First, the spleen and stomach are weak, the vitality is insufficient, and dampness and heat are felt.

The second is insufficient Yin blood.

In terms of treatment, Li Dongyuan advocates "the first step is to help the vitality and treat the deficiencies of Gengxin (large intestine and lung)".

Therefore, astragalus, ginseng, atractylodes, and licorice are used to replenish qi and strengthen the spleen; angelica is used to nourish blood and yang; Ophiopogon japonicus and schisandra chinensis produce fluid; atractylodes is used to dry dampness; orange peel, Shenqu is used for digestion and neutralization; Phellodendron cypress clears away heat and dries dampness. Cimicifuga and Yang.

Selection of case studies

Source: "On the Spleen and Stomach" volume. This recipe is also known as Astragalus, Ginseng, Schisandra and Ophiopogon japonicus soup.

Consisting of one penny of astragalus, if there is excessive spontaneous sweating, add one penny of cohosh, six cents of ginseng, 5 cents of ginseng, 5 cents of atractylodes, 5 cents of white rhizome and above, and 5 cents of cork wine, and The source of saving water, stir-fry koji, 3/3 portions of Angelica sinensis, wash and roast licorice with wine, 2/4 portions each of schisandra chinensis and nine schisandra chinensis seeds.

Usage: Take a bite of the above and mix them into one serving with two cups of water. Fry until one cup is cooked, remove the residue and stir-fry for a while. Take it hot, take it away from food or empty stomach. Avoid alcohol, wet noodles, large food, and overeating cold food.

Effects: Replenish the spleen and lungs, remove dampness and balance the body.

It is mainly used for laziness, sleepiness, lack of energy, weak legs, cold in the morning and evening, and after the sun rises, Yang Qi will be strong, and the heat will return like fire. Qi deficiency due to labor can also damage the large intestine. Either heat relapse and yin deficiency, or cold relapse and qi deficiency. Spontaneous sweating. There is no taste in the mouth, there is fire in the eyes, and the eyes are sparse and nothing can be seen. Unable to eat, or feeling full after eating other people, without thinking about food at all. Frequent urination, difficulty in defecation and constipation. Frequent fright when lying down, stranguria when urinating, white pus after defecation, or only white pus in stool. Pain in the epigastrium, pain in both flanks or rapid contractions. The area below the navel feels tight like a rope, or even stabbing like a knife, making it difficult to stretch the abdomen. Occlusion in the chest, sometimes vomiting, or coughing with phlegm, foaming at the mouth, and strong tongue. There is pain in the waist, back, and eye blades, and it occurs when there is a headache.

This prescription treats many syndromes, and its pathogenesis can be roughly divided into two categories:

First, the spleen and stomach are weak, lack of vitality, and dampness and heat are felt.

The second is insufficient Yin blood.

In terms of treatment, Li Dongyuan advocates that "we should first support the vitality and treat the deficiencies of Gengxin (large intestine and lung)".

So astragalus, ginseng, atractylodes, and licorice are used to nourish qi and strengthen the spleen; angelica is used to nourish blood and yang; Ophiopogon japonicus and schisandra chinensis produce fluid; atractylodes is used to dry dampness; orange peel, Shenqu is used to eliminate food and neutralize the disease; Phellodendron cypress can clear away heat and dry dampness. Cimicifuga and Yang.

Selected Cases

1. Patient with chronic atrophic gastritis, female, 47 years old, first diagnosed on October 4, 1996.

The pain in the epigastrium has been recurring for nearly 5 years, and has worsened for more than a month. I self-administered Weisu Granules, Weifuchun Tablets, Yangwei Granules, etc., but no effect was seen and I came to see a doctor.

Symptoms: lackluster complexion, fatigue and fatigue, dull pain and swelling in the epigastrium, sometimes belching, poor appetite, pale tongue, thin yellow greasy coating, and weak and thready pulse. Gastroscopy pathological examination showed: chronic atrophic gastritis (moderate) with atypical hyperplasia.

TCM diagnosis: epigastric pain. Treatment should mainly focus on strengthening the spleen and replenishing qi, supplemented by products that unblock collaterals and clear away heat.

Fangtou Astragalus and Ginseng Decoction, 15g of Astragalus, 6g of Cimicifuga, 15g of Codonopsis pilosula, 6g of tangerine peel, 10g of Ophiopogon japonicus, 10g of Atractylodes, 12g of Atractylodes, 12g of Cortex Phellodendri, 10g of Jiaoliuqu, 10g of Angelica sinensis, Zhizhi 6g of licorice and 6g of Schisandra chinensis. 1 dose per day, decoction in water and divided into 2 doses. After taking the medicine for a follow-up visit for 1 week, I felt that the epigastric pain and belching were significantly improved. After taking the medicine for another 2 weeks, the epigastric pain and belching basically disappeared, the appetite also increased, and the complexion began to turn rosy. Take it for another 2 months. Repeat gastroscopy and pathological examination showed: chronic atrophic gastritis (mild) and atypical hyperplasia had disappeared.

2. Summer fever in children. Song, male, 9 years old, first diagnosed on May 25, 1996. Fever occurs every year in late spring and early summer, and the body temperature often fluctuates between 37.5°C and 38°C, accompanied by poor appetite, fatigue, and weight loss. It naturally improves after the beginning of autumn and has been recurring for 3 years. I have been to the pediatrician for diagnosis and treatment many times, and all diagnoses have been made. It was caused by summer fever, and treatment with energy mixture, antibiotics, etc. was ineffective, so he was referred to a traditional Chinese medicine department for treatment. The tongue is light red, the fur is thin and yellow, and the pulse is weak and rapid.

The syndrome belongs to "Xia Xia" in traditional Chinese medicine. The disease is caused by Yin deficiency and spleen weakness in the body, combined with dampness evil. Human Xia Yang Qi leaks out, the middle Qi is insufficient, the spleen loses its transportation and transformation, and summer-dampness traps the spleen. .

Astragalus and ginseng soup additions and subtractions: 30g of Radix Pseudostellariae, 9g each of Astragalus, Ophiopogon japonicus, Peilan, Artemisia annua, Atractylodes, and Fried Shenqu, 6g each of Atractylodes, Tangerine Peel, Angelicae, Cimicifuga, Cortex Phellodendron, Zhigancao, and Schisandra chinensis. 3g each. Decoction in water, 1 dose per day, 3 times a day, 100ml each time. After taking 6 doses, my body temperature basically returned to normal, my energy level improved, and my appetite improved. After taking another 8 doses, all the symptoms were eliminated, the weight increased, and there was no recurrence for 2 years.

3. Impotence syndrome: Shi, female, 52 years old, first diagnosed on October 2, 1996. The patient began to suffer from fatigue and fatigue in March of the same year, and the treatment with traditional Chinese and Western medicine in many hospitals showed little effect. I reluctantly participated in the summer harvest, but the symptoms worsened later. The feet are weak, it is difficult to walk, shortness of breath and laziness, and the pain in the crown and brow bone is severe.

I once went to a city hospital for diagnosis and treatment. After multiple examinations such as examinations and X-rays, no organic disease was found. I was diagnosed with "neurosis" and was treated with oryzanol and other Western medicines, which had no effect. The man was losing weight day by day and had restless sleep, so his daughter accompanied him to the doctor.

Immediately, I feel tired, short of breath, lazy to talk, soft feet and difficulty walking, lukewarm limbs, pale complexion, emaciated body, poor sleep, no desire to eat, and a full stomach after eating too much. Sometimes noisy as if hungry, belching, pain under the hypochondriac, bitter mouth but not dryness, yellow urine, normal stool, pale tongue, thin tongue with tooth marks, thin white coating, and weak pulse.

The symptom is weakness of middle qi, and the astragalus and ginseng decoction can be modified.

Prescription: 50g astragalus, white ginseng, cohosh, tangerine peel, and atractylodes

10g each of atractylodes, angelica, chinensis, cork, and angelica, 6g each of schisandra and licorice, Shenqu, wheat winter. 15g, after taking 5 doses of the above medicine, my appetite increased, my spirit also improved, the pain in the crown and brow bone was also significantly reduced, all improved, the bowel movements were adjusted, the tongue was light red, the coating was thin and white, and the pulse was gentle and gentle. If the effect does not change the prescription, use Codonopsis 10 to defend the prescription.

Easy white ginseng, remove cork, and take 5 more doses, all symptoms disappeared.

Clinical Application

The composition of gastrointestinal dysfunction after trauma is: 20g of astragalus, 10g each of ginseng, atractylodes, and divine song. Schisandra 5g, 6g cohosh, 10g each of tangerine peel, atractylodes, and angelica. , Ophiopogon japonicus 15g, Phellodendron 8g, Zhigancao Yujin 10g each, Panax notoginseng and Salvia miltiorrhiza 15g. The efficacy was determined after 10 days of treatment, and the total effective rate was 98.4. For constipation, add rhubarb, loose stools, white and thick fur, add Magnolia officinalis, and Pinellia ternata; for abdominal pain, add Columbine and white peony root; for headache, add Pueraria lobata and Fructus Fragrans; for insomnia, add Albizia Julibrissin and stir-fried rhizome.

Clinical Syndrome Summary Astragalus and Ginseng Decoction has the functions of nourishing the spleen, lungs, qi and yin, clearing away heat and dampness and harming the stomach. It is mainly used to treat spleen and stomach diseases, impotence syndrome, etc. It can also be used to treat weak spleen and stomach and those injured by summer heat. Summer syndrome caused by heat-dampness and spleen stasis.

The pathogenesis is deficiency of both Qi and Yin, combined with dampness and heat. If the heat is severe during summer, the aroma of Peilan and Artemisia annua can dissolve dampness and relieve heat. For headaches, Angelica dahurica and Ligusticum officinale can dispel wind and relieve pain. For those with blood stasis, turmeric, salvia miltiorrhiza and notoginseng can activate blood circulation and remove blood stasis.

Astragalus and ginseng decoction has many symptoms, and clinical symptoms need to be applied flexibly according to the addition and subtraction method proposed by Li Dongyuan, as detailed below.

For headaches, blurry eyes, add two or three parts of Coptidis rhizome, and three parts of Ligusticum chuanxiong; for headaches, blurred vision, and heat in the upper part of the body, add two or three parts each of Vitex officinale, Ligusticum chuanxiong, and Ligusticum rhizome. , 2 points each of Rehmannia glutinosa and above, and 1 point Asarum.

For shortness of breath, energy as if in a dream, sleepiness and weakness, add nine Schisandra chinensis.

If there is qi stagnation in the chest, add one or two parts of green peel and twice the amount of orange peel to remove the evil energy. This disease is caused by a lack of vitality, so it should be replenished rather than purged. If the qi stagnation is severe, or the tonic is excessive, or the patient has depression and stagnation in the heart, add two or three parts of the above parts of the woody and Amomum villosum seeds, and two parts of the white cardamom kernels, and decoct them with the correct medicine.

If you feel depressed, add 2 or 3 points of coptis.

For epigastric pain, use medicine to reduce cold and add five minutes of cardamom kernels. If there is pain or contraction under the hypochondriac, add two or three points of Bupleurum.

For those with abdominal pain and no aversion to cold, add 5 points of white peony root, 2 points of skullcap and less schisandra chinensis.

If the stool is astringent and stagnant and disappears after one or two days, it will cause less food, inability to eat, less blood, and there is fire in the blood and cannot be moisturized. Add Danggui Shen, Sheng Rehmannia glutinosa, and Pockmarked Seed Seed for five times each. Divide and take three peach kernels (soak in the soup, peel off the tips and grind separately). If the stool passes, do not take the added medicine.

If the stool is not smooth and smooth, do not use other medicines. If it is unfavorable, it is not caused by blood clots and blood secretion. It is caused by heat and wind, and the patient will definitely have wind syndrome. Single blood medicine cannot be added, and regular use of astragalus and ginseng decoction is recommended. , only use Qianghuo, Fangfeng and above five qian each, two flavors, hei zui, add four cups of water, decoct until two cups, remove the residue, take it empty, the stool will be loose, and it will stop after just one dose.

For those who have quick and easy urination and are not yellow and astringent, only add two parts of Alisma and two parts of Alisma to eliminate the dampness.

For those with impotence, their limbs are soft and weak, and they are constantly upset and unjust. Jue Ni refers to the reversal of Qi, and even severe reversal is called Jue Ni.

For the symptoms of flaccidity and multi-phase whiskers, add 2 points of Poria cocos, 4 points of Alisma, and 1 point each of Polyporus polyporus and Atractylodes macrocephala.

Those who walk incorrectly, have weak ankles and knees, and push their feet to the sides are suffering from impotence. Add three or five minutes of wine to wash Cortex Cortex and Anemarrhenae, so that the energy will flow out of the two feet.

For those with impotence, dampness and heat are caused by the kidneys and liver, so they should be eliminated urgently. Otherwise, the vitality of the lower Jiao will be exhausted and become limp and paralyzed. The waist will be unable to move, and the heart will be upset and unjust.

If the body weight has decreased, the breath is not short, the urine is normal, and the dampness and heat have subsided, or the increased disease qi has subsided, do not use Schisandra chinensis, Alisma Poria, Polyporus, Phellodendron, Anemarrhena, and Atractylodes. , Atractylodes medicine can only be added or subtracted according to the syndrome of the disease.

When taking medicine regularly, you should also use two or three parts of wine and Cortex Cortex. If the season is more seasonal and the clear and dry Qi is prevalent, add pungent and warm to purge it.

For those with profuse sweating and diarrhea, if it is urgent to stop it, add six pieces of Schisandra chinensis, 5 minutes of fried Cortex Phellodendron, and 3 minutes of fried Anemarrhenae.