The patient, Ms. Wang, 41 years old, went to the hospital for treatment due to cold and fever half a year ago, but after the fever subsided, the patient had a yellow stain all over his body, and the urine was dark yellow like tea. The hospital examined total bilirubin (TBIL) 1115umol/L, direct bilirubin (DBIL) 713umoL/L, hepatitis A antibody (+), and residual virus tests were all negative. Although the patient was treated by the hospital, the effect was not obvious. After seeking TCM treatment.
Patients report fatigue and heavy, self-sweating night sweats, dark yellow urine, white stool color or thin and unpleasant, 3 to 4 times a day, itchy skin throughout the body, and eating is acceptable. The tongue is dark, the moss is thick, and the veins are deep. Evidence is qi deficiency damp heat block, biliary tract unfavorable. The patient is tired and heavy, self-sweating night sweats, loose stools, evidence of positive qi deficiency, treatment of qi tonic and positive focus, and clear damp heat, blood and choleretic.
Therefore, the following prescription medicines are given: raw astragalus, Yin Chen, Amaranth, Peran, almond, tangerine peel, chai hu, angelica, xiangfu, poria, ze diarrhea, psyllium, pigweed, barley kernel, sand kernel, bamboo leaf, etc., ten medicines, water decoction, one day, one in the morning, one in the morning, one in the evening. When the patient came to the clinic for the second time after taking the drug, he said that the jaundice obviously subsided after the drug, the fatigue was reduced, the sweats and night sweats stopped, and the skin itching was still the same as before. Review total bilirubin (TBIL) 150umok/L. The front strengthens the strength of dry and wet spleen, and adds Cang Shu, Party Ginseng and so on. After taking ten more, the patient's skin itching gradually improved, the liver area was slightly uncomfortable, chest tightness, and heavy lower limbs. Laboratory tests total bilirubin (TBIL) decreased to 45umok/L. Later, on the basis of the original formula, he adjusted the formula many times, and took more than 40 chinese medicines before and after, the jaundice was completely eliminated, and the urine color was normal. The bilirubin was reduced to normal on review. Later, he took Four Gentlemen's Soup to consolidate the curative effect, and there was no recurrence after two years of follow-up.
Jaundice is a kind of hepatobiliary disease evidence caused by feeling the external evils such as damp heat epidemic poison, resulting in wet turbidity block, spleen, stomach, liver and gallbladder dysfunction, bile fluid not following the usual path, and yellow eyes, yellow body and yellow urine caused by blood overflow.
Jaundice is one of the common clinical symptoms, which can be suffered by both men and women, young and old, but mostly young and middle-aged. Successive generations of physicians have attached great importance to this disease, ancient medical records have many records, modern research has also made great progress, traditional Chinese medicine treatment of this disease has a good effect, some of which have obvious advantages.
The "Neijing" already has the name of jaundice, and has a preliminary understanding of the causes, mechanisms, symptoms, etc. of jaundice, such as the "Suwen Pingren Meteorological Treatise" Yun: "Drowning Huang chi, lying down, jaundice; ...... Yellow-eyed people are known as jaundice. "Su Qing, The Great Treatise of the Six YuanZheng Dynasty" Yun: "The summer is wet and hot, and they are fighting for the left, and the people are sick and yellow and swollen." "Lingshu Meridian" Yun: "He who is sick of the main spleen ,...- jaundice and cannot lie down." The Outline of the Golden Plateau makes jaundice a special treatise and divides it into five scabies, including jaundice, valley gangrene, wine gangrene, female laborer's gangrene, and black gangrene. "On Typhoid Fever" also put forward the yellowing of Yang Ming and the yellowing of Taiyin, indicating that at that time it was recognized that jaundice could be caused by external sensation, diet and positive deficiency, the disease machine had damp heat, stasis in it, cold and dampness in it, related organs had spleen and kidneys, etc., and recorded the clinical manifestations of jaundice in more detail, and created a number of prescriptions such as Artemisia incinus soup, Yinchen Wuling powder, etc., which embodied a variety of methods of yellowing such as diarrhea, table dissolution, purification, warming, stasis, diuresis, etc., and these treatments and prescriptions are still used today. It shows that the Han Dynasty's dialectical treatment of jaundice has reached a high level. "The Theory of the Origin of Diseases: Yellow Diseases and Syndromes" proposes a kind of "rapid yellowing" that is yellow and lives in an instant. "Taiwan Secretarial Essentials: Wen Illness and Jaundice" quotes "Bi Gong" as saying: "Every night in the urine, the white patch is soaked, and the color is withdrawn for examination." The colorimetry detected by the experiment was first used to determine the progress and retreat of jaundice after treatment. In addition to discussing the "Yang Evidence" of jaundice, Han Qihe's "Treatise on typhoid Fever" in the Song Dynasty also specially set up the "Yin Huang Certificate" and pioneered the treatment of Yin Huang with warm medicines.
Luo Tianyi's book "Health Treasure Jian And Yellowing" in the Yuan Dynasty summarized the experience of predecessors, further clarified that wet changed from heat to yang yellow, wet from cold to yin yellow, and systematized the dialectical treatment of yang yellow and yin yellow, and was of great significance to clinical practice guidance, which is still used today. The "Jingyue Quanshu Jaundice" contains evidence of gangrene, believing that its onset is related to "biliary discharge", suggesting the relationship between jaundice and bile. "The Source of Miscellaneous Diseases, Rhinoceros Candles, and the Source of Gangrene" recognizes the contagiousness and severity of jaundice: "There are also natural plagues of plague, so that those who develop yellowing are commonly known as plague yellow, and killing people is the most urgent."
This disease has the same meaning as jaundice described in Western medicine, which is roughly equivalent to hepatocellular jaundice, obstructive jaundice, hemolytic jaundice, viral hepatitis, cirrhosis, cholelithiasis, cholecystitis, leptospirosis, certain digestive system tumors, and sepsis with jaundice in Western medicine, etc. If jaundice is the main manifestation, it can be treated by reference dialectical arguments.
【Dialectical Typing】
2. Common types
Humid and hot steaming certificate: According to the weight between the humid and hot and the presence or absence of evidence, it can be divided into three types: wet weight, hot weight and clamp table. Wet and heavy people are yellow, yellow is not fresh, drowsy or acidic, chest tightness, less, bloating, loose stool, unfavorable urination, no thirst, white or yellowish and greasy tongue, slow pulse. The hot and heavy body is as yellow as orange, hot, thirsty and bitter, upset, chest tightness, full abdomen, constipation, yellow and short urine, yellow tongue, strong pulse strings. The tableholder also sees fever, chills, headache, paralysis or pain, no sweat or sweat.
Wet poison admission certificate: sudden onset of illness, rapid appearance of yellowing like gold, fever, irritability, chest and abdomen fullness, constipation; or fainting, bloody blood and blood in the stool, or the appearance of petechiae and ecchymosis on the skin. The tongue is red or purple, the moss is yellow and dry, and the number of pulses or strings.
Evidence of hepatobiliary depression: jaundice is more distinctly orange-colored at the beginning of the disease, if it is chronic or intermittent yellowing, the jaundice can be light or heavy, its color is mostly obscure yellow, the stool color is gray and white like clay, or yellow and gray. Other symptoms may vary slightly depending on the nature of "ketu" and "yu biliary". Symptoms of the Kers are seen in the flanks of abdominal distension or hard and painful abdomen, nausea and vomiting, belching or belching, intestinal sounds, stool or discharge, thin white and greasy tongue, slow or slightly numbered pulse strings. Patients with depressed bile can see cramps of pain under the flank or stomach, nausea and vomiting when in pain, nausea and vomiting, not thinking about eating, fever and thirst or cold and hot exchanges, thin white or yellow tongue, and deep pulses.
Spleen deficiency and wet sleepiness: the body is yellow and dark as smoke, tired, cold, less, chest tightness, abdominal fullness or swelling, false stool. The tongue is pale, the pointed edges are bruised, the moss is thin or thick, and the veins are dull and weak.
Evidence of hepatosplenic stasis: yellow bruising is not uncommon, mucuna face, swelling or tingling under the flank, hepatosplenomegaly, if the disease progresses to the obstruction of network stasis, it becomes swelling (see bulging in this book).
2. Identification of similar certificates
Yellowing: Yellowing of the face due to blood loss, postmalarial, or hookworm disease, is called "yellowish". Its yellowing is mainly seen on the face, and the heavy can also see the yellowing of the skin of the whole body, but the whites of the eyes are not yellow, such as the "Tips for The Cure" Cloud: "After the blood loss, the face is yellow... There are also people who are yellow all over the body, but the yellow is not as good as the eyes and ears. "Yellowish after malaria ... Color is seen in the face. In addition, it is not difficult to distinguish those who see symptoms of anemia such as pale lips and claws, dry skin, dizziness, palpitations, tinnitus, fatigue and weakness.
In the heat: the "Compendium of Medicine" says: "Those who are yellow through the clouds are known as jaundice, but there are also those who are yellow and their bodies are not yellow, and the wind is from the yang into the stomach, and the pulse goes up to the eyes, and its human fat, the wind must not leak out, then it is hot and yellow." "It is clearly pointed out that those who are simply yellow in the eyes and the whites of the upper and lower eyes are not yellow cannot be recognized as jaundice.