Dyspepsia and stomach fullness and discomfort seem to be the "common diseases" of modern people. Among them, early satiety, postprandial fullness, loss of appetite and belching are the main clinical features, and there are no organic, metabolic or systemic diseases that can explain their symptoms, which are characterized by repeated attacks and difficult to cure.
Since no obvious abnormality is found in modern medical examination, what is the cause of frequent bloating and indigestion?
In fact, the exploration of spleen and stomach diseases has long been recorded systematically and in detail in Chinese medicine, and doctors in past dynasties have also summarized effective treatments. Traditional Chinese medicine calls this disease "fullness", which, as the name implies, means stagnation. In traditional Chinese medicine, it refers to a conscious symptom of obstruction of qi between the chest and abdomen, and some of them only feel full; And "full" means full of boredom.
"Rhinoceros Candle in the Origin of Miscellaneous Diseases" points out: "fullness, spleen disease is also." In fact, the root cause of bloating is mostly in the spleen and stomach. Because the spleen and stomach live in the middle jiao of the human body, they are the hinge of qi movement, and they are dynamic and endless. If the spleen loses its health and cannot move qi to the spleen and stomach, the qi will be stagnant but not scattered, and it will be full.
For example, the spleen and stomach are a food processing factory. If the spleen and stomach are dysfunctional, not only the food can't be processed smoothly, but even the finished products can't be transported to all places, and the substances such as "waste water" and "garbage" in the processing factory can't be transported normally.
There are many reasons for the dysfunction of spleen and stomach transport, which are often related to the invasion of external evils, improper diet, emotional failure, excessive fatigue and insufficient endowment, and lead to cold, heat, phlegm, dampness, food, depression and blood stasis, which makes the spleen and stomach qi stagnate and the congestion become a disease.
Therefore, in order to get rid of bloating, the key is to treat the spleen.
However, regulating the spleen and stomach is not simply invigorating spleen and benefiting qi. Different patients have different pathogenesis and syndrome factors, so the clinical treatment of invigorating spleen is also different. As Le Qisheng's Chinese medicine team said, "Spleen health is not tonic, but it is precious to transport", and spleen treatment should be based on transport as health and transport as supplement. In actual treatment, there are five kinds of treatments:
(1) Regulating liver and spleen to treat bloating
The clinical practice of Le Qisheng's Chinese medicine team found that among patients with bloating, many patients mainly suffer from liver depression and qi stagnation, because the function of relieving qi of the liver usually affects the transport and transformation of the spleen and stomach, just as the liver belongs to wood and the spleen belongs to soil. For example, the function of the liver is like a tree, while the function of the spleen is like soil. The roots of trees have the functions of loosening and stabilizing the soil, while the soil in turn provides nutrients for the growth of trees.
Therefore, such patients often show fullness in the stomach, hypochondriac pain, which is induced or aggravated when the mood changes greatly, and they like to sigh, accompanied by breath, impatience and irritability, dry eyes and swollen eyes, with red tongue and white fur. Attention should be paid to soothing the liver and activating the spleen in treatment.
(2) Regulating qi, transporting spleen and smoothing qi.
The smooth flow of qi in the spleen and stomach is the premise of normal digestion. If the spleen and stomach are frozen and stagnated, or the food accumulation is blocked, the phlegm and dampness are sticky, which will lead to the unfavorable operation of qi and the stagnation of spleen and stomach, resulting in bloating.
This kind of people mostly show no appetite, but they always feel full and sluggish when they don't eat much, and they feel relieved after burping or farting. Treatment should be based on regulating qi to help transport, opening depression and activating spleen. Moreover, because qi stagnation syndrome rarely appears alone, its causes are different, and the pathogens involved are also different, so the drugs for regulating qi should be compatible according to the causes in clinical application. For example, if the patients with food stagnation need to be compatible with drugs for eliminating food stagnation, the representative prescription is Baohe Pill; Due to spleen and stomach qi deficiency, drugs such as Zhizhu Pill and Jianpi Pill are combined. For those who are blocked by dampness, dampness-resolving drugs are combined with qi-regulating drugs, such as Sanren Decoction and Hopu Xialing Decoction.
(3) promoting digestion, invigorating spleen and promoting health.
The main symptoms of the patients are fullness and tightness in the chest, fullness and stuffiness, mainly burping and acid regurgitation, and they may also have symptoms such as not thinking about food, nausea, vomiting, stagnant food in the stomach, rancid stool, indigestion of food, reddish tongue and thick and greasy tongue coating, which are usually referred to as dyspepsia syndrome in Chinese medicine. Treatment should be based on digestion and spleen transport.
(4) Removing dampness and transporting spleen to resume ascending and descending.
Dysfunction of spleen and stomach transport and transformation is often related to dampness, that is, we often say that dampness is heavy. Patients often show chest tightness and fullness, loss of appetite, feeling full after eating, nausea, vomiting, pale mouth, listlessness of limbs, thin stool, reddish tongue and thick and greasy fur. Treatment should be based on eliminating dampness and transporting spleen.
(5) benefiting qi and activating spleen and yin and yang
Among the patients who are full after eating, those who are caused by weakness of the spleen and stomach are also more common. In general, the clinical manifestations are fullness in the stomach, sometimes light and sometimes heavy, loss of appetite, and a feeling of fullness after eating. loose stool, who is physically exhausted, has a low voice, a pale tongue and a thin and white fur, should be given priority in treatment.
In addition, there is also a special type, which exists in many patients with long-term bloating. Traditional Chinese medicine often talks about "blood stasis caused by a long illness". If you are ill for a long time, or if you don't recover for a long time, you can consider treating it from blood stasis. "Blood stasis" is like an abandoned car in expressway, which will lead to road congestion and affect the normal driving of the vehicles behind you. Therefore, for stubborn diseases, the method of promoting blood circulation and activating spleen can be adjusted according to the condition.
Ms. Jiang, a 37-year-old patient who came to see a doctor recently, reported repeated bloating, especially after eating, occasional pantothenic acid, impatience and irritability, early menstruation and pigmentation of facial skin. Before going to the local hospital for examination, no organic lesions were found. It can be seen that the tongue is dark.
According to Ms. Jiang's condition, TCM syndrome differentiation is considered as spleen deficiency, liver and stomach stagnation, and stomach gas congestion. Treatment: strengthen the spleen to help transport, soothe the liver and relieve heat, eliminate the swelling and dissipate the stagnation.
The prescription uses Prunella Spica, Rhizoma Chuanxiong, Rhizoma Chuanxiong, Rhizoma Cyperi, cuttlefish bone preparata, fried atractylodes, Endothelium Corneum Gigeriae Galli preparata, Caulis Spatholobi, Flos Camptothecae Campestris, Radix Arnebiae, Flos Lonicerae, and Bombyx Batryticatus preparata, with a dosage of 14, which is decocted in water and taken half an hour after breakfast and dinner.
Second diagnosis: Ms. Jiang said after taking the medicine, the bloating was obviously relieved, and the pantothenic acid was relieved, but the menstruation still did not appear normally. The original prescription added fried Angelica sinensis and told her to continue taking 14 dose. After three and four treatments, Ms. Jiang said that all the symptoms such as bloating were basically cured. After 3 months of follow-up, menstruation was normal and bloating did not recur.
According to the remarks, Ms. Jiang has a long medical history and is mixed with excess and deficiency, so the treatment should adopt multiple methods and consider in many directions. Chuanlian, Evodia rutaecarpa and cuttlefish bone are used to drain the liver and stomach, suppress acid and reduce adverse reactions; Prunellae Spica, Rhizoma Cyperi, and Rhizoma Ligustici Chuanxiong can clear liver and soothe liver; White residual flower, dried tangerine peel, fried atractylodes, fried chicken's gizzard-membrane and zhongyun spleen; Spatholobus suberectus, Camptotheca grandiflora and Arnebia euchroma promote blood circulation, nourish blood, regulate menstruation and eliminate facial pigmentation; Bombyx batryticatus can remove phlegm and blood stasis, and enhance the curative effect. The symptoms of the second diagnosis patients have obviously improved. Considering the menstrual period and facial pigment, Angelica sinensis is added to nourish blood and promote blood circulation to enhance the curative effect. All the drugs were compatible, and the follow-up after conditioning showed that all the symptoms were relieved.
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