The strength of healthy qi depends on the rise and fall of qi and blood spirit, and the rise and fall of spirit and blood are closely related to the vigorous function of spleen and stomach. As early as Neijing, there were rich discussions about spleen and stomach, such as Su Wen's theory of distinguishing meridians, which said: "Drinking in the stomach, overflowing essence, losing in the spleen, dispersing essence in the spleen, reaching the four branches of lung and water, and the five meridians are parallel." Another example is the Lingshu Nutrition Health Club, which says, "People collect qi from the valley, and the valley gas enters the stomach. It shows that the normal functional activities of human organs and tissues depend on the supply of subtle substances by the spleen and stomach, that is, the so-called "five internal organs are full of qi in the stomach", so the spleen and stomach are called "the official who hides the intestines" and "the foundation of the day after tomorrow"
In the process of Shui Gu's acceptance, decomposition, digestion, absorption, distribution and slag discharge, although the spleen and the stomach cooperate with each other, after all, the spleen is dirty and the stomach is fu-organ, and their characteristics and functions are different, that is, the spleen likes dryness and hates dampness, and the stomach likes moistening and hates dryness for yang; Spleen-qi dominates ascending, while stomach-qi dominates descending; Spleen governs transport and transformation, while stomach governs reception, which are both opposite and unified. Therefore, we must pay attention to the relationship between the spleen and stomach in clinic, and we must not generalize, otherwise pathological changes will occur. At the same time, we should also pay attention to the interaction between spleen and stomach, that is, stomach diseases can reach the spleen, and the spleen can also involve the stomach. For example, the stomach is unhealthy, the stomach can't eat, and the spleen can be transported. However, due to the lack of subtle sources of Shui Gu, there is no such thing as heart and lung, gasification and hematopoiesis, and the spleen is also sick; For example, if the spleen disease does not rise and cannot be transported, then although the stomach can tolerate it, Shui Gu will stay in the stomach because he can't walk alone with body fluids, and his stomach will get sick, or he will have abdominal distension after eating, or he will be tired and sleepy, and his limbs will be weak, or even he will get sick. Therefore, the spleen and stomach must be well coordinated to maintain the balance of the body.
(1) judge whether you can eat or not, so as to determine the sick stomach or spleen.
Stomach governs reception and spleen governs transport and transformation. When the spleen and stomach are normal, they are healthy and energetic, so they have a strong appetite, full of blood, muscular and energetic. The symptom of hunger is that pathogenic factors invade the stomach, leading to the loss of stomach qi, which is caused by insufficient food storage. The treatment is mainly to strengthen the stomach, supplemented by strengthening the spleen. For those with phlegm-dampness and food retention, it can regulate qi and eliminate phlegm, eliminate dampness and guide stagnation, such as Xiangsha Zaqu Weiping Powder or Baohe Pill; Due to the deficiency of stomach yin, it is advisable to be sweet and cold to promote fluid production, nourish yin and regulate the stomach, such as Yiwei decoction. If the stomach is full at the sight of food, it means that the stomach is normal and the spleen is dysfunctional, that is, the so-called stomach is strong and the spleen is weak, and the spleen should be strengthened, supplemented by the stomach; Because of spleen deficiency, it is necessary to replenish spleen and replenish qi, such as four gentlemen and six gentlemen of fragrant sand; Because of spleen-yang deficiency, when it is warm and scorching, Lizhong decoction and the like can be used; If the spleen is wet and sleepy, the spleen is transported to remove dampness and the middle energizer is raised and lowered, just like adding and subtracting Zhengqi powder. If you don't eat hungry, your spleen and stomach will get sick and your appetite will be ignored. Because of qi deficiency, it is advisable to tonify the middle and replenish qi; Because of yang deficiency, it is advisable to warm and tonify deficiency; Deficiency of both qi and yin in spleen and stomach, such as Shen Ling Baizhu Powder or Shiseido Pill, can benefit qi without consuming yin and nourish yin without hurting yang.
(2) Pay attention to the thickness of tongue coating, which can often be cured.
Tongue is the opening of the heart, which means "the pulse of the spleen foot is too yin, which passes through the tongue and disperses under the tongue" (Lingshu Meridian), so the tongue is also related to the spleen. However, the tongue coating attached to the tongue is the result of gastric gasification. "Tongue coating is like grass growing on the ground." Therefore, distinguishing tongue coating is the focus of clinical diagnosis of spleen and stomach diseases. Yellow and thick tongue coating is mostly caused by damp-heat blocking middle energizer, which can cause many diseases, such as abdominal distension, pain, headache, dizziness and insomnia. It should be based on clearing heat and drying dampness, such as Ban Ling Decoction and Huanglian Wendan Decoction; Thick and greasy tongue coating is mostly due to deficiency of yang, and dampness is easy to turn from cold to prosperity. When the fragrance turns to dampness, the bitter temperature turns to dryness and dampness, and the light infiltration turns to diuresis, or the yang needs to turn to dampness, such as Ling Jiang Shu Gui Tang, Shu Jiao Jiu Xin Tang and Ling Wei Tang. In addition, the thick tongue coating is due to the deficiency of yin deficiency and body fluid, and its coating will be thick and dry, which is what Ye called "stomach dryness and gas injury". If there is no moss on the tongue, it is not a good omen, such as "barren land, its soil is withered." If the tongue is light and tender, it is qi deficiency of the spleen and stomach, so it is advisable to use Shenling Baishu Powder, which is sweet and light to feed the spleen; If the tongue is dry and red, which belongs to the dryness of stomach yin, Yiwei decoction and Shashen Maidong decoction should be used; Or invigorating qi and nourishing yin, two-pronged, so that the tongue coating gradually grows thin, white and moist, until the spleen and stomach gradually get angry, it is expected that the disease will recover for a certain period of time, otherwise it will be difficult to treat.
(3) Qi deficiency and yang deficiency should be divided, and blood deficiency and yin deficiency should not be mixed.
For spleen and stomach diseases, we should not only distinguish qi deficiency and yang deficiency from blood deficiency and yin deficiency, but also distinguish qi deficiency and yang deficiency from blood deficiency and yin deficiency. If qi and blood are insufficient and the method of nourishing blood and nourishing yin is misused, it will certainly damage qi and blood, help dampness and produce phlegm, greasy tongue coating, anorexia, abdominal distension and even edema; If the yin blood is insufficient and warm tonics are misused, the yin blood will be consumed more and the condition will be aggravated. Qi deficiency and etiology of Yang Can.
Lead to hyperactivity of yang and excessive consumption of gas; Yang deficiency and qi supplement can make qi stagnation and yang deficiency difficult to recover; Blood deficiency and yin deficiency must also be clearly distinguished. If blood deficiency tonifies yin, or yin deficiency tonifies blood, the medicine syndrome is not suitable, the effect is not good, and other diseases may even breed. Spleen and stomach qi deficiency can be used with sweet products, such as ginseng, surgery, astragalus, grass, coix seed, lentils, lotus seed rice and so on. Ginger, cinnamon, aconite and other pungent, warm and dry products can be added to those with yang deficiency; People with blood deficiency have a thick and sticky taste, such as tortoise plastron, colla corii asini, Radix Rehmanniae, Radix Angelicae Sinensis, sea cucumber, mussel, abalone, eel, grouper and tortoise. ; Yin deficiency patients often use products with thin gas and light taste, such as ginseng, Adenophora adenophora, Ophiopogon japonicus, lily, Polygonatum odoratum, Polygonatum sibiricum and Paeonia lactiflora. Based on syndrome differentiation, qi deficiency, yang deficiency and blood deficiency should be treated. Yin deficiency should be distinguished, and attention should be paid to the relationship and influence between them, such as qi deficiency and yang deficiency, qi and blood deficiency, blood deficiency and yin deficiency, yang deficiency and yin deficiency. , you can often see it at the same time. Therefore, in the treatment, it is necessary to comprehensively consider, highlight the key points, and solve them step by step and in a planned way, so that the curative effect will be good.
(4) For a period of time, Yin and Yang should be equal, both rigid and flexible.
Spleen is yin, body is yin, and yang is used; The stomach is the organ of the yang government, and the body is used for yang and yin. Dampness of spleen and stomach, dryness of yang; The stomach is dry soil, which makes the yin feel safe and happy. Between the spleen and stomach, dryness and dampness are combined, yin and yang are balanced, rising and falling are normal, and transportation and transformation are vigorous. Therefore, in the treatment of spleen and stomach diseases, we must pay attention to restoring the state of dryness and dampness, yin and yang are secret, and the medication must be both rigid and soft, not excessive. For example, chronic atrophic gastritis is often due to insufficient stomach yin. Simply nourish the stomach with sweet and sour products, such as Radix Adenophorae, Radix Ophiopogonis, Mume Fructus, Radix Paeoniae Alba, Radix Glycyrrhizae, etc. Generally, more results can be achieved. If the tongue coating is greasy and the face is yellow and loose stool, it belongs to the deficiency of stomach yin and the weakness of spleen and stomach, so it is necessary to balance the stomach with both rigidity and softness; Or first strengthen the spleen and eliminate dampness, wait for dampness to remove moss, and then nourish yin to treat the stomach; Or combine rigidity and softness alternately, so as not to be greasy and hinder the spleen, and to be too dry and hurt the yin. Only in this way can yin and yang be reconciled and the curative effect can be gradually achieved.
(5) Regulating the spleen to increase and decrease the weight, and treating stomach depression.
"Ascending is spleen health, descending is stomach harmony". For the syndrome of dampness stagnation, qi stagnation and food stagnation, the key is to eliminate dampness and regulate qi, promote digestion and guide stagnation, and restore the ascending and descending nature. Even if it is spleen and stomach deficiency and cold syndrome, when filling sweet herbs, it can't be filled blindly, which will hinder the rise of spleen and the decline of stomach. Therefore, spleen-invigorating and stomach-regulating agents are often combined with qi-regulating and transport-assisting products, such as dried tangerine peel, radix aucklandiae and fructus aurantii. Or replenish and transport the spleen and participate in each other. It's always used to make up for it, but not to cure it. Cimicifuga rhizome, Bupleurum root for clearing yang, and dried tangerine peel for regulating qi and assisting transportation; It is also the purpose of spleen and stomach medicine to add notopterygium root to Shengyang Yiwei decoction to prevent and stimulate stomach qi. For qi deficiency and yang deficiency, even if the stomach yin is insufficient, only sweet, cool and moist products should be used to restore the aging of stomach qi, and greasy and stagnant things should be avoided to achieve the purpose of strengthening and nourishing the stomach.
(six) long-term illness, cold and heat mixed, cold and heat should be treated at the same time.
It is important to "examine the evidence and seek the cause" in treating diseases in traditional Chinese medicine. Therefore, in clinical practice, we should not stick to the rules and copy mechanically, especially for some patients with long course of disease and mixed conditions, and we should flexibly allocate prescriptions according to the condition. For example, some stubborn cases of stomachache, vomiting and diarrhea in clinic are difficult to cure. Self-study to figure out the condition mostly belongs to spleen-qi deficiency and cold syndrome, accompanied by liver and stomach stagnation. However, the stomach is stuffy, sore and sour, qi stagnation, heart fever, hunger, thirst, cold limbs, yellow urine, dry stool, red tongue, thin and white fur, and weak and rapid pulse. At this time, if only warm cooling and heat clearing are used, the heat potential will be stronger, and spleen yang will be stimulated. For those with deficiency cold and mild depression heat, the method of Liantangli can be used; For those who have obvious symptoms of heat and deficiency-cold stagnation, the methods in Treatise on Febrile Diseases, such as Jiaomei Decoction, Zhongjing Huanglian Decoction, Wu Mei Pill and Banxia Xiexin Decoction, all belong to this category, which have been applied properly in clinic and achieved great success.
(7) The disease is difficult to treat, and both liver, gallbladder and kidney are involved.
The liver rises with the spleen, the gallbladder falls with the stomach, the liver and wood disperse the soil, help it transport and transform, and the spleen and soil nourish the wood, which become its purpose of dispersing and discharging. Liver qi stagnation, attacking the spleen and stomach, spleen and stomach unhealthy, deficiency into the liver qi. Therefore, for epigastric pain, vomiting and diarrhea, if the hair is treated as usual, Bupleurum, Paeonia lactiflora, Saposhnikovia divaricata, papaya and other liver-calming products should be added, but it is not suitable for treatment. Or Xiaoyao Powder for regulating spleen and soothing liver, or Yueju Pill for relieving depression and six yin, alternately used with traditional Chinese medicine, can achieve certain curative effect. Spleen is acquired, and kidney is congenital. The two use and nourish each other. The source of spleen deficiency is less, the essence of five internal organs is less, and the kidney is lost; Deficiency of kidney and yang, loss of temperature in middle earth, spleen and stomach rising and falling, poor appetite. Long-term diarrhea, when worrying about the deficiency of kidney essence, is difficult to warm the middle earth, spleen and kidney are treated together, but there are also points of qi deficiency and yang deficiency. If qi deficiency is excessive, it will become more and more tired, which will easily lead to both qi and yin injuries; Yang deficiency, misuse of warm stagnation products, yin and cold are more abundant every time, and wet evil breeds. For patients with chronic diarrhea and deficiency of kidney essence, qi deficiency of spleen and kidney is the main symptom, and the treatment should be mainly to tonify spleen and kidney, such as shuangbu decoction. Once spleen and kidney are full of qi, diarrhea can stop; If diarrhea occurs at dawn, abdominal chills, chills in lower limbs, and delayed pulse, this is spleen and kidney yang deficiency, which should be supplemented by fire. Representative prescriptions are Fuzi Lizhong Decoction and Shen Si Pill.
(eight) pay attention to life conditioning, and finally take medicine to deal with the aftermath.
The occurrence and development of spleen and stomach diseases are closely related to poor diet and emotional stimulation. For example, some patients with stomachache and diarrhea often eat cold and unclean products by mistake during remission or initial recovery, or get angry and worried, which leads to the recurrence or aggravation of their illness. Therefore, we should pay attention to diet regulation, develop good eating habits, such as regular quantitative, do not eat cold and corrupt things, and at the same time pay attention to teasing and anger to avoid excessive emotional stimulation, so as to prevent and treat spleen and stomach diseases and consolidate the curative effect. In addition, for some chronic spleen and stomach diseases that are easy to recur, when the disease is initially cured, timely application of pills and powders for regulating the spleen and stomach can often completely consolidate the curative effect and reduce or prevent the recurrence of the disease.