Dr. Tsui
Editor|Xin Yi
Hypothyroidism is mostly classified as "empty labor" and "gall" because of its clinical manifestations of deficiency of essence and damage to internal organs.
Hypothyroidism
Hypothyroidism can cause symptoms such as chills, fatigue, malaise, memory loss, etc., and severe cases can lead to cardiovascular and cerebrovascular, neurological, reproductive and other system lesions, and even hypothyroidism crisis.
This disease is mostly caused by emotional disorders, eating disorders, insufficient endowments and lack of self-constitution, which is evidence of this false standard.
Lu Zhizheng et al. believe that hypothyroidism is based on spleen and kidney yang deficiency, and sputum and blood stasis are the standard; Chen Fangzhong pointed out that liver yang deficiency is the key to the pathogenesis.
The author is inspired by the "Refinement into Qi" of "Suwen, Yin and Yang Should Be Like the Great Theory", and comprehensive research of modern medical scientists believes that the kidney is the innate foundation, the spleen is the acquired foundation, the kidney contains the innate essence, and the spleen is scattered and the acquired essence.
If the spleen essence and renal essence are insufficient, the source of refined qi deficiency, and the spleen and kidney yang deficiency for a long time, a series of clinical manifestations of hypothyroidism occur, so the onset of hypothyroidism is mainly responsible for "sperm insufficiency".
Weakness for a long time, lean deficiency, refined qi, but also can affect the liver, heart, lungs, and the function of multiple organs is reduced, just as the "Suwen Tongjian Commentary on the False Reality" clouds "Essence is void".
Therefore, this article discusses the onset of hypothyroidism from "sperm insufficiency", and then focuses on "sperm deficiency, supplement with taste", and then discusses its treatment with "warm qi", in order to provide certain ideas for the clinical prevention and treatment of hypothyroidism.
A brief analysis of the transformation of "essence-qi"
1. The analysis of "fine"
"Jing" was first seen in "Tube", which refers to subtle substances with metaplasia and reproductive activities, also known as "essence".
"Guanzi Neiye" says: "The essence of all things, this is life, the next gives birth to five grains, and the upper is the stars", and proposes that "essence" is the root of all things.
Looking at the Inner Canon of the Yellow Emperor, "essence" and "essence" have many meanings such as "the essence of reproduction", "the essence of the foundation of life", "the subtlety of the water valley", "the essence of blood", "yin liquid", "the spiritual energy of all things, the essence of matter" and so on.
Among the many expositions on "jing" in the "Yellow Emperor's Internal Canon", "those who are deficient in essence, make up for it" comes from the "Suwen Yin and Yang Yingxiang Great Treatise", and there are different views on the "essence" of the previous generations of physicians.
In summary, the author believes that "jing" is understood in a broad sense, that is, all the essence substances of the human body; In a narrow sense, it can also refer to "spleen essence" and "kidney essence", or other internal organ essence.
2. Refining gas
The "refining into qi" mentioned in the Suwen Yin and Yang should be "refined into qi" explains that essence is the storage form of qi, and essence can be transformed into qi through the transformed form.
The adequacy of essence is the root of the abundant qi of the human body, on the contrary, "insufficient essence" will be derived into insufficient qi.
For example, from the perspective of "kidney essence", the essence hidden in the kidney can be transformed into vitality, and the vitality is further divided into yin and yang qi, and the lack of qi directly affects the balance of yin and yang in the human body, or manifested as yin deficiency, or manifested as yang deficiency, or yin and yang are weakness.
The relationship between thyroid hormones and "essence"
Essence is the foundation of human life activities, the role of thyroid hormones is mainly reflected in the body's metabolism, growth and development, organ activities three aspects, and these three aspects are the combination of "spleen essence" and "kidney essence" function.
1. Thyroid hormones and "spleen"
Water valley into the stomach, sufficient spleen essence and metamorphosis spleen yang, can transport the fine substances of water valley to spread to the whole body, return to the heart vein, metamorphosis into blood, nourish the whole body, enter the two veins of Chong Ren as meridian water, fill the cell uterus.
In addition, the combination of the loose essence of the spleen and the ventilation of the stomach can not only turn the essence of the water valley into camp qi, metamorphosis blood transfusion throughout the body, but also turn the waste of the water valley into health qi and regulate body temperature.
"The spleen is the foundation of the day after tomorrow, the source of qi and blood biochemistry", its essence dispersion function, that is, the performance of "qi to essence", the essence of the acquired water valley of the spleen can be attributed to the kidney and replenish the innate essence.
The synergistic effect of thyroid hormones and adrenal hormones reflects the relationship between spleen yang and kidney yang: both can make the body produce heat, kidney yang is warm and spleen yang, spleen and yang are sufficient, and the spleen disperses sperm and supplements kidney yang.
Therefore, the function of the thyroid gland can be regarded as the function of the spleen, that is, the "spleen disperses the essence", the main movement, and the warmth of the spleen and yang and the subtlety of the water valley, so as to maintain the normal metabolism of the human body.
2. Thyroid hormones and "kidney essence"
The main sealing nature of the kidney makes the kidney essence have a regulatory effect on the qi, blood and fluid of the whole body, and has a promoting effect on the growth and development of offspring.
Thyroid hormones have a similar function to the essence in the kidneys.
Thyroid hormones increase tissue oxygen consumption, so they stimulate the body to produce heat.
At the same time, thyroid hormones can maintain the excitation state of the nervous system, and can also directly act on the myocardium, enhance myocardial contractility and accelerate heart rate.
These can be regarded as kidney essence, refined energy, qi energy to promote the operation of the human body, promote growth and development, warm the human body.
"Insufficiency" is the root cause of hypothyroidism
1. From the etiology theory
(1) Insufficient innate essence
The essence hidden in the kidney is the root of innate endowments, the source of acquired growth and development.
The occurrence of hypothyroidism is closely related to congenital endowments, and the mother has gall, and children often suffer from gall.
Modern studies have found that congenital hypothyroidism is closely related to maternal thyroid function, and hypothyroidism caused by TSH or thyroid hormone resistance also has a familial predisposition.
Insufficient endowment, kidney deficiency, growth retardation in early childhood, short stature, and mental retardation;
Fetal denourishment, weak physique, adulthood mainly affects metabolism, cold backache, dry skin accompanied by memory loss, limb edema, decreased sexual function, premature aging, hair loss and other manifestations of multi-system function loss.
The innate essence of the kidney is the material basis of life activities, which shows that the lack of congenital essence is an important factor in the pathogenesis of hypothyroidism.
(2) Acquired essence denourishment
The spleen is the foundation of the day after tomorrow and the source of qi and blood biochemistry.
The innate essence is not filled, the essence does not dissolve the qi, which further leads to the deficiency of kidney yang, and the spleen soil must not be warm, the spleen soil is cold and the "spleen essence" is insufficient, and the health luck is lost.
The function of the spleen is weakened, and the subtlety of the water valley cannot be attributed to the five internal organs for prosperity, further weakness will occur, and over time, there will be a false image such as virtual labor.
At the same time, the acquired diet is inappropriate, excessive eating of fat ointment thick, raw and cold products, or sorrowful qi, thinking into diseases, "dynamic qi increases", can also hurt the spleen and stomach.
If the spleen is deficient, the water valley is subtle, and the wet phlegm condenses in front of the neck.
The water of the northwestern residents eating from the valley damaged the spleen and yang, the phlegm was difficult to turn into dampness, and the cysts were like galls.
In "Suwen Commentary", "no essence, can not eat" means that the spleen is insufficient and people cannot eat, so patients with hypothyroidism can also have loss of appetite, bloating, constipation and other manifestations.
The main limb muscles of the spleen, patients with hypothyroidism may have fatigue, muscle weakness, myalgia and other symptoms; Menstrual disturbances in women are also closely related to splenic blood function.
Therefore, insufficient spleen sperm, spleen luck loss, and spleen failure are also important causes of hypothyroidism.
2. From the theory of pathogenesis
The spleen and kidneys are deficient, the flow of qi and blood is blocked, and the accumulation of moisture, phlegm, and stasis does not melt, and it is called "empty labor" and "gall".
The spleen is the foundation of the day after tomorrow, and the main movement is transformed.
If the spleen is deficient and unhealthy, the movement is lost, and the gas is weak and watery, it will produce wet phlegm.
As Zhang Jiebin said, "Madame's phlegm is caused by the void."
The kidney is the innate foundation, the house of water and fire, and the yuan yin and yuan yang.
Kidney yang deficiency, can not transpire warm jin liquid, wet phlegm turbidity;
Spleen yang is rooted in kidney yang, the physiological function of the spleen depends on the essence in the kidney energy filling and warmth, kidney yang deficiency, can not warm the spleen yang, kidney deficiency water can insult the spleen soil, and even more unable to make water, that is, "there is kidney deficiency water pan phlegm, this is also by soil decline can not make water".
Zhang Jingyue's "Jingyue Quanshu Phlegm Drink" pointed out: "Although the diseases of the five internal organs can produce phlegm, they have no reason for the spleen and kidneys, covering the spleen and wetness, and wetness is phlegm; The main water of the kidney, the water is also phlegm, so the transformation of phlegm is all in the spleen, and the essence of phlegm is in the kidney."
If the spleen and kidney are deficient and the fluid in the body stops, it will become wet and sputum.
Sputum is turbid, blocking the veins for a long time, and the blood flow is not smooth, forming blood stasis; Blood is unfavorable for water, on the contrary, it affects the metabolism of water fluid, phlegm turbidity and blood stasis affect each other, transform each other, and lingering is difficult to heal.
On the one hand, the source of spleen deficiency is lacking, qi deficiency is unlucky, and qi does not cause blood stasis.
This is what is recorded in the "Essays on Reading Medicine": "Qi deficiency is not enough to push blood, then blood will have stasis", and "Blood Evidence Theory - Theory of Internal Organ Disease Mechanism" also has the discussion that "the blood of the spleen is through the clouds, and the operation of blood depends on the spleen".
On the other hand, the kidney essence is insufficient, the vitality is deficient, the blood is bloodless, the veins are lost, the blood flow is weak, and the blood stasis stops.
For example, "Medical Forest Correction Error" said: "Vitality is deficiency, must not reach the blood vessels, blood vessels have no air, must stay and stasis", phlegm and stasis before the neck, it is hypothyroidism.
It can be seen that the onset of hypothyroidism from the cause to the pathogenesis is closely related to the spleen and kidney sperm deficiency.
The effect of "sperm deficiency" on his dirt
The kidney is the innate foundation, and the yang of the five internal organs all originates from the essence qi in the kidney; The spleen is the foundation of the day after tomorrow, and the essence in the kidney depends on the water valley to nourish subtly.
Many patients with hypothyroidism have congenital insufficiency, so the initial onset of hypothyroidism is in the kidneys, and as the disease progresses, it affects the spleen.
The spleen and kidney are deficient, the source of refined qi is lacking, and the dirt is not warm, which will inevitably damage other organs, manifested as the decline of liver, heart, and lung functions.
1. Insufficient liver blood
The liver stores blood, the kidney stores essence, and the sperm and blood are homologous and mutual.
Sperm deficiency affects liver blood metaplasia, liver blood storage is derelict in duty, liver body is lost in nourishment, then liver yang deficiency, rising weakness, and leakage is not enough.
Liver yang deficiency, clear yang does not rise, see drowsiness; Liver loss, poor qi, uncomfortable mood, mental depression, menstrual disorders; Liver loss and leakage, disorderly rise and fall of qi machine, abnormal spleen and stomach, loss of appetite, bloating, constipation.
The liver is in the body and tendons, its hua is in the claws, the liver qi is weak, the tendons are weak, the fatigue is weak and fatigue is intolerant, and the claw nails are not nourished and proud.
Clinically, patients with hypothyroidism often have insomnia, hair loss, forgetfulness, low menstrual flow and even amenorrhea.
2. Heart yang weakness
"Lingshu Camp Health Association" said: "Camp guards, spirit also; Blood, divine qi also. Blood to God, camp to essence; The heart hides the god, the spleen hides the camp".
Insufficient essence, kidney yang must not warm the spleen soil, spleen movement weakness, loss of warmth, damage to heart yang, chest yang is not vibrant, palpitations, chest tightness and other symptoms can be seen;
Kidney yang deficiency, yin cold and prosperous, blood stasis, water moisture stay, the formation of heart and kidney yang deficiency, resulting in water drinking stop gathering pericardium, this is "kidney life can not be steamed, heart yang agitation has no right".
In addition, the heart and kidney yuan yang weakened, yang qi is unlucky, gasification is lost, opening and closing is unfavorable, water wetness, phlegm, blood stasis and other pan-reverse obstruction in the brain, can appear dull, mental atrophy, and even confusion, manifested as hypothyroidism crisis.
3. Lung Loss Festival
The lungs are in the upper focus, the waterways are diverted, the hundred veins are in the direction, and the main treatment section depends on the publicity and suppression of lung qi.
The subtle substances are transported to the lungs and nourished through the lungs and the function of the hundred veins.
Gold and water are born, kidney essence is insufficient, and at the same time spleen essence deficiency, will inevitably make the lungs lose nourishment, lung qi deficiency, weaken the propaganda function, fine substances and water are lost in dispersion, skin pores and organs are lost in nourishment, dry skin and dry stools can occur;
Weak lung qi, no right to dissolve qi, see less qi, lazy speech, fatigue, and empty pulse;
If the lungs are lost and the fluid is not good, then edema is seen.
The connotation and application of "supplement with taste"
1. Analysis of "make up for the taste"
"Make up for the taste", Wang Bing's note: "Taste, the taste of the five organs";
Yang Shangshan's "Yellow Emperor Neijing Taisu" Yun: "Those who have less semen in the five internal organs, nourish them with medicine and five tastes";
Zhang Jiebin said: "Those who lack essence, the decline of yin, and the non-taste is not enough to make up for it";
"The Legend of He's False Labor" Yun: "Taste, taste, not only medicine, but also the taste of five grains, all taste." Replenish the taste and save the effort, and gradually there will be a surplus";
"The Case of the Four Doctors of Liu Xuan" said: "Supplement it with taste, when seeking the genus of essence and blood, cure its kidney".
Looking at the notes of physicians throughout the ages, it can be seen that "tonic with taste" can be used both animals and plants, as well as drugs with thick taste, and also refers to treatment that conforms to the physiological characteristics of each internal organ.
As the Difficult Sutra says: "He who damages his spleen adjusts his diet... Those who damage their kidneys benefit their essence...".
The disease of hypothyroidism is a deficiency, starting from insufficient sperm, the kidney is the innate foundation, the essence is stored, the spleen is nourished, and the main movement of the spleen is the acquired foundation, and it can supplement the essence in the kidney through the action of sperm dispersion, and the innate essence is transformed from this.
When he first got the disease, the kidney essence was insufficient, and the temper was not weak, and the essence was cured in the filling of the kidney; The essence in the kidney that has been ill for a long time cannot nourish the spleen, the spleen essence is weak, the movement is weak, and then the spleen and kidney are weak, and the function of various organs is damaged for a long time.
"Those who are sick and injured with essence qi still seek it from essence qi", so the treatment of hypothyroidism is to replenish the kidney and fill the sperm and help the spleen to disperse sperm.
The treatment should be based on thick and thin products, and then according to the clinical symptoms, accompanied by other products, and more drugs for the spleen and kidneys should be used in terms of menstruation.
2. Insufficient renal sperm treatment in filling sperm
In the initial stage of hypothyroidism, the treatment principle of "tonic with taste" should be followed to replenish the kidney and fill the sperm.
The human body and internal organs need to be constantly nourished and nourished by sperm blood, the so-called "essence blood is shape, form is essence blood".
Based on the thick taste and thin qi products, the thin gas slowly transpires and gasifies, which can avoid the loss of "strong fire and disperse gas", so that the thick taste of the medicine circulates around the body, transforms into essence, and nourishes the internal organs.
Therefore, cooked ground yellow, deer antler gum, tortoiseshell gum, ejiao, yellow essence, goji berries and other products are often used to tonify the essence in the kidney and nourish the source of qi.
"Lei Gong Concocted" is ripe ground yellow: "Activate blood qi, seal bone marrow; Nourish kidney water, nourish true yin. ”
"Materia Medica" says: "Deer antler gum, strong yuan yang, replenish blood qi, produce essence." ”
Tortoiseshell gum is sweet and salty into the kidney, long in filling the essence and replenishing the pith, combined with goji berries, taking the meaning of turtle deer two immortal gum, used for kidney deficiency, sperm blood deficiency.
That is, to replenish deficiency, we need to focus on nourishing the essence, especially the essence in the kidney.
3. Insufficient spleen essence accompanied by loose sperm
"Suwen Yin and Yang should be like the great treatise" cloud: "Taste returns to form, form returns to qi, qi returns to refinement, and essence naturalizes."
"The spleen is the master of the muscular body, and the shape is eventually refined into essence.
The function of fine affects the function of shape, and "insufficient precision" can cause "insufficient shape".
In terms of treatment, the "Jing Yue Quanshu" has a saying: "Whoever wants to cure the disease must take the body as the main thing, and those who want to cure the form must take the essence and blood first." ”
Therefore, when the "shape is insufficient", on the basis of "replenishing the taste", add medicines that warm the spleen and replenish qi, such as ginseng, astragalus, yam, etc., that is, follow the purpose of "those who are deficient in shape, warm with qi, and those with insufficient essence, make up for it with taste".
At the same time, the spleen essence is insufficient, the scattered essence is weak, and the character of tonifying the kidney and filling the essence is more greasy, which is easy to hinder the movement of the spleen and stomach, affecting the absorption of drugs, and should be added as appropriate to aromatic awakening of the spleen, rational qi and dissipation of the genus, such as tangerine peel, sand kernel, jiao sanxian, etc., in order to supplement without stagnation, nourishment but not greasy;
It can also be combined with Wu Gan Ginger and Gui Zhi Xin Wen Tongyang to help refine qi, warm the spleen and yang, and take the effect of "less fire and anger".
For pathological products such as blood stasis and sputum turbidity produced by spleen and kidney abnormalities, drugs can be added or subtracted as appropriate.
Blood stasis can obviously be added to Chuanxiong, Xiangxiong, angelica, curcum, etc.; Phlegm turbidity can obviously be added magnolia, banxia, calamus, white art, etc.
epilogue
Based on the "refining into qi" in the "Yellow Emperor's Internal Canon", this paper discusses the onset of hypothyroidism based on "insufficient essence", and then proposes that the treatment should be based on "insufficient essence, make up for the taste", that is, "fill the essence" as the general principle of treatment.
With the progression of hypothyroidism, when the clinical manifestations of "infine" and "insufficient shape" appear, "warm and breathy".
The use of warm spleen and qi supplementation products, spleen and kidney treatment, improve its physical symptoms, improve clinical efficacy, in order to provide a certain theoretical basis for the clinical treatment of hypothyroidism in traditional Chinese medicine.