吴志洲运用经方辨治便秘经验OA

Professor Wu Zhizhou believes the main etiology and pathogenesis of constipation lies in qi movement disorder,disharmony of the spleen and stomach,and retained food causing obstruction.This condition may arise from excessive yang constitution with a prefer-ence for spicy and rich foods,leading to intestinal heat accumulation,or from qi and blood deficiency and lack of body fluids,resulting in heat retention in the intestines.In clinical practice,Professor Wu skillfully applies classical formulas and employs various TCM approa-ches,such as"warming purgation,""moistening purgation,""clearing purgation,"and"cold purgation,"tailored to different consti-tutions and syndromes.For constipation due to gastrointestinal heat accumulation,clearing heat and removing masses is necessary;mild symptoms of yang brightness excess are treated with Minor Purgative Decoction,which is called"mild purgation method".For milder symptoms with weakness,Stomach-Regulating and Purgative Decoction is used for relieving heat accumulation gently,which is called"moderate purgation".For severe heat symptoms,"cold purgation"should be used,so Major Purgative Decoction can be adopted.For yang brightness excess with nausea,Major Bupleurum Decoction is employed to clear interior heat,harmonize lesser yang,and regulate qi movement.Based on Minor Purgative Decoction,Maziren(Fructus Cannabis),Shaoyao(Radix Paeoniae Alba seu Rubra),Xingren(Semen Armeniacae Amarum),etc.are prepared to Cannabis Fruit Pill.It can be used for the secondary constipation caused by chronic diseases with severe intestinal dryness,constipation in the elderly or postpartum constipation caused by dehydration in women.This is called"moistening purgation method."For cold accumulation in the intestines,it is necessary to disperse cold and resolve accumulation using Rhubarb and Aconite Decoction or Spleen-Warming Decoction.For constipation with syndrome of greater yin dysfunction,it is nec-essary to invigorate the spleen and dispel dampness using Immature Bitter Orange and Atractylodes Macrocephala Pill,Officinal Magno-lia Bark and Fresh Ginger and Pinellia and Licorice and Ginseng Decoction,Cinnamon Twig Decoction plus Peony,etc.For constipation due to qi stagnation and blood dryness,it is necessary to regulate qi and nourish blood.For constipation due to liver depression and qi stagnation,Modified Frigid Extremities Powder is commonly used.For severe qi stagnation with abdominal distension and pain,Officinal Magnolia Bark Three-Ingredient Decoction can be used to move qi,resolve masses and eliminate stasis.For weak or pregnant individu-als with insufficient blood and fluids causing intestinal dryness and hard stools,moistening method is prioritized with formulas such as Fluid-Replenishing Decoction,Chinese Angelica and Bulbus Fritillariae and Radix Sophorae Flavescentis Pill,Chinese Angelica Blood-Supplementing Decoction,etc.Qi is the commander of blood,while blood is the mother of qi,so for long-time blood deficiency combined with qi deficiency,Modified Chinese Angelica Blood-Supplementing Decoction is often adopted in clinical practice.