There are many reasons for obstruction, such as qi stagnation or phlegm dampness in the body, which will lead to poor circulation of qi and blood, thus causing pain. In addition, there is a very common cause of obstruction and pain, which is the pain caused by "blood stasis blocking collaterals"
The pain caused by blood stasis in the body is more common in patients with long-term pain. Clinically, the position of pain is fixed every time, such as headache, pain near the temple and chest pain, all of which are heart pain, and the pain is like stabbing or vein exposure. The degree of pain is mild during the day and aggravated at night, often accompanied by purple tongue coating or purple sublingual collaterals.
Why is this happening?
In fact, this phenomenon, as well as the etiology and pathogenesis of pain, was systematically discussed in the classic Chinese medicine Huangdi Neijing and Su Wenju's Treatise on Pain: "The meridians pass and circulate endlessly ... If you are in the pulse, you will feel suffocated, so you will feel pain." It fully shows that deficiency of qi and blood is one of the causes of pain.
Le Qisheng's TCM team pointed out that the collaterals of the human body have the function of running qi and blood and transporting body fluid, and are the hub of running qi and blood and transporting body fluid. Only when qi, blood, body fluid flow through collaterals for infiltration and perfusion can zang-fu organs play their normal functions. But the collaterals are small and tortuous, criss-crossing and distributed all over the human body. Once the circulation of qi, blood, body fluid is blocked, qi movement is blocked, and meridians are stagnant, pathological products such as blood stasis and phlegm-dampness will be formed, which will cross each other for a long time, and eventually the collaterals will be out of balance, resulting in pain and symptoms.
For example, the meridians in the human body are like water pipes all over the city. If the water pipe in a certain place is blocked, there will be no water in that place, and the daily life of residents will be affected.
Modern medical research has also confirmed that blood is an important carrier for transporting nutrients throughout the body and plays an important role in metabolism, energy conversion, nutrient absorption and other functions involving multiple organs and systems. Blood microcirculation disturbance, abnormal hemodynamics or hemorheology will affect blood circulation and distribution function, and then affect metabolism and nutrient absorption function.
Therefore, when blood stasis is blocked in our chest, it usually leads to chest pain; Spleen and stomach stagnation will be manifested as epigastric pain; Uterine stagnation can lead to irregular menstruation, obvious dysmenorrhea or menstrual blood clots.
So, what should we do in the face of the pain caused by blood stasis blocking collaterals?
In the understanding of syndrome differentiation and treatment in traditional Chinese medicine, the diseases caused by "blood stasis" are often persistent and repetitive, which is related to "blood stasis" as both a pathological product and a pathogenic cause. "Blood stasis" is like vomit. We will vomit for some reasons. In the process of vomiting, seeing and smelling vomit will further aggravate vomiting.
Therefore, as Chinese medicine says, "a long illness will lead to blood stasis", when the body is uncomfortable, early attention and conditioning are the key to prevent the disease from becoming intractable.
However, if the pain caused by "blood stasis" is clearly defined through disease differentiation and syndrome differentiation, Xuefu Zhuyu decoction can be used as the basic prescription to adjust and improve clinically.
Xuefu Zhuyu Decoction comes from Wang Qingren, a famous doctor in Qing Dynasty. It consists of Angelica sinensis, Radix Rehmanniae, Carthami Flos, Semen Persicae, Fructus Aurantii, Radix Paeoniae Rubra, Radix Platycodi, Rhizoma Chuanxiong, Bupleuri Radix, Radix Glycyrrhizae and Achyranthis Radix. Commonly used for blood stasis, such as headache, chest pain, chest distress, sweating at dawn, impatience, night sleep, hiccups, drinking water, etc.
It should be noted that most patients with long-term headache and chest and back pain are accompanied by pathological factors such as blood stasis, as well as pathological conditions such as miscellaneous qi deficiency and qi stagnation. Therefore, we should add and subtract flexibly according to the actual situation, and we must never copy this prescription directly.
For example, a 49-year-old female patient who came to see a doctor before reported that Ms. Wu suddenly suffered from chest tightness and chest pain after being tired and angry two years ago, and then she had repeated attacks, and she could relieve herself after each rest. Three days before seeing a doctor, the pain was worse than before, even to the shoulders and back. The pain is as fixed as acupuncture, accompanied by palpitation, chest tightness and dark purple tongue. TCM syndrome differentiation is qi stagnation and blood stasis syndrome, so the treatment is to promote blood circulation to remove blood stasis, promote qi circulation to relieve pain, and Xuefu Zhuyu Decoction is used to modify the prescription:
Radix Salviae Miltiorrhizae, Semen Persicae, Carthami Flos, Radix Paeoniae Rubra, Rhizoma Chuanxiong, Radix Angelicae Sinensis, Radix Curcumae, Radix Aucklandiae, Fructus Aurantii, Curcuma Rhizome, Rhizoma Corydalis, Radix Glycyrrhizae Preparata and Radix Notoginseng (orally). 7 doses, decocted in water, daily 1 dose, taken twice in the morning and evening.
The second diagnosis: Ms. Wu reported that after taking the clothes above, her chest pain and chest tightness were relieved, and she occasionally had palpitations; It can be seen that the tongue is black; Considering that long-term use of drugs for promoting qi and blood circulation will damage healthy qi, especially the spicy and fragrant effect of radix aucklandiae is obvious, so radix aucklandiae is removed; Combined with the improvement of symptoms, Radix Astragali and Ramulus Cinnamomi are added to warm yang and replenish qi, so as to enhance the efficacy of replenishing qi, promoting blood circulation and warming tongxin pulse.
Third diagnosis: After taking the above 7 doses, Ms. Wu complained of slight chest tightness and no chest pain. The tongue picture is basically normal. On the basis of the above prescription, the medication is slightly adjusted, and it is required to continue taking 7 doses to consolidate.
In this case, according to Ms. Wu's condition, the treatment principle is to promote blood circulation to remove blood stasis, promote qi circulation to relieve pain, and Salvia miltiorrhiza is the monarch drug of the whole prescription, which has the effect of promoting blood circulation to remove blood stasis without hurting vital qi. Sanqi is good at promoting blood circulation to stop bleeding, removing blood stasis and relieving pain, and safflower can break blood stasis and promote blood circulation and dredge meridians. Both of them are helpful for Danshen to remove blood stasis and relieve pain, and * * * is a minister medicine. Chuanxiong has the effects of promoting qi circulation, promoting blood circulation and relieving pain. Radix Paeoniae Rubra has the effects of clearing away heat and cooling blood, removing blood stasis and relieving pain, removing blood stasis and resolving hard mass. Angelica sinensis nourishes blood and promotes blood circulation without hurting blood; Rhizoma Corydalis, Radix Curcumae, and Curcuma Rhizome promote qi circulation, promote blood circulation, and relieve pain. Because blood moves with qi, qi stagnation leads to blood stasis, so Fructus Aurantii and Radix Aucklandiae are added to promote qi and blood circulation, among which Fructus Aurantii regulates qi and broadens chest, and can inhibit qi in chest, which are all adjuvant drugs. Radix Glycyrrhizae Preparata can harmonize medicinal properties, invigorate qi and middle energizer, and protect vital qi, thus promoting blood circulation and qi circulation without harming vital qi. The combination of various drugs can relieve pain, and the medication should be adjusted according to the condition in the later stage, and the symptoms such as pain and palpitation should also be paid attention to.
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