Spleen Qi deficiency

　　Spleen Qi deficiency leads to the failure of transportation and transformation, with the retention of food and grain in the interior, resulting in a decrease in appetite and abdominal distension; the burden is加重 after meals, so the abdominal distension is more severe; the failure to transport dampness leads to its flow into the intestines, causing loose stools; the spleen governs the muscles and limbs, and long-term spleen deficiency leads to malnourishment of the limbs, resulting in fatigue and weakness; insufficient middle Qi leads to a lack of vitality and weakness of speech; the failure of the spleen to transport and transform leads to the infiltration of dampness into the muscle layer, resulting in a pale and puffy complexion; the spleen and stomach are the source of Qi and blood production. Long-term spleen Qi deficiency can lead to deficiency of nutrient essence and blood, or deficiency of both Qi and blood. The skin loses the nourishment and warmth of blood, leading to emaciated body, a sallow complexion, pale tongue with white coating, and a floating, weak pulse, which are signs of spleen Qi deficiency.

　　Pale and puffy complexion

　　The spleen and stomach are related in terms of their interior and exterior relationships, physiological functions, and pathological conditions. The spleen governs transportation and transformation, while the stomach governs reception. The Qi of the spleen tends to rise, and the Qi of the stomach should descend. Therefore, the typical symptoms of spleen Qi deficiency are a lack of appetite, abdominal distension, and loose stools, while the typical symptoms of stomach Qi deficiency are a decrease in appetite, belching, nausea, and vomiting. Further development of spleen Qi deficiency can lead to insufficient spleen Yang and the generation of endogenous cold Yin, forming a syndrome of spleen Yang deficiency. The clinical manifestations are the addition of epigastric and abdominal pain that is relieved by pressure and warmth, intestinal noises and diarrhea without digestion of undigested food, vomiting of clear saliva, difficulty in urination, aversion to cold, and cold limbs on the basis of spleen Qi deficiency. Deficiency of the spleen Qi can lead to the descent of clear Yang, even to the point of not rising, which can transform into a syndrome of descending spleen Qi. The clinical manifestations are the addition of chronic diarrhea and dysentery, prolapse of the rectum, metrorrhagia, prolapse of the uterus, and a heavy feeling in the umbilical and abdominal region on the basis of spleen Qi deficiency.

　　The spleen likes dryness and dislikes dampness, so if there is a heavy accumulation of dampness in the body, the spleen's transportation and transformation function will be impaired, leading to symptoms such as abdominal distension and diarrhea, which are signs of poor digestion. If this continues for a long time, it can easily lead to malnutrition.

　　Distension and fullness in the epigastrium and abdomen, more pronounced after meals, with a lack of taste and even a loss of appetite, loose stools, lack of vitality, emaciated body, fatigue, weakness, pale or sallow complexion, or edema of the limbs, pale tongue with white coating, and a slow, soft, and weak pulse. These manifestations reflect two aspects of pathological changes: one is the weakening of the spleen's transportation and transformation function, where the spleen fails to maintain its healthy function, leading to the retention of essence and qi, endogenous dampness, and thus a decrease in appetite, abdominal distension, and loose stools; and the spleen's deficiency leads to the泛滥 of dampness, causing edema of the limbs. The other aspect is the deficiency of Qi and blood production, as the spleen governs the limbs and muscles. Deficiency of the spleen's Qi leads to malnourishment of the limbs, resulting in fatigue; deficiency of Qi and blood leads to insufficient middle Qi, resulting in lack of vitality, weakness of speech, emaciated body, and a sallow complexion. The clinical manifestations of spleen Qi deficiency vary with age: in infants and children, it often manifests as poor digestion, vomiting, distended abdomen, emaciated body, and a sallow complexion; in the elderly or those with chronic diseases, it often manifests as a heavy body, weakness of the limbs, fatigue, or emaciation with weakness, low voice, and a sallow complexion.

　　1. Maintain a cheerful spirit, avoid excessive fatigue, sorrow, sadness, fear, tension, and other factors that may cause spiritual trauma.

　　2. Minimize mental exertion before meals, eat with concentration, take a short rest after meals, and develop good eating habits.

　　3. Pay attention to keeping warm, especially the abdomen, and wear a cotton belly bandage in the abdomen when necessary. Do not seek coolness and stay outdoors during summer.

　　4. Exercise to strengthen physical fitness, practice internal cultivation exercises, health exercises, and Tai Chi Chuan appropriately.

　　Diagnosis mainly relies on physical signs and pulse, and attention should be paid to distinguishing similar symptoms: the changes in spleen deficiency are numerous, and the differences in manifestations among different patients are significant. However, as a qi deficiency syndrome, it is not difficult to differentiate from heart and kidney deficiencies, which have unique localization symptoms. The related organs are the stomach and intestines. Since qi deficiency is often attributed to the spleen, and gastrointestinal qi deficiency is often treated from the spleen. Therefore, after determining qi deficiency and excluding heart and kidney qi deficiency, most cases are spleen qi deficiency.

　　For those with qi deficiency, it is advisable to eat foods that tonify qi, foods with a neutral taste and sweet or sweet and warm properties, and foods that are rich in nutrition and easy to digest for a balanced supplementation.

　　Forbidden foods

　　Foods with a cold and cool nature that easily damage the spleen's qi, such as bitter melon, cucumber, winter melon, eggplant,空心菜(hollow vegetable), celery, amaranth, bamboo shoots, lettuce, mushroom, persimmon, banana, loquat, pear, watermelon, mung bean, tofu, and millet. Foods with thick and greasy properties that easily obstruct the spleen's function of transformation and transportation, such as duck meat, pork, eel meat, oyster meat, milk, and sesame. Foods that promote Qi and reduce accumulation, which easily consume the spleen's qi, such as buckwheat; hawthorn, radish, and coriander, etc.

　　Key points of treatment:

　　(One) The spleen and stomach are interrelated as exterior and interior organs. The spleen is responsible for transformation and transportation, while the stomach is responsible for receiving and storing food. The spleen rises and the stomach descends, complementing each other in drying dampness and ensuring normal metabolism. Hence, it is said: 'The spleen should rise to be healthy, and the stomach should descend to be harmonious.' When the spleen's qi is insufficient, it is necessary to invigorate qi, strengthen the spleen, and promote its function. In clinical treatment, Li Dongyuan is a representative who uses ginseng and astragalus to tonify qi, two kinds of atractylodes to strengthen its function, and chuanxiong and muxiang to regulate qi. When used appropriately, the effects are as effective as striking a drum. Additionally, due to the close relationship between spleen deficiency and dampness, or the spleen's failure to transport due to dampness, or the spleen being constrained by cold and dampness, leading to poor spleen function, in treatment, it is necessary to combine the condition with drying dampness, transforming dampness, and permeating dampness, so that the spleen's function becomes evident with the elimination of dampness.

　　(Two) Spleen Qi deficiency often results from diet disorder, over-exertion, or excessive vomiting and diarrhea, the disease belongs to chronic, with a long course, and after treatment, it may relapse. It is difficult to consolidate. Therefore, after the treatment of invigorating the spleen, replenishing Qi, removing dampness, and lifting Yang, when the condition is relieved, pain and diarrhea stop, and it is still not advisable to stop the medicine abruptly. It is necessary to take Shuangsuan Yangwei Wan and other preparations regularly to regulate and improve the condition, in order to benefit the recovery of spleen Qi.

　　(Three) Herbs for invigorating the spleen and regulating Qi, often with spicy aroma, and with the functions of dispersing and promoting Qi, such as Muxiang, Houpu, Zhike, Chenpi, etc., on the one hand, can unblock the Qi, treat Qi stagnation symptoms, and on the other hand, if used improperly, can consume Qi through acrid dispersing, for those with spleen and stomach Qi deficiency and Qi stagnation, if only such drugs are used singly, or used excessively, it may further damage the spleen and stomach Qi. Therefore, for treating those with deficiency and fullness, it should focus on invigorating the Qi and strengthening the spleen, appropriately match with Qi-regulating herbs, and should not use bitter and cold purgatives excessively, otherwise it will inevitably lead to the aggravation of fullness, and violate the principle of treating the deficiency with deficiency.

　　Oral Medication

　　1. Basic Prescription:

　　(1) Liu Junzi Decoction: 12 grams of Dangshen, 10 grams each of Baizhu, Fuling, Chenpi, Fashen, and Zhigancao. Suitable for symptoms of spleen Qi deficiency.

　　(2) Shenling Baizhu Powder: 100 grams each of Dangshen, Baizhu, Fuling, Zhigancao, and Shanyao; 75 grams of stir-fried扁豆, 50 grams each of Lianzi, Yiyiren, Suosharen, and Jiegeng, grind all the herbs into fine powder, take 10 grams each time, with boiling water or Jiaotang. Suitable for symptoms of spleen Qi deficiency with dampness.

　　2. Modification and Change:

　　If there is chest and abdominal stuffiness, swelling, and pain, nausea and vomiting, add 8 grams each of Muxiang, Shaoyao, and Huoxiang to formula (1);

　　If there is diarrhea with cold pain in the abdomen and coldness in the hands and feet, you can add 6 grams of Pao Fupian and 8 grams of Ganjiang to formula (1);

　　Or if there is cough, a lot of sputum, nausea, and dizziness, add 10 grams each of Zhuru and Zhike to formula (1);

　　If there is persistent cough with a lot of thin sputum and shortness of breath, fatigue, add 10 grams each of Zhizhu, Donghua, and Baiqian to formula (1);

　　If there are more leukorrhea with white color, thin quality, and large amount, you can add 10 grams of Cangzhu, 12 grams of Cheqianzi, 10 grams of Zexie, and 10 grams of Chaihu to formula (2).

　　If the leukorrhea does not stop for a long time, you can also add 10 grams of Jinyingzi, 12 grams of Eguoshu, and 15 grams each of calcined Longmu and Muhuang.

　　Child malnutrition, take formula (2), add 30 grams of chicken gizzards, 100 grams each of Shengfu,麦芽, and hawthorn, grind into fine powder, take 3 grams each time, 3 times a day.