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  • Current location: home>> Life Cultivation and Rehabilitation of TCM(PREVENTION) >> Rehabilitation Examples of Commonly-Seen Diseases >> Rehabilitation for sequelae
    3 Edema
    Edema is a disorder of muscular tumefaction. In this section, edema refers to mild tumefaction, in which urinary test shows no marked abnormal changes and nephrotic edema is not included.
    Syndrome differentiation and treatment
    Edema due to dampness and heat
    It manifests sublumbar edema, abdominal fullness, dyspnea, dysphoria with thirst, unsmooth urination and defecation, yellowish and greasy fur, deep and rapid pulse. It is advisable to dispel water and clear away heat The prescription used is Muli Zexie Powder (Powder of Concha Ostreae and Rhizome Alismatis ). Take the powder by mixing it in rice soup three times a day, five to ten grams. After smooth urination, reduce the dosage accordingly or stop the administration. The modified Sanren Decoction (Decoction of Three Kinds of Kernels) may be applied in the case of the mild symptoms of dampness-heat stagnation.
    Edema due to qi deficiency
    It manifests edema of the face and limbs which happens and vanishes alternately, lassitude, hypodynamia, pale and lustreless complexion, short breath, anorexia, pale tongue with a little fur, slow and weak pulse. In the case of yang deficiency of the spleen and stomach, edema is marked, especially on the lower limbs, with the concurrent manifestations of epigastric and abdominal distension, loose stool, scanty urine, sallow complexion, cold limbs, pale and slippery fur, deep and slow pulse. It is suitable to strengthen the spleen and eliminate dampness. In the case of mild symptoms, after soaking Baizhu (Rhizoma Atractylodis Macorcephalae ) in waxgourd decoction for a night, remove Baizhu (Rhizoma Atractylodis Macrocephalae) and add Yiyiren (Semen Coicis) to the decoction to be decocted for oral administration; in the case of severe symptoms, use the modified Shenling Baizhu Powder (Powder of Ginseng, Poria and Bighead Atractylodes); in the case of severe edema due to yang deficiency of the spleen and stomach, it is suitable to warm the spleen and promote diuresis with the modified Shipi Decoction (Decoction for Reinforcing the Spleen).
    Edema due to yang deficiency
    It manifests general edema which is particularly severe below the waist, soreness and flaccidity of the waist and knees, aversion to cold, cold limbs, reduced amount of urine, pale tongue with white fur, deep and weak pulse. In the case of prolonged renal yang deficiency, yang impairment involving yin, symptoms mainly due to renal yin deficiency may occur as well which manifest as repeated onset of edema, mental fatigue, soreness of the waist, seminal emission, dry mouth and throat, dysphoria with feverish sensation of the chest, palms and soles, red tongue, thready and rapid pulse. It is advisable to warm the kidney to promote diuresis. The prescription used is the modified Jisheng Shenqi Pill (Life-Preserving Pill for Replenishing the Kidney Qi) in combination with Zhenwu Decoction (Decoction for Strengthening the Spleen Yang).
    Edema due to qi stagnation
    It manifests marked edema of the abdomen and limbs with normal skin color, bulging abdomen like a drum when tapped, oppressed sensation and distension of the chest, susceptibility to eructation, smooth urination, white fur and taut pulse. It is advisable to activate qi flow, remove qi stagnation and promote diuresis. The prescription used is Kuanzhong Decoction with additional Muxiang (Radix Aucklandiae), Xiangfu ( Rhizoma Cyperi) and Qingpi (Pericarpium Citri Reticulatae Viride). In the case of gastric fullness, belching, loose stool, greasy fur and slippery pulse, it is advisable to dry dampness, activate the spleen, remove food retention and regulate the stomach with the modified prescription of Pingwei Powder (Peptic Powder) in combination with Baohe Pill (Lenitive Pill).
    Edema due to yin deficiency
    This is commonly seen in the patients who have not recovered from deficiency of yin and blood following the febrile disease, with the manifestations of mild edema of limbs, or low fever, flushed complexion, feverish palms and soles, dry mouth and throat, mental fatigue, deep red tongue with a little fur, feeble and thready or knotted and intermittent pulse. It is suitable to nourish and tonify the kidney yin and promote diuresis simultaneously. The prescription used is Zuogui Pill with additional Fuling (Poria) and Zexie (Rhizoma Atismatis ), or the modified Fumai Decoction (Decoction of Prepared Licorice ) with large dosage of Gancao (Radix Glycyrrhizae).
    Rehabilitation methods
    Proper sports activities promote qi flow and blood circulation and relief of edema. The patients may take a walk, jog and practice qigong and Taijiquan.
    Acumox and massage
    Acumox: Select Shuifen (CV 9 ), Qihai (CV 6 ), Sanjiaoshu (BL 22), Zusanli (ST 36) and Yinlingquan (SP 9) for accumox. In the case of yang syndrome with dampness and heat, add Feishu (BL 13) and Hegu (LI 4); in the case of yin syndrome with deficiency and cold, add Pishu (BL 20) and Shenshu (BL 23), with the reinforcing method and moxibustion with the warming needle; in the case of edema due to qi stagnation, add Zhongwan (CV 12) and Tianshu (ST 25), with the reducing method and moxibustion; in the case of edema due to yin deficiency, add Xuehai (SP 10) and Sanyinjiao (SP 6), with the uniform reinforcing-reducing method.
    Massage: Massage the underbelly clockwise. Meanwhile, press and knead Zhongwan (CV 12), Qihai (CV 6) and Guanyuan (CV 4). In the case of dampness and heat, press and knead Sanyinjiao (SP 6), Yinlingquan (SP 9) and Pangguangshu (BL 28); in the case of splenic asthenia, press and rub Weishu (BL 21) and Pishu (BL 20); in the case of renal asthenia, push and rub Shenshu (BL 23) and Mingmen (GV 4); in the case of yin deficiency, press and knead Xuehai (SP 10), Sanyinjiao (SP 6) and Zusanli (ST 36). The manipulations should be gentle, slow and mild.
    Dietary therapy
    In the case of edema due to dampness and heat, select Maogen Chidou Gruel (Gruel of Radix Rubi Parvifolii and Semen Phaseoli); in the case of edema due to splenorenal asthenia, select Fuling Yiyiren Gruel (Gruel of Poria and Semen Coicis); in the case of edema due to qi stagnation, select Jupi Gruel (Gruel of Pericarpium Citri Reticulatae); in the case of edema due to yin deficiency, select Yali Pear Gruel.
    TCM has always emphasized that the patients with edema should abstain from salt. They may be given the low salt diet or the salt-free diet The patients with edema have the weak splenogastric function in transportation and transformation. Therefore, their diet should be fine, soft, bland, nutritious and readily digestible. They should abstain from pungent, fat and sweet foods and drink. They should avoid craputence completely, particularly at the time of recovery.
    Nursing in daily life
    The patients with edema should attach importance to rest and abstinence from sexual life so as to prevent the relapse of edema due to overstrain. Common cold may aggravate the illness. Accordingly, they should pay attention to climatic changes to prevent repeated attack by exogenous pathogenic factors. Simultaneously, they should keep the skin clean and avoid skin injury. Otherwise, it may cause infection easily and the resultant deterioration. However, the patients with edema are not advisable to take more showers in order to prevent the internal invasion by water and dampness from influencing the removal of edema.
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