产后泄泻,大率虚弱食积,土虚不能胜湿而然。但恶露未除,脾胃又弱,难于消燥而用补也。治法∶先服生
化一煎后即加茯苓一钱,以利小便,俟血生化,然后议补、议消、议燥,使无滞涩、虚滑之失。若产毕即泻者,宜
加减生化汤。若胎前久泻,产后不止者,宜参、苓生化汤从权以防虚脱。若久泻不止或脾泻者,须
服参术莲子饮百剂。甚至形脱、眼昏花者,服丹溪急救方。
加减生化汤
川芎(一钱) 当归(一钱五分) 黑姜 炙草(各五分) 桃仁(十粒) 茯苓(一钱五分) 莲肉
诃子(各八分) 姜(一片)
水煎二帖。泻不止,加人参三钱。
参苓生化汤
川芎(一钱) 当归(二钱,土炒) 姜炭 炙草(各五分) 茯苓(一钱五分) 陈皮(一钱) 白术
(一钱五分) 人参(二钱) 肉果(煨) 诃子(各一钱) 莲子(八分) 糯米(一撮)
水煎。寒痛泻,加砂仁五分。热泄,加炒连三分。泻久,加升麻三分。泻水,加苍术一钱。泻出食肉如败卵,
及噫气,加神曲、砂仁各八分,山楂、麦芽各五分,或加豆蔻、丁香各一钱。渴,加麦冬一钱,五味六分。
参术莲子饮
人参 焦术(各二钱) 茯苓(一钱) 当归(一钱五分) 炒芍(八分) 炙草(五分) 陈皮 升麻(各
三分) 山药(一钱) 莲子(十粒) 姜(一片)
如腹痛,加炮姜五分。
丹溪救急方
人参(五钱) 白术(三钱) 茯苓(三钱) 制附(一钱)
水煎服。
以上各方,可加五味子酒炒二十粒,干面粉炒黄二钱。虚脱者,暂加枯矾少许以涩之。
产后泄泻,大多是由于身体虚弱和饮食积滞,脾土虚弱不能克制湿气所致。但是恶露尚未排净,脾胃功能又弱,难以直接采用燥湿或补益的方法治疗。治疗方法:先服用一剂生化汤,然后加入一钱茯苓,通过利小便来祛湿,等到瘀血化生、新血生成后,再讨论使用补法、消导法或燥湿法,以避免出现气血阻滞或滑脱不禁的失误。如果是分娩结束后立即发生泄泻的,适宜使用加减生化汤。如果是怀孕期间长期泄泻,产后仍未停止的,适宜使用参苓生化汤,根据情况灵活处理以防虚脱。如果是长期泄泻不止或属于脾虚泄泻的,必须服用参术莲子饮一百剂。甚至出现形体消瘦脱失、眼睛昏花视物不清的,服用丹溪急救方。
加减生化汤
川芎(一钱) 当归(一钱五分) 黑姜 炙甘草(各五分) 桃仁(十粒) 茯苓(一钱五分) 莲肉 诃子(各八分) 生姜(一片)
加水煎煮两帖。如果泄泻不止,加入人参三钱。
参苓生化汤
川芎(一钱) 当归(二钱,用土炒制) 姜炭 炙甘草(各五分) 茯苓(一钱五分) 陈皮(一钱) 白术(一钱五分) 人参(二钱) 肉豆蔻(煨制) 诃子(各一钱) 莲子(八分) 糯米(一小撮)
加水煎煮。如果是寒性疼痛导致的泄泻,加入砂仁五分。如果是热性泄泻,加入炒黄连三分。如果是久泻,加入升麻三分。如果是水样便,加入苍术一钱。如果泻出食物残渣如腐败的蛋类,以及嗳气,加入神曲、砂仁各八分,山楂、麦芽各五分,或者加入豆蔻、丁香各一钱。如果有口渴症状,加入麦冬一钱,五味子六分。
参术莲子饮
人参 焦白术(各二钱) 茯苓(一钱) 当归(一钱五分) 炒白芍(八分) 炙甘草(五分) 陈皮 升麻(各三分) 山药(一钱) 莲子(十粒) 生姜(一片)
如果出现腹痛,加入炮姜五分。
丹溪救急方
人参(五钱) 白术(三钱) 茯苓(三钱) 制附子(一钱)
加水煎服。
以上各方,可以加入用酒炒制的五味子二十粒,用干面粉炒黄的米粉二钱。对于虚脱的患者,暂时加入少许枯矾以起到收敛固涩的作用。
Postpartum diarrhea is generally caused by deficiency and food stagnation, where Spleen Earth (Pi Tu) is too weak to control dampness. However, since lochia has not yet been expelled and the Spleen and Stomach are weak, it is difficult to directly use drying or tonifying methods. Treatment method: First, take one decoction of Shenghua Tang (Life-Birth Decoction), then add one qian of Fuling (Poria) to promote urination and drain dampness. Wait until blood stasis transforms and new blood generates, then discuss whether to use tonification, digestion-promoting, or drying methods, to avoid complications such as Qi/Blood stagnation or incontinence. If diarrhea occurs immediately after delivery, Jiajian Shenghua Tang (Modified Life-Birth Decoction) is suitable. If chronic diarrhea existed during pregnancy and continues postpartum, Shenling Shenghua Tang (Ginseng-Poria Life-Birth Decoction) should be used flexibly to prevent collapse. For persistent chronic diarrhea or Spleen-type diarrhea, Shen Zhu Lian Zi Yin (Ginseng-Atractylodes-Lotus Seed Drink) must be taken for a hundred doses. In severe cases with physical emaciation and blurred vision, Danxi Jiuj Fang (Danxi's Emergency Rescue Formula) is indicated.
Jiajian Shenghua Tang (Modified Life-Birth Decoction)
Chuanxiong (1 qian) Danggui (1.5 qian) Heijiang (Charred Ginger) Zhigancao (Honey-fried Licorice Root) (each 0.5 qian) Taoren (Peach Kernel) (10 grains) Fuling (Poria) (1.5 qian) Lianrou (Lotus Seed Meat) Hezi (Chebula Fruit) (each 0.8 fen) Jiang (Ginger slice) (1 piece)
Decoct in water for two doses. If diarrhea persists, add Renshen (Ginseng) 3 qian.
Shenling Shenghua Tang (Ginseng-Poria Life-Birth Decoction)
Chuanxiong (1 qian) Danggui (2 qian, stir-fried with soil) Jiangtan (Charred Ginger) Zhigancao (Honey-fried Licorice Root) (each 0.5 qian) Fuling (Poria) (1.5 qian) Chenpi (Aged Tangerine Peel) (1 qian) Baizhu (Atractylodes Macrocephala Rhizome) (1.5 qian) Renshen (Ginseng) (2 qian) Rouguo (Nutmeg, baked) Hezi (Chebula Fruit) (each 1 qian) Lianzi (Lotus Seed) (0.8 fen) Nuomi (Glutinous Rice) (a small pinch)
Decoct in water. For cold-induced painful diarrhea, add Sharen (Amomum Fruit) 0.5 fen. For heat-induced diarrhea, add Chao Lian (Stir-fried Coptis Rhizome) 0.3 fen. For chronic diarrhea, add Shengma (Cimicifuga Rhizome) 0.3 fen. For watery stool, add Cangzhu (Atractylodes Lancea Rhizome) 1 qian. If excrement resembles spoiled eggs accompanied by belching, add Shenqu (Medicated Leaven) and Sharen (Amomum Fruit) each 0.8 fen, Shanzha (Hawthorn Fruit) and Maiya (Sprouted Barley) each 0.5 fen, or add Doukou (Cardamom Fruit) and Dingxiang (Clove) each 1 qian. For thirst, add Maidong (Ophiopogon Tuber) 1 qian and Wuweiizi (Schisandra Berry) 0.6 fen.
Shen Zhu Lian Zi Yin (Ginseng-Atractylodes-Lotus Seed Drink)
Renshen (Ginseng) Jiaozhu (Charred Atractylodes Macrocephala Rhizome) (each 2 qian) Fuling (Poria) (1 qian) Danggui (Angelica Sinensis Root) (1.5 qian) Chao Shao (Stir-fried White Peony Root) (0.8 fen) Zhigancao (Honey-fried Licorice Root) (0.5 fen) Chenpi (Aged Tangerine Peel) Shengma (Cimicifuga Rhizome) (each 0.3 fen) Shanyao (Dioscorea Rhizome) (1 qian) Lianzi (Lotus Seed) (10 grains) Jiang (Ginger slice) (1 piece)
If abdominal pain occurs, add Paojiang (Prepared Ginger) 0.5 fen.
Danxi Jiuj Fang (Danxi's Emergency Rescue Formula)
Renshen (Ginseng) (5 qian) Baizhu (Atractylodes Macrocephala Rhizome) (3 qian) Fuling (Poria) (3 qian) Zhi Fu (Prepared Aconite Root) (1 qian)
Decoct in water and take orally.
For all the above formulas, twenty grains of Wuweiizi (Schisandra Berry) stir-fried with wine and two qian of dry flour powder stir-fried until yellow can be added. For patients with collapse, a small amount of Kufan (Alum) may be temporarily added to astringe.