Edema refers to the accumulation of water in the body, flooding the skin and causing eyelids.
Head, face, limbs, abdomen, back and even whole body edema, which may be accompanied by pleural effusion in severe cases. Ascites and so on. Can be seen in glomerulonephritis, nephrotic syndrome, liver disease, congestive heart failure, endocrine disorders, nutritional disorders and other diseases.
Etiology and pathology
The etiology of edema has internal and external causes. Externally, due to the invasion of wind and evil, sores and poisonous water are soaked in wet water, the lungs are out of balance, and the temper is blocked; Due to hunger, fatigue, spleen and stomach injury, or long-term ward fatigue, kidney injury, resulting in lost syndrome, renal function can not be opened and closed, edema.
Pathological changes are as follows: wind evil attacks from outside, stays in the lungs, the lungs fail to descend, and the waterways are blocked, resulting in wind restraining water resistance, feng shui fighting with each other and overflowing the skin; The skin can't be removed and subsided due to carbuncle sore poison, and the sore poison returns to the spleen and lungs, which leads to the obstruction of water metabolism and overflows the skin; The invasion of wet qi, or improper diet, eating too much cold, can make the syndrome wet and sleepy, lose health, and the water is not transported but scattered on the skin; Damp heat persists for a long time, or turns into heat, which makes the spleen and stomach of the middle jiao lose the ability to ascend and clear, and the triple jiao is inhibited, and the waterway is blocked, resulting in edema;
Poor diet, overwork, spleen deficiency and loss of luck, and water and dampness can't stop the skin from overflowing; Overworked house, kidney essence loss, kidney qi erosion, can not turn gas into water, leading to bladder gasification loss, unfavorable opening and closing, water retention and edema.
Diagnostic points
1. In mild cases, only the eyelids and head and face are swollen; In severe cases, edema may occur in the lower back of limbs and the whole body.
2. Functional edema is generally normal in physical examination, and organic edema has corresponding signs, such as cardiogenic edema, organic murmur or cardiac enlargement; Renal edema can have obvious impression of depression of lower limbs; Hepatic edema may have abdominal mobile dullness.
3. Organic edema generally has corresponding physical and chemical examination, which can help diagnosis.
Dialectical classification
1. Symptoms of feng shui flooding: eyelid edema, then swelling of limbs and whole body, rapid onset, aversion to cold and fever, limb pain, dysuria and other symptoms. Those who are prone to wind-heat are accompanied by sore throat, red tongue and slippery pulse; People with wind-cold aversion to cold, cough and asthma, thin and white tongue coating, and slippery or tight pulse. If the edema is serious, you can also see deep veins.
Syndrome analysis: wind pathogen attacks the exterior, the lung does not descend, the waterway is blocked, and the bladder can descend, so the symptoms such as wind pathogen fever, limb pain, unfavorable urination, and systemic edema are seen; Wind is yang evil, which is light in nature, and feng shui fights with each other, adding fuel to the fire, so edema starts from the face and quickly spreads to the whole body; Such as wind pathogen accompanied by heat, sore throat, red tongue and slippery pulse; If the wind is cold at the same time, the wind evil is on the muscle surface, the defensive yang is inhibited, and the lung qi is not declared, so the wind is cold and aversion to cold, fever and cough; If the swelling is serious and the yang is suppressed, you will see a heavy pulse, or a slippery pulse, or a heavy pulse.
2. Symptoms of wet toxin invasion: eyelid edema, spreading to the whole body, unfavorable urination, sores and sores on the body, even ulceration, bad wind and fever. Red tongue, thin yellow fur, floating or slippery pulse.
Syndrome analysis: the skin is dominated by the lung and spleen, and it is wet and toxic, so the skin is scarred; Damp toxin can not be cleared in time, which belongs to viscera, so that the spleen and stomach of middle jiao can not transport water and dampness, lose the function of ascending and descending turbidity, make the lungs unable to pass through the waterway, and make urination unfavorable; Wind is the length of all diseases, so it is often accompanied by wind evil at the beginning of the disease, which is manifested as eyelid swelling and spreading to the whole body quickly, and the evil wind is like fever; The tongue is red and the fur is thin and yellow, and the pulse is floating or slippery, which is caused by wind evil mixed with wet poison.
3. Symptoms of wet immersion: general edema, insufficient urination, heavy body, chest tightness, anorexia and disgust. White and greasy fur, slow pulse. The onset is slow and the course of disease is long.
Syndrome analysis: the evil of water and dampness infiltrates the skin and stagnates, leading to edema of limbs; The water is wet and sticky, the triple energizer must be abnormal, and the bladder gasification is abnormal, so the urine is short, the water is wet and there is no way out, and the skin is full, so the swelling is even worse. I didn't mean to. The syndrome is wet and sleepy, and Yang Can can't stretch, so it is manifested as physical fatigue, chest tightness, anorexia, general nausea and other symptoms; White and greasy fur and slow pulse are also signs that dampness is better than spleen deficiency; Damp pathogen is sticky pathogen, which is not easy to change suddenly, so the course of disease is longer.
4. Symptoms of excessive damp and heat: edema all over, tight and shiny skin, fullness in the chest, fatigue and thirst, short and red urine, or dry stool. The fur is yellow and greasy, and the pulse is heavy or moist.
Syndrome analysis: the pathogen of water-dampness turns into heat, or the pathogen of damp-heat is confined between the tunnels of the skin, so the whole body is swollen and the skin is tense and bright; Due to damp-heat accumulation in triple energizer and abnormal qi movement, chest tightness and flatulence are seen; If the heat pathogen is excessive, the body fluid will be consumed, so you will see polydipsia, short urine and constipation; Yellow and greasy fur, heavy pulse or excessive pulse are all manifestations of damp-heat.
The above four types are edema yang water.
Symptoms of spleen yang deficiency: body swelling, especially below the waist, difficult to recover, abdominal distension in the hospital, loose stool, sallow complexion, listlessness, cold limbs, short and red urine. The tongue is pale with white fur, greasy or slippery, and the pulse is slow or weak.
Syndrome analysis: the weakness of the middle yang, the disorder of healthy movement, and the inability of qi to dissolve water lead to the flooding of pathogenic water in the lower energizer, so the body is swollen, especially below the waist, and can not afford to droop; Spleen deficiency is weak, so epiglottis is reduced and abdominal distension is delayed; Spleen deficiency has no right to biochemistry, and yang is not warm, so the face is sallow and the limbs are cold; Yang qi does not turn into qi, water is not wet, and urine is short; Pale tongue, greasy or slippery coating, and slow or weak pulse are symptoms of spleen-yang deficiency and stagnant water.
6. Symptoms of kidney yang decline: facial edema, especially below the waist, inability to droop, palpitation and shortness of breath, severe cold pain in the waist, decreased or increased urine output, cold limbs, chills and fatigue, and pale face. It is white. The tongue is pale, fat and white with fur, and the pulse is thin or stagnant.
Syndrome analysis: below the waist and knee, kidney qi is dominant, kidney qi is weak, yang qi does not turn into qi, and water is wet and gathers, so it is swollen below the waist and does not sag;
Water vapor affects the heart and lungs, which leads to palpitation and shortness of breath; The waist is the house of the kidney, with kidney deficiency and water dampness, and low back pain; Kidney and bladder are exterior-interior, kidney yang is insufficient, and bladder gasification is unfavorable, so urine volume decreases, or edema and polyuria are common because of instability of lower part; Deficiency of kidney-yang, failure of life-gate fire and inability to be warm, so the limbs are cold, afraid of cold and tired; Yang Qi cannot be warm and glorious, so his face is gray or white; Light and fat tongue, white fur, thin or slow pulse are all symptoms of yang deficiency and water dampness.
Both of the above are edema of yin water.
Typing therapy
1. Rule of expelling wind and water: dispelling wind and clearing heat, dispersing lung and activating water.
Prescription: Yuemai plus soup.
Ephedra 9 g Gypsum 30 g (decocted first) Atractylodes macrocephala 15 g Poria 12 g Rhizoma Alismatis 12 g Ginger 3 tablets Jujube 7 licorice 3 g Add and subtract with the symptoms: sore throat, add Radix Isatidis 15 g, Radix Platycodi 6 g, Fructus Forsythiae 9 g to clear the throat and disperse the stagnation; For those with heavy heat and less urine, add 30 grams of fresh Rhizoma Imperatae to clear away heat and diuresis; In addition to gypsum, 9 grams of perilla leaves, 9 grams of Saposhnikovia divaricata and 9 grams of cassia twig are added to help ephedra relieve exterior syndrome.
For patients with severe cough and asthma, 9 grams of Peucedanum praeruptorum and 0/2 grams of almond/kloc-are added to reduce qi and relieve asthma.
2. Treatment principle of wet toxin invasion: dispersing lung and detoxifying, promoting diuresis and reducing swelling.
Prescription: ephedra, forsythia and red bean soup combined with Wuwei disinfection drink.
Ephedra 9 g almond 12 g mulberry bark 12 g forsythia 9 g adzuki bean 15 g honeysuckle 9 g wild chrysanthemum 9 g dandelion 15 g viola yedoensis 15 g Chinese cabbage 15 g add and subtract with the symptoms: if septicemia is serious, dandelion should be used again. 9 grams of Radix Sophorae Flavescentis and 0/2 grams of Rhizoma Smilacis Glabrae/kloc-are added to those with excessive dampness to clear away heat and dry dampness; For wind-heat pruritus, Cortex Dictamni Radicis 12g and Fructus Kochiae 12g are added to dispel wind, dry dampness and relieve itching; For constipation patients, 9 grams of yellow (lower back) and 9 grams of mirabilite (flushing) are added to clear away heat and dredge fu organs.
3. Water-wet immersion treatment: strengthening the spleen and eliminating dampness, rising yang and promoting diuresis.
Prescription: Wupi Drink and Ling Wei Decoction.
Mulberry bark 12g dried tangerine peel 9g dried tangerine peel 12g poria cocos 12g ginger bark 3g atractylodes macrocephala 12g poria cocos 12g atractylodes macrocephala 9g magnolia officinalis 9g Polyporus 15g Alisma orientalis 15g cassia twig 9g can be added or subtracted according to symptoms: if there is swelling or even wheezing. For patients with chest pain, almond 12g, Amomum villosum 3g and Amomum villosum 3g are added to promote qi circulation.
4. Damp-heat stagnation rule: clearing heat and promoting diuresis, and eliminating water evil.
Prescription: Shu Chi's introduction.
Notopterygium 6 g Gentiana macrophylla 9 g Pericarpium Citri Reticulatae 12 g Poria 12 g Ginger 3 g Alisma orientalis 12 g Akebia trifoliata 3 g Zanthoxylum bungeanum 6 g Phaseolus vulgaris 30 g Phytolacca acinosa 6 g Areca 9 g Add and subtract symptoms: if the abdomen is full and the stool is blocked, it can increase jaundice 9 g (below), Stephania tetrandra 9 g and Callicarpa areca 9 g. ..
5. Treatment principle of spleen-yang deficiency: warming spleen and promoting diuresis.
Prescription: Shipi drink is added and subtracted.
9 grams of Radix Aconiti Lateralis Preparata (decocted first), 3 grams of dried ginger, 6 grams of Amomum Tsaoko, 6 grams of Atractylodes macrocephala, 9 grams of Pericarpium Arecae 12, 9 grams of Fructus Chaenomelis, 6 grams of Radix Aucklandiae, 9 grams of Magnolia Officinalis, 7 grams of Radix Glycyrrhizae, and 3 grams of Radix Glycyrrhizae. Symptoms can be modified: Astragalus membranaceus 12 grams and Radix Codonopsis 12 grams can be added to
6. Treatment principle of kidney-yang failure: warming kidney to help yang, transforming qi into water.
Prescription: Jisheng Shenqi Pill combined with Zhenwu Decoction.
Rehmannia glutinosa 12g yam 12g dogwood 9g peony bark 9g poria cocos 12g Alisma orientalis 15g aconite 9g cinnamon 3g Achyranthes bidentata 12g plantain 15g atractylodes macrocephala 12g white peony root 12g ginger. Palpitation, astringent lips, pulse deficiency or stagnation, water pathogen attacking the heart, blood stasis and internal resistance should be reused, and 9 grams of Ramulus Cinnamomi, 9 grams of Salvia Miltiorrhiza 15 grams and 9 grams of Radix Glycyrrhizae Preparata should be added to warm the yang and remove blood stasis; For patients with short breath, excessive sweating, floating pulse and water pathogen attacking the lung and kidney, 9 grams of Ginseng, 9 grams of Schisandra chinensis and 30 grams of Oyster should be added to replenish qi and absorb qi to prevent collapse.
Chinese patent medicine
1. Jisheng Shenqi Pill: 9g each time, 3 times a day. Used for kidney deficiency and edema.
2. Jianpi Pill: each time 12g, three times a day. Used for spleen edema.
one side
1. adzuki bean 30g, stigma Maydis 12g, decocted in water, daily 1 dose, taken twice, has diuretic and repercussive effects.
2. Watermelon peel 15g, plantain 15g, decocted in water, daily 1 dose, taken twice, suitable for all kinds of edema.
Other therapies
Hot water bath method: Take the same amount of Herba Ephedrae, Notopterygii Rhizoma, Rhizoma Atractylodis, Radix Bupleuri, Herba Schizonepetae, Radix Saposhnikoviae, Caulis Perillae, Ramulus Salicis, and Onion, decoct in soup, and sweat in hot water bath. It has the functions of dispelling wind, clearing heat, promoting diuresis and promoting diuresis, and is suitable for edema with excess syndrome.
Diet therapy:
(1) Red bean carp soup: red bean 100g, carp 1 (about 250g), add seasoning, and boil the soup together. Function of invigorating spleen and qi, diuresis and detumescence.
(2) Stewed pork loin with Astragalus membranaceus: Astragalus membranaceus 100g, 2 pork loins, stewed with seasoning. Function of tonifying kidney and waist, diuresis and detumescence.
Matters needing attention
1. Edema should be treated in time when the cause is clear, which is the key to fundamentally solve edema.
2. Pay attention to your diet. Avoid salt in the early stage of edema, the swelling gradually subsided and gradually turned into low salt; Avoid spicy food.
3. Pay attention to health care, be careful about life, avoid cold and restrain housework.