Clinical Experience of Xuefu Zhuyu Tang (Part 1)
1. Elderly lower limb weakness. Zhang, male, 76 years old, retired cadre, first visit on March 21, 2005. He had been experiencing heavy and weak lower limbs for more than half a year, which worsened after activity and was accompanied by lower abdominal distension. CT scan of the head, abdominal ultrasound, colonoscopy, and other examinations showed no abnormalities. Treatment with medications for arteriosclerosis and traditional Chinese medicine for spleen deficiency and digestion enhancement were ineffective, and tonics worsened the condition. In the past half month, he needed to rest after walking about 200 meters, felt irritable, had temporary relief from abdominal distension after passing gas, had unsatisfactory bowel movements, no swelling in the lower limbs, slightly dark tongue, thin coating, and deep, hesitant pulse. The diagnosis was blood stasis and qi stagnation, with obstruction of the meridians. Xuefu Zhuyu Tang with modifications was prescribed: 12g of Danggui, 9g of Chishao, 12g of Shengdi, 12g of Chuanxiong, 12g of Taoren, 9g of Honghua, 6g of Zhike, 6g of Chaihu, 6g of Jiegen, 9g of Niuxi, 3g of Gancao, 9g of Zhizi, 6g of Muxiang, 6g of Xiangfu, 6g of Yujin, and 9g of Wuyao. After five doses, the symptoms were reduced by half, and the treatment was continued with the same prescription. The patient regained strength in the lower limbs and normal mobility. He could walk long distances without feeling tired, the abdominal pain was relieved, and all symptoms disappeared. The disease was cured, and there was no recurrence after six months of follow-up. Note: This condition is caused by long-term blood stasis and qi stagnation, which leads to poor blood circulation and obstruction of the meridians. If weakness is the only symptom and it worsens after activity, mistakenly assuming it is qi deficiency and using tonics will aggravate the stagnation of qi and worsen the blood flow, inevitably worsening the condition. By using Xuefu Zhuyu Tang with modifications, blood stasis can be eliminated and the flow of qi can be smooth, resulting in recovery from the disease.
2. Neurodermatitis. Deng, 74 years old, male, retired cadre. First visit on April 16, 2005. He had been suffering from neurodermatitis on the face for more than 4 years, with itchy and thickened skin on the eyelids, face, and front of the ears. The skin had dark brown streaks and slight scaling, which worsened in spring and when in a bad mood. He had tried external and internal use of Chinese and Western medicine, with symptoms fluctuating in severity. He also experienced chest tightness, irritability, poor sleep, and frequent dreams. His tongue was dark with purple spots on the sides, thin coating, and the pulse was taut and hesitant. The diagnosis was blood stasis and deficiency of nourishment to the skin. Xuefu Zhuyu Tang with modifications was prescribed: 9g of Danggui, 6g of Chishao, 9g of Shengdi, 9g of Chuanxiong, 12g of Taoren, 12g of Honghua, 6g of Zhike, 6g of Chaihu, 6g of Jiegen, 9g of Niuxi, 3g of Gancao, 9g of Zhizi, 9g of Xiangfu, 9g of Yujin, 9g of Chanyi, 9g of Quanxie, 3 scolopendra, and 9g of Wuweizi. After seven doses, the itching of the skin slightly reduced, and the chest tightness and irritability decreased. The prescription was continued for ten doses, and the itching and dark brown color of the skin decreased. The sleep became normal, and there was no more chest tightness or irritability. Xiangfu and Yujin were discontinued after continuing the prescription for half a month. The color of the skin approached normal, with mild pigmentation, no itching, and the prescription was adjusted by reducing Wuweizi, Chanyi, Quanxie, scolopendra, and Wuweizi. The prescription was continued for one week to consolidate the therapeutic effect, and the patient was advised to maintain a happy mood. There was no recurrence after three months of follow-up. Note: This case involves long-term obstruction of the skin by wind-heat pathogen, resulting in malnutrition of the skin. Combined with the theory of phlegm stasis, Xuefu Zhuyu Tang with modifications was used to promote blood circulation and remove stasis, clear heat, and eliminate dampness. This resolved the stasis of blood and phlegm, and the skin received nourishment, resulting in recovery from the disease.
3. Chronic and refractory urinary tract infection. Guo, female, 65 years old, retired worker. First visit on April 26, 2004. She had been experiencing intermittent urinary frequency, urgency, pain, and discomfort in the lower abdomen for more than a year. One year ago, the patient developed the above symptoms without any obvious cause. Urinalysis at the municipal hospital showed leukocytes (++++) and red blood cells (++++), diagnosed as acute urinary tract infection. After treatment with antibiotics, the urine analysis became normal, and the symptoms improved but were not completely cured. The symptoms recurred 7-8 times despite treatment with Chinese medicine. She had undergone ultrasound and cystoscopy, which showed no abnormalities. The symptoms recurred again, and although the urine test was normal, the symptoms did not improve. The patient had poor sleep, frequent dreams, irritability, occasional headaches, difficulty with bowel movements, a slightly dark tongue with purple spots, thin and slightly yellow coating, and a deep, hesitant pulse. Treatment was aimed at promoting blood circulation and resolving stasis, clearing heat, and eliminating dampness. The prescription was Xuefu Zhuyu Tang with modifications: 12g of Danggui, 12g of Shengdi, 12g of Chuanxiong, 12g of Chishao, 9g of Gancao, 6g of Zhike, 6g of Chaihu, 9g of Niuyao, 9g of Zhizi, 12g of Huashi, 12g of Qumai, 9g of Huainiuxi, 12g of Taoren, and 9g of Honghua. After five doses, the symptoms improved, sleep was still acceptable, no more headaches, and bowel movements became regular. The tip of the tongue was no longer red, and the same prescription was continued for five doses. The symptoms were completely relieved, except for a small amount of purple spots on the tongue tip. The prescription was adjusted by reducing Niuyao, Zhizi, Huashi, Qumai, and continuing for one week to consolidate the therapeutic effect. There was no recurrence after six months of follow-up, and the purple spots on the tongue tip disappeared. Note: The patient had a long-standing illness resulting in blood stasis, impaired blood circulation, and obstruction of the meridians. If only blood stasis is seen without new energy, the condition worsens. The treatment should focus on promoting blood circulation and resolving stasis to restore the smooth flow of qi and blood vessels. This allows the water channels to regulate themselves and improve the condition.
