Contents 1 Pinyin 2 Overview 3 Stroke in the middle viscera 4 Stroke in the middle viscera 5 Syndrome differentiation treatment of the middle viscera 5.1 Closure of syndrome 5.1.1 Acupuncture treatment of stroke and closure of syndrome 5.1.2 Yang closure 5.1.2.1 Symptoms of Yang closure 5.1.2.2 Syndrome analysis 5.1.2.3 Treatment method 5.1.2.4 Prescription treatment for Yang blockage 5.1.2.5 Wind and fire blockage 5.1.2.5.1 Symptoms of wind and fire blockage 5.1.2.5.2 Syndrome analysis 5.1.2.5.3 Acupuncture treatment for wind-fire obscuration 5.1.2.6 Phlegm-fire obscuration 5.1.2.6.1 Symptoms of phlegm-fire obscuration 5.1.2.6.2 Syndrome analysis 5.1.2.6.3 Acupuncture treatment for phlegm-fire obscuration 5.1.2.7 Phlegm fire Blood stasis 5.1.3 Yin 5.1.3.1 Symptoms of yin 5.1.3.2 Syndrome analysis 5.1.3.3 Treatment of yin 5.1.3.4 Prescriptions for yin 5.1.3.5 Phlegm and dampness in the orifice 5.1.3.5.1 Phlegm and dampness Symptoms of phlegm-dampness syndrome 5.1.3.5.2 Syndrome analysis 5.1.3.5.3 Acupuncture treatment of phlegm-dampness syndrome 5.1.3.6 Phlegm, turbidity and blood stasis syndrome 5.2 Syndrome withdrawal 5.2.1 Stroke symptoms 5.2.2 Syndrome analysis 5.2 .3 Treatment methods 5.2.4 Prescriptions for stroke treatment 5.2.4.1 Prescription 1 5.2.4.2 Prescription 2 5.2.5 Acupuncture treatment for stroke 5.2.5.1 Prescription 1 5.2.5.2 Prescription 2 6 About stroke 7 References attached: 1 Prescriptions for treating Zang Zang 2 Zhong Fu Zang in ancient books 1 Pinyin
zhòng fǔ zàng 2 Overview
Stroke·Zhong Zang (apoplexy involving zang and fuviscera[1]) is It refers to stroke syndromes in which the disease is in the organs and is characterized by sudden coma, inability to speak, and often mental changes [1]. It is divided into middle-fu stroke and middle-organ stroke [2]. 3 Zhongfu apoplexy
Zhongfu apoplexy (apoplexy involving fuviscera[1]) refers to the entry of evil into the fuviscera, resulting in sudden fainting. After waking up, hemiplegia, squinting of the mouth and eyes, difficulty in speech, or accompanied by small and large symptoms can be seen. Obstruction of stool and other common symptoms of severe stroke [2]. 4 Zangzang apoplexy
Zangzang apoplexy (apoplexy involving zangviscera[1]) refers to the more common symptoms of evil entering the zangviscera, such as sudden coma, inability to speak, slow lips, drooling at the corners of the mouth, etc. The most severe syndrome of stroke is when the fu organs are slightly severe [2]. The disease is in the organs. Symptoms include sudden coma, confusion, hemiplegia, and astringent speech [3]. 5 Syndrome Differentiation and Treatment of Zang-Fu Organs
According to the situation of good and evil, Zang-Fu Organs can be divided into two categories: closed syndrome and out-of-syndrome [3]. They are all critical syndromes with different treatments, so they must be distinguished clearly for correct clinical treatment. [4]
The main syndrome of closure is internal closure due to excessive evil, which is a syndrome and it is urgent to eliminate the evil [3]. Symptoms include trismus, clenched hands, flushed face, thick qi, phlegm in the throat, and obstruction of bowel movements [3]. This is caused by the reversal of qi and fire, blood pooling in the upper part, and phlegm blocking the clearing of the orifices [3].
The main symptom of detachment is the desire to detach Yang Qi, which is a deficiency syndrome; it is urgent to correct the condition [3]. Symptoms include opening of the eyes and mouth, enuresis on the hands, cold limbs and weak pulse, etc. This is caused by the weakening of the true energy and the sudden loss of the vitality [3].
In clinical practice, closure of syndrome is more common and withdrawal of syndrome is less common. However, closure and de-certification can transform into each other, and can also be seen at the same time. If the closed syndrome is not treated in time or is treated incorrectly, or the good cannot overcome the evil, it may turn into out-of-syndrome. After treatment, the symptoms will gradually disappear, the symptoms will gradually disappear, and there may be a chance of improvement. Therefore, in the process of transformation from obscuration to abstention, symptoms of obscuration and escape from each other often appear. Therefore, during treatment, we must always grasp the priority of the specimen and the principles of strengthening the body and eliminating evil. Under normal circumstances, the main method of treating syndromes is opening and closing, dispelling evil, and treating the symptoms; the main method of treating syndromes is consolidating and strengthening the symptoms, and treating the root cause. Those who are isolated from each other must weigh the priorities and take into account both the symptoms and root causes. If symptoms of syndrome release appear during closed syndrome, it is a tendency for the condition to become more serious. While eliminating evil, attention should be paid to strengthening the body. [4] 5.1 Apoplexy with blocking syndrome (apoplexy with blocking syndrome [1]) refers to the internal blockage of evil into the blood, resulting in sudden fainting, unconsciousness, trismus, and clenched hands. Symptoms of stroke are common symptoms [1].
The main symptoms of closed syndrome are sudden fainting, unconsciousness, trismus, mouth shut, clenched hands, closed urine and defecation, and strong spasm of the limbs. Depending on the presence or absence of heat signs, it can be divided into Yang closure and Yin closure. [4] 5.1.1 Acupuncture treatment for stroke syndrome
Acupuncture therapy can be combined with acupuncture treatment to treat stroke syndrome, and the effect will be faster [4].
To close the syndrome, the main points are Renzhong, Shishijing, Taichong, Fenglong and Laogong [3]. Trismus is associated with cheekbones and Xiaguan; strong tongue and mute speech are associated with mutemen and Lianquan[3]. 5.1.2 Yang Shu 5.1.2.1 Symptoms of Yang Shu
In addition to sudden fainting, unconsciousness, trismus, mouth shut, hands clenched, urine and defecation closed, and strong spasms of limbs, There is also a red face, hot body, thick breath, bad breath, restlessness, yellow and greasy coating, and a stringy and rapid pulse [4]. 5.1.2.2 Syndrome analysis
The liver yang is violently expanded, the yang is rising and the wind is moving, the qi and blood are reversed, and the phlegm and fire are brought up to clear the orifices, so they suddenly become faint and unconscious. That is what the "Huangdi Nei Jing Su Wen·Tiao Jing Lun Chapter" says: "When blood and Qi go up together, it is a big disease." The evil of wind-fire and phlegm-heat closes the meridians internally, so the face becomes red, the body is hot, the mouth is numb, the hands are clenched, the breath is thick, bad breath, constipation, yellow and greasy coating, stringy and slippery pulse, etc. [4] 5.1.2.3 Treatment method
Clear the liver and extinguish wind, and the pungent coolness will open the mind. [4] 5.1.2.4 Prescriptions for the treatment of yang blockage
First, take the prescription Zhibaodan by gavage (or use nasogastric feeding) [Remarks] Zhibaodan ("Taiping Huimin Heji Bureau Prescription"): cinnabar, Musk, benzoin, gold and silver foil, rhinoceros horn, bezoar, amber, realgar, tortoiseshell, borneol or Angong Niuhuang Wan [Note] Angong Niuhuang Wan ("Febrile Disease Treatise"): bezoar, turmeric, rhinoceros horn, coptis, Cinnabar, borneol, pearl, gardenia, realgar, skullcap, musk, and gold foil are pungent and cool to penetrate the orifice; and use antelope horn decoction [note] antelope horn decoction ("Yi Chun Yi Yi"): antelope horn, turtle version, raw rehmannia, Add or subtract paeonol, white peony root, bupleurum, mint, cicada, chrysanthemum, prunella vulgaris, and cassia to clear the liver and extinguish wind, nourish yin and subdue yang. In the prescription, antelope horn is the main medicine for clearing the liver and extinguishing wind. It is mixed with chrysanthemum, prunella vulgaris and cicada to make the fire subside and extinguish the wind, so that the qi and blood will return; Guban, white peony root and stone cassia nourish yin and subdue yang; paeonol, Raw rehmannia cools the blood and relieves heat. If there is convulsion, whole scorpions, centipedes, and zombie silkworms can be added. For those with excessive phlegm, Zhuli, Tianzhuhuang, and Dannanxing can be added. For those with excessive phlegm and lethargy, turmeric and calamus can be added to enhance the ability to clear away phlegm and penetrate the orifices. [4] 5.1.2.5 Wind-fire blocking orifices
Stroke·apoplexy with syndrome of wind-fire blocking orifices[1] means that wind-fire disturbs the orifices, blinds the clear orifices, and causes sudden coma. Servant, unconscious, hemiplegic, limbs convulsed, mouth and eyes squinting, eyes squinting or looking straight, face and eyes red. Silence of mouth, strong nape, tightness in holding hands, and even twitching, red tongue, and heavy pulse are common stroke syndromes [2]. 5.1.2.5.1 Symptoms of Wind and Fire Closure
Sudden fainting, unconsciousness, squinting or looking straight, flushed face, stiff limbs, mute mouth, strong neck, clenched hands Acute, severe convulsions, opisthotonus, red or crimson tongue, yellow and dry or burnt fur, stringy and rapid pulse. [5] 5.1.2.5.2 Syndrome analysis
Liver yang is extremely hyperactive, yang rises and wind moves, qi and blood are blocked and the orifices are closed, and the orifices are closed and the gods are hidden, and the gods cannot guide the qi, so there is a sudden appearance. Fainted and unconscious. The wind and fire are elevated, the qi and blood are reversed, and the meridians are blocked, so the face is red and the eyes are red[5], the eyes are squinting or looking straight, the limbs are rigid, the mouth is silent and the neck is strong, the hands are clenched and nervous or twitching, and the angles and arches are opisthotonus. and other symptoms. The tongue and pulse are also signs of wind and fire being closed in reverse. 5.1.2.5.3 Acupuncture treatment for wind and fire closed orifices
[5]
Treatment method: rejuvenate the mind, clear the liver and extinguish the wind. The main points are the Du Meridian and Hand Jueyin Pericardium Meridian.
Prescription: Shuigou, Shixuan, Neiguan, Fengchi, Taichong
According to the syndrome: for severe convulsions, Jiahegu and Yanglingquan.
Acupuncture and moxibustion methods: Acupuncture and purgative method. Shi Xuan used a three-edged needle to prick the blood.
Fang Yi: The Du Meridian "enters the brain", Shuigou belongs to the Du Meridian, and acupuncture can open up the mind and wake up the mind. Shixuan bloodletting is a commonly used first aid method, which can regulate the qi and blood of the twelve meridians to open and close the orifices. Neiguan is a collateral point of the pericardium meridian, and the pericardium is the outer guard of the heart. It can not only receive evil spirits on behalf of the heart, but also give orders on behalf of the king. The heart governs the gods, so acupuncture at Neiguan can regulate the mind, open the mind, and restore the mind's clarity. Taichong and Fengchi can clear the liver and extinguish wind. 5.1.2.6 Phlegm-fire blocking orifices
Stroke·apoplexy with syndrome of phlegmfire blocking orifices[1] refers to the combination of phlegm-fire and phlegm-fire blocking orifices, which obscures the clearing of the orifices, leading to sudden coma and inability to clear the orifices. Common symptoms include hemiplegia, strong spasm of limbs, slanted mouth and eyes, snoring and phlegm, flushed face and eyes, restlessness, constipation, red tongue, yellow and greasy coating, slippery and heavy pulse. The syndrome of stroke closure [2]. 5.1.2.6.1 Symptoms of phlegm-fire obturation
Sudden fainting, unconsciousness, restlessness, stiffness of limbs, excessive phlegm, shortness of breath, looking straight into the eyes, snoring, body heat, big Constipation, red tongue, yellow and thick greasy coating, slippery and rapid pulse.
[5] 5.1.2.6.2 Syndrome analysis
Phlegm-dampness is accumulated inside, which turns into fire due to stagnation. The phlegm-fire is covered with clear orifices, so sudden fainting and unconsciousness are seen. Restlessness and restlessness are caused by phlegm fire disturbing the mind. When phlegm fire blocks the meridians, stiffness of the limbs, excessive phlegm, shortness of breath, and direct vision will appear. Tongue and pulse, constipation and body heat are also signs of phlegm-fire. [5] 5.1.2.6.3 Acupuncture treatment for phlegm-fire and closed orifices
[5]
Treatment method: rejuvenate the mind, relieve phlegm and clear away heat.
Acupoint selection: The main points are the Du Channel, Hand Jueyin Pericardium Meridian and Foot, Yangming Stomach Meridian. Qishuigou, Shixuan, Neiguan, Fenglong and Tiantu.
Acupoints are allocated according to the syndrome: for patients with anuria, add Zhongji and Hegu.
Acupuncture and moxibustion methods: Acupuncture and purgative method. Shi Xuan used a three-edged needle to prick the blood.
Fang Yi: Shuigou and Neiguan are as mentioned above. Shixuan can not only clear the body and open the mind, but also relieve heat. The spleen is the source of phlegm, and Fenglong is a point on the stomach meridian of Foot Yangming. It uses phlegm to resolve phlegm and turbidity, relieve constipation and clear away heat. Combination with Tiantu can enhance the effect of eliminating phlegm. 5.1.2.7 Blockade of phlegm-fire and blood stasis
Stroke·apoplexy with syndrome of blockade caused by phlegmfire stasis and blocade[1] refers to blockade of phlegm-fire and stasis, resulting in sudden fainting and unconsciousness. Common symptoms include clenching the teeth, holding the mouth shut, clenching the hands tightly, constriction of urine and feces, strong convulsions in the limbs, red face and hot body, thick breath and bad breath, restlessness, red tongue, yellow and greasy coating, slippery and heavy pulse, etc. The syndrome of stroke closure [2]. 5.1.3 Yin blockage 5.1.3.1 Symptoms of Yin blockage
In addition to the above-mentioned symptoms of Yin blockage, there are also white face and dark lips, no trouble lying still, lukewarm limbs, excessive phlegm and saliva, and white and greasy coating. , the pulse is slow and slow. [4] 5.1.3.2 Syndrome analysis
The phlegm-dampness is excessive, the wind carries the phlegm-dampness, the upper part of the body clears the orifices, and the meridians are closed internally, so suddenly fainting, unconsciousness, unable to open the mouth, hands and feet Symptoms such as firm grip and strong spasm of limbs. Phlegm-dampness belongs to yin, so it is not troublesome to lie still. Phlegm-dampness blocks Yang Qi and cannot warm the body, so the limbs are not warm, and the face is white and the lips are dark. White and greasy coating, slow and slippery pulse, etc. are all signs of excessive dampness and phlegm. [4] 5.1.3.3 Treatment of yin blockage
Remove phlegm and extinguish wind, and use pungent and warm medicine to rejuvenate the mind. [4] 5.1.3.4 Prescriptions for the treatment of Yin blockage
Urgent use Suhexiang pills [Remarks] Suhexiang pills ("Taiping Huimin Heji Bureau Prescription"): Atractylodes, agarwood, rhinoceros horn, Cyperus rotundus, cinnabar, Dissolve myrobalan, sandalwood, benzoin, agarwood, musk, clove, peppercorns, styrax oil, fumigation incense, and borneol in warm boiled water and take it orally (or use nasogastric feeding) to warm the orifices, and use Ditan Decoction [ Remarks] Ditan Decoction ("Yan's Jisheng Prescription"): Decoction of Pinellia ternata, Nanxing, tangerine peel, Citrus aurantium, Poria, ginseng, Acorus, bamboo root, licorice and ginger. In the prescription, Pinellia ternata, Tangerine, Poria, and Bamboo Ru are used to dry dampness and resolve phlegm; Acorus calamus and Dannanxing are used to clear the mind and eliminate phlegm; Citrus aurantium is used to reduce Qi and facilitate the downward movement of wind-induced phlegm. Gastrodia elata and Uncaria can be added to calm the liver and calm wind. [4] 5.1.3.5 Phlegm and dampness clouding the orifices
Stroke·apoplexy with syndrome of phlegmdamp clouding orifices[1] refers to phlegm and dampness clouding the orifices, resulting in sudden coma and drowsiness. Hemiplegia, paralysis of limbs, dull complexion, excessive phlegm and saliva, cold limbs, dull tongue, white and greasy coating, etc. are common stroke syndromes [2]. 5.1.3.5.1 Symptoms of phlegm-dampness and blindness
Sudden drowsiness, hemiplegia, paralysis of limbs, dull complexion, excessive phlegm and saliva, cold limbs, pale tongue, white and greasy coating, The pulse is slow, slippery or slow. [5] 5.1.3.5.2 Syndrome analysis
The phlegm-dampness is excessive, the wind carries the phlegm-dampness, the upper part of the body clears the orifices, and the internal meridians are closed, so sudden coma, hemiplegia, and paralysis of the limbs occur. Phlegm-dampness is yin, which blocks Yang Qi and prevents the limbs from being warm, so the complexion is dull and the limbs are cold. Excessive phlegm and saliva, tongue and pulse are all symptoms of excessive phlegm and dampness. [5] 5.1.3.5.3 Acupuncture treatment of phlegm and dampness in the orifices
[5]
Treatment: Rejuvenate the mind, relieve phlegm and extinguish wind.
Acupoint selection: Mainly points on the Governor Meridian, Hand Jueyin Pericardium Meridian and Foot Yangming Stomach Meridian. Take Shuigou, Shixuan, Neiguan, Zusanli, Sanyinjiao, Fenglong and Qihai.
According to the syndrome, acupoints should be assigned: If the phlegm is not satisfactory, add Tiantu.
Acupuncture and moxibustion methods: The needles are used for flat tonic and diarrhea method, and the ten points are used for bleeding. Qihai and Zusanli can be used together with acupuncture.
Fang Yi: The Du Meridian "enters the brain", Shuigou belongs to the Du Meridian, and acupuncture can open the mind and wake up the mind. Shixuan bloodletting is a commonly used first aid method, which can regulate the qi and blood of the twelve meridians to open and close the orifices. Neiguan is a collateral point of the pericardium meridian, and the pericardium is the outer guard of the heart. It can not only receive evil spirits on behalf of the heart, but also give orders on behalf of the king. The heart governs the gods, so acupuncture at Neiguan can regulate the mind, open the mind, and restore the mind's clarity. The combination of Zusanli and Sanyinjiao can strengthen the spleen and stomach and warm up phlegm. Adding Fenglong can enhance the effect of eliminating phlegm. Qihai can warm and unblock yang qi to treat lukewarm limbs, and can also help the spleen and stomach qi and resolve phlegm.
5.1.3.6 Syndrome of blockade of phlegm, turbidity and static blood
Stroke·apoplexy with syndrome of blockade of phlegmturbidity and static blood[1] refers to blockade of phlegm, turbidity and static blood, followed by sudden fainting and unconsciousness. Save time, trismus, mouth cannot open, hands firmly held, urine and defecation closed, limbs spasmodic, white face, dark lips, no trouble lying still, limbs not warm, phlegm and saliva are blocked, pale tongue, white and greasy coating, weak pulse Stroke syndromes such as slippage and sinking are common symptoms [2]. 5.2 Out of syndrome 5.2.1 Symptoms of stroke out of syndrome
Sudden fainting, unconsciousness, pale complexion, dilated pupils, eyes closed and mouth open, snoring slightly, shortness of breath, cold hands and limbs , excessive sweating, cold skin, spontaneous urination and defecation, limp limbs, purple tongue or flaccid tongue, loose and weak pulse or faint pulse. [4][5] 5.2.2 Syndrome analysis
Since the decline of Yuan Yang has reached the extreme, Yang floats above and Yin depletes below. Yin and Yang have the tendency to separate, the righteousness is exhausted, and the mind is depressed. Therefore, it is seen as a critical disease of sudden collapse, unconsciousness, pale complexion, large eyes, dilated pupils, open mouth, snoring, loose hands, tongue impotence, incontinence of urine and feces, etc. Slow breathing, excessive sweating, cold limbs, thin and weak pulse, shortness of breath, purple or light tongue, white and greasy coating, etc. are all signs of sexual desire and sudden loss of Yang Qi. [4][5] 5.2.3 Treatment method
Replenish qi and return yang to save yin and consolidate it. [4] 5.2.4 Prescription treatment for stroke syndrome 5.2.4.1 Prescription 1
Immediately use a large dose of Shenfu Decoction [Remarks] Shenfu Decoction ("Women's Prescription"): ginseng, cooked aconite , ginger, jujube combined with Shengmai Powder [Remarks] Shengmai Powder ("Luji Qianjin Essential Prescriptions"): ginseng, Ophiopogon japonicus, Schisandra chinensis. In the prescription, ginseng, Ophiopogon japonicus and Schisandra chinensis are used to replenish qi and yin, and aconite is used to restore yang and relieve the disease. If you have excessive sweating, you can add astragalus, dragon bone, oyster, and cornus to stop sweating and solidify sweating. [4] 5.2.4.2 Recipe 2
Prescription: 10 to 15 grams of ginseng and 10 to 15 grams of aconite.
Usage: Decoction and oral administration or nasal feeding.
Commonly used prescriptions: Shenfu Decoction, Sini Decoction plus ginseng, etc.
Efficacy: For the above four types, 2203 cases were treated completely, 680 cases were basically cured, 746 cases were markedly effective, 692 cases were effective, 85 cases were ineffective or died, and the total effective rate was 96.1%. 5.2.5 Acupuncture treatment for stroke syndrome relief 5.2.5.1 Fang Yi
For syndrome relief, select Shenque, Guanyuan and other points, and use large moxa cones to strengthen moxibustion [3]. Deficiency and persistent sweating may cause yin deficiency; in cases of deficient yang and excessive yang, moxibustion on Mingmen, Qihaishu, Shenshu and other points may be more important [3]. 5.2.5.2 Prescription 2
[5]
Treatment method: Restore Yang and consolidate the condition.
Acupoint selection: Mainly the Ren meridian and Du meridian points. Take Guanyuan, Shenque, Zusanli, Shuigou and Neiguan.
Matching acupoints according to the syndrome: For those who are restless, add Sishencong.
Methods of acupuncture and moxibustion: Use large moxa sticks to moxibustion Guanyuan and Shenque, no matter how strong the condition is. It is better to use acupuncture and moxibustion at the same time in Zusanli. Shuigou and Neiguan leveling tonic and diarrhea method.
Fang Yi: Guanyuan is the intersection point of Ren meridian and the three yin meridians of the foot, and it is also connected with the true yang of Mingmen, so it is a point with yang in yin; Shenque is located in the navel, and the umbilicus is The root of life is tied to the true qi; therefore, the Guanyuan and Shenque points of the Ren meridian are used for heavy moxibustion to restore the yang and save the reverse and collapse. Zusanli can nourish qi and blood. Shuigou and Neiguan are refreshing and refreshing. 6 About stroke
Stroke (zhòng public) (apoplexy[1][6]) is the name of the disease[7]. Also called stroke[7][3]. Published "Yellow Emperor's Internal Classic Lingshu·Patterns of Evil Qi and Mansion Diseases". It refers to a disease that is characterized by sudden coma, hemiplegia, slurred speech or aphasia, crooked speech and tongue, and numbness on one side of the body. It also has the characteristics of sudden onset and rapid change, such as wind evil and good deeds that change frequently [1][6] . Because the disease has a sudden onset, multiple symptoms, and rapid changes, which are similar to the characteristics of wind-type good deeds and several changes, it is named after stroke [4].
Stroke is caused by the reversal of qi and blood, resulting in cerebral artery blockage or blood overflowing into the brain [5]. The patient's symptoms include sudden coma and unconsciousness, accompanied by squinting of the mouth and eyes, hemiplegia, and speech difficulties, or the main symptoms are only paralysis without coma [4]. Most stroke patients are middle-aged or older [5]. There are often aura symptoms such as dizziness, headache, and numbness of the limbs before the onset [5].
Stroke belongs to the scope of cerebrovascular diseases, which is equivalent to diseases such as cerebral hemorrhage, cerebral thrombosis, cerebral embolism, subarachnoid hemorrhage, and transient ischemic attack in modern medicine [5].
Acupuncture is very effective in treating stroke. Recent studies have proven that acupuncture is not only good at treating the sequelae of stroke, but is also effective in the acute phase. In the acute stage of stroke, those who develop high fever, coma, cardiopulmonary failure and gastrointestinal bleeding should receive comprehensive treatment and timely rescue.
[5]