most of the clinical manifestations of chronic spleen and stomach diseases are deficiency in essence but excess in substance, and damp-heat is one of the manifestations of excess in substance. "Urgent is to treat the symptoms", when the rising damp-heat is the main contradiction, it is necessary to clear the damp-heat mainly and strengthen the spleen to help transport.
Wendan decoction comes from "Three Causes and Extremities-Prescriptions of Disease and Syndrome", and consists of dried tangerine peel, Pinellia tuber, Poria, Fructus Aurantii Immaturus, bamboo shavings, roasted licorice, ginger and jujube. The original "after treating a serious illness, you can't sleep because of virtual annoyance, which makes you feel cold, and also treats fright." The coolness of its medicinal properties depends entirely on the amount of ingredients. This prescription is simple and mild in nature. Through flexible addition and subtraction, the exterior-interior syndrome of deficiency and excess cold and heat can be applied, and its clinical application is far beyond the scope of syndrome treatment recorded in the original records. Teachers often use their prescriptions to treat spleen-stomach damp-heat syndrome. Fangzhong Erchen Decoction can eliminate dampness and phlegm, and regulate qi and middle energizer. Pinellia ternata has the functions of eliminating dampness and resolving phlegm, harmonizing stomach, resolving mass, tangerine peel regulating qi and regulating stomach, moistening qi, Poria strengthening spleen and infiltrating dampness, liquorice harmonizing herbs, invigorating qi and regulating middle warmer, ginger and jujube strengthening spleen and regulating stomach, so that soil can be strengthened to overcome dampness, immature bitter orange can guide stagnation and eliminate stagnation, dispel swelling and help dampness, and bamboo shavings are sweet and cold to regulate stomach, clearing heat and eliminating phlegm. * * * Play the effects of eliminating pathogenic factors and strengthening the body resistance, eliminating dampness and clearing heat, regulating qi and guiding stagnation. Although it means strengthening the spleen without stagnation, it eliminates dampness without helping heat. It is quite symptomatic to treat spleen-stomach heat syndrome by clearing away heat instead of helping dampness.
Because damp-heat syndrome is difficult to heal, it is necessary to examine the cause of the syndrome, distinguish between dampness and heat, and add and subtract flexibly. Damp-heat syndrome of spleen and stomach is characterized by abdominal distension, fullness, nausea, lethargy, dry mouth without drinking or not drinking much, sticky mouth, sticky stool or secret knot, pale or red tongue, yellow and greasy tongue coating, and slippery or slow pulse. Rhizoma Atractylodis, Herba Agastaches, Coicis Semen, Fructus Amomi Rotundus and Rhizoma Acori Graminei are added when the wet weight is heavier than the hot weight; Remove ginger and jujube from damp heat, and add Scutellariae Radix or Coptidis Rhizoma and Herba Artemisiae Scopariae; It is rare that heat is heavier than dampness, and cold and cool should not be used too much. Reed root is added in the combination of damp and heat to clear away heat, promote fluid production and facilitate urination, and radish seeds and burnt betel nuts are added to make heat go away from stool. Eating with Jiao Sanxian and Raphanus sativus; Radix Bupleuri, Caulis Perillae and Cortex Magnolia Officinalis are added for stagnation of liver qi; Atractylodes rhizome and Atractylodes macrocephala are obviously added to spleen deficiency. Damp-heat of spleen and stomach caused by exogenous factors is combined with warming gallbladder and intestine in the prescription of syndrome differentiation and treatment, which can treat both exterior and interior. In patients with spleen-stomach dampness-heat syndrome, gastroscopy often finds that there is a lot of retained fluid in the stomach, which is sticky. At this time, Atractylodes lancea is reused, so as to dispel dampness with fragrance, invigorate the spleen and help transport.
It should be noted that heat belongs to yang and dampness belongs to yin, so cold drugs should be used for clearing heat, while cold drugs should help dampness, warm drugs should be used for treating dampness, and warm drugs should help heat. In addition, dampness-treating drugs are fragrant and dry, which is easy to consume body fluids. Therefore, it is necessary to distinguish carefully in clinical practice and master the discretion in medication. Deficiency of spleen and stomach is the source of dampness, which often occurs first and then turns into heat. In clinic, dampness is more important than heat, that is, both damp and heat are paid equal attention to. The treatment is mainly to eliminate dampness and regulate qi, because dampness is the most likely to block qi movement, and regulating qi helps to eliminate dampness. The most common aromatized and mild products for eliminating dampness, such as Herba Agastaches, Eupatorium, Fructus Amomi, Rhizoma Acori Graminei, Poria, and Coicis Semen, are added with heat-clearing drugs when dampness and heat are eliminated.
treatment: regulating qi and invigorating spleen, eliminating dampness and clearing heat. Wendan decoction is modified. Prescription: 1g of dried tangerine peel, 15g of processed Pinellia ternata, 3g of Poria, 1g of bamboo shavings, 1g of Pogostemon, 15g of Rhizoma Atractylodis, 12g of Magnolia officinalis, 12g of Acorus calamus, 2g of Coicis Semen, 1g of Scutellariae Radix and 6g of Glycyrrhiza uralensis. After taking 4 doses, the upper abdominal distension was relieved, and the thick greasy fur became thinner. In the front, Herba Agastaches and bamboo shavings were removed, 15g of charred hawthorn and Massa Medicata Fermentata were added, and 15g of Atractylodes macrocephala was changed to Atractylodes macrocephala. After taking more than 1 doses, all the symptoms basically disappeared, the appetite was still small, the stool was soft and the amount was small, and there was still thin white and slightly greasy fur in the center of the tongue. Xiangsha Liujunzi Pill and Baohe Pill were taken instead to consolidate the curative effect.