| Cholecystitis is a common disease.It can be classified into acute and chronic cholecystitis according to the onset,and also into calculous and non— calculous cholecystitis.Cholelithiasis can be often the cause of Cholecystitis.When cysticduct is obstructed by gallstones,bilestasis and bacteria proliferation will occur,which leads to gallbladder infection and Cholecystitis. Some non—calculous cholecystitis is caused by gallbladder functional abnormity,ejective disturbance,or pathgen spread from blood circulation.Cholecystitis belongs to gallbladder distortion in TCM.the cause of the disease include endopathic cause(Deficiency of Vital-Qi)and exopathic cause(excess of pathogen). Exopathic causes are usually the seven emotions and diet bias.Over-thinking,over-worrying and anger in an excessive state will lead to the dysfuntion of liver in smoothing ang discharging action.Fat overintake will injure the function of spleen and stomach,or affect the gallbladder,if the depression is so long that it turns into heat,which leads to gallbladder distortion.Gallbladder Stasis Syndrome is a typical psychosomatic(psychological - physical) disease in digestire system,which definites as a physical disease mainly caused by psychological factors(in the narrow sense). The basic pathogenic mechanism lies in dysfunction of the body caused by emotional factors manifesting at many organs.The determination of treatment based on differentiation of gallbladder Stasis Syndrome originates from the basic theory of psychological - physical medicine of TCM — Rigid and Gental Psychosomatic Theory. Its pathogenisis is disharmony between Rigid and Gental caused by Liver' s smoothing and discharging function disorder presenting with discoordination of Qi , biood, Yin and Yang, treating Psychosomatic disease in both Psychological and Physical aspect. Psychological therapy is firstly used and always combined with Traditional Chinese Medicine. Gallbladder Stasis of rigid syndrome usually occurs in those patients who are yang sufficient in constitution with excessive seven emotion, the liver disperses Qi without limit and result in excessive liver fire, insufficient Yin and excessive Yang. The Rigid symptom of excessive disperseof liver Qi should be treated with suppressing disperse. The gental syndrome patients having constitutional Yang deficiency with excessive seven emotion , the liver disperses Qi insufficiently and result in Qi, biood and water stagnant. The Gental disperse liver Qi, enhance its disperse function.Gallbladder distortion commonly attacks in the population between 40 and 65 years old.The incidence in female is higher than male,The patients are usually seen fat in figure.Nowadays,the incidence of gallbladder distortion is on the rise and the causes are closely related with not only the emotional changes of people but also the changes of people' s diet structure.The characteristic symptoms of gallbladder distention are fullness and distending pain in the right upper abdomen,which attacks repeatedly and is accompanied by other clinical manifestations ,such as nausea,eructation,dry mouth,bitler taste in mouth,emotional abnormity,and so on.1 Purpose:This subject mainly reserch the "Rigid- Gental syndrome differentiation" of gallbladder distention disease in digestire system in both theory and clinical practice, in order to verify the "Rigid- Gental syndrome differentiation'' theory is reasonable and scientific ,and provide references for the clinical practice and scientific reserch in medical psychosomaic diseases.This subject aiso makes the etidogy,pathogenesis andregular rule of syndrome and treatment of TCM psychosomatic medicine be understand further and makes the theory, syndrome differentiation method and the thinking way of TCM psychosomatic medicine.2 Methods2.1Theoretic reserarch:Summaring the knowledge of rigidity-flexibility,and Yin-Yang from the past dynasties,mainly according to the document research.Providing theoretic basis for "rigidity-flexibility syndrome differentiation",andexpoundingthe etidogy,pathogenesis,the guiding principle of its syndrome differentiation,therapeutic principle and basic herbs used in TCM psychosomatic medicine. Summing up the tutor' sxperience in treating the disease of gallbladder distention. 2.2 Clinical research:In this study,the subjects were 50 gallbladder distentionpatients, who were divided into two groups, gental group(G group)and rigid group(R group),according to the criteria of " rigidity-flexibility syndrome differentiation" ,and were treated in dhTerenfways,treating Psychosomatic disease in both Psychological and Physical aspect. The Rigid symptom of excessive disperse of liver Qi should be treated with suppressing disperse. The gental syndrome patients having constitutional Yang deficiency with excessive seven emotion , the liver disperses Qi insufficiently and result in Qi, biood and water stagnant. The Gental disperse liver Qi, enhance its disperse function.The caurse of treatment was 6 weeks.After 6 weeks,observing clinical curative effects(such as fiillness,dry mouth and bitter taste in mouth,and emotional changes),evaluating the curative effects according to the patients' conditions before and after treatment,and closely observing the changes of various indexes and the possible adverse effects. 3 Results 3.1 Theoretic research result:Gallbladder distention belongs to the typicai psychosomatic(psychological - physical) disease and abides by the theory of psychosomatic medicineits pathegenesis is that gental and rigidity are unable to suppiement each other caused by liver' s excessive disperse or liver* sin sufficient disperse,manifested as imbalance of Qi,Xue,Yin and Yang.The thereapentic principle is that rigidity subjugates gental and gental subjugates rigidhy,which is guided by the theory of diagnosis and treatment based on the "rigid-gental syndrome differentiation".Concretely,the patients who belong to yigid syndrome caused by liver' s excersive disperse were treated by "gentaTmethod in order to pressing liver' s excersive disperse. The patients who belong to gental syndrome caused by liver' s insufficient disperse were treated by "rigjd"method in order to strengthen liver' s disperse.That is said in "Internal classic" : "tonifting with herbs of acrid taste,puring with herbs of sour taste".In TCM psychosomatic medicine,cholecystitis patients are divided into two types according to their temperament: "Yang-rigid'' type and "Yin-gentaFtype.The patients whose temperament is over irritable mostlybelong to"Yang-rigid"type,mainly manifested as distending pain in right upper abdomen or hypochondrium,or fullness and pain in stomach,distention in abdomen,restlessness,insomnia,dizzness,headache,bitter taste inmouthjUnsmooth strool,ozostomia, red tongue,yellow fur,and string,thin and smooth puise.This kind of patients are irritable,act arbitrarily, speak in high tone and can' t easily tranquilize their emotions.TCM syndrome differention belongs to liver hyperactivity and Yin deficiency,and blood stasisand phlegm blocking.The therapeutic principle is mitigating liver and replenishing Yin,and activating blood and resolving phlepm.The patients whose temperament is over depressed mostly belong to "Yin-gental"type,mainly manifested as distending pain in right upper abdomen or hypochondrium,or distention and pain in stomach,abdominal pain,unsmooth stool,hot drink,red tongue,white fur and string pulse,This kind of patients are soft in temperament,resteain theirselves strongly, speak in low tone and dare not speak when anger. They are in the depressive state over a long period of time.TCM syndrome differention blongs to liver depression and Qi stagnation,blood stasis and dampness blocking.The therapewtic principle is dispersing liver and repulating Qi flow,and activating blood and resolving dampness. 3.2 Clinical research results:The clinical effect is significant using "rigid-gental syndrome differentiation"to treat gallbladder distentioaThe clinical symptoms,such as fullness and distending pain in the right upper abdomen,dry mou1h,bitter taste in moutanausea,eructatioarestlessness or depression,and so on,were relieved obviously, Brain E lectrical Activity Mapping(BEAM) showed that the disease was relieved dramatically. All about fully indicated that gallbladder distention can be classified into two syndrome: the "rigid" and "gental". In 95% patients of gallbladder distention, their Brain E lectrical Activity Mapping(BEAM) were abnormal. 4 ConculsionThe clinical effect is significant using "rigid-gental syndrome differentiation" to treat gallbladder distentiono The clinical symptoms, such as fullness and distending pain in the yight upper abdomen, dry mouth, bitter taste in mouth,nausea,eructation,restlessness or depression,and so on,were relieved obviously. At the same time, patients' whole phycho-physical functions were... |
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