Treatment Of Constipation With Cistanche Deserticola Decoction

Summary

Constipation is a common digestive tract disease in clinics. Its incidence rate is high and there is no effective clinical cure method, which seriously endangers the healthy life of patients. Huang Yuanyu believed that constipation was caused by a disorder in the "one qi circulation" of the human body, and the key to treatment was to regulate the central axis qi mechanism. Therefore, he used the "Cistanche deserticola" listed in the "Four Sages Heart Source" to treat Yin Sheng Earth Dampness type constipation, which has a significant effect.

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Keywords

constipation; A flow of energy; Cistanche deserticola soup; Yin Sheng earth dampness; Four Sacred Heart Sources

Cistanche deserticola soup

The concept of "One Qi Circulation" was first seen in the famous Qing Dynasty physician Huang Yuanyu's "The Source of the Four Saints' Heart". Huang inherited the thoughts of Huang Emperor, Qibo, Bianque, and Zhongjing [1], connected the systems of yin and yang, five elements, and syndrome differentiation and treatment, and proposed a theory of "One Qi Circulation" that focuses on one's own intrinsic qi, namely "the rise of a wood fire on the left side, the convergence and fall of golden water on the right side, and the mediation of earth qi in the middle jiao", This provides a new idea and method for future doctors in treating diseases and guiding health preservation. Our research group, guided by the concept of "one qi circulation", will classify and treat constipation according to its symptoms. The formulas used are all based on the original formulas listed in "Four Sages Heart Source" combined with clinical experience. This method has a significant therapeutic effect on constipation. This article mainly discusses the use of Cistanche deserticola decoction to treat Yin Sheng earth dampness type constipation.

1 Overview of the Theory of "One Qi Flow"

1.1 The Origin of "One Qi Flow"

One Qi "is first seen in the book" Lingshu Jue Qi ", which states that" a person has an essence, qi, fluid, blood, and pulse, and the rest of the meaning is that one Qi ear... but the five grains and stomach are the sea "[2]. Yiqi can be transformed into various forms required by the human body. The term 'Yiqi' here is similar to Yuanqi, but has a wider range than Yuanqi. Yuanqi is the primitive substance that constitutes the human body, while 'Yiqi' includes Yuanqi, Zongqi, Yingqi, Weiqi, etc. The Complete Collection of Huangyuan Imperial Medical Records states: "Yin and Yang are undiagnosed, and one Qi is confused. When Qi contains Yin and Yang, it becomes clear and turbid. When clear, it rises, and when turbid, it settles. This is the nature of nature. When rising, it becomes Yang, and when falling, it becomes Yin. Yin and Yang are heterotopic, and the two Yi are separated. Between clear and turbid, it is called the middle Qi, which is the pivot of the rise and fall of Yin and Yang, and it is called the earth. 'Yiqi' is also known as Zhongqi 'or' Tuqi '. Qi contains yin and yang, separating clear and turbid, ascending and descending clear and turbid, while the middle qi is located between clear and turbid, becoming the pivot for the rise and fall of yin and yang. When a person is born, they first form their ancestral qi, which is indistinguishable from the two senses. The four phenomena are not yet apparent and are chaotic and inexplicable. This is called innate. The ancestral qi moves, turning left to turn into their own soil, turning right to turn into their own soil, and the spleen and stomach generate energy. When their own soil rises to the east, it turns into ethylene wood, and when their soil rises to the south, it turns into Ding fire. When their soil falls to the west, it turns into Xin gold, and when they fall to the north, it turns into Gui water. Therefore, the four phenomena are complete and the five elements are prepared. When one qi starts to move, the yin and yang sides rise and fall in an orderly manner, and the four phenomena and five, On the right side, the golden water converges and descends, while the earth and energy of the middle coke mediate. In summary, it is a flow of energy.

1.2 The Movement Mode of "One Qi Flow"

The movement form of Qi is mainly reflected through the connections and functional activities between the five organs and six organs and can be summarized into four types: ascending, descending, exiting, and entering. The "one qi" of the human body is the qi of the middle earth. The middle qi is the foundation of human life and the pivot of the qi movement. The pivot movement involves turning the clear qi to the left, ascending to turn into fire, turning the turbid qi to the right, and descending to turn into water. Transforming water into the cold is called wood. When the temperature of wood rises continuously, it accumulates into heat and transforms into fire. When the temperature of wood rises by half, it accumulates into heat and transforms into fire. When the temperature of wood rises by half, it accumulates into gold. When the qi of gold cools, it falls but does not exist, it accumulates into cold and transforms into water. When the spleen and soil rise to the left, the liver qi and kidney water then rise, and the kidney water rises to half to nourish the liver and wood, Ascending to the highest level to prevent the heart from becoming overheated; When the stomach qi decreases to the right, the gallbladder qi and heart fire also decrease, and the heart fire decreases to half warm the lung and gold, and then decreases to lower levels, causing the kidney water to remain cold; Thus, it forms a circular motion with the central qi as the pivot, rising and falling left and right, with a continuous circumference [7]. In addition, the middle qi is located between the nonpenta and the nonself, not between the golden and nonwooden periods. It is enriched and rises to the left, while the solid ones rush towards the void and descend to the right. There is no surplus on the right, and there is no deficiency on the left. If the middle qi is not strong, the wheel pivot should not rotate. Those who are weak will benefit from weakness and sink to the left, while those who are solid will benefit from weakness and reverse to the right.

2 "One Qi Circulation" and Constipation

2.1 Basic understanding of constipation

Constipation is a common internal medicine disease in clinical practice, which refers to defecation less than 3 times a week, dry and hard stools, and difficulty in defecation. Occasional nonpathological symptoms of constipation can be improved by adjusting dietary structure, drinking habits, and exercise. If constipation lasts for more than 12 weeks, it is considered chronic constipation and requires systematic treatment [9]. Some scholars have also proposed that the course of chronic constipation is at least 6 months [10]. Constipation can often be accompanied by abdominal pain, decreased appetite, fatigue and weakness, decreased memory, dizziness, nausea, and rough skin. Patients with long-term constipation often experience anal diseases such as anal sinusitis, hemorrhoids, and anal fissure; Moreover, patients with cardiovascular and cerebrovascular diseases can trigger serious adverse events such as arrhythmia, angina, and sudden death.

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There are many reasons for constipation. The primary factors are pelvic floor muscle coordination disorder, abdominal muscle weakness, anal sphincter dysfunction, physiological sphincter dysfunction, rectocele, intestinal nervous system diseases, intestinal flora imbalance, etc. The secondary factors are psychosocial factors, personal behavior, diet structure factors, environmental factors, age factors, childhood health education, sports factors, genetic factors Gender factors, physical factors, sleep factors, educational level, etc. [12]. Clinically, according to different pathophysiological mechanisms, it can be divided into defecation disorder type, slow transit type, and mixed type constipation; According to the presence of organic lesions, it can be divided into functional constipation and organic constipation. Organic constipation can be improved by treating the primary disease. Functional constipation has many factors and many are unknown, so its treatment results are often unsatisfactory, such as fecal bacterial transplantation, microbial regulation, etc. In recent years, more and more people have found that traditional Chinese medicine has a long history of treating constipation and rich treatment methods. If the diagnosis and treatment are accurate, the therapeutic effect is good, with fewer adverse reactions, and is superior to Western medicine [13]. Traditional Chinese medicine believes that the normal operation of defecation requires the normal functions of the kidney, lung qi, large intestine, and liver. The causes of constipation include heat in the colon, dryness, deficiency of the intestines, weakness of qi deficiency, and spleen deficiency. According to different syndrome types, constipation can be divided into four types: cold constipation, heat constipation, solid constipation, and deficiency constipation. In clinical practice, there are very few cases of a single syndrome type, and more cases are caused by a combination of cold, heat, deficiency, and excess. This article mainly discusses the Yin Sheng earth dampness type of constipation, which is equivalent to the combination of cold constipation and deficiency constipation in traditional classification.

2.2 Constipation from the Perspective of "One Qi Flow"

Positive qi is present within the body, and evil cannot be interfered with. The competition between positive and evil within the body indicates the development and outcome of the disease. Huang proposed that "the orderly rise and fall of soil qi determines the normal operation of the circulation of one qi in the human body. The Qi mechanism is flexible and fluent, and the circulation of one qi is endless. All internal and external emotional and miscellaneous diseases are caused by soil dampness". If the middle earth is deficient, the wheel pivot should not rotate, and the circulation of the five elements is abnormal, causing illness. And the disease of middle qi is mostly due to yang deficiency and soil dampness, which is due to the fact that the dry soil of the stomach in the foot yang ming is not as good as the wet soil of the spleen in the foot tai yin. The stomach yang fails while the spleen yin is prosperous, and the dampness can reach up to 89% for ten people. The source of the Four Sages' Heart: The Root of the Stool "states:" The stool is firm, which is a disease of the hand and foot Yangming. The hand Yangming is commanded by the dry gold, and the foot Yangming transforms from the dry gold to the qi, so the hands and feet Yangming are all dry... Therefore, the stool of the typhoid fever Yangming is formed, and the intestines and stomach are dry; the stool of the nausea and choking diaphragm is formed, and the stomach is wet but the intestines are dry. "[14]. It is pointed out that the difficulty in releasing dry stools is caused by pathological changes in the Yangming meridian of the hands and feet. The Yangming meridian of the hands and feet is dominated by dryness and dryness, and "if the golden nature is concentrated but the wooden nature is discharged, and if it does not reach the target, the Geng gold is also concentrated; if it is hidden but not closed, the Yi wood is also discharged. Wood and gold gather and release one by one, controlling the soul gate to allow for constant release. When the Gengjin, also known as the Yangming meridian, is relatively high compared to the Yimu meridian, there is a tendency for feces to converge, and if feces accumulate in the intestines for a long time, they become more and more dry, leading to a half month cycle. The fundamental reason for the decline of Yimu is the decline of the middle qi, the failure of the spleen yang to rise, the depression of Yimu, and the inability to promote the movement of feces in the intestine. At the same time, Yang dominates opening, Yin dominates closing, and when Yin Qi is abundant, the door closes and becomes astringent, resulting in constipation. The weakness of the spleen Yang is one of the reasons for constipation [15]. The source of the Four Sages' Heart - Six Qi Prejudice "states:" Taiyin dampness, Yangming dryness, regulating dryness and dampness, cares about the middle qi. If the middle qi is strong, Xin Jin transforms qi into damp soil without damaging dryness in the lungs, while Wu Earth transforms qi into dry gold without damaging dampness in the stomach. If the middle qi is weak, the Yin Yang does not intersect and causes dryness and dampness bias. If dryness surpasses dampness, the water conservancy becomes firm. "[14] It is pointed out again that the main root cause of difficulty in releasing hard stool is the deficiency of qi in the middle, which is the deficiency of qi in the spleen and stomach. In recent years, more and more scholars have also proposed that emptiness is the root of constipation, but it is actually the standard of constipation [16]. Deficiency of central qi leads to blockage of the circulation of the central axis qi in the human body, resulting in malfunctioning transmission of gengjin and yimu, poor dryness and dampness, dry intestinal fluid, and difficulty in bowel movements, resulting in constipation. Therefore, starting from qi deficiency, regulating the rise and fall of the central axis qi function is an important principle for treating constipation. Based on this, dialectical treatment can be applied, and despite the many complex symptoms, good clinical efficacy can be achieved [17].

３ Exploring the Treatment of Constipation with Cistanche Decoction Based on the Theory of "One Qi Circulation"

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The first appearance of Cistanche deserticola soup is in Volume 6 of "The Source of Four Saints' Heart: Miscellaneous Diseases Solution": "All internal injuries and miscellaneous diseases, like sheep's sagittal dung, are astringent and difficult to get down, or even half a month in a row, although the liver and large intestine are dry and the root-soil is wet. The spleen does not spend time, the grain essence absorbs stagnation and dissipates phlegm and saliva, the liver and intestines lose nourishment, and stagnation generates wind dryness, which is why. The method is to use cistanche to nourish the liver and moisten the intestines, and smooth the stool. All nitrates, yellows, Gui, Di, ass hide glue, tortoiseshell, and asparagus, and the cold stomach and intestines smooth." [14]. The hasty use of methods such as using bitter cold to relieve constipation or moistening the intestines to relieve constipation due to Yin Sheng earth dampness can damage the body's positive qi and worsen the patient's symptoms. Only when the patient is diagnosed with Yangming Fu syndrome can appropriate medication be administered to overcome the bitter cold, and it is recommended to stop the disease immediately. As Zhong Jing once said, "There are only two ways to discern a secret syndrome... those with yin and yang should nourish and nourish... those with yang first and then yin and yang should attack and diarrhea. And the saying 'feces are like sheep's arrows, and the knot is astringent and difficult to descend' is caused by the deficiency of soil qi in the middle, the abundance of yin and soil dampness, and the disadvantage of the pivot. The qi deficiency of the spleen and stomach in middle earth leads to a lack of warmth and weakness. Dampness and evil are trapped in middle earth, further developing into soil dampness and wood stagnation, ultimately leading to the inability of "one qi" to circulate normally, resulting in the generation of various diseases. It is different from constipation caused by Yang Sheng soil dryness. Although both are constipation, compared to constipation caused by Yin Sheng soil dampness, the former has a more severe heat accumulation, and there are differences in the pathogenesis and treatment of the disease. Cistanche deserticola soup can warm yang and dissipate dampness, relieve liver stagnation, and is suitable for the syndrome of yin excess and soil dampness.

Characteristics of Cistanche Tang Recipe: Cistanche Tang can warm yang and dissipate dampness, soothe the liver, and relieve depression. Its formula includes Cistanche Sanqian, Ma Ren Sanqian, Poria cocos Sanqian, Pinellia ternata Sanqian, Glycyrrhiza Erqian, and Cinnamomum cassia Sanqian. The medicinal properties of Cistanche deserticola in the prescription are sweet, salty, warm, and beneficial to the kidneys and large intestine meridians. It has the functions of tonifying the kidneys, nourishing essence, moistening dryness and smoothing the intestines to relieve constipation. Its nature is warm, smooth, and gentle, and it is good at nourishing the yang in the lower jiao yang. For constipation, spleen deficiency, dampness, stagnation, water and soil damage, and the accumulation of stagnant water is not clear, Cistanche deserticola is an excellent product. The "Classic" states: "Cistanche deserticola has a sweet taste and a mild temperature, which is mainly used to treat five pains and seven injuries, tonify the middle, nourish the five internal organs, strengthen yin, and benefit essence and qi." Cistanche deserticola has the function of tonifying qi, and its warm nature has the effect of tonifying yang. Later generations of physicians believe that cistanche can relieve constipation, and Ming Miao Xiyong said in Shennong's Classic of Materia Medica that "cistanche can be used alone... light Baijiu can be boiled and eaten to cure old people's dryness and constipation" [19].

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Animal experimental studies have found that the effective active site of Cistanche deserticola, total oligosaccharides, can promote excretion in constipation rats, significantly increase 5-HT, VIP, and NT content, and significantly reduce AQP3 levels. Supplemented with sweet and flat Poria cocos, it can promote water infiltration and restore dampness. When dampness is removed, the spleen yang can be restored, and the spleen soil can rise to the left. The licorice has a sweet and gentle taste. The "Rihuazi Materia Medica" records that licorice has the function of "calming the mind, calming the soul, benefiting the essence, and nourishing the qi". The use of licorice here can nourish the heart qi, balance the middle and urgency, and transform the source of energy. Ma Ren is the seed of the mulberry plant hemp, which contains oil and is a representative drug for moistening the intestines and relieving constipation. It can restore the function of large intestine communication and promote fecal excretion by returning to the spleen, stomach, and large intestine meridian; Cinnamon twigs are fragrant and warm, which can help Yang transform Qi, calm Chong, and lower Reverse, relieve stagnation of liver and wood, restore the power of Yi wood to relieve stress, and smooth the right descending of stomach Qi; Pinellia ternata has a warm and pungent taste, which can dry and damp phlegm, warm the spleen, lower reflux and stop vomiting. When used here, it can help the spleen and soil to rise while lowering stomach qi. Therefore, restoring the normal circulation of "one qi" with Cistanche deserticola soup is the key to treating constipation. With the rotation of the atmosphere, the qi of the spleen and stomach can rise and fall, the qi of the liver and wood can rise, and the function of restoring the large intestine to convey bowel movements is to facilitate bowel movement.

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4 Examples of Case Verification

Patient He, a male, 66 years old, was initially diagnosed on November 26, 2021. Chief complaint: Constipation for over 30 years. Current medical history: Difficulty in defecation, defecation 6-7 days once, dry and hard as sheep manure, conscious fatigue, weak waist, and knees, loss of appetite, prone to burping after eating, poor night sleep, difficulty falling asleep and easy to wake up, difficulty falling asleep again after waking up, nocturia 2-3 times, yellowish and dark complexion, obvious anxiety state. No dizziness, headache, palpitations, chest pain, light tongue coating, white and greasy, and weak pulse. I have a history of constipation for more than 30 years and have taken traditional Chinese medicine (specific formulas are unknown) multiple times, as well as medication such as lactulose, bifidobacteria, senna leaves, and aloe vera capsules, which have not shown significant effects. Therefore, it is often necessary to use Kaisailu to aid in defecation. The patient requested pure Chinese medicine treatment, so no other laxatives have been given at the moment. Diagnosis: Constipation (Yin Sheng Earth Dampness Syndrome); Treatment method: warming yang to dissipate dampness, soothing the liver and relieving depression; Recipe: Cistanche soup flavored; Drug composition: 30g each of Cistanche deserticola and Atractylodes macrocephala, 15g each of Huomaren, Qingpinxia, and Beichaihu, 12g each of Guizhi, 6g of roasted licorice, 20g each of Poria cocos and fried sour jujube kernels, 9g each of Scutellaria baicalensis, Polygala tenuifolia, Muxiang, and Albizia bark, for 7 doses. Take 1 dose daily and decoct in water. At the same time, advise patients to eat more fiber-rich foods, drink more water, exercise appropriately, and develop a habit of regular bowel movements every morning. Second diagnosis: On December 3, 2021, after taking the medication, the patient reported that their bowel movements had improved compared to before, with a shorter interval of 2-3 days. The stool in the front section was still dry and hard, resembling sheep feces, while the stool in the back section was soft and strip-shaped. Fatigue and lack of qi have been alleviated compared to before, with a slight increase in stomach intake. The phenomenon of burping after eating has also significantly improved. Although night sleep has improved, it is still difficult to fall asleep. The tongue is light red and the fur is white and greasy, and the pulse strings are weak. On the basis of the front, reduce the sour jujube kernel to 10g, add 15g of Angelica sinensis, 7 doses, 1 dose per day, and decoct in water. Third diagnosis: On December 11, 2021, the follow-up examination showed that the difficulty in defecation had significantly improved. The stool was soft and formed once every 1-2 days, and can be completely defecated within 5 minutes. Consciously good in spirit, reduced fatigue compared to before, able to sleep comfortably, slightly improved nocturia, pale red tongue with thin white fur, and stringy pulse. The effect is not more effective, and after multiple outpatient visits, the patient basically no longer has constipation problems under a regular lifestyle, achieving a clinical cure.

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Note: At the initial diagnosis, the patient had difficulty defecating, with stools every 6-7 days. The feces were as dry and hard as sheep feces, accompanied by fatigue, mental fatigue, fatigue, and lack of qi. The stomach had a poor appetite, and the complexion was yellowish and dark, indicating the deficiency of the Taiyin spleen and the inability to clear the yang. The patient may have previously used a large amount of bitter cold and laxative products, which damaged the spleen yang of the body. Spleen yang deficiency resulted in weakness in semen and fluid distribution, and loss of nourishment in limbs, muscles, and mental muscles, resulting in fatigue, weakness, and lack of qi; Qi deficiency is unable to push the grain residue in the stomach, which cannot flow down. It is scattered and disconnected, causing the dryness of the large intestine during the Yang Ming period to refine into granules, making it difficult to pass through. Loss of appetite and tendency to burp after eating are symptoms of yang deficiency, soil dampness causing an imbalance in qi movement, and the phenomenon of stomach qi rising instead of falling. The right side of the stomach soil cannot descend, and the heart fire also disturbs the stomach fire, resulting in difficulty sleeping at night. A bladder is a place where the sun is cold and the water is cold. The patient is elderly and lacks kidney essence. Kidney water cannot accumulate in the bladder as the spleen soil rises, resulting in frequent nocturia and weak waist and knees. Thus, the treatment of warming yang and transforming dampness with Cistanche deserticola decoction was given to achieve good therapeutic effects. In clinical practice, a prescription is used, with the selection of Cistanche deserticola decoction. It can be adjusted according to the symptoms to restore the body's ascending and descending mechanism, and the "circulation of qi" returns to normal. When the atmosphere is turned, the qi is dispersed and the qi and blood are coordinated. Although the clinical symptoms of constipation are not complex, there are many types of symptoms, and it is difficult to distinguish between true and false, deficiency and excess. Therefore, when using prescriptions for clinical symptoms, it is not necessary to adhere to the provisions, understand the pathogenesis, combination of disease and syndrome, and treat according to syndrome differentiation, and use ancient prescriptions flexibly.