The Treatment of Modern Western - Biblio.nhat-nam.ru

324 THE TREATMENT OF MODERN WESTERN DISEASES WITH CHINESE MEDICINEpura or in chronic ITP whose nature has become heavier.TREATMENT PRINCIPLES: Clear the liver and drain fire, coolthe blood and stop bleedingRX: Wen Qing Yin Jia Jian (Warming & Clearing Beveragewith Additions & Subtractions)INGREDIENTS:Sheng Di (uncooked Radix Rehmanniae)Bai Shao (Radix Paeoniae Albae)Bai Mao Gen (Rhizoma Imperatae)Dang Gui (Radix Angelicae Sinensis)Chi Shao (Radix Paeoniae Rubrae)Chuan Xiong (Rhizoma Chuanxiong)Zhi Zi (Fructus Gardeniae)Huang Qin (Radix Scutellariae)Huang Bai (Cortex Phellodendri)Mu Xiang (Radix Auklandiae)Long Dan Cao (Radix Gentianae)Da Huang (Radix Et Rhizoma Rhei)Huang Lian (Rhizoma Coptidis)30g18g18g9g9g9g9g9g9g6g6g6g3gANALYSIS OF FORMULA: Chi Shao, Zhi Zi, Huang Qin, LongDan Cao, and Huang Lian clear the liver and drain fire. In addition,Huang Qin and Huang Lian with Huang Bai clear firefrom all three burners. Sheng Di, Chi Shao, Bai Shao, and BaiMao Gen cool the blood and stop bleeding. Dang Gui, ChiShao, and Chuan Xiong quicken the blood and transform stasisto avoid further bleeding. Da Huang discharges fire and quickensthe blood, and Mu Xiang rectifies the qi.ADDITIONS & SUBTRACTIONS: If there is concomitant qivacuity, add 15 grams of Huang Qi (Radix Astragali) and sixgrams of uncooked Gan Cao (Radix Glycyrrhizae).ACUPUNCTURE & MOXIBUSTION: Ge Shu (Bl 17), Gan Shu(Bl 18), San Yin Jiao (Sp 6), Xue Hai (Sp 10), Yong Quan (Ki 1)ANALYSIS OF FORMULA: Draining Ge Shu cools the bloodand clears the constructive, quickens the blood and stopsbleeding mainly in the upper part of the body. DrainingXue Hai cools the blood and clears the constructive, quickensthe blood and stops bleeding mainly in the lower partof the body. Draining San Yin Jiao cools the blood andclears the constructive, quickens the blood and stops bleedingin the whole body. Gan Shu clears the liver and drainsfire. Yong Quan downbears liver fire and subdues liver yang.It is also an empirical point for the treatment of ITP.Acupuncture for the acute stage of ITP should only be usedas an auxiliary therapy.ADDITIONS & SUBTRACTIONS: For epistaxis, add Kong Zui (Lu6). For bleeding gums, add He Gu (LI 4). For hemafecia, addShang Ju Xu (St 37). For hematuria, add Zhong Ji (CV 3). Forhematemesis, add Xi Men (Per 4). For excessive menstruationlike a flood, add Zhong Du (Liv 6). For splenomegaly, addZhang Men (Liv 13). For severe liver fire, add Xing Jian (Liv 2).REMARKS1. In all cases of chronic ITP, one should expect that there isconcomitant liver depression qi stagnation simply due to thepatient being an adult and being chronically ill. In that case,there will be a bowstring pulse. Therefore, one or more qirectifyingmedicinals should usually be added to the aboveformulas which do not accomplish rectification of the qi orharmonization of the liver as part of their standard functions.2. Thrombocytopenic purpura may also be present in HIV diseaseor secondary to collagen vascular disorders, such as SLE.Drug-related immune thrombocytopenias, such as to quinidine,have clinical findings identical to ITP except for the historyof drug ingestion. It is also possible to develop thrombocytopeniaas a reaction to heparin. Drug-related thrombocytopeniasusually remit spontaneously after the offending drugis withdrawn, with platelet counts beginning to increase in 1-7days. Although this chapter specifically deals with idiopathicthrombocytopenic purpura, all types of thrombocytopenicpurpura are included in the above Chinese medical discussionbased on the dictum: “Same disease, different treatments; differentdiseases, same treatment.”3. Thrombotic thrombocytopenic purpura (TTP) oftencomplicates acute renal failure. This is then refered to as TTPand hemolytic-uremic syndrome (TTP-HUS). This is typicallyan acute, potentially fatal disorder. For more informationon the Chinese medical pattern discrimination andtreatment of uremia and kidney failure, see the chapter onchronic renal failure above.4. In real-life practice, chronic ITP is mainly a mixture of qiand yin dual vacuity with fire effulgence and blood stasis. Ifthere is qi and yin vacuity with blood stasis, there must alsobe liver depression qi stagnation.5. Chinese medicinals with a marked empirical effect on ITPinclude: uncooked Gan Cao (Radix Glycyrrhizae), 15-30gper day, Lian Qiao (Fructus Forysthiae), 18g per day, DongChong Xiao Cao (Cordyceps), 3g of powder per day, and YangTi Gen (Radix Rumicis), 10-15g per day. Other medicinalswith a demonstrated effect on ITP include: Dang Gui (RadixAngelicae Sinensis), Shan Zhu Yu (Fructus Corni), E Jiao(Gelatinum Corii Asini), Zhi Zi (Fructus Gardeniae), Lu JiaoJiao (Gelatinum Cornu Cervi), Ling Zhi (Ganoderma), andXian He Cao (Herba Agrimoniae). Although Huang Qi(Radix Astragali) is not mentioned in the research literatureas being a specific for ITP, it is present in almost all modernChinese medicinal formulas, with a heavy dosage of 15-60gper day.