产后浮肿有败血停积,以致营卫阻滞,营运失度,面目四肢浮肿者,宜芎归汤加血余炭、荆芥、牛膝、瞿
麦,血行则肿自消,有气血大虚,肢体浮肿者,不可利水,宜八珍汤。若水气浮肿必发嗽,小便必数,治当利
水,宜宣气汤。
芎归汤
当归 川芎(各五钱)
水煎服。
八珍汤
人参 白术(蜜炙) 当归 熟地黄 川芎 茯苓 白芍 炙甘草(各一钱) 姜(三片) 枣(二枚)
水煎服。
宣气汤
白术(蜜炙) 郁李仁 葶苈子 桑白皮 炙甘草 赤茯苓 陈皮 川芎 当归 白芍 生地黄
水煎服。
产后小便不利由火盛也,宜木通散。即木通 滑石 葵子 槟榔 枳壳 甘草(各五分)
水煎服。
产后大便闭结由失血亡阴,津液不足而势,宜行也,宜济川煎。若去血过多,宜十全大补汤。血虚火燥,
宜加味四物汤。气血俱虚,宜八珍汤。若数日不通,饮食如常,腹中如故,宜八珍汤加桃仁、杏仁以治之。
济川煎
当归(三钱) 牛膝(二钱) 肉苁蓉(酒洗,二钱) 泽泻(一钱五分) 升麻(五分) 枳壳(一钱,虚
者去之)
水煎食前服。
气虚加人参;肾虚加熟地黄;有热有火加黄芩。
十全大补汤
人参 熟地黄 当归 川芎 白芍 茯苓 黄 (蜜炙) 白术(蜜炙,各一钱) 炙甘草 肉桂(各五分)
姜(三片) 枣(二枚)
水煎服。
加味四物汤
熟地黄 当归(各三钱) 川芎(一钱) 白芍(二钱) 山栀仁(炒) 柴胡 丹皮(各一钱)
水煎服。
八珍汤
人参 白术(蜜炙) 茯苓 炙甘草 熟地黄 当归 白芍 川芎(各一钱) 姜(三片) 枣(两枚)
水煎服。
产后出现浮肿,若因败血停滞积聚,导致营卫之气阻滞、运行失去常度,从而引起面目及四肢浮肿者,适宜使用芎归汤加入血余炭、荆芥、牛膝、瞿麦;血液运行通畅后,浮肿自然消退。若因气血严重亏虚,导致肢体浮肿者,不可采用利水的方法治疗,适宜使用八珍汤(Bazhen Tang, Eight Treasure Decoction)。若是水气引起的浮肿,必定伴有咳嗽,小便次数必然增多,治疗应当利水,适宜使用宣气汤(Xuanqi Tang, Qi-Releasing Decoction)。
芎归汤(Xionggui Tang)
当归(Danggui, Angelicae Sinensis Radix)、川芎(Chuanxiong, Ligustici Chuanxiong Rhizoma),各五钱。
用水煎煮后服用。
八珍汤(Bazhen Tang)
人参(Renshen, Ginseng Radix)、白术(Baizhu, Atractylodis Macrocephalae Rhizoma,蜜炙)、当归(Danggui, Angelicae Sinensis Radix)、熟地黄(Shudihuang, Rehmanniae Radix Preparata)、川芎(Chuanxiong, Ligustici Chuanxiong Rhizoma)、茯苓(Fuling, Poria)、白芍(Baishao, Paeoniae Radix Alba)、炙甘草(Zhigancao, Glycyrrhizae Radix et Rhizoma Preparata),各一钱。生姜(三片)、大枣(二枚)。
用水煎煮后服用。
宣气汤(Xuanqi Tang)
白术(Baizhu, Atractylodis Macrocephalae Rhizoma,蜜炙)、郁李仁(Yuliren, Pruni Semen)、葶苈子(Tinglizi, Lepidii Semen)、桑白皮(Sangbaipi, Mori Cortex)、炙甘草(Zhigancao, Glycyrrhizae Radix et Rhizoma Preparata)、赤茯苓(Chifuling, Poria cum Rubro)、陈皮(Chenpi, Citri Reticulatae Pericarpium)、川芎(Chuanxiong, Ligustici Chuanxiong Rhizoma)、当归(Danggui, Angelicae Sinensis Radix)、白芍(Baishao, Paeoniae Radix Alba)、生地黄(Shengdihuang, Rehmanniae Radix)。
用水煎煮后服用。
产后小便不利,是由于火邪亢盛所致,适宜使用木通散(Mutong San)。方剂组成:木通(Mutong, Akebiae Caulis)、滑石(Huashi, Talcum)、葵子(Kuizi, Abutilonis Semen)、槟榔(Binglang, Arecae Semen)、枳壳(Zhiqiao, Aurantii Fructus)、甘草(Gancao, Glycyrrhizae Radix et Rhizoma),各五分。
用水煎煮后服用。
产后小便尿血,是由于血虚且有热所致,适宜用牛膝(Niuxi, Achyranthis Bidentatae Radix)二钱,浓煎后服用。
产后大便闭结,是由于失血导致亡阴,津液不足而形成的,适宜使用济川煎(Jichuan Jian)。若因去血过多,适宜使用十全大补汤(Shiquan Dabu Tang)。若属血虚火燥,适宜使用加味四物汤(Jiawei Siwu Tang)。若属气血俱虚,适宜使用八珍汤(Bazhen Tang)。若数日不大便,但饮食正常,腹部无不适感,适宜使用八珍汤加入桃仁(Taoren, Persicae Semen)、杏仁(Xingren, Armeniacae Semen Amarum)来治疗。
济川煎(Jichuan Jian)
当归(Danggui, Angelicae Sinensis Radix)三钱、牛膝(Niuxi, Achyranthis Bidentatae Radix)二钱、肉苁蓉(Roucongrong, Cistanche Deserticolae Herba,酒洗)二钱、泽泻(Zexie, Alismatis Rhizoma)一钱五分、升麻(Shengma, Cimicifugae Rhizoma)五分、枳壳(Zhiqiao, Aurantii Fructus)一钱(体虚者去除)。
饭前用水煎煮后服用。
气虚者加人参(Renshen, Ginseng Radix);肾虚者加熟地黄(Shudihuang, Rehmanniae Radix Preparata);有热有火者加黄芩(Huangqin, Scutellariae Radix)。
十全大补汤(Shiquan Dabu Tang)
人参(Renshen, Ginseng Radix)、熟地黄(Shudihuang, Rehmanniae Radix Preparata)、当归(Danggui, Angelicae Sinensis Radix)、川芎(Chuanxiong, Ligustici Chuanxiong Rhizoma)、白芍(Baishao, Paeoniae Radix Alba)、茯苓(Fuling, Poria)、黄芪(Huangqi, Astragali Radix,蜜炙)、白术(Baizhu, Atractylodis Macrocephalae Rhizoma,蜜炙),各一钱。炙甘草(Zhigancao, Glycyrrhizae Radix et Rhizoma Preparata)、肉桂(Rougui, Cinnamomi Cortex),各五分。生姜(三片)、大枣(二枚)。
用水煎煮后服用。
加味四物汤(Jiawei Siwu Tang)
熟地黄(Shudihuang, Rehmanniae Radix Preparata)、当归(Danggui, Angelicae Sinensis Radix),各三钱。川芎(Chuanxiong, Ligustici Chuanxiong Rhizoma)一钱、白芍(Baishao, Paeoniae Radix Alba)二钱。山栀仁(Shanzhiren, Gardeniae Semen,炒)、柴胡(Chaihu, Bupleuri Radix)、丹皮(Danpi, Moutan Cortex),各一钱。
用水煎煮后服用。
八珍汤(Bazhen Tang)
人参(Renshen, Ginseng Radix)、白术(Baizhu, Atractylodis Macrocephalae Rhizoma,蜜炙)、茯苓(Fuling, Poria)、炙甘草(Zhigancao, Glycyrrhizae Radix et Rhizoma Preparata)、熟地黄(Shudihuang, Rehmanniae Radix Preparata)、当归(Danggui, Angelicae Sinensis Radix)、白芍(Baishao, Paeoniae Radix Alba)、川芎(Chuanxiong, Ligustici Chuanxiong Rhizoma),各一钱。生姜(三片)、大枣(两枚)。
用水煎煮后服用。
Edema occurring after childbirth may be caused by the stagnation and accumulation of residual blood (residual blood), leading to obstruction of Ying and Wei (nutritive and defensive qi) and loss of normal circulation. In cases where edema affects the face, eyes, and four limbs, Xiongui Tang (Cnidium and Angelica Decoction) should be used with added Yuchutan (Charred Human Hair), Jingjie (Schizonepetae Spica), Niuxi (Achyranthes Root), and Qumai (Dianthera Herb). Once blood circulation is restored, the edema will subside spontaneously. If the edema of the limbs is due to severe deficiency of Qi and Blood, diuretic methods should not be employed; instead, Bazhen Tang (Eight Treasure Decoction) is indicated. If the edema is caused by Water-Qi, it must be accompanied by coughing and frequent urination; in such cases, treatment should focus on promoting urination, and Xuanqi Tang (Qi-Release Decoction) is appropriate.
**Xiongui Tang (Cnidium and Angelica Decoction)**
Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Ligustici Chuanxiong), each 5 qian.
Decoct in water and take orally.
**Bazhen Tang (Eight Treasure Decoction)**
Renshen (Radix Ginseng), Baizhu (Rhizoma Atractylodis Macrocephalae, honey-fried), Danggui (Radix Angelicae Sinensis), Shudihuang (Radix Rehmanniae Praeparata), Chuanxiong (Rhizoma Ligustici Chuanxiong), Fuling (Poria), Baishao (Radix Paeoniae Alba), Zhigancao (Radix et Rhizoma Glycyrrhizae, prepared), each 1 qian. Jiang (Fresh Ginger, 3 slices), Zao (Fructus Jujubae, 2 pieces).
Decoct in water and take orally.
**Xuanqi Tang (Qi-Release Decoction)**
Baizhu (Rhizoma Atractylodis Macrocephalae, honey-fried), Yuliren (Semen Pruni), Tinglizi (Semen Lepidii), Sangbaipi (Cortex Mori), Zhigancao (Radix et Rhizoma Glycyrrhizae, prepared), Chifuling (Poria cum Rubro), Chenpi (Pericarpium Citri Reticulatae), Chuanxiong (Rhizoma Ligustici Chuanxiong), Danggui (Radix Angelicae Sinensis), Baishao (Radix Paeoniae Alba), Shengdihuang (Radix Rehmanniae Recens).
Decoct in water and take orally.
Difficult urination after childbirth is caused by excessive Fire-Heat. Mutong San (Akebia Powder) is indicated. The formula consists of Mutong (Caulis Akebiae), Huashi (Talcum), Kuizi (Semen Abutilonis), Binglang (Semen Arecae), Zhiqiao (Fructus Aurantii), Gancao (Radix et Rhizoma Glycyrrhizae), each 5 fen.
Decoct in water and take orally.
Hematuria (blood in urine) after childbirth is caused by Blood deficiency with Heat. Niuxi (Radix Achyranthis Bidentatae), 2 qian, should be decocted strongly and taken orally.
Constipation after childbirth results from loss of Blood leading to Yin exhaustion, causing a deficiency of Body Fluids. Jichuan Jian (Jichuan Decoction) is indicated. If there has been excessive blood loss, Shiquan Dabu Tang (Ten Thousand Complete Tonifying Decoction) is appropriate. If the condition is characterized by Blood deficiency with Dryness-Fire, Jiawei Siwu Tang (Modified Four Substance Decoction) is suitable. If both Qi and Blood are deficient, Bazhen Tang (Eight Treasure Decoction) is indicated. If there is no bowel movement for several days, but appetite remains normal and the abdomen feels unchanged, Bazhen Tang (Eight Treasure Decoction) with added Taoren (Semen Persicae) and Xingren (Semen Armeniacae Amarum) should be used.
**Jichuan Jian (Jichuan Decoction)**
Danggui (Radix Angelicae Sinensis), 3 qian; Niuxi (Radix Achyranthis Bidentatae), 2 qian; Roucongrong (Herba Cistanche, wine-washed), 2 qian; Zexie (Rhizoma Alismatis), 1.5 qian; Shengma (Rhizoma Cimicifugae), 5 fen; Zhiqiao (Fructus Aurantii), 1 qian (omit if the patient is deficient).
Decoct in water and take before meals.
For Qi deficiency, add Renshen (Radix Ginseng); for Kidney deficiency, add Shudihuang (Radix Rehmanniae Praeparata); for Heat and Fire, add Huangqin (Radix Scutellariae).
**Shiquan Dabu Tang (Ten Thousand Complete Tonifying Decoction)**
Renshen (Radix Ginseng), Shudihuang (Radix Rehmanniae Praeparata), Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Ligustici Chuanxiong), Baishao (Radix Paeoniae Alba), Fuling (Poria), Huangqi (Radix Astragali, honey-fried), Baizhu (Rhizoma Atractylodis Macrocephalae, honey-fried), each 1 qian. Zhigancao (Radix et Rhizoma Glycyrrhizae, prepared), Rougui (Cortex Cinnamomi), each 5 fen. Jiang (Fresh Ginger, 3 slices), Zao (Fructus Jujubae, 2 pieces).
Decoct in water and take orally.
**Jiawei Siwu Tang (Modified Four Substance Decoction)**
Shudihuang (Radix Rehmanniae Praeparata), Danggui (Radix Angelicae Sinensis), each 3 qian. Chuanxiong (Rhizoma Ligustici Chuanxiong), 1 qian; Baishao (Radix Paeoniae Alba), 2 qian. Shanzhiren (Semen Gardeniae, stir-fried), Chaihu (Radix Bupleuri), Danpi (Cortex Moutan), each 1 qian.
Decoct in water and take orally.
**Bazhen Tang (Eight Treasure Decoction)**
Renshen (Radix Ginseng), Baizhu (Rhizoma Atractylodis Macrocephalae, honey-fried), Fuling (Poria), Zhigancao (Radix et Rhizoma Glycyrrhizae, prepared), Shudihuang (Radix Rehmanniae Praeparata), Danggui (Radix Angelicae Sinensis), Baishao (Radix Paeoniae Alba), Chuanxiong (Rhizoma Ligustici Chuanxiong), each 1 qian. Jiang (Fresh Ginger, 3 slices), Zao (Fructus Jujubae, 2 pieces).
Decoct in water and take orally.