从肝脾论治便秘

便秘一证,证候多样,由瘀致秘的病机为气滞血瘀、血瘀血虚、血瘀津亏.血乃脾胃运化水谷精微而成,故治血者,治脾为主.肝藏血,有疏泄、调节血液之功,故由瘀致秘多从肝脾论治.血瘀可致气滞,血瘀既是病理产物,亦是致病之因,瘀血停留,阻塞脉道,气机运行失常,宜用风药和血疏风、行气化瘀,方用大柴胡汤、小柴胡汤."久病必虚,久病兼瘀"...

Discussion About Treating Constipation from the Liver and Spleen

Constipation is a syndrome with various types.The pathogenesis caused by blood stasis due to qi stagnation,blood stasis due to blood deficiency,blood stasis due to fluid deficiency.Blood is the essence of water and grain transported by the spleen and stomach,so the treatment of blood disease mainly focuses on the treatment of the spleen.The liver stores blood and has the function of dispersing and regulating blood.Therefore,constipation caused by blood stasis is mostly treated from the liver and spleen.Blood stasis can cause qi stagnation.Blood stasis is not only a pathological product,but also a cause of disease.Blood stasis stays,blocks meridians,which makes qi movement run abnormally.It is appropriate to use wind medicines to promote blood circulation and disperse wind,circulate qi and remove blood stasis,so Major Bupleurum Decoction and Minor Bupleurum Decoction can be used to harmonize blood,disperse wind,promote qi circulation and remove blood stasis."Long-standing illness will lead to deficiency combined with blood stasis".Insufficient qi and blood lead to failure in generating tangible blood,so qi-tonifying medicinals and formulas are often added,qi aspect medicinals such as Taoren(Semen Persicae),Danggui(Radix Angelicae Sinensis),Chishao(Radix Paeoniae Rubra),Muxiang(Radix Aucklandiae),Zhiqiao(Fructus Aurantii),etc.can be added to tonify qi and nourish blood,moisten dryness and generate fluid.Blood and water are of the same origin.When blood stasis transforms into water,body fluid transportation is abnormal,the intestines lose moistening,and the body fluid becomes exhausted and constipation occurs.Treating constipation caused by blood stasis must take into account nourishing yin and promoting urination.It should be treated with formulas for nourishing fluid and regulating qi.Therefore,Shengdihuang(Radix Rehmanniae),Taoren(Semen Persicae),Danggui(Radix Angelicae Sinensis),Honghua(Flos Carthami),Zhiqiao(Fructus Aurantii),Maren(Fructus Cannabis),Gancao(Radix Glycyrrhizae),Xingren(Semen Armeniacae Amarum)are often used.If the course of disease is long,the body fluid and blood are consumed and injured,and there are blood stasis at the same time.It is appropriate to strengthen healthy qi and remove blood stasis,and Modified Four Substances Decoction is often used.