Cold stagnation in the liver meridian syndrome

　　This syndrome is often caused by external cold affecting the liver meridian, leading to blood stasis. Pathogenesis analysis: This syndrome is characterized by cold stagnation causing qi stagnation in the liver meridian. The foot jueyin liver meridian runs around the genitals and reaches the lower abdomen. Cold stagnation in the liver meridian leads to unsmooth flow of liver and blood, causing cold pain, distension, and resistance to palpation in the lower abdomen, testicle, and scrotum, and mutual influence and traction to the lateral side of the thigh. Cold is a Yin evil that mainly contracts and draws. When attacked by cold evil, the tendons and vessels become rigid, and blood and qi become stagnant, leading to pain when unobstructed. Therefore, the pain resists palpation or worsens in cold weather and relieves with warmth. Experiencing cold evil, the Yang qi is blocked, or the warming function of Yang deficiency is weakened, leading to cold body and pale complexion, pale tongue, and white coating. A deep and wiry pulse is a pulse sign of liver disease.

　　The main manifestations of cold stagnation in the liver meridian syndrome include cold pain in the scrotum, distension and resistance to palpation, or pain extending to the lateral side of the thigh, which worsens in cold weather and relieves with warmth. Accompanied by cold body and pale complexion, and other cold signs. The tongue is pale with white or dark coating, and the pulse is deep and wiry. The common complications of this disease are cold hernia in hydrocele.

　　The main clinical manifestations of this disease include lower abdominal traction of the testicle, cold pain of the scrotum, distension and resistance to palpation, or pain extending to the lateral side of the thigh. The pain worsens in cold weather and relieves with warmth, accompanied by cold body, pale complexion, and other cold signs. The tongue is pale with white or dark coating, and the pulse is deep and wiry.

　　There are no effective preventive measures for cold stagnation in the liver meridian syndrome, and early detection and diagnosis are the key to prevention and treatment. In cold weather, pay attention to keeping warm, which has a certain preventive effect; at the same time, pay attention to a balanced diet, eat less cold and cool foods, and also have a certain preventive effect.

　　For patients with cold stagnation in the liver meridian syndrome, routine urine and blood tests, and liver and gallbladder function tests can be performed to rule out organic lesions; traditional Chinese medicine's four diagnoses can also be conducted. Patients may show pale complexion and other cold signs, with pale tongue coating and a deep, wiry pulse.

　　Patients should eat more five-spice braised foods, drink plenty of water; eat more foods rich in fiber, such as baby pak choi; eat more fruits and vegetables, such as bananas and green vegetables. Avoid cold and raw foods, and smoking and drinking alcohol.

　　The principle of traditional Chinese medicine treatment for this disease is to warm the meridians and expel cold, and to warm the liver and unblock the collaterals.　　

　　1, Internal Medication Formula

　　1, Basic Formula:
　　Modification of Nuogan Jian: 10 grams of Angelica sinensis, 10 grams of Lycium barbarum, 3 grams of Cinnamon, Fructus Foeniculi, Evodiae Fructus, Acorus gramineus, Poria, 6 grams each, 3-5 grams of ginger. This formula is suitable for those with mild cold retention in the liver meridian.
　　Modification of Tiantai Wu Yao San: 10 grams each of Tiantai Wu Yao, Fructus Amomi, Pericarpium Citri reticulatae var. aurantium, Rhizoma Aucklandiae, and Semen Arecae, 9 grams each of Fructus Foeniculi and Fructus Meliae toosendan. This formula can be taken with warm wine or decocted in water, and is suitable for patients with hernia due to cold retention in the liver meridian and obvious qi stagnation.
　　Modification of Wening Fang: 8 grams of Ramulus Cinnamomi, 9 grams of Evodiae Fructus, Angelica sinensis, Radix Paeoniae alba, Rhizoma Pinelliae, and Ophiopogon japonicus. This formula is suitable for gynecological cold-type dysmenorrhea.
　　2, Modification and Change:If there is severe pain in the lower abdomen, the basic formula is suitable.
　　Add 10 grams of Radix et Rhizoma Atractylodis macrocephalae and 10 grams of Cyperus rotundus. If there is internal cold and cramping pain around the navel, and the testicles are pulled and painful, the basic formula can be used.
　　Add 5 grams of each of prepared Eucommia ulmoides and Eucommia ulmoides sinensis; if there is abdominal distension and hard testicles, add 10 grams of roasted Citrus aurantium kernel, 9 grams of Kombu, 10 grams each of Sargassum and Persica, if a woman has cold and clear leukorrhea, the basic formula can be used.
　　Add 10 grams of附片, 12 grams of Xianlingpi, 15 grams of Poria, if dysmenorrhea is severe, add 10 grams of Cyperus rotundus and 15 grams of Corydalis yanhusuo; if amenorrhea occurs, increase the amount of Chuanxiong to 15 grams.

　　2, External Medication
　　1, 0.5 grams of Musk, 5 grams of Fructus Foeniculi, ground into powder, placed on gauze and applied to Zhongji, Guanyuan or Qihai, retain for 6-24 hours, can be used continuously for 2-5 months.
　　2, Hernia Zui散: 1 piece of Belamcanda chinensis, 30 grams of Fructus Meliae toosendan, 15 grams each of Fructus Amomi, Fructus Foeniculi, Ramulus Cinnamomi, 20 grams of Evodiae Fructus, ground and sieved, take 15 grams of medicine powder, mix evenly with yellow wine, place on the Shénqu point, cover with gauze, fix with adhesive tape, once a day, 5-7 days as a course, can be used continuously for 3-4 courses.
　　3, Hernia Lin膏: 5-7 seeds of Ricinus communis, an appropriate amount of flour, pounded into paste and applied to Yongquan, once a day.
　　4, Mix Yimucao paste with Evodiae Fructus powder and apply it externally to Guanyuan and Qihai, once a day.

　　3, Enema Therapy
　　1, Add 15 grams of附片, 20 grams of赤芍, boil to extract 200 milliliters of juice, high-position retain enema, once a day, it is better to use it for 7-14 days consecutively.
　　2, Add 15 grams of附片, 30 grams of motherwort, boil to extract 150 milliliters of juice, retain enema for 1-2 weeks, suitable for cold-type dysmenorrhea.