1.How does Chinese medicine recognize “constipation”? In Chinese medicine, constipation is a disease that causes constipation, prolonged defecation time or difficulty in passing stool. In ancient Chinese medicine, constipation has many names, such as “difficult to pass stool”, “after unfavorable”, “spleen about”, “closed “, “Yin knot”, “Yang knot”, “constipation”, “stool dry knot “, “intestinal knot”, etc.
Ancient medical doctors have many discussions on the causes of constipation, that there are many causes of constipation, among them, constipation and kidney, spleen, stomach, large intestine, lung, qi, blood and fluids, cold and heat deficiency, etc. are related. Generations of doctors believe that: in the process of transferring water and grain, the stomach is the main receiver, ripening water and grain, its gas downward; the spleen is the main transporter, its gas upward, the small intestine “by the Sheng” by the role of the spleen and stomach after the water and grain to secrete the turbidity; the large intestine to conduct the dregs. Therefore, the stomach’s malfunction of ripening and Qi loss and descent, the spleen’s failure to transport and transform and clear Qi does not rise, the small intestine’s failure to secrete, and the large intestine’s abnormal conduction can all cause abnormal stools. The kidney is the main liquid, the lung is the main gas, when the kidney deficiency and lung dryness can also cause constipation. Generations of medical books, a lot of discussion on this: “constipation, kidney disease. The scriptures said that the northern black water, into the pass in the kidney, open the orifice in the two yin, covered with the kidney main five fluids. Fluid is very, then the stool and.” “If hunger is out of order, excessive labor, damage to the stomach and eat hot and spicy taste thick things and help fire evil, ambush in the blood, dissipate the true yin, fluid deficit, so the stool is dry. However, the disease of dry knot is different, there is hot dry, there is wind dry, there is Yang knot, there is Yin knot, and there is old age and Qi deficiency, fluid deficiency and dry knot.” The above discussion attaches great importance to factors such as deficiency of kidney yin, deficiency of fluids, and damage to stomach qi. The discussion of heat and cold can cause constipation is also a lot: “the stool does not work, by the Sanjiao five organs, hot and cold gas is not regulated, hot gas into the intestines and stomach, fluid exhaustion dry, so that the dregs are not knotted, congestion does not work.” “Stuffy common for secret, stool astringent stagnation, heat consumption of its fluids, the dung firm knot and large intestine dry tight convergence.” “Cold hands and feet, constipation, urine red, or stool black, the pulse is sunken and slippery …… this name yang evidence like yin also.” And the Qing dynasty doctors put forward the constipation and lung dryness related views: “stool closed, people think that the large intestine dry, who knows is dry lung gas? The lung is dry, then the clean air can not go down in the large intestine.” Some doctors even proposed constipation and room, diet, seven emotions are related to the discussion: “Originally its cause, are room overwork, diet disorder, or wanton drinking wine and syrup, over-eating spicy heat, the fire of food in the spleen and stomach, the fire of lust in the life of the door, resulting in fire and water deficit, fluid is not born, so the transmission is out of order, gradually into the evidence of dryness.” It is proposed that “insect accumulation”, “seven emotions and closed qi”, “phlegm stagnation and obstruction”, “medicine and stone poisoning”, “dirty cold”, and “dirty cold”. “dirty cold”, “blood dry” can lead to constipation, thus enriching the etiological theory of constipation.
Chinese medicine also has a deeper research on the treatment of constipation. Treatment proposed not delusion with attack, “…… most of the treatment must be investigated its source, not a general use of croton, bullock and the like under the, loss of its fluid, dry knot more even.” “Such as the delusion to the harsh medicine by the, then fluid away, blood consumption, although temporary pass and that is secret carry on.” Ming Dynasty physician Li Zhongzi put forward the harm of delusional use of attack: “Every time I see the Jianghu prescription, light with nitrate yellow ten injuries four or five, light with croton ten injuries seven or eight, can not be careful, or long and more knot, or become impotent lung vomiting pus and blood, or diet does not come to death.” Therefore, the treatment must seek the root of the disease. In addition to drug treatment, the Qing dynasty doctors also focus on the use of the guide technique to treat constipation, the secret of health care said: “to the tongue on the palate, guard the hanging yong, quiet thoughts and liquid from the mouth, once full, red dragon stirring, frequent gargling and frequent swallowing, the drop straight down to the Dantian, and guard the quiet throat for several days, the large intestine since the moist, line after the efficacy.”
Chinese medicine attaches great importance to the impact of constipation on the human body, as early as the Han Dynasty, the doctor will put forward the theory of the internal organs do not work to decline: “to get long life, the intestines are always clear, to get immortality, intestines without dregs.” “five flavors into the mouth, that is, into the stomach, stay poison does not disperse, the accumulation of both long, resulting in injury and punch, all diseases are born.” Explains the protection of smooth stool, easy to prolong life this truth. Therefore, once suffering from constipation, to immediately identify the cause, timely treatment to avoid future problems.
2, Chinese medicine will be divided into several types of constipation?
In ancient times, there were many classifications of constipation, such as “Treatise on Typhoid”, which divided constipation into “Yin knot”, “Yang knot”, “Spleen about”, “Jin exhaustion “and so on; later medical practitioners and have wind, gas, wet, cold, cold, cold, cold, false secret, hot dry, wind dry points. Later and because the name is too complicated, and constipation to Yin knot and Yang knot to generalize: with fire for Yang knot, no fire for Yin knot. In modern Chinese medicine internal medicine works, constipation is mostly divided into hot constipation, cold constipation, gas constipation, false constipation (including gas deficiency constipation, blood deficiency constipation, gas and blood deficiency constipation).
What is hot constipation?
Hot constipation refers to constipation caused by heat accumulation in the stomach and intestines, i.e., dryness and heat, depletion of fluids, loss of large intestine conduction and moistening, and dry stools.
Hot constipation usually occurs in people who have a strong Yang body, are addicted to alcohol and spicy food, or after heat illness.
What is qi constipation?
Qi constipation refers to constipation caused by stagnation of Qi, and the inability to pass and descend, so that the dregs stop inside and cannot move down.
Qi constipation mostly occurs in people who are worried, overthinking, emotionally unstable or sedentary and not moving.
Both qi constipation and heat constipation belong to the actual evidence of constipation.
What is cold constipation?
The so-called cold constipation refers to constipation caused by Yang Qi deficiency, Yin cold, resulting in Yang Qi inaccessibility, weak intestinal transmission and difficult stool.
Cold constipation mostly occurs in the elderly and the chronically ill.
What is “deficiency constipation” and how is it classified?
The so-called deficiency constipation is the constipation caused by deficiency evidence, which is due to fatigue, internal injury from diet or postpartum, post-disease, as well as old age and physical weakness, deficiency of Qi and blood, Qi deficiency is the weakness of large intestine transmission, blood deficiency is the fluid can not nourish the large intestine, and lead to difficulty in the discharge of stool, resulting in constipation.
Constipation is divided into Qi deficiency constipation, blood deficiency constipation and Qi and blood deficiency constipation three categories.
3.What is the basic pathogenesis of constipation according to Chinese medicine?
Diet enters the stomach, and after the spleen and stomach have transported it and absorbed its essence, the remaining dregs are transmitted out by the large intestine, which is the stool. If the large intestine conduction function is abnormal, the stool stays in the intestine for too long, and the stool is dry or hard, the disease of constipation can be formed.
Ancestral medicine believes that the basic pathology of constipation, although the large intestine conduction malfunction, but with the spleen, stomach, liver and kidney and other organs of the dysfunction. If Yangming stomach heat is too much, heat burns fluid, fluid injury and fluid depletion, the intestines lose moist; spleen qi deficiency, then qi deficiency and transmission is weak; liver qi stagnation, qi stagnation, then “qi stagnation and things do not work”, or qi depression into fire, fire evil harming fluid, can also make the intestines lose moist; kidney open the orifice in two yin and evil dry, and the main five fluids, kidney yin deficiency, the intestines lose moist, kidney yang Insufficient kidney yin, the intestines are not moistened, the kidney yang is not enough, the yin cold stagnation, fluid is not. Therefore, the dysfunction of the four, are the cause of constipation.
Constipation can be summarized into four aspects: cold, heat, deficiency and reality. Gastrointestinal accumulation of heat is hot secret; Qi stagnation or diet stagnation, the internal Qi is not passable secret; Qi and blood deficiency, it is false secret; and Yin cold stagnation, stagnant fluid does not move, called cold secret or cold secret. Among the four, and the virtual reality for the outline, such as hot secret, gas secret is real, false secret, cold secret is virtual. And between the cold and hot virtual reality, often with each other or evolution. Such as heat constipation mismanagement or failure to treat, after a long time, fluid depletion, into the loss of kidney yin, resulting in the lack of fluid, large intestine loss of moisten, the disease from real to deficiency. Qi stagnation, the day long into fire, the gas knot and heat knot and see. Weak qi and blood, vulnerable to injury by diet, or emotionally energetic, the deficiency is combined with the real. Cold constipation is Yang deficiency and Yin cold stagnation, but if the warmth and dryness is too much, depleting its fluids, or Yang loss and Yin, can be seen in the evidence of Yin and Yang deficiency.
In short, the abnormal conduction function of the large intestine is the main mechanism of constipation.
4.What are the main points of Chinese medicine identification of heat constipation?
The occurrence of heat constipation is mostly due to Yang Sheng or spicy and thick diet, or after heat illness, dryness and heat, burning fluid, internal Qi, and cause intestinal heat, loss of moistening. The main symptoms and key points of identification are obvious internal heat, dry stools, abdominal fullness, pain when pressed, dry mouth and bad breath, red tongue, yellow dry coating, smooth and numbered pulse. In addition, some internal heat syndromes may be seen, such as short and red urine, sores on the mouth and tongue, hot body and red face, etc.
5.What are the key points of TCM identification of deficiency constipation?
Patients are weak in Qi and Blood due to overwork, old age and decrepitude, or after illness, childbirth and excessive blood loss. When the Qi is weak, the transmission is weak, and when the blood is weak, the large intestine loses its glory, therefore, constipation or difficult defecation is seen. Therefore, for deficiency constipation should be divided into two aspects: Qi deficiency constipation and blood deficiency constipation.
The main points of identification and main evidence of Qi deficiency constipation are: although the patient has the intention to stool, but every time in the toilet and struggle weak, struggle is sweating and short of breath, the tongue is light and tender, moss is thin, the pulse is weak, but also the face white light white, fatigue, weakness after the stool and other Qi deficiency evidence. Sometimes, there is also a drop in the anus, or even prolapse and other Qi deficiency evidence.
The key points and main evidence of blood deficiency constipation are that the patient has constipation like chestnuts, and because of blood deficiency, the patient has a yellowish complexion, pale lips and claws and tongue, thin pulse, etc., and also has blood deficiency evidence such as dizziness and palpitations. Blood deficiency at the same time with yin deficiency, but also visible dry mouth and less fluid, five heart irritability and other signs of yin deficiency internal heat.
6.What are the key points of TCM identification of cold and constipation?
Yang deficiency in the body, or Yang deficiency after illness, resulting in Yin cold, stagnation of the intestines and stomach, Yang Qi is not transported, fluid is not distributed, thus forming the evidence of cold and constipation. The main symptoms are: difficult stool, difficult discharge, cold pain in the abdomen, lack of warmth in the extremities, coldness in the waist and knees, light tongue, thin coating, and sunken pulse. The side effects include clear and long urine, white and white face, and other signs of cold deficiency. If it is a cold stagnation, the evidence is constipation, abdominal pain and fullness, like hot drinks, fear of wind and cold, tight and strong pulse, etc.
7.What are the main points of diagnosis and treatment of constipation?
The pathogenesis of constipation is related to lung, liver, spleen and kidney. According to the classification of deficiency and reality, the real evidence includes heat and qi stagnation; the deficiency evidence includes qi deficiency, yin deficiency, blood deficiency and yang deficiency. The treatment of constipation, although the main focus is to pass, but belong to the heat knot, it is appropriate to also diarrhea heat, qi stagnation is appropriate to move qi to guide stagnation, qi deficiency, benefit qi moisten intestines, blood deficiency, nourish blood moisten dry, yang deficiency with warm intestine laxative method. The above-mentioned constipation, sometimes a single alone, sometimes both and see, so a variety of treatments, should be applied flexibly with the evidence, such as qi deficiency and blood deficiency constipation, often appear in conjunction, treatment, according to the degree of qi and blood deficiency, the use of benefit qi blood, laxative method. For those with Qi deficiency and Yang deficiency, it is appropriate to benefit the Qi and moisten the intestines, accompanied by the method of warming the Yang to open the stool. For those who have blood deficiency and dry heat, it is appropriate to nourish blood and moisten dryness, accompanied by the method of diarrhea and heat to open the bowels. Therefore, the treatment of constipation, can not be mechanically used to pass the method, but should be based on different etiology and clinical symptoms, the use of different treatment methods. Constipation in the elderly is mainly deficiency, real is rare, deficiency in the host of real is especially, therefore, the clinical evidence should identify the nature of deficiency, to guide the use of drugs. Pay particular attention to the regulation of diet and life, pay attention to the habit of regular bowel movements.
8.What is the method of promoting lung laxity?
The lung is the main organ of propagation and purification, thus maintaining the body’s metabolism. The lungs and the large intestine, the lungs of the cathartic purging, to maintain the smoothness of the large intestine bowel gas, has an important role. If the lungs are not declaring and purifying, the large intestine conduction function will be incompetent, resulting in constipation, or stool obstruction. It can be effective to use the method of lung circulation, such as lung circulation soup, using: Mulberry Bark, Almond, Mandarin, Citrus Aurantium, Qian Hu, Su Zi, Gua Gua Ren, Yu Li Ren, Rutabaga, Licorice. It is used for constipation caused by lung diseases such as loss of lung circulation, yin deficiency and lung heat, etc. Its effectiveness is most rapid and not comparable to that of Cheng Qi and Ma Ren formulae. It is mainly used for clearing the source and enlightening the upper and lower parts of the body, which is a good method for treating the root of the disease and laxative.
On the other hand, the regulation of the stool is also conducive to the promotion and lowering of lung qi. Therefore, the laxative is another way to cure lung disease, and keeping the stool unobstructed is conducive to the cure of lung disease. In the prescriptions for lung diseases, the addition of laxatives can improve the efficacy and accelerate the healing process. For example, in the clinical evidence, the use of hemp apricot and stone sweet soup with fishy grass, mulberry peel, rhubarb and guavas, the treatment of pediatric pneumonia, the fever, cough, lung rales are quickly disappeared, indicating that the laxative, for the treatment of lung disease has some clinical significance.
8.What is the bitter-cold method to pass down?
It is used to treat cold evil that turns into heat, evil heat that enters the internal organs of Yin Ming, or warmth that enters the middle Jiao, and heat that injures the fluids, resulting in dryness in the intestines, obstruction of the stool, and fullness in the chest and abdomen. According to the principles of “diarrhea of the solid” and “the lower one is led and exhausted”, the treatment can be done by the bitter-cold method of passing down the bowels, using rhubarb, mannitol and erxiang as the main medicines to cleanse the heat knots, supplemented by thick park and hedgehog to move the qi and remove the fullness. Representative prescriptions include Da Cheng Qi Tang, Xiao Cheng Qi Tang, Tong Gastric Cheng Qi Tang, and Du Fang Da Cheng Qi Tang.
This method has the function of stepping down heat knots, clearing internal organs and eliminating distension, clearing heat and detoxifying toxins, activating blood circulation and resolving blood stasis, and is suitable for a variety of conditions caused by heat knots in Yangming: ①Yangming internal organs: symptoms include fever, abdominal fullness, hard pain and refusal to press, inability to pass stool, irritability and delirium, or even dizziness, discordant eyes, sweating from hands and feet, yellow, dry and prickly tongue coating, or scorched black and dry, with a sunken and solid pulse. ② heat nodules flowing next to the abdomen, abdominal pain, pressed hard and lumpy, discharge of clear and foul water. ③ pain caused by internal heat, epilepsy. ④Poisoning and blood stasis. (⑤) Headache, sore throat, epistaxis and vomiting of blood caused by heat.
This method is mainly used for treating internal heat, but it can be used in conjunction with other methods if there are concurrent or hostage evidence. If the qi blockage is obvious, it can be used with the method of moving qi, adding hedgehog, thick park, lycopodium, such as small Cheng Qi Tang; withered intestine dry, with the method of laxative, adding fire mace, almonds, such as hemp seed pill; yin deficiency, with the method of nourishing yin, adding Shengdi, yuan shen, such as the increase of liquid Cheng Qi Tang; deficiency of evil, with the method of tonic, adding ginseng, angelica, such as the new plus Huanglong Tang; such as heat and toxicity congestion of the lung, with heat detoxification The method is used with the method of clearing heat and detoxifying the lung, adding gardenia, scutellaria, forsythia, etc., such as Liang Di San; if high fever and thirst, it is used with the method of clearing Qi, adding gypsum, Zhi Mu, etc., such as Bai Hu Cheng Qi Tang, all of which belong to the category of bitter cold and pass down method.
In recent years, it has been used to treat acute simple intestinal obstruction, paralytic intestinal obstruction, ascaris intestinal obstruction, acute jaundiced hepatitis, acute bacterial dysentery, postoperative intestinal distention, and pyloric obstruction, all with remarkable efficacy. It is also effective for some febrile diseases, infectious inflammatory lesions, toxic diseases, neurological and psychiatric diseases, and can make heat, inflammation and poisonous evil expelled from the stool.
9.What is the method of warming the Yang and clearing the lower part of the body?
This formula is suitable for those with cold accumulation in the stomach and intestines, constipation, abdominal pain and constipation, abdominal pain with warmth, or dysentery for a long time, with a sunken and tight pulse.
This method is often based on pungent heat medicine, with appropriate combination of laxative medicine, with the use of eucommia, dry ginger to remove the cold, with rhubarb, mannite to attack the internal reality. Because the dose of warming medicine is more than cold medicine, the laxative effect still exists, but the bitter cold nature to go, can achieve the purpose of “remove the sex to take”, this is a major feature of this type of prescriptions, after the medicine can make the cold stagnation dispersion, stagnation line, bowel movement, the internal Qi smooth and healing.
This method commonly used formulas are rhubarb and fenugreek soup, three things urgent preparation pill, warm spleen soup (rhubarb, fenugreek, dry ginger, licorice, codonopsis) and so on. It is commonly used to treat acute intestinal obstruction, postoperative intestinal distension, food accumulation, pyloric obstruction, etc., which are cold and real.
10.What is the method of laxative?
The large intestine is the official of conduction, to pass down as smooth, but must always moisten not dry to do its duty. If the actual heat injury, loss of yin, can lead to intestinal dryness, constipation or constipation. This kind of constipation, should not be violent attack, it is appropriate to use the laxative method, commonly used formulas such as Run Intestinal Pill (angelica, raw earth, peach kernel, fire hemp kernel, hedgehog), Five Ren Pill (peach kernel, almond, cypress kernel, pine kernel, Yu Li Ren, Chen Pi), hemp seed kernel pill (hemp seed kernel, peony, fried hedgehog, rhubarb, thick park, almond). It is mainly based on oil-rich kernel medicine, nourishing Yin and nourishing blood, and is suitable for dryness of the intestines, difficult stools, constipation of the deficient, elderly, postpartum, hemorrhoids, anal fissure, intestinal obstruction, etc.
11.What is the method of venting heat?
Heat toxin congestion in the internal organs, Qi and blood stagnation, the light can be inflammation, serious canker sores, common canker sores, intestinal canker sores, pancreatitis, etc.. The most important treatment is to vent the heat, so that the heat and toxicity can be dissipated and the Qi and blood can flow smoothly, so that the inflammation can be dissipated and the carbuncle can be eliminated.
Canker sores are usually caused by wind-cold injury to the lung and heat, or by heat poisoning of the lung and heat injury to the blood vessels, resulting in canker sores and pus. In the initial stage, it can be seen as fever, cough and shortness of breath, vague pain in the chest, or coughing up pus and sputum. After the carbuncle is formed, coughing and vomiting of pus and blood, which looks like rice porridge, shortness of breath and fever can be seen. In the early stage, it can be treated with mala-xing-shigang-tang plus fishy grass, guajouren and rhubarb; after the carbuncle is formed, it can be treated with qianjin-reed-stem-tang (reed-stem, coix seed, peach kernel and winter melon kernel) plus fishy grass and rhubarb.
Intestinal canker sores are mostly caused by heat and toxicity in the intestines and stagnation of qi and blood, which can be seen as fever, thirst, distension and pain in the right lower abdomen and refusal to press, or even a lump can be found in the painful area and constipation. Danpi, Rhubarb, Neem, Radix Paeoniae Alba, Peach kernel, Raw licorice).
Acute pancreatitis is one of the acute abdominal diseases, the symptoms are epigastric pain, intense and persistent, abdominal muscle tension, nausea and vomiting, fever, etc., is the evidence of heat stagnation of internal Qi, the treatment is also to pass the internal attack, clear heat and detoxify the main method, commonly used Da Chai Hu Tang (Chai Hu, Scutellaria, Paeonia, Semen, Ginger, Citrus, Dazao), Qing Pancreas Tang (Tianjin Nankai Hospital experience formula: Chai Hu, Scutellaria, Hu Lian, Bai Shao, Mu Xiang, Yuan Hu, Sheng Jun , mangosteen).