How to treat edema

Under normal physiological conditions, the hydrostatic pressure in blood vessels is in equilibrium with interstitial colloid osmotic pressure. When the former pressure is higher than the latter, the fluid moves from the blood vessel to the gap, causing edema clinically. Localized edema: (1) venous blood flow is blocked; (2) Lymphatic blood flow obstruction; (3) local inflammation; (4) allergic reaction; (5) burns and ice sores. Systemic edema: (1) cardiogenic; (2) renal; (3) liver; (4) malnutrition; (5) endocrine disorders; (6) Simple edema. Clinically, according to the different distribution, the cause can be inferred. For example, edema of one limb or both limbs is often due to obstruction of blood vessels and lymphatic vessels. Edema caused by low plasma protein is often systemic, especially in eyelids and face, which is obvious in the morning. Another example: edema caused by heart failure, especially edema of lower limbs, is aggravated at night. Clinical treatment of edema should be based on different causes to treat the primary disease. In addition, the hydrostatic pressure in blood vessels decreased and the interstitial colloid osmotic pressure increased.

Treatment of edema based on TCM syndrome differentiation

Edema refers to a disease characterized by local or systemic edema. It is caused by exogenous pathogenic factors, internal injuries due to fatigue, or eating disorders, which leads to unfavorable gasification, abnormal transport and transformation of body fluids, resulting in water retention and overflow to the skin, causing symptoms characterized by head, face, eyelids, limbs, abdomen and back, and even systemic edema. The differential treatment of edema is mainly yin and yang. First of all, we should distinguish between yin and yang. However, the development and change of the disease is transformed with the progress of the disease, which requires specific analysis of specific problems and treatment based on syndrome differentiation.

1 Shui Yang 1. 1 feng shui flood, eyelid swelling slightly, then limbs undulate and the whole body fluctuates, and the onset is urgent, mostly accompanied by aversion to cold, fever, limb pain and unfavorable defecation; Or accompanied by wind-heat manifestations such as sore throat, red tongue and slippery pulse; Or accompanied by cough and asthma, aversion to cold, pale tongue, thin white fur, slippery or tight pulse and other cold manifestations. It is advisable to dispel wind and clear heat, and promote lung and water. The prescription is modified by Yuemai plus decoction. If you are afraid of cold and the wind is strong, use ephedra, perilla, notopterygium root, divaricate Saposhnikovia root and gypsum removal; If the sore throat is obvious, gypsum, honeysuckle, isatis root and cogongrass rhizome should be reused; For patients with cough and asthma, almond and mulberry bark are added; If you have a bad wind and have yang deficiency, you can take Ji Fang Huangqi Decoction and so on.

1.2 Wet toxin invades the eyelid slightly swollen and spreads to the whole body, causing dysuria, skin sores and even ulceration, fever due to foul wind, red tongue, thin yellow fur and floating or slippery pulse. It is advisable to disperse lung and detoxify, promote diuresis and reduce swelling. The prescription is ephedra, forsythia and red bean soup combined with Wuwei disinfection drink. Purulent people reuse Gongying and Viola yedoensis; Radix Saposhnikoviae, Cortex Dictamni Radicis, Fructus Kochiae and Semen Ziziphi Spinosae are added for those with excessive wet itching, and Cortex Moutan and Radix Paeoniae Rubra are added for those with red blood heat; If the stool is blocked, use Tiaowei Chengqi Decoction.

1.3 The onset of cold and dampness is slow, the course of disease is long, the whole body is swollen, the waist is swollen, the urine is short, the body is tired, the chest is tight, the tongue is pale or dull, the coating is white and greasy, and the pulse is slow. It is advisable to strengthen the spleen and eliminate dampness, and promote yang and diuresis. Fang uses five skins to drink soup. For patients with anorexia and nausea, Cortex Magnolia Officinalis and Rhizoma Zingiberis Recens are added; For patients with cough and asthma, drugs such as Herba Ephedrae, Semen Armeniacae Amarum and Semen Lepidii can be added.

1.4 Damp-heat with edema, tight and bright skin, tightness in the chest, vexation and thirst, short and red urine, dry stool, red tongue, yellow and greasy fur and heavy pulse. Treatment should be divided into damp heat, diuresis and detumescence. Add and subtract decoction with a chisel. If the abdomen is full and constipation does not decrease, you should take Jiaotiaohuang pills. Cortex Phellodendri, Rhizoma Imperatae, Herba Cirsii Cirsii and Herba Cirsii Cirsii are added for hematuria and dysuria; Damp-heat turns to dryness and injures yin. Take Zhu Ling Decoction.

2. Yin water 2. 1 Spleen yang deficiency, body distension, especially below the waist, depression is not easy to recover, abdominal distension loose stool, sallow complexion, listlessness, cold limbs, short and red urine, pale tongue, white and slippery fur and slow pulse. Treatment should be warming and invigorating spleen yang, diuresis and detumescence. The prescription is a spleen-strengthening drink. If you have a long-term eating disorder, spleen and stomach weakness, mental fatigue, normal or loose stools, and excessive urination, you should strengthen the spleen and eliminate dampness, and use Shen Ling Baizhu Powder to add and subtract.

2.2 Kidney-yang failure with edema, especially below the waist, is not easy to droop, palpitation, shortness of breath, soreness of waist and knees, chills of limbs, pale complexion, decreased urine output or increased nocturia. The tongue is pale, fat and white with fur, and the pulse is thin or stagnant. The treatment should be to warm the kidney and help yang, and turn qi into water. The prescription is Jisheng Shenqi Pill Quanzhenwu Decoction. If urine output is excessive, Semen Cuscutae, shredded paper and Fructus Alpinae Oxyphyllae are added, and Alismatis Rhizoma and Semen Plantaginis are removed; For patients with severe palpitation, Radix Aconiti Lateralis Preparata is reused, and Radix Glycyrrhizae and Ramulus Cinnamomi are added; Ginseng, gecko, Schisandra chinensis, Cornus officinalis, etc. Shortness of breath, excessive sweating and pulse deficiency should be reused.

In the process of clinical treatment of edema, the author realized that Chinese herbal medicine has the advantages of obviously improving symptoms, diuresis and detumescence, moderate stability and few side effects. Such as Poria, Polyporus, Alisma orientalis, etc., and Radix Aconiti Lateralis, Radix Angelicae Sinensis, Folium Pyrrosiae, Ginseng, Radix Astragali, Radix et Rhizoma Rhei, etc. It can not only induce diuresis and reduce swelling, but also have a good effect on restoring renal function and removing urinary protein. It is also helpful to control the progress of diseases, delay the damage of kidneys, regulate the immune function of the body, reduce the blood viscosity, and alleviate the damage of renal tissue cells ischemia, hypoxia and inflammatory reaction. The treatment of edema is still closely related to diet conditioning. As the saying goes, "seven points are two and three points are raised." Only the combination of treatment and conditioning can achieve satisfactory curative effect.