Identification and treatment of ulcerative colitis

  Ulcerative colitis is a chronic non-specific inflammatory bowel disease of unknown etiology. The main clinical manifestations are abdominal pain, diarrhea, mucopurulent stools, and post-urgency. The disease is often recurrent, lingering and long-lasting, which seriously affects the physical and mental health of patients. In Chinese medicine, this disease is classified as “dysentery”, “diarrhea”, “abdominal pain”, “intestinal wind”, etc. The author This type is more common than the cold-heat mixed type. Patients often have a long duration of illness, which is difficult to be healed, with intermittent attacks, abdominal pain and distension, unpleasant stools, diarrhea with pus and blood, and shortness of breath, mostly occurring in the presence of improper diet, cold, and exertion, accompanied by little food and fatigue, and lack of warmth in the hands and feet, with a light tongue, greasy and slightly yellow coating, and a sunken string or moist pulse. This is due to weakness of the spleen and stomach, or injury to the spleen and stomach after a long period of illness, or overuse of bitter cold, resulting in damage to the Yang, while the evil of dampness and heat has not yet gone, resulting in cold-heat mixed evidence of spleen cold and intestinal heat. The treatment should be to warm the middle and clear the intestines and use both cold and heat. Take Lian Li Tang as an addition. Basic formula: Radix Codonopsis pilosulae 15g, Rhizoma Atractylodis Macrocephalae 12g, Radix Ginger 10g, Rhizoma Huanglian 12g, Radix Muxiang 10g, Betel nut 10g, Citrus aurantium 10g, Radix Angelicae Sinensis 12g, Radix Glycyrrhiza Uralensis 6g.  2, Damp-heat congestion type patients with initial or short duration of illness, or in summer and autumn. The symptoms include abdominal pain, refusal to press, diarrhea, red, white, pus and blood in the stool, sticky and fishy, burning in the anus, short yellow urine, yellow and greasy tongue coating, and slippery pulse. This is due to external dampness and heat, or spleen deficiency and dampness, dampness and heat from heat, resulting in dampness and heat, which causes congestion in the intestines, loss of harmony between the qi channels and veins, and blood defeat and corruption. The treatment is to clear the intestines and dissolve dampness, regulate qi and invigorate blood. We use Bai Tou Weng Tang and Paeoniae Tang to resolve the problem. Basic formula: Bai Tou Weng 20g, Bai Shao 20g, Rhubarb 12g, Scutellaria 12g, Huang Lian 10g, Mu Xiang 10g, Betel nut 10g, Angelica sinensis 10g, Licorice 6g, Cinnamon 6g. If there is stagnation in the intestine, add Lycopodium and Hawthorn; if there is a lot of blood or heat in the diarrhea, add Di Yu and Qin Pi; if there is a lot of pus, add Chen Pi; if there is superficial evidence, add Ge Gen.  3. Spleen deficiency and dampness are mostly seen in the remission stage of the disease. The symptoms include vague abdominal pain, loose stools and sometimes diarrhea, more than once, repeatedly, diarrhea with no transformation of the finished grain, or watery pus and blood, with attacks or aggravation in case of exertion or greasy food, or even prolapse, accompanied by atrophy, fatigue, dull abdominal distension, light tongue with white fur, or with teeth marks on the side, and weak pulse. This is due to the weakness of the spleen and stomach, or long-term diet, or fatigue, or long-term illness, the spleen and stomach function is impaired, the transport and transformation function is not in order, water gathered for dampness, grain accumulation for stagnation, the clear turbidity is not divided. The treatment is to strengthen the spleen and benefit the qi, permeate dampness and stop diarrhea. Add and subtract Ginseng and Atractylodes macrocephala. Basic formula: Ginseng 15g, Poria 15g, Atractylodes Macrocephala 12g, Chen Pi 10g, Radix Platycodon 10g, Sharen (later) 10g, Lentil 20g, Yam 15g, Coix Seed 10g, Roasted Licorice 10g. For diarrhea, add Horehound; for prolapse, reuse Ginseng and Astragalus, add Shengma and Chaihu, remove Lentil and Coix Seed; for yin-cold, add Radix et Rhizoma.  4, kidney deficiency and fire failure type is mostly seen in the elderly or patients with prolonged illness. Symptoms include pain in the umbilicus and abdomen, diarrhea, diarrhea, complete bowel movements or red, white and thin, or even slippery incontinence, anal swelling, accompanied by cold form and limbs, less food and fatigue, weakness of the waist and knees. The tongue is pale and white, and the pulse is sunken and weak. The disease is lingering and easy to make in cold weather. This is caused by old age and weakness, or prolonged illness, or overexertion of room, etc., which damages kidney qi and kidney yang, the vital gate fire fails, the spleen loses its warmth, and the transportation and transformation are out of order. The treatment is to warm the spleen and kidneys, and to collect the astringent and fix the detachment. We use Radix et Rhizoma Polygoni, and Real Man’s Drainage Soup as the basis. Basic formula: 12g of Radix et Rhizoma, 15g of Radix Codonopsis, 12g of Atractylodes Macrocephala, 10g of Radix Ginger, 6g of Radix Glycyrrhiza Uralensis, 12g of Radix Angelicae Sinensis, 10g of Nutmeg, 15g of Radix Paeoniae Alba, 10g of Muxiang, 10g of Chebulo. for Wujian diarrhea, add Cornu Cervi Pantotrichum and Boneset; for slippage, add Wuwei Zi and Poppy husk; for kidney deficiency, add Cinnamon and Duzhong.  5, liver and spleen disharmony type mostly seen in women. The symptoms include chest distension, belching and less food, abdominal pain and diarrhea, mucus stool or blood stool whenever depressed and irritated, or mood swings, the pain does not decrease after diarrhea, abdominal pain is often accompanied by intestinal tinnitus, tapping and scurrying, vector gas. The tongue is light red, the coating is thin, and the pulse is stringent or thin. This is due to mental tension, depression, irritation and other emotional disorders, resulting in liver qi stagnation, and the attack on the spleen and earth, or a deficiency in the spleen, earth deficiency and wood multiplied. Treatment is to suppress the liver and support the spleen, and to regulate the qi flow. This formula is based on the formula for pain and diarrhea and the formula for four reverse directions. Basic formula: Bai Shao 15g, Bai Zhu 12g, Chen Pi 10g, Fang Feng 10g, Chai Hu 10g, Citrus aurantium 10g, Xiang Shen 12g, Roasted Licorice 6g; for prolonged diarrhea, add Huang Qi, Dang Shen, Lentil; for yellow tongue, add Huang Lian.  6, Qi stagnation and blood stasis type This type is rare. Symptoms include abdominal pain like stabbing, or abdominal cramps when lying down, pain with a fixed location, diarrhea with pus and blood or mucus stool, urgency and heaviness, or dark eyes and dark lips, etc. Women are often accompanied by dysmenorrhea or menstrual stasis. The tongue is dull red or with petechiae, and the pulse is astringent or tight. This is due to the stagnation of internal Qi, conduction disorders, Qi stagnation and blood stasis, or disease into the complex for a long time, blood defeat and flesh rot. Treatment is to invigorate blood circulation, resolve blood stasis, regulate qi and open the intestines. Basic formula: Wu Ling Li 10g, Angelica Sinensis 15g, Chuan Xiong 10g, Tao Ren 10g, Safflower 15g, Dan Pi 10g, Red Peony 10g, Yan Hu Suo 10g, Xiang Shen 10g, Citrus Aurantium 10g, Glycyrrhiza Glabra 6g. For abdominal pain, use Red Peony; for women with abnormal menstruation, add Cumin, Pu Huang, Cinnamon; for prolonged diarrhea, add Chebul.