Etiology and pathogenesis theory of traditional Chinese medicine. Phlegm and blood stasis cause disease

Phlegm and blood stasis are unique etiological concepts in traditional Chinese medicine. Generally speaking, phlegm and blood stasis are the pathological products of human viscera dysfunction under the action of some factors. As secondary pathogenic factors, they can directly or indirectly act on a certain part of human body and some organs and tissues to produce corresponding pathological changes, leading to a series of complex diseases and syndromes.

(1) Drink phlegm

Phlegm drink is a pathological product caused by local disorder of water metabolism in human body, and it is the liquefaction of water in human body. Charcoal drink is a broad concept in traditional Chinese medicine. Phlegm includes wind phlegm, heat phlegm, cold phlegm, stubborn phlegm, wet phlegm and other different types. According to clinical evidence, phlegm can be divided into tangible and intangible. Tangible phlegm drink refers to visible and audible phlegm drink, that is, objectively seen phlegm; Invisible expectoration refers to the common symptoms of expectoration, but you can't directly see the actual expectoration.

The dysfunction of zang-fu organs and the disorder of water-liquid metabolism are the fundamental causes of phlegm production, especially the dysfunction of lung, spleen and kidney, and the disharmony of diuresis in Sanjiao waterway.

Lung failure declared surrender. The lung is mainly used for knots and dressings. It comes from Haruki on the water and has the function of water diversion. When exogenous pathogens invade the lung, causing lung qi to lose the duty of promoting the spirit, body fluid will condense into phlegm. If the lung is qi-deficient, there is no right to treat depression, and the body fluid is lost to xuanhua, or the spleen is deficient in phlegm, and the phlegm is turbid in the lung, that is, the so-called "spleen is the source of life therapy and the lung is the device for storing phlegm", which can make the lung lose its publicity and make Nie gather into phlegm.

The spleen is unhealthy. Under normal physiological conditions, the spleen is responsible for transporting essence. If improper diet hurts the spleen and stomach, or stays in the wetland for a long time, wading in the rain, leading to external dampness and spleen stagnation, or thinking about fatigue and impaired temper, leading to unhealthy gland movement, water will stop gathering and become phlegm. Therefore, there is a saying that "spleen and soil are deficient in dampness, and it is difficult to ascend when it is clear, and it is difficult to descend when it is turbid, and it becomes phlegm when it stays in the diaphragm".

Loss of renal elements. Kidney is the dirty of fire and water, which controls the opening and closing of temperature and regulates the metabolism of water and fluid in the whole body. The transportation of spleen and the gasification of bladder are inseparable from the warmth of kidney yang. Deficiency of kidney yang and weakness of kidney qi will lead to weakness of sweat steam, abnormal opening and closing, qi not returning to yuan, water not transforming qi, and accumulation of dampness and phlegm.

In addition, six exogenous evils affect heat or seven emotions turn into heat, five emotions turn into fire, diet fatigue, and irregular life can all cause dysfunction of viscera, poor transportation and phlegm accumulation, which becomes an indirect factor for phlegm formation.

In the clinical treatment of traditional Chinese medicine, there are various diseases caused by drinking phlegm. The ancients said that "phlegm is the mother of all diseases" and "phlegm gives birth to strange diseases".

Turbidity is not conducive to qi activity. Excessive phlegm and turbidity will hinder the circulation of qi, and the disorder of qi will lead to the stagnation of clear qi and turbid qi. Clinically, chest tightness, cough, shortness of breath, phlegm in pharynx, dizziness, stuffy stomach, loss of appetite, diarrhea, bowel sounds, heavy limbs and so on can often be seen.

Phlegm disturbs the mind and makes people uneasy. Phlegm and turbidity disturb the clearing of the orifices, and it is easy to cover the heart with purple, and the spirit has no owner and goes against the chaos. You can often see sudden fainting, unconsciousness, stubborn dementia, moodiness, vomiting, spitting, or mania, screaming and cursing, climbing over the wall into the house, not avoiding relatives and friends, or destroying things to hurt people, and your strength is too great.

Phlegm channeling meridians, qi and blood impassability. Turbid phlegm flowing through meridians often leads to idle blockage of meridians and poor circulation of qi and blood. If sputum flows into the collaterals of Yangming, shoulder and back traction will cause pain, fistula and numbness of limbs. If the tendons and veins are blocked, it can be seen that the mouth and eyes are skewed and even hemiplegia. Such as phlegm and blood stasis, subcutaneous lump, gall tumor and scrofula can be seen. Phlegm and dampness are blocked in the cell network, and qi does not run, which can cause infertility.

Phlegm-fire disturbs the heart: after great anger, the liver is hot, which encourages Yangming's phlegm-heat, disturbs the mind and becomes crazy. This syndrome is equivalent to the spermatic cord fissure defect in modern medicine. Clinically, there are various emotional abnormalities such as impatience, blushing, arrogant attitude, incoherent speech, endless cursing, destroying things and hurting people, and not avoiding relatives and friends. The tongue is red and yellow with slippery pulse. The main therapeutic methods are calming the heart and resolving phlegm, purging the liver and clearing fire.

Phlegm blocking lung: Phlegm blocking lung collaterals, making it lose its status as Su Xuan. This syndrome is equivalent to bronchitis and bronchial asthma in modern medicine. Clinically, chest tightness, cough, shortness of breath, phlegm in the throat, excessive phlegm and saliva, inability to lie down, thick and greasy tongue coating and slippery pulse. The main treatment is to eliminate phlegm and lung.

Phlegm blocking middle energizer: spleen is unhealthy, phlegm drinking stops, and middle energizer is blocked. This syndrome is equivalent to acute and chronic gastritis and gastric neurosis in modern medicine. Clinically, dizziness, palpitation, chest tightness, loss of appetite, vomiting, diarrhea, heavy limbs and other symptoms are common, with white and greasy fur and slippery pulse. The main treatment is to adjust the gastric frequency.

Wind-phlegm blocking collaterals: internal injury due to strain, spleen losing health, gathering dampness to produce phlegm, phlegm and blood stasis to turn into heat, blocking meridians, improving eyesight and clearing orifices. Or hyperactivity of liver yang, invasion of spleen and stomach, spleen losing health, endogenous phlegm, heat refining into phlegm, phlegm fire running through meridians, improving eyesight and clearing orifices. It can be seen that sudden fainting, unconsciousness, phlegm in the pharynx, hemiplegia of limbs, unkind skin, unfavorable language, thick and greasy fur and slippery pulse. It is equivalent to cerebrovascular accident in modern medicine. The main treatment methods are expelling wind and dredging collaterals, resolving phlegm and inducing resuscitation.

Blood stasis is a symptom of poor blood circulation or even stagnation and coagulation in a certain place. The meaning and concept of blood stasis in traditional Chinese medicine are very extensive. Blood stasis is caused by impassable pulse, menstrual blood, dirty blood and lumps. Some diseases in modern medicine are very similar to blood stasis syndrome in traditional Chinese medicine.

Such as myocardial infarction, cor pulmonale, ascites due to cirrhosis, gastric and duodenal ulcer tumor, etc.

The causes of blood stasis syndrome are very complicated. Traditional Chinese medicine believes that human blood should run in a certain direction and circulate endlessly in veins, otherwise it will lead to the occurrence of blood stasis syndrome. As far as the five internal organs are concerned, blood stasis syndrome is closely related to heart, liver and spleen. Heart governs blood, and the flow of blood in veins depends on the promotion of heart qi. The liver stores blood and regulates blood volume. Spleen produces blood and governs blood. The pathological changes of any organ will lead to blood supply disorder and blood stasis.

Emotional stagnation. "Blood is the mother of qi, and qi is the handsome of blood", which is a summary of the relationship between qi and blood in TCM theory. The two are like a mixture of water and milk. If the mood is too extreme, yin and yang Yang Qi and blood will be lost, leading to qi and blood disorder, which often leads to blood stasis. "Anger leads to exhaustion of qi and blood" and "Anger leads to aversion of qi and even hematemesis" are all descriptions of emotional blood stasis. In daily life, some people have cerebrovascular accidents and myocardial infarction because of excessive emotional fluctuations, which is an example of emotional stagnation.

Blood stasis caused by trauma. Trauma of human body often leads to blood stasis. It is mentioned in Neijing that "there is a fall, and evil blood stays inside". Trauma can often damage meridians, make blood flow out of veins, and produce blood stasis, such as skin abrasion after falling, intracranial hematoma caused by severe trauma, visceral bleeding, etc., which are all concrete manifestations of blood stasis caused by trauma.

Blood stasis caused by exogenous pathogens. Exogenous six yin pathogens can also be a factor leading to blood stasis, especially cold pathogens. As the saying goes, "Cold induces coagulation" is a popular truth. The invasion of cold pathogen into human body can stop blood circulation and cause blood stasis. In addition, dryness and heat can often consume blood, and hot poison fumigation can make blood stasis fester and cause sores. Heat entering the blood can also cause muscle ecchymosis.

Insufficient positive energy leads to blood stasis. Chronic illness consumes healthy qi, while qi deficiency weakens the power of promoting blood circulation and removing blood stasis. What's more, yang is weak, cold is endogenous, and blood vessels can also cause blood stasis. Or body yin deficiency, qi and blood insufficiency, blood stasis stagnation. The veins of blood flow are like river beds. If the water source is sufficient and the water flow is smooth, the sediment is not easy to deposit. On the other hand, the water source is poor, the water flow is slow, and it is easy to clog.

The meridians are blocked, and qi and blood are blocked. Stagnation of blood stasis will block channels and collaterals, and the circulation of qi and blood will lose smoothness. According to the theory of Chinese medicine, "pain can't get through", so pain is a major feature of blood stasis syndrome. The pain seen in blood stasis syndrome is mostly stabbing pain, dull pain and knife pain, and the pain refuses to be fixed by pressing. If the head and orifices are blocked by blood stasis, you will have a headache. Blood stasis in the heart stung the precordial area. Uterine stagnation leads to dysmenorrhea.

If blood stasis persists, new blood will not be born. It has been stated in the Theory of Blood Syndrome and Blood Stasis: "All blood that leaves the meridians is completely incompatible with the blood that nourishes the whole body ... This blood is in the body, so it can't be added to good blood, but it will hinder the transformation of new blood." Blood stasis blocking collaterals will affect the metabolism of new blood, and the orifices and skin will lose nutrition. Therefore, patients with blood stasis syndrome are often accompanied by dull complexion, dark, blue and purple tongue or ecchymosis, sparse and dry hair, easy to break or fall off, pigmentation of skin, desquamation of nails, exposure of blue veins, numbness of limbs and urgency of urination.

Stagnation of blood stasis, blood does not return to menstruation. If blood stasis is internal resistance, and blood can't run normally and overflow, then blood stasis syndrome is often accompanied by bleeding syndromes such as vomiting blood, epistaxis, hematochezia and hematuria. You can also see scars, accumulation, skin petechiae, purple spots, red moles in the blood and other symptoms. Somewhere in the trunk of the limbs.

Blood stasis lasts for a long time, and vital qi fails. Qi is the handsome of blood, blood is the mother of qi, the carrier of blood is qi, and the carrier of qi is blood. The two are mutually useful. If blood stasis persists for a long time and blood flow stagnates, blood will hinder the generation, transport and regulation of qi, leading to the failure of vital qi. Therefore, there is a saying that "blood is not born, and yin is not enough to match yang, which will inevitably damage the five internal organs."

People who suffer from blood stasis for a long time often have symptoms of yin and yang decline, such as palpitation, shortness of breath, dizziness and tinnitus, pale face, dry eyes, emaciation, loss of appetite, aversion to cold and warmth, numbness of limbs and so on.

Although blood stasis syndrome has certain pathogenic characteristics, its clinical manifestations are different due to different parts of blood stasis.

Blood stasis in the heart: emotional injury, prolonged qi stagnation, poor blood flow and blocked collaterals. Or yang deficiency in the body, insufficiency of chest and yin, qi stagnation, and blood stasis in the heart pulse. This syndrome is equivalent to coronary heart disease and myocardial infarction in modern medicine. Clinically, you can often see chest tightness, chest pain, palpitation and restlessness, and even dyspnea, chills in limbs, blue hands and feet, dark purple tongue and dull pulse. The treatment method is mainly to promote blood circulation and remove blood stasis.

Stagnation of blood stasis in the middle: anxiety and anger, prolonged stagnation of qi, liver depression, nausea, obstruction of circulation of qi, poor blood circulation, and stagnation of blood stasis in the middle. This syndrome is equivalent to gastric and duodenal ulcer, acute and chronic gastritis, gastric neurosis, gastric cancer and other diseases in modern medicine. Clinically, upper abdominal pain can be seen, such as acupuncture or knife cutting, involving hypochondriac back, pain refusing to press, incomplete retention, nausea and vomiting, pantothenic acid and noise, loss of appetite, constipation or loose stool, and even hematemesis, bloody stool, dark purple tongue and unsmooth pulse. The main treatment methods are promoting blood circulation, removing blood stasis, regulating qi and relieving pain.

Abdominal stagnation: emotional stagnation, or because of improper diet, partial eclipse addiction, or because of the toxicity of the disease, long-term injury to the liver and spleen. Stagnation of liver qi, stagnation of qi and blood, loss of spleen health, insufficient transport, and stagnation of liver and spleen veins. This syndrome is equivalent to cirrhosis ascites, abdominal tumor, schistosomiasis and other diseases in modern medicine. Clinically, there are dull complexion, purple lips, bloodshot or red moles on the face, neck and chest, mass in hypochondriac or abdomen, hypochondriac abdominal pain, large and solid abdomen, even vomiting, bloody stool and coma. The main treatment methods are promoting blood circulation to remove blood stasis and tonifying liver and spleen.

In addition to the common pathogenic factors such as exogenous pathogens and six evils, epidemic qi, internal injuries and food fatigue, there are also some pathogenic factors that can not be ignored-trauma, accidental injury of insects and livestock and so on.

Accidental injuries can be caused by accidents such as work, life, sports activities or natural disasters. Such as work-related injuries, traffic accidents, load-bearing, falls, violent blows, gold blade injuries, burns or chemical poisoning. , may cause harm to local departments and the whole body, leading to a variety of diseases. Injury usually varies according to the specific etiology and nature.

More common are skin meridian injury, abrasion, bleeding, pain, dislocation, fracture, and clinical manifestations such as coma, high fever and convulsion caused by severe pain, severe blood loss, extensive burns and chemical poisoning. Among them, blood stasis and bleeding are important pathological changes of trauma, and they are also secondary diseases that affect the change of illness.

Etiology can refer to the pathogenic characteristics of blood stasis etiology. Some local skin injuries can be caused by unclean wounds, improper handling, invasion of external evils, etc., and can also be turned into pain, swelling and ulceration due to suppurative infection.

Insect and animal injuries include all kinds of accidental injuries caused by animals. Such as poisonous snake bite, mosquito bite, scorpion bee sting, etc., are very common, and the degree of injury can lead to local itching, numbness, pain, swelling, ulceration, general coma and serious lesions. In addition, "rabies" caused by mad dog bites will cause unique mental disorders, extreme fear of water and other clinical manifestations.