Under normal physiological conditions, the intravascular hydrostatic pressure and the colloid osmotic pressure in the interstitium maintain a balanced state. When the pressure of the former is higher than the latter, fluid moves from the intravascular to the interstitial space, clinically producing Edema. Localized edema: (1) Venous blood flow obstruction; (2) Lymphatic blood flow obstruction; (3) Local inflammation; (4) Allergy; (5) Burns and ice sores. Generalized edema: (1) cardiogenic; (2) renal; (3) hepatic; (4) malnutrition; (5) endocrine disorders; (6) simple edema. Clinically, the cause can be speculated based on the different distributions. For example: edema in one or both limbs is often caused by blockage of blood vessels and lymphatic vessels. Edema caused by low plasma protein is often systemic, especially on the eyelids and face, and is obvious in the morning. Another example: edema caused by heart failure, especially in the lower limbs, worsens in the evening. Clinical treatment of edema should treat the primary disease according to different causes. Moreover, the intravascular hydrostatic pressure is reduced and the colloid osmotic pressure in the interstitium is increased.
Dialectical treatment of edema with traditional Chinese medicine
Eedema refers to a disease characterized by clinical symptoms of local or systemic edema. It is a disease characterized by clinical symptoms of edema of the head, face, eyelids, limbs, abdomen and back, and even the whole body due to external pathogens, fatigue, internal injuries, or eating disorders, which lead to unfavorable gasification and abnormal distribution of body fluids, resulting in water retention and overflowing on the skin. certificate. The dialectical treatment of edema mainly focuses on yin and yang. First of all, it is necessary to distinguish whether it is yin water or yang water. However, the development and changes of the disease will change with each other as the disease progresses, so specific problems must be analyzed in detail and dialectical treatment should be used to solve them.
1 Yang Shui 1.1 The eyelids are slightly swollen due to Feng Shui, followed by waves on the limbs and the whole body. The onset is rapid, often accompanied by aversion to cold, fever, soreness in the limbs, difficulty in defecation, etc.; or accompanied by a red and swollen throat. Symptoms of wind-heat include pain, red tongue, slippery and rapid pulse; or symptoms of wind-cold such as cough and asthma, severe aversion to cold, pale tongue, thin and white fur, slippery or tight pulse. Treatment should be to dispel wind, clear away heat, and relieve the lungs and circulate water. Just use Yuejiajiashu Decoction. For those who are averse to cold and wait until the wind and cold are strong, use ephedra, perilla, qianghuo, fanfeng, and remove gypsum; for those with obvious swelling and pain in the throat, use gypsum, add Shuanghua, isatis root, and Imperata root; for those with cough and asthma, add almonds and mulberry bark; If there is bad wind due to sweating and the Wei Yang is already weak, you can take Fangji Huangqi Decoction, etc.
1.2 When dampness poison invades, the eyelids will be slightly swollen, extending to the whole body, difficulty urinating, sores or even ulcers on the body, aversion to wind and fever, red tongue, thin yellow coating, floating or slippery pulse . The treatment is suitable for relieving the lungs and detoxifying, removing dampness and reducing swelling. Use Ephedra, Forsythia, Red Bean Decoction and Five Flavors Disinfectant Drink. For patients with severe sepsis, use dandelion bark and purpurea root; for those with excessive dampness and itching, add sapsroot, white moss bark, kochia bark, and purple root; for those with blood heat and redness and swelling, add paeonol bark and red peony root; for those with difficulty in defecation, use them together. Tiaowei Chengqi Decoction.
1.3 Cold-dampness maceration has a slow onset and long course, with edema all over the body, severe swelling below the waist, short urine, heavy body sleepiness, chest tightness, nausea, and pale tongue. Or faint green, white and greasy coating, slow and slow pulse. Treatment should be to invigorate the spleen and resolve dampness, to unblock yang and diuresis. Use Wupi Yin Heweiling Decoction. For those with severe indigestion and nausea, add Magnolia officinalis and dried ginger; for those with cough and asthma, add laxative and asthma medicines such as ephedra, almonds, and Tilizi.
1.4 Damp-heat congestion causes edema all over the body, tight and shiny skin, tightness in the chest and epigastrium, irritability and thirst, short red urine, dry and hard stools, red tongue, yellow and greasy coating, and rapid and rapid pulse. . The treatment is suitable for diuresis of dampness and heat, diuresis and swelling. Use sparse chisels to add or subtract. For those with persistent abdominal fullness and constipation, take Jijiao Lihuang Pills; for those with damp-heat and hematuria and dysuria, add Cortex Phellodendron, Imperata Imperata, Da Thistle, and Small Thistle; for those with damp-heat that transforms dryness and impairs yin, take Zhuling Decoction. wait.
2 Yin water 2.1 Deficiency of spleen yang, swelling of the body, especially below the waist, depression that is difficult to recover when pressed, abdominal distention, loss of appetite, loose stools, sallow complexion, tiredness, cold limbs, and short urine , pale tongue, white and slippery coating, and slow pulse. Treatment should be to warm the spleen and activate spleen yang, remove dampness and reduce swelling. Use the spleen-strengthening drink. If you have a long-term eating disorder, weak spleen and stomach, fatigue and fatigue, normal or loose stools, and excessive urination, the treatment should be to strengthen the spleen and reduce dampness, and use Shenling Baizhu Powder.
2.2 The kidney yang is weak, the face is bloated, the body is swollen, especially below the waist, the depression cannot be felt when pressed, palpitations, shortness of breath, soreness and weakness in the waist and knees, fear of cold and cold limbs, pale complexion, decreased urine output or Increased nocturia. The tongue is light and fat, with white coating, and the pulse is slow and weak. Treatment should be to warm the kidneys, assist yang, transform qi and circulate water. Use Jisheng Shenqi Pills and Quanzhenwu Decoction. If the urine is clear, long and heavy, add Cuscuta, Poguzhi, Aizhiren, and remove Alisma and Plantain; for severe palpitations, use Aconite, add licorice and cinnamon twigs; for those with shortness of breath, sweating, and weak and rapid pulse , using ginseng, gecko, schisandra, cornus, etc.
In the process of clinical treatment of edema, the author realized that Chinese herbal medicine has the advantages of significantly improving symptoms, diluting water and reducing swelling, and having few side effects. For example, using diuretic drugs such as Poria, Polyporus, Alisma and other diuretic drugs plus aconite, angelica, stone reed, ginseng, astragalus, rhubarb, etc. can not only diuretic and reduce swelling, but also have a good effect on restoring kidney function and clearing urinary protein. It is beneficial to control the progression of the disease, delay kidney damage, regulate the body's immune function, reduce blood viscosity, and reduce the damage of renal tissue cells from ischemia, hypoxia and inflammatory response. The treatment of edema is still closely related to dietary conditioning. As the saying goes: "Seven points of treatment, three points of nourishment." Only by combining treatment and conditioning can satisfactory results be achieved.