We know that the pathogenesis of bone arthralgia is mainly the obstruction of qi and blood in the meridians, and the dystrophy of muscles and bones and joints. The disease is mainly in the bones, but can also involve muscles, joints, liver, spleen, kidneys, etc. The viscera are closely related and are mostly caused by the feeling of external evil, liver and kidney deficiency, and phlegm and blood stasis. So how does Chinese medicine treat Gu Bi? Today, I will share with my friends the treatment of Gu Bi in Traditional Chinese Medicine.
Because bone arthritis is divided into deficiency and excess and the mixture of deficiency and excess, the actual situation is mostly cold, damp, hot, phlegm , blood stasis, etc.; deficiency is mostly liver and kidney deficiency. Therefore, the treatment of Gu Bi should also be based on the dialectical treatment based on the deficiency and the actual condition: the empirical evidence should be based on eliminating the evil, and the deficiency syndrome should be based on strengthening the vitality and dredging the collaterals. Common treatments include dispelling cold and removing dampness, clearing heat and dampness , dispelling phlegm and dredging collaterals, and nourishing the liver and kidneys for normalization.
Why is bone palsy found and should be treated in time? This is because the prognosis is generally good if bone arthritis can be treated promptly and correctly in the early stage. If the treatment is delayed, the disease does not heal for a long time, or the treatment is missed, deformities and stiffness will appear, which are often difficult to reverse and are easily disabled, and the prognosis is poor. In addition, if bone palsy persists for a long time, it can develop as kidney palsy .
So how should bone paralysis be dialectic? The author believes that there are two main points to distinguish: first distinguishing cold and heat, and then distinguishing deficiency and actuality. Cold syndrome usually manifests as fixed pain, bone pain, cold limbs and aversion to cold, reduced heat and pain, pale tongue, white fur, tight pulse string; heat syndrome more common joint swelling, heat pain, fever, sweating, annoyance, tongue The red moss is yellow, and the pulse is slippery or finely counted. To distinguish between deficiency and excess, the positive evidence is mostly caused by the six evils of exogenous feelings, or the interlocking of phlegm and blood stasis, which blocks the muscles and bones and meridians. It is often caused by severe pain in the joints of the limbs and unfavorable flexion and extension; , Muscles and bones meridians are not nourished, and the limbs are sore, numb, dull pain, and even deformity.
The specific dialectical treatments are as follows:
1. Cold and damp arthralgia syndrome
If the evil of cold and damp invades the human body and stays in the condyles, it will be issued as a syndrome.
Clinical symptoms: cold pain, swelling, and heaviness in the joints of the limbs; poor joint flexion and extension,Day is light and night is heavy, afraid of cold, aggravated by rainy days. The tongue is pale red, the coating is thin white or greasy; the pulse string is tight.
The treatment should be: dispelling cold and removing dampness, Pinbi Tongluo.
Representative prescription: Coix Seed Decoction (" miraculous prescription ") addition and subtraction.
prescription: chuanwu, ephedra , cassia twig, 羌huo, , , _span_span_span_span_span_span11, _span_span_span_span_span11, _span_span_span_span_span11 All prescriptions play the power of dispelling cold and removing dampness, Pinbi and dredging collaterals.
If the joints are swollen or have effusion, add Poria, Alisma , plantain; for severe upper limb pain, add mulberry branch turmeric, lower limb pain For those with pine joint, , burrow wind; for those with dry throat or sore throat after taking the medicine, add , Ophiopogon , raw land, scrophulariaceae.
2. Damp-heat accumulation syndrome
If the evil of dampness and heat invades the human body, or the cold and damp stays for a long time, and the stagnation turns into heat; or the heat is prosperous, and the heat, damp and heat stays in the condyle, this syndrome is issued.
Clinical symptoms: red, swollen, hot, painful and heavy limb joints; poor joint flexion and extension, fluid effusion, or sore limbs, poor body heat,Sweat and annoyance, bitter and sticky mouth, yellow and red urine. Red tongue, yellow greasy coating; slippery pulse.
The treatment should be: clearing heat and removing dampness, pinbi and dredging collaterals.
represents the prescription: Si Miao Pill (" into convenient reading ") addition and subtraction.
prescription: atractylodes, phellodendron, coix seed , Sichuan achyranthes bidentata, papaya , fangji , all prescriptions play the effect of clearing heat, removing dampness, and dredging collaterals.
If fever and joint swelling are obvious, add Banlangen; joint effusion add plantain, Alisma; joint stiffness plus pagoda, scorpion, .
If bone arthralgia, kidney fever, bladder obstruction, obstructed urine and feces, scorched and black skin, tinnitus deficiency and heat, suitable for Sanhuang Decoction ("Preparation of Emergency Medicine"); if bone arthritis is really hot, bone marrow acid Pain, Yisheng Dihuangjian ("Tai Ping Sheng Hui Fang"); if the bones are really hot, tinnitus, scorched complexion, undisturbed bladder, pain in the teeth and brain, pain in the hands and feet, closed bowel and urine, the treatment is suitable for three yellow rounds ( "Three Causes and One Disease Syndrome") or Xuanshen Decoction ("Yanshi Jisheng Prescription").
3. Liver and Kidney Deficiency Syndrome
If the appetite is disordered, or the young and the congenital insufficient endowment, or the old age, the decline of the kidney qi, the liver and kidney deficiency, the lack of kidney essence, and the bone marrow Empty, insufficient liver blood, muscle and bone dystrophy occurred, this is the card issued.
The clinical symptoms are: dull pain in the limbs, heavy joints, deformities, bone steaming and backache; waist pain, upper nape, lower hips and knees, stiffness and anxiousness, unfavorable turning, difficult pitching, pain when moving between the groin and thigh.Zygomatic red night sweats. The tip of the tongue is red, the coating is thin and there is little fluid; the pulse is heavy or thin.
The treatment should be: tonic liver and kidney, activating blood and dredging collaterals.
Representative prescriptions: Duhuo Jiefang Decoction ("Emergency Preparation Prescriptions") addition and subtraction.
prescription: rehmannia , eucommia , ginger root, pueraria lobata , zonghuo, soil beetle, peach kernels, spanspanspan, spanspan 11span, span span 11span, spanspan, span Nourishing liver and kidney, promoting blood circulation and dredging collaterals.
If has bone steaming and hot flashes, spontaneous sweats, waist and hip burning, add honeysuckle, paeonol, zhimu, rehmannia instead of yellow rehmannia ; For those with cold, cold limbs, heat and pain reduction, add Guizhi, , Sichuan pepper, and cooked aconite.
If the bones are numb, the limbs are sore, the feet and shin are weak, the ears are weak, and the ears are ringing. Yifuzi pills ("Taiping Shenghui Fang"); dark complexion, cold feet and tinnitus, thin limbs, weak feet and knees, urination For slippage, use Bushen Shugan Dihuang Pills (" Sanji General Record"); lumbar and spine pain, no pitching, cold feet pain, weakness, dizziness and deafness. The voice is muddy, the limbs are heavy, use Fuzi Duhuo Decoction ("Sanji General Record"); Gubi appears swollen and dark face, spinal pain can not stand for a long time, qi declines and loses teeth, low back pain, even saliva, is suitable for antlers Pills ("Yan Shi Ji Sheng Fang").
IV. phlegm and blood stasis syndrome
Endogenous phlegm dampness, or due to exogenous dampness, accumulating dampness and producing phlegm, phlegm dampness block; or arthralgia enters the collaterals for a long time, blood flow is slow, blood stasis is generated, phlegm stasis is knotted, meridian qi and blood cannot be unblocked, condensing joints This proves.
Clinical symptoms: diffuse swelling, tingling, heaviness of the limbs, deformity, stiffness, rigid; unfavorable flexion and extension of the limbs, difficult to flexion and extension rotation, severe pain, numbness, skin with sputum nucleus , Ecchymosis. The tongue is purple and dark, or there are petechiae, and the coating is white and greasy; the pulse is heavy and thin or astringent.
should be treated as follows: to promote blood circulation and remove blood stasis to resolve phlegm and dredge collaterals.
Representative prescriptions: Angelica Myrrh Pills (" Women's Complete Recipe ") and Mi Fuling Pills (" Syndrome and Treatment Criterion ") addition and subtraction.
prescription: angelica, peach kernel, safflower, frankincense, myrrh, pangolin, chuanxiong, pinellia , white mustard seed, citrus aurantium, cinnamon sticks, all prescriptions are used to promote blood circulation, remove blood stasis, and eliminate phlegm The power of Tongluo.
If the joints are red, swollen and painful or have low-grade fever, add honeysuckle, Radix Isatidis, Polygonum cuspidatum ; if the joints are cold and painful, add Sichuan pepper.
The above prescriptions can be decoctions, ointments,
pills, etc. according to clinical needs.
In addition to the above dialectical treatment, it is more important to cooperate with other therapies, such as acupuncture ( , water needle knife , moxibustion, ear acupuncture), massage, external application, etc., so I won't repeat them here. Like my sharing, please pay attention, the next issue will be more exciting.
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