The Marvelous Effect of Zhengan Xifeng Decoction (Part III)
Cerebral Infarction
Cerebral infarction, also known as cerebral thrombosis, is the narrowing and blockage of arteries in the cerebral vascular system due to atherosclerosis and thrombosis, leading to acute cerebral ischemia and resulting in localized brain tissue necrosis. Clinically, it is often characterized by sudden-onset focal neurological deficits such as hemiplegia and aphasia. Cerebral infarction is mainly seen in patients with arteriosclerosis and often reaches its peak within minutes to hours or half a day, with many patients experiencing it during sleep. When hemiplegia occurs, the consciousness is usually clear. If there is impaired consciousness at the onset, basilar artery or posterior cerebral artery infarction should be considered. Extensive infarction, ischemia, and edema in the cerebral hemisphere can affect the function of the midbrain and upper brainstem, leading to the onset of consciousness disorders shortly after the onset. The diagnosis is mainly based on clinical manifestations and general examinations, followed by comprehensive analysis and research. If necessary, further confirmation of the diagnosis should be made through special examinations. Non-destructive brain imaging examinations such as computed tomography and magnetic resonance imaging are the first choice for diagnosis.
Cerebral infarction belongs to the category of "zhongfeng" in traditional Chinese medicine. It has different manifestations in the meridians, organs, and sequela stages. The pathological mechanism is related to blood stasis, and the main treatment methods are promoting blood circulation and removing blood stasis, and unblocking the meridians. In the stage of meridian and sequela, Zhengan Xifeng Decoction is used for patients with yin deficiency and yang hyperactivity.
Ingredients of Zhengan Xifeng Decoction: 30g Radix Cyathulae, 30g Raw Ochre, 20g Raw Dragon Bone (ground), 20g Raw Tortoise Plastron (ground), 25g Raw White Peony Root, 20g Radix Asparagi, 20g Radix Scrophulariae, 6g Melia Toosendan, 6g Barley Sprout, 6g Herba Artemisiae Scopariae, 6g Licorice. If the patient has unclear speech, add 12g Acorus Tatarinowii and 9g Polygala Tenuifolia; if the dizziness is severe, add 12g Radix Viticis and 9g Chrysanthemum; if the mouth and throat are dry, add 12g Dendrobium and 12g Ophiopogon.
(1) According to "Practical Journal of Integrative Chinese and Western Medicine", 1997, 10(11): 1075, Li Guochen reported: Zhengan Xifeng Decoction was used to treat 31 cases of sequelae after stroke, with 13 cases cured, 16 cases improved, and 2 cases not cured, with a total effective rate of 93.6%. Prescription: Radix Cyathulae, Raw Ochre, White Peony Root, Radix Asparagi, Radix Scrophulariae, Raw Tortoise Plastron, Raw Dragon Bone, Ostrea gigas, Herba Artemisiae Scopariae, Barley Sprout, Melia Toosendan, Licorice, Roasted Semen Strychni, and Rhizoma Drynariae. Decoction and administration showed satisfactory therapeutic effects.
(2) According to "Journal of Chengdu University of Traditional Chinese Medicine", 1995, 18(3): 28-29, Lin Yueming reported: Combined Chinese and Western medicine treatment of 50 cases of stroke, among which Zhengan Xifeng Decoction was used for patients with yin deficiency and yang hyperactivity. The basic prescription included Radix Cyathulae, Raw Ochre, Raw Dragon Bone, Raw Ostrea gigas, Raw Tortoise Plastron, Raw White Peony Root, Radix Scrophulariae, Radix Asparagi, Melia Toosendan, Barley Sprout, Radix Atractylodis, and Licorice. If there is also blood stasis with dark red tongue and purple spots, add Salvia miltiorrhiza, Paeonia lactiflora, and Hirudo medicinalis.
(3) According to "Liaoning Journal of Traditional Chinese Medicine", 1991, (6): 22, Mao Xianzhang reported: Zhengan Xifeng Decoction has achieved good results in the treatment of ischemic stroke. Prescription: Raw Ochre 30g, Raw Dragon Bone 20g, Raw Ostrea gigas 20g, Uncaria 12g, Chrysanthemum 12g, Raw White Peony Root 12g, Raw Tortoise Plastron 15g, Radix Scrophulariae 12g, Radix Cyathulae 20g, Rhubarb 9g, Glauber's Salt 10g, Barley Sprout 12g, and Herba Artemisiae Scopariae 9g. Take one dose daily, decoct with water, and take warm twice a day.
(4) According to "Chinese Medicine Information", 1997, (5): 26, Zou Yaoguang reported: One case of elderly patient with cerebral infarction was treated with Zhengan Xifeng Decoction, and the therapeutic effect was satisfactory. Prescription: White Peony Root 20g, Radix Scrophulariae 20g, Radix Cyathulae 20g, Dragon Bone 5g (precede decoction), Ostrea gigas 30g (precede decoction), Raw Ochre 30g (precede decoction), Deer Antler 30g (precede decoction), Gastrodia 25g, Uncaria 25g (add later), Cassia Seed 30g (precede decoction), and Raw Tortoise Plastron 30g (precede decoction), Sangjisheng 20g, Gentian 15g. Take one dose daily and adjust the prescription according to the condition.
Cerebral Hemorrhage
Cerebral hemorrhage refers to non-traumatic bleeding in the brain parenchyma, accounting for about 20% to 30% of all strokes, with a high mortality rate. Most cases are caused by hypertension combined with arteriosclerosis, while only a few cases are caused by other factors. This disease is more common in hypertensive patients over 50 years old, and it often occurs during emotional stress, excitement, defecation, or exertion. There is no premonitory symptom before the onset, but a few patients may experience symptoms such as headache, dizziness, difficulty in movement, and slurred speech before the onset. The onset is sudden, usually reaching its peak within minutes to hours, and is often characterized by sudden headache, dizziness, nausea, vomiting, hemiplegia, aphasia, consciousness disorders, urinary and fecal incontinence, and increased blood pressure. The diagnosis of cerebral hemorrhage is based on clinical manifestations, and the preferred auxiliary examination is computed tomography, which helps differentiate it from cerebral infarction.
Cerebral hemorrhage belongs to the category of "zhongfeng" in traditional Chinese medicine. It has similar manifestations in organs and meridians. The pathogenesis of stroke is complex, but the root cause is liver and kidney yin deficiency, leading to liver yang hyperactivity, liver wind internal movement, and Qi and blood counterflow, directly attacking the brain and causing various types of stroke. Zhengan Xifeng Decoction is suitable for stroke patients with yin deficiency and yang hyperactivity.
Ingredients of Zhengan Xifeng Decoction: 30g Radix Cyathulae, 30g Raw Dragon Bone (precede decoction), 30g Raw Ostrea gigas (precede decoction), 15g Raw Tortoise Plastron (precede decoction), 15g Raw White Peony Root, 15g Radix Scrophulariae, 15g Radix Asparagi, 12g Melia Toosendan, 15g Chrysanthemum, 10g Licorice.
If the patient has impaired consciousness, add 1 pill of Angong Niuhuang Pill and administer 80ml of Qing Kailin Injection through intravenous drip, once daily; if there is excessive phlegm, remove Raw Tortoise Plastron and Radix Asparagi, and add 6g Rhizoma Arisaematis, 15g Crocus, and 6g Glauber's Salt; if there is heart irritability and heat, add 12g Scutellaria baicalensis; if there is headache, add 3g Antelope Horn Powder (take as a decoction) and 30g Prunella vulgaris; if there is constipation, add 10g Rhubarb (add later).
(1) According to "Journal of Hunan University of Traditional Chinese Medicine", 1998, 18(2): 60, Dai Juan reported: Combined use of Zhengan Xifeng Decoction and Western medicine to treat 30 cases of acute cerebral hemorrhage, with a total effective rate of 90%. A comparison group of 30 cases was also observed. Traditional Chinese medicine achieved a cure in 10 cases, significant improvement in 12 cases, improvement in 5 cases, and no effect in 3 cases, with a total effective rate of 90.0%. The control group did not receive traditional Chinese medicine, with a total effective rate of 83.3%. The prescription included Raw Ochre 30g (precede decoction), Raw Dragon Bone 30g, Raw Ostrea gigas 30g, Radix Scrophulariae 15g, Radix Cyathulae 15g, Raw Tortoise Plastron 15g, Raw White Peony Root 10g, Radix Asparagi 10g, Melia Toosendan 10g, Barley Sprout 6g, Herba Artemisiae Scopariae 6g, Acorus Tatarinowii 10g, Licorice 5g, Sanqi Powder 3g. Take one dose daily, decoct with water, and take orally or through nasal feeding. At the same time, use drugs to reduce intracranial pressure, anti-brain edema, lower blood pressure, and provide general supportive therapy to maintain water and electrolyte balance.
(2) According to "Chinese Journal of Traditional Chinese Medicine", 1985, (3): 3, Cao Yangnan reported: Satisfactory results were achieved in the treatment of stroke patients who were still at risk or had limb paralysis after awakening from stroke or had hemiplegia. Prescription: Raw Ochre, Dragon Bone, Ostrea gigas, Raw Tortoise Plastron, Radix Cyathulae, Raw White Peony Root, Radix Scrophulariae, Radix Asparagi, Melia Toosendan, Barley Sprout, Herba Artemisiae Scopariae, Licorice. For patients with severe liver yang hyperactivity, add Uncaria, Gastrodia, Deer Antler, or Rhizoma Gastrodiae, or Chrysanthemum; for patients with excessive phlegm and obstruction of meridians, add Bulbus Fritillariae Cirrhosae, or Rhizoma Gastrodiae, or Resina Draconis, or Ginger Juice; for patients with severe yin deficiency, add Semen Ziziphi Spinosae, Gelatinum Asini, and Decoction of Water Crowfoot; for patients with qi deficiency, add Radix Astragali, Radix Ginseng; for patients with blood stasis, add Radix Salviae Miltiorrhizae, Flos Carthami, Radix Notoginseng; for patients with constipation, add Rhubarb, or Semen Cannabis, Herba Cistanches, and White Honey; for patients with swelling of hands and feet, add Rhizoma Notopterygii or Rhizoma Drynariae, Semen Coicis.
