Liu Chen1, Liu Xiaotian2 (1. Second Hospital of Jilin University, Changchun 130041, Jilin, China; 2. School of Instrument Science and Electrical Engineering, Jilin University, Changchun 650504, Jilin, China 130051) Keywords: Yin deficiency swelling; Chinese medicine therapy; experimental cases Yin deficiency symptoms accompanied by swelling are not much discussed in classics and few representative formulas, but they are often seen in clinical practice, so here are a few examples to discuss together. A few cases are given here to discuss. Liu Chen, Department of Traditional Chinese Medicine, Second Hospital of Jilin University 1 Typical case Case 1: The patient, female, 46 years old, was first diagnosed on December 8, 2007. She has a history of hypertension for 5 years and has been taking Schweitzer and Geping. In recent months, she has been suffering from swelling of the face and eyelids and lower extremities, dizziness and headache, palpitations and irritability, insomnia and dreaminess, baking and sweating in the face and neck, pain in the waist and knees, heat in the hands and feet, frequent urination, red tongue with white fur, thin and slightly counted pulse, BP 180/120LHg, and was given the method of nourishing Yin and submerging Yang, clearing heat and diuresis. Prescription: Dragon bone 30g (decoction), oyster 30g (decoction), hooked vine 20g, acacia flower 30g, ground bone bark 20g, zedoary 20g, white wormwood 20g, hyssop 30g, psyllium 20g (decoction), poria 30g, cassia 20g, nightshade 30g, 1 dose daily, decoction with water. On January 5, 2008, he complained that the swelling had subsided after taking the above medicine for more than 10 doses, but still felt dizzy, sleepy and dreamy, BP 150/100LHg. 30g of Xia Gu Cao Cao and 20g of Dragon’s tooth (decoction first) were added to the original formula, and 1 dose of decoction was taken daily. On January 12, 2008, the patient returned to the clinic, complaining of slight dizziness, sleep is still possible, BP 150/LHg, and was advised to take Zhenju antihypertensive tablets and Tianshu capsule. Press: this case patient hypertension appears swelling, Yin deficiency and Yang hyperactivity hosts water-dampness, so the dragon bone, oyster with hooked vine, acacia subdue liver Yang, ground bones, white vetch, cassia nourish Yin and clear heat and diuresis, Huai Niu Knee blood diuresis, zedoary, psyllium, Tu Fu Ling clear heat and diuresis, nightshade vine to nourish the heart and calm the mind. Case 2: The patient, male, 43 years old, was first diagnosed on December 4, 2006. One year ago, after excessive sadness and crying due to his father’s death, he developed bilateral swelling of the eye cells, dry eyes and easy fatigue, dizziness, insomnia, sleeplessness, heat in the hands and feet, body heat, often sweating, heart trouble, chest tightness, palpitations, weakness, yellow urine, red tongue with little coating, thin and slightly counted pulse. p89 times/min, BP130/70LHg. (normal reference value 3.19-9.15 pmol/L), free T4 (FT4) 17.65 pmol/L (normal reference value 9.11-25.47 pmol/L), high sensitive thyrotropin (hTSH) 0.20 mu/L) (normal reference value 0.3-5.6 mu/L). I gave the method of draining the liver and clearing heat, nourishing Yin and inducing diuresis. Prescription: Chai Hu 15g, Xiang Fu 20g, Meng Hua 20g, Fu Ling 30g, Di Bone Bark 20g, Tortoise A 20g (decoction first), Angelica Sinensis 20g, Bai Wei 20g, Huai Niu Kne 30g, Ze Di 20g, Huang Qi 20g, Chicken Blood Vine 30g, 1 dose daily with water. On December 20, 2006, the second diagnosis, taking more than ten doses of the above, the swelling of the eye cells, hand and foot heart heat and spontaneous sweating, etc. alleviated, continue to take the above. On January 5, 2007, the third diagnosis, eye cell slightly swollen, hand and foot heart heat sweating has not been, dry eyes obviously, in December 4, 2006 formula plus Guggul 10g, day 1 dose of water decoction. On January 15, 2007, the swelling of the eyes had disappeared and the lumbar I. The triple test of A gong was FT36.82 pmol/L, FT419.39 pmol/L and hTSH 0.76 mu/L. On December 4, 2006, he added 10g of Cyperus rotundus, 20g of Cyperus rotundus and 20g of Cyperus rotundus, the two doses were combined and finely powdered, 5g each time and taken twice a day. On October 17, 2007, the symptoms did not appear in the re-examination, and the three A-factors were still normal. The case was investigated to be caused by hyperthyroidism. Therefore, Chai Hu, Xiang Shen, Xia Ku Cao and Meng Hua were used to clear heat from the liver, Di Bone Bark and Tortoise Nail to nourish Yin and clear heat, Bai Wei, Huai Niu Knee and Ze Xie to clear heat and diuresis, and Huang Qi to benefit Qi and fix the surface and diuresis. Case 3: The patient, female, 48 years old, was first diagnosed on June 18, 2008. She had thyroid tumor surgery ten years ago and has been taking Eugenol since then. Her menstruation had stopped for more than a year. In January, he developed bilateral swelling and heaviness in the lower limbs, sweating with heat in the face and neck, poor sleep, large chloasma on the face, palpitations, heartburn, burning in the hands and feet, lumbar pain and weakness, yellow urine, red tongue with a little white moss, sunken pulse, and was given the method of nourishing Yin and clearing heat, calming and diuretic. Prescription: Dry lotus herb 30g, Chasteberry 20g, Dioscorea 20g, Artemisia 20g, Baiwei 20g, Huai Niu Knee 30g, Ze Xie 20g, Chicken Blood Vine 30g, Nightshade 30g, Fu Shen 30g, Longan 20g, Astragalus 20g, 1 dose daily with water decoction. On June 25, 2008, after taking the medicine, the swelling of the lower extremities and the heat in the heart of the hands and feet have been significantly reduced, sleep is still poor, stomach and epigastric discomfort, the above minus Bai Wei, Zegeia, plus Buddha’s Hand 20g, Dragon’s Tooth 20g (first decoction), Hefei 20g, 1 dose of water decoction per day. On July 3, 2008, the third diagnosis, swelling is no longer, sleep is still possible, facial brown spots significantly lightened, heat in the heart of the hands and feet has been mild, diet is slightly worse, epigastric distension. On June 18, 2008, the formula was reduced by Bai Wei, Ze Xie, Huai Niu Knee, Longan, plus 20g of Tortoise A (decoction first), 20g of Buddha’s Hand, 30g of malt bud, and one dose of decoction daily. On July 11, 2008, the patient was followed up with no obvious discomfort and was advised to stop taking the medicine for observation. This patient has been taking thyroid hormone for a long time and has the manifestation of perimenopausal syndrome, and has liver and kidney yin deficiency, accompanied by edema, so we used the medicine of nourishing liver and kidney to clear deficiency heat, together with Huai Niu Knee, Bai Wei and Ze Xie Di to clear heat and diuresis, and Huang Qi to benefit Qi and diuresis to remove the symptoms. Case 4: The patient, female, 37 years old, was first diagnosed on February 25, 2008. Three months ago, she developed painful swelling and stiffness in the interphalangeal joints, which gradually spread to the toes, elbows and knees, and was diagnosed as rheumatoid arthritis in a hospital. There was no abnormality in blood uric acid, rheumatoid factor (RF) 306.6 IU/ml (normal reference value 0-30 IU/ml), C-reactive protein (CRP) 5.27 mg/L (normal reference value 0-0.8 mg/L), erythrocyte sedimentation rate (ESR) 46L/h. The method of nourishing Yin, clearing heat, promoting diuresis was given. Prescription: Tortoise A 20g (decoction first), Radix Aconiti 30g, Radix Gentianae Macrophyllae 20g, Radix Lutea 10g, Semen Coix 30g, Radix Angelicae Sinensis 20g, Radix Dioscorea Z 20g, Atractylodes Macrocephala 15g, Radix Curcuma Longa 15g, Radix Bupleurum Wang 30g, Radix Peach kernel 20g, Radix Safflower 15g, Radix Gentianae Sinensis 30g, Radix Aconiti 30g, 1 dose daily with water. On March 5, 2008, the right calf swelling had been significantly reduced, pain was also reduced, urine output increased, adding 20g of papaya, 30g of Fu Ling, 30g of Lonicera japonica, 1 dose of decoction with water daily. March 11, 2008 re-examination, calf and joint swelling is no longer, joint pain, followed by March 5, 2008 prescription, at the request of the patient temporarily not to review the relevant test items, and purchase their own Kunming Mountain Begonia tablets, Zu Shi Ma tablets adhere to take. 2 Discussion: There is pigling soup evidence in the prescription, also known as yin deficiency water-heat mutual junction evidence, yangming water-heat mutual junction evidence, see symptoms such as unfavorable urination, fever and thirst to drink, etc. The power of nourishing yin in the formula is insufficient. In a certain stage of cardiovascular disease, there may be yin deficiency and swelling. In the formula for invigorating blood in the submerged yang, we should add Huai Niu Knee, cassia seeds, Kun Cao and Di Long, which are diuretic and have the function of invigorating blood and clearing heat. The perimenopausal syndrome also has liver and kidney yin deficiency with swelling, can be used to calm the liver and nourish the kidney, remove blood stasis and diuretic method, the formula can be added Baiwei clear heat and diuretic, kozoic nourish yin and diuretic, astragalus benefit qi and diuretic, such as frequent urination and yellow urinary tract burning or bring down a large amount of yellow, etc. can add white flower snake tongue grass, verbena, Tu Fu Ling, etc. clear heat and detoxify, activate blood and diuretic. Many diseases can be seen after the application of hormones Yin deficiency swelling, can add discretionary Lulutong, Huai Niu Knee, Coix seeds, etc. Tongluo diuretic.