Accumlation
and Aggregation
Treatment
based on differentiation of symptoms and signs
Accumulation
and aggregation attack and develop often slowly, and they
are related and transformed with jaundice, hypochondrial pain, malaria,
vermination, tympanites, and other syndromes each other Accumulation and
aggregation, are difficult to be absolutely differentiated ai initial stage.so
they should be divided into three stages, initial, middle and late stages
according to duration of disese, characteristics of syndrome, patholongical
cahges,and then give treatment based on differentiation of symptoms and signs In
differentiation of symptoms and signs, should differention over stagntion
of Qi over accumulation of phlegm, retention of food, over coagulation of
phlegm ,of over accumulation of phlegm, retention of food, over
coagulation of phlegm, or over vital deficiency ,and should combine with parts
of accumulation and aggregation ,in the abdomen or in hypochondrium.
I.Main
points of differentiation of symptoms and signs
(1)
Differentiation of initial, middle and late stages ;At initial stagr occurrence
of accumulation and aggregation, and diseases of the liver and spleen are caused
by stagnation of Qi, blood stasis and retention of danmpness .Retention in
abdomen belongs to injury of the spleen and stomach and it is caused by
stagnation of Qi,food retention retention of dampness as main; retention in
hypochondrium belongs to injury of the liver and spleen and it is caused mainly
by stagnation of Qi and blood stasis.At the
middle stage, stagnation of Qi and blood stasis, accumulation of dampness
into phlegm, coagulation of Qi and blood and phlegm into mass in the abdomen or
in the hypochondrium. At the latter stage, pathogenic factors do not decline and
vital Qi has had impaired,defic9iency of vital Qi, and
execessive patheogens, so it belongs deficiency in orgin and excess in
superficiality.
(II)
Differentiation of in Qi or in blood, and belonging to dempness, phlegm or
deficiency; at the initial stage,
often seen stagnation of Qi, marked by distending pain as main,with no fixed
part .At chronic stage,it attackes
collaterals, marked by blood stasis,with a fixed pain part and touchable
mass,often being hard in property.Disease of the spleen easily produces dampness
pathogen,marked by fullness in the stomach,disgestion,loose stool,dull
complexion,lassitude of limds.Protracted retention of dampness coagulates into
phlegm,marked by expectoration,or swelling distenticn with a shape,thicker in
size,movadle astouching it.protracted retention of pathogenic factors exhausts
vital Qi,manifesting Yin-deficiency of Qi,deficiency of Qi and blood,or
deficiency of YangQi.
Differentiation
of mass in the abdomen,mass at the right hypochondrium and tympanites
Accumlation
and aggrgation are marked by mass in the abdomen with distenion or
pain.Aggregation can form or resolve,and accmulation has a shape with no
resolution for long time.
Mass at
the right hypochondrium is marked by feeling of fullness in the chest and upper
abdomen,with no shape.It has differences of deficiency and excess
syndromes,being deficiency begfore meal,hunger,and being excess after
meal,fullness.
Ttympanites
is marked by enlargement of abdominal distention,pale-yellow skin,exposition
ofblood vessels in the abdominal skin Tympanites
has differences,of Qi tympanites blood tympanites,water tympanites,tympanties
bue to parasitic infestation but it is characterised by unique water-vibrated
sound,or like abdomen-pressed capsel filling water,and it is developed form
accumulation and aggregation bue to lack of treatment and delayed treatment.
II.Main
points of therapeutic prnciple
(I)According
to the law of clinical changes for mass in the abdomen,at initial atage,it is
caused often by stagnation of Qi,food retention,blood stasis and retention of
dampness,promoting the flow of Qi,promoting digestion and relaxing the
bowels,activating circulation of blood,removing dampness should be used as main
methods;at middle stage,it is caused often by stagnation of Qi,blood
stasis,accumulation of phlegm,promoting the flow of Qi ,removing
blood stasis and clearing away phlegm should be used as main methods;at
late stage,excess of pathogen and deficiency of vital Qi are often seen,so
strengthening the body resistance to eliminate pathogenic factors,reinforcement
and elimination in combination should be adopted.
(II)Protracted
mass in the abdomen impairs Qi and blood,so in treatment should protect vital
Qi,and should not use over amount of drugs resolving mass,for avoiding injury of
vital Qi.
(III)Because
aggregation is milder that accumulation,aggregation syndrome is in the Qi
system,regulating Qi is main method for its treatment,and accumulation syndrome
is in the blood system, activating circulation of blood should be main method.
Therapeutic effects is more easily attained for aggregation syndrome and
accumulation syndrome is difficult to be cured.
III
classification of syndromes and Treatment
(1)Initial
stage
Main
symptoms : Distenting pain in the abdomen ,Qi aggtegates or disperls with
emotional change.
Accompanying
symptoms: Anorexia, nausea, even vomiting of phlegm and saliva, constipation,
distention and fullness sensation in the hypochondrium.
Tongue
and pulse: Dart tongue with white and gteasy fur, taut and slippery pulse.
Analysis:
incoordination between Qi and blood, infree ciyculation of Qi and blood.
stagnation of Qi and blood in the abdomen induce distention and pain in the
abdomen, and aggregation of Qi; emotional change induces disorder of Qi,so state
of syndrome exacerbates. Ease of mind causes free flow of Qi.Injury of
both the lover and spleen,dysfunction in transporting and transforming
nutrients,production of pathogenic dampnes in interior,checking ascending
ascending function of Qi,so occur anorexia and nausea,even vomiting of phlegm
and saliva, constipation,or distention and fullness sensation in the
hypochondrium. Infree ciculation of Qi and blood results in dark
tongue,retention of pathogenic dampnese in the interir induces greasy fur. Taut
and slippery pulse are sings of incoordination between the live and spleen.
Therpeutic
principle: regulating Qi and activating circuation of blood,eliminating dampness
and resolving aggregation.
(II)
Middle stage
Main
symptoms:Mass in the abdomen with immobilization and fixaion part of distending
pain.
Accompanied
symptoms;Darkish complexio and emaciation,anorexia,viscous phlegm,cold and heat
now and then,squamous and dry ski and amenorrhea for women.
Tongue
and pulse:blue-purple tongue proper,or ecchmosis on the tongue,with greasy
fur,taut pulse,slippery or fine and uneven pulse.
Analysis:protracted
aggregation of Qi forms gradyually accumulation syndrome,stagnacy of Qi,blood
stasis and coagulation of phlegm in the abdomen,hence mass in the abdmen with
immobilization,and fixation part of distending pain.Incoordination between the
liver and spleen,infree circulation of and blood, dysfunction in transport and
transformation,insuficiency of nutrients, induce drakish complexion and general
thin,anorexia and viscous phlegm, squamous and dry skin. stagnancy of Qi,blood
stasis and incoordination between the Ying and Wei, result in cold and heat now
and then.Stagnation of the liver-Qi and blood stasis leads to ammenorrhea for
women.Blue-purple tongue proper with ecchymosis, fine and uneven pulse all are
signs of blood stasis and stagnancy of Qi. Gleasy fur on the tongue markes
retention of phlegm phlegm turbit in the inrterior; taut and slippery pulse are
signs of incoordination between the liver and the spleen.
Therapeutic
principle: Promoting circulation of Qi and blood, resolving phlegm and removing
stagnation of Qi.
III¡¢late
stage
Headache
due to Deficiency of Qi
Main
Symptom:lingering headache,aggravated with fatigue.
Accompanying,symptoms;sallow
complexion,thinness,lassitude,tasteless in the mouth,anorexia,and loose stool.
Tongue
and Pulse:pale enlarged tongue,thin and white fur and thready,feedle and
powerlee pulse.
Analysis:The
spleen is in charge of lifting lucid yang.Deficiency of the spleen causes
failure of lucid yang to ascend,failure of turbid yin to descend,and failure of
seven orifices to be nourished,leading to lingering headache.Headache will be
aggravated with fatigue and alleviated after rest.Failure to transport nutrients
due to deficiency of the spleen and failure of the yang-qi to reacn limds and
bones cause sallow complexion,thinness and lassitude,Indiges-tion bue to weak
spleen and stomach canses tasteless in the mouth,anorexia and loose stool.pale
enlarged tongue,thin and white fur,and thready,feeble and powerless pulse are
signs of weakness of the spleen and deficiency of qi.
Treatment:strengthening
the tongue proper with less fur and eccymosis,taut and fine pulse are signs of
deficiency of both Qi and Yin with blood stasis;pale,purple and enlarged tongue
with thin and greasy fur,deep and thin pulse are signs of deficiency of both Qi
and blood or great of Yang-Qi with blood stasis.
Therapeutic
principle:Strengthening the body resistance to eliminate pathogenic factors.
Measures
of prvention and nursing care
1.Stble
mention,avoid restlessness,deppress and anger.
2.Regular
diet,absain from peppery,greasy and sweet,fried food,do not drink wine.
3.Pay
attention to personal hygiene and environmental hygiene,for preven-tion from
invasion of exopathogenic factors.
4.Actively
treat jaundice,hypocondrial pain,mass in the abdomen,and schistosomiasis,etc.
Accumulation
and aggregation are referred to mass in the abdomen,or distension or pain.There
is a form with fixed posiston and
fixed pain pard for accumulation;and there is no form and wandering pain.The
caustive factors are for accumulation and aggregation are mainly mental
upsets,improper diet,pathogenic attacking and jundice,hypochdail
pain,malaria,and schistosmiasis can turn to accumulation and aggregtion
syndromes.Its pathological pathogenic factors are stagnation of Qi,dlood
stasis,and coagulation of phlegm,and deficiency of vital Qi is internal intetnal
factors of attacking.
Clincally,should
pay attention to diffetentiation of mass and tympanites.Mass is characterized by
spontaneous discomfort bue to fullness in the stomach with no shape,and
tympanites characterized by abdominal distension and fullness,pale and explosion of smsll blood vessel on the
abdomen.
In
treatment,the method of regulating Qi should mainly be used for aggregation
syndrome and the method of regulating blood for accumulation syndrome,which can
be divided into three stages,early,middle and later,stages for treatmet.The
drugs for removing sasis and resolving mass are ofrer used to enimilate
excess,but for accumulation and aggrgation,the vital-Qi is ertainly deficiency
and often are deficecncy accompanied with excess,or excess with deficiency,so,in
the treatment,should correctly treat relationship among the ¡°vita-Qi¡±¡°eliminate
and¡°tonifying¡±.
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