Dr. KangEditor | ShiwufollowChronic diarrhea is a common digestive system disease in clinical practice,In clinical symptoms, it is mostly manifested as an increase in stool frequency, increased stool volume, and loose and thin feces

Dr. Kang

Editor | Shiwu

• follow

Chronic diarrhea is a common digestive system disease in clinical practice,In clinical symptoms, it is mostly manifested as an increase in stool frequency, increased stool volume, and loose and thin feces.

Chronic diarrhea has a longer course of disease,It often recurs, persists and is difficult to cure, and treatment is more challenging.

Western medicine often uses the combination of intestinal mucosal protective agents and microecological agents for treatment, but the treatment effect of some patients is not good. Although some patients are effective, they are more likely to relapse after drug withdrawal, and can not fundamentally solve the problem of Gut microbiota imbalance and functional disorder.

The treatment of chronic diarrhea with traditional Chinese medicine is guided by holistic dialectical thinking,We have used treatment methods such as strengthening the spleen, soothing the liver, and tonifying the kidneys,While improving the symptoms of the condition, it can regulate the body's qi, blood, yin and yang, reduce the recurrence rate, and the treatment effect is significantly effective.

In recent years, we have adoptedModified Treatment of Traditional Chinese Medicine Wumei PillsThere are 26 cases of chronic diarrhea with mixed symptoms of cold and heat, and the treatment effect is significant. The following will be reported.

General information: 52 patients with chronic diarrhea, cold and heat syndrome, who visited the Traditional Chinese Medicine Clinic of Wuxi People's Hospital from January 2018 to December 2020, were selected as the research subjects,Divide into a treatment group and a control group using a random number table method, with 26 cases in each group.

There was no statistically significant difference in general data such as gender, age, and course of disease between the two groups of patients (P>0.05), indicating comparability.

This study was approved by the Medical Ethics Committee of our hospital.

Diagnostic criteria: Western medical diagnostic criteria are formulated according to the diagnostic criteria for chronic diarrhea in Internal medicine.

1) Increased frequency of bowel movements (more than 3 times per day), increased fecal volume (more than 200g per day), and sparse fecal quality (water content>85%); 2) Diarrhea lasts for more than 3-6 weeks or recurs.

The standard of TCM syndrome differentiation is formulated with reference to Internal medicine of Traditional Chinese Medicine and Guiding Principles for Clinical Research of New Traditional Chinese Medicine (Trial).

Main symptom: Increased frequency of defecation, exceeding 3 or more times a day, thin feces or incomplete grains, and even discharge like water.

Secondary symptoms: dry mouth, bitter mouth, abdominal pain or discomfort, frequent belching, overall fatigue, poor diet, fear of cold in the abdomen or lower limbs. Tongue pulse: The tongue is light red, with greasy or yellowish white fur, and the pulse is heavy or thin.

It has any two or more primary and secondary symptoms, and can be differentiated by combining tongue and pulse.

Inclusion criteria: 1) Comply with the diagnostic criteria of Western medicine and traditional Chinese medicine differentiation criteria mentioned above; 2) Age 18-70 years old, with good compliance; 3) Have not taken any relevant treatment medication within one month; 4) The patient has informed consent and signed an informed consent form.

Exclusion criteria: Individuals with severe gastrointestinal, liver, and kidney system diseases,Patients with organic diseases such as intestinal tumors and intestinal stenosis, as well as pregnant or lactating women.

Treatment method: The control group was given orally 4 bifidobacterium triple viable enteric coated capsules, twice a day, for 6 consecutive weeks. Jincheng Haisi Pharmaceutical Co., Ltd., with national drug approval number S19993065, with a specification of 0.21g per capsule.

Modified Treatment of Traditional Chinese Medicine Wumei Pills

Formula composition: 15g Wumei, 3g Asarum, 10g Cinnamomum cassia, 10g Codonopsis pilosula, 3g Zanthoxylum bungeanum, 6g Ganjiang, 10g Fupian (decocted first), 6g Huanglian, 10g Huangbai, and 10g Danggui.

Add or subtract according to symptoms: For those with sticky mouth, heavy and weak limbs, thick and greasy tongue with teeth marks, thick and greasy fur, and severe spleen deficiency and dampness, add 15g of Poria cocos, 10g of fried Atractylodes macrocephala, and 10g of Huoxiang; For those with dry mouth, severe bitter taste, burning sensation in the anus, hot flashes and night sweats, yellow and greasy fur, and severe damp heat, please change the dosage of Huanglian to 9g and add 30g of Pueraria lobata.

In case of severe diarrhea due to cold diet, diarrhea at the fifth hour, low back acid, low back pain, and obvious kidney yang deficiency, add 10g of Cullen corylifolium, 10g of nutmeg, and 3g of Tetradium ruticarpum; For those with combined abdominal pain and bloating, add 10g of Muxiang and 10g of Chuanzhizi; For those with combined insomnia, add 30g of raw dragon bones (pre fried) and 30g of raw oysters (pre fried).

For those who merge belching, add 20g of Xuanfuhua (pre fried) and 30g of Daizheshi (pre fried); For those who merge and accept differences, add 15g of each of the three immortals.

Boil the above traditional Chinese medicine twice and combine the decoction twice. Take it half an hour after breakfast and dinner, and continue taking it for 6 weeks.

The patient will seek medical attention once a week, and adjustments will be made based on the above traditional Chinese medicine prescriptions according to changes in their condition.

Observation indicators: According to the TCM syndrome score, the five symptoms of stool characteristics, frequency of bowel movements, abdominal pain, bloating, and incomplete defecation are scored as 0, 1, 2, and 3 points, respectively, based on no, mild, moderate, and severe symptoms; If there is mucus, score 1 point, and if there is no mucus, score 0 point.

If the score is higher, it indicates that the condition is more severe. Compare the TCM syndrome scores of the two groups before and after treatment.

The clinical efficacy standards are formulated in accordance with the "Guiding Principles for Clinical Research of New Traditional Chinese Medicine (Trial)".

The counting data is expressed as a percentage using the x2 test. P<0.05 indicates a statistically significant difference.

Comparison of TCM syndrome scores before and after treatment between the two groups: There was no statistically significant difference in TCM syndrome scores between the two groups before treatment (P>0.05), indicating comparability.

After treatment, both groups of traditional Chinese medicine syndrome scores significantly decreased, with a statistically significant difference compared to the same group before treatment (P<0.05),And the treatment group showed a more significant decrease, with a statistically significant difference compared to the control group after treatment (P<0.05).

Comparison of clinical efficacy between two groups: The total effective rate of the treatment group was 88.46% (23/26), while the control group was 65.38% (17/26). The difference between the two groups was statistically significant (P<0.05).

Chronic diarrhea is a common clinical disease with a longer course of disease.

Its etiology and pathogenesis are mainly intestinal infectious or non infectious diseases, intestinal motility abnormalities, intestinal absorption dysfunction, etc., and can also be secondary to systemic diseases and stomach, liver, gallbladder, pancreas, spleen diseases,Its triggers are often closely related to mental tension, fatigue, and malnutrition.

Chronic diarrhea disease belongs to the category of "diarrhea" and "downward benefit" in Traditional Chinese medicine. In Internal medicine of traditional Chinese medicine, it is mostly divided into three syndrome types, namely, spleen deficiency, liver depression and kidney deficiency. Most of them are based on the principles of invigorating the spleen and qi, soothing the liver and spleen, warming and tonifying the spleen and kidney, and are treated with modified Shenling Baizhu Powder, Tongxie Yaofang, and Sishen Pill.

But in clinical practice, we found that,These three syndrome types cannot cover all types of chronic diarrhea symptoms, and the more common syndrome types in clinical practice are mixed cold and heat syndrome.

The patients mostly showed dry mouth and bitter mouth, abdominal pain, diarrhea, bowel ringing, Rectal tenesmus, and other conditions, and the number of stools was more, the diet was cold, greasy, or emotional stimulation aggravated, the tongue was light red, yellow greasy or yellow white, and the pulse was more thin or thick.

Dry mouth, bitter mouth, and greasy fur are often heat symptoms,At this point, simply using drugs that clear heat and dry dampness may exacerbate the condition of diarrhea.

Diarrhoea worsens after bowel ringing and cold diet, and the pulse becomes cold. At this time, if only warming and tonifying drugs are used, the symptoms of dry mouth and bitter mouth and Rectal tenesmus may be aggravated.

Therefore, it is not advisable to simply use cold or hot drugs, as this type of chronic diarrhea is often characterized by a mixture of cold and heat, deficiency and excess. Treatment should be carried out by clearing the upper and warming the lower, soothing the liver and regulating the middle.

The traditional Chinese medicine Wumei Pill is an effective formula that combines cold and heat, attack and tonify. When used in clinical practice, as long as the patient's chronic diarrhea manifests as upper heat and lower cold,According to the indications for the use of Wumei Pill, even if the cold or hot symptoms are not very obvious, it can still be boldly used.

The traditional Chinese medicine Wumei Pill came from the Shanghan Lun by Zhang Zhongjing in the Eastern Han Dynasty,The original formula is a pillThe medicine is composed of black plum, asarum, cinnamon twig, Codonopsis pilosula, prickly ash, dried ginger, monkshood, coptis chinensis, phellodendron, and Angelica sinensis.

The combination of sour, bitter, sweet, and spicy ingredients is an effective formula for treating Jueyin disease, which is characterized by a mixture of cold and heat, as well as a combination of deficiency and excess,In clinical practice, it is often used for the treatment of roundworm syncope and prolonged dysentery.

The dark plum in the prescription has a sour taste, which can astringent, relieve diarrhea, and relieve pain. It is the king's medicine.

Zanthoxylum bungeanum, Asarum, and dry ginger are warm in nature and have a pungent taste. They can warm the internal organs and dispel colds, making them official medicines.

Warm osmanthus twigs and aconite can enhance the function of dispelling cold and warming the middle; Huanglian and Huangbai taste bitter and can clear heat and dry dampness; The sweet taste of Codonopsis pilosula and Angelica sinensis can tonify the spleen and stomach qi and blood, and both are adjuvants.

All drugs are used together to tonify the liver and nourish blood, warm the spleen and kidney, and suppress wood and soil. They balance yin and yang as a whole, thus achieving the goal of stopping diarrhea.

Modern pharmacological research indicates that,Traditional Chinese Medicine Wumei PillhaveIt can regulate the function of spleen and stomach, anti-inflammatory, antioxidant, enhance the immunity of the body, and protect the Gastric mucosa.

Traditional Chinese Medicine Wumei Pill

The results of this study showed that after treatment, the TCM syndrome score of the treatment group was significantly lower than that of the control group (P<0.05), and the total effective rate was significantly higher than that of the control group (P<0.05).

Modified Treatment of Traditional Chinese Medicine Wumei PillsAnd it significantly improved the symptoms of diarrhea in patients, which is worth further in-depth research in future clinical practice.

Disclaimer: The content of this article is sourced from the internet. The copyright of the text, images, and other materials belongs to the original author. The platform reprints the materials for the purpose of conveying more information. The content of the article is for reference and learning only, and should not be used for commercial purposes. If it infringes on your legitimate rights and interests, please contact us promptly and we will handle it as soon as possible! We respect copyright and are committed to protecting it. Thank you for sharing.(Email:[email protected])