greasy fur and slippery pulse.
When the liver is depressed, it will be blocked by the spleen, and the body fluid will not be distributed, turning into phlegm. If it stays stagnant for a long time, the semen will turn into phlegm, and the phlegm and qi will be combined, which will block the qi. Therefore, the treatment of phlegm will first regulate qi, and qi will disappear by itself.
It is appropriate to soothe the liver and relieve depression, assist in eliminating dampness and phlegm, soothe the liver and regulate qi, eliminate phlegm and dampness, and remove pharyngeal stalk.
The prescription is modified with Sini Powder and Banxia Houpu Decoction: Radix Paeoniae Alba, Radix Bupleuri, Rhizoma Pinelliae, Rhizoma Cyperi, Radix Curcumae, Cortex Magnolia Officinalis, Fructus Aurantii, Perillae, and Jin Lingzi.
Phlegm heat, adding Coptidis Rhizoma and bamboo shavings; Chest tightness, plus Fructus Trichosanthis.
(8) Clearing liver, relieving depression and regulating stomach
It is suitable for liver depression to turn into fire and liver fire to attack the stomach.
Symptoms include burning pain in the epigastric cavity, vomiting, restlessness, bitter mouth and dry mouth, abdominal distension, constipation or diarrhea, red tongue with yellow fur and slippery pulse.
Stagnation of liver qi will turn into fire for a long time, or the liver will be full of qi, "qi will lead to fire", and the liver fire will rebel, the spleen will be subtle, and the turbid liquid will not drop, and it will turn from wood to acid.
Ye Shi Tian said, "Relieving Jueyin is beneficial to its use, and harmonizing Yangming is beneficial to its internal organs". The treatment is mainly bitter and bitter, supplemented by acid, which can clear away heat, remove bitterness, dispel depression and remove pungent, and converge the tendency of acid. The combination of bitterness and bitterness is used to drain the liver; The combination of acid and bitterness releases the heat of the liver. Bitterness and bitterness can promote health and restore the healthy function of stomach and fu organs, and its qi is safe.
The prescription consists of Zuojin Pill and Jinlingzi Powder: Evodia rutaecarpa, Coptidis Rhizoma, Scutellariae Radix, Radix Paeoniae Alba, Rhizoma Pinelliae, Jin Lingzi, Rhizoma Corydalis, Caulis Perillae, Rhizoma Cyperi and Pericarpium Citri Tangerinae.
(9) Soothing the liver, removing dampness, and dispersing stagnation
It is suitable for swelling caused by stagnation of liver qi and obstruction of collaterals due to dampness and turbidity.
Symptoms include abdominal distension, beating like a drum, not pressing firmly, abdominal distension after eating, unpleasant belching, thick and greasy fur, and slippery pulse.
Long-term stagnation of liver qi will inevitably lead to poor transport and transformation of spleen and spleen, irregular ascending and descending, and retention of water and dampness in the middle energizer.
The prescription is Bupleurum, Atractylodis Rhizoma, Atractylodis Rhizoma, Poria, Pinellia ternata, Plantago asiatica, Pericarpium Citri Tangerinae and Rhizoma Cyperi. From wet to hot, add Herba Artemisiae Scopariae and Herba Agastaches.
(10) Removing blood stasis, soothing liver and dredging collaterals
It is suitable for patients with disharmony between liver and spleen who cannot be cured after long-term treatment. The method of soothing the liver should not be used. Obstruction of qi, obstruction of collaterals, abdominal pain in chest and hypochondrium, which will not heal for a long time. The pain point is fixed, or the stool is black, or even hematemesis, the tongue is dark or purple, and the pulse is string or astringent.
"Theory of Blood Syndrome" says: "Those who transport blood are qi." The liver governs the storage of blood, and the blood vessels are unobstructed when the wood gas reaches; The stomach is the fu-organ, full of qi and blood, the liver can dredge the soil, the ascending and descending movement is smooth, and the blood circulation is not stagnant.
If the liver fails to drain and qi stagnation is not smooth, blood stasis will not work, stomach collaterals will be blocked, and it will hurt. When soothing the liver and regulating qi, the spleen and stomach will rise and fall, the blood circulation will be promoted, and the blood stasis in the stomach collaterals will be removed.
The prescription consists of Jinling Zi San and Shixiao San: Jin Lingzi, Rhizoma Corydalis, fried Ganoderma, Pollen Typhae, Rhizoma Cyperi, Pericarpium Citri Tangerinae, Fructus Aurantii, Radix Salviae Miltiorrhizae and cuttlefish bone.
For intractable pain, add aspongopus and hedgehog skin.
First, the liver wood hurts the soil, and the disease affects the liver, spleen and stomach. Pay attention to two points when using drugs.
First, when choosing a prescription, we should consider the characteristics of multiple drugs and multiple uses of one drug, and choose a medicine that is beneficial to soothing the liver and regulating the wood, but also has the effect of invigorating the spleen and stomach, and does not hurt the stomach or stagnate the spleen.
Second, the liver likes to moisten dryness and the spleen likes to moisten dampness, so we should pay attention to proper moistening dryness, combining rigidity with softness, and treating it according to syndrome differentiation.
Second, guiding patients to be optimistic, cheerful and relaxed is also the key to regulating liver and regulating spleen and stomach qi.
The cover picture comes from the picture network.
//////////