Accumulation

　　First, pathogenesis

　　1. The key to the pathogenesis is Qi stasis and blood stasis: The etiology includes cold evil, damp heat, phlegm turbidity, food retention, and parasitic accumulation, among which they often intermingle and appear together, ultimately leading to Qi stasis and blood stasis.

　　2. The disease location is in the liver and spleen.

　　3. The initial pathological nature is mostly excess, and over time, it becomes mixed with deficiency and excess:

　　(1) At the initial stage of the disease - evil Qi is full, and the body's Qi is not deficient - mostly due to excess.

　　(2) Accumulation for a long time - the disease is more severe, and Qi is damaged - with both deficiency and excess.

　　(3) At the late stage of the disease, Qi and blood are deficient, and the body is weak - mainly due to Qi deficiency.

　　Second, pathological evolution

　　Generally, the prognosis is good. A few cases of accumulation may not heal for a long time, which can transform from Qi into blood to form accumulation syndrome. The pathological evolution of accumulation is closely related to diseases such as blood stasis, jaundice, and abdominal distension. The diagram of the etiology and pathogenesis of accumulation is as follows: emotional disorders, liver and spleen disharmony, cold evil and Qi and blood mutually binding, irregular diet, phlegm turbidity, Qi and blood stasis, accumulation syndrome, cold dampness, damp heat, post-disease food retention, Qi stasis, blood stasis, and parasitic accumulation.

　　1. Tumors and accumulations mostly belong to the inflammatory, spastic, and obstructive changes of hollow viscus organs such as the gastrointestinal tract. A diagnosis can generally be made based on medical history, symptoms, and signs, and abdominal X-ray and ultrasound can be used for necessary checks.

　　2. The accumulation of fluids often leads to liver and spleen enlargement, abdominal tumors, and hyperplastic intestinal tuberculosis. It is necessary to combine with ultrasound, CT, MRI, X-ray, pathological tissue biopsy, and relevant blood tests for an accurate diagnosis. If the accumulation mass continues to grow and becomes hard and uneven, malignant lesions should be ruled out.

　　What are the typical symptoms of mass and accumulation

　　How to prevent mass and accumulation

　　1. Develop good living habits, quit smoking and limit alcohol. The World Health Organization predicts that if people stop smoking, the world's cancer will decrease by 1/3 after 5 years; secondly, do not overindulge in alcohol. Smoking and drinking are extremely acidic substances, and those who smoke and drink for a long time are prone to acidic体质.

　　2. Do not eat too much salty and spicy food, do not eat overheated, cold, expired, and deteriorated food; for the elderly and the weak, or those with certain genetic diseases, eat some anticancer foods and alkaline foods with high alkali content according to circumstances to maintain a good mental state.

　　1. Mass:Mostly inflammation, spasm, obstruction, and other lesions of hollow organs such as the gastrointestinal tract. Diagnosis can be made roughly based on medical history, symptoms, and signs, and can be supplemented with abdominal X-ray, ultrasound, and other examinations if necessary.

　　2. Mass:Mostly liver and spleen enlargement, abdominal tumors, hyperplastic intestinal tuberculosis, which must be combined with ultrasound, CT, MRI, X-ray, pathological tissue biopsy, and relevant blood tests to make a clear diagnosis. If the mass continues to swell and becomes hard and uneven, malignant lesions should be excluded.

　　1. Quit smoking:Smoking not only can cause chronic cough and increase intra-abdominal pressure, but also can inhibit the synthesis of collagen fibers, promote degenerative changes in abdominal muscles, and is one of the important precipitating factors for senile inguinal hernia. Therefore, the elderly are best not to smoke or reduce the amount of smoking.

　　2. Should eat more:Vegetables, fruits, drinking water in fixed amounts, developing the habit of regular defecation. Regulate diet, maintain regular living habits, pay attention to cold and heat, regulate emotions, maintain Qi and blood flow smoothly. For patients with mass and accumulation, it is especially important to avoid overeating, and to avoid cold, greasy, and油腻 foods to prevent cold dampness retention and damage to the spleen and stomach. For those with Yin injury and bleeding, avoid spicy, alcohol, and hot foods to prevent further injury to Yin and blood.

　　1. Syndrome of liver Qi stagnation

　　1. Main symptoms:Soft lumps in the abdomen, with intermittent sharp pain, sometimes聚 sometimes 散.

　　2. Associated symptoms:Distension and discomfort in the epigastrium and hypochondrium, tongue coating and pulse: thin coating, wiry pulse, etc.

　　3. Summary of pathogenesis:Liver failure to release, Qi stagnation in the abdomen forming into lumps.

　　4. Treatment method:Relieving liver depression and resolving stagnation, promoting Qi flow and resolving lumps.

　　5. Prescription:Soybean Paste Powder, Benxiang Shunqi Powder (from Shen Shizheng Shengshu: Costus, Unshu, Tangerine peel, Licorice, Aurantium, Prunus, Atractylodes, Amomum, Cyperus, Cinnamon, Chuanxiong) with additions. The former is used to relieve liver depression and resolve stagnation, invigorate the spleen and nourish blood, suitable for liver Qi stagnation and spleen weakness with blood deficiency; the latter is used to relieve liver Qi stagnation and promote Qi flow, warm the middle-jiao and transform dampness, suitable for cold dampness obstructing the middle-jiao and Qi stagnation.

　　6. Commonly used drugs:Bupleurum, Angelica, White Peony, Licorice, Ginger, Mint - Relieving liver depression and resolving stagnation;Xiangfu, Qingpi, Zhiqua, Yujin, Taiwuyao - promote Qi and dissipate masses..

　　7. Additions and subtractions:If there is severe distension and pain, add Chuanlianzi, Yanhusuo, and Muxiang to regulate Qi and relieve pain. If there are stasis signs, add Xuanhu, Yixu, and Huoxue to activate blood and dissipate stasis.. If there is cold and dampness obstruction, abdominal distension, and white greasy tongue coating, add Cangzhu, Houpu, Chenpi, Shaoyao, Guixin, and other warming and transforming herbs..

　　Second, food retention and phlegm obstruction syndrome

　　1. Main symptoms:Abdominal distension or pain, there are cord-like masses in the abdomen at times, and pressing on them causes more distension and pain.

　　2. Associated symptoms:Constipation, anorexia, tongue coating and pulse: greasy tongue coating, wiry slippery pulse, etc.

　　3. Summary of pathogenesis:Obstruction of worm masses, food retention, and phlegm turbidity, Qi aggregation not dispersed, and masses form.

　　4. Treatment method:Regulate Qi, dissolve phlegm, and promote bowel movements.

　　5. Prescription:The main prescription is Liumoyao decoction (Chenxiang, Muxiang, Binglang, Wu Yao, Zhishi, Dahuang) from 'Zhengzhi Zhunren'. This formula promotes Qi, dissolves phlegm, promotes bowel movements, and is suitable for symptoms of phlegm and food obstruction, epigastric and abdominal distension, chest oppression, and constipation.

　　6. Commonly used drugs:Dahuang, Binglang, Zhishi - promote bowel movements; Chenxiang, Muxiang, Wu Yao - promote Qi and dissolve phlegm.

　　7. Additions and subtractions:

　　If there is severe distension and pain, add Chuanlianzi, Yanhusuo, and Muxiang to regulate Qi and relieve pain. If there are stasis signs, add Xuanhu, Yixu, and Huoxue to activate blood and dissipate stasis.

　　If there is cold and dampness obstruction, abdominal distension, and white greasy tongue coating, add Cangzhu, Houpu, Chenpi, Shaoyao, Guixin, and other warming and transforming herbs.

　　Masses - Mass syndrome

　　Third, Qi stasis and blood stasis syndrome

　　1. Main symptoms:Abdominal masses, fixed and not movable, distension and pain, soft and not firm.

　　2. Associated symptoms:Distension and fullness in the chest and hypochondrium.

　　3. Tongue coating and pulse:Thin tongue coating, wiry pulse, purple spots or purple dots on the tongue.

　　4. Summary of pathogenesis:Qi stasis and blood stasis, collaterals not harmonious, masses form.

　　5. Treatment method:Regulate Qi and dissipate masses, activate blood and dissipate stasis.

　　6. Prescription:Jinlingzi powder combined with Shifu powder with additions and subtractions. The former is biased towards promoting Qi, activating blood, and relieving pain, suitable for masses with Qi and blood stasis, pain and discomfort; or you can choose Daqiqi decoction, which focuses on dispelling cold and resolving masses, promoting Qi and dissipating stasis, suitable for symptoms with Qi and blood stasis and cold signs.

　　7. Commonly used drugs:Bupleurum, Qingpi, Chuanlianzi - promote Qi and relieve pain; Danshen, Yanhusuo, Puhuang, Wulingzi - activate blood and dissipate stasis.

　　8. Additions and Subtractions:If there are symptoms such as fever, dry mouth, red tongue, and wiry and thin pulse, add Danpi, Shanzhi, Chishao, Huangqin, and other cool blood and clear heat herbs. If there is abdominal cold pain, aversion to cold, preference for warmth, white tongue coating, and slow pulse, add Rougui, Wuyu, and Quan Danggui to warm the meridians and dispel cold and resolve masses.