Wenjing decoction
Huang Huang thinks that Wenjing Decoction "can be regarded as an addition and subtraction prescription of Guizhi Decoction". Evodia rutaecarpa, cassia twig and ginger are three kinds of products for warming and dispersing, including Ophiopogon japonicus 65,438+0 liters, Ejiao 22 pieces (if patients find Ejiao troublesome or unpalatable, it can often be changed to jujube 65,438+02 pieces in clinic), Paeonia lactiflora 22 pieces for nourishing yin, Ligusticum Chuanxiong, Angelica sinensis and Cortex Moutan each promoting blood circulation, Pinellia ternata half liter, and Radix Glycyrrhizae 22 pieces. Many Japanese doctors use it to treat skin diseases, which proves that it "can improve the rough state caused by skin malnutrition." The indications for treating psoriasis with Wenjing decoction are: large skin lesions, obvious dryness (the smaller ones are mostly treated by stasis, and the larger ones are mostly treated by dryness), desquamation and fragmentation, long chronic course, pale or dark tongue, and no obvious heat image.
Examples of medical records
Cheng Moumou, male, 45 years old, with a course of 4 years. After repeated treatment, the lesions were concentrated in the calf, elbow, back and abdomen, all of which were relatively large. The lesions in the chest and back are larger than those in the palm, the base is not very red, the dryness is obvious, the dry mouth is not bitter, the stool is sparse, the pulse is thin, the tongue is thin and white, and the sublingual is dull. The first visit time was 20 10, 10, 14. Mahuang Ji Fang Huangqi decoction had no obvious effect on lower limb anhidrosis. Followed by the treatment of smooth pulse, dark red sublingual and hypertrophy of skin lesions, the addition and subtraction of Coix lachryma Fuzi Patrinia Powder has no obvious effect. Following the original recipe of Wenjing Decoction, the dosage is one or two 6 grams, and one liter is 24 grams. Radix Paeoniae Alba is used for defecation, and 28 pieces of roasted licorice and ginger are used for licorice. After 4 doses, the abdominal skin lesions became thinner obviously, with less abdominal fever and sparse stool. After adding Wenjing Decoction, Radix Astragali, Cortex Cinnamomi and Herba Ephedrae, the dosage of ginger gradually increased to hundreds, with good effect, less skin damage and even sweating.
Gui Ling Shugan Decoction
Huang Huang thinks that Gui Ling Shugan Decoction is a diuretic in Guizhi Decoction ... Anything that is tired, nervous and fond of cold for a long time will damage Yang Qi, and the water in the body will not stay and cause diseases. As for the formation of drinking water, the author thinks that "iatrogenic damage" can not be ignored in Yang Qi. The abuse of antibiotics is very common at the grass-roots level in China, which requires Chinese medicine to pay attention to the "drug evil" caused by the abuse of antibiotics in syndrome differentiation and treatment. In many cases, the damage of yang will lead to drinking water diseases. The indications for treating psoriasis with Gui Ling Shugan Decoction are: history of abusing anti-inflammatory drugs, fat and slippery tongue, easy sweating and uneven sweating (Mahuang Jia Zhu Decoction is often used by the author to treat sweating and uneven sweating). Abuse of antibiotics in the treatment of upper respiratory tract infections is an important cause of many acute psoriasis. For this kind of patients, first of all, ephedra prescription is needed to resolve phlegm and stop diarrhea, and Gui Ling Zhugan decoction is commonly used to resolve phlegm and stop diarrhea.
Examples of medical records
Feng Mou, male, 23 years old, was first diagnosed on 20 10/0, 165438. The patient complained of a cold and tonsillitis a month ago. The doctor gave me azithromycin, amoxicillin and cold medicine, which relieved my sore throat and cold symptoms. But a week later, little red dot appeared on his back, and dandruff appeared on his face. Three days later, he was covered with red spots. "This is a typical process of acute progressive psoriasis, and the rash lasts for 20 days. Without treatment, I sought medical advice from the author. Skin lesions spread all over the body from carved rice to mung bean erythema, with obvious itching, smooth hands, fat and light tongue, thin and white fur and no fear of cold. Usually the trunk is sweaty, the hands and feet are sweaty, and it is easy to sweat when drinking hot porridge. According to syndrome differentiation and classification, stomach tube and yingshu are used together with cold drinks. The treatment is 9 grams of ephedra, 9 prepared aconites, 3 grams of Asari, 65,438+04 slices of ginger and 65,438+02 slices of jujube, which are decocted for 65,438+050 minutes, and then taken at different temperatures. After taking the medicine, drink hot porridge and aim at sweating all over. Follow-up for 3 days showed that sweating increased, dandruff decreased, itching was greatly reduced, and the vamp effect was good. After taking Ephedra Jia Zhu Decoction and Coix Seed Fuzi Patrinia Powder, take 12 dose.
165438+1On October 25th, due to uneven sweating, the tongue was light and fat, and the fur was white and greasy. The prescription was revised as follows: Poria cocos 60g, Ramulus Cinnamomi 45g, Atractylodis Macrocephalae 30g, Glycyrrhiza uralensis Fisch. 20g, Lonicera japonica Thunb. 20g, Chinese liquor 20g, which patients take daily. 1 dose will aggravate itching, so add wine. Then add 3 grams of Herba Ephedrae, Cinnamomum cassia instead of Ramulus Cinnamomi, Rhizoma Atractylodis instead of Rhizoma Atractylodis, and reduce Flos Lonicerae to 15 grams, and continue taking.
To 20 10, 10, the tongue is fat, the skin lesions are few, and the sweating is obviously uniform (less sweating on the hands, sweating on other parts). It is required to take Fangfeng Tongsheng Pill with warm wine, once 1 bag, three times a day, and pay attention to sweating. After half a month's follow-up, he was in good health and stopped taking drugs.
Guizhi Fuling pills
Professor Huang Huang also evaluated the efficacy of Guizhi Fuling Pill in treating psoriasis: "The wife of a driver in a public institution is in her thirties. I have been suffering from psoriasis for many years and have red and yellow papules on my body. I found that my menstrual cycle is normal, but it is black and has abdominal pain. Dry stool is difficult to solve ... if it is not cured for a long time, I hope Chinese medicine can recuperate and improve physical fitness. I came to the clinic in the autumn of 2004. His face is dark red, with deficiency and blood stasis ... so he uses cassia twig, poria cocos, peony bark, peach kernel, red peony root, Ligusticum wallichii and salvia miltiorrhiza. After taking it for half a month, the papules tend to decrease and the stool is unobstructed. After taking the original prescription for 3 months, except for two elbows, there are one or two places larger than soybeans, and there is one place on the hairline of the headrest, and the skin lesions of the body and lower limbs basically disappear. ..... The leather armor is wrong, which is an indication of using blood-activating drugs such as peach kernel. Blood stasis, also known as dry blood, will never make people's skin coagulated, dry or dark red ... Taohe Chengqi Decoction is a stronger prescription than Guizhi Fuling Pill, and most of it needs to be accompanied by mental symptoms or abdominal pain, which can lead to diarrhea after taking it. Guizhi Fuling pills will be more peaceful and won't have diarrhea. Taohe Chengqi Decoction and Guizhi Fuling Pill can also be used as a pair of prescriptions to treat psoriasis. The former is used to treat acute symptoms and the latter is used to treat chronic symptoms. Indications of Guizhi Fuling Pill in the treatment of psoriasis are: long course of disease, small lesion area, limited, dense texture, tight scales, and partial to lower limbs, while women tend to have less menstrual flow and their lower abdomen is afraid of cold.
Examples of medical records
Guo Moumou, female, 23 years old, was originally engaged in the beauty industry. In the afternoon 10 after work, she lives in the basement. After three years, menstruation is delayed, the amount is small and the color is dark. Half a year later, in summer, her lower limbs were scattered in psoriasis lesions and disappeared after applying essential oil. After another half year, until June 5438+February, 2009, psoriasis lesions appeared again in the calf. Take Mahuang decoction for about 5,438+10 month in June, and the effect is not obvious. In the patient's patient explanation, the patient realized that the yang was damaged and the dampness could not be cured for a long time, so he resigned from his original job and actively cooperated with the treatment. Take more exercise and get more sunshine. Guizhi Fuling Pill is the main medicine, and Xiaoyao Pill, Dahuangchong Pill, Baohe Pill, Xuan Tong Li Fei Pill and Fangfeng Tongsheng Pill are used intermittently. After about half a year, the menstruation was normal and the skin lesions subsided.
The core idea of the author's treatment of psoriasis is to obtain "positive sweat", and the sign of positive sweat is Guizhi Decoction. "For a while, I was covered in sweat, and Zhi Zhi seemed to have sweat." There are two conditions for correct sweating: first, yin and yang are abundant, and second, the way of rising and falling of yin and yang is smooth (Li Shimao's Sweating Theory). For acute psoriasis with excessive pathogenic factors and unknown mystery, Mahuang Sweating Prescription is undoubtedly the most direct treatment scheme to "make pathogenic factors have a way out". For chronic psoriasis with disharmony between ying and Wei (that is, yin and yang, qi and blood), Guizhi recipe is needed to obtain positive sweat. Not only the three prescriptions mentioned in this paper, but also Guizhi Decoction, Xiaojianzhong Decoction, Zhigancao Decoction, Guizhi Shaoyao Mu Zhi Decoction, etc. have the opportunity to be used for the treatment of psoriasis.