▲Ren Jixue, Master of Traditional Chinese Medicine (1926-2010)
Ren Jixue, the first master of traditional Chinese medicine, was the chief physician of the Affiliated Hospital of Changchun University of Chinese Medicine, a well-known expert in emergency medicine of Chinese medicine, and a pioneer of emergency medicine of traditional Chinese medicine. Ren Jixue has traced the source of many patients with cervical spondylosis who were misdiagnosed as coronary heart disease, and achieved good results in syndrome differentiation treatment. It is introduced as follows for the benefit of colleagues.
Diagnose the cause of the disease and identify the pathogenesis in detail
In years of clinical practice, Ren Jixue found that many patients were misdiagnosed as coronary heart disease and angina pectoris due to numbness and pain in the neck, shoulder, upper limbs, accompanied by chest tightness and shortness of breath, palpitations, dizziness, nausea and other symptoms, but the ECG did not change significantly. Ren Jixue believes that cervical spondylosis (known as cervical and shoulder syndrome in Western medicine) is different in severity, with different pulse patterns and more complex symptoms, so it is inappropriate to call it "disease", and it should be called "cervical spine syndrome", and it is believed that the disease is mostly caused by strong weight bearing or excessive exertion of the kidneys. Because the main bone of the kidney produces marrow, the kidney injury and sperm deficiency leads to the loss of the medulla and cannot fill the bone, resulting in bone dystrophy and lesions. In addition, because the evil of wind and cold invades the body, stagnates in the meridians, phlegm and poison are endogenous, and the qi is unfavorable, resulting in the loss of nourishment of the pulse and the obstruction of qi and blood, causing stiffness of the neck and back, headache, dizziness, nausea, numbness of the upper limbs and even cataplexy, etc., so the treatment should be based on nourishing the liver and kidneys, relaxing the meridians and activating the meridians, and dissolving stasis and phlegm.
Syndrome differentiation and treatment, and the use of medicine is precise
Based on the above understanding, Ren Jixue emphasized that "the treatment of disease is on the bones", and "the bone is the house of the marrow, and the marrow is the filling of the bone", so the essence is the root of the treatment. The "Su Wen · Theory of Reverse Adjustment" records: "The kidney is water, and is born in the bone, and the kidney is not born, the marrow cannot be full, so the cold is even the bone." In the treatment of cervical spondylosis, Ren Jixue often chooses deer horn gum, tortoiseshell gum, pig spinal cord, wolfberry, deer tendon, dog spine, eucommia, etc. to nourish the liver and kidneys and strengthen the muscles and bones.
➤ Activate the blood stasis and relieve the tendons and channels Patients with cervical spondylosis have mild neck and shoulder pain and discomfort, severe limb weakness, numbness, and even paralysis. In the treatment, Ren Jixue often chooses mountain crabs, broken bones, turtle insects, dung beetles, Chuanxiong, myrrh, and Zeelan to promote blood stasis and dissolve knots. "Southern Yunnan Materia Medica" said: "Mountain crabs are strong and strong, and can run rampant. "Materia Medica" says that it is "salty and bloody, soft and hard, so it can dissolve and disperse blood." Ren Jixue said that it can "and ossification stasis". If the meridians are stasis for a long time, they will produce dampness and phlegm, so Ren Jixue often uses phlegm-reducing products in the stasis, such as banxia, sand kernels, etc.; If the arm is numb, add mulberry branches and slices of turmeric; Those with numbness and swollen limbs and hands add stone vines and defend themselves; Those with sore backs add dog spine, eucommia charcoal, and pangolin; Those with headache and bloating add pangolin beads and heather.
▲ Self-defense
➤ Specimen Consideration Syndrome Differentiation Treatment In the treatment of cervical spine syndrome, Ren Jixue emphasized syndrome differentiation and treatment, and divided the syndrome into five.
1. Neck emergency certificate. The neck is a few strong, accompanied by headache, shoulder and arm pain, hand pain, and even unbearable pain, neck muscles are tight, the tips of the hands are swollen and numb, the face is slightly yellow and green, the tongue is light red, the moss is thin white or white greasy, and the pulse is floating or tight. It is advisable to soothe the meridians and meridians, relieve emergencies and relieve pain. The addition and subtraction of Pueraria Pueraria Root Decoction is selected, in which bone crushing is reused to replenish the kidney, invigorate blood and relieve pain. "Treatise on Medicinal Properties" cloud: "The main bone is poisoned, the wind and blood are painful, the five labors and six extremes, the mouth and hands are not closed, the top is hot and the bottom is cold." "Materia Medica" says: "Heal the evil poison in the bones, wind heat and pain." "Cooperate with Chuanxiong and Sumu to invigorate blood circulation, dispel stasis and relieve pain. Pueraria lobata, Qianghuo, zombie silkworm, white peony, tendon grass, panmountain dragon dispel wind and relieve muscles, relax tendons and activate the nerves, and relieve pain.
2. Supervise the gods and obstruct the evidence. Pain on both sides of the neck, as well as pain in the shoulders, arms, forearms, hands, chest and back, numbness, cold fingers, weakness or atrophy of the palmar muscles. It is accompanied by sluggishness, abdominal distention, red tongue, pale moss, and heavy and tight pulses. It is advisable to treat the kidneys and channels, relax the tendons and relieve urgency. Ren Jixue is self-simulating the benefit of the kidneys and supervising the drink. Prescription medicines: deer antler cream, Chuanxiong, white peony, broken bones, dung beetle, licorice, turtle insect, myrrh, old crane tendon. Dung beetles, turtle insects, old crane tendons break blood and stasis, and relieve pain. "Changsha Medicinal Solution" records: "Dung beetles are good at breaking and can open dryness. "Materia Medica" cloud: "Turtle insects break all blood accumulation, bruises and serious injuries, and bones." "Southern Yunnan Materia Medica" cloud: "The old crane tendons treat muscle and bone pain, phlegm and fire weakness, hand and foot tendon spasm, and numbness. "The general dosage is 10~15g. If the hands are numb, add mulberry branches and slices of turmeric; Those with headaches add vitex and angelica; Those who are afraid of cold and cold limbs add aconite and ginger.
3. Medullary cerebral stasis obstruction syndrome. Muscle flaccid weakness or muscle spasm, or even paralysis on one or both sides, not knowing pain and itching, accompanied by upset insomnia, dripping urine, tendons and flesh run (eyes + leap, traditional body is 瞤), or even two fecal incontinence, or constipation, the tongue is red and red, less lichen, and the pulse is more weak or weak. It is advisable to nourish the kidneys and marrow, activate the blood and dispel stasis. Choose a decoction that increases loss and nourishes yin and marrow. Prescription medicine: rehmannia rehmannia (rehmannia for wine), tortoiseshell gum, deer horn gum, tendon grass, turtle insect, angelica, deer tendon, wolfberry, sand kernel, roll plate, pig bone marrow, etc. This recipe reuses tortoiseshell gum, deer horn gum, deer tendon, wolfberry, and pig bone marrow to nourish the kidney and marrow, and uses angelica to nourish blood and nourish blood, activate the veins and dispel stasis.
4. Upper and lower stasis syndrome. Confusion, episodic vertigo, even syncope, congestion in both ears or in one ear, and deafness in severe cases, with nausea, vomiting, and unsteady gait. The tongue is red or light red, the moss is thin and white, and the pulse is smooth. This syndrome is mostly due to the lack of essence, the lack of nourishment of the pulse, and the manifestation of the evidence of upper deficiency, such as dizziness, tinnitus, deafness, and even fainting, etc., and the root cause of the evidence of cerebral medullary deficiency lies in the cervical spine osteohyperplasia lesions that cause the imbalance of qi, blood, and fluid operation, and the stagnation of meridians. Therefore, it is advisable to clear the pulse and guide stagnation, and dispel stasis and smooth the circulation. Ren Jixue self-mimicking bone crushed soup. Prescription medicines: Broken bones, Pueraria, Chuanxiong, Gastrodia, Turtle Worm, Shengpu Huang, Mountain Crab, Red Peony, Tribulus terrestris, Banxia, Zelan, etc. Fangzhong gastrodia and tribulus terrestris are combined with all kinds of products that invigorate blood and dispel blood stasis to relax the muscles and activate the nerves and relieve paralysis. The mountain crab disperses stasis and circulation, and the bones are dispersed, and it is accompanied by semi-summer dryness and dampness to dissolve phlegm, reduce inversion and stop vomiting, eliminate phlegm and disperse knots, so that the flow of qi and blood is unimpeded, and the sea of marrow is full freely.
5. Evidence of mental damage. Dizziness and pain, pain in the head and chest, shortness of breath, palpitations, cold limbs, numbness and pain in the limbs, red face and cheeks, pale red tongue, tender and red tongue, thin and white moss, and pulse sinking or promoting. This syndrome is due to the severity of the stagnation of the pulse, resulting in cerebral and spinal loss and mental disturbance. To calm the nerves, choose the soup of soothing the nerves. Medicinal: Angelica sinensis, Chuanxiong, broken bones, mountain crab, safflower, raw dragon tooth, turtle insect, calcined magnet, red peony, purple quartz, etc. If the heart palpitations are restless, those who are annoyed and sleep less add wine coptis and cinnamon; limb numbness and pain plus self-defense, blood exhaustion powder (flush); Those with cold limbs add aconite, dried ginger, and green onions. This recipe focuses on the town of Qianyang, calming the nerves and calming the heart, and uses raw dragon teeth, calcined magnets, purple quartz, etc. to match with the drugs that invigorate blood circulation and remove blood stasis, relax the tendons and channels, and play the function of calming the nerves and soothing the muscles.
➤ Auxiliary external treatment of medicine Specialized Glory Ren Jixue in the treatment of cervical spondylosis, especially advocates both internal and external treatment, focusing on local wet compresses and dressings of external drugs, so that the drugs can directly reach the disease to enhance their efficacy. The commonly used wet compress drugs are: Duhuo, Qingang, Fengfeng, Artemisia Artemisia, Penetrating Bone Grass, Liu Jinu, Wushao Snake, Bile Nanxing, Red Peony, Bone Crushing, Turtle Insect, Cinnamon Branch, Zhu Ling, Ze Yuan, etc., after decoction, apply it to the neck with gauze soaked juice, 2~3 times a day, 30 minutes each time, suitable for cervical spondylosis with qi and blood stasis. Homemade Shujin San: Panax notoginseng, Chuanxiong, blood exhaustion, frankincense, turmeric, myrrh, eucommia, gastrodia, angelica, pepper, musk, black snake, bone crushing, etc., in addition to musk, the others are finely mixed into a paste with rice vinegar, spread on gauze, rub the musk on it, and apply it to the affected area. After drying, the powder can be mixed into a paste with vinegar and then used, each dose can be used 3~5 times, 15 times for 1 course of treatment, suitable for various types of cervical spondylosis.
Typical medical cases
Wang, male, was 43 years old at the time. On 10 May 2002, he was presented with more than one year of post-event numbness. Due to long-term desk work, the patient has felt numbness, stiffness and discomfort after the neck in the past 1 year, dizziness, weakness of the whole body, chest tightness and shortness of breath, numbness in the right fingers, occasional tinnitus, poor sleep, light red tongue, thin white greasy, and smooth pulse. Cervical bioblique X-ray showed that the fourth and fifth cervical vertebrae had bone hyperplasia, and the intervertebral foramen became smaller.
Diagnosis: (upper deficiency and lower stasis type) cervical spondylosis.
Rule: Pulse stagnation.
Prescription: Mountain Crab 15g, American Ginseng 10g, Snake 15g, Bone Crushing 15g, Chuanxiong 15g, Turtle Worm 10g, Gastrodia Gastrodia 15g, Pueraria Pueraria 15g, Chicken Blood Vine 15g, Lotus Leaf 15g, Poria Cocos 15g. Take 8 doses. Take 600ml of decoction per serving, 300ml each time, 2 times a day, after breakfast and dinner.
For external use, use rice vinegar to mix the powder into a paste and apply it to the affected area, 2 times a day.
After 2 weeks of medication, the symptoms disappeared, and after half a year, there was no recurrence.
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 fifth edition of "China Traditional Chinese Medicine News" on January 11, 2023, Jing Ying, Wang Zhongnan, Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Ren Xiyao, Jilin Provincial People's Hospital]