Dr. Kang
Editor|Stone House
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Chronic diarrheal disease is a common clinical digestive system disease, and most of the clinical symptoms are manifested as increased stool frequency, increased stool volume, and thin feces.
Chronic diarrheal diseases have a long course of disease, often recur, are difficult to heal, and are difficult to treat.
Western medicine often uses intestinal mucosal protectors and microecological preparations for treatment, but the treatment effect of some patients is not good, and some patients, although effective, are more likely to relapse after stopping the drug, and cannot fundamentally solve the problem of intestinal dysbacteriosis and dysfunction.
Traditional Chinese medicine treatment of chronic diarrhea is guided by holistic dialectical thinking, using treatment methods such as strengthening the spleen, thinning the liver, and tonifying the kidney, which can regulate the body's qi, blood, yin and yang, reduce the recurrence rate, and the treatment effect is obviously effective.
In recent years, we have used the traditional Chinese medicine Wumei Pill Plus and Minus to treat 26 cases of chronic diarrhea, cold and fever, and the treatment effect is remarkable, which will be reported as follows.
1. Information and methods
General information: A total of 52 patients with chronic diarrhea and fever syndrome who visited the outpatient clinic of traditional Chinese medicine of Wuxi People's Hospital from January 2018 to December 2020 were selected as the research subjects, and 26 cases were divided into treatment group and control group by random number table method.
There were 16 males and 10 females in the treatment group; Age 18~70 years old, average (40.6±2.6) years; The course of disease is 0.5~5.0 years, and the average is (3.2±1.5) years.
There were 14 males and 12 females in the control group; Age 20~70 years old, average (42.0±2.4) years; The course of disease is 1.0~6.0 years, with an average of (3.0±1.8) years.
There were no significant differences in general data such as sex, age and course of disease between the two groups (P>0.05), which were comparable.
This study was reviewed and approved by the Medical Ethics Committee of our hospital.
Diagnostic criteria: The diagnostic criteria of Western medicine are formulated with reference to the diagnostic criteria for chronic diarrhea in Internal Medicine.
1) Increased frequency of bowel movements (more than 3 times a day), increased fecal volume (more than 200g per day), thin feces (water content >85%); 2) Diarrhea for more than 3~6 weeks, or recurrent attacks.
The differentiation standards of Chinese medicine are formulated with reference to the "Internal Medicine of Traditional Chinese Medicine" and "Guidelines for Clinical Research of New Chinese Medicines (Trial)", and the differentiation is mixed with cold and heat.
Main symptoms: increased frequency of bowel movements, more than 3 times a day or more, thin or unfinished stool, and even spilled out like water.
Secondary symptoms: dry mouth and bitter mouth, abdominal pain or bloating discomfort, frequent belching, fatigue, poor diet, cold abdomen or cold lower extremities. Tongue veins: the tongue is red, lichen yellow or yellow-white, and the pulse is number or fine.
It has any 2 or more of the main and secondary symptoms, and can be distinguished by combining the tongue vein.
Inclusion criteria: 1) meet the above Western medicine diagnostic standards and Chinese medicine differentiation standards; 2) Age 18~70 years old, good compliance; 3) Have not taken relevant therapeutic drugs within 1 month; 4) The patient gave informed consent and signed the informed consent form.
Exclusion criteria: patients with severe gastrointestinal, hepatic and renal system diseases, intestinal tumors, intestinal luminal stenosis and other organic diseases, pregnant or lactating women.
Treatment: The control group was given Bifidobacterium triple live bacteria enteric-coated capsules orally, 4 capsules each time, 2 times a day, for 6 weeks. Jincheng Hays Pharmaceutical Co., Ltd., Sinopharm S19993065, specification 0.21g per capsule.
The treatment group was given the traditional Chinese medicine Wumei pill plus and minus treatment.
Prescription drug composition: Ume 15g, Xiexin 3g, Guizhi 10g, Codonopsis 10g, Sichuan peppercorn 3g, dried ginger 6g, Attached slices (fried first) 10g, Huanglian 6g, Huangbai 10g, Angelica 10g.
Add and subtract with symptoms: sticky mouth, sleepy limbs, fat tongue with tooth marks, thick moss, spleen deficiency and heavy wetness, add poria 15g, fried white art 10g, lotus 10g; Dry mouth, bitter mouth, burning, hot flashes and night sweats, moss yellow greasy, heavy humid heat, change the yellow lien to 9g, add kudzu root 30g.
Diet raw cold diarrhea aggravated, five more diarrhea, backache, low back pain, kidney yang deficiency obvious, add psoralen 10g, nutmeg 10g, evodia 3g; For patients with abdominal pain and bloating, add 10g of wood fragrance and 10g of Sichuan neem seed; For patients with insomnia, add 30g of raw keel (fried first) and 30g of raw oysters (fried first).
For those who combine belching, add 20g of swirling flowers (frying) and 30g of substitute ochre (fried first); Combined with the difference in the Na, add 15g each of the three immortals.
The above Chinese medicine was decocted twice, combined with 2 decoctions, and divided into half an hour after breakfast and dinner for 6 weeks.
The patient visits the doctor once a week, and according to the changes in the condition, the addition and subtraction are adjusted on the basis of the above Chinese medicine prescription.
Observation indicators: 5 symptoms of traditional Chinese medicine syndrome, including stool characteristics, stool frequency, abdominal pain, abdominal distention, and incomplete bowel movements, were scored 0, 1, 2, and 3 points according to none, mild, medium, and severe; 1 point for stool with mucus and 0 points for stool without mucus.
A higher score indicates a more severe condition. The scores of TCM symptoms before and after treatment of the two groups were compared.
The clinical efficacy and efficacy standards are formulated with reference to the Guidelines for Clinical Research of New Chinese Medicines (Trial).
Healing: Complete or almost disappearance of symptoms. Obvious effect: the symptoms were significantly improved, and the TCM syndrome points were reduced by ≥70% and <95%. Effective: Symptoms improved, TCM syndrome points decreased by ≥30%, <70%.
Ineffective: Symptoms did not improve, or even worsened, and TCM syndrome points decreased by <30%. TCM syndrome points decreased/%= (pre-treatment TCM syndrome points - post-treatment TCM syndrome points) / pre-treatment TCM syndrome points× 100% (nimodipine).
Statistical methods: SPSS20.0 statistical software was used for statistical analysis, and the measurement data were expressed in x"±s when they followed the normal distribution, and the paired t-test was used for comparison before and after treatment within the group, and the t-test of two independent samples was used for the comparison between groups.
Count data is expressed as a percentage using the x2 test. P<0.05 indicates that the difference is statistically significant.
Second, the results of treatment
Comparison of TCM syndrome points between the two groups before and after treatment: The comparison of TCM syndrome points in the two groups before treatment was not statistically significant (P>0.05), which was comparable.
After treatment, the scores of medical syndrome in the two groups were significantly reduced, and the difference was statistically significant compared with the same group before treatment (P<0.05), and the decrease was more obvious in the treatment group, and the difference after treatment with the control group was statistically significant (P<0.05).
The total effective rate of the two groups was 88.46% (23/26) in the treatment group and 65.38% (17/26) in the control group, and the difference between the two groups was statistically significant (P<0.05).
III. Discussion
Chronic diarrhoeal disease is a common clinical disease, and the course of the disease is generally long.
Its etiology is mainly intestinal infectious or non-infectious diseases, intestinal motility, intestinal malabsorption, etc., and can also be secondary to systemic diseases and stomach, liver, gallbladder, pancreas, spleen diseases, and its causes are mostly closely related to mental tension, fatigue and malnutrition.
Chronic diarrheal diseases belong to the category of "diarrhea" and "lower profit" in traditional Chinese medicine, and traditional Chinese internal medicine mostly divides them into three types of symptoms, such as spleen deficiency, liver depression and kidney deficiency, and most of them are treated by strengthening the spleen and qi, thinning the liver and strengthening the spleen, warming the spleen and kidney, and using ginseng white technique dispersion, pain and diarrhea essentials, and four god pills plus and minus treatment.
However, in clinical practice, we found that these three types could not cover all types of chronic diarrhea symptoms, and the more common clinical symptom type was cold and fever complications.
Patients are mostly manifested as dry mouth, bitter mouth, abdominal pain and diarrhea, bowel sound, tenesmus, etc., and the frequency of stool, the diet is cold, greasy or aggravated after emotional stimulation, the tongue is light red, moss yellow greasy or yellow and white, and the pulse is fine or deep.
Dry mouth, bitter mouth, moss yellow greasy is mostly a hot image, at this time, if you simply use hot and wet drugs, it may aggravate the diarrhea.
Diarrhea aggravates after bowel sound, cold diet, and the pulse is cold and cold, at this time, if you simply use warm tonic drugs, it may aggravate the symptoms of dry mouth and bitter mouth, tenesmus.
Therefore, cold drugs or hot drugs can not be used alone, suggesting that this chronic diarrhea is mostly cold and hot, false and real, and the treatment should be clear and warm, slow liver adjustment.
The traditional Chinese medicine Wumei pill is an effective prescription for cold and heat homology, attack and supplementation, in the clinical use of patients, as long as the patient's chronic diarrhea is manifested as upper heat and cold down, in line with the indications for the use of Wumei pill, even if the cold or heat image is not very obvious, it can also be boldly used.
The traditional Chinese medicine Wumei pill comes from Zhang Zhongjing's "Typhoid Miscellaneous Diseases" of the Eastern Han Dynasty, the original prescription is a pill, and its medicine is Wumei, Xiexin, Guizhi, Codonopsis, Sichuan peppercorn, dried ginger, attached tablets, Huanglian, Huangbai, and angelica.
The combination of whole medicated acid, bitter, sweet and bitter is an effective prescription for the treatment of Yin disease, cold and heat, and the interaction between reality and reality, and is mostly used in clinical treatment for ascaria and long-term diarrhea.
The sour taste of plum in the prescription can converge and stop diarrhea, analgesia, and is a jun medicine.
Sichuan peppercorns, fine spicy, dried ginger are warm and spicy, can warm the dirt and dispel cold, and are medicines.
Warm laurel branches and aconite can strengthen the power of dispelling cold and temperature; Coptis and cypress have a bitter taste, which can clear heat and dryness; Sweet ginseng and angelica can nourish the spleen, stomach and blood, and are used as adjuvants.
All drugs are used together to play the function of nourishing the liver and blood, warming the spleen and kidneys, and suppressing wood and soil, and leveling yin and yang as a whole, thus achieving the purpose of stopping diarrhea.
Modern pharmacological studies have shown that the traditional Chinese medicine Wumei Pill has the functions of regulating spleen and stomach function, anti-inflammatory, antioxidant, enhancing the body's immunity, and protecting the gastric mucosa.
Studies have shown that the traditional Chinese medicine Wumei Pill can regulate the body's qi, blood, yin and yang as a whole, significantly improve the symptoms of chronic diarrhea in patients, relieve abdominal pain, bloating, belching, dry mouth, bitter mouth and other accompanying symptoms, improve intestinal function, and have no obvious adverse reactions.
The results of this study showed that the medical syndrome score in the post-treatment treatment group was significantly lower than that of the control group (P<0.05), and the total effective rate was significantly higher than that of the control group (P<0.05).
It shows that the clinical treatment effect of traditional Chinese medicine Wumei Pill plus minus in the treatment of chronic diarrhea cold and heat complications is remarkable, and the symptoms of diarrhea in patients are significantly improved, which is worthy of further in-depth research in future clinical practice.