Dr. Liang Bing, the chief physician, is the instructor of the succession of academic experience of Chinese medicine experts in the country, and was awarded a special allowance certificate by the State Council in 1991. He has been practicing medicine for more than 50 years, and I have been studying under Dr. Zhang for more than 10 years, and I am deeply impressed by his unique experience in identifying and using medicine. In particular, the treatment of chronic aplastic anemia (referred to as reblastosis) has its own differences. Zhou Hong, Department of Oncology, Guangdong Provincial Hospital of Traditional Chinese Medicine
Most of the reblasts belong to the scope of “deficiency labor” in Chinese medicine, including those with deficiency of heart and spleen, those with deficiency of spleen and kidney, and those with deficiency of liver and kidney. The heart is the master of blood, the spleen regulates blood, the liver stores blood, and the kidney is the essence of blood and the source of bone marrow. If the kidney is deficient in producing marrow, and the source of essence and blood is lacking, how can the heart, spleen and liver be mastered, hidden and unified? Liang Lao believes that the heart and spleen two deficiencies, to the spleen soup; spleen and kidney two deficiencies, to ZuoGui drink (pill) as the main; liver and kidney two deficiencies, to the peony Dihuang Tang as the main, as well as tortoise and deer two immortal cream, HeChe DaTian Wan, etc., can be used. Here is a case of collation for the benefit of readers.
Lin Mou, female, 40 years old. Date of first consultation: November 6, 1973. The patient had anemia for half a year. Half a year ago, she had used many antibiotics, such as penicillin, streptomycin, erythromycin, chloramphenicol, and furans, because she often suffered from nephritis, cystitis, etc. She felt that her mental strength was decreasing, her diet was decreasing, and her complexion was white. He was diagnosed with anemia, the cause of which is to be investigated. After taking a lot of blood supplements, she was referred to Tongji Hospital for bone marrow aspiration examination, which revealed that the red bone marrow was obviously suppressed. He was recommended to take Chinese medicine for treatment. On examination: the pulse is sunken and weak, the tongue is pale, the moss is thin and white, the lips are pale, the face is pale. The diagnosis belongs to deficiency of heart and spleen and deficiency of blood. Treatment: Tonify the heart and spleen. Prescription: Atractylodes macrocephala 10g, Radix Codonopsis pilosulae 10g, Radix Astragali 15g, Radix Angelicae Sinensis 10g, Radix Glycyrrhiza Uralensis 8g, Fu Shen 10g, Yuan Zhi 8g, Fructus Jujubae 10g, Fructus Cinnamomi 10g, Fructus Jujubae 8g, Radix Magnoliae 10g, Fructus Lycii 10g. 10 doses.
Second diagnosis: the above 30 consecutive doses, the spirit of slight improvement, sleep slightly safe, the rest of the situation as before, blood tests and no change before, the pulse is sunken micro. Then turn to the spleen and kidney method. Prescription: deer horn gum 10g (melted), turtle gum 10g (melted), Epimedium 10g, Bacopa monniera 10g, Chinese wolfberry 10g, Cistanches 10g, Astragalus 15g, Radix Codonopsis 15g, Cornu Cervi Pantotrichum 10g, Radix Rehmanniae 15g, Angelicae 10g, Pericarpium Citri Reticulatae 10g. 20-30 doses of the above.
Third diagnosis: above continuous taking more than 30 doses, during the cold 2 times, and spirit, diet, sleep have improved, epistaxis phenomenon significantly reduced, face lip color slightly turn red. Blood test: RBC2 6×1012/L, BPC60×1012/L, Hb60g/L, WBC2 8×109/L. The blood picture has improved, the disease has turned around, the original prescription added 20g of Radix et Rhizoma Polygonati, 8g of jujube, 30 more doses, and advised that if the appetite improves, pig bone marrow, beef bone marrow simmered soup can be taken, turtle fish, tortoise and other foods, as much as possible to eat, in order to take the essence of the blood, the products of affection, the gentle method of tonifying the kidney.
The fourth diagnosis: last month a light cold, mental, diet, sleep are in the process of improvement, bleeding tendency has stopped, the face appears lustrous, menstruation, the amount of less red, the pulse is sunken thin and strong, tongue light red, moss thin white, routine blood tests: RBC3 2 × 1012/L, Hb80g/L, WBC3 4 × 109/L, BPC70 × 1012/L, the condition has greatly improved, advised to continue to take 30 doses according to the original prescription, and increase the nutritious food, medicine and food, take effect when The effect should be more rapid.
The fifth diagnosis: the original prescription was taken for 2 months, the spirit and diet gradually returned to normal, the face and lips are now rosy, menstruation has been normal, the hair is dark and lustrous, sleep is also safe, and can work normally. Because of the long time of taking tonics and the inconvenience of working, she requested to take ointment instead. Prescription: Deer horn gum 60g, tortoise gum 60g, Agaricus blazei 60g, Chinese wolfberry 80g, Cistanche blazei 80g, cinnamon meat 60g, red dates 200g, Cordyceps sinensis 60g, Radix et Rhizoma Polygonati 80g, Radix Angelicae Sinensis 80g, Chen Pi 60g, Radix Astragali 100g, Radix et Rhizoma Ginseng 60g, Radix et Rhizoma Yam 80g, Cornus officinalis 80g, Radix et Rhizoma Baccatae 60g, Radix et Rhizoma chasteensis 100g, Radix et Rhizoma salviae 80g. A material plus 2kg of rock sugar, close the paste, 3 times a day, each time 1 spoon, boiled water, 2 months to review, reportedly normal spirit, can work, skin color, face color, rarely catch a cold, the pulse is sunken fine strong, tongue light red, moss thin white, blood routine review: RBC3 8 × 1012 / L, WBC4 5 × 109 / L, Hb90g / L, BPC90 × 1012 / L, close to normal. The original formula of ointment 1 is still in place to consolidate the therapeutic effect. At the recent follow-up visit, the patient had already passed the age of the elderly and retired to live a peaceful life at home.
According to this case, the diagnosis was that the heart and spleen were both deficient, and the method of tonifying the heart and spleen was not effective, so it was easy to use the method of tonifying the spleen and kidney, and the method of tonifying the kidney was emphasized, such as the turtle and deer Erxian cream was the main drug in the treatment. The combination of the two gums can be used to strengthen the kidney essence, benefit the qi and blood, both use the qi and blood to supplement the qi and blood, the so-called tonic with its class. Ginseng is a great tonic for the vital energy, wolfberry nourishes yin and helps yang, which is a tonic for blood and yin and yang. The combination of Yam, Cornu Cervi Pantotrichum, Shu Di 3 medicines, also to achieve the three yin and tonic function; adjuvant Chen Pi to rationalize the spleen; cinnamon meat, Angelica nourishes blood and camp; with Astragalus to benefit the blood; Baji Tian, Cistanches warm and strong kidney yang; chasteberry, Sha Yuan Zi nourish the liver and kidney. The combination of all the medicines fills the true yin and nourishes the kidney essence. As the patient insisted on taking the medicine, the medicine and evidence match, thus receiving the expected effect. However, taking medicine for a long time, it is inevitable to get bored, and finally depends on the effect of ointment, so changing the dosage form is also a help to treatment.