Pay attention to the treatment, drain turbidity, clear away heat and toxic materials, and remove blood stasis.
Stone therapy for gout emphasizes the combination of disease differentiation and syndrome differentiation. He said that from the perspective of modern medicine, gout is caused by purine metabolism disorder, high blood uric acid and deposition in joints or their adjacent tissues; From the theoretical analysis of traditional Chinese medicine, blood heat is accompanied by external cold, dampness, blood coagulation, qi stagnation, and meridian obstruction, which leads to pain in limbs, upper limbs, lower limbs and middle limbs. Its pathological feature is "turbid blood stasis and retention of meridians", so the treatment should be based on expelling turbid blood and heat toxin. Since 1997, Shi has made a clinical study on Danxi Tongfeng recipe, and observed the clinical symptoms, main laboratory indicators, analgesic onset time, analgesic duration and recurrence times within 1 year before and after treatment, which confirmed the effectiveness of Tongfeng recipe. He said that Danxi Tongfeng recipe uses Rhizoma Atractylodis, Notopterygii Rhizoma, Radix Clematidis, Radix Stephaniae Tetrandrae, Ramulus Cinnamomi and Radix Angelicae Dahuricae to dispel wind and remove dampness, Cortex Phellodendri, Rhizoma Arisaematis cum bile, Massa Medicata Fermentata, Radix Gentianae to remove heat, Rhizoma Chuanxiong, Semen Persicae and Flos Carthami to dissipate blood stasis, which can dispel wind, warm and clear heat, dissipate blood stasis, reduce swelling and relieve pain. It is an effective prescription for treating gout. As long as we can focus on this syndrome, the result is remarkable.
Discussion on drug use and reuse of Arisaema cum bile, Atractylodes lancea and Cortex Phellodendri
Shi attaches great importance to the role of Arisaema cum bile, Atractylodes lancea and Phellodendron amurense in the prescription, and thinks that Arisaema cum bile can dissipate phlegm and dispel wind, Atractylodes can eliminate dampness, and Phellodendron amurense can clear heat, so the dosage should be heavy and should be pushed as the main medicine. Arisaema cum bile can eliminate dampness and phlegm, dispel wind, relieve convulsion, reduce swelling and dissipate stagnation, and treat wind-phlegm swelling and pain. The dosage can reach 12g. Cortex Phellodendri purges fire, dries dampness and detoxifies. "Purging fire can tonify yin" (in Zhu Danxi), so it is very important to use it. Because of the heat, it is impossible to purge fire, and gentian is also used in the formula. For patients with severe heat pain, Rhizoma Anemarrhenae and Flos Lonicerae. Add heat-clearing, even Flos Lonicerae, Cortex Fraxini and Herba Violae. Use Shā rotto Katakuri to clear away heat and toxic materials, reduce swelling and dissipate stagnation. Atractylodes lancea is good at eliminating dampness and strengthening spleen, expelling wind and removing filth, and it can enhance the effect of eliminating dampness and resolving phlegm when used together with Arisaema cum bile. When used together with Cortex Phellodendri, it can treat downward flow of damp-heat, pain in bones and muscles, swelling and pain in feet and knees, and the combination of the three drugs can clear away heat, dry dampness and resolve phlegm, which is the basis of its good curative effect.
Whether the onset of gout is "spontaneous boiling of blood heat" or "stagnation of blood cold", the disease has involved blood, phlegm and blood stasis. Therefore, when Arisaema cum bile and Atractylodes lancea are used to eliminate phlegm and dampness, peach kernel, Ligusticum chuanxiong and safflower are used to promote blood circulation and remove blood stasis, which can remove phlegm and blood stasis, loosen cementation, relieve pain and shorten the course of disease. For those who have not been cured for a long time, Eupatorium adenophorum, Radix Cyathulae, Eupolyphaga Seu Steleophaga, Lumbricus, Hirudo, etc. can also be added to the stone.
Gout is swollen and painful. Fang zhong used self-defense to promote diuresis and eliminate dampness, but after all, he was weak. Clinically, coix seed, Rhizoma Smilacis Glabrae, Alisma orientalis, Polygonum cuspidatum, Commelina communis and other turbidity-reducing products are selected according to the condition, while rhubarb is used to dredge viscera to reduce blood uric acid and relieve pain. Shi stressed that we should not blindly benefit from water, but should pay attention to purification and use drugs such as atractylodes rhizome, rhizoma Dioscoreae Septemlobae, silkworm excrement and Gentiana macrophylla. , and should pay attention to the compatibility with blood-activating drugs and tonic drugs. For gout complicated with kidney calculi, Lysimachia christinae, Lygodium japonicum, Natrii Sulfas, Cirsium japonicum, Lalang Grass Rhizome, and Folium Pyrrosiae Tonglin fossils should be added, and Pericarpium Citri Reticulatae Viride and Pericarpium Citri Tangerinae can also be added to alkalize urine and promote uric acid dissolution.
Carefully select auxiliary drugs, heavy stagnation, care for stomach qi.
Another feature of Danxi Tongfeng Prescription is that it pays attention to dispelling wind: Notopterygium root dispels wind, angelica dahurica dispels wind, cassia twig and clematis root dispels wind, arm and shin. The wind-dispelling medicine has the function of warming and dispersing, which is helpful to relieve the pathogenic factors such as "involving cold water, establishing wetland, fan cooling and lying in the wind", and also embodies the therapeutic proposition of "pungent medicine dispersing cold and dampness and opening phlegm". Clinically, we should choose the corresponding wind-dispelling drugs according to the different pain parts; The purpose of using wind-dispelling drugs is to dispel depression, and the dose should be light rather than heavy.
The medicated leaven is used in gout prescription, although it can eliminate the accumulated gas in Zhongzhou, but it has a certain effect on protecting stomach gas. Drugs for treating gout, except for dampness, warm and pungent, are incompatible with the stomach, and drugs for clearing heat, removing turbidity and removing blood stasis all have certain effects on the transport and transformation function of the spleen and stomach. Therefore, Shi attaches importance to the application of Divine Comedy, emphasizing the use of Coix lachryma, dried tangerine peel, fried hawthorn and so on. Invigorating the spleen and nourishing the stomach, those with insufficient stomach yin are compatible with Dendrobium, Radix Rehmanniae, Lily and Radix Glehniae. Symptoms such as tibial weakness, mental fatigue, plantar pain, foot fever, night sweats, etc. appeared in the later stage of the disease. Suitable land for tonic is yellow and medlar.