This disease belongs to the category of "stroke" and "stroke" in traditional Chinese medicine. As early as Neijing, the understanding of stroke was recorded as "thin syncope". Before the Tang and Song Dynasties, the theory of "exogenous wind" was the main theory, and most of them argued from "internal deficiency and evil". Zhang Zhongjing thinks that "collaterals are virtual", and wind evil entering the middle is the main cause of this disease. According to the depth of evil and the severity of the disease, it can be divided into middle meridians, middle viscera and fu organs. In the treatment, expelling pathogenic factors and strengthening the body resistance are the main methods. After the Tang and Song Dynasties, emphasizing the theory of "internal wind" was a major turning point in the theory of stroke etiology. In the Ming Dynasty, Zhang Jingyue thought that the disease had nothing to do with the external wind, but advocated the theory of "non-wind" and put forward the argument of "internal injury accumulating damage". "Jing Yue Quan Shu" said: "It is not a wind disease, or even a stroke. This disease is more common in sudden falls, mostly caused by fainting. This is caused by internal injuries and overwork, not by exogenous cold. " Ye first made it clear that the argument was based on "internal wind" and pointed out that stroke hemiplegia was caused by "qi deficiency and blood stasis". Libuyanghuanwu decoction is still commonly used to treat hemiplegia in clinic.
Treatment 1. The main symptoms of wind-driven syndrome of yin deficiency are dizziness, tinnitus, backache, sudden deviation of mouth and eyes, slurred speech, drowsiness of fingers and even hemiplegia, red tongue with greasy fur and rapid pulse. Fangji Zhengan Xifeng Decoction consists of Achyranthes bidentata 30g, raw ochre 30g, raw keel 15g, raw oyster 15g, raw tortoise plastron 15g, raw peony 15g and Scrophularia 15g.
Has the effects of nourishing yin, suppressing yang, calming wind and dredging collaterals.
Usage: decoct with water, one dose per day.
In the prescription, Achyranthes bidentata belongs to the liver and kidney meridian, so reusing its blood has the effect of tonifying liver and kidney. This jujube Jing Shu said that it "can make up for what it does, and its nature is good"; Use ochre to suppress liver and reduce reflux; Os Draconis, Oysters, Tortoise Shell and Radix Paeoniae Alba are beneficial to yin and yang, calming the liver and calming the wind; Radix Scrophulariae and Radix Asparagi nourish yin and clear heat, and strong water contains wood; The liver likes to express itself but hates depression. If it is forced to express itself only by products from important towns, it will inevitably affect its expressive power. Therefore, Herba Artemisiae Scopariae, Fructus Toosendan and Fructus Hordei Germinatus are used for clearing away lung heat, soothing the liver and regulating qi, which is beneficial to calming liver yang and latent heat. Ural Glycyrrhiza uralensis Fisch. blended with raw malt can harmonize the stomach and prevent epigenetic drugs from choking the stomach. The compatibility of this prescription is characterized by: reusing drugs with latent heat to nourish yin, relieving symptoms to relieve latent heat, nourishing yin at the root, treating both symptoms and root causes, and treating symptoms mainly. The combination of these drugs has the effect of calming the liver and calming the wind.
According to the statement, the phlegm is hot, the fur is yellow and greasy, and the pathogen is widespread. Adding Danxing, Julie, and Bulbus Fritillariae Cirrhosae for clearing away heat and resolving phlegm; Annoying heat in the chest, add Gardenia and Scutellaria to clear away heat. Fang 'er Jianling Decoction consists of 30 grams of raw yam, 30 grams of Achyranthes bidentata, 24 grams of raw ochre, raw keel 18 grams, raw oyster 18 grams, raw rehmannia root 18 grams, raw white peony root 12 grams and platycladi seed 12 grams.
Has the effects of nourishing yin, suppressing yang, calming wind and dredging collaterals.
Fang Jiesheng's ochre can calm the liver and calm the wind, and its power can clear the stool; Achyranthes bidentata leads blood downward, and Radix Rehmanniae and Radix Paeoniae Rubra clear away heat and nourish yin; Raw keel can calm the liver, lower yang and soothe the nerves.
Usage: decoct with water, one dose per day.
For patients with severe headache, goat horn, concha Haliotidis and Prunella vulgaris are added to clear the wind and yang; For insomnia and dreaminess, mother-of-pearl, dragon's teeth, Polygonum Multiflori Radix and Poria are added to soothe the nerves.
2. The main symptoms of wind-yang disorder syndrome are dizziness, headache, tinnitus, dizziness, sudden onset, skewed mouth and eyes, strong tongue, heavy stagnation of hands and feet, and even paralysis of cattle, red tongue with yellow fur and heavy pulse. Fang Yi Tian Ma Gou Teng Yin, derived from the new meaning of treating miscellaneous diseases, consists of 9 grams of Gastrodia elata, Uncaria 12 grams, Concha Haliotidis 18 grams, 9 grams of Gardenia, 9 grams of Scutellaria baicalensis Georgi, 9 grams of Achyranthes bidentata 12 grams and 9 grams of Eucommia ulmoides Oliv. 9 grams of motherwort, 9 grams of mistletoe, 9 grams of Polygonum Multiflori Radix, and 9 grams of Zhu.
Efficacy of calming the liver and suppressing yang, promoting blood circulation and dredging collaterals.
Usage: decoct with water, one dose per day.
Gastrodia elata and Uncaria are kings, and concha Haliotidis is salty, calming the liver and subduing yang, clearing away heat and improving eyesight. It is compatible with Gastrodia elata and Uncaria rhynchophylla to strengthen the power of calming the liver and calming the wind, and Achyranthes bidentata promotes blood circulation and removes blood stasis, so that qi and blood are reduced. Scutellaria baicalensis Georgi, Shan Zhi Qinggan Xiehuo, Leonurus japonicus Huoxue Lishui; Eucommia ulmoides Oliv Parasitic mulberry nourishes liver and kidney; Caulis Polygoni Multiflori and Rhizoma Bambusae are both adjuvant drugs. When used together, * * * becomes a medicine for calming the liver, calming the wind, clearing away heat and promoting blood circulation, and tonifying the liver and kidney.
According to the statement, if the liver depression turns into fire, the liver fire is inflamed, and the symptoms are severe headache, red eyes, bitter taste, impatience and yellow constipation, then Prunella vulgaris, Radix Gentianae and Radix et Rhizoma Rhei are added. Lycium barbarum, Radix Paeoniae Alba and Corni Fructus can be added for patients with liver and kidney deficiency, dizziness, listlessness and soreness of waist and knees. Teng Yinyuan, a Fang Gou, is a doctor's doctor. It consists of 3 grams of ginseng, 0.9 grams of scorpion detoxification, 6 grams of antelope horn (0.3 grams, ground into powder), 6 grams of gastrodia elata, 6 grams of roasted licorice and 9 grams of Uncaria rhynchophylla.
Efficacy of calming the liver and suppressing yang, promoting blood circulation and dredging collaterals.
Usage: decoct with water, one dose per day.
Tianma Gouteng Pinggan Xifeng Qingre recipe; Ginseng strengthens the spleen and benefits qi to prevent overdose; Scorpion and antelope horn relieve wind and spasm; Roasted licorice mixed with various medicines.
It is said that the potential of yang hyperactivity is higher than that of the author, adding ochre, raw keel and raw oyster, hiding yang in the important town and calming the liver wind; For those with dry stool, Senna leaf and Fructus Cannabis are added to clear the intestines and purge heat.
3. The main symptoms of wind phlegm entering collaterals are numbness of the skin, numbness of hands and feet, sudden mouth and eye deviation, unfavorable language, salivation, strong tongue, even hemiplegia, or contracture of hands and feet, joint pain and other symptoms, thin and white tongue coating and floating pulse. Fang Yi Huatan Tongluo Decoction consists of Pinellia ternata 12g, Poria 9g, Atractylodes macrocephala 12g, Arisaema cum bile 6g, concretio silicea Bambusae 9g, Rhizoma Gastrodiae 9g, Rhizoma Cyperi 6g, Salvia Miltiorrhiza 12g and Radix et Rhizoma Rhei 6g.
Efficacy: expelling wind, resolving phlegm and dredging collaterals.
Pinellia ternata, Poria cocos and Atractylodes macrocephala in the prescription strengthen the spleen and eliminate dampness; Arisaema cum bile and concretio silicea bambusae clearing away heat and resolving phlegm; Tianma calms the liver and calms the wind; Cyperus rotundus soothes the liver and regulates qi, regulates qi and smoothes qi, and helps the spleen to eliminate dampness; Cooperate with Danshen to promote blood circulation and remove blood stasis; Rhubarb purges heat and cools blood to prevent excess dirty. The dosage of rhubarb should be light, with phlegm as the degree, not excessive.
Usage: decoct with water, one dose per day. Fangerda Gentiana Decoction consists of Gentiana macrophylla 12g, Ligusticum Chuanxiong 8g, Radix Angelicae Pubescentis 8g, Radix Angelicae Sinensis 8g, Radix Paeoniae Alba 9g, Gypsum Fibrosum 8g, Glycyrrhrizae Radix 3g, Notopterygii Rhizoma 6g, Radix Saposhnikoviae 8g, Radix Angelicae Dahuricae 8g, Scutellariae Radix 8g, Atractylodis Rhizoma 12g and Poria.
Efficacy: expelling wind, resolving phlegm and dredging collaterals.
Usage: decoct with water, one dose per day.
Prescription and syndrome take wind evil as the etiology, the disease is located in meridians, and the pathogenesis is that vital qi is deficient first, and wind evil takes advantage of it, resulting in stagnation of qi and blood. In the prescription, Gentiana macrophylla can dispel wind and dredge collaterals; Notopterygii Rhizoma, Radix Angelicae Pubescentis, Radix Saposhnikoviae, Radix Angelicae Dahuricae and Asari are used for expelling wind; Angelica sinensis, Radix Paeoniae Alba, Radix Rehmanniae Preparata and Rhizoma Chuanxiong nourish blood and soften tendons, promote blood circulation and dredge collaterals; Atractylodes macrocephala and Poria cocos are beneficial to qi and spleen; Scutellaria baicalensis Georgi, Gypsum Fibrosum and Radix Rehmanniae are used for clearing heat and cooling blood; Glycyrrhiza uralensis Fisch blends various drugs.
According to the statement, compared with the author, Arisaema cum bile and concretio silicea bambusae are added to patients with phlegm heat.
4. The main symptoms of phlegm-heat fu-organs syndrome are headache, dizziness, upset, irritability, sudden attack, hemiplegia, tongue askew, pale or silent tongue, unclear or confused, acute limbs, excessive and sticky phlegm, abdominal distension, constipation, dark red tongue or petechiae, yellow and greasy fur, slippery or astringent pulse. Fang Yi Ren Tao Chengqi Decoction comes from Treatise on Febrile Diseases and consists of 12g peach kernel, 12g rhubarb, 6g cassia twig, 6g licorice and 6g mirabilite.
It has the effects of clearing away fu-organs, clearing heat, calming wind and resolving phlegm.
Usage: decoct with water, one dose per day.
In the prescription, peach kernel and rhubarb are both monarch drugs, peach kernel promotes blood circulation and breaks blood stasis, rhubarb breaks blood stasis and purges heat, and they are compatible, which can treat both phlegm and heat. Guizhi promotes blood circulation.
Note that you can also take zhibaodan or angong Niuhuang pill to clear your heart and begin to understand. Can also use Xingnaojing or Qingkailing injection intravenous drip. Fang Er Xing Lou Cheng Qi Decoction consists of Arisaema cum bile 65438 00g, Fructus Trichosanthis 65438±05g, Radix et Rhizoma Rhei 65438 00g, Natrii Sulfas 65438 00g, Cynanchum atratum 65438 00g and Cortex Lycii 65438 00g.
It has the effects of clearing away fu-organs, clearing heat, calming wind and resolving phlegm.
Usage: decoct with water, one dose per day.
Cheng Qingfu purges heat, and Arisaema cum bile resolves phlegm and calms wind. Fructus Trichosanthis can eliminate phlegm, open chest and relieve arthralgia; Cynanchum atratum and Lycium barbarum peel clear heat and cool blood.
According to the statement, if the fu-organs are excess heat, abdominal distension and constipation, and the fur is yellow and thick, the yellow, sodium sulfate and immature bitter orange should be increased; Gaza ginseng, Ophiopogon japonicus and Dendrobium nobile are suitable for patients with phlegm-heat injury to body fluids, dry red tongue and yellow and rough fur.
5. The main symptoms of phlegm-fire and blood stasis syndrome are: sudden onset, dizziness or drowsiness, hemiplegia, restlessness, sleepless at night, red face, bad breath, restlessness, yellow and greasy fur. Fang Yi Lingyang Gouteng Decoction originated from the popular Treatise on Febrile Diseases, and consists of antelope horn 4.5g, Uncaria 9 g, frosted mulberry leaf 6 g, chrysanthemum 9 g, Radix Rehmanniae15g, Radix Paeoniae Alba 9 g, Bulbus Fritillariae Cirrhosae12g, Lophatherum Bambusae12g, Poria 9 g and Radix Glycyrrhizae 3 g.
The effects of calming wind and clearing fire, resolving phlegm and inducing resuscitation.
Usage: decoct with water, one dose per day.
The antelope horn in the prescription enters the liver meridian, cooling the liver and calming the wind; Uncaria rhynchophylla has the functions of clearing heat, calming liver, calming wind and relieving spasm, and * * * is the monarch drug. Compatible with mulberry leaves and chrysanthemum, it can cool and stop diarrhea, clear away heat, calm the liver and calm the wind, so as to strengthen the effect of cooling the liver and calming the wind. It was used as a courtier medicine. Fresh Radix Rehmanniae, Radix Paeoniae Alba and Glycyrrhrizae Radix are combined, sweet and sour, nourishing yin and promoting fluid production, softening liver and relaxing muscles and tendons. These drugs can be combined with antelope horn, Uncaria rhynchophylla and other drugs to clear heat, cool liver and calm wind, treat both the symptoms and root causes, and enhance the effect of calming wind and relieving spasm; Evil heat is rampant, and it is easy to burn body fluid into phlegm, so Fritillaria cirrhosa and fresh bamboo shavings are used to clear away heat and resolve phlegm; Heat disturbs the mind, and Shen Fu can calm the liver, calm the heart and soothe the nerves, all of which are adjuvant drugs. Raw licorice is also a medicine to reconcile various medicines. The compatibility of this prescription is mainly based on drugs for cooling the liver and calming the wind, and it is a representative prescription for cooling the liver and calming the wind.
According to the statement, if the phlegm resistance is higher than the airway, and the phlegm in the throat is rumbling, you can take bamboo drain water and monkey jujube powder to eliminate phlegm and calm down; The liver fire is vigorous, the face is red and the eyes are red, and the pulse is strong. Gentiana macrophylla should be added as appropriate.
6. The main symptoms of the syndrome of yin exhaustion and yang death are sudden fainting, unconsciousness, closing eyes and opening mouth, slight nasal snoring, cold hands and feet, sweating, spontaneous help, weakness of limbs, and heartbroken of yin and yang. Fang Yi Shenfu Decoction consists of 12g ginseng and 15g cooked aconite root, which is produced from Yao Lei Zhengti.
Efficacy: Yiqi Huiyang Gutuo.
Usage: decoct with water, one dose per day.
Ginseng in the prescription greatly tonifies the vitality, and aconite warms the kidney and strengthens the yang. The combination of the two drugs has the functions of invigorating qi, restoring yang and strengthening the body. Shenmai injection or Shengmai injection can also be used for intravenous drip.
If you are unconscious, you can wake up by intravenous drip of Xingnaojing; If it is manic, you can take Zixuedan; If the heart-yang is about to break away, the patient can also strengthen the function of dredging fu-organs, lowering turbidity and detoxifying through enema. The formula is red ginseng 2438+05g, cooked aconite 15g, cinnamon 6g, dogwood 12g, keel 10g, oyster 10g, Polygonatum odoratum 12g, and roasted licorice 6g.
Efficacy: Yiqi Huiyang Gutuo.
Usage: decoct with water, one dose per day.
This recipe can relieve red ginseng and replenish vitality, warm aconite, warm cinnamon, consolidate cornus officinalis keel and oyster, and roast licorice with Polygonatum odoratum to nourish yin and replenish qi.
If you are in a coma, you can wake up by intravenous drip of Xingnaojing. 8. The main symptoms of qi deficiency and blood stasis syndrome are strong tongue, withered limbs, weakness of limbs, sallow complexion, pale purple tongue or ecchymosis, thin white fur, thin and astringent pulse or weakness. Fang Yi Buyanghuanwu Decoction consists of 0/20g of Radix Astragali/kloc-,3g of angelica tail, 5g of Radix Paeoniae Rubra, 3g of Lumbricus, 3g of Rhizoma Chuanxiong, 3g of Carthami Flos and 3g of Semen Persicae.
Efficacy: Yiqi Yangxue, Huayu Tongluo.
Usage: decoct with water, one dose per day.
Raw astragalus is reused in the prescription, which greatly supplements the vitality of the spleen and stomach, makes qi and blood run, removes blood stasis and unblocks collaterals, and is the monarch medicine. Angelica tail is good at promoting blood circulation and removing blood stasis without hurting blood, so he is a minister medicine. Ligusticum Chuanxiong, Radix Paeoniae Rubra, Semen Persicae and Carthami Flos help angelica tail to promote blood circulation and remove blood stasis, and Lumbricus dredge channels and activate collaterals, all of which are adjuvant drugs. The compatibility of this prescription is characterized by a large number of qi-invigorating drugs combined with a small number of blood-activating drugs, which can promote healthy qi and blood circulation without damaging healthy qi, and play a role in invigorating qi, promoting blood circulation and dredging collaterals.
According to the statement, blood deficiency is very serious, and Lycium barbarum and Polygonum multiflorum are added to replenish blood; Cold limbs, loss of yang temperature, plus cassia twig to warm the meridians and dredge the pulse.
Selected medical records Huang, female, 54 years old. First visit:19761June 14.
Known to have a history of hypertension, he suddenly developed the disease ten days ago and got better after being rescued by integrated traditional Chinese and western medicine. Inscription: confusion, right hemiplegia, astringent speech, constipation, thready pulse, red tongue and little body fluid. Deficiency of kidney yin, water containing no wood, sudden movement of wind and yang, internal resistance of phlegm and heat, infatuation, imitating the meaning of Dihuang Yinzi.
Prescription: Radix Rehmanniae 18g, Radix Glehniae 18g, Radix Ophiopogonis 15g, Rhizoma Chuanxiong (parched first) 18g, Herba Cistanches 12g, Radix Polygalae 6 g, Radix Salviae Miltiorrhizae 12g, and Flos Sophorae 650.
Second visit: 65438+1October 20th. Conscious, able to move slightly on the right side, able to eat a little, but still awkward to speak, red tongue, thin pulse. Wind-yang gradually subsides, kidney-yin injury has not recovered, and phlegm-heat has changed, which will aggravate the injury. Remove Radix Curcumae, concretio silicea bambusae, and add 6 grams of earthworm. 12.
Third consultation:165438+1October 6th. The activity of the right hemisphere is getting better and better, the speech is getting clearer and clearer, the stool is normal, the tongue is red, and the pulse is thin. The kidney yin injury gradually recovered, and the wind-yang phlegm-heat was also reduced. The second child was used to replenish the heart and kidney.
Radix Rehmanniae 12g, Radix Glehniae 18g, Radix Ophiopogonis 15g, Dendrobium candidum 18g (fried first), Herba Cistanches 12g, Radix Polygoni Multiflori Preparata 15g, Poria Zhu 9g, Radix Polygalae Zhu 6g, Radix Polygalae Zhu.
After taking the above medicine, his speech is clear, his right limb can move, he walks on crutches, his tongue is red and his pulse is small. In the process of recovery, the former method should still be adjusted to deal with the aftermath.
(waiting for Zhang Bokun's medical case. Shanghai Science and Technology Press. 1979)