徐志华-经行头晕 – Xu Zhi-hua’s Treatment Of Dizziness During The Menstrual Cycle

徐志华 - 经行头晕

Xu Zhi-hua’s Treatment Of Dizziness During The Menstrual Cycle
Translated by XU Zhi-jun & J. Heaverlo

经行前后或经期,出现头目眩晕,并伴随月经周期发作者,称 “经行头晕”。徐老着重于”无痰不作眩”,施用半夏天麻自术汤而获效.

Dizziness may develop before, during or after the menstrual period.  When this occurs it is called “dizziness during menstrual cycle”.   Xu Zhi-hua emphasizes the concept “Without phlegm, there can be no dizziness”.  He achieves excellent results with the formulation ban xia tian ma bai zhu tang.

经行头晕责痰障  施用半夏天麻汤
Menstrual cycle dizziness due to phlegm – use ban xia tian ma tang

组成:天麻 10g   姜夏 10g    白术10g  神曲lOg   麦芽 lOg    泽泻lOg   党参 10g   夜苓 10g   黄柏 10g   陈皮lOg 于姜 10g   生姜 3 片

Ban Xia Bai Zhu Tian Ma Tang
Ingredients:  tian ma 10g, jiang ban xia 10g, bai zhu 10g, shen qu 10g, mai ya 10g, ze xie 10g, dang shen 10g, fu ling 10g, huang bai 10g, chen pi 10g, gan jiang 10g, sheng jiang 3 pieces



Functions:  Strengthens the Spleen and dries damp.  Expels phlegm and descends turbidity

Primary Treatment: dizziness during the menstrual cycle


Explanation:  Tian ma is acrid and slightly warming.  It can expel wind and transform phlegm.  It serves as the chief herb when there is liver wind and phlegm damp causing dizziness.  This formula also contains er chen tang with ze xie and huang bai.  Together these herbs can transform damp and expel phlegm, descend counterflow and stop vomiting.  Dang shen and bai zhu strengthen the spleen and benefit the qi.  Shen qu and mai ya strengthen the stomach and harmonize the center.  Sheng jiang disperses water dampness.

例一:女,42岁。初诊日期: 1987 年 5 月5 日。患者近年来每至经行之时即觉头晕,后脑作胀微痛,不能见行驶车辆。发作严重时恶心呕吐,不能起坐。头重如蒙,胸闷纳少,整日昏昏欲睡。月经初潮 15 岁,3 - 5 / 2 6 - 3 0天,量中色红无块,末次月经:  1987 年 4 月 11  日,舌质淡,苔白腻,脉濡。

Case Study 1:
A 42 year old female patient reports, in the past few years, at the time of her menstrual period, she has  dizziness and occipital distention with slight pain.   She cannot even bear to see moving vehicles. When the dizziness worsens she also experiences nausea and vomiting, and cannot sit up.   The head feels heavy and foggy.  She has chest oppression and is unable to eat much.  She feels tired all day and only desires sleep.  Her menstrual cycle began when she was 15 years old.   The cycle lasts 26-30 days and the period is 3-5 days.  It is medium in amount, red in color and without clotting.   Her last menstrual period was 3 weeks prior to the time of diagnosis.   The tongue body is pale-red and the coating is white and greasy.  The pulse is soggy.


This condition is due to phlegm turbidity obstructing the clear yang, causing dizziness and a sensation of fogginess and heaviness in the head.  When phlegm turbidity obstructs the center, the turbid yin cannot descend causing the Qi mechanism to become obstructed.  Therefore, there will be chest oppression and nausea.  The spleen yang is unable to ascend, causing diminished appetite and excessive sleepiness.   In addition, during the menstrual cycle, the Qi and blood pour downward, causing the Qi to be even more vacuous.  The clear yang is unable to ascend causing phlegm-damp to harass the upper body. Administer ban xia tian ma bai zhu tang.

天麻 10g,姜夏  10g,臼术 1 g,泽泻  10g,党参 10g夜苓lOg ,干姜 10g,陈皮 10g,黄柏 10g,麦芽10g,神曲10g,生姜 3 片。4 剂。水煎服。

Ingredients:  tian ma 10g, jiang ban xia 10g, bai zhu 10g, ze xie 10g, dang shen 10g, fu ling 10g, gan jiang 10g, chen pi 10g, huang bai 10g, mai ya 10g, shen qu 10g, sheng jiang 3 pieces.  4 formulas were administered for decoction.

二诊: 1987 年 5 月 10 日。此次经行已 3 天,精神明显好转,仅觉轻度头晕,尚能坚持正常教学。舌质淡,苔白微腻,脉濡滑。嘱下次经前 5天按上方再服 4 剂。3 月后随访,头晕己愈。

Follow up:  At the time of the second visit (5 days later) the patient was on day 3 of her period.  Her vitality had clearly improved.  Not only was the dizziness less intense but she was able to return to work.  The tongue body was pale-red.  The tongue coating was white and slightly greasy.  The pulse was moist and slippery.  The patient was urged, next time to start taking the herbal formulation 5 days before her menstrual cycle begins.  She was instructed to take 4 formulations at that time.  After 3 months, follow up showed that her dizziness had already recovered.

例二:付某,女,37 岁,干部,已婚。1990 年 11 月 7日初诊。患者经前头晕反复发作 2 年,头晕多在月经前 1 周发作。头晕头重如裹,胸院痞塞,恶心欲呕,纳呆,肢重乏力。末次月经,1990 年 10 月 12 日。舌质淡红,苔白腻而厚,脉滑。证属痰湿中阻,风痰上扰。方用半夏臼术天麻汤:

Case Study 2:
A 37 year old female patient reports dizziness occurring one week before her menstrual cycle begins.  This has been repeatedly occurring for 2 years.  The head feels heavy as if wrapped.  There is a sensation of chest and stomach glomus and blockage, nausea with a desire to vomit, torpid intake, and heavy limbs without strength.  Her last menstrual cycle was 3 1/2 weeks prior.  The tongue is pale-red.  The tongue coating is white, greasy and thick.  The pulse is slippery.  The diagnosis is phlegm-damp obstructing the center with wind-phlegm harassing the upper body.  Administer ban xia bai zhu tian ma tang.

天麻lOg ,姜夏 10g,自术 10g,神曲 10g,麦芽 10g,浑海  10g,党参 10g,夜苓 10g,黄柏 10g,陈皮 10g,干姜10g,生姜 3 片。5 剂。

Ingredients:  tian ma 10g, jiang ban xia 10g, bai zhu 10g, shen qu 10g, mai ya 10g, ze xie 10g, dang shen 10g, fu ling 10g, huang bai 10g, chen pi 10g, gan jiang 10g, sheng jiang 3 pieces.  5 formulas were administered.

二诊: 1990 年 11 月 13 日。头晕减轻,纳可。现月经将至,舌脉同前,原方加泽兰叶lO g,再进 7 剂,经净晕止,一切正常,以后每临经前,继续宗方调治半年,痊愈。

Follow up:  After one month, the dizziness was mitigated and the appetite returned.  At the time of the follow up, the menstrual period was about to begin.  The pulse and the tongue were unchanged.  The same formulation was administered with the addition of ze lan ye 10g.  Seven formulations were prescribed.   After the period, the dizziness stopped and the symptoms were no longer present.  At each follow up visit, prior to the beginning of the menstrual cycle, the same formulation was prescribed.  After 6 months the patient recovered completely.

按1 经行头晕是妇科临床常见症候之一。轻者闭目即止,重者如坐舟车,旋转不定。加之经行之时,营血趋向于下,髓海空虚,肝阳偏亢,阳扰于上,则头目为之昏眩。正如《内经》云:”诸风掉眩,皆属于肝”、”上虚则眩”、”髓海不足则脑旋耳鸣”,     <金匮要略》云:”心下有痰饮,胸胁支满目眩,”刘河间认为眩晕由风火所致;朱丹溪认为”无痰不作眩”,张景岳认为”无虚不作眩”等。因此,眩晕之由,不外风、火、痰、虚。而以风阳上扰及气血亏虚者最为多见。治疗中必须首先审证求因,分清虚实,然后再确立治法。本类患者脾虚水湿失运,聚而成痰,经行痰浊上扰,蒙闭清窍,清阳被遏,故经行头晕。

Discussion:  Clinically, in gynecological medicine, dizziness during the menstrual cycle is a commonly seen condition.  In less severe cases, if the patient closes their eyes the dizziness will stop.  In more severe cases, however, it may feel as if one is riding on a boat, causing a continuous spinning sensation.  In addition, during the menstrual period, the construction blood are moving downward leaving the sea of marrow empty and depleted.  The inclination is for the  liver yang  then to ascend and harass the upper body causing dizziness.  The Nei Jing states “All wind with shaking and dizzy vision is ascribed to the liver.”“when the upper body is vacuous there will be dizziness”, “when the sea of marrow is insufficient there will be dizziness and tinnitus.”.   The Jin Gui Yao Lue states, ” when there is phlegm-rheum below the heart there will be distention in the chest and rib-side, and dizziness.”  Liu He-jian  believes dizziness is caused by wind-fire.  Zhu Dan-xi states ” without phlegm there cannot be dizziness.”  Zhang Jing-yue states “without vacuity there cannot be dizziness”.  Therefore, the causes of dizziness are nothing more than external wind, fire, phlegm and vacuity.  Among these causes the  most commonly seen are due to  the liver yang rising to harrass the upper body and qi and blood depletion and vacuity.  Treatment first must be determined by seeking the root cause and distinguishing between vacuity and repletion.  After this, the correct treatment method can be established.  Typically, these are patients with spleen vacuity and water damp causing loss of transportation.  This allows for the accumulation of phlegm.  At the time of the menstrual cycle, this phlegm turbidity will ascend and harass the upper causing fogginess and obstruction of the clear orifices.  The clear yang will be blocked leading to “dizziness during the menstrual cycle”.

徐老几十年的临床实践中,对东垣指出的”足太阴痰厥头晕非半夏不能疗,眼黑头旋,虚风内作,非天麻不除”体会尤深。遵其所论,以半夏天麻臼术汤加减屡用皆效。《本草从新》称:”天麻入肝经,通血脉,疏痰气,治诸风掉眩, 头眩眼黑”、”半夏体滑性燥,能走能散,治咳逆头眩,痰厥头痛”,浑泻利水行饮下走水道,小便一行,水湿有其出路,三焦阳气通达,表里通畅,故头晕病解。
Xu Zhi-hua has numerous years of clinical practice that has brought about a deep understanding of this condition.  As Li Dong-yuan points out ” ban xia is capable of treating foot tai-yin  phlegm-rheum causing dizziness.  When the eyes are black and the head is spinning, and there is vacuity wind internally occurring, tian ma is indispensable”.  Following this theory, the usage of modified ban xia tian ma bai zhu tang will bring results.   The Ben Cao Cong Xin states, ” tian ma enters the liver channel, opens the blood vessels, dredges the phlegm-qi and thereby treats all wind with shaking and dizzy vision, as well as, dizzy head and dim eyes.  Ban xia is slippery in body and dry in nature.  It is capable of moving and dispersing and can treat cough, counterflow, dizziness, and phlegm reversal  headaches.”  Ze xie opens waterways, moves fluids downward and promotes urination.   Once urination is unblocked,  water-damp finds a passage out and the Yang Qi of the Triple Burner becomes open and free. Thus, both the exterior and interior are open and unblocked and the dizziness can be relieved.

中医药治疗慢性胃炎的临床体会 – Clinical Experiences Using Chinese Medicine to Treat Chronic Gastritis

谢天佐 陈永祥

Clinical Experiences  Using Chinese Medicine to Treat Chronic Gastritis
Xie Tian-zuo  Chen Yong-xiang

Translated by:  XU Zhi-jun & J. Heaverlo

摘要 通过对慢性胃炎病因病机的认识及中医药治疗慢性胃炎的诊疗思路,联系临床所见病例,体会到临床运用健脾和胃,攻补兼施等综合调理方法可获良好的疗效。

Abstract: This thesis studies the disease causes and pathomechanisms of chronic gastritis.  It explores the methods of diagnosing and treating chronic gastritis with Chinese medicine, and cites clinical cases for its support. It is intended to prove that beneficial results can be achieved by using a combination of  clinical methods such as fortifying the spleen and harmonizing the stomach, and simultaneous supplementing and attacking.

关键词 胃炎,慢性;中医药;治疗

Key words: Gastritis, Chronic: Chinese medicine; Treatment


Chronic gastritis is a common disease of the digestive system. According to Tang Xiao-qun, essentially, repeated lesions of the gastric mucosa will lead to the atrophy of the glands. It can be classified as an inflammatory condition of the gastric mucosa and may be due to various causes. Many patients don’t experience early symptoms, or may present with varying symptoms of indigestion such as: epigastric pain or discomfort, abdominal distention, belching, acid regurgitation, or poor appetite. It is not until the middle stages of the disease will more obvious clinical manifestations appear. This disease has to be diagnosed by gastroscopy; and if necessary,  a biopsy will be performed. In Chinese medicine there is not a disease name for “chronic gastritis. According to its clinical manifestations, it is classified within the patterns of: “stomach duct disease”,“glomus and fullness”, “acid swallowing”, and “vomiting”.

•    病因病机的认识


1.  Understanding the disease causes and pathomechanisms

The clinical manifestations of chronic gastritis may vary and they include: stomachache, distention and fullness, acid swallowing, glomus and fullness, and belching. The causes and pathomechanisms are very complicated. It may arise from: affect-mind inhibition and depressed anger damaging the liver; thereby, the liver-wood cannot freely course spleen-earth;  dietary irregularities and excessive drinking of liquor; so that the spleen and stomach are damaged directly; or from constitutional insufficiency and invasion of external evil.  Relevant descriptions can be found within the documents of past dynasties. For example, in “Magic Pivot ·Explanation of the Use of Small Needles”, it says, “Excessive cold or warmth, or unclean food may lead to the diseases of the intestines and stomach.” In “Plain Questions ·Great Treatise on the Regular Principles of the Six Origins”, it says, “Depressed wood…will lead to the disease of the stomach duct with heart pains. The throat is blocked and  unable to pass food.” In “Jing Yue’s Complete Compendium ·Heart and Abdomen Pain”, it says, “The symptoms of stomach duct pain may be due to diet irregularities, cold, or Qi stagntion.” Li dong-yuan points out in his treatise “On the Spleen and Stomach”, “unclean foods lead to stomach disease, physical taxation leads to spleen disease.” In “Miscellaneous Diseases·Chest Impediment and Heart Pain”, it says, “Excessive food intake, and the inability to digest, will harm the stomach duct. If this condition lasts for a long time, pain will arise even with a slightly irregular diet.”


There are various causes and complicated pathomechanisms with chronic gastritis; however, there are some basic principles of pathogenesis and treatment. For example, in “The Yellow Emperor’s Inner Classic”, it relates, “If the upright Qi is internally maintained, then evil cannot invade.” And, “if evil enters the body, the Qi must be vacuous”.  In “ Essential Prescriptions of the Golden Coffer”, it says, “If the true origin of the viscera is unobstructed, the body will be healthy and harmonious”, “evil cannot invade if the spleen is vigorous during the four seasons of the year. Based on these theories and clinical cases, most scholars believe the root cause of chronic gastritis is a vacuity-repletion complex and spleen-stomach vacuity; whereas, the branch is the evil Qi invading the stomach.

•    治疗


•    Treatment

Up until now Chinese medicine does not have a standardized treatment for chronic gastritis. What Chinese medicine emphasizes is to assess the patterns and seek the cause to determine the treatment.  If it is due to exuberant evil Qi, the treatment should focus on dispelling evil Qi; if it is due to upright Qi vacuity, the focus will be on nourishing the stomach; if it is vacuity-repletion complex, both the root and branch should be treated by using supplementing and dispersion methods.  The writer believes that in order to achieve good clinical effects, the following combined treatment methods should be utilized: fortify the spleen and harmonize the stomach with simultaneous supplementing and dispersion methods, regulate and open the liver Qi. Treatment should be a combination of acupuncture and herbal medicine.

•    健脾和胃,补消兼施


2.1 Fortify the spleen and harmonize the stomach using both supplementing and dispersion methods

The spleen and stomach are the root of latter heaven. If their function is exuberant, the upright Qi is easy to recover and disease will easily be cured. As Li Dong-yuan says, “good doctors emphasize the regulation of the spleen and stomach”. Professor Li Pei attaches great importance to fortifying the spleen while treating chronic gastritis. According to him, if the spleen is fortified, the stomach will be calm. In “Plain Questions·Great Treatise on the Correspondences and Manifestations of Yin and Yang”, it says, “To treat disease, it is necessary to seek the root”.  Chronic gastritis, in most cases, is due to spleen-stomach vacuity, but very few are due to vacuity alone. More often, the symptoms are combined with some form of repletion evil. It may be Qi stagnation, blood stasis, damp-heat, etc.  Therefore, in clinical treatment, the focus should be to treat the root by fortifying the spleen and stomach. At the same time, the branches should also be treated in accordance with the presenting disease evil, such as regulating the Qi, quickening the blood, clearing the heat, etc.

案  赵某,女,56岁,退休干部,2007年7月9日初诊。患者胃脘部痞满不适,隐隐作痛3
年余,2006年11月曾作纤维胃镜检查,提示为慢性萎缩性胃炎,间断服枸橼酸铋胶囊、胃必治等药,无明显疗效。1周前因操劳过度,胃脘部痞满不适加重,时有烧灼样痛,以解痉药治疗,疼痛虽明显减轻但胃脘部痞满仍在,其他症状也无明显改善。就诊时患者胃脘部痞满不适,时轻时重,隐隐作痛,不思饮食,倦怠乏力,气短懒言,大便溏泄,舌质淡,苔薄白,脉沉弱,轻度贫血貌,心肺无异常,腹软无抵抗及压痛,肝脾未触及,肾区无叩击痛,心电图,大便常规及B型超声波检查无异常,血常规显示血红蛋白 92 g/L,白细胞 4.8×109/L,中性粒细胞 0.65,淋巴细胞 0.35,纤维胃镜检查提示慢性萎缩性胃炎。西医诊断为慢性萎缩性胃炎,中医诊断为痞证,证属脾胃气虚型。治以健脾益气,和胃消胀。方选香砂六君子汤加减。

Case study:

Female, 56 years old. Her first visit to the hospital was July 9, 2007. The patient complained of glomus, fullness, discomfort and dull pain in the stomach duct. This symptom had continued for more than 3 years. It was diagnosed as chronic atrophic gastritis after a stomach fiber endoscopy in November, 2006. She had been continuously taking potassium citrate capsules and gentamycin sulfate injections but without clear results. One week before the first visit,  her condition worsened due to overwork: she experienced increased sensations of glomus, fullness and discomfort in the stomach duct.  At times, she experienced scorching pain. After taking spasmolytics, the pain was greatly alleviated but the glomus remained. Other symptoms showed no improvement.  At the time of examination, she continued to experience intermittent feelings of glomus, fullness and discomfort, and dull pain in the stomach duct. She had no desire for food or drink. She felt tired and a lack of strength. She was short of breath and no interest in speaking. She had sloppy diarrhea. The tongue was pale and the tongue coating was thin and white. The pulses were sunken and weak. She had slight anemia. The heart and lungs were normal.  The abdomen was soft and did not feel pain under pressure. The liver and spleen were not palpated. The kidney area showed no tenderness with applied tapping.  Electrocardiogram, stool, and B-type ultrasonic examinations were all normal.   Hemoglobin was 92 g/L,  leucocyte count was  4.8×109/L,neutrophil count 0.65, and lymphocytes were 0.35.  According to western medicine, following an endoscopy, her symptoms were diagnosed as chronic gastritis. According to Chinese medicine, this was diagnosed as spleen-stomach Qi vacuity. The treatment should be to fortify the spleen, boost the Qi, harmonize the stomach and disperse distension. The formula was Costusroot and Amomum Six Gentlemen Decoction (with additions and subtractions).

处方: 党参15g, 白术15g,茯苓15g,砂仁10g,甘草6g,大枣6枚,神曲10g,麦芽10g,
山药15g,陈皮10g,蒲公英15g,佛手10g,丹参10g。水煎分早晚温服,1剂/d。嘱患者调饮食、畅情志、勿劳累。守方加减4周,患者自觉症状消失,精神饮食均佳。将上方制成胶囊,2粒/d, 3次/d,连服3个月以巩固疗效。停药后随访半年,胃病未复发。

Formula: codonopsis (dang shen) 15g, white atractylodes (bai zhu)15g, poria (fu ling) 15g, amomum (sha ren) 10g, licorice (gan cao) 6g, jujube (da zao) 6 pieces, medicated leaven (shen qu) 10g, barley sprout (mai ya) 10g, dioscorea (shan yao) 15g, tangerine peel (chen pi) 10g, dandelion (pu gong ying) 15g, Buddha’s hand (fo shou) 10g, salvia (dan shen) 10g. To be taken warm in the morning and evening. One formulation a day.

The patient was instructed to regulate food and drink, smooth the affect-mind, and not to overwork. After using a modified version of this formula for 4 weeks,  the patient felt the symptoms disappeared and reported improvement in both spirit and diet.  The patient was advised to continue taking the prescription in capsule form at a dosage of 2 capsules three times per day.  This was repeated for 3 months to secure the effect of the treatment. After 3 months the gastritis had not returned.

按   本方取四君子汤之义加减,注意补益脾胃,并配理气活血之品,诸药合用,共奏健脾益胃,

Note: The formula utilizes a modified Four Gentlemen Decoction. The emphasis is on supplementing and boosting the spleen and stomach.  With the additional herbs, it can also regulate the Qi and quicken the blood. This formula can fortify the spleen, boost the stomach, and simultaneously supplement and attack. It supplements without causing stagnation. It recovers the upright Qi while dispelling evil in order to effectively treat the disease.

•    脏腑相关,注意调肝


•     Chronic gastritis and its relationship with the liver

Although chronic gastritis is located in the central burner, it’s predominant relationship is with the liver Qi.  This combination forms an imbalance of the liver, spleen and stomach. Clinically, the liver Qi should be regulated, even without the symptom of liver depression. In treatment, liver-coursing medicinals can be added to course the liver Qi, and unimpede the central Qi, in order to recover the function of the spleen-stomach . According to Liu Jing-long and Zhao Rui-hua, beneficial effects can be achieved when treating chronic gastritis with the method of coursing the spleen and harmonizing the stomach. The liver belongs to wood, which governs free coursing and orderly reaching. The spleen and stomach belong to earth, which governs movement, transformation and intake. The relationship between the liver and spleen-stomach is that of wood and earth. The normal free coursing and orderly reaching is beneficial to the absorption and digestion of the spleen-stomach. This is what is referred to as “wood courses earth”. This not only can assist the movement and transformation of the spleen, upbear clear Yang, and deliver the essence of grain and water up to the lungs; but, it also may assist the stomach decomposition intake, downbear the turbid Yin, and deliver the chyme down to the intestines.

案  袁某,女57岁,退休教师,2007年7月23日初诊。患者胃脘胀满,反复发作2年,生气及饭后尤著,伴嗳气吞酸,口苦,食欲不振,经多方治疗症状未见好转,面色萎黄,舌淡红,苔薄白,脉弦。此次就诊主因与家人生气后上述症状加重。胃镜提示:慢性浅表性胃炎,幽门螺旋杆菌阳性。中医诊断:胃脘痛,证属肝胃气滞型。治宜疏肝和胃,理气止痛。拟以柴胡舒肝散加减。

Case study:

Female, 57 years old. Her first visit to the hospital was on July 23, 2007. The patient had suffered from gastric distention and fullness repeatedly for two years. It was worsened with anger and especially after dinner. This symptom was also accompanied with belching, acid swallowing, bitter taste, and poor appetite. After multiple treatments there was no improvement in the symptoms.  The patient had a withered-yellow facial complexion; her tongue was pale red; the tongue fur was thin and white; and the pulse was stringlike.  Gastroscopy indicates that her condition is chronic superficial gastritis. Helicobacter pylori was positive. According to Chinese medicine, this was diagnosed as stomach duct pain due to liver and stomach Qi stagnation. The treatment should focus on coursing the liver, harmonizing the stomach, regulating the Qi and relieving the pain. Chai Hu Liver-Soothing Powder was adopted with abductions and subtractions.

处方: 柴胡10g,川芎10g,香附10g,白芍15g,赤芍10g,陈皮10g,枳壳6g,旋覆花10g,神曲15g,麦芽10g,半夏10g,甘草9g。水煎分服,1剂/d。嘱患者调饮食,畅情志,勿劳累。治疗3个疗程后,诸症消失,胃镜提示:未见异常, HP(-)。随访半年未见复发。

Formula: bupleurum (chai hu) 10g, chuan xiong rhizome (chuang xiong) 10g, cyperus (xiang fu) 10g, white peony (bai shao) 15g,  red peony (chi shao) 10g, tangerine peel (chen pi) 10g, bitter orange (zhi ke) 6 g, inula flower (xuan fu hua) 10g, medicated leaven (shen qu) 15g, barley sprout (mai ya) 10g, pinellia (ban xia) 10g, licorice (gan cao) 9g. Take one formula twice a day. The patient was instructed to regulate food and drink, smooth the affect-mind, and not to overwork. After three courses of treatment all of the symptoms disappeared. Gastroscopy indicated no abnormalities. HP was negative.

按  本方取柴胡舒肝散之义加减,有疏肝解郁,消食和中,理气止痛之效。充分体现了调肝可使全身气机畅达,脾胃功能如常。

Note: Chai Hu Liver-Soothing Powder can soothe the liver, resolve depression, disperse food, harmonize the center, regulate the Qi and relieve pain. This case study illustrates that by regulating the liver, the dynamic of the whole body becomes unblocked and the function of the spleen-stomach return to normal.
•    针药结合 内外同治


•    Combination of Acupuncture and herbal medicine and the simultaneous treatment of internal and external

Acupuncture is an external method of treatment which works on stomach disease through acupoints and network vessels. Chinese herbal medicine is an internal method of treatment which regulates the stomach directly. Increased results can be achieved by combing these two methods.  However, according to Rao Yan, beneficial results may also be achieved by utilizing acupuncture as a single treatment method.  Immune functions may be improved by regulating the nervous system. According to Tong Chun-quan, in treating peptic ulcer, it is safer to utilize “threaded acupuncture”  which is capable of achieving longer lasting effects. Clinically, it is important to make the correct diagnosis and implement the appropriate method of treatment.

案  李某,女,42岁,2007年9月11日初诊。患者诉胃病史3年,3年前因饮食不节,冒雨露宿,随即脘腹胀闷,隐痛时作,大便溏薄,四肢乏力。1年前在某医院胃镜检查诊断为慢性浅表性胃炎,曾服用“雷尼替丁”、“吗丁啉”、“枸橼酸铋胶囊”、“胃必治”等西药,效果不明显。遂于2007年9月11日来我院就诊。诊见胃脘隐痛,喜按,脘胀痞闷,嗳气便溏,时欲呕恶,面色少华,自觉肢冷,舌淡苔白,脉沉细。中医诊断:胃脘痛,证属脾胃虚寒。治宜温阳祛寒,燥湿健脾。以附子理中丸内服配合针灸治疗。附子理中丸,6g/次,每日早晚饭后温开水送服。嘱患者调饮食、畅情志、勿劳累。配合针灸足三里、中脘、章门、关元等穴,以补法为主,一次/d,7次为一个疗程。治疗3个疗程后患者胃脘疼痛消失,大便正常,痞闷减轻,面色转润,精神饱满。续服上药3个疗程以巩固疗效。2008年1月6日胃镜复查显示上消化道未见明显异常。后随访3个月未见复发。

Case study:

Female, 42 years old. The patient’s initial visit was on September 11, 2007. She had suffered from stomach problems for three years. Three years prior, due to dietary irregularities and camping in the rain, she began to feel distention and oppression in the stomach duct and abdomen. She experienced frequent attacks of dull pain. She had thin stools and fatigued limbs. The previous year, her condition was diagnosed as chronic superficial gastritis with a gastroscopy exam. She took ranitidine, domperidone, potassium citrate capsules, gentamycin sulfate injections without obvious effects. The following symptoms were present at the time of examination: dull pain in the stomach duct which is improved with pressure, distention and oppression in the stomach duct, belching, sloppy stool,  frequent sensations of nausea and vomiting, lusterless facial complexion, and cold limbs.  The tongue was pale and the tongue coating was white.  The pulse was fine and sunken.  The Chinese medicine diagnois was stomach duct pain due to spleen-stomach vacuity cold. The treatment focus is to warm the Yang, dispel cold, dry dampness and fortify the spleen. Aconite Center-Rectifying Pill was prescribed, combined with acupuncture. The patient was advised to take 6g of Aconite Center-Rectifying Pill twice a day, mornings and evenings. She was further directed to regulate food and drink, smooth the affect-mind, and not to overwork.  The acupoints used were: Leg Three Miles (ST-36, Zu San Li), Central Stomach Duct (CV-12, Zhong wan), Camphorwood Gate (LV-13, Zhang men), and Pass Head (CV-4, Guan yuan). The primary method of acupuncture was supplementation, and was performed once per day.  One course of treatment consisted of seven treatments.  After three courses of treatment , the stomach duct pain disappeared, the stool was normal, the oppression in the spleen was alleviated, the facial complexion turned moist, and the patient was full of vigor. Three more courses of treatment were added to secure the treatment. On January 6, 2008, a follow up gastroscopy exam showed no abnormalities were found in the upper gastrointestinal tract.

按  附子理中丸取干姜、附子温中散寒以助阳,白术健脾燥湿,人参大补元气以助运化,甘草和中益气。此方可使中焦之寒得辛热而去,虚证得甘温而复,清阳升,浊阴降,运化健而中焦治,加之关元及元气所聚,中脘、章门乃脾胃之募穴,足三里乃足阳明合穴具较强保健之功,针药结合治疗,取其温补而不滞,行气而不散,从而脾胃阳气得复,寒湿得除,由此标本兼顾,正得复,邪得除。另外,李燕认为附子理中丸还可治疗功能性消化不良,附子理中丸对于消化不良导致的慢性胃炎亦能收到良好疗效。


In the formula of Aconite Center-Rectifying Pill, dried ginger (gan jiang)  and aconite (fu zi) can warm the center and dispel cold to assist the Yang. White atractylodes (Bai zhu) can fortify the spleen and dry dampness. Ginseng (Ren shen) can greatly supplement the original Qi of the body so as to aid movement and transformation. Licorice (Gan cao) can harmonize the center and boost the Qi. In this formula, the cold in the middle burner is dispelled by warm medicinals, the vacuity pattern is treated with warm and sweet medicinals.  When the clear Yang upbears and the turbid Yin downbears, movement and transformation is strengthened, thereby, harmonizing the middle burner. In addition, Pass Head (CV-4, Guan Yuan) is the gathering point of the original Qi, Central Stomach Duct (CV-12, Zhong wan) and Camphorwood Gate (LV-13, zhang men) are the front-mu points of the spleen and stomach,  Leg Three Miles (ST-36, Zu san li) is the uniting point of the foot Yang brightness. Needling these points will have a strong effect on the overall health of the body.  Acupuncture and herbal medicine are used in combination to warm and supplement without stagnating, and to move the Qi without dispersing; thereby, the Yang Qi of the spleen-stomach can be recovered and cold-damp can be dispelled. By treating both the root and branch, the upright Qi can be recovered and evil eliminated. Furthermore, according to Li Yan, Aconite Center-Rectifying can also treat functional indigestion leading to chronic gastritis.

•    结语


•    Conclusion

According to the New Sydney System, chronic gastritis is classified as: superficial gastritis, atrophic gastritis and special type gastritis. Nowadays, it is commonly agreed that the main cause of chronic gastritis is Helicobacter pylori.  In treatment, Western medicine generally adopts a triple therapy method to root out helicobacter pylori. Other medicinals are added to improve the digestive system, such as gastrointestinal drugs and antacids. This works to some extent, but it’s hard to achieve ideal effects because the course of treatment is long, and the symptoms may relapse again and again. Chinese medicine has a unique advantage in treating chronic gastritis. Under the guidance of  basic Chinese medicine theory and the practice of identifying patterns to determine treatment, satisfactory effects can be achieved.  The root treatment is to protect the stomach Qi; and the branch treatment is to eliminate causitive disease factors. In addition, once the condition is under control, it is important to prevent relapse by keeping in mind, the patient is still in a period of recovery and the function of the stomach is still not completely recovered.

According to Jia Feng-yun, the onset of chronic gastritis is closely related with the affect-mind and diet. According to Yin Yan, it is very important to pay close attention to the diet and health care after treatment. The measures to prevent the relapse should be comprehensive: regulating diet, daily life, physical activity and the mental spirit; the patient should also be careful not to take substances that are harmful to the gastric mucosa.   Medicinal food may also beneficial to improve the function of the spleen and stomach and help recover the function of the internal organs. Chinese medicine has a significant effect in treating chronic gastritis with fewer side effects, and for some, may be economically more viable. Therefore, it is widely accepted by patients and has a broad perspective in it’s clinical application.

中医中药与针灸治疗脱发150 例 – Fu Mei-hua’s Treatment of 150 Cases of Hair Loss with Herbs and Acupuncture

中医中药与针灸治疗脱发150 例 – Treatment of 150 Cases of Hair Loss with Herbs and Acupuncture

Translated by Xu Zhi-jun & J. Heaverlo

关键词: 中医中药;针灸;脱发
Key words: Chinese medicine; herbs; acupuncture; hair loss


Modern medicine classifies hair loss into many various types; such as alopecia areata, seborrheic alopecia, and symptomatic alopecia. There are also numerous accounts of hair loss in the Chinese medicine classics. For examples, hair loss is called “demon-licked head” in “The Origin and Indicators of Diseases” of the Sui Dynasty. It is recorded as “oil wind hair loss” in “Orthodox Manual of External Medicine” of the Ming Dynasty. According to Chinese medicine theory, symptomatic alopecia should be categorized into “oil wind hair loss”. Although the disease pathomechanisms may vary, there are commonalities within the treatments. The author has treated 150 cases of hair loss with herbs and acupuncture, and achieved notable results. The following is a report of his findings.

•    一般资料


1. General information
Among the 150 cases, there are 80 males and 70 females. The age ranges from 11 to 46.

•    治疗方法

2.1 中药治疗:健脾祛湿、清利湿热、养血生发为主:白术12g、茯苓12g、泽泻12g、生薏米30g、 升麻12g、丹皮12g、当归12g、川芎12g、鸡血藤15g、干生地12g、熟地12g、柴胡12g、首乌12g、焦三仙45g. 每日一剂,每日二次。湿服;如皮脂溢出过多者加赤石脂12g、侧柏叶12g、猪苓12g;如腰腿酸软、遗精盗汗、夜寐不安,加龙骨12g(先煎) 、牡蛎12g(先煎) 、乌梅12g;气虚加黄芪20g;如突然大把脱落,急躁易怒,加女贞子12g、旱莲草12g、钩藤12g等进行辩证论治。

2. Treatment

2.1 Herbs-  The therapy focuses on the following treatment methods: fortify the spleen, dispel dampness, clear heat, nourish the blood and promote hair growth.
White atractylodes (bai zhu) 12g,  poria (fu ling) 12g,  alisma (ze xie) 12g, coix (yi mi ren) 30g, cimicifuga (sheng ma) 12g, moutan (mu dan pi) 12g, Chinese angelica (dang gui) 12g, chuanxiong rhizoma (chuan xiong) 12g, spatholobus (ji xue teng) 15g, dried rehmannia (sheng di huang) 12g, cooked rehmannia (shu di huang) 12g, bupleurum (chai hu) 12g, flowery knotweed (shou wu) 12g, scorch-fried three immortals (jiao san xian) 45 g.   Cook one dose a day and take twice while it is warm.

If there is too much seborrheic production, add happoysite (chi shi zhi) 12g, arborvitae leaf (ce bai ye) 12g, and polyporus (zhu ling) 12g.

If the patient has lumbar soreness and/or leg achiness, seminal emissions, night sweating, and restless sleep, add dragon bone (long gu) (predecocted) 12g, oyster shell (mu li): 12g (predecocted), and mume fruit (wu mei) 12g.

If the patient has Qi vacuity, add astragalus (huang qi) 20 g.

If there is great hair loss with irritability add ligustrum (nu zhen zi) 12g, eclipta (han lian cao) 12g, and uncaria (gou teng) 12g.

•    针灸法:以养血活血祛风、健脾祛湿生发为主:选穴:百会、风池、足三里、血海、

2.2    Acupuncture treatment principles are: quicken the blood, dispel wind, fortify the spleen, dispel dampness, and promote hair growth.

Selection of acupuncture points: GV-20 (one-hundred convergences), GB-20 (wind pool), ST-36 (Leg Three Li), SP-10 (sea of blood), HT-7 (spirit gate), and PC-6 (inner pass).

Manual needling methods should be used to supplement vacuity and drain repletion. Use supplementation method on BL-18 (liver transport) and BL-23 (kidney transport). Use draining method on all other points.

•    疗效标准


•    Standard of Curative Effect

Full recovery: the symptom of hair loss disappears, and the test result is negative;
Improvement: the symptom of hair loss is alleviated, and the test result is positive;
No effect: the symptom of hair loss remains the same, and the test result is positive.

•    治疗结果


•    Therapeutic effect:

Full recovery: 140 cases;
Improvement: 9 cases;
No effect: 1 case.

•    病例

王某,男,37岁,脱发2个月,患者自述平素工作紧张,平时皮脂溢出过多。 查:脱

5. Case Study

Examination:  Mr. Wang is 37 years old. He has been experiencing hair loss for two months. His work is very stressful. He has a considerable amount of seborrheic production. The test for hair loss is positive. His symptoms include itchy scalp, scant hair, and excessively oily hair. He appears listless, has a lack of strength, and restless sleep. His stool and urine are normal. His tongue is pale with a white tongue fur. His pulse is stringlike and slippery.

Chinese medicine diagnosis: :  “Oil wind hair loss” due to spleen vacuity and damp-heat binding.

Western medicine diagnosis: seborrheic alopecia.  TCM treatment principles should be: fortify the spleen, dispel dampness, clear heat, disinhibit dampness, nourish the blood, and promote hair growth.

Therapy: fresh white atractylodes (sheng bai zhu) 12g, poria (fu ling) 12g, coix (yi mi ren) 30g, rhizoma dioscorea (bi xie) 15g, plantago seed (che qian zi) 15g, alisma (ze xie) 15g, Chinese angelica (dang gui) 12g, flowery knotweed (shou wu) 12g, chuanxiong rhizoma (chuan xiong) 12g, astragalus (huang qi) 20g, mume fruit (wu me) 20g, notopterygium (qiang huo) 12g, cimicifuga (sheng ma) 12g, scutellaria (huang qin) 10g, coptis (huang lian) 12g,  dragon bone (long gu) (predecocted) 12g oyster shell (mu li) 12g, bitter orange (zhi ke) 12g,  moutan (mu dan pi) 12g, scorch-fried hawthorne fruit (jiao shan zha) 15g, stir-fried barley sprout (chao mai ya) 15g.

(Combine herbs and 1200 ml of water).  Decoct in water until 400 ml. remain. Drink 200 ml twice per day.  Drink once in the morning and once in the evening.  Should be consumed warm.

Acupuncture treatment was used in combination. Selections of acupuncture points: GV-20 (hundred convergences), GB-20 (wind pool), ST6 (three Yin intersection), ST-36 (Leg Three Li), SP-10 (sea of blood), HT-7 (spirit gate), and PC-6 (inner pass), BL-18 (liver transport) and BL-23 (kidney transport). Manual needling methods used should be supplement vacuity and drain repletion. Acpuncture is performed once a day.

After 3 days of treatment, the symptoms were alleviated to some extent. The patient also had sore and aching low back and dizziness.  Therefore additional herbs were utilized.  Additions include: halloysite (chi shi zhi) 12g, arborvitae leaf (ce bai ye) 12g,  mix-fried dioscorea (zhi shan yu) 12g.  These additions may help dispel dampness, move the Qi, supplement the liver and kidney.

The symptom completely disappeared after 22 days of treatment.   After 3 months, the symptoms had not returned.

•    讨论


•    Discussion:

Although skin diseases manifest on the skin, they are often closely related with the viscera. According to Chinese medicine theory, the key to treating skin diseases is to find the relationship between the disease and the viscera, and then to administer treatment according to the pattern. In the therapy, atractylodes (bai zhu), poria (fu ling), coix (yi mi ren), arborvitae leaf (ce bai ye), halloysite (chi shi zhi), bitter orange (zhi ke), rhizoma dioscorea (bi xie), plantago seed (che qian zi), and alisma (ze xie) can fortify the spleen, move the Qi and dispel dampness. Cimicifuga (sheng ma), dragon bone (long gu), oyster shell (mu li), and mume fruit (wu mei) can astringe and secure, upbear the Yang, quiet the spirit, boost the essence and increase the appetite. Chinese angelica (dang gui), rhizome chuanxiong (chuan xiong)  spatholobus (ji xue teng), flowery knotweed (shou wu), astragalus (huang qi), and moutan (mu dan pi) can boost the Qi, nourish and quicken the blood, dispel stasis, and engender the new. Scutellaria (huang qin) and coptis (huang lian) can clear heat, dry dampness, and clear  heat on the head and eyes. Mix-fried dioscorea (zhi shan yu) can supplement the liver and kidney. Hawthorne fruit (shan zha) and stir-fried barley sprout (chao mai ya) can regulate the stomach.   Acupuncture can free the channels, and regulate the spleen, stomach, liver and kidney. The overall effect is to greatly harmonize the Qi and blood so that the hair can be nourished by the essence and blood.