How to dispense medicine for TCM clinical syndrome

Mondo Health Updated on 2024-02-07

Medication is the addition or subtraction of a prescription based on the specific condition when determining the use of a certain prescription after optimization. Traditional Chinese medicine formula, medicine is divided into Jun, Chen, Zuo, and Make, each plays a different role, only a strict combination of blending, in order to exert a synergistic effect, produce the best effect, to avoid the production of acupuncture, but also according to the treatment method, the organization of acupuncture, in order to meet the principle of syndrome differentiation and treatment.

Drug discharge, also known as medication, refers to the clinical procedure of selecting, adding, subtracting, and adapting the selected prescription according to the condition on the basis of the clinical prescription. In the selection of prescriptions, there are two types of prescriptions: general prescription and main prescription. A general prescription is a prescription that can be used for a variety of diseases. The main prescription refers to the prescription that specializes in the treatment of a certain disease syndrome. There are also main disease prescriptions in clinical syndrome, but their application range is wider than that of the main prescription. When selecting parties, they are generally selected from ancient and modern famous parties. Therefore, the specific application of prescriptions must analyze the main treatment and main drugs, and at the same time reasonably add or subtract according to the condition. Alternative treatments are the usual prescriptions for clinical prescriptions. Appropriate to the condition, that is, the prescription listed should be consistent with the **, location, condition, and main symptoms of the disease.

Knowing the drug should know and avoid: knowing the need to know and avoid means that when discharging the drug, not only should know the best effect of the drug taste, but also should know the adverse effects of the drug taste, and should also see the drug compatibility and avoidance. At the same time, it is also necessary to understand the interests and stakes between medicine and disease, and between medicine and people. Avoid the harm first, and then use the benefit. If the treatment is used to disperse, it must be far from sour and cold; Treat and lower, do not rise and disperse; **Yangwang, when you know the heat; **Yang decay, no cold; To treat the above facts, avoid using elevated drugs; Treat the following facts, avoid using solid secrets; The upper void is taboo down, and the lower void is taboo discharged. For example, if you have a dry mouth and phlegm, you don't need Banxia and Nanxing, but use melon and fritillary. Almonds relieve lung qi, and those who have qi deficiency and cough for a long time will stop after one or two doses. Millet husks are mostly used for the treatment of cough, but the root of the disease must be removed first, which is the medicine after harvesting.

To sum up, the discharge of drugs should be based on the four qi and five flavors of the drug and the characteristics of ups and downs, and accurately adapt to the pathology, nature, location and other factors of the disease. When choosing drugs, it is necessary to fully consider the different stages of the disease, so as to choose the most appropriate drugs. As the ancients said, "The use of medicine depends on the compatibility of its nature, the control of each other, the opposite, and the evil of each other." In the drug compatibility, in addition to being familiar with the compatibility taboos of "eighteen anti" and "nineteen fears", it is also necessary to have an in-depth understanding of the advisability and avoidance of drugs after compatibility.

For example, there is a case recorded in the "New Interpretation of the Rejuvenation Record": an elderly man suffered from chronic diarrhea, with white and non-viscous stools, no hunger or thirst, and a slight pain in the abdomen but not fullness. After Meng Ying's diagnosis, his pulse was sluggish. So a large dose of Zhenwu Tonga ginseng was administered**, eventually**. In this case, the patient's stool was white and non-sticky, indicating that it was not caused by real heat; Slight pain in the abdomen but not fullness indicates that there is no stagnation of fasting; Being old and having a sluggish pulse is a sign of weakness of yang energy. Therefore, large doses of Zhenwu decoction were used to replenish yang and invigorate qi, and ginseng was added to enhance the efficacy.

Another example is a case recorded in "Lenglu Medical Words": a boatman Chen suffered from a fever disease, fever, no sweating, no food for seven days, thirst, chest ruffian, cough, headache, and the number of pulses was more on the right than on the left. Doctor Hangzhou prescribed a prescription for him, and the medicines were in line with his condition, but unfortunately two flavors of antelope horn and citrus aurantium were added. After taking one dose, the condition did not improve, and the chest became more stuffy. So I consulted him, and I removed the antelope horn and citrus husk for him, and added light tempeh and mint. After taking one dose, the whole body sweats, the body cools down and the appetite is restored. Then subtract the light tempeh and burdock seeds, add smallpox pollen, and heal after two doses. It can be seen from this that there must be a basis and theoretical support when dispensing and dispensing medicines, and the smell of medicine must not be disorderly.

The experience of the predecessors should be learned: the predecessors have accumulated rich experience in drug selection in the clinical practice, which is mainly summarized as the principle of drug selection, that is, the prescription of this group, and varies from person to person, at any time, and with the disease, so that the medicine can be used according to the symptoms and according to the condition.

The addition and subtraction of prescriptions is one of the commonly used methods by doctors, which can adapt to a variety of different conditions by adding or subtracting slightly according to the different symptoms of the original prescription. For example, when facing a female patient who is about 30 years old and has a thin body, Yu Hengde used the four things Tonga Qianghuo, parsnip, and nepeta**. Patients suffer from excessive blood loss after menstruation, which leads to the entry of wind evil, causing spasms, mouth shutting, hand and foot contractures and other symptoms. By using Siwu Tang plus or minus, Yu Hengde relieved half of his condition with only two doses of medicine, and the patient was completely ** after six doses of medicine. In addition, the addition and subtraction with the syndrome is also one of the important methods of the first disease syndrome. For example, in Danxi**, a woman with a thick endowment, the patient used medication on her own because of chest and abdominal distention, which caused diarrhea many times, but the fullness was not relieved. Danxi judged that this was a superficial evidence rather than a internal evidence, so it was carried out with Siwu Tonga ginseng, atractylodes, tangerine peel, and boiled licorice**. However, after half a month, his condition still did not improve. Danxi adjusted the prescription again, removed peony and rehmannia root, added astragalus membranaceus and atractylodes, and took it after a large dose of thick decoction. At the same time, Danxi also swallowed ginseng as a pill. Ten days later, the patient recovered. However, at this time, there are symptoms such as food difficulty and self-interest, and Danxi takes ginseng and atractylodes as the main medicine, flesh fruit and chebula as the subordinate medicine, and a little tangerine peel and hawthorn as adjuvant medicine to make porridge pills and swallow. After forty or fifty doses of the drug, the patient ends. In the case of blood syndrome, Siwu decoction is a commonly used prescription for predecessors. However, due to individual differences, not everyone is suitable for Siwu soup. Therefore, when using Siwu decoction in clinical syndrome, it is necessary to add, subtract and adapt according to the specific situation of the patient. If you need to generate blood and cool blood, you can choose raw land, peony and other medicines; If blood dispersion is required, drugs such as Chuanxiong can be used. However, at the same time, it is necessary to pay attention to the contraindications of various drugs, such as angelica sinensis should not be used for those who move blood due to fire, and Chuanxiong should not be used for those who carry blood due to fire. To sum up, the use of prescriptions to add or subtract ** disease syndromes requires doctors to have rich clinical experience and a solid theoretical foundation. In the face of different syndromes, doctors should add or subtract according to the specific situation of the patient to achieve the best effect. At the same time, doctors also need to have an in-depth understanding of the properties of various drugs to ensure that they are safe and effective. In the philosophy of medicine in ancient Chinese medicine, the compatibility and preparation of drugs are extremely important links. This point is elaborated in the book "Chishui Xuanzhu". There are many classic medicinal pairs recorded in the book, such as the compatibility of Zhimu and Phellodendron can enhance the effect of tonifying yin, and the combination of angelica and shengdi can promote blood production. These pairs of drugs not only complement each other, but also have a mutually restrictive compatibility relationship, which makes the effect of drugs more precise and powerful. In addition to compatibility, the ancients also attached great importance to the application of medicinal introduction. The drug introduction is a bridge to guide the drug directly to the hospital, it can enhance the efficacy of the drug, reduce the use of fresh ginger when cold, use ginger when warm, use ginger peel to relieve swelling, and use ginger juice to eliminate phlegm. Jujubes, red dates, longans, etc. are often used to regulate the camp and benefit health, relieve fire and dispel wind, replenish qi and benefit the lungs, etc. In addition, there are a variety of other medicines, such as mulberry leaves, mulberry branches, lake lotus, stone lotus, lotus stamen, lotus whiskers, etc., each of which has a unique role and enriches the means of traditional Chinese medicine. When it comes to drug processing, the ancients also had a strict set of methods. Through processing, it can not only eliminate the adverse reactions of the drug, but also enhance its ** effect. For example, mugwort leaves can warm the uterus, Chenbi soil can calm the spleen, and pine yellow and pine resin can prolong life. These preparation methods all reflect the rigor and wisdom of the ancients in the use of medicines. In summary, the predecessors have accumulated rich experience in the compatibility, processing and application of drugs. These experiences are not only a supplement and improvement to the theory of traditional Chinese medicine, but also provide a valuable reference for modern medicine. For scholars who want to have a deeper understanding of this field, exposing the medical theories and medical cases of previous people is the only way to increase their knowledge and skills. February** Dynamic Incentive Program

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