Constipation is a disease in which the main symptom is a malfunction in the conduction of the large intestine, resulting in constipation or prolonged intervals between bowel movements or difficult and unpleasant bowel movements. Constipation is common in various clinical diseases, but it can also be a symptom, (such as abdominal pain, stomach pain, biliary distension) similar to functional constipation in Western medicine, while intestinal irritation syndrome, constipation caused by weakened intestinal peristalsis during recovery from enteritis, constipation caused by rectal and anal disorders, drug constipation, constipation from endocrine and metabolic diseases, and difficulty in defecation due to muscle weakness, etc., can refer to the contents of this article The treatment of constipation is based on the evidence and combined with the treatment of the disease. In this article, we are discussing a group of diseases characterized by constipation. 1, “Nei Jing” refers to constipation as “the back is not favorable, difficult to defecate”. It is thought to be related to the attack of cold and dampness on the spleen. 2, Han. Zhang Zhongjing called constipation as “spleen contracted, closed, yin knot, yang knot”, which is considered to be related to cold-heat and qi stagnation. 3.Sui . The “Treatise on the Origin of Diseases” suggests many causes of constipation, such as “evil in the kidneys also makes it difficult to defecate”, “when one is thirsty, it is also difficult to defecate”, and “disharmony of the five organs of the Sanjiao, and imbalance of yin and yang can cause constipation. “. 4, Jin-Yuan era: Liu Hejian: “heat depletion of fluid” Zhu Danxi: proposed classification as gas, wind, heat, deficiency, damp constipation 5, Ming . Zhang Jinyue’s theory and method is more concise. He believes that the ancient formula book of wind, gas, heat, deficiency, wet and hot dry, wind dry, etc., said the name of the standing too annoying, said the yin knot, Yang knot is sufficient. “Yang knot evil surplus, should be attacked should be diarrhea, Yin knot is insufficient, should be supplemented should be nourished.” Third, the location of the disease is in the large intestine. It is closely related to the lung, spleen, kidney and liver. The key to the disease mechanism: abnormal conduction of the large intestine. Diagnosis 1. Symptoms: decreased frequency of defecation, prolonged defecation cycle; or hard stool, difficulty in passing stool, or weakness in passing stool, and poor discharge. 2, concurrent evidence: abdominal distension, pain, dullness, dizziness, bad breath, anal fissure, hemorrhoids, blood in the stool, as well as sweating and shortness of breath, palpitations, etc. 3, related factors: the onset of the disease is often related to external cold and heat, diet and emotions, imbalance of internal organs, sitting and lying down, old age and frailty. Slow onset, for the chronic process of disease should be excluded from other internal diseases appearing constipation symptoms, such as stomach pain. Although the legislation is based on the principle of “pass”, it is necessary to distinguish between cold and heat, deficiency and reality. The cold is hot, the hot is clear, the deficient is tonic, the real is diarrhea. Treatment of actual constipation 1, gastrointestinal accumulation of heat hemp nut soft capsule hemp seed nut pills The main evidence: dry stool, abdominal distension and fullness, bad breath and dry mouth. Secondary evidence: red face and body heat, restlessness, excessive sweating, desire to drink cold, short red urine. Tongue: red and dry tongue, yellow and dry coating, or burnt and yellow with awning. Pulse: Slippery, or stringy. Treatment: Relieving heat and stagnation, moistening the bowels and relaxing the stool. Remedy: Ma Zi Ren Wan (Ma Ren, Rhubarb, Citrus aurantium, Hou Pu, Almond, Paeonia lactiflora). This formula focuses on the diarrhea of heat and laxative bowel, taking its laxative without hurting the right, rhubarb, hemp seed laxative and laxative bowel is the main medicine, with the internal organs thick park, hedgehog, almond laxative bowel, white honey for the pill is intended to slow down. Add or subtract: heat and injure the body with raw earth, dendrobium, xuan ginseng to nourish yin and generate fluids; depression and anger injure the liver with gentian grass, scutellaria; external medicine can be used 3 large field snails, 10g skin nitrate on the two flavors with pounding, put on the umbilicus, treatment of heat constipation (Journal of Traditional Chinese Medicine 92-7) 2, qi stagnation four grinding soup main evidence: dry stool, want to stool, fullness in the abdomen. Secondary evidence: fullness in the chest, belching and erratic, loss of appetite, intestinal tinnitus and yagging, and poor post-poo flow. Tongue: thin white, or thin yellow, or thin greasy tongue coating. Pulse: String, or slow string, or string count, or string tightness. Treatment: Smooth the Qi, induce stagnation, lower the rebellion and clear the bowels. Prescription: six grinding soup (“evidence of treatment”) (Wu Yao, incense, betel nut, Citrus aurantium, Mu Xiang, rhubarb) Add or subtract: after the medicine to pass stool, can remove rhubarb, betel nut; gas stagnation into fire (bitter mouth, dry throat, yellow coating) plus scutellaria, gardenia, gentian grass; laxative enema with pig bile enema or onion honey external method are effective, can be taken locally, according to the evidence of treatment. Deficiency constipation 1, Qi deficiency constipation Astragalus oral solution with honey to take the main evidence: although there is the intention to stool, the toilet struggle weakness, difficult to discharge. Secondary evidence: weakness after defecation, sweating and shortness of breath, white face and fatigue, tired limbs and lazy speech. Tongue: light fat tongue, or tongue with teeth marks, thin white coating. Pulse: thin and weak. Treatment: Tonify Qi and strengthen the spleen, moisten the bowels and open the bowels. Remedy: Huangqi Tang. (Jin Kui Yao) (Astragalus, Chen Pi, Fire Ma Ren, White Honey) Add and subtract: Qi deficiency is obvious plus Radix et Rhizoma Atractylodes Macrocephalae, to supplement the Qi function. Add Chai Hu and Sheng Ma for Qi deficiency and subsidence. Can not pass constipation as soon as you see it. 2, blood deficiency constipation Compound Agaricus syrup main evidence: dry stool, struggling hard to get down, pale face. Secondary evidence: dizziness, palpitations and shortness of breath, insomnia and forgetfulness; or dry mouth and heart, hot flashes and night sweats, tinnitus, lumbar and knee weakness. Tongue: pale tongue with white coating; or red tongue with little coating. Pulse: fine, or fine count. Treatment: Nourishing blood and moistening dryness, nourishing Yin and relaxing the bowels. Add and subtract: for obvious abdominal distension and abdominal abdominal plagiocele, add Hou Pu to enhance the function of moving Qi; if there is heat in blood deficiency, and dry mouth and heart, red tongue, little moss, thin pulse, it is easy to add He Shou Wu, Yu Zhu, Zhi Mu, etc. to clear heat, generate fluid and nourish Yin. 3.Yang deficiency constipation Cistanche oral liquid Main symptoms: difficult and astringent stool, difficult to pass, and secondary symptoms: white face, unheated extremities, heat and cold, clear and long urine, or cold pain in the abdomen, constriction and urgency, refusal to press, or soreness and coldness of the waist and knees, tongue: pale tongue, white fur, or thin and greasy, pulse: sluggish or sunken string, treatment: warming Yang and opening the stool, prescription: Jichuan decoction, (Jing Yue Quan Shu) (angelica, cow’s knee, cistanche, zedoary, ascending marijuana, heliotrope) Add and subtract: for Qi deficiency, add Astragalus and Radix Codonopsis to benefit Qi. Yang deficiency constipation can be used to add cinnamon, cistanches, angelica, locking yang, or use the four gods pill, etc. Preventive care 1, eliminate the causes of the disease, eat less fried, alcohol spicy, should eat more coarse grains, vegetables, drink more water. 2.Avoid sitting for a long time and move less to circulate qi and blood. 3.Do not use slow laxative for a long time. 4, the stool is dry and hard, can use oil suppositories into the anus, so that the stool is easy to eliminate, to prevent local damage. 5, for several days of constipation, and the elderly and frail, pay particular attention to careful care. Prevent excessive force to struggle caused by deficiency, and can guide the patient to do the guiding technique. Chai Hu, ascending marijuana amount of less then ascending and lifting, more then draining dry and rationalizing Qi. Summary constipation is a common clinical evidence, although the clinical division of evidence is more complex, but no more than two categories of deficiency and reality. The real one is caused by evil heat, cold stagnation, qi stagnation causing evil stagnation in the stomach and intestines, congestion and obstruction; the deficient one is caused by deficiency of yin and yang qi and blood causing intestinal loss of warmth and moistening, and weakness of propulsion. The deficiency is caused by deficiency of yin, yang, qi and blood, resulting in the loss of intestinal warmth and moistening, and weak propulsion. The disease is located in the large intestine, and often related to the spleen, stomach, lung, liver, kidney and other viscera. In the treatment, the actual should be ventilated, the deficient should be moistened, attention should be paid to the examination of evidence to seek the cause, the examination of the cause of treatment. Can not be based only on the dryness of the stool and not pass down. Treatment should be individualized.