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? Cui Yingmin's Clinical Experience in Flexible Use of Wendan Decoction
Cui Yingmin, graduate tutor and chief physician of Henan College of Traditional Chinese Medicine. Cui Yingmin has been teaching and educating people for more than 30 years, treating diseases and saving lives. He is good at all kinds of common diseases and incurable diseases, and talks about how to simplify medication and how to make it clear. The clinical application of Cui Yingmin Wendan Decoction is recorded as follows.

Get to the bottom of it.

Add, subtract, cut, whatever you can.

Wendan Decoction is recorded in Sun Simiao's "Prepare a Thousand Golden Prescriptions for Urgent Need" and Wang Tao's "The Secret of Outer Taiwan" in the Tang Dynasty. "The Secret of Outer Taiwan" said that it originated from the "Collection of Prosecutions" written by Yao Sengyuan in the Southern and Northern Dynasties, and it was composed of six kinds of medicines: Pinellia ternata, Fructus Aurantii Immaturus, Pericarpium Citri Tangerinae, Radix Glycyrrhizae and ginger, which was mainly used to treat "insomnia after severe illness due to chills". Later, Wendan decoction was found in Chen Wuxuan's "Three Causes and One Disease Syndrome". Medically, Poria cocos and Jujube were added to the original prescription of "Preparing for Emergency and Making Thousand Gold Prescriptions Brilliant", and ginger was reduced from four to five tablets, mainly treating "various diseases caused by stagnation of qi and phlegm".

Doctors in Ming and Qing dynasties also summed up many methods of addition and subtraction, such as adding coptis root to those who are annoyed by heat and naming it Huanglian Wendan decoction; Those with phlegm and blood stasis go to bamboo shavings and add Arisaema cum bile, which is called Daotan decoction; Chaihu Huangqin, also known as Chaiqin Wendan Decoction; Adding ginseng and calamus is called Ditan decoction. In the Standard of Syndrome and Treatment, bamboo shavings were removed and jujube kernel, Schisandra chinensis, polygala tenuifolia, Radix Rehmanniae Preparata and ginseng were added, which was named Shiwei Wendan Decoction. Through addition, subtraction and modification, the clinical indications of this prescription have been greatly expanded.

Cui Yingmin widely used Wendan Decoction and its modified formula in clinical departments to treat apoplexy, chest obstruction, hypochondriac pain, insomnia, stomach pain, dirty mania, amenorrhea, anorexia, heartache, fright, nervous vomiting, epilepsy, tinnitus, dizziness, madness and other diseases. Satisfactory results have been achieved.

Stroke due to brain deficiency and phlegm and blood stasis

A little courage to work miracles.

The deleted prescription says: "Liver and gallbladder should be responsible for the deficiency of marrow", "heat should be dirty, cold should be fu-organs", and "the brain is painful because of the deficiency of marrow; Those with solid bone marrow are brave. " The brain is the marrow sea, and the marrow deficiency is the brain deficiency, that is, the brain is not healthy enough, so treating the fu-organs is also treating the gallbladder. It is not difficult to see the relationship between gallbladder, marrow and brain, so Wendan decoction can treat the deficiency of brain vital qi.

Case: sequelae of cerebral infarction, Kang, male, 59 years old, came to the clinic on June 2, 2009. The history of cerebral infarction is 2 years. The symptoms are paralysis of the right limb, poor sleep, irritability, language disorder, shapeless stool, fat tongue, purple color, slightly thick and white fur and heavy and slippery pulse. Intermediate diagnosis: stroke. Western medicine diagnosis: sequelae of cerebral infarction. The etiology and pathogenesis of stroke are wind, fire, phlegm and blood stasis, which leads to cerebral blood stasis or blood overflow. Here, it should be divided into wind, phlegm and blood stasis. Prescription: fried atractylodes 15g, Curcuma longa 15g, Ramulus Mori 30g, Rhizoma Gastrodiae 15g, Ramulus Cinnamomi 15g, Rhizoma Cyperi 15g, Rhizoma Pinelliae 30g, Pericarpium Citri Tangerinae 10g, Poria 30g and Fructus Aurantii. Arisaema cum bile 15g, Rhizoma Cyperi 12g, Rhizoma Acori Graminei 12g, Herba Siegesbeckiae 30g, Prunellae Spica 30g, Radix Glycyrrhizae 10g, Ramulus Cinnamomi 10g, Dracaena Dracaena 30g, and Pheretima/kloc. Seven clothes. 300 grams of leech and 300 grams of scorpion were used. Separate capsules, three capsules each time, three times a day.

The main prescription Wendan decoction has the functions of eliminating phlegm, relieving depression and dredging collaterals. To treat diseases, it is important to distinguish the main symptoms first, and then use drugs according to specific symptoms, such as limb paralysis, and add turmeric, mulberry twig, gastrodia elata, cassia twig, Spatholobus suberectus, Siegesbeckiae Herba and so on. Promoting blood circulation and dredging collaterals; Poor sleep, use Gardenia, Prunella vulgaris, Coicis Semen, Radix Cyathulae, etc. Clearing phlegm and purging fire; For brain atrophy, Scorpio, Hirudo, Scolopendra, and Lumbricus are added, or decocted or capsules are used to promote blood circulation and induce resuscitation; The language is unfavorable, the wry smile is abnormal, and polygala tenuifolia, lotus plumule and lophatherum gracile are added to clear the heart; Because the sequela of stroke is actually blood stasis blocking collaterals, it is necessary to increase the intensity of promoting blood circulation and removing blood stasis, and often add Acorus gramineus, Radix Curcumae, Radix Salviae Miltiorrhizae, Radix Notoginseng and other products for promoting blood circulation and inducing resuscitation. This medicine is very effective.

Shortness of breath, dizziness and panic

Coptis chinensis has obvious gallbladder warming effect.

The clinical manifestations of palpitation are shortness of breath, palpitation and dizziness. It can be treated with Huanglian Wendan Decoction. Cui Yingmin's theory has two meanings: First, there is a close relationship between heart and gallbladder. Su Wen's six dirty images say, "All eleven dirty organs depend on gallbladder." "Introduction to Medicine" contains: "Heart and gallbladder are connected, and heart disease is palpitation, so it is advisable to warm gallbladder soup. Zhang Jingyue said: "Shaoyang belongs to wood, and wood is used for making fires. Therefore, those who are full of evil are courageous, their appearance is in their hearts, and those who are obvious are also marked. " There is both phlegm and blood stasis in the heart. Courage is a clean house, with God hidden in it. I also like cleanliness, and I can't be disturbed by the turbidity of phlegm and blood stasis.

Case: Yue Mou, female, 63 years old, first diagnosed in 2008 1 1.5. Sudden dizziness, physical activity failure for 2 days, the patient's body fat, shortness of breath at ordinary times, weakness of lower limbs, facial edema, dry mouth, anorexia, vomiting and spitting, tinnitus at night, blood pressure 150/90mmHg, heart rate of 58 beats/min, ST-T ischemic changes, previous myocardial ischemia history, large tongue body, tooth marks and dark purple. Diagnosis: palpitation and dizziness. This is the mutual resistance of phlegm and blood stasis. Prescription: Rhizoma Coptidis 10g, Rhizoma Pinelliae 10g, Pericarpium Citri Tangerinae 10g, Poria 30g, Almond 10g, Caulis Bambusae Bambusae 10g, Rhizoma Acori Graminei 12g, and Radix Curcumae12g. Seven clothes.

The prescription adopts Huanglian Wendan decoction to clear gallbladder and stomach, eliminate phlegm and dredge collaterals; Radix Salviae Miltiorrhizae, Radix Curcumae, Radix Puerariae and Radix Notoginseng promote blood circulation to remove blood stasis; Because of phlegm and saliva imbalance, blindness leads to dizziness and tinnitus, so Banxia Tianma Baizhu Decoction is used to eliminate dampness and phlegm, regulate qi and regulate stomach; Guizhi warms the child's heart; Chuanxiong relieves depression. The patient complained of dizziness, tinnitus and obvious improvement in food intake after taking the medicine, which was mainly based on the original prescription and slightly adjusted according to the symptoms. After one month of treatment, the symptoms disappeared.

Stubborn insomnia is so annoying

Chai Qin's warm and brave feelings are the most real.

Clinical intractable insomnia is quite difficult. Cui Yingmin believes that insomnia caused by emotional depression or disharmony between gallbladder and stomach can be treated with Chaiqin Wendan Decoction. It is clearly recorded in "The Secret of Outer Taiwan" that Wendan Decoction is used for "physical weakness and insomnia after a serious illness and chills", which is a common clinical syndrome of disharmony between gallbladder and stomach, and "disharmony between stomach leads to anxiety". It is necessary to eliminate phlegm with stomach, add Bupleurum and Scutellaria, and relieve shaoyang, so as to dredge the meridians of triple energizer. Harmony of gallbladder and stomach, smooth qi movement and stable sleep.

Case: Sun, female, 26 years old, came to the clinic on July 28th, 2009. She is always grumpy. Two weeks ago, she was so emotional that she couldn't control herself because she had a fight with her half-brother. Now she suffers from difficulty in falling asleep, insomnia, irritability, memory loss, purple tongue, greasy fur and slippery pulse. Give Chaiqin Wendan Decoction plus mother-of-pearl, Radix Curcumae, Rhizoma Cyperi, fried Ziziphi Spinosae, etc. And tell them to be happy and relaxed. A week later, the patient reported that his sleep was obviously improved, but his mood was still excitable. If he did addition and subtraction on the basis of the above, he still said his feelings. This treatment is more than a month.

Epilepsy is mostly caused by phlegm and blood stasis.

Wonderful effect of guiding phlegm and adding flavor

Cui Yingmin believes that epilepsy is mostly a syndrome of phlegm and blood stasis. The brain is the viscera from the clearest to the purest, gathering the true qi, maintaining the meridians, coordinating the inside and outside, and controlling the Yuan-Shen. The brain is clear, the mind is clear, and the Lord is moderate; The brain is hidden by marrow sea, Shui Gu subtle and kidney essence. Qingnian zang-fu organs prefer quietness to disturbance, which is easy to be weak and solid, so the pathological basis is mental injury and occlusion. When the mind is disturbed, the Yuan God is out of control, and the machine is exhausted, the servant is convulsive; The marrow sea is not full, the Yuan God is not nourished, and the brain God lacks opportunities, resulting in trance anxiety and dull eyes. Clinically, Wendan decoction can be used to remove bamboo shavings, add Arisaema cum bile and Acorus gramineus (that is, Daotan decoction) and platinum pills, and add scorpion, centipede, leech and other insect drugs to search wind, dredge collaterals and relieve spasms. It always works well.

Case: A 24-year-old male from Wenchang City, Hainan Province made a home visit in June 2009. The patient had a seizure 10 years, with sallow complexion, emaciation, weak diarrhea, white sputum, fat tongue and greasy fur. Prescription: Codonopsis pilosula 20g, fried atractylodes15g, Pericarpium Citri Tangerinae10g, Pinellia ternata12g, Poria 30g, Radix Paeoniae Alba 30g, Rhizoma Gastrodiae10g, Uncaria Uncaria10g, and Lumbricus/kloc-0. Rhizoma Acori Graminei 12g, Radix Curcumae 15g, Radix Glycyrrhizae 6g, Radix Angelicae Sinensis 10g, Radix Astragali 30g, Scorpio and Scolopendra 200g each, which are crushed and ground into hollow capsules, three capsules each, twice a day. On February 22, 2009, I called and said that the attack had decreased, but the stool was still loose and had no effect.

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Wendan decoction and its modified formula have a wide range of main symptoms, so we should firmly grasp the main symptoms and key points of syndrome differentiation in clinical application. Cui Yingmin believes that there are three main symptoms in this prescription: first, mental and emotional diseases, such as fright or timidity, dizziness, headache, insomnia, forgetfulness, etc. Second, spleen and stomach diseases, such as anorexia, indigestion of phlegm and saliva, abdominal distension, loose stool or constipation; Third, the pulse is string-shaped or string-shaped, and the tongue is greasy. In clinic, if one of the above symptoms or all the symptoms are found at the same time, the principle of "treating different diseases at the same time" can be adopted and this prescription can be selected. Otherwise, it is not appropriate to use this side.