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Chinese Herbs by Oren at NESA > Internal_Med_2_Exam_2_stomach_pain_constipation_diarrhea > Flashcards

Internal_Med_2_Exam_2_stomach_pain_constipation_diarrhea Flashcards

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1
Q

Constipation due to Heat accumulating in the ST and LI - indications?

A

Acute or chronic, Causes: constitution of yang qi excess, diet (spicy food, ETOH, eating too much, heavy food), lack of H2O, warm febrile disease; Heat can damage the fluids directly or can disturb the qi flow. Infrequent BMs and difficult passing stool. Stool is hard, dry and can be big. Can go 5-7 days with no BM. Qi stagnation signs: bloating, distention, fullness, pain. Tummy hard and firm, dislike pressure, foul gas, burping, hiccup. Yangming heat signs: thirsty, dry mouth, likes cold water, red face, very hungry, irritable, hot, easily sweats, fever, urine can be concentrated and scanty. T: red with yellow coating. P: Forceful, deep (if qi constrained a lot), slippery (heat)

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2
Q

Constipation due to Heat accumulating in the ST and LI - tx principles?

A

Drain heat, promote movement of qi, moisten the intestine and unblock the bowels

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3
Q

Constipation due to Heat accumulating in the ST and LI - basic formula?

A

Ma Zi Ren Wan (Hemp Seed Pill)- Huo Ma Ren, Zhi Da Huang, Zhi Shi, Hou Po, Bai Shao, Chao Xing Ren; 300g of the first 2 and 150g of others

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4
Q

Constipation due to Qi Stagnation - indications?

A

Acute or chronic. Associated with stress level and related to emotion. Very difficult to pass the stool. Only pass small amts, doesn?t feel complete. BMs very sluggish, Stools could be dry or normal. Bloating distention, fullness, cramping. Emotional state directly connected to this. Tension HA, jaw tightness, shoulder/neck tight, PMS, plum pit qi, lack of activity or feel lazy. T: No significant change. If darker than qi stag has impacted blood flow. P: wiry.

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5
Q

Constipation due to Qi Stagnation - tx principles?

A

Promote the Movement of qi, Eliminate Stagnation and unblock

the bowels

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6
Q

Constipation due to Qi Stagnation - basic formula?

A

Liu Mo Tang (Six Milled-Herb Decotion) - Chen Xiang 6g, Bing Lang, Wu Yao, Zhi Shi, Mu Xiang, Da Huang 6g, all others 9g

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7
Q

Constipation due to Cold Accumulating in Interior - indications?

A

Seen less often than previous patterns. Usually r/t improper diet ? too much cold foods or exterior cold slows down LI movement. Acute onset. Bloating, distention, pain, difficulty passing stools and infrequent BMs, cold abdomen, hands, feet, cold aggravates it. Likes warmth, not thirsty, clear urine, no heat signs.

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8
Q

Constipation due to Cold Accumulating in Interior - tx principles?

A

Warm the Interior, disperse cold, unblock the bowels

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9
Q

Constipation due to Cold Accumulating in Interior - basic formula?

A

Da Huang Fu Zi Tang (Rhubarb and Aconite Accessory Root Decoction) - Fu Zi 9g, Da Huang 9g, Xi Xin 6g

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10
Q

Constipation due to Qi Deficiency - indications?

A

Usually elderly, weak muscles, difficulty passing stools ? great effort leaves them exhausted. Rectal prolapse, stool is not dry unless it has gone too long between BMs (like 7 days), general fatigue, pale complexion, SOB, spontaneous sweating, poor appetite T: Swollen, pale, TWC. P: weak

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11
Q

Constipation due to Qi Deficiency - tx principles?

A

Tonify the qi, moisten Intestine and open the bowels

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12
Q

Constipation due to Qi Deficiency - basic formula?

A

Huang Qi Tang - zhi Huang Qi 30-60g, Dang Shen 15-24g, chao Bai Zhu 12-15g, Chen Pi 9-12g, Huo Ma Ren 15g, Feng Mi (honey, 1 spoon)

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13
Q

Constipation due to Blood Deficiency - indications?

A

Hx of suddenly losing a lot of blood (childbirth, heavy period, etc). Chronic or acute, stools dry and hard, difficult to pass, small stools, infrequent BMs, bloating & distention isn?t too bad unless 7 days or more. Pale complexion, tongue, nails, feels light-headed, dizzy, blurred vision, poor memory, sleeps lightly, scanty period, mentally and physically tired, dry scaly skin, hair is dry and thin, regrows slowly, poor diet. T: pale, TWC. P: thin, weak.

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14
Q

Constipation due to Blood Deficiency - tx principles?

A

Nourish the blood, moisten the Intestine and free the stools

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15
Q

Constipation due to Blood Deficiency - basic formula?

A

Run Chang Wan (Moisten the Instetines Pill from Master Shen?s Book) - Dang Gui, Sheng Di, Tao Ren, Huo Ma Ren, Zhi Ke, 30g each

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16
Q

Constipation due to Yin Deficiency - indications?

A

Acute if heavy sweating, dehydrated, warm febrile disease, or chronic. Stools very dry, pebble like. Dry and hard. Bloating, distention, pain isn?t too bad, lose weight, empty heat or feels warm at night, night sweats, dizziness, tinnitus, sleep is poor, insomnia, irritable, depends on the organ yin xu for symptoms: ST yin ? very thirsty, dry mouth. LV yin ? dry eyes. KD yin ? dry hair, tinnitus, LBP. LU yin ? chronic dry cough. T: red, dry, cracks, patch, peeled. P: thin, rapid, weak

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17
Q

Constipation due to Yin Deficiency - tx principles?

A

Nourish yin, moisten intestine, and unblock the bowels

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18
Q

Constipation due to Yin Deficiency - basic formula?

A

Zeng Ye Tang (Increase the fluids decoction) + Bai Shao, Yu Zhu, Shi Hu, Huo Ma Ren, Gual Lou Ren, Bai Zi Ren (to moisten intestine)

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19
Q

Constipation due to Yang Deficiency - indications?

A

Different than cold accumulation bc that was excess cold. This is r/t constitution or disease (hypothyroid), sluggish bowels, stools may or may not be dry, very sluggish, difficult to pass, bloating & fullness not too bad, hands and feet always cold, likes heat. A lot r/t KD ? unable to warm intestine or SP, profuse urination ? large volume, frequent and pale, makes intestines more dry. T: pale, TWC. P: deep, slow, weak

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20
Q

Constipation due to Yang Deficiency - tx principles?

A

Warm the KD yang, Moisten the Intestine and unblock the bowels

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21
Q

Constipation due to Yang Deficiency - basic formula?

A

Ji Chuang Jian (Benefit the River (flow) Decotion) - Rou Cong Rong 30g, Dang Gui 9-12g, Niu Xi 9-12g, Zhi Ke 6-9g, Ze Xie 6-9g, Sheng Ma 3-6g, Rou Gui 3g

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22
Q

Stomach Pain due to Cold Invading the ST - indications?

A

Sudden, often violent, cramping, spasmodic epigastric pain, or recurrent colicky pain assoc with certain foods. Pain is better with warmth but worse with pressure. No thirst, or a desire for warm drinks, N/V, hypersalivation, may be fever/chills, HA, floating tight pulse. T: normal or pale with white coat P: wiry, tight, or slow

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23
Q

Stomach Pain due to Cold Invading the ST - tx principles?

A

Warm the ST, dispel cold, promote the movement of qi, and alleviate pain

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24
Q

Stomach Pain due to Cold Invading the ST - basic formula?

A

Liang Fu Wan (Galangal and Cyperus Pill)

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25
Q

Stomach Pain due to Retention of Food - indications?

A

Epigastric distention, fullness, discomfort and pain which is relieved by vomiting, belching. Worse with pressure and eating. Sour, foul belching and indigestion, acid reflux, heartburn, bad breath, flatulence, N/V with undigested food, constipation, sluggish, foul stools or diarrhea that relieves the pain. T: thick, greasy, white or yellow coat P: slippery and full

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26
Q

Stomach Pain due to Retention of Food - basic formula?

A

Bao He Wan

27
Q

Stomach Pain due to Retention of Food - tx principles?

A

Reduce food stagnation, regulate qi, harmonize the ST, and stop pain

28
Q

Stomach Pain due to Liver Qi Attacking the ST - indications?

A

Spasmotic epigastric pain, distension, fullness which may radiate to hypochondriac region. Usually emotional component. Hx of having ?knot in the ST? when tense/emotional. The pain and distention are worse with pressure, better with exercise and relaxation. Frequent sighing, belching, flatulence, variable appetite, bloating, acid reflux, tension HA, dizziness, alternating constipation/diarrhea, fullness/tightness in chest, depression, moody, irritable, irregular menstruation, PMS, poor circulation. T: normal or dark tongue with TWC; with heat: red tongue or red edges and dry, yellow coat P: wiry

29
Q

Stomach Pain due to Liver Qi Attacking the ST - tx principles?

A

Soothe the LV, regulate qi, harmonize the ST, and relieve pain

30
Q

Stomach Pain due to Liver Qi Attacking the ST - basic formula?

A

Chai Hu Shu Gan San (Blupeurum powder to Dredge the LV)

31
Q

Stomach Pain due to Accumulation of Heat in the LV and ST - indications?

A

Above symptoms plus Heat ? indeterminate gnawing hunger, severe heartburn, restlessness, irritability, easily angered, bitter taste in mouth, thirst, constipation. T: red tongue or red edges and dry, yellow coat P: wiry and rapid

32
Q

Stomach Pain due to Accumulation of Heat in the LV and ST - tx principles?

A

Soothe the LV, clear heat, harmonize the ST, and relieve pain

33
Q

Stomach Pain due to Accumulation of Heat in the LV and ST - basic formula?

A

Jia Wei Xiao Yao San (Augmented Rambling powder)

34
Q

Stomach Pain due to Blood Stasis in the ST - indications?

A

Epigastric pain that is fixed, sharp, stabbing, worse with pressure, eating and at night. May start intermittent but can become more constant. Stools may be black and tarry. N, belching, acid reflux, vomiting of coffee ground material if severe. Dark complexion, spider veins on cheeks/epigastrium/trunk/inner ankle/knee, poor appetite or anorexia, weight loss. T: dark or purple body with dark spots, distended SL veins P: wiry, or thready and choppy

35
Q

Stomach Pain due to Blood Stasis in the ST - tx principles?

A

Invigorate blood, dispel blood stasis, harmonize the ST, and relieve pain

36
Q

Stomach Pain due to Blood Stasis in the ST - basic formula?

A

Shi Xiao San (Sudden Smile Powder) + Dan Shen Yin (Salvia Drink)

37
Q

Stomach Pain due to Heat-Dampness Obst the Middle Burner - indications?

A

Prolonged nagging pain and distention, thirst with no desire to drink, N/V (may be blood-streaked), alternating constipation/diarrhea, variable appetite, heavy sensation in body, lethargy. T: red, puffy with greasy yellow coat P: wiry, slippery, rapid

38
Q

Stomach Pain due to Heat-Dampness Obst the Middle Burner - tx principles?

A

Clear heat, transform dampness, regulate qi, and harmonize the ST

39
Q

Stomach Pain due to Heat-Dampness Obst the Middle Burner

A

Qing Zhong Tang (Clear Middle Decoction)

40
Q

ST Pain due to ST Yin Deficiency - indications?

A

Vague, dull, nagging or burnig epigastric pain, worse with empty ST, may be better with pressure. Pain worse at night, patient may wake with pain in the early hours of am. Dry mouth, throat, thirst with desire for cold, mild N, poor appetite or indeterminate gnawing hunger, constipation or dry stools. T: slightly red and peeled, or red and dry with little coat. P: thready and rapid

41
Q

ST Pain due to ST Yin Deficiency - tx principles?

A

Nourish yin, strengthen ST, harmonize middle burner, and alleviate pain

42
Q

ST Pain due to ST Yin Deficiency - basic formula?

A

Yi Guan Jian (Linking Decoction) + Shao Yao Gan Cao Tang (Peony and Licorice Decoction)

43
Q

ST Pain due to SP/ST Yang Deficiency - indications?

A

Chronic mild, dull, nagging continuous epigastric pain, better with warmth, pressure. Vomiting thin watery fluids, poor appetite or anorexia, loose stools/diarrhea, abdominal distention (worse with eating), borborygmus, tiredness, heaviness/lethargy, fluid retention, pale or sallow complexion, cold extremities. T: pale, swollen, scalloped, thin or thick coat P: moderate and weak, or deep and slow

44
Q

ST Pain due to SP/ST Yang Deficiency - tx principles?

A

Warm and supplement the SP and ST, relieve pain

45
Q

ST Pain due to SP/ST Yang Deficiency - basic formula?

A

Huang Qi Jian Zhong Tang (Astragalus Decoction to Construct the Middle)

46
Q

Diarrhea Etiology and Pathology - what are causes?

A
  1. INVASION EXT. PATHOGENS (C/H/S-H/D invade Intestine directly, mostly D. - Evil Qi disturbs SP function of separating pure/turbid & impair Intenstines extraction of water) 2. IMPROPER DIET (overeating, excess consumption of cold, meat, raw, rich, sugar/sweet food, dairy, contaminated food, eating irregularly, eating late, eating while stressed - injure the SP, upset digestive functions, generate cold, heat or dampness in the interior) 3. EMOTIONAL FACTORS (prolonged frustration, anger, resentments, hatred, worry, obsessive thinking, repressed emotion and stress can cause qi stagnation in MB, obstruct SP, ST, Intestinal digestive functions) 4. SP QI OR SP/KD YANG XU (overexertion, chronic illness, aging, inherited condition, excess ingestion of cold substances, GI surgery, excess lifting and standing, drug SE - either deficiency will cause excess dampness accumulation and disturb the intestine?s transporting function, and fail to separate clear and turbid)
47
Q

External Damp-Cold Diarrhea - indications?

A

Often ST flu. Acute onset, significant increase in freq, watery stool ? clear or extremely loose. Usually with cramping, pain, borborygmus, ST feels full, decreased appetite, maybe chest tightness from qi not flowing smoothly. Feels very tired, sick, dehydrated. Plus maybe external W/C sx: stuffy or runny nose, HA, body aches, N/V, not have heat sx, don?t feel thirsty. T: thick, white, greasy coating P: moderate, floating, softer

48
Q

External Damp-Cold Diarrhea - tx principles?

A

Transform dampness, dispel cold, release the exterior and harmonize the middle burner

49
Q

External Damp-Cold Diarrhea - basic formula?

A

Huo Xiang Zheng Qi San (Agastache Powder to Rectify the Qi)

50
Q

External Damp-Heat Diarrhea - indications?

A

Violent, explosive, borborygmus, urgency, cramps, bloating, burning sensation at anus, pt feels thirsty, strong odor. Color is yellow or brown. Feels incomplete, fever, irritable, scanty/yellow urine. T: red, yellow greasy tongue coat P: slippery, rapid or moderate/rapid

51
Q

External Damp-Heat Diarrhea - tx principles?

A

Clear heat, eliminate dampness and relieve dairrhea

52
Q

External Damp-Heat Diarrhea - basic formula?

A

Ge Gen Huang Qin Huang Lian Tang (Kudzu, Scutellaria, and Coptis Decoction)

53
Q

Retention of Food Diarrhea - indications?

A

Eaten spoiled food or too much food. Acute. Diarrhea is very strong odor. After diarrhea they feel better. Cramps and bloating, borborygmus, burping, hiccup, N/V, don?t want to eat food, very bloated, foul gas. T: greasy or thick coat P: slippery

54
Q

Retention of Food Diarrhea - tx principles?

A

Disperse food, eliminate stagnation and relieve diarrhea

55
Q

Retention of Food Diarrhea - basic formula?

A

Bao He Wan (Preserve Harmony Pill)

56
Q

SP Xu Diarrhea - indications?

A

SP qi xu causes dampness accumulation. Chronic, frequent loose stools, occasionally watery, often undigested food. Worse with improper diet, cold water, raw food, overexertion, eating fast, sluggish digestion, poor appetite, bloating, tired after eating, oily food. Pale or yellow, dull complexion, tired 4 extremities, puffy, vaginal discharge. T: pale, puffy, swollen P: thin, weak

57
Q

SP Xu Diarrhea - tx principles?

A

Strengthen the SP, augment qi, leach out dampness and stop diarrhea

58
Q

SP Xu Diarrhea - basic formula?

A

Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder)

59
Q

KD and SP Yang Deficiency Diarrhea - indications?

A

Cold plus KD symptoms on top of SP qi xu. Early am diarrhea or any time of day with undigested food. Cold food, cold weather, improper diet make it worse. Inside feel cold. Borborygmus. SP xu: fatigue, poor appetite, poor digestion. KD: LB/knee weakness, tinnitus, fertility issues, hands/feet cold, lower abdomen cold. T: pale, white coating, could be thicker, greasy P: deep, thin, weak, slow

60
Q

KD and SP Yang Deficiency Diarrhea - tx principles?

A

Warm and tonify the SP and KD, bind up the Intestine and stop diarrhea

61
Q

KD and SP Yang Deficiency Diarrhea - basic formula?

A

Si Shen Wan (Four-Miracle Pill)

62
Q

Disharmony of LV and SP - indications?

A

LV is stagnated and is attacing the SP (which was already weak or becomes weaker). Diarrhea occurs with emotions. Lots of qi stagnation in abdomen or hypochondria. Gassy, cramping, borborygmus, burping/hiccup, chest tightness, tension HA, depression. T: sl pale, TWC P: wiry

63
Q

Disharmony of LV and SP - tx principles?

A

Soothe the LV, support the SP and relieve diarrhea

64
Q

Disharmony of LV and SP - basic formula?

A

Tong Xie Yao Fang (Important Formula for Painful Diarrhea)

Chinese Herbs by Oren at NESA (13 decks)

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