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Source: China journal of traditional Chinese medicine


Author: zhang zhiwei




The application of xiaofang in the treatment of complicated diseases is the prominent feature of the school of complicated diseases. The late famous clinical doctor of traditional Chinese medicine of this school, Mr. Menzunde, once said that if a small prescription can be used for the treatment of clinical symptoms, one should not be generous. Use classics recipe, do not open chowder soup, want to make recipe essence medicine as far as possible namely brief. Mensch school of miscellaneous diseases summarized this characteristic as "fang jing yao jian", and applied it in clinical practice, with prominent curative effect. The school USES lizhong pill for the treatment of complicated diseases.


[literature review]


One side of lizhongwan comes from ginseng soup in treatise on typhoid fever, namely synopsis of the golden chamber. The original text describes the following points: treatise on typhoid fever: distinguishing the pulse syndrome of cholera and treating it: Cold do not use water, li zhongwan Lord. "Treatise on typhoid fever · distinguish the pulse syndrome of complex disease after Yin and Yang are easy to be poor and treat" : "after serious disease is poor, like saliva, long time no longer, there is cold on the chest, when the pill temperature, appropriate in the pill. < golden chamber yaoliu chest pain heartache shortness of breath > : "chest bi heart rupi, leaving qi knot in the chest, chest full, under the side of the heart against robbing, zhishi xieguizhi soup Lord; Ginseng soup is also important.


All the syndromes treated by this prescription are caused by deficiency and cold of spleen and stomach. The pathogenesis is the deficiency of zhongyang, cold in the middle of life, Yang deficiency, temperature loss, abnormal transport movements, more often see the fear of cold limbs, wan abdominal pain, xi wen xi, wan PI eat less, vomiting, loose stool, pale tongue moss white moist, mouth thirst, pulse sinking fine or late weak and other manifestations. Square dry ginger for the king, warm spleen Yang, remove cold evil, Yang fu Yin. Ginseng for the minister, taste sweet temperature, invigorate qi spleen. King and minister match, warm the spleen. Spleen is wet soil, deficiency is prone to wet turbidity, so the use of sweet, warm and bitter dry atractylodes atractylodes as adjuvant, spleen dry wet. Licorice and all drugs equal, meaning there are three: one for the combination of ginseng, techniques to help qi jianpi; Second, slow and urgent pain relief; For the purpose of regulating the medicinal property, it is used as an adjuvant and concurrently as an adjuvant. Throughout the whole square, temperature-supplemented and combined, mainly temperature-zhongyang, temperature-invigorated, yunhua, so called "li zhong".


[clinical treatment and experience]


However, the clinical symptoms are not all so typical. Menchun DE is good at grasping the core pathogenesis of this prescription by using lizhong pill: deficiency and cold of spleen and stomach in middle jiao. The movement of the sun starts from the temperature, the temperature of the gas and the fine grain transport, grain gas and the rise of chi zhan. All kinds of miscellaneous syndromes caused by medium coke deficiency can be treated. Mun chunde USES this prescription to treat a variety of diseases, such as the original prescription for the treatment of chronic diarrhea, long-term lingering; To treat children with oral salivation and constipation; With this prescription and yam treatment women leucorrhea too much, less abdomen empty cold; To add cassia twig and evodia corni to treat gonghan infertility; With this prescription and coptis chinensis treatment deficiency cold sickness vomit acid water more than; The prescription was added with poria cocos, cassia twig and pinellia tuber to treat the patients with cold and wheezing of weak spleen and stomach. With this prescription with small red ginseng, with aconitum, e-jiao treatment of coronary heart disease belongs to the cold coagulation of the heart pulse, spleen and stomach deficiency cold, repeatedly used repeatedly, "door pure DE Chinese medicine clinical syndrome to record" have detailed records, this is not redundant.


Chapter ix inspection


Professor menjiuzhang is the fourth son of Mr. Menchunde, the main inheritor of the academic school of menshi miscellaneous diseases, and a famous traditional Chinese medicine of Shanxi Province. Adhering to the school's consistent academic thought of "prescription essence and medicine simplification", mun jiuzhang has applied the prescription to perfection in clinical practice. The author had the honor to learn from door nine chapters. He used lizhong pill to treat many difficult diseases. Here are two typical cases as follows.


Case 1: for the treatment of adverse pregnancy obstruction, if multiple methods are ineffective, lizhong pill or dry ginger ginseng pinellia pill are selected, with excellent efficacy.


A female, 42 years old, due to pregnancy obstruction caused by multiple spontaneous abortion, this pregnancy 5 weeks. Since pregnancy, vomiting is not only affected by eating, serious vomiting every 5~10 minutes or so, with food with vomiting, first for food, after water substances, light no smell; The body is extremely thin, 160 cm tall, only 37 kg weight, painful. The patient and family member fear again miscarry, hence hospitalization treatment, hospitalization period can only with injection nutrition support treatment, western medicine at a loss what to do. < / p > < p > door nine chapters were invited to the diagnosis of the patient's disease, diagnosis of the disease for more than 10 minutes, the patient vomits for 3 times, are clear water sputum and saliva, tongue thin moss, pulse is very heavy and thin, four at the end of the tepid, so the administration of lizhong soup: dangshen 9 grams, Fried atractylodes 6 grams, dried ginger 3 grams, roasted licorice 3 grams. Due to frequent vomiting, patients are advised to decoction a small amount of frequency sip, a day to two doses. The patient took one dose half a day, the vomiting was significantly reduced, and a small amount of food could be eaten. After taking 8 doses in total for 3 days, the patient had only slight symptoms of dry vomiting, and then intermittent medication was taken until production.


Case 2: for the gastrointestinal reaction after chemotherapy and radiotherapy for malignant tumors, the combination of menjiuzhang duolizhong pill and pinellia ternata for treatment has excellent efficacy, and most patients can greatly reduce the chemotherapy reaction.


Fu mou, female, 80 years old, was diagnosed with postoperative ovarian mucinous adenocarcinoma accompanied by a large number of ascites. As a result of patient year exceeds 80 years old, add medicaments action, the patient appears chemotherapy reaction, disgusting vomiting is frequent, appetite is extremely poor, when serious water enters vomit namely, giddy and tired, drowsy lack of power, oral tasteless, glossiness is qualitative weak, moss is thin white water is slippery, pulse is heavy string and fine slippery. This is the reaction that chemotherapy patient often appears, break for empty cold of medium coke spleen and stomach, in order to manage medium pill addition pinellia. 9 grams of codonopsis pilosula, 9 grams of Fried atractylodes atractylodes, 6 grams of dried ginger, 6 grams of broil licorice, 6 grams of French pinellia, patients were told to take a small amount of frequency after decoction, one to two doses a day. Two days after taking the medicine, the patient's nausea and vomiting symptoms basically disappeared, and his appetite gradually increased, and he was able to move freely. The addition of pinellia in the recipe, because it has a good dry wet phlegm, anti - nausea; And pinellia and dried ginger, ginseng, and take the meaning of the dried ginger and ginseng pinellia pill.


The author put test


The author has the honor to follow the door nine chapters to learn, benefit a lot. The author USES li zhong pill to treat a lot of experience in outpatient service, cite an example here. You xx, female, 36 years old. Because one side ovary chocolate cyst and adhesion of bowel cavity cause serious dysmenorrhea, the patient cannot bear its bitter, choose operation to treat accordingly. The whole operation process is relatively smooth, but due to surgery in patients with concurrent incomplete ileus, septic shock, after western medicine rescue the stable vital signs, successively to vancomycin, ty can anti-infection treatment for 2 days, cefoperazone/he thiazole ba jotham, ornidazole and levofloxacin hydrochloride combined anti-infection treatment 2 weeks, remission of patients, but still have nausea, vomiting, paroxysmal abdominal pain, diarrhea, sweating more, lack of power wait for a symptom, not more repeatedly, routine blood the leucocytes, neutrophils still lingered in 12 x x 109/109 / L and 7.7 L, the patient and family to seek treatment of traditional Chinese medicine. In the initial diagnosis, the patient showed yellow complexion, dull luster, fatigue, weakness, excessive sweat, tepid fourth terminal, nausea, retching, paroxysmal abdominal pain, continuous abdominal pain, poor appetite, loose stool, 3 to 5 times a day, less urine color yellow, pale red tongue, thin white moss, fine pulse, and the patient always complained of saliva. In the initial diagnosis, the author was a little hesitant. The syndrome of deficiency and cold of spleen and stomach was prominent, but the reason why the urine volume was low and yellow was also affected by the blood routine examination of the patient. He was worried about whether the blood routine of the patient would be affected and whether the infection would worsen after the patient received the traditional Chinese medicine of warming Yang and strengthening spleen. But back door chapter nine in clinical confirmed, often in the face of patients with complex diseases, thick paper, tend to hold the patient's underlying problem, directly to artful reply directly solve the principal contradiction, and we are often told that clinical confirmed to the reference theory of western medicine, but it can't be check for our TCM clinical thinking interference with the test results. The author hence looked into this case, the patient to use antibiotics for more than two weeks in a row, and after a serious illness, will surely hurt the spleen Yang, spleen and stomach influence, Shanghai are the upper abdomen spleen and stomach, caused by cold as overstrain recurrence after on distinguishing Yin and Yang yi, a bad disease pulse license and cure "cloud:" after illness worse, xi tuo, long, chest cold, when the pill of warm, appropriate principle of pills." However, the amount of urine affected by this disease can be caused by less sweat and drinking water. Despite the influence of blood routine, three doses of lizhong pill were given: 5 grams of red ginseng, 10 grams of Fried atractylodes atractylodes, 5 grams of dried ginger and 5 grams of browed licorice. Patients were instructed to take one dose of lizhong pill slowly after decoction. During the medication, the patient gradually improved and was not treated with antibiotics. 3 days later, the patient was delighted to bring the blood routine report sheet, the white blood cell was 8.3 x 109/L, the neutrophil was 5.8 x 109/L, the symptoms were significantly improved. Only sweat more fatigue, after the astragalus jianzhong decoction 5 agent and receive work.


"Fang jing yao jian" is the outstanding characteristic of the school of miscellaneous diseases of shan ximen. Affected by the door of pure professor Mr Bai nine chapters, school students clinical confirmed, choose party is not so strange, how to pursue to medication, more is to check for careful card, syndrome differentiation, can use small fang treatment in clinical difficult and complicated, in domestic journals and has published more, shot put to test in this principle is only one of them, we would like to share with readers.


(please use the prescription and treatment in this article under the guidance of a physician)