Ulcerative colitis
[Overview]
Ulcerative colitis, also known as chronic non-specific ulcerative colitis, the rectum and colon is a chronic inflammatory disease of unknown cause.
The main symptoms characteristic of chronic recurrent diarrhea, bloody mucus or pus, tenesmus, abdominal pain, and fever, weight loss, anemia. Lesions mainly in the colon mucosa, and the ulcer-based, many involving the rectum and distal colon, but can be extended to the proximal as well as throughout the entire colon.Course of a long, varying severity, exacerbation and remission alternating, or was sustained and gradually increased. The disease can be seen at any age, but is more common 20 to 30 years old, male and slightly more than women. China’s incidence rate is lower than abroad, in recent years, the disease seems to be increasing. Ulcerative colitis is a traditional Chinese medicine, “dysentery,” “diarrhea”, “stool” and other areas.
[Etiology and pathology]
The pathogenesis in the intestine, and liver, spleen, stomach, intestines and other organs related. Since the beginning of many because of poor emotional, liver qi stagnation, committed and stomach; or because of diet, overeating Feigan, or because the body heat of the stomach resulting in complex food cold damage, leading to the spleen lost health movement, voicing; feel the heat or because the evil poison of Shushi, which intrinsic heat toxin, under the force of intestinal, blood stagnation, stasis and suppurative; bleeding course of time, there will certainly consume blood Shangyin. Long the patient contact, can cause bleeding resistance; long illness spleen deficiency, Qing Yang does not rise and subsidence in the air, temperature and transport solid weakness stomach does not close.
[Diagnostic points
1 Common symptoms: diarrhea, blood stools, mucus-like bloody stool, blood and pus, tenesmus, abdominal pain, fever, poor appetite, weight loss, anemia.
2. Sigmoid endoscopy: intestinal mucosa in diffuse hyperemia, edema, increased mucosal fragility, easy bleeding, often with multiple erosions or ulcers of varying sizes, attached to mucopurulent exudate; late pseudo polyps can be seen , pale mucous membranes, have shrunk plaques, wall stiffness, colon bags disappear.
3.X-ray barium enema: a result of mucosal edema in the acute phase and see the thick folds disorder; have ulcers when the serrated edge of the intestinal wall; the latter part of the intestinal wall fibrosis, colon pocket disappears, the intestinal wall hard, bowel shortening , lumen stenosis, was water-like.
4 Laboratory tests: stool examination showed the majority of red, white blood cells or pus; blood count may show anemia; blood hypercoagulability; obvious severe electrolyte imbalance, low potassium-based.
[Dialectical type]
l. Spleen heat symptoms: diarrhea, frequency range, tenesmus, or anal burning, pus and mucus in feces samples will be relying on, fishy taste, abdominal pain, scanty dark urine, fatigue, weight loss, fever, mouth pain, poor appetite. Greasy yellow tongue coating, smooth pulse number.
Syndrome analysis: Spleen Health and wet, depression and fever, intestinal injuries, communication disorders, there are diarrhea, frequency range; suffocating heat intestine, choroid injury, blood stasis, into pus and blood, so the stool mucus, pus and blood samples will be relying on taste fishy; Yongzhi intestine damp heat evil, gas-poor, there are abdominal pain, tenesmus; damp burning anus dam u * \ will be a short red; temper weak, showing Shenpi fatigue, Na stay thin; fever, mouth pain, greasy yellow tongue coating are damp and the like; Spleen pulse; slippery pulse of the pulse is hot and humid.
2 liver and spleen Wang symptoms: abdominal pain or diarrhea, pain reduction after diarrhea, often due to depression, anger, emotional stress or excitement and seizures, sepsis folder stool, chest fullness, irritability, heating, poor appetite, abdominal bowelswelling, headache, made. Pink tongue, wiry pulse.
Syndrome analysis: the impassioned injury, liver failure be reached, the gas-poor, tribulations guilty of the spleen, loss of health transport department, leading to abdominal pain or diarrhea, pain reduction after diarrhea, and every tune conditions fail to materialize due to stagnation of blood for gas block , obstruct and purulent, pus and blood may have stool folder;
Liver Wang is Xiong Xie fullness, irritability, headache, made; Qi stagnation is belching, bowel distension; Spleen poor appetite, pink tongue, wiry pulse is a deficiency of liver Wang Zheng.
3. Stagnation of intestinal symptoms: stomach irritation, according to the Tong Shen, pus or stool folder often purple blood clots, dark complexion dark. Dark red tongue, with purpura, pulse string.
Signs Analysis: intestinal stasis, gas-poor, and therefore lower abdomen tingling, according to the Tong Shen; stagnation, stasis and festering, pus or folder so often purplish black stool blood clots; dark complexion dark, tongue dark red, some purple, pulse string for signs of blood stasis.
4. Spleen and stomach symptoms: bowel lining is thin, can rely on a mucus, intestinal or mixed with a large scale, sepsis, diarrhea and even then more than, diet immediately and had frequent seizures, weakness, fatigue, loss of appetite, pale? S white. Pale tongue, white, pulse fine.
Syndrome analysis: weak stomach, transport and power, water, grain is not oriented, voicing, so the loose stools thin, or rely on a mucus, intestinal or mixed with a large scale.
Pus and blood, even more than is diarrhea, diet is not immediately have seizures; weak stomach, lack of biochemical source of blood loss, showing weakness, fatigue, loss of appetite, pale? S white; pale tongue, white, thin veins of the spleen and stomach Confucianism of the levy.
5 deficiency heat symptoms: diarrhea when, belly pain, blood in the stool red sticky, often accompanied by the afternoon hot flashes, night sweats, upset, insomnia. Red tongue, little pain, rapid pulse.
Syndromes: Chronic Diarrhea diseases, injuries Yinxue, may have made the diarrhea, belly pain, blood in the stool red sticky; Yin raw heat, so it is afternoon, hot flashes, night sweats; Hot disturbed mind is upset, insomnia ; red tongue, little pain, rapid pulse are signs of heat for the deficiency.
6 spleen deficiency symptoms: before dawn, abdominal pain, diarrhea, bowel, diarrhea, after the safety, blood mucus stool, Yuhan that hair, cold limbs, pale mouth pay less, like hot drinks, backache, fatigue, pale. Pale tongue, white, thin weak pulse.
Syndromes: diarrhea course of time, deficiency of kidney yang, not temperature transport Spleen, transport disorders, before dawn yang is not vibration, chill more filled, so there is abdominal pain, diarrhea before dawn, also known as “Dawn diarrhea”; Tom Lee diarrhea after bowel gas, it is safe after diarrhea; chill stagnate, blood pool, injuring intestinal network, then the blood mucus stool; Yang and students within the cold, Yuhan seen that hair, cold limbs;
Kidney is less, the backache fatigue; spleen yang deficiency measured pale mouth pay less, hi hot drinks; pale; pale tongue, white, thin weak pulse are signs of spleen deficiency.
[And Treatment]
1 Spleen oil is hot and humid: detoxification, dampness Xiaozhi.
Recipe: Even Li Tang Pulsatilla Decoction.
Codonopsis 12 grams 12 grams Atractylodes fried Pulsatilla 30 grams of honeysuckle Qin skin 9 g 9 g 3 g Coptis Burnet Treats 9 grams of carbon 12 g meat, 12 g seeds Baojiang wood charcoal 9 g 3 g 12 by Lang 9 g Fructus Kege 9 grams 6 grams of licorice root subtraction with the disease: loss of appetite, mouth pain, plus Gallus gallus domesticus 6 grams of skullcap.
Gardenia 9 grams each, to heat digestion; pus and blood, plus white and powder 3 grams, Agrimony 30 grams, more blood in the stool.
2 liver and spleen Wang Therapeutic: inhibition of liver Fu spleen, diarrhea and pain.
Recipe: Pain Diarrhea together Xiaoyaosan.
Bupleurum 6 grams Atractylodes wind 9 g 9 g Poria 12 grams 15 grams 15 grams of yam Yiyiren simmer ginger 6 grams 6 grams of licorice and white peony root 9 g 9 g powder 3 grams dried tangerine peel with the Modified disease: abdominal distension significantly heating the gas , could add turmeric 9 g, Fructus 12 grams, 6 grams of dried tangerine peel to qi; poor appetite, plus Divine Comedy 9 grams to digestion; headache, irritability, can be added skullcap, gardenia, paeonol 9 grams, 6 grams gentian to heat.
3. Stagnation of intestinal rule is: qi and blood circulation, stasis diarrhea.
Recipe: Ge Xia Zhu Yu Tang Peony Decoction.
Angelica sinensis 9 g Chuan Xiong Radix 9 g 3 g 9 g safflower Wulingzhi 9 grams (including fry) myrrh 9 g 9 g dl 9 Kewu drug wood betel nut 9 g 6 g 9 g Scutellaria Cork 9 grams of white and pink 3 g Burnet SJ 9 g 15 g 6 grams of licorice subtraction with the disease: Tong Shen, plus Cyperus rotundus 12 grams, Sichuan?? sub 9 grams, to Qi and relieve pain; stasis worse, plus Tri, Ezhu 9g to eliminate blood stasis.
4. Spleen and stomach rule: Qi Sun, spleen to stop diarrhea.
Recipe: Bu Zhong Yi Qi Decoction.
15 grams of astragalus Codonopsis 12 grams 12 grams Atractylodes Bupleurum 6 g Poria 12 g yam Cimicifuga 9 g 15 g 15 g lentil seeds woody 3 g of meat 9 g 3 g Campanulaceae Amomum Angelica 9 g 3 g 6 g of dried tangerine peel jujube 15 grams 6 grams of licorice.
Subtraction with the disease: there is blood and pus, plus SJ 9 grams berberine 3 grams, Pulsatilla 30 grams, the blood on the bowel; Jiuxie slip, plus River sub 9 grams, I Yu Liang, Chi Shizhi 15 grams to convergence diarrhea.
5 Yin heat treatment is: nourish Yin and Blood, heat diarrhea.
Recipe: parking Pill.
Habitat 12 g angelica peony root 9 g 9 g 9 Yasar plastic Digupi 12 g Bai Wei 9 g Scutellaria 9 grams berberine 3 g Baojiang 6 grams 6 grams of licorice subtraction with the disease: abdominal pain, faint, plus Cyperus rotundus 12 grams, Corydalis 9 grams, the Qi and relieve pain; bright red blood in the stool, can be added Sophora japonica 9 grams, Biota orientalis, Burnet Wei 2 grams of carbon, to cooling bleeding.
6 spleen deficiency rule is: Warming spleen and kidney, Shibuya intestinal diarrhea.
Recipe: Decoction real dirty raising four gods nine addition and subtraction.
Codonopsis 15 grams Atractylodes 9 grams 6 grams of licorice 3 grams of cinnamon nutmeg Baojiang 6 g 9 g 9 g Schisandra psoralen River sub 9 g 3 g 6 to 9 grams poppy Evodia 3 g angelica peony root 9 g 9 g jujube wood 6 grams plus or minus 15 with the disease: backache, cold worse, plus tuber, ginger 6 grams each, to yang and cold.
[Chinese medicine]
1. Berberine tablets 2 tablets 3 times a day.
2. Guben beneficial intestinal tablets every 4, 2 times a day.
3. Liushen, Yunnanbaiyao, Xileisan these three drugs can be taken orally at the same time, can be used for enema.
[Side] is simple
1. Pulsatilla 30 g, 9 g Scutellaria, Coptis 6 grams of wood 6 grams of betel nut 9 grams, decoction, day one.
2. Huaijiao 9 grams, creeper grass 30 grams, Coix seed, lentils, 15 grams, decoction, day one.
[] Other therapies
Acupuncture: acupoints spleen, the abdominal, Tianshu, Zhang door, three feet, the giant virtual, under the giant virtual points.Needle for 20 minutes every other day, can moxibustion.
(1) diet:
100 grams of rice, the new lentils 30 grams, add water to a thick porridge, a little salt into the onions, dressed in uniforms.
(2) lamb 500 grams, ginger 12 grams, scallion 1, one pot add water, amount of rice wine, Wuhuoshaofei. To the floating foam, slow fire Dunlan consumption. For chronic illness, diarrhea before dawn were.
(3) seeds 15 g (immersed in cold water 1 hour), 30 grams of yam, cook until thick were consumed. Spleen were applied.
(4) Green Tea (3 years, that gets the better efficiency) 25 grams, add water, 1 cup fried thick, graded to drink, drank 1.
Enema: Pulsatilla, matrine and 30 grams, humifusa, Patrina, alum, 15 grams of Sophora japonica, white, and, cedar charcoal, Burnet carbon, 10 grams, fried thick 250 ml per dose, every nightretention enema before going to sleep, 14 days for a course of treatment breaks 7 days.
The amount of bleeding, the bleeding in the western invalid, and the emergence of intestinal stenosis, intestinal obstruction, intestinal perforation, abscess or fistula formation, cancer and other complications, surgery may be considered.
[Notes]
1. Acute or serious illness should be bed rest. Avoid mental stimulation, fatigue, eating disorders, infection, and so on.
(2) Yi Shi light digestible, nutritious food. Rezhou useful to help the rehabilitation of the disease. Eat greasy Feigan goods, MO abuse tonic to prevent Hua Chang.
3 Most patients with good prognosis, patients were long increased risk of cancer, there are complications and poor prognosis.