Sa aking mahabang praktikal na karanasan, ako ay nakakalikha ng ilang karanasan sa paggamot ng digestive disorders, at narito ang aking pagbuo ng pag-unawa at karanasan sa paggamot:
Unang, ang pangunahing katangian ng digestive system ay ang pag-akyat at pagbaba
Ang digestive system ay tinaguriang "source of postnatal life" at "source of blood and qi." Ang kanilang functional characteristics ay nakatuon sa pag-akyat at pagbaba. Ang spleen ay responsable sa pagpapalawak ng nutrients at pag-akyat ng clear energy; ang stomach ay responsable sa pagtanggap at pagluluto ng food at pagbaba ng turbid energy. Ang spleen ay maganda kung nag-akyat, ang stomach ay maganda kung nagbaba. Kung ang spleen ay hindi maganda sa pag-akyat, ang clear energy ay hindi makakatawid; kung ang stomach ay hindi maganda sa pagbaba, ang turbid energy ay hindi makakatawid at bumabalik bilang reverse. Ang spleen ay isang yin organ, ang stomach ay isang yang organ, sila ay magkaugnay, isang nag-akyat at isang nagbaba, na nagpapahiwatig ng paggalaw ng energy, na hindi lamang nagpapahintulot sa pagluluto ng food at paghahatid ng nutrients, kundi nagpapahiwatig din ng paggalaw ng yin and yang, blood and qi, at fire and water sa buong katawan, kaya ito ay ang "pivot" ng paggalaw ng katawan. Ang pag-akyat at pagbaba ng digestive system ay interdependent: kung ang stomach ay hindi maganda sa pagbaba, ang spleen ay hindi makakatawid sa pag-akyat; kung ang spleen ay hindi maganda sa pag-akyat, ang stomach ay hindi makakatawid sa pagbaba. Ayon kay Yu Jia Yan: "Kung ang center energy is strong, ang clear energy from food will rise and supply all the vessels, while the turbid energy descends into the large and small intestines through urine and stool." Kung ang spleen's clear energy rises at ang stomach's turbid energy descends, ang blood and qi ay may source, at ang paglabas at pagpasok ay maayon. Kung ang pagluluto ay hindi naganap at ang energy ay hindi makatawid, ang production ay walang simula; kung ang pagbaba ay hindi naganap, ang transmission ay walang paraan, at ang pagkakakalat ay magdudulot ng sakit.
Pangalawa, ang mga sintomas ng digestive disorder ay pangunahin ay dampness at stagnation
Bagaman ang mga sakit sa digestive system ay marami, ang pangunahing mekanismo ay ang dampness at stagnation. Ang digestive system ay tinaguriang "warehouse official" at "sea of food and drink", na walang bagay na hindi maaaring tanggapin, kaya madaling maapektuhan ng pathogenic factors at nananatili sa loob, na nagdudulot ng pagkakalat ng paggalaw at pagbaba, na nagdudulot ng water becoming dampness at food becoming stagnation. Ang dampness blockage, food accumulation, phlegm formation, qi stagnation, blood stasis, at fire stagnation ay lahat ay magkakasundo. Ang mga pathogenic factors at healthy energy ay magkakasundo, ang energy pathway ay nakakalat, at ang dampness at stagnation ay nakakalat sa the middle jiao, na ito ay ang "real stagnation." Kung ang digestive system ay mahina, ang pagluluto ay hindi gumagana, ang paggalaw at pagbaba ay nabigo, ang clear at turbid energy ay nagkakalat, ang dampness at stagnation ay maaaring lumitaw mula sa loob, na tinatawag na "deficiency leading to excess, deficiency with stagnation." Ayon sa "Suwen·Tiao Jing Lun": "Kung ikaw ay masyadong mabigat sa trabaho, ang physical strength ay bumaba, ang food energy ay hindi sapat, ang upper jiao ay hindi gumagana, ang lower jiao ay hindi bukas..." Dahil sa dampness at stagnation bilang pangunahing mekanismo, kaya sa paggamot ng digestive disorders, ang mga pamamaraan ay maaaring warm, cool, tonify, or purge, pero ang pangunahing layunin ay palakasin ang stagnation, alisin ang dampness, at balikan ang pag-akyat at pagbaba.
Pangatlo, ang paggamot ng digestive disorders ay pangunahin ay pag-aayos, kasama ang pagpapalawak ng lung energy
Ang mga sakit sa digestive system ay puno ng dampness at stagnation, kung saan ang spleen ay madalas na dampness, madaling maapektuhan ng dampness; ang stomach ay madalas na heat, madaling maapektuhan ng heat. Lahat ay dahil sa abnormal na paggalaw ng energy. Kaya ang paggamot ng digestive disorders ay hindi dapat masyadong tonify o purge, kundi dapat ay pag-aayos, hanapin ang ugat ng problema, suriin ang dahilan ng imbalance ng energy, at magbigay ng treatment batay sa ugat, balikin ang normal na pag-akyat at pagbaba ng digestive system, upang alisin ang dampness at stagnation, balansehin ang paggalaw, at alisin ang lahat ng sintomas.
Sa pag-aayos ng digestive system, dapat din ay bigyan pansin ang lung energy. Dahil ang spleen ay responsable sa pagpapalawak ng food, na parang "fermenting"; ang lung ay responsable sa paghahatid ng nutrients, na parang "mist." Ang spleen ay kailangan ng tulong ng lung upang maisakatuparan ang paghahatid ng nutrients, ayon sa "Suwen·Jingmai Bie Lun": "Spleen ay nagpapalawak ng nutrients, na papunta sa lungs, na nagpapalawak ng waterways, at nagpapalawak sa bladder." Ang lung ay responsable sa spreading and descending, ang digestive system ay responsable sa rising clear and descending turbid, pareho ay nagpapahintulot sa paggalaw ng energy. Kaya ang paggamot sa spleen ay hindi dapat kalimutan ang pag-aayos ng lung, at ang paggamot sa lung ay dapat suriin ang spleen. Sa paggamot, dapat idagdag ang mga gamot na nagpapalawak ng lung at nagpapalaya sa depression, tulad ng apricot seed, trichosanthes, at ephedra. Si Ye Tian Shi sa "Linzheng Zhinan Yian" ay gumamit ng apricot seed upang palawakin ang lung at alisin ang depression, na nagbukas ng landas para sa lung diuresis, water regulation, at spleen tonification.
Pang-apat, karanasan sa paggamot
1. Spleen dampness with external wind invasion: Ang wind ay tinaguriang "leader of all diseases", at madalas ay kasama ang iba pang pathogenic factors. Ang wind with dampness invasion ay may mga sintomas tulad ng fever, chills, epigastric fullness, nausea, vomiting, dizziness, head heaviness, stiff neck and back discomfort. Gamitin ang Pingwei San with additions of apricot seed, kudzu root, patchouli, cinnamon twig, qianghuo, and schizonepeta to dispel wind and remove dampness from the stomach, na angkop para sa gastrointestinal flu.
2. Cold-dampness trapping the spleen: Ang cold and dampness ay parehong yin pathogenic factors, na madaling makapit sa spleen yang, at magpapahina sa energy flow. Ang mga sintomas ay kasama ang back coldness, chills, epigastric fullness, poor appetite, loose stools, nausea, and vomiting. Gamitin ang Wu Ling San combined with Pingwei San, apricot seed, ephedra, patchouli, cardamom seed, and ginger, upang palakasin ang pag-alis ng dampness at tulong sa spleen. Kung ang cold ay mas malakas kaysa sa dampness, palitan ang cardamom seed sa sandalwood; idagdag ang cinnamon twig at high-quality ginger upang warm the stomach and dispel cold. Kung ang dampness ay mas malakas kaysa ang cold, idagdag ang atractylodes.
3. Damp-heat in the digestive system: Ang damp-heat sa digestive system ay may maraming sintomas, tulad ng gastric pain, burning sensation, dry mouth but not wanting to drink, hungry but not wanting to eat, yellow urine, and constipation—ang mga pangunahing tanda ng damp-heat. Ang paggamot ay dapat sumunod sa prinsipyo ng "clear heat without hindering dampness, and remove dampness without promoting heat." Gamitin ang Sanren Tang with modifications, na madalas idagdag ang winter melon skin and patchouli to remove dampness and clear heat, making the digestive system balanced. For damp-heat diarrhea, use Ge Gen Qin Lian Tang with modifications; if jaundice appears, use Yinchen Wuling San with modifications.
4. Liver qi stagnation with spleen dampness: Ang pag-akyat at pagbaba ng digestive system ay malapit na kaugnay sa liver qi. Kung ang emotions ay depressed, liver qi becomes stagnant and cannot spread, then invades the digestive system, causing imbalance in the movement and transformation, resulting in internal dampness, blocking the middle jiao, and producing symptoms such as epigastric distension, bilateral rib pain, chest tightness, frequent belching, preference for long sighs, loose stools, poor appetite, heavy limbs, and worsening during emotional stress. Treatment should focus on soothing the liver, resolving depression, strengthening the spleen, and drying dampness. If there is more stomach qi stagnation, use Chaihu Shugan San with modifications; if there is more spleen deficiency, use Xiaoyao San combined with Pingwei San; for abdominal pain and diarrhea due to liver-spleen disharmony, use Tongxie Yaofang as the main formula, with additions of patchouli, cardamom seed, green tangerine peel, and aromatic herbs to resolve depression and dry dampness, allowing the liver to spread and the spleen to move dampness, restoring balance and removing dampness.
5. Weak digestive system: People who are constitutionally weak, combined with irregular eating habits, damage the digestive system, leading to impaired function and weakness. Symptoms include shortness of breath, fatigue, pale complexion, poor appetite, and loose stools—signs of qi deficiency. If yang deficiency is present, symptoms may include gastric pain, preference for warmth and pressure, cold extremities, fatigue, poor appetite, worsened by cold and improved by warmth, and clear diarrhea. Long-standing spleen qi deficiency may lead to sinking of central qi, causing prolonged diarrhea, rectal prolapse, or uterine bleeding. For qi deficiency, use Liujunzi Tang to strengthen the spleen and tonify qi; the addition of tangerine peel and pinellia prevents stagnation. For spleen-stomach yang deficiency, warm and disperse cold using Liangfu Wan, Lǐzhōng Tāng, or Huángqí Jiànzhōng Tāng with modifications. For central qi sinking, tonify qi and lift yang, using Bu Zhong Yi Qi Tang with modifications.
6. Spleen deficiency with dampness: This condition is characterized by deficiency at the root and excess at the surface, requiring treatment that strengthens the root and removes the excess, balancing both aspects. Commonly used formulas include dangshen, baizhu, lingzhi, patchouli, cardamom seed, magnolia bark, citric fruit, apricot seed, and ephedra. Dangshen is neutral in nature, sweet in taste, entering the spleen and lung meridians, with effects of tonifying the center and boosting qi; Baizhu is slightly warm, sweet and bitter, specifically targeting the spleen and stomach meridians, with functions of strengthening the spleen, harmonizing the stomach, drying dampness, and promoting diuresis, especially effective in strengthening the spleen and boosting qi; Lingzhi strengthens the spleen, promotes diuresis, harmonizes the stomach, and calms the spirit, and when paired with baizhu, enhances its ability to strengthen the spleen and dry dampness, thus supporting the body and eliminating pathogens; Patchouli is aromatic, slightly warm, with functions of transforming dampness and harmonizing the center, and when used with cardamom seed, helps to expel pathogens and support the body; Apricot seed and ephedra are both bitter and warm, entering the lung meridian, opening the upper jiao lung energy, enabling the lung to spread, and allowing dampness to be moved; Magnolia bark and citric fruit regulate qi and transform phlegm, lifting clear and descending turbid. Together, these herbs have the effect of strengthening the spleen, drying dampness, promoting lung function, and resolving phlegm, suitable for various conditions involving spleen dampness such as edema, diarrhea, and coughing. These formulas can be modified for use in all cases of spleen deficiency with dampness, regardless of whether it is cold or heat.
Pang-anim, mga halimbawa ng kaso:
1. Gastric pain case: Mr. Zhang, male, 45 years old. Gastric distension and pain, chest and rib fullness, frequent sighing, frequent belching, poor appetite, heavy limbs, drowsiness, bowel movements are not smooth, pale tongue with thick white greasy coating, deep wiry slippery pulse. Diagnosis: Liver qi stagnation with spleen dampness. Treatment: Soothe the liver, harmonize the stomach, strengthen the spleen, and remove dampness. Formula: apricot seed 10g, trichosanthes peel 12g, bupleurum 6g, cyperus 9g, poria 20g, patchouli 12g, cardamom seed 9g, magnolia bark 9g, citric fruit 9g, white peony root 12g, licorice 6g, pinellia 6g. After taking 3 doses, gastric distension and pain gradually decreased, bowel movements became normal, appetite improved, and the thick greasy coating on the tongue gradually disappeared. Continued for another 4 doses and fully recovered.
Gastric pain often results from emotional distress, fatigue, irregular eating, or exposure to cold, leading to stagnation of digestive qi. Although the causes are many, the underlying mechanism is gastric qi stagnation, which leads to pain. Based on the characteristic of gastric distension and pain that occurs during emotional distress, treatment is often focused on the liver. Therefore, the formula uses bupleurum and cyperus to soothe the liver and regulate qi; patchouli and cardamom seed to transform dampness and harmonize the stomach; poria to promote diuresis and remove dampness; apricot seed and trichosanthes to open the lung and relieve depression, enabling the lung to spread and allowing dampness to be moved; white peony root and licorice to relieve spasms and stop pain. Together, these herbs achieve the effect of soothing the liver, harmonizing the stomach, strengthening the spleen, and drying dampness.
2. Damp-heat oral ulcer case: Mr. Li, male, 50 years old. Oral ulcers have recurred for over three years. Using cold and cooling drugs makes the ulcers disappear, but diarrhea worsens. Switching to warm and tonifying drugs improves diarrhea, but the ulcers become worse, causing unbearable pain and inability to eat. The episodes are often related to fatigue. Current symptoms include headache, dry mouth without desire to drink, loose stools, fatigue, pale tongue with yellow thick coating, and slippery rapid pulse. Oral mucosa shows congestion, with two ulcers on the edges and tips of the tongue, surrounded by redness. Diagnosis: Damp-heat in the digestive system with fire toxin affecting the mouth. Treatment: Use herbs to clear heat and detoxify: apricot seed 10g, coix seed 15g, cardamom seed 6g, poria 15g, dandelion 15g, schizonepeta 9g, yam 20g, patchouli 10g, bamboo leaf 6g, patchouli 10g, raw licorice 6g. After 4 doses, the oral ulcers healed, pain disappeared, bowel movements normalized. Continue with the original formula for one week, then stop. Follow-up after one year showed no recurrence.
Oral ulcers are commonly caused by stomach heat or yin deficiency with fire. However, this case has been recurring and difficult to heal, accompanied by bloating and loose stools, indicating spleen deficiency and dampness. It is impossible to tonify or purge effectively, requiring comprehensive analysis and diagnosis as damp-heat in the digestive system with stomach heat affecting the mouth. Due to dietary and mental fatigue, the digestive system is damaged, leading to impaired transformation and internal generation of dampness and heat. The damp-heat scorches the spleen's orifice, causing mouth sores and unbearable pain. The formula uses patchouli and bamboo leaf to clear damp-heat; apricot seed to elevate the upper jiao lung energy, allowing dampness to be moved; poria, coix seed, and yam to strengthen the spleen and promote diuresis; patchouli and cardamom seed to transform dampness; dandelion, schizonepeta, and raw licorice to clear heat and detoxify without hindering diuresis, thus clearing heat and removing dampness, leading to quick recovery.
3. External wind-dampness case: Mr. Song, male, 60 years old. Headache, dizziness, heaviness in the head, general fatigue, weakness in the limbs, back coldness, slight fever, nausea, vomiting, poor appetite, coughing, sneezing, white greasy tongue coating, floating and slow pulse. Diagnosis: External wind-dampness. Treatment: Dispel wind, release the exterior, and transform dampness. Formula: apricot seed 10g, ephedra 6g, patchouli 10g, cardamom seed 10g, cinnamon twig 6g, red peony root 9g, poria 10g, kudzu root 9g, fresh ginger 3 slices, jujube 4 pieces. After 2 doses, symptoms improved, but still had heavy limbs and lack of appetite. Used Huoxiang Zhengqi Wan (two boxes) to continue treatment.
External illnesses are often caused by wind, including wind-cold, wind-heat, and wind-dampness. Patients who are obese and have excessive spleen dampness, when exposed to new wind pathogens, develop wind-dampness combination. Treatment should externally dispel wind using cinnamon twig, ephedra, kudzu root, and patchouli, and internally remove dampness using cardamom seed and poria, while also using apricot seed to open the lung and relieve depression, collectively achieving the effect of dispelling wind, releasing the exterior, strengthening the spleen, and drying dampness.
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