Spleen constraint

　　This condition is due to excessive yang in the body, or due to excessive alcohol consumption, overeating of spicy and rich foods, leading to heat accumulation in the gastrointestinal tract; or residual heat after a febrile disease has not been cleared: or excessive diaphoresis and urination, leading to excessive consumption of body fluid, and heat accumulation in the gastrointestinal tract; or due to excessive intake of acrid and drying drugs, thus causing further damage to body fluid and heat stasis in the gastrointestinal tract. These various reasons lead to excessive stomach heat, loss of body fluid, and inability to moisten the large intestine. The large intestine fails to conduct, leading to the condition of spleen constraint. The location of the disease is in the stomach and large intestine, and it is a sign of deficiency and excess.

　　Irritability, dry mouth and halitosis, constipation. It can also induce extraintestinal complications, such as stroke, affecting brain function (decreased memory, attention deficit, dull thinking), sexual dysfunction, etc. It also plays an important role in the occurrence of diseases such as hepatic encephalopathy, breast diseases, and Alzheimer's disease. Clinically, there is an increasing trend of cardiovascular disease attacks caused by increased abdominal pressure due to straining during defecation, such as angina pectoris and myocardial infarction.

　　Constipation or difficulty in defecation, dry and hard stool, even resembling sheep dung, or not defecating for several days, abdominal distension without pain, normal diet, frequent and short urination, or with irritability, dry mouth and halitosis, red tongue, yellow and dry tongue fur, slippery and rapid pulse, floating and涩脉(pulse that is rough and unsmooth).

　　Nursing care:

　　1. Engage in appropriate physical exercise to promote the circulation of Qi and blood. Avoid prolonged sitting or lying down, which can lead to stagnation of Qi and blood.

　　2. Develop the habit of defecating at regular intervals, even if there is no urge to defecate, also go to the toilet at a fixed time.

　　3. Advise the patient not to self-medicate with purgatives. Although this condition is not very painful, the course of the disease is often long, and patients often use purgatives to seek temporary relief. After taking the medicine, although the stool may pass temporarily, it further injures the body fluid; subsequently, the stool becomes drier and harder.

　　1. Rectal examination:It is necessary to carefully observe for external hemorrhoids, anal fissures, anal fistulas, and other pathological changes. During palpation, attention should be paid to the presence of internal hemorrhoids, whether the anal sphincter is spasmodic, whether the rectal wall is smooth, and whether there are ulcers or neoplasms.

　　2. Barium enema X-ray examination and abdominal flat film barium enema X-ray examination:It is of great help in diagnosing colonic, rectal tumors, colonic stenosis or spasm, megacolon, etc., and can also have a comprehensive understanding of the colonic motor function (peristalsis). If multiple stepped liquid levels are found in the X-ray abdominal film, it is of great help in diagnosing intestinal obstruction.

　　3. Colonoscopy:Colonoscopy is of great help in diagnosing various colonic lesions that cause constipation, such as colon, rectal cancer, colonic polyps, and organic colonic stricture, etc., combined with histopathological examination of living tissue, can obtain a definite diagnosis.

　　1. Peach Blossom Porridge: Take 4 grams of fresh peach blossoms (or 2 grams of dried peach blossoms), and 100 grams of sticky rice, cook them together into a thin porridge. Take it once a day, stop when defecation is smooth. If constipation recurs, you can continue to take it.

　　2. Wu Ren Porridge: Mix 10 grams of sesame seeds, 10 grams of pine nuts, 10 grams of walnut kernels, 10 grams of peach kernels (peeled and roasted), and 10 grams of sweet almonds, grind them into powder, and then add 200 grams of sticky rice to cook into a thin porridge. Add an appropriate amount of sugar, take one dose a day, and divide it into two doses in the morning and evening.

　　3. Spinach Porridge: Take 100 grams of fresh spinach, wash it, and blanch it in boiling water. After half-cooked, take it out and chop it. Then cook 100 grams of sticky rice into porridge and mix in the spinach, boil and serve it warm. Take it twice a day, once in the morning and once in the evening.

　　4. Maziren 12 grams, Suzi 10 grams, grind the two into powder, soak in water to get the juice, and then add 100 grams of sticky rice to cook porridge. Take it once a day.

　　5. Cane sugar cooked banana: Two bananas (peeled), add appropriate amount of sugar, steamed over water and eaten. Take twice a day for 3-5 days.

　　6. Xiaofu Tongjie Decoction: Cut 2500 grams of fresh radish into slices, add 150 grams of raw nitrate, and boil with 2500 milliliters of water. After the radish is cooked, remove the juice and discard it. Then add another 500 grams of fresh radish to the decoction, cook until soft, remove and discard it, and repeat this process 5 times. You will get 1000 milliliters of radish juice, which should be taken in three divided doses, all at once. Take it once a day.

　　One, Internal Medication

　　1. Basic Prescription: Mizi Ren Wan: 60 grams of flaxseed, 20 grams of bai shao, 30 grams of atractylodes, 60 grams of rhubarb, 30 grams of houpu, 30 grams of bitter almond, appropriate amount of honey. The first six ingredients are ground into fine powder, refined honey is made into pills, as big as the seeds of a wutong tree, take ten pills each time, twice or three times a day, with warm water. Spleen binding Mizi Ren Wan: take 10 grams each time, twice or three times a day. If the stool has not passed, the dosage can be gradually increased until the stool passes. If there is no ready-made medicine, it can also be changed from pills to decoction, using 10 grams of mizi ren, 12 grams of bai shao, 10 grams of atractylodes, 10 grams of rhubarb (added later), 10 grams of houpu, 12 grams of bitter almond, one dose per day, decocted to 300 milliliters, taken 2-3 times, mix with appropriate amount of white honey when served.

　　2. Modification: If the stool is dry and hard like goat dung, add 12 grams of mirabilitum; if there is dry mouth and tongue, red tongue and less saliva, add 15 grams of raw earth, 15 grams of yuanshen, 10 grams of shihu, 10 grams of maimendong, 15 grams of shashen; if there is hemorrhoids with bleeding, add 12 grams of huaihua, 10 grams of raw dihuangyu; if there is bitter mouth, dry throat, red eyes and easy to be angry, add 10 grams of longdancao, 10 grams of huangqin, or take more yaoyiwan.

　　Two, External Medication

　　1. Snails with shells 5-6 pieces, musk 0.3 grams, both pounded into paste, apply to the Shenque acupoint, cover with medical paper or plastic film, and fix with medical adhesive tape. Once a day.

　　2. Green onion 50 grams, chopped and pounded into paste, add appropriate amount of vinegar, stir-fried and heated, apply it to the Shenque acupoint, and use a hot water bag to compress it, three times a day, each for 30 minutes.

　　Three, Moistening Conduction Method

　　1. Pig Gallbladder Conduction Method: One large pig gallbladder, extract the gall juice, add a small amount of vinegar, mix well, and灌入肛门内。Use it when there is frequent and urgent defecation desire.

　　2. Laxative Pill: 12 grams of Asarum, 12 grams of soapbean, 120 grams of honey. First, grind Asarum and soapbean into powder; then place honey in a pot, heat it over low heat until it drops like dew, then add the powder and stir well, wait until it is slightly warm, make it into a suppository about 5 centimeters long and 1 centimeter thick, with a slightly pointed tip at the front, for reserve. Use 1-2 pills and insert into the anus, once a day.

　　3. Method of Honey Conduction: Appropriate amount of white honey is placed in a pot, heated over low heat to form a gelatinous consistency, then wait until it is slightly warm, take it out and knead into a finger-like shape, about 6 centimeters long, with a small and rounded head and a slightly thicker tail, as a suppository for reserve. When there is a desire to defecate but cannot be defecated, insert it into the anus, once a day.

　　4. Diet Therapy

　　1. Peach Blossom Porridge: Take 4 grams of fresh peach blossoms (or 2 grams of dried peach blossoms), and 100 grams of sticky rice, cook them together into a thin porridge. Take it once a day, stop when defecation is smooth. If constipation recurs, you can continue to take it.

　　2. Wu Ren Porridge: Mix 10 grams of sesame seeds, 10 grams of pine nuts, 10 grams of walnut kernels, 10 grams of peach kernels (peeled and roasted), and 10 grams of sweet almonds, grind them into powder, and then add 200 grams of sticky rice to cook into a thin porridge. Add an appropriate amount of sugar, take one dose a day, and divide it into two doses in the morning and evening.

　　3. Spinach Porridge: Take 100 grams of fresh spinach, wash it, and blanch it in boiling water. After half-cooked, take it out and chop it. Then cook 100 grams of sticky rice into porridge and mix in the spinach, boil and serve it warm. Take it twice a day, once in the morning and once in the evening.

　　4. Maziren 12 grams, Suzi 10 grams, grind the two into powder, soak in water to get the juice, and then add 100 grams of sticky rice to cook porridge. Take it once a day.

　　5. Brown Sugar Steamed Banana: Peel 2 bananas and add an appropriate amount of brown sugar, then steam them in water. Eat them after steaming. Take twice a day for 3 to 5 days.

　　6. Xiaofu Tongjie Decoction: Cut 2500 grams of fresh radish into slices, add 150 grams of raw nitrate, and boil with 2500 milliliters of water. After the radish is cooked, remove the juice and discard it. Then add another 500 grams of fresh radish to the decoction, cook until soft, remove and discard it, and repeat this process 5 times. You will get 1000 milliliters of radish juice, which should be taken in three divided doses, all at once. Take it once a day.

　　5. Key Points of Treatment

　　24. This condition is mainly characterized by a deficiency of body fluid. Although there is internal obstruction of dryness and heat in the gastrointestinal tract, it has not reached the stage of extreme fullness. The treatment should focus on moistening dryness and moderately promoting defecation. In formulating the prescription, attention should be paid to not being too strong in purgation and not being greasy in moistening. It is strictly forbidden to滥用bitter and cold purgatives that can seriously damage Yin fluid.

　　23. Although the Maziren Pill is said to be lubricating and promoting defecation, the formula still contains rhubarb, hawthorn, and magnolia bark, which implies the meaning of the Xiao Chengqi Decoction, and can relieve heat and eliminate stagnation, promote Qi and relieve constipation, which still belongs to the method of clearing and promoting defecation, so it should not be used for a long time. If the Maziren Pill is taken for a considerable period of time and the heat symptoms have been relieved but constipation persists, it is advisable to switch to herbal remedies that mainly nourish Yin and fluid and moisten dryness.

　　22. There are many treatments for this condition, and it is advisable to adopt a treatment method that combines medication and dietary therapy, and to consider using methods such as enema and injections. Regulating emotions, regular bathroom visits, and dietary adjustments are very important. It cannot be solved by simply using the method of promoting defecation.