The quality of decoction of Chinese medicine directly affects the therapeutic effect and the safety of medication. The correct way of taking medicine can also reduce the bad stimulation to play a better medicinal effect.
1.Decoction utensils
Decoction utensils are closely related to the quality of medicinal solution. It is recorded in history that “silver is the best, magnetic is the second best”, and it is not recommended to decoct in pots such as tin or iron. At present, it is generally considered appropriate to use casserole and tile pot for decoction, and avoid using copper, iron and aluminum pot.
Among them, the sand pot is preferred because it heats evenly, conducts heat slowly and is stable in nature, and is not easy to change with the chemical composition contained in the Chinese medicine. Some drugs will precipitate when they encounter copper, iron and other metals, and these metals are chemically active and can easily react with the tannin and glycosides contained in the Chinese medicine, which can discolor the liquid and destroy the active ingredients and even produce toxic side effects.
2.Decoction method
(1) Decoction fire
Decoction has “martial fire” and “civil fire”. The fire that makes the temperature rise and water evaporate quickly is called wu huo, also known as rapid fire; the fire that makes the temperature rise and water evaporate slowly is called wen huo, also known as slow fire. Generally, the first wu is followed by wen, i.e., start with a rapid fire, and then change to a slow fire after decoction.
(2) Decoction method
The time and method of decocting Chinese medicine differs due to the different nature and function of the drug and the requirements of the treatment. Generally speaking, the decoction should be soaked in cool water for at least 30 minutes before decoction, and the roots and fruits should be soaked for a longer time, while the flowers, herbs and leaves can be soaked for a slightly shorter time, so that the water can gradually penetrate into the medicine and the active ingredients of the medicine can be fully dissolved, so that the medicine can give full play to its proper efficacy.
Add water to submerge the drug surface 1-2cm is appropriate. Boil it with martial fire first and then change to civil fire. The general decoction time is 30 minutes for the first decoction, 20 minutes for the second decoction, and 10 minutes for the third decoction if there is a special need.
It should be noted that the decoction time should be timed from the time the liquid is boiled. For those with weak spleen and stomach, it is recommended to use a long decoction with a gentle fire. For hard shells and minerals, it is recommended to decoct for 20-60 minutes first, and for drugs with fragrance and easy volatility, it is recommended to decoct for 5-10 minutes.
In addition, the decoction should not be stirred frequently, on the one hand, it will make the temperature in the pot lose too much, which is not conducive to the dissolution of the active ingredients of Chinese medicine, on the other hand, it will make the volatile ingredients in some drugs volatile, which will affect the efficacy of the drugs.
You can turn it over once in about 10 minutes. For clinical use in treating gastric diseases, generally decoct 2 times with water over a gentle fire, and take a total of 300mL of juice, remove the slag and filter the decoction, mix it and take it in 2 doses.
3.Method of taking medicine
Patients with gastric diseases should take the medicine at a warm temperature of about 40 degrees to reduce the direct stimulation of the stomach and intestines by heat and cold. The method and time of taking medicine should be treated differently according to the patient’s specific situation.
Chinese herbal medicine is usually taken in 2 warm doses. There are two recommended methods of taking herbal medicine: one is to take the medicine 2 hours after breakfast and dinner, such as 9:00 and 21:00; the other is to take the medicine in the morning on an empty stomach and before going to bed. The time of taking medication can be adjusted according to the individual’s physical condition, illness and life style. Special cases should follow medical advice.
Some patients have a small amount of food and even drink a little bit more water, they may feel full and stuffy, and some herbal decoctions have a special taste, so they may experience epigastric discomfort and nausea after taking the medicine.
For those with more serious conditions, such as cancer or vomiting patients, it can be adjusted to taking medicine 5-6 times a day, such as 9:00, 11:00, 14:00, 17:00, 21:00, reducing the amount of medicine taken each time, and just finish 1 dose of medicine a day.
For the consumption of proprietary Chinese medicine, we generally advocate taking it half an hour after meals, because when taken before meals, it tends to affect the diet. Generally speaking, patients with gastric diseases have a poor appetite and cannot eat after taking several medicines before meals, so they cannot keep up with the nutrition without eating, which makes the disease less likely to recover. For stimulating drugs should be taken after meals.
4.Medication course
Gastric diseases have a long course, complex pathogenesis, common cold and heat deficiency mixed with the real, its treatment is difficult, not two or three clinics can be effective. The treatment of gastric disease more long course of treatment, and the middle is easy to repeat. Therefore, it is important to take the medication according to the course of treatment.
In the course of treatment, adhere to the word “keep”, and not chaotic change the prescription, the drug both in the disease, when the prescription to keep the law to take, as the recent famous doctor Yue Meizhong said: “the treatment of chronic diseases to have a prescription to keep”, not because of short-term results and change course.
For ordinary chronic gastritis, such as superficial gastritis, medication is generally in 4-6 weeks, such as with bile reflux or bleeding erosion, the treatment time is correspondingly longer, generally in 6-8 weeks.
Patients with reflux esophagitis also take more than 6 weeks of medication. For patients with peptic ulcer, the duration of treatment varies depending on the severity of the disease. For duodenal ulcer with ulcer surface ≤2cm, the ulcer heals in about 6 weeks; for duodenal ulcer with ulcer surface >2cm or multiple ulcers, or gastric ulcer, or compound ulcer (both gastric and duodenal ulcers), the duration of medication should be extended to 8 weeks.
Atrophic gastritis occurs when repeated damage to the epithelium of the gastric mucosa leads to atrophy or even disappearance of the intrinsic mucosal glands, and because of its irregular clinical presentation and lack of typical symptoms, gastroscopy or even biopsy is required for a clear diagnosis. For the treatment of atrophic gastritis, especially in the presence of intestinal epithelial hyperplasia and/or atypical hyperplasia, the duration of medication is relatively long.
Currently, most scholars believe that the recovery of intrinsic glands of gastric mucosa takes 3 months (i.e., 3 months is a course of treatment), and a single clinical treatment usually takes 2-3 courses (6-9 months). As for the patients after gastric cancer surgery, they should adhere to the medication as needed.
In addition, when the condition is stable, we suggest to gradually reduce the dosage without stopping abruptly. For example, for patients with chronic gastritis, after the clinical symptoms such as gastric discomfort and belching have basically disappeared, the number of doses or the amount of doses can be reduced and the treatment can be consolidated for about 2 weeks.
The original 1-dose of Chinese medicine soup can be changed to 1 dose on 2 days, which can be taken once a day in the evening and not in the morning; or the number of doses remains the same and the amount of medicine is reduced by taking half of the original amount of medicine each time.
Sometimes in the recovery process, due to the stimulation of certain factors, such as improper diet, emotional influence and weather changes, there is a recurrence of the disease, you should be flexible and extend the time of taking medicine appropriately.