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Cholecystitis
  • The alias disease:
  • Cholecystitis
  • Their location:
  • Systemic
  • Attendance sections:
  • Syndrome Patterns of the Liver and Gallbladder
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    ble mass in the right hypochondrium with tenderness, add Chuanxiong (Rhizorna Chuanxiong) 10 g and Danshen (Radix Salviae Miltiorrhizae) 30 g; for severe qi stagnation, add Xiangfu (Rhizoma Cyperi ) 10 g and Chuanlianzi (Fructus Meliae Toosendan) 10 g; for cases accompanied by dry mouth and feverish feeling due to yin deficiency, add Shihu (Herba Dendrobii) 10 g and Shashen ( Radix Glehniae ) 15 g; for gallstone, add Jineijin (Endotheliurn Corneum Gigeriae Galli ) 10 g, Chuanshanjia ( Squama Manitis, to be decocted first) 12 g, Haijinsha (Spora Lygodii, wrapped) 12 g and Jinqiancao ( Herba Lysimachiae ) 15 g; for deep yellow urine, add Huashi (Talcum, wrapped ) 10 g, Cheqianzi ( Semen Plantaginis,wrapped) 10 g and Tongcao (Medulla Tetrapanacis) 6 g; for severe dampness with white greasy tongue coating, remove Dahuang (Radix et Rhizoma Rhei) and Zhizi ( Fructus Gardeniae), add Fuling (Poria) 10 g, Baikouren (Fructus Amomi Rotundus, to be decocted later) 3 g and Sharen (Fructus Amomi, to be decocted later) 3g.

    Yin Deficiency and Liver-qi Stagnation

    Chief Manifestations: Dull pain or slight burning sensation in the right hypechondrium, dryness in the mouth and throat, irritability, feverish sensation in the chest, vertigo, low fever in the afternoon, red tongue with little coating, and thready and rapid pulse.

    Therapeutic Methods: To nourish yin, clear away heat, soothe the liver and increase bile secretion.

    Prescription: Modified Yiguan Jian ( Ever-effective Decoction for Nourishing Liver and Kidney), composed of Shengdihuang ( Radix Rehmanniae) 12 g, Shashen ( Radix Glehniae ) 10 g, Maimendong (Radix Ophiopogonis ) 10 g, Danggui (Radix Angelicae Sinensis) 10 g, Gouqizi (Fructus Lycii) 10 g and Chuanlianzi (Fructus Meliae Toosendan) 10 g.

    Modifications: For restlessness and insomnia, add Suanzaoren (Semen Ziziphi Spinosae) 10 g, Baiziren (Semen Platycladi) 10 g and Yejiaoteng (Caulis et Folium Polygoni Multiflori) 12 g; for burning pain in the right epigastrium, add Baishaoyao (Radix Paeoniae A1ba) 12 g and Gancao (Radix Glgcyrrhizae) 3 g; for irritability, add Zhizi ( Fructus Gardeniae ) 10 g, Qingpi (Pericarpium Citri Reticulatae Viride ) 6 g and Zhenzhumu (Concha Margaritifera Usta, to be decocted
    first) 20 g.

    Yang Deficiency and Liver-qi Stagnation

    Chief Manifestations: Intermittent dull pain in the right hypochondrium, distension and fullness in the abdomen, vomiting of saliva, aversion to cold, cold limbs, lassitude, shortness of breath, pale tongue with white greasy coating, and wiry and weak pulse.

    Therapeutic Methods: To warm yang, replenish qi, regulate the liver and increase bile secretion.

    Prescription: Lizhong Tang Jiawei ( Decoction for Regulating Middle Energizer with Additions), composed of Dangshen (Radix Codonopsis) 10 g, Baizhu (Rhizoma Atractylodis Macrocephalae ) 10 g, Fuling ( Poria ) 12 g, Ganjiang (Rhizoma Zingiberis) 3 g, Paofuzi (RadixAconiti Lateralis, roasted in hot cinders) 6 g, Chaihu (Radix Bupleuri ) 6 g, Baishaoyao ( Radix Paeoniae Alba) 12 g, Muxiang (Radix Aucklandiae) 10 g, Sharen (Fructus Amoral, to be decocted later) 3 g, Zhibanxia ( Rhizoma Pinelliae Preparata ) 10 g and Chenpi ( Pericarpium Citri Reticulatae ) 6 g.

    Modifications: For cold pain in the abdomen, add Wuzhuyu ( Fructus Evodiae ) 3 g and Wuyao ( Radix Linderae) 10 g; for gallstone, add Jinqiancao (Herba Lysimachiae) 15 g and Jineijin (Endothelium Corneum Gigeriae Galli) 10 g.

    Other Treatments

    Chinese Patent Drugs

    Shugan Zhitong Wan (Bolus for Soothing Liver and Relieving Pain): 1 bolus each time, 3 times a day;applicable to hypochondriac pain caused by liver qi stagna-
    tion.

    Danshitong Jiaonang (Capsule for Discharging Gallstone) : 4 - 6 capsules each time, 3 times a day; applicable to cholecystitis with gallstone.

    Jiawei Xiaoyao Wan (Xiaoyao Pill with Additions) = 6 g each time, twice or thrice daily; applicable to cholecystifis due to liver qi stagnation and spleen deficiency.

    Longdan Xiegan Wan (Gentianae Pill for Purging Liver Fire) ~ 6 g each time, twice or thrice daily; applicable to cholecystitis due to damp heat in the liver and gallbladder.

    Single-drug or Experiential Prescriptions

    Yumixu ( Stylus Zeae Maydis ) 30 g, Pugongying ( Herba Taraxaci) 15 g and Yinchenhao (Herba Artemisiae Scopariae) 15 g. Decoct the herbs in water for oral administration. It is applicable to damp-heat type cholecystitis.

    Ludangshen ( Radix Codonopsis ) 15 g, Chao- baizhu ( Rhizoma Atractylodis Macrocephalae, stirbaked) 12 g, Chenpi ( Pericarpium Citri Reticulatae) 6 g, Fuling (Poria) 12 g, Gancao (Radix Glycyrrhizae) 5 g, Muxiang (Radix Aucklandiae) 5 g, Yujin (Radix Curcumae) 10 g, Chenxiangyuan ( Fructus Cirri) 6 g, Hehuanpi ( Cortex Albiziae) 10 g, Chuanlianzi ( Fructus Meliae Toosendan ) 12 g and Shensanqi (Radix Notoginseng) 10 g. Decoct the above herbs in water for oral administration, 1 dose daily.

    External Therapy

    Grind Qingpi (Pericarpium Citri Reticulatae Viride) 15 g into powder, stir-bake it with vinegar and apply it to the affected part when it is still hot. This is applicable to cholecystitis caused by stagnation of liver qi and gallbladder qi.

    Mix equal amounts of Zhizifen (Fructus Gardeniae, to be powdered) and Dahuangfen (Radix et Rhizoma Rhei, to be powdered) with ricini oil, or paraffin oil and several drops of 75 % alcohol to make paste. Apply the paste to the pain spot, cover it with a gauze and fix it with adhesive plaster, once a day. This is applicable to acute cholecystitis or episodes of chronic cholecystitis.

    Dahuang (Radix et Rhizoma Rhei) 50 g, Muxiang (Radix Aucklandiae) 30 g, Ruxiang (Olibanum) 20 g, Baijiezi ( Semen Sinapis Albae) 20 g and Bingpian (Borneolum Syntheticum) 5 g. Grind the drugs into powder and mix them thoroughly. Then mix 10 - 15 g of the powder with proper amount of boiled vinegar into paste, and spread the paste on a 15 cm x 10 cm dressing.Apply it to the tender point and fix it with adhesive plaster. This is applicable to episodes of cholecystitis with pronounced pain.
     

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