▲Qiu Peiran, Master of Traditional Chinese Medicine (1913.1-2010.5)
Qiu Peiran, a master of traditional Chinese medicine, is a well-known Chinese medicine scientist in mainland China, known for his good treatment of difficult and miscellaneous diseases. This article attempts to explore Qiu Peiran's academic thoughts from the treatment of eczema, rubella and other skin diseases, so as to serve Chinese medicine colleagues.
Impregnation sores
Medical case 1: Chen, male, 8 years old at the time. First visit on November 9, 1969. Chief complaint: frequent rash of the lower limbs for half a year. Since the beginning of summer, the skin of the lower limbs has appeared red spots, papules of different sizes, itching and blisters. Eczema was diagnosed in other hospitals, and Western medicine was used for internal and external treatment, but the effect was not obvious. Since the beginning of autumn, the erythema and papules on the lower limbs have not been reduced, the itching is more intense, the soaking blisters, the mouth is slightly thirsty, and the two stools are unblocked. The tongue coating is thin and white, the tongue is slightly red, and the pulse is thin.
Diagnosis: (damp heat retention, long-term fire type) eczema.
Treatment: clear the dampness and heat, accompanied by fire and detoxification.
Prescription: Sophora sophora tablets 12g, Sichuan phellodendron 12g, cicada clothes 12g, duckweed 12g, fresh ground 24g, Poria cocos 30g, dandelion 30g. 3 doses.
Fresh dandelions, fresh wild chrysanthemums, an appropriate amount of mashed external application.
Second diagnosis: the itching has improved significantly, there is no soaking blister, and the local scab has been crusted.
Prescription: net ephedra 6g, forsythia shell 9g, red adzuki bean 24g, net cicada coat 6g, sophora sophora slices 9g, Sichuan cinnamon branch 6g, dandelion 30g, duckweed 18g, fresh ground 18g. 4 doses.
30g of duckweed, decoction of thick soup to wash the lower limbs.
Third diagnosis: all scabs have been formed, no new rash has been seen, and the itching has disappeared. It is recommended to take 2 more doses to consolidate.
Note: The child lives in a rural area, the living environment is humid, and the diet is not modest, and the food is raw and cold, so the external dampness and internal dampness are condensed in the body, and the heat is turned into heat over time, and the dampness and heat are steamed on the muscle surface. Qiu Peiran was treated with a combination of internal and external treatment. The initial diagnosis is mainly to clear heat and dampness, detoxify and relieve itching, and reuse Sophora sophora, Phellodendron phellodendron and cicada clothes. The bitter participation in the cork matching, so that the fire dehumidification work is greatly increased; In addition to evacuating wind and heat, cicada clothes are good at walking on the skin surface, and also have a more significant anti-itching effect.
Fresh dandelion and fresh chrysanthemum should be mashed and applied externally, so that it can directly act on the eczema area, and have the effect of clearing heat, detoxifying and dehumidifying. The second diagnosis is based on ephedra forsythia red bean soup, which not only relieves the surface evil, but also clears away heat and dampness; Add cinnamon branches to adjust the health of the camp; Ephedra vents the evil of camp guards; Then use cicada clothes and sophora ginseng to relieve itching and dissolve dampness; dandelion and duckweed clear heat and dampness, detoxify and relieve itching; Freshly nourishing yin and clearing heat. Duckweed decoction is washed outside to take its healing effect of heat penetration. In this case, in addition to the combination of medication, it is not confined to the method of internal administration, combined with external application and washing, so that the medicine can be directly hit the disease, so it can be quickly cured.
▲Cicada robe
Medical case 2: Shen, female, 48 years old at the time. First visit on November 20, 2008. Complaints of recurrent rashes on the face and extremities for 5 years. For the past 5 years, rashes on the face and limbs have been frequent, accompanied by mild itching, and the attacks are more severe in autumn and winter. The rash can subside after applying Western medicine urea cream, but the effect is gradually not obvious after long-term use of Western medicine containing hormones, so the number of applications is increasing.
The rash on the face and limbs of the symptoms is punctate and flaky, and it has been applied with urea cream for 2 weeks, leaving many pigmented spots after the rash has subsided; The joints of the limbs have been sore for many years, and the pain is obvious when the weather turns cold recently; occasional head swelling; Every time you drink alcohol or eat spicy food, your nose will feel hot, your eyelids will be red, and even mouth ulcers will appear. Naco, stool is still in tune; He has been known to be afraid of cold for more than 20 years. The tongue is pale red, thin and white, and the veins are small and stringy.
Diagnosis: (Yang deficiency constitution, lack of qi and blood, poor blood circulation, yin and blood deficiency, damp heat and internal type) eczema.
Treatment: Benefit the temperature and yang, nourish the blood and invigorate the blood, clear the dampness and heat.
Prescription: 15g of net ephedra, 18g of raw licorice, 15g of cooked attached block, 15g of northern asaroxin, 12g of Sichuan Wu (decoction for 2 hours), 40g of raw astragalus, 1g of saffron, 15g of Dachuanxiong, 10g of Coptis chuanensis, 9g of gentian, 18g of Phellodendron chinensis, 18g of Atractylodes atractylodes, 15g of Angelica dahurica, 15g of vitex. 12 doses.
Second visit on December 3, 2008: After taking 3 doses, the number of urea cream applications was reduced by half, and after taking 12 doses, the rash subsided 67 out of 10, the pigmentation spots became slightly lighter, and the pain in the joints of the limbs was greatly improved. There is still confusion, the stool is relatively dry in the past 3 days, the stomach is not happy, and the nasal cavity is hot and the head is swollen. Add 15g of cassia seeds to the top, and 15g of all angelica. 14 doses.
Note: The eczema in this case is in the remission period, and the symptoms and root causes should be treated. This prescription to ephedra as the king, this is the treatment of rubella itching medicine, with the function of penetration, and licorice composition of the medicine pair, not only the treatment of eczema has a good effect, but also can be used to treat cough, asthma, rhinitis, stroke sequelae, etc., and with cork, coptis, atractylodes to clear heat and dampness, is conducive to the regression of rash, this cold and temperature match is Qiu Peiran's clinical habitual method, take the opposite effect, especially for the treatment of cold and heat mixed with the disease is quite effective.
Therefore, the use of aconite, Chuanxiong and Asarum aconitum to warm and yang is not only conducive to eliminating rashes and pigmentation spots, but also to make up for the deficiency of body yang, and has the function of relieving joint soreness. The use of a large dose of astragalus and angelica can enhance the power of nourishing qi and nourishing blood; The use of saffron and Dachuanxiong focuses on blood circulation and blood stasis, which is combined with dampness and heat, and the power of warming and channeling veins is enhanced, which is conducive to the elimination of pigmentation spots; Due to the long-term use of hormone-containing creams in patients, the compatibility of astragalus, angelica, saffron and Chuanxiong is used, focusing on nourishing qi and nourishing blood and activating blood, which can help gradually eliminate the dependence on hormone drugs; Gentian grass, vitex seed, cassia seed clear heat and fire and clear eyes; Angelica dahurica and Dachuanxiong can be used to treat head swelling.
Itchy case
The medical case was executed by Dong, male, 45 years old at the time. First visit on January 3, 1991. Complains of skin rash itching recurrent for 3 years. In the past 3 years, there have been frequent rashes and itching in winter and summer, and Western medicine dermatology has diagnosed pruritus as skin. In the past 2 months, his illness has reappeared, especially in the popliteal fossa, armpits, elbow bend, abdomen, the rash site skin is red, there are scratches, self-reported itching at night, so that the rash is itchy all night, so sometimes get up in the middle of the night to scrub with cold water to fall asleep, and accompanied by thirst and irritability, normal stool, the right hypochondrium has a dull pain after exertion, 2 years ago suffered from hepatitis A, now healed. The tongue is slightly red, the tongue coating is thin and greasy, and the veins are stringy.
Diagnosis: (loss of qi and blood, blood deficiency and wind, blood and heat body, damp heat and obscenity type) rubella.
Treatment: Nourish qi, nourish blood and moisten dryness, clear away heat, detoxify and promote dampness.
Prescription: Angelica sinensis 18g, raw astragalus 30g, raw and cooked rehmannia (each) 24g, Coptis chuanensis 10g, light skullcap 24g, Sichuan phellodendron 15g, net ephedra 9g, yellow medicine 15g, human yellow 12g, turmeric 10g. 7 doses.
After taking the above 7 doses, the skin itching was greatly reduced, and the night was peaceful, but the stool was 2 times a day, but it was formed, and he was still asked to take the above 7 doses, and the illness was sick. After 1 month, due to careless diet (eating seafood and wine), the rash reappeared, and the yellow medicine was still removed above, 12g of forsythia was added, and 9g of net cicada clothes were added. After 7 more doses, the rash subsided.
Note: Pruritus is a skin disease that feels itchy without primary damage, and is more likely to occur in the elderly and adults. It is more common in winter, and there are often secondary lesions such as scratches, blood crusts, pigmentation, and lichenoid changes due to constant scratching, and sometimes it can be accompanied by secondary infections such as folliculitis, boils, and lymphadenitis. This disease belongs to the category of "itching" in traditional Chinese medicine.
Pruritus is often related to blood deficiency, blood dryness, blood heat and damp heat, poison and other factors, Xianzheyun "blood deficiency and wind" and "blood dryness and wind", itching and wandering are the characteristics of wind evil, and the treatment should be based on nourishing blood and moistening dryness, invigorating blood and dispelling wind, clearing and benefiting dampness and heat. Qiu Peiran is accustomed to using Angelica Liuhuang decoction to disintegrate, which is a combination of qi and blood, and both evil and good, which can not only nourish qi, nourish blood and moisten dryness, but also clear away heat and dampness and detoxify; Accompanied by ephedra to dispel wind and relieve the table; Yellow medicine seeds cool blood and detoxify; Turmeric invigorates blood and disperses wind. It is to treat both the symptoms and the root cause, ironing the pathogenesis, so after taking a few medicines, Huo was cured.
粟疮案
The medical case was executed by Gao, male, 47 years old at the time. First visit on August 23, 1981. Complained of a rash all over the body for more than 1 week. 3 months ago, he was treated in the hospital for high fever, abdominal distension, and swollen parotid glands, and was diagnosed with eosinophilia. In the past 1 week, the whole body has a milia-like rash itching endlessly, accompanied by bad breath, thirst, fatigue, abdominal flatulence, loose stools, and poor stomach. The veins are fine and the moss is slightly greasy.
Diagnosis: (the epiphery is not solid, the dampness is turbid, and the heat is also hot and depressed, the heat is in the blood, and the dampness and heat are obstructed in the muscle phenotype).
Rule: Nourish qi and strengthen the surface, dissolve dampness and cool blood.
Prescription: Raw Astragalus 30g, Qingfengfeng 15g, Shengbaizhu 15g, Ginger Citrus Shell 9g, Duckweed 15g, Yuquan Powder (Pack) 15g, Sichuan Magnolia 6g, Dried Lotus Leaf 6g, Pure Cicada 5g, Dashengdi 20g, Bergamot 9g, Pure Ephedra 5g. 14 doses.
After taking it for half a month, the abdominal distension is removed, the rash recedes, and the itching of the skin basically disappears.
Note: In traditional Chinese medicine, the disease is called "millet sore" according to its shape, itching and excessive itching, and modern medicine calls it "prurigo" or "simple pruritus". Most scholars believe that it is related to allergies, while traditional Chinese medicine believes that it is caused by internal depression and heat, relapse from wind evil, or heat depletion of blood, wind and dryness, and skin dystrophy. The patient had a generalized miliary rash with constant itching and had had suffered from eosinophilia 3 months earlier, thus meeting the diagnosis of "prurigo".
However, in addition to the pathogenesis of blood fever, patients also have signs of spleen deficiency and dampness such as fatigue, sluggishness, loose stools, and greasyness, so in the treatment, astragalus is reused as the king's medicine, with atractylodes and fengfeng to benefit qi and strengthen the surface; With citrus aurantium shell, one rise and one drop to nourish the middle qi; The mating land and jade spring are scattered to clear the air and cool the blood; With Sichuan magnolia bark and bergamot, it can reduce swelling by regulating gas and dampness; Duckweed, lotus leaves, and cicada clothes clear away heat and dampness, and penetrate the heat and dampness on the surface. The characteristic of this prescription is that ephedra is used as an essential medicine, which is a pungent and warm product, although the dosage is lighter, but it can "remove evil heat" ("Shennong's Materia Medica"); "Daming Materia Medica" says "regulate blood and veins, open pores and skin"; Zhang Yuan called it "stroke fever in the vent guard", and Qiu Peiran used ephedra every time in skin diseases, and the effect was quite good.
▲ Ma Huang
Cases of hair loss
The medical case was executed by Jin, female, 36 years old at the time. Initial visit on April 5, 2005. Complained of hair loss for half a year. Now the hair on the top of the head is scarce and countable, the scalp is exposed, and it has been increasing for half a year, accompanied by thirst and drinking, dizziness occasionally, tinnitus and blur, backache and discomfort, and poor spirit. The moss is thin and white, slightly reddish, and the veins are thin.
Diagnosis: (Deficiency of kidney essence, inflammation of deficiency fire, dry essence and fire, hair dystrophy type) hair loss.
Rule: Nourish the kidneys and relieve fire.
Prescription: Turtle Plate 18g, Deer Horn Powder 3g, Lycium Berry 9g, Herba Grass 15g, Epimedium 12g, Cuscuta Seed 12g, Psoralen 15g, Raw Licorice 6g, Angelica Sinensis 9g, Dendrobium 12g, Rehmannia 24g, Raw Astragalus 15g, Raw Atractylodes 15g, Qingfengfeng 9g. 7 doses, decoction with water, 1 dose per day.
Second diagnosis: After taking 7 doses of medicine, his spirit improved, and the hair loss improved slightly.
Third diagnosis: After taking the medicine for 1 month, the hair gradually grew, and the color deepened, and after taking the medicine until June 12 (about 50 days), there was no follow-up.
Note: The patient's hair loss is only a symptom, and dizziness, blur, tinnitus, thirst, backache, fatigue and other symptoms are the loss of kidney yin, which is the root cause of his disease. With angelica, rehmannia, wolfberry, dendrobium, to enhance the power of tonifying the kidney, nourishing blood and moisturizing dryness; Combine fairy grass, epimedium weed, dodder seed, and psoralen to seek yin from yang; Later, it is equipped with a jade screen to disperse to benefit qi and strengthen the surface, and adjust the body's immunity. It can be seen that the treatment of the disease must be based on the roots, in order to achieve satisfactory results. ■
▲菟丝子
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.
[Content compiled from: "China Traditional Chinese Medicine News" November 12, 2021 fifth edition, author: Shanghai University of Traditional Chinese Medicine Wang Qingqi, Li Xiaogang, Zou Chunpu, Liang Shanghua, Wang Shaomo, Qiu Shike]