Professor Huang Huang:
Mao, male, 5 1 year old. At the end of June, 2004, 1 1, due to swelling and pain in the left leg, was diagnosed as venous thrombosis of the left lower extremity, with a thrombus length of 20cm. He is hospitalized locally. The doctor wants to remove the thrombus by surgery, but the patient is afraid of surgery and intravenous antithrombotic therapy is ineffective. I hope to try taking Chinese medicine. On May 2, 2005, the following decoctions were taken: Ramulus Cinnamomi 10g, Cortex Cinnamomi 5g, Poria cocos 15g, Semen Persicae 12g, Cortex Moutan 10g, Radix Paeoniae Rubra 15g and Achyranthes bidentata 35. After taking it for two months, the venous thrombosis of lower limbs has disappeared by B-ultrasound.
Venous thrombosis mostly occurs in the lower limbs, and mostly in the left lower limbs. The affected limb is swollen, thickened and painful, and the onset is rapid. Its complication, pulmonary infarction, has a high morbidity and mortality. It is said that about 50,000 to 200,000 people in the United States die of lung infarction every year. Injury of venous wall, venous blood stasis and hypercoagulability are the three major factors of venous thrombosis in lower limbs. Long-term bed rest, postoperative nephropathy, intravenous intubation, myocardial infarction, malignant tumor, smoking, oral contraceptives, rough massage, obesity, old age, etc. Both can be inducing factors. The treatment of this disease in modern medicine mainly adopts raising the affected limb, intravenous drip of low molecular dextran, compound salvia miltiorrhiza and low dose thrombolytic agent. If the symptoms are still not relieved and aggravated after the above treatment lasts for 3 days, interventional therapy can be considered. Chinese medicine generally also uses drugs that promote blood circulation and remove blood stasis.
From the perspective of traditional Chinese medicine, the patient's blood stasis not only refers to the thrombosis of lower extremity blood vessels, but also has its unique diagnostic focus. First of all, the patient is a stout middle-aged man with dark red face and tense abdominal muscles. Second, the left lower limb is swollen and painful, and the pain is aggravated during exercise; Third, I have had hemorrhoids before, and they have been more frequent recently. Hemorrhoids are also a manifestation of blood stasis. The above three items are consistent with the judgment of blood stasis.
The prescription used in this case consists of Guizhi Fuling Pill and Siwei Jianbu Decoction. Guizhi Fuling pill is a classic prescription for promoting blood circulation and removing blood stasis, and the relevant discussion can be seen in the previous case. I will focus on my own experience, Siwei Jianbu Decoction. The prescription consists of Radix Paeoniae Alba, Radix Achyranthis Bidentatae, Radix Salviae Miltiorrhizae, and Herba Dendrobii. It is mainly used to treat blood stasis characterized by lower limb pain, and the main site of action is blood vessels. Many complications of diabetes, such as diabetic foot, diabetic nephropathy and venous thrombosis, often have application opportunities. These drugs in this prescription were mostly used to treat lumbago and leg pain or fatigue in ancient times. Shaoyao Gancao Decoction is the main medicine in the classic prescription of Shaoyao Gancao Decoction. In Treatise on Febrile Diseases, Shaoyao Gancao Decoction is used to treat "foot contracture", saying that after taking the medicine, "its feet will stretch". Interestingly, Zhu Jifang regarded this side as unable to walk and renamed it "Tang". Shennong's Herbal Classic also says that Paeonia lactiflora "removes blood arthralgia", and blood arthralgia is painful. It is clearly recorded in Shennong's Classic of Materia Medica that Achyranthes bidentata "can treat cold-dampness flaccidity, limb contracture, and knee pain without flexion and extension", which was mostly used to treat soreness and weakness of waist and knees in Tang and Song Dynasties. There is also Dendrobium, which was used to treat soft feet and low back pain in ancient times. For example, the raw Dendrobium wine recorded in "The Secret of Outer Taiwan" is made of three kilograms of raw Dendrobium, one kilogram of Achyranthes bidentata, eight ounces of Eucommia ulmoides, eight ounces of Salvia miltiorrhiza and three liters of Rehmannia glutinosa, which are used to treat wind arthralgia, foot weakness, waist and hip pain and wind chill. There is a prescription named Dendrobium and Scrophularia Decoction in the Record of Syndrome Differentiation and Treatment, which is decocted with Dendrobium and Scrophularia to treat stomach fire, boredom, palpitation and fright. After a long time, it will become flaccid and weak, and it will be impossible to walk. Now it seems that most of these symptoms of soft feet and low back pain are caused by diabetes, and some of them are diseases such as venous thrombosis. After a period of clinical verification, it is found that this prescription has a good effect, which is mainly manifested in the relief of lower limb pain, numbness, spasm and edema, the hypertension of some patients can also be reduced, and the constipation that some patients have been troubled for many years can also be solved. There are two kinds of peony in the prescription: Paeonia lactiflora and Paeonia lactiflora. It is used to think that Paeonia lactiflora mainly nourishes blood and softens liver, and is mainly used for muscle spasmodic diseases. Radix Paeoniae Rubra is mainly used for promoting blood circulation and removing blood stasis, and is used for dark purple tongue coating or blood viscosity. I often use Paeonia lactiflora and Paeonia lactiflora together in clinic, and adjust the dosage according to the condition. If the pain is severe and the stool is dry, the total amount of Paeonia lactiflora can reach 120. Achyranthes bidentata, there are two kinds of pieces, Achyranthes bidentata and Achyranthes bidentata. According to custom, Achyranthes bidentata has the effect of nourishing liver and kidney, so it is better for the weak with low back pain and soft feet, and the dosage can reach 100g.
The effect of this patient is still relatively good. Later, after taking traditional Chinese medicine for three months, the thrombus has disappeared, leaving a local thrombus capsule shell with swelling feeling, and hemorrhoids have not appeared. I'm not sick. At present, the drug has been discontinued.