▲Zhu Liangchun, Master of Traditional Chinese Medicine (1917.8-2015.12)
Zhu Liangchun, the first master of traditional Chinese medicine, born in Zhenjiang, Jiangsu, is a famous Chinese medicine scientist and educator in mainland China, one of the first batch of national academic experience tutors of old Chinese medicine experts, the first president of Nantong Hospital of Traditional Chinese Medicine, and a tenured professor of Nanjing University of Chinese Medicine. The experience of Zhu Lao in the treatment of gout is summarized as follows for the benefit of colleagues.
Discussion of the name of gout
The name of gout began with Li Dongyuan and Zhu Danxi, but gout in traditional Chinese medicine is a disease in a broad sense, while gout in Western medicine refers to "gouty arthritis" and its secondary symptoms of hyperuricemia caused by purine metabolism disorders, so although the name of the disease is the same, the concept is different. From clinical observation, there are its characteristics, such as middle-aged and elderly, plump body, or a history of drinking, and people who like to eat ointment and fatness; Joint pain is worse in the middle of the night, and there are nodules or ulcerative lipids. From the point of view of etiology, although cold and dampness are one of the triggers, it is not the main cause, and the internal obstruction of dampness and stasis is the main pathogenesis, and the evil of dampness and turbidity is not subject to the outside, but is born from the inside.
Because most of the patients are phlegm and dampness in the body, and have a habit of alcohol and liking, resulting in dysfunction of the viscera, there is no right to raise and clear and reduce turbidity, so the phlegm and dampness are blocked in the blood veins, which is difficult to discharge, and the blood is combined with turbidity and stasis, and is retained in the meridians, the bone joints are swollen and painful, the nodules are deformed, and even ulcerated, oozing lipin. Or the depression and heat, agglomeration into poison, damage to the spleen and kidney, at the beginning of the low back pain, blood in the urine, for a long time then congestion of the three coke, and the "Guange" crisis, that is, "gouty nephritis" and kidney failure. All of this is caused by turbidity and stasis internal resistance, and it is not caused by wind evil, so Zhu Lao calls it "turbidity stasis paralysis", which seems to be more suitable for the pathogenesis.
The main treatment is to dissipate turbidity and stasis
Since the occurrence of gout is caused by turbidity and stasis, we should adhere to the rule of "discharging turbidity and stasis", and the turbidity and stasis can be gradually discharged by adding or subtracting from the evidence, and the blood uric acid will also decrease, so that the function of distinguishing turbidity can be restored, and it will tend to be healthy. This also shows that although gout also belongs to the scope of paralysis syndrome, with joint pain, swelling and other common manifestations of paralysis syndrome, but turbidity and stasis retention in the meridians is its characteristic, if you do not pay attention to this, it is difficult to treat it with a general set of paralysis prescriptions.
Syndrome differentiation and flexible medication
Zhu Lao's commonly used prescription drugs for gout: Poria cocos, Coix coix, Clematis, Zelan, Zexiao, Qin Gang are good medicines for turbidity and detoxification, and Wu Yi red peony, ground turtle insect, peach kernel, earth dragon and other products that invigorate blood and dispel stasis, can promote dampness and turbidity, dissolve stasis, promote the old and new, enhance the curative effect, can significantly improve the symptoms, reduce the concentration of blood uric acid.
▲ Clay 茯苓
After six years of systematic observation, most cases have significantly improved their symptoms after taking the medicine for 2~3 days, and they can be cured if they continue to take it. According to the experiment of the Institute of Basic Theory of the China Academy of Chinese Medical Sciences, the observation of experimental gout caused by microcrystalline urine sodium in rats with gout powder showed that the plantar swelling of rats in the dosing group subsided after 2 hours of administration and was obviously faster than that of the model group, and compared with the colchicine group, the gout powder was not inferior to the colchicine group in terms of swelling. The toxicity test proves that gout powder is safe and reliable for the human body.
As for those who contain and dissipate heat, you can add humulus to clear and drain the veins, knotweed, Sanmiao pills, etc.; If the pain is even worse, the whole scorpion, centipede, Yanhusuo, and Wuling Fat are used to open the stasis and fix the pain; If the swelling is worse, add phlegm-reducing drugs such as zombie silkworm, white mustard seed, and Chen Danxing, which can accelerate the reduction of swelling and relieve pain; For example, if the joints are stiff and the nodules are hard, adding armor, dung beetles, beehives, etc. can break the knots and open the stasis, which can not only reduce the swelling but also help reduce the blood uric acid index.
▲ Tiger cane
For example, in the acute attack period, it is advisable to increase the dosage of Poria cocos and Rhizome, and according to the different hot and cold syndromes, it is necessary to use raw land, cold water stone, Zhimu, buffalo horn, etc. to clear heat and circulation; Or add Sichuan Wu, Cao Wu, Sichuan Guizhi, Asarium, Xianling Spleen, Deer Horn Cream, etc. to warm the meridian and dispel the cold, which can reduce swelling and pain, and control the attack. For those who are weak, they should also choose rehmannia rehmannia, psoralen, bone crushing, raw astragalus, etc. to tonify the kidney and strengthen the bones. As for low back pain and hematuria, you can add drenched fossil products, such as desmodium, sea gold sand, miscanthus salt, small thistle, grass root, etc.
Case examples
Guo, male, 57 years old, farmer. He was first visited on 7 January 2000.
It has been many years since gout and rheumatoid arthritis were diagnosed. The ten fingers of both hands are deformed, the little finger of the left hand has gout stones, the joints of the whole body are sore, and the toes are suddenly red, swollen, hot and painful recently, so I came to see a doctor. Nake, stool tune, tongue red, moss yellow turbidity, pulse strings, this turbidity and stasis obstruction, there is a sign of heat injury yin, treatment should be discharged and turbidity stasis, nourish yin and clear heat, and clear the pain.
Prescription: 1. 30 grams of Qingfeng vine, Poria cocos, Zelan, Zexiao, Fen grass, fried Yuanhu, 20 grams of raw land, 15 grams of myrrh and red white peony, 10 grams of beehive and turtle insects. 14 doses.
▲ Qingfeng vine
2. 9 packs of gout powder× 4 bags, 1 pack per serving, 3 times a day, after meals.
3. 4 grams × 42 packets of Yi Kidney Bi Pills, 4 grams per serving, 3 times a day, after meals.
Second diagnosis (February 8, 2000): I had used hormones in the past without telling him, and after using traditional Chinese medicine, I suddenly stopped taking 4 tablets of prednisone a day without authorization, so the pain was reverse, the swelling did not go away, the mouth was dry, the phlegm was abundant, the stool was normal, the moss was white and greasy, the tongue was red, and the pulse was stringy. Profit and loss of the previous method.
Prescription: 1. 50 grams of Panshanlong, 30 grams of Poria cocos, Pigweed, Qingfeng vine, Zelan, Zexiao, Golden Buckwheat, and Fried Yuanhu, 15 grams of Xu Changqing, Myrrh, Dilong, Red Peony, and Zombie Silkworm, 10 grams of Soapthorn, Ground Turtle Worm, and Angelica, and 6 grams of Licorice. 14 doses.
2. 9 packs of gout powder× 4 bags, 1 pack per serving, 3 times a day, after meals.
3. 4 grams × 42 packets of Yi Kidney Bi Pills, 4 grams per serving, 3 times a day, after meals.
Third diagnosis (March 14, 2000): After the medicine, the swelling and pain were relieved, the tongue was red, the moss was white and greasy, and the pulse was smooth. The hormones have been removed, and the original method is different.
Prescription: 1. 50 grams of Panshan Dragon, 30 grams of chicken blood vine, Poria cocos, clematis, and golden buckwheat, 15 grams of Xu Changqing, 10 grams of Sichuan Wu, Black Snake, Burning Beehive, Ground Turtle Insect, Guangdi Dragon, Burning Silkworm, and Angelica sinensis, and 8 grams of Phoenix clothes. 30 doses.
▲Panshan Dragon
2. 9 packs of gout powder× 4 bags, 1 pack per serving, 3 times a day, after meals.
3. 4 grams × 42 packets of Yi Kidney Bi Pills, 4 grams per serving, 3 times a day, after meals. The follow-up has been relieved, and it is recommended to avoid eating purine-containing foods such as various beans, marine fish, animal offal, spinach, etc., and alcohol, drink more water, and still take 2 packs of Yi Kidney Bi Pills every day in order to consolidate.
Note: Long-term use of hormones should be reduced in the process of changing to traditional Chinese medicine, and no sudden arrest should be allowed. According to Mr. Zhu Liangchun's experience, it seems to have the effect of replacing hormones without hormone side effects; Golden buckwheat is a good expectorant, stasis, heat clearing and anti-inflammatory.
Kidney Pills
The composition of this pill is: Rehmannia rehmannia, fairy spleen, deer bit, cistanche, all angelica, chicken blood vine, beehive, snake (can be used as a substitute for black snakes when missing), ground turtle insects, zombie silkworms, dung beetles, cannon beetles, whole scorpions, centipedes, Guangdi dragons, licorice, etc., a total of very fine powder, pan pills such as mung beans, 6~8 grams per serving, 3 times a day, after meals.
The stubborn lesion is in the bone, and the bone is dominated by the kidney, and the pulse can supervise the pulse of the body, so "benefiting the kidney and strengthening the body" is the way to cure the root cause, which can enhance the body's immune function, adjust bone metabolism, and play a decisive role in the root cause of the disease. Therefore, in the selection of drugs, in addition to plant drugs, it is advisable to focus on insect drugs, because insect drugs not only have the ability to search, but also contain animal allogeneic proteins, which have their special effects on the body's tonic adjustment. In particular, snakes can also promote the synthesis and release of adrenocorticotropic hormone in the anterior pituitary gland, so that the concentration of this hormone in the blood increases, so as to achieve anti-inflammatory, swelling, and analgesic effects. In practice, it is realized that the use of insect drugs plays an important role in shortening the course of treatment and improving the efficacy.
Due to the dryness of wind medicine, according to the principle of "treating wind and blood first", the cube reuses rehmannia rehmannia sinensis, angelica sinensis, chicken blood vine and other blood-nourishing products to slow down its dryness and improve the curative effect.
Zheng reiterates:
Since each person's constitution and condition are different, the prescription and dosage in this case are only applicable to the patient's condition at that time. Without TCM syndrome differentiation diagnosis and treatment, the prescription and dosage in this case must not be copied. If necessary, readers should go to a regular hospital for diagnosis and treatment to avoid delaying their condition. ■
[Source: China Traditional Chinese Medicine News, the content is selected from the fourth edition of "China Traditional Chinese Medicine News" on January 25, 2016, excerpted from "China's 100 Years of 100 Chinese Medicine Clinicians Series - Master of Traditional Chinese Medicine Volume: Zhu Liangchun", this article is organized by Xu Meng]