patient Liu, female, married, 35 years old, , Wenzhou , businessman, first diagnosed on May 6, 2008. 
Usually emotional depression, insomnia and dreamy, low menstrual flow, dark color, blood clots, abdominal pain during menstruation, accompanied by breast swelling and pain, poor stool , loose stool , bleak tongue, stringy and thin pulse.
Traditional Chinese medicine diagnosis : Black spot , syndrome belongs to Liver depression and spleen deficiency , and qi and blood stasis.
Western medicine diagnosis: chloasma.
Treatment methods: relieve liver and spleen, remove blood stasis and remove freckles.
prescription: Self-made Huaban Tang with flavor. Bupleurum 10 grams, Xiangfu 10 grams, Green Pig 10 grams, Crafted Rehmannia 15 grams, Red Peony 10 grams, Chuanxiong 15 grams, Angelica 15 grams, Ligama 10 grams, Angelica 10 grams, Angelica 10 grams, Angelica 10 grams, 15 grams of fried Atractylodes macrocephala, 15 grams of fried yam, 110 grams of Poria 10 grams, 215 grams of fried Coix seed 15 grams, 210 grams of fried lentils 10 grams.
14 doses, 1 dose per day, decocted in water, and taken in warm two hours after morning and dinner. Please eat light food and avoid greasy and spicy foods, keep your mood comfortable, sleep well, and pay attention to sun protection.
2nd visit on May 20: The area of the color spots has shrunk, the color has become lighter, the diet has gradually increased, the loose stools have disappeared, the menstruation has arrived as scheduled, the amount is small and the color is dark, the lower abdomen is painful, the tongue is dark, and the pulse is stringy and thin. In the front, subtract fried yam , poria cocos, fried coix seed, fried lentil , add 15 grams of Salvia miltiorrhiza, 215 grams of motherwort html, 210 grams of safflower html, and 10 grams of peach kernel. Followed 14 doses.
6 June 3rd diagnosis: the complexion is rosy, most of the color spots have subsided, menstruation is smooth, breast swelling and painful, insomnia and dreaming are significantly improved, the tongue is pale and the pulse is stringy and thin. Subtract safflower and peach kernels in the front and take 14 doses to consolidate the efficacy.
htmlJune 17th Fourth Clinic: The color spots subside, there are no new color spots, the tongue is pale and red, the coating is thin and white, and the pulse is stringy and thin. I advise them to keep a comfortable mood and pay attention to sun protection. After half a year of follow-up, chloasma did not recur again and menstruation was smooth.Note: The patient has depression in his emotions, his liver is out of strength, his liver is depressed, his qi is stagnant, his blood flow is slow, his liver overcomes the spleen and earth, his source of transformation is insufficient, his yin and blood are deficient, and his qi and blood are stagnant, and he cannot be prosperous on the face. His face is lost in prosperity and nourishment, causing spots, darkness and no glory.
The liver is not relieved and discharged, so the emotions are depressed, and the breasts are swelling and painful; the liver blood is deficient and the soul has no place to leave, so there is insomnia and dreams; the blood sea is empty, so the menstrual volume is small; the qi and blood are stagnant, and the blood flow is not smooth, so the menstruation is painful, the color is dark, and there are blood clots; the liver overcomes the spleen earth, and the spleen is ineffective, so it is seen that the patient is poor and the stool is loose.
The tongue is dull and the pulse is stringy, thin and astringent, all of which are signs of liver depression and spleen deficiency and stagnation of qi and blood. Therefore, the treatment is to relieve the liver and strengthen the spleen, replenish blood circulation, and remove blood stasis and remove freckles. The prescription is Huaban Tang, add Poria cocos, fried Atractylodes macrocephala, fried yam, stir-fried Coix seed, stir-fried lentils to strengthen the spleen and replenish qi, remove dampness and stop diarrhea. The second diagnosis was that the loose stool disappeared, the spleen deficiency improved, but the tongue was dark, and the menstrual period was not adjusted in . Considering that the blood stasis syndrome was still there, the fried yam, Poria cocos, fried coix seed, fried lentils were reduced, and Salvia miltiorrhiza, motherwort, safflower, and peach kernel were added.
Yang Muxiang believes that this patient suffered from both melasma and irregular menstruation, and the two were related. From the perspective of modern medicine, both were caused by endocrine disorders. From the perspective of traditional Chinese medicine, it is caused by liver qi stagnation, spleen deficiency and loss of luck, and qi and blood stasis. Therefore, following the principle of treating different diseases at the same time, we will give the method of relieving liver and strengthening the spleen, removing blood stasis, and removing freckles. Not only will the chloasma disappear, but irregular menstruation will also be cured.
Huaban Decoction for Melasma
Yu Wentao Nie Jintao
Yu Wentao Nie Jintao Yang Muxiang Famous Traditional Chinese Medicine Studio of Hebei Medical University
Etiology and Pathogenesis
Melasma, also known as liver spots and butterfly spots, is a common clinical facial pigmentation skin disease, mostly female patients. Traditional Chinese medicine calls it "black spot", Eastern Jin Ge Hong's " elbow reserve emergency prescription " called it "black spot", and Chen Shigong's " authentic surgery " in the Ming Dynasty called it "black spot". In addition, there have been records of "liver spots", "brown yellow spots", and "butterfly spots".
This disease is more common in women. The "Taiping Shenghuifang" written by Wang Huaiyin in the Song Dynasty says: "Women have long-term water flow, and the years are far-reaching, and their faces are dark.
... This is because blood coagulation is in the organs, and heat enters the blood chamber ."The Song Dynasty's "Shengji Zonglu·Volume 89" says: "Women's organs are cold for a long time, their heads and temples are thin, and their faces are black."
shows that facial spots are related to factors such as weak qi and blood, menstrual disorders, and cold uterus. The kidney belongs to water, which has black color, deficiency of kidney essence, insufficient essence and blood, and cannot be overly prosperous on the face, or the kidney yin is deficient, and the deficiency of fire is dark, which can also cause the skin to be dark and unlucky, forming dark spots.
" Theory of the Causes of All Diseases" by Chao Yuanfang in the Sui Dynasty pointed out: "For those with black faces, they may have phlegm and fluid in the internal organs, or their skin is subjected to wind evil, which causes Improper blood and qi lead to black tumours".
Ming Dynasty Li Shizhen in "Compendium of Materia Medica" believes that "black dry and black wind evil once visited the skin, phlegm and fluid were stained on the internal organs, that is, sparrow egg spots, and women's name powder and dregs were spots." It indicates that the wind evil attacks outside and is trapped in the lungs, the lungs are lost and the water channels are blocked, causing the wind to stop water, drink stops inside, stains on the internal organs, and the qi and blood are inconsistent, and cannot be prosperous on the skin of the face. In short, the cause and effect of this disease is summarized as deficiency of kidney qi, and the qi and blood are not harmonious, and cannot be prosperous on the face.
Yang Muxiang believes that this disease occurs on the face , The disease is in the liver, and is related to spleen and kidney dysfunction.
The liver stores blood, likes to be strong and hates depression, if the emotions are not satisfactory, the liver loses distraction, qi stagnates and blood stasis, or the qi is depressed for a long time, which burns the yin blood, causing the face and face to lose harmony and cause the disease; The kidney stores essence , which belongs to water. If the water is deficient, the fire will be strong, and the fluid and blood will be consumed, and it cannot moisten the face; the spleen is responsible for transportation and transformation, and is the source of qi and blood biochemical, and it will cause qi and blood to become a source of qi and blood. If the diet is not stable, it will damage the spleen and stomach, spleen deficiency and loss of luck, and the biochemical source will cause qi and blood deficiency, which will cause qi and blood deficiency, and cannot rise to the face, thus causing melasma.
Combined with years of clinical experience, chloasma is more common in women, first of all, because women are born The influence of rational, psychological and social factors is very prone to emotional disorders and liver qi stagnation; secondly, women are blood-based, and various reasons can easily lead to the loss of qi and blood or the emptiness of qi and blood, insufficient essence and blood, and the essence and blood cannot be prosperous on the face, resulting in this disease. Therefore, liver stagnation and qi stagnation, and the loss of qi and blood are the main pathogenesis, and it is emphasized that "there are spots and there will be stagnation, and no stagnation will not form spots."
prescriptions and medicines
teacher Yang Muxiang takes the main treatment of relieving liver qi and removing stasis. In the agent to relieve liver stagnation, add products that nourish blood circulation and remove blood stasis.
self-described "Huaban Tang", the prescription is Chaihu 10 grams, 10 grams of Xiangfu, 10 grams of Green Skin, 15 grams of Rehmannia, 10 grams of Red Peony, 15 grams of Chuanxiong, 15 grams of Angelica sinensis, 15 grams of Angelica sinensis, 10 grams of Shengma, 10 grams of Angelica sinensis and other medicines.
Among them, Bupleurum, Xiangfu, and Qingma sinensis can relieve liver and regulate qi; Rehmannia sinensis, Red Peony, Chuanxiong, and Angelica can promote blood circulation and remove blood stasis; Shengma and Angelica can increase yang and reach the surface, warm and unblock blood vessels, and help remove freckles. To achieve the effects of relieving liver and regulating qi, removing stasis and removing freckles. When clinical symptoms are achieved, add and subtract according to the symptoms. If blood deficiency is worse, the face is pale, the lips and nails are unpretentious, the menstrual volume is small, the color is light, and even the menstrual stops, add htm as appropriate l1 donkey-hide gelatin 10 grams (melted), make 15 grams of Polygonum multiflorum;
If blood deficiency cannot nourish the heart, the mind is uneasy, accompanied by palpitations, restlessness, insomnia and dreams, add 15 grams of jujube seeds, 15 grams of Poria god, 230 grams of night-josen html;
If biased to kidney yin deficiency, , accompanied by soreness of waist and knees, dry mouth and dry throat, five hearts and heat , add 1 literati 15 grams of 15 grams of 15 grams of 15 grams of 15 grams of 15 grams of 15 grams of 17 grams of 17 grams of 17 grams of 17 grams of 17 grams of 17 grams of 17 grams of 17 grams of 17 grams of 17 grams of 17 grams of 17 grams of 17 grams of 17 grams of 17 grams of 17 grams of 17 grams of 17 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 grams of 18 230 grams of mulberry parasitol, 15 grams of Eucommia ulmoides, 210 grams of severity, 215 grams of severity, 215 grams of severity, 215 grams of severity, swelling and pain in the chest and flanks, and irregular menstruation, add severity, 210 grams of severity, 210 grams of severity, 210 grams of severity, 210 grams of severity, 210 grams of severity, 210 grams of severity, 210 grams of severity, 210 grams of severity, 210 dysmenorrhea, 210 grams of severity, 210
If blood stasis is severe, 21 dysmenorrhea, 2 or delayed menstrual period, 200 grams of severity, 200 grams of severity, 200 grams of dysmenorrhea, 200 grams of severity, 200 grams of severity, 200 grams of dysmenorrhea, 200 grams of severity, 200 grams of severity, 200 grams of dysmenorrhea, 200 grams of severity, 200 grams of dysmenorrhea, 200 grams of severity, 200 grams of severity, 200 grams of dysmenorrhea, 200 grams of severity, 200 grams of dysmenorrhea, 200 grams of severity, 200 grams of dysmenorrhea, 200 grams of s Spots, stringy and astringent pulse, add 15 grams of Salvia miltiorrhiza, 15 grams of Motherwort, 10 grams of Peach kernel, and 10 grams of Safflower;
If the spleen deficiency is severe, accompanied by abdominal distension and loose stools, add 15 grams of fried Atractylodes macrocephala, 15 grams of fried yam, and 15 grams of Poria cocos;
If the liver is stagnant, liver fire is on the swelling and swelling of the head and the pain, add gardenia 10 grams, gentian grass 10 grams, and 10 grams of Scutellaria baicalensis.
prescription ling
zhisheng Chai Fu Siyu
