【Prescription】
Yellow Qi Bu Zhong Yi Qi Tang
【Ingredients】145g of Huangqi, 9g of Hong Shen, 15g of Zhishi, 30g of Chao Baizhu, 15g of Fuzi (pre-boiled for 8 hours), 30g of fresh ginger.
【Dosage】
15g of Huangqi, 15g of Renshen (Dangshen), 10g of Baizhu, 15g of Zhigancao (honey-fried), 10g of Danggui, 6g of Chenpi, 6g of Shengma, 12g of Chaihu, 9 slices of fresh ginger, 6 jujubes.
【Administration】
Take all the ingredients and chew them thoroughly. Use 300ml of water to decoct until it reduces to 150ml. Remove the residue and drink it warm on an empty stomach.
【Functions】
Tonifies the middle and augments qi, raises yang and lifts sinking.
【Indications】
① Spleen deficiency and qi sinking pattern. Reduced appetite, fatigue, weak voice, sallow complexion, loose stools, pale tongue, weak pulse; as well as prolapse of anus, uterine prolapse, persistent diarrhea, prolonged dysentery, menorrhagia, and metrorrhagia.
② Qi deficiency and heat pattern. Body heat with spontaneous sweating, thirsty for hot drinks, shortness of breath, lack of strength, pale tongue, weak and forceless pulse.
【Clinical Case】
Ms. Bai, female, 56 years old. She had been suffering from recurrent epigastric pain for 30 years and came for consultation in early February 2009. She had a history of "gastric prolapse" for 30 years, and also had superficial gastritis. Current symptoms: distending pain in the epigastrium and abdomen, aggravated by cold and cold food, occasional nausea, poor appetite, palpitations when hungry, aversion to cold, fatigue, easy to get angry, swollen and painful gums, soreness in the lower back, poor sleep with many dreams. Frequent urination, loose stools, diarrhea after eating oily or cold food. The tongue coating is slightly dry and white, the tongue base is dark, and the pulse is deep and weak.
TCM diagnosis: Gastric pain. TCM syndrome differentiation: Spleen and stomach deficiency-cold, insufficient middle qi. Treatment principle: Tonify the middle and augment qi, warm and nourish the spleen and stomach.
Second consultation in March 2009: Took the prescription 7 times, and the nausea and abdominal pain were relieved, but the aversion to cold and shortness of breath were still obvious. Increased Fuzi to 30g to remove the cold, and added Hong Shen to tonify qi and blood. Thick and damp tongue coating, added Fuling 30g to strengthen the spleen and promote diuresis. By the eighth consultation in June, she had taken more than a hundred doses of Huangqi Bu Zhong Yi Qi Tang as the main prescription. During this period, the prescription was adjusted according to the symptoms. The current symptoms of abdominal pain and aversion to cold had disappeared, and the gums were not swollen and painful anymore. Urination improved, and bowel movements became slightly loose. The tongue coating was yellow and thick, the tongue base was dark, and the pulse was deep, thin, and slightly rapid. The prescription Huangqi Bu Zhong Yi Qi Tang was still used as the main treatment to fully exert its effects: 90g of Huangqi, 15g of Zhishi, 30g of Chao Baizhu, 9g of Hong Shen, 6g of Shengma, 6g of Chaihu, 3g of Huanglian, 18g of fresh ginger.
For the disease of gastric pain, most doctors treat it with methods that regulate qi and harmonize the stomach. If symptoms such as abdominal distension and swollen gums are present, it is easier to diagnose it as an excess heat pattern and treat it with methods that clear the stomach and relieve stagnation. However, the patient has been suffering from this disease for more than 30 years, and it started with "gastric prolapse". The current symptoms of aversion to cold and worsening with cold clearly indicate deficiency and cold. The symptom of abdominal distension is due to deficient qi not moving properly. Swollen and painful gums are what Li Dongyuan called "yin fire". When there is cold in the Taiyin, it forces the qi of Yangming to rise, resulting in poor circulation of the meridians and swelling. The treatment should focus on tonifying the middle and augmenting qi, using a large dose of Huangqi to invigorate the qi of the spleen and stomach. With vigorous qi in the spleen and stomach, the qi can circulate smoothly and the distension and pain will naturally disappear. Adding Fuzi can dispel the cold, enhance the analgesic effect, and also promote the descending of the Yangming fire, so as not to cause excessive yang due to long-term illness. Therefore, the duration of medication is prolonged to eradicate the root of the disease.
