In clinical practice, there are patients whoseProfuse sweating accompanied by aversion to cold, cold intolerance, cold hands and feet, bland taste in the mouth without thirst or thirst with a preference for warm drinks, clear and copious urine, loose stools, pale complexion, enlarged tongue with teeth marks, white or white and slippery tongue coating, deep and weak or deep and slow pulse.
The patient exhibits typical symptoms of yang deficiency, but when the doctor attempted to warm and tonify the yang qi, it was found that the yang qi could not be replenished at all. Not only did symptoms such as fear of cold and aversion to cold show no significant improvement, but the deficiency also failed to respond to tonification, leading to discomforts such as toothache due to internal heat, acne, mouth sores, palpitations, discomfort in the precordial area, chest tightness, dizziness, head distension, headache, stomach bloating, acid reflux, heartburn, indigestion, reduced appetite, constipation, dry mouth and throat, feverish sensations in the palms and soles, burning sensation during urination, and even aggravated spontaneous sweating and night sweats.
When this situation occurs, how should we adjust the treatment?Next, I will discuss several strategies and ideas for adjusting prescription medications, which can be considered as a starting point for further discussion.
1. After taking yang-tonifying medications, the patient experiences discomfort symptoms such as toothache due to excessive internal heat, acne, and oral ulcers. This indicates that the dosage of yang-tonifying drugs is too high, or the patient's yang deficiency syndrome may be accompanied by upper heat and lower cold. It is necessary to reduce the dosage of yang-tonifying drugs and, as appropriate, combine them with drugs that guide fire back to its origin or clear heat. By guiding heat downward and clearing heat to purge fire, the excess yang heat can be directed to the lower jiao or expelled from the body.
2. After taking yang-tonifying drugs, the patient experiences symptoms such as palpitations, discomfort in the precordial area, and chest tightness. This indicates that the dosage of yang-tonifying drugs is too high, or the dosage is not excessive but the patient has a sensitive constitution. The yang-tonifying treatment has triggered the patient's pre-existing heart issues, leading to adverse reactions such as increased heart rate or arrhythmia. In such cases, it is necessary to promptly reduce the dosage or discontinue the current yang-tonifying drugs, switch to alternative yang-tonifying medications, or incorporate heart-nourishing and blood-activating Chinese herbs. Additionally, close observation of changes in the patient's symptoms is essential.
3. After taking yang-tonifying medications, the patient experiences discomfort symptoms such as dizziness, head distension, and headache. This indicates that the use of yang-tonifying medications may have caused liver yang hyperactivity or yin deficiency with wind stirring, leading to potential fluctuations in blood pressure. In such cases, it is necessary to reduce the dosage of yang-tonifying medications or combine them with Chinese herbs that nourish yin, calm the liver, and subdue yang to pacify the liver and extinguish wind. Additionally, close observation of changes in the patient's symptoms is required.
4. After taking yang-tonifying medications, the patient experiences discomfort symptoms such as chest tightness, abdominal bloating, acid reflux, heartburn, indigestion, and reduced appetite. This indicates the possibility of spleen and stomach qi stagnation after using warming and tonifying drugs. It is necessary to combine qi-regulating and spleen-strengthening or qi-moving, stomach-soothing, and digestion-promoting medications while using warming and tonifying drugs, in order to enhance the transportation and transformation functions of the spleen and stomach, and promote the metabolism and absorption of the medications.
5. After taking yang-tonifying medications, the patient experiences symptoms such as dry mouth and throat, feverish sensations in the palms and soles, and burning urination. This indicates that while the patient has yang deficiency, there is also yin deficiency present. Simply tonifying yang exacerbates the symptoms of yin deficiency and leads to signs of internal heat due to yin deficiency. In such cases, a treatment approach of seeking yang within yin can be considered. This involves primarily using yin-nourishing medications, supplemented with yang-warming drugs. This method allows yang to be supported by yin, promoting endless transformation and growth, while avoiding the drawbacks of tonifying yang at the expense of yin and generating heat.
The constitution, condition, pathogenesis, and symptoms of each patient are never exactly the same. During clinical practice, it is essential to thoroughly understand the patient's medical history, complete the four diagnostic methods, and clearly differentiate the patient's yin and yang, exterior and interior, deficiency and excess, as well as cold and heat. Careful consideration must be given when prescribing medication, and the treatment process should be gradual and systematic. Only in this way can the goal of controlling the patient's condition, achieving partial recovery, or complete healing be accomplished.
