Treatment of Blood Deficiency
Abstract:
1. Overview 2. Treatment 3. Conclusion
1. Overview
A 42-year-old patient has not had her menstrual period for two months, has dry skin, palpitations, fatigue, hair loss, white hair, and a yellow complexion. What could be the cause?
The absence of menstruation can be attributed to two main conditions: one is insufficient blood production, meaning there is no blood to flow down, which is classified as deficiency (虚). The other is sufficient blood but obstructed pathways, such as Qi stagnation, blood stasis, or phlegm-dampness, which is classified as excess (实). Based on her other symptoms, this patient falls under the category of deficiency.
Dry skin is caused by the inability of blood deficiency to nourish.
Palpitations occur because the blood does not nourish the heart.
Fatigue is due to Qi deficiency, as Qi and blood are closely related; Qi is the commander of blood, and blood is the mother of Qi. Therefore, blood deficiency can lead to Qi deficiency, and Qi deficiency can also lead to blood deficiency, resulting in fatigue.
Hair is nourished by blood; when blood is deficient, it cannot nourish the hair, leading to hair loss and greying.
A yellow complexion also indicates insufficient Qi and blood, especially spleen deficiency. The spleen is the foundation of postnatal health and the source of Qi and blood production. Thus, treating Qi and blood deficiency, whether Qi deficiency or blood deficiency, requires focusing on the spleen.
Therefore, this patient has insufficient Qi and blood, with blood deficiency as the primary issue and Qi deficiency as secondary.
2. Treatment
So how should we treat this?
Although blood deficiency is the primary issue and Qi deficiency is secondary, we must tonify both Qi and blood. The formula Shi Quan Da Bu Tang (十全大补汤, Ten Complete Great Tonifying Decoction) can be used for treatment.
Shi Quan Da Bu Tang consists of Ba Zhen Tang (八珍汤, Eight Treasure Decoction) plus Sheng Huang Qi (生黄芪, Raw Astragalus) and Rou Gui (肉桂, Cinnamon). Ba Zhen Tang is composed of Si Wu Tang (四物汤, Four Substance Decoction) for nourishing blood and Si Jun Zi Tang (四君子汤, Four Gentlemen Decoction) for strengthening the spleen and benefiting Qi, thus tonifying both Qi and blood. Adding Sheng Huang Qi enhances the Qi tonifying effect, and since Qi can generate blood, using Sheng Huang Qi serves to tonify Qi and indirectly tonify blood.
Notably, a small amount of Rou Gui is added, which can be considered the finishing touch. In formulas that tonify Qi and blood, adding a small amount of Rou Gui can invigorate the growth of Qi and blood.
Shi Quan Da Bu Tang can be somewhat cloying, so adding Chen Pi (陈皮, Aged Tangerine Peel), Sha Ren (砂仁, Amomum Fruit), and Jiao San Xian (焦三仙, Three Roasted Immortals) can activate the spleen and stomach to assist the movement of the medicinal properties.
Thus, for this patient, we will use Shi Quan Da Bu Tang with Chen Pi, Sha Ren, and Jiao San Xian for treatment.
Prescription:
Sheng Huang Qi 20g, Shu Di Huang (熟地黄, Cooked Rehmannia) 10g, Dang Gui (当归, Angelica) 10g, Chao Bai Shao (炒白芍, Fried White Peony) 10g, Chuan Xiong (川芎, Ligusticum) 5g, Dang Shen (党参, Codonopsis) 10g, Chao Bai Zhu (炒白术, Fried Atractylodes) 10g, Fu Ling (茯苓, Poria) 10g, Sheng Gan Cao (生甘草, Raw Licorice) 5g, Rou Gui 3g, Chen Pi 10g, Sha Ren 5g, Jiao San Xian (各) 5g.
The combination is precise, and the dosage is balanced.
3. Conclusion
Daily maintenance is also very important. A balanced diet and a cheerful mood are essential for good spleen and stomach function, which can generate Qi and blood to nourish the body. Finally, adequate rest and avoiding staying up late, along with taking the medicine, will achieve the best treatment results.
This reflection from the patient is shared here with everyone.
Warm reminder: The prescription mentioned in this article should be used under the guidance of a professional.
Finally, I wish everyone abundant vitality and good health…
2023.9.8 Written in Beijing