Just after the second anniversary of reading Chinese medicine, today ushered in the annual “World Book Day”, many “bookworms” are obsessed with books, experience the charm of reading, feel the pleasure of reading, but also in the sea of knowledge to sublimate themselves, cultivate sentiment! And many constipated friends, is a sad frown, do what things can not be quiet, constipation, many people understand, want to get rid of constipation, listen to the old Chinese medicine how to say! Chronic constipation, that is, constipation, refers to the prolonged interval between bowel movements, or not prolonged but difficult to defecate, clinical manifestations of the number of bowel movements less than 3 times a week, accompanied by poor defecation, prolonged, small amount of hard stool, or a sense of incomplete defecation. Chronic constipation, no organic lesions found by various examinations, known as functional constipation. It occupies a high proportion in chronic constipation. The disease can occur at any age, in the past, the middle-aged and elderly people are common, but now young adults, especially young women are also a lot of incidence. Most have a long history, ranging from a few months to several years, have a history of taking laxatives, and some even rely on laxatives to maintain bowel movements. Chronic constipation is a common clinical disease, the Chinese medicine identification is divided into real and virtual, but real constipation is easy to treat, virtual constipation is difficult to regulate, virtual constipation is divided into qi, blood, yin, yang of different, and intestinal organs, lungs, spleen, stomach, liver, kidney related. Chronic constipation, from the point of view of Chinese medicine theory and clinical practice, spleen deficiency constipation occupies a very high proportion, in other words, chronic deficiency constipation, is to spleen deficiency as the core pathology, gas stagnation, fluid deficiency, kidney deficiency is the secondary or mixed pathology. The spleen and stomach are involved in the digestion process of food and drink, and the spleen is responsible for the transportation of water and grain, on the one hand, through the Qi transformation of the spleen and the warming effect of the spleen Yang, so that the food and drink is transformed into water and grain essence. The diet into the stomach, the stomach’s acceptance and ripening effect, so that the initial digestion and down to the small intestine, by the small intestine by the role of Sheng chemical, so that further digestion, decomposition into water and grain essence and dregs of two parts. But the role of the stomach and small intestine must depend on the spleen qi and spleen yang warming effect, in order to turn water and grain into fine, into meal, if the spleen deficiency (including spleen qi deficiency, spleen yang deficiency), it is easy to cause the function of turning fine, into meal abnormal. If the spleen is deficient (including spleen qi deficiency and spleen yang deficiency), the function of turning essence and meal into dregs will be abnormal. 2, spleen deficiency qi lift abnormal, intestinal bowels do not descend The normal excretion of stool depends on the body’s qi lift normal, the large intestine is six bowels, six bowels to descend as smooth. The spleen and stomach are actually the hub of the body’s qi lift, the spleen is the main ascending clear, the stomach is the main descending turbid, although the two complement each other, but for chronic constipation, the stomach is the main descending turbid malfunction is actually dominated by the spleen ascending clear malfunction. 3, the loss of intestinal moistening also originates from the spleen “spleen qi disperses essence” to the whole body, providing energy and nutrition for the body’s tissue cells, which includes maintaining the intestinal wall cells to secrete intestinal fluid to moisten the intestinal tract, the abnormal function of the spleen “dispersing essence” will easily lead to the loss of intestinal moistening, as stated in the Suwen – Taiyin In addition, the spleen and stomach qi lift and lower abnormal, causing the dregs to live in the intestines for a long time, excessive absorption of water, is also a cause of dry stools. The ancients have “Yang both up and down, then the fluid is not dry, why suffer from the large intestine is not passable” said. The surface seems to be the intestinal fluid deficiency, the essence is in the spleen and stomach transportation and Qi Qi lifting malfunction. Second, the treatment 1, the benefit of the spleen is the fundamental method of modern life is fast-paced, work pressure, often do not follow the ancient “eat and drink in moderation, get up and live in moderation, not delusional labor” admonition, but rather the diet is out of moderation, raw and cold, living out of moderation, coupled with the abuse of laxatives, more serious damage to the spleen and stomach, the ancient cloud “hunger is spleen injury, satiety is spleen trapped, labor is spleen lack, escape is spleen stagnation”, so although modern people have a wide variety of food, nutrition level has improved, but the function of the spleen and stomach has declined. Therefore, to solve the problem of chronic constipation, the first priority should be to strengthen the spleen and restore the spleen’s function of transporting and clearing. The main formula should be Ginseng, Astragalus, Atractylodes, etc. Astragalus is sweet, slightly warm, enters the lung and spleen meridian, and is good at benefiting the qi and replenishing the deficiency, as described in the “Benjing Shuzhi”: it goes straight into the middle earth and travels the three jiao, so it can replenish the middle qi inside …… can travel the Ying qi …… can travel the Wei qi down. Shennong Ben Cao Jing hundred kinds of record” is said: tonic deficiency, replenish the spleen and stomach deficiency. Astragalus ascends the spleen qi, for the treatment of spleen deficiency constipation important medicine, to be used heavily. Astragalus is in line with the spleen to get up the stomach began to descend the theory of the famous doctor Chen Shiduo in the Qing Dynasty, “Yang Qi a rise, Yin Qi immediately descend, and can be blocked” said. Secondly, to strengthen the spleen and stomach, the first push atractylodes, especially must be used, generally in more than 30 grams. Modern research proves that Atractylodes has the effect of promoting gastrointestinal secretion, which can make the gastrointestinal secretion flourish and peristaltic movement increase. If you eat cold and raw food or use bitter cold medicine to damage the spleen and Yang, Yang deficiency and internal cold, Yin cold stagnation, intestinal tract loss of warmth can lead to constipation. The symptoms include difficulty in defecation, but the feces is not dry and hard, accompanied by cold pain in the abdomen, the hands and feet are not warm, the coating is white and not thirsty, the pulse is sluggish, etc. The treatment is to warm the spleen and moisten the intestines, using Radix et Rhizoma Atractylodis Macrocephalae, Radix et Rhizoma Atractylodis Macrocephalae, etc. as the main formula. Restoring the function of the spleen and stomach is a longer-term process for the treatment of chronic constipation, unlike the use of laxatives, the effect is immediate, so while correcting the unreasonable aspects of diet and living, patients should be informed that they need to be prepared for longer-term conditioning. 2, the key step is to regulate the flow of qi, the six internal organs to pass for use, the dregs of the internal stagnation, the evil blocked qi stagnation, so to move the qi to pass the internal organs, drain turbidity as the key. The use of hedgehog, thick park, lycopodium, mucuna pruriens, clear half asia, incense, to move the gas stagnation in the gastrointestinal tract. However, the movement of qi and stagnation must be preceded by strengthening the spleen and benefitting the qi. (1) The use of Astragalus and Atractylodes: Astragalus is combined with Atractylodes to strengthen the spleen and help transport, restore the function of the spleen and stomach, synergistic effect. The two drugs need to be used for a long time to see the effect. Especially for the deficiency of vital energy, the bowels do not work but no abdominal distension and stagnation, more need to guard the application of the formula, not strong for the Tongli. Chen Pi and Almond: Chen Pi is hard in taste and warm in nature, belongs to the spleen and lung meridian, regulates qi, strengthens the spleen, dries dampness and dissolves phlegm; Almond is bitter and slightly warm in taste, belongs to the lung and large intestine meridian, stops coughing, calms asthma and laxates. It regulates the qi of the lung, spleen and large intestine, and moistens the intestines. And the two drugs are calm, without the suspicion of depletion of Qi and injury to the spleen. Rhubarb and Radix et Rhizoma: Rhubarb is bitter and cold in nature, with the effect of “cleansing the intestines and stomach, pushing the old to the new, opening up the water and grain channels” (Shennong Ben Cao Jing), and is not guarded by its nature, and has the name of “general”. It is used to laxate all real heat and cleanse the heat between the stomach and intestines, specifically for the treatment of non-defecation. However, its bitter cold nature is fierce, improper use is easy to punish without fault, damage the righteousness (spleen qi). Rhubarb is paired with Radix et Rhizoma, which is pungent and very hot, returns Yang and replenishes fire, disperses cold, removes dampness and relieves pain, and is said by Yu Tuan to be “endowed with the quality of masculinity, with the qi of cutting off the pass and taking away the general, and can lead the qi tonic to travel the twelve meridians”. The combination of the two drugs, the pungent and hot nature of the sapodilla can restrain the bitter-cold nature of rhubarb, the sex to take the use, the line of medicine potential, the stool pass without bitter-cold injury is suspected. In the book of “Jin Kui Yao”, “Rhubarb and Radix Pseudostellariae” and “Qian Jin Yao Fang”, “Warm Spleen Soup” are used to warm down cold accumulation. Although there is no suspicion of harming the righteousness, it is only used symptomatically. If the stool is clear, then consider reducing the dosage and should not be used for too long. (2) Slow and acute medicine Slow medicine: such as cassia seeds, shouwu, etc., two drugs with laxative effect, but the effect is slow, if both liver Yang hyperactivity or essence and blood deficiency available. Acute medicine: rhubarb and mannitol, which are used to stop the disease and should not be used for a long time. According to modern pharmacological research confirmed that rhubarb mainly contains anthraquinones and tannin two components, the two have opposite effects, anthraquinones have a laxative effect, fast-acting, short duration of action; and tannin with astringent intestinal function, slow-acting, moderate and long-lasting effect, so rhubarb is mostly used in acute, febrile constipation, the stool is cleared that stop taking. Mannitol to serve, the source of Zhongjing “typhoid”. It is better to take it in the morning, otherwise it will affect the sleep at night. (3) increase the liquid Xingzhou: the former doctor has the method of increasing the liquid Xingzhou, mostly used for heat disease late intestinal dryness and fluid deficiency, such as increase the liquid soup, increase the liquid Chengqi Tang. But for chronic constipation, too much use of nourishing yin medicine is suspected of nourishing and greasy, because the key to chronic constipation in the spleen, the spleen is like dryness and evil moisture, there is indeed yin injury, nourishing yin medicine to use as appropriate. (4) Nourish blood and moisten dryness: if there are symptoms of blood deficiency, use angelica, peony, raw earth, shouwu, etc.