Syndrome of disharmony between liver and stomach: Syndrome of disharmony between liver and stomach due to stagnation of liver qi, prolonged stagnation of fire and stagnation of heat in liver and stomach. The main manifestations are hypochondriac pain, noisy acid swallowing and other symptoms.
Etiology
Syndrome of liver-spleen disharmony: If the emotion is depressed, the liver will be drained, the liver-qi will stagnate, and the spleen will be disharmonious, just as Dialectical Records said: "Although the husband's threat is the liver position, the liver will restrain the spleen, and the spleen will be restrained by the liver, so the spleen can also be painful with the liver. If the food is hungry and full, fatigue and internal injuries can also lead to spleen deficiency, dereliction of duty in transportation and transformation, confusion between clear and turbid, stagnation of qi and dampness, and stagnation of liver wood, which makes the liver lose its drainage, that is, "stagnation of soil and wood."
Syndrome of disharmony between liver and stomach: emotional disorder, liver stagnation, stagnation of liver qi, and invasion of spleen and stomach by transgression. "Dirty qi is uneven, and victory depends on illness, such as anger hurting liver, liver restraining spleen, and unhealthy temper; It will swell in the stomach, and it is called Shengke. "If liver depression turns into fire for a long time, the liver and stomach accumulate heat.
Pathogenesis
Syndrome of disharmony of liver and spleen: the liver belongs to wood, which governs ascending hair and dispersing qi; Spleen belongs to soil, which is the main transport and transformation. Wood can dredge soil, and soil can cultivate wood, so the two affect each other physiologically and are inseparable, which is mainly reflected in the drainage of liver and the transport and transformation of spleen. Because the normal function of spleen transport depends on the function of dispersing liver qi, only when the function of dispersing liver qi is normal can the function of spleen transport be carried out normally. The healthy movement of the spleen and nourishing the liver can enrich the liver and exercise the normal function of relieving diarrhea. If the liver fails to dissipate qi, it will affect the transport function of the spleen, resulting in the syndrome of liver depression and spleen deficiency, which is what Zhang Zhongjing said: "When you see the disease of the liver, you should know that the liver transmits the spleen, and you should first strengthen the spleen. "If liver qi stagnates, qi disease and blood, qi stagnation and blood stasis, liver stagnation and spleen, spleen does not make water, and water and dampness overflow, the soil will be defeated by equisetum, liver and spleen are blood stasis, qi stagnation and dampness resistance, and qi, blood and water will stay in the body, thus becoming a pathological outcome of bloating. Therefore, "Shen Shi Zunsheng Book" said; "Bulging ... or anger hurts the liver, gradually erodes the spleen, and the spleen is extremely deficient, so the yin and yang do not meet, and the turbidity is mixed, and the tunnel is impassable. Depression is heat, heat stays wet, and damp and heat coexist, so its abdominal distension is large. "Liver-qi is not comfortable, so it can attack the spleen soil, which is hindered by qi-qi, and the blood is stagnant, but the spleen does not transport body fluid and blood, which gradually accumulates into lumps over time. As the book Jing Yue says," Stagnation of blood stasis is a disease, but only women have it ... or anger hurts the liver, qi goes against it and blood stays, or worry hurts the spleen, and qi deficiency leads to blood stagnation, ... "If spleen deficiency fails to transport, dampness stops gathering in the middle energizer, and the liver wood is restrained, then liver qi will be lost to excessive qi, qi will stagnate, and blood stasis will stop inside, which is qi stagnation, water stagnation, blood stasis and stagnation in the abdomen, thus forming a distension syndrome.
Syndrome of disharmony between liver and stomach: the liver governs the discharge, ascending and descending, while the stomach governs the intake and decay of Shui Gu, descending, ascending and descending of liver, and regulating the ascending and descending balance of qi. It is helpful for the normal functioning of the stomach to drain the qi. If the liver fails to drain the qi, the stomach loses harmony and falls, and the stomach qi goes up. If the liver and stomach accumulate heat and the heat injures the blood collaterals, there is a danger of vomiting blood and bleeding, which is always caused by liver fire invading the stomach and burning the stomach collaterals. "If you vomit blood, every mouthful is full of blood, it is the blood that comes from the liver, with a bluish color, and it is carried by fire, and it is caused by anger." As the saying goes, anger is contrary to qi, and even vomiting blood, so it is advisable to draw blood to the liver "(Purpose of Chinese Medicine). Therefore, excessive liver fire burns stomach collaterals, and it is easy to form the pathological outcome of vomiting blood and hematemesis.
Key points of differentiation
Syndrome of liver-spleen disharmony: hypochondriac, * * *, less abdominal distension, frowsty and pain, excessive breath, emotional depression or irritability, aggravated by anger, abdominal distension, loose stool's discomfort, abdominal pain after diarrhea, loss of appetite, wheezing, white or greasy tongue coating, and thready pulse. The clinical features are liver depression syndrome of hypochondriac swelling and pain and spleen deficiency syndrome of abdominal distension, diarrhea and anorexia.
Syndrome of disharmony between liver and stomach: chest and hypochondrium, * * *, little abdominal distension and pain, abdominal distension and pain, impatience and irritability, vomiting sour water, noisy anorexia, hiccups and belching, red tongue, thin yellow fur and slightly rapid pulse. The clinical features are hypochondriac pain, noisy pantothenic acid, irritability and red tongue with yellow fur.
Differential analysis
Syndrome of liver-spleen disharmony: the liver pulse distributes in hypochondriac ribs, runs through the diaphragm, and circulates in less abdomen, so the liver qi is stagnant, and the menstrual qi is unfavorable, so the chest and hypochondriac, * * *, and less abdominal distension are dull and painful; When discussing the etiology and pathogenesis of liver depression and hypochondriac pain, An Introduction to Medicine Dantaiyu Case holds that "the liver is hidden inside, and the outside should depend on the hypochondriac, where the hypochondriac is, and where the liver is". The blood of the hidden is the anger of the owner. ..... or have external contact anger, want to vibrate but can't stretch, stagnation, hidden in the liver, although there is no blood stasis and pain. As for abdominal pain due to qi stagnation, The Treatment of Causes and Pulse says: "Abdominal pain due to qi stagnation is caused by fullness in the chest and abdominal distension, with pain in the back of the heart, while qi stagnation is very painful, and the medicine for breaking qi is slightly reduced, but the medicine for invigorating qi is more painful, which is also the symptom of abdominal pain due to qi stagnation. Sighing is the solution of liver depression, and the fullness is comfortable, so it is good to sigh; Liver depression can not be reached, so the mood is depressed; Losing its pliability leads to irritability, which is called "liver disease" in Huangdi Neijing Su Wen, which makes people angry. Anger is even worse, so the symptoms are aggravated; Stagnation of the liver by the spleen, spleen deficiency without transport, confusion between clear and turbid, dereliction of duty in ascending and descending, obstruction of qi-moving, eating turbid food, and stagnation of damp evil will lead to abdominal distension, abdominal pain will be diarrhea, loose stool will be upset, and the bowel sounds will rise. Therefore, Zhang Jingyue thought: "Anyone who has diarrhea in anger must first take food in anger and cause damage to the spleen and stomach, so if he commits a crime, it will happen with the touch. This disease of liver and spleen is also covered with liver and spleen." "The Essentials of Syndrome and Treatment" holds that "qi diarrhea leads to bowel sounds, qi moves away from the chest and diaphragm, and the fullness of the abdomen is urgent and painful, while diarrhea leads to a sudden and urgent abdomen, and there are also people whose abdomen is blocked by gas. This is caused by stagnation of Zhong Wan, stagnation of qi and indifference of Shui Gu. After defecation, qi stagnation can pass, so the pain is reduced after diarrhea; Spleen deficiency and stomach, poor appetite, so loss of appetite; The coating is white, and there is no obvious heat image. The greasy coating is spleen deficiency and dampness resistance, and the pulse string governs liver disease.
Syndrome of disharmony between liver and stomach: Anger hurts the liver, the liver loses its function, qi stagnation, transgressive attack on the stomach, and stomach qi disharmony, which leads to pain, so the epigastric region is distended and painful, which is what Shen Shi Zunshengshu said: "Stomach pain, pathogenic dryness and epigastric disease are also ... only the multiplication of liver and qi is especially serious, especially the sudden attack of wood. "Treating Syndrome by Analogy" also holds that: "When qi is depressed and painful, it is bound to attack and swell. "Liver depression is lost in the article, so it is irritable and irritable; The liver and stomach are depressed with heat, and the qi and fire are abundant, so it is full of sour water and noise; Liver-qi attacks the stomach, and the stomach loses harmony and falls, so it is not acceptable, so it is foolish; As "Secret Records of Stone Chambers" says: "People who are sick and have stomachache, or have a bad temper, can't eat, or can eat but can't melt, and they are not full of pain, vomiting and diarrhea, which is also caused by the liver meridian. If the liver is flat, the soil of the spleen and stomach will be raised, and the former symptoms will be cured. If the stomach loses balance and falls, and the stomach qi goes up, it will be suffocating; If the stomach qi moves against the diaphragm, it will cause hiccups. According to the Secret Record of Feng's Tips, "most of the patients with belching gas are due to stomach deficiency, and the choking gas does not rise and fall. If it exceeds the limit, it will spread and the turbid gas will go out of the stomach ... If there is stagnation of qi in the stomach, but there is no sour smell, it is advisable to regulate the stomach and the middle. The tongue is red, the coating is thin and yellow, and the pulse string is slightly counted, all of which are symptoms of liver and stomach stagnation.
As far as clinical symptoms are concerned, the syndrome of liver-spleen disharmony and the syndrome of liver-stomach disharmony all have the same symptoms as chest and hypochondrium, * * *, less abdominal distension and pain, irritability, loss of appetite, and rapid pulse, which are caused by stagnation of liver-qi, unfavorable menstruation, excessive ascending and discharging, and rising of yang. The syndrome of liver-spleen disharmony is accompanied by the spleen losing health, and the clinical manifestations of qi stagnation and dampness resistance: abdominal distension, loose stool's discomfort, abdominal pain due to diarrhea, decreased pain after diarrhea, and rising bowel sounds. Syndrome of disharmony between liver and stomach also includes epigastric pain due to disharmony of stomach, epigastric pain due to disharmony of stomach-qi, hiccups and belching due to upward movement of stomach-qi, impatience due to liver-stomach stagnation, acid and watery vomit, noisy tongue, thin yellow fur, and slightly rapid pulse. Among them, the symptoms of epigastric pain, hiccups and liver-stomach stagnation are syndrome of liver-spleen stagnation.
liver-spleen disharmony syndrome and liver-stomach disharmony syndrome, in terms of their pathogenesis, both have the characteristics of stagnation of liver-qi and unfavorable menstruation, but the difference is that the former also has spleen's loss of healthy movement, while the latter has stomach's loss of harmony and depression of qi and stagnation of fire. Specifically, liver-spleen disharmony syndrome is: liver-qi stagnation, stagnation of wood, spleen's loss of healthy movement, Shui Gu's failure to change, and qi. Syndrome of disharmony between liver and stomach is: the liver loses the function of dispersing qi, the stomach goes against the stomach, the stomach loses harmony and falls, the qi goes against the upper, the qi stagnates and turns into fire, the liver and stomach accumulate heat, the liver and stomach stagnate qi, and the appetite is neglected. Both diseases are located in the liver, the former in the liver and spleen, and the latter in the liver and stomach, all of which belong to qi stagnation syndrome. The former is spleen deficiency due to liver depression, which is liver deficiency, just as Wu Hegao said: "The spleen that purges responsibility, the liver that is painful to blame, the spleen that is deficient in responsibility, and the spleen deficiency is liver deficiency, so it causes pain and diarrhea. The syndrome of disharmony between liver and stomach is the syndrome of stagnation of qi and stagnation of heat in liver and stomach. Syndrome of liver-spleen disharmony can often be caused by qi stagnation, water stagnation and blood stasis, resulting in liver-spleen blood stasis, swelling and accumulation of soil-defeated equisetum. Syndrome of disharmony between liver and stomach can often lead to the pathological outcome of vomiting blood and hematemesis due to stagnation of qi and burning stomach collaterals.
Insofar as the etiology and history of liver-spleen disharmony syndrome and liver-stomach disharmony syndrome are concerned, they have the same cause of emotional failure and liver-qi depression. The former often has a history of eating fatigue and spleen injury, while the latter has a history of stagnation of qi and heat.
For the syndrome of liver-spleen disharmony, the clinical treatment should be soothing the liver and regulating qi, strengthening the spleen and regulating the stomach, and the prescription of relieving diarrhea (Jing Yue Quan Shu) should be used. "For those with depressed qi, soothing the liver and strengthening the spleen should be the main method, and the pain should be stopped by regulating qi" (Yi Tong Zheng Mai Quan Shu Living Book); For the syndrome of disharmony between liver and stomach, the treatment should be clearing away heat and regulating qi, purging the liver and regulating the stomach. The prescription is Huagan Decoction (Jingyue Quanshu) and Zuojin Pill (Danxi Heart Therapy). The treatment of similar syndromes holds that: "... those who suffer from epigastric pain due to the liver taking advantage of the stomach, will be made of bitter fruit, Evodia rutaecarpa, Paeonia lactiflora, Pericarpium Citri Reticulatae Viride and papaya. ..... Fire depression causes pain, hair is continuous, pulse must be rapid, when bitter and bitter are used to relieve heat, Rhizoma Coptidis and Fructus Gardeniae are fried in ginger juice, purging fire is the king, Rhizoma Cyperi, Rhizoma Ligustici Chuanxiong, dried tangerine peel and Fructus Aurantii are used to relieve depression, and the fried ginger is used as a guide. 」