腹胀脾虚因久病，胃实多由食滞停，补虚健脾兼理气，攻食消导自然宁。
[注]
腹胀之病，脾胃二经主之，有虚有实，宜分晰焉，
虚者因久病内伤其脾，
实者因饮食停滞于胃，虚则补脾，实则消导，调治合宜，其胀自渐除矣。
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腹胀门
久病脾虚失运健，或因吐泻暴伤脾，食少即胀精神倦，面黄肌瘦四君宜。
[注]
凡小儿久病脾虚，或吐泻暴伤脾气，健运失常，
所以饮食不化，食少腹即胀满，现证精神倦怠，面黄肌瘦，此虚胀也，
宜用香朴四君子汤治之。
(香朴四君子汤)
人参 白术土炒 白茯苓 甘草炙 香附制 厚朴姜炒 引用生姜水煎服。
(方歌)
香朴四君治虚胀，参术甘草共茯苓，香附厚朴宜加人，引姜煎服胀即宁。
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腹胀门
饮食过度内伤胃，停滞腹胀便不通，潮热烦渴形气壮，平胃承气施治灵。
[注]
小儿饮食过度，则胃中停滞，
以致腹胀，大便不利，身体潮热，心烦口渴，形气壮实，此实胀也，
轻者平胃散主之，重者小承气汤主之。
(加味平胃散) 南苍术炒 厚朴姜炒 大腹皮制 甘草生 陈皮 莱菔子焙
山查 麦芽炒 神麴炒 引用生姜水煎服。
(方歌)
加味平胃治实胀，苍术厚朴大腹皮 甘草陈皮莱菔子，山查麦芽炒神麴。
(小承气汤) 方见食痛。
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腹胀一症，若因脾虚所致，多由久病引起；若属胃实，则大多因为食物停滞。治疗上应补益虚损、健脾并调理气机，或攻逐食积、消食导滞，如此自然安宁。
[注]
腹胀这一疾病，主要由脾胃二经主管，分为虚证和实证，应当仔细分辨。
虚证是因为久病内伤导致脾气受损；
实证是因为饮食停滞在胃部。虚证应当补脾，实证应当消食导滞，只要调治得当，腹胀自然会逐渐消除。
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腹胀门
久病导致脾虚，失去健运功能；或者因为剧烈呕吐腹泻突然损伤脾气。表现为进食少即感腹胀，精神疲倦，面色萎黄，肌肉消瘦，适宜使用四君子汤（加香附、厚朴）。
[注]
凡是小儿久病导致脾虚，或者因吐泻突然损伤脾气，致使健运功能失常，
所以饮食不能消化，吃得少腹部就胀满，出现精神倦怠、面色萎黄、肌肉消瘦的症状，这是虚胀，
适宜用香朴四君子汤来治疗。
(香朴四君子汤)
人参 白术（土炒） 白茯苓 甘草（炙） 香附（制） 厚朴（姜炒） 引用生姜水煎服。
(方歌)
香朴四君治疗虚胀，人参、白术、甘草配合茯苓，加入香附、厚朴，引用生姜煎服，腹胀即可安宁。
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腹胀门
饮食过度内伤胃部，食物停滞导致腹胀，大便不通畅，伴有潮热、烦躁、口渴，形体气势壮实，可用平胃散或小承气汤灵活施治。
[注]
小儿饮食过度，导致胃中食物停滞，
以致腹部胀满，大便不利，身体出现潮热，心烦口渴，形体气势壮实，这是实胀，
轻症以平胃散为主治方，重症以小承气汤为主治方。
(加味平胃散) 南苍术（炒） 厚朴（姜炒） 大腹皮（制） 甘草（生） 陈皮 莱菔子（焙）
山楂 麦芽（炒） 神曲（炒） 引用生姜水煎服。
(方歌)
加味平胃治疗实胀，苍术、厚朴、大腹皮，甘草、陈皮、莱菔子，山楂、麦芽炒神曲。
(小承气汤) 方剂见“食痛”条下。
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Abdominal distension caused by Spleen deficiency often results from prolonged illness, while that due to Stomach excess is mostly caused by food stagnation. Treatment should tonify deficiency, strengthen the Spleen, and regulate Qi; or purge food accumulation and promote digestion, thereby restoring tranquility.
[Note]
The disease of abdominal distension is primarily governed by the Spleen and Stomach meridians, manifesting as either deficiency or excess patterns, which must be carefully differentiated.
Deficiency patterns arise from internal injury to the Spleen due to prolonged illness;
Excess patterns arise from food stagnation in the Stomach. Deficiency requires tonification of the Spleen, while excess requires promotion of digestion. With appropriate regulation and treatment, the distension will gradually resolve.
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Chapter on Abdominal Distension
Prolonged illness leads to Spleen deficiency and loss of transportation and transformation functions, or sudden injury to Spleen Qi due to severe vomiting and diarrhea. Symptoms include abdominal distension after minimal food intake, mental fatigue, sallow complexion, and emaciation. The formula Si Jun Zi Tang (Four Gentlemen Decoction) modified with Xiang Fu and Hou Po is indicated.
[Note]
In children, prolonged illness causing Spleen deficiency, or sudden injury to Spleen Qi due to vomiting and diarrhea, results in abnormal transportation and transformation functions.
Consequently, food fails to digest, leading to abdominal fullness even with small amounts of food. Clinical manifestations include mental fatigue, sallow complexion, and emaciation, constituting a deficiency-type abdominal distension.
Xiang Po Si Jun Zi Tang (Atractylodes and Cyperus Four Gentlemen Decoction) is suitable for treatment.
(Xiang Po Si Jun Zi Tang)
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma, stir-fried with soil), Bai Fu Ling (Poria), Zhi Gan Cao (Prepared Licorice Root), Zhi Xiang Fu (Prepared Cyperi Rhizoma), Jiang Chao Hou Po (Magnolia Bark stir-fried with ginger juice). Decoct with fresh ginger water.
(Verse Formula)
Xiang Po Si Jun treats deficiency distension; Ginseng, Atractylodes, and Licorice combined with Poria; Add prepared Cyperi Rhizoma and Magnolia Bark; Decoct with ginger to calm distension.
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Chapter on Abdominal Distension
Overeating causes internal injury to the Stomach, leading to food stagnation and abdominal distension, accompanied by unsmooth bowel movements. If there is tidal fever, irritability, thirst, and robust physical constitution, Ping Wei San or Xiao Cheng Qi Tang may be applied flexibly.
[Note]
When children overeat, food stagnates in the Stomach,
resulting in abdominal distension, difficult defecation, tidal fever, irritability, thirst, and a robust physical constitution. This constitutes an excess-type abdominal distension.
For mild cases, Ping Wei San (Calm the Stomach Powder) is the primary formula; for severe cases, Xiao Cheng Qi Tang (Minor Order the Qi Decoction) is the primary formula.
(Jia Wei Ping Wei San - Modified Calm the Stomach Powder) Nan Cang Zhu (Atractylodis Rhizoma, stir-fried), Jiang Chao Hou Po (Magnolia Bark stir-fried with ginger juice), Zhi Da Fu Pi (Areca Peel processed), Sheng Gan Cao (Raw Licorice Root), Chen Pi (Citrus Reticulatae Pericarpium), Bei Lai Fu Zi (Raphani Semen roasted).
Shan Zha (Crataegi Fructus), Chao Mai Ya (Hordei Fructus Germinatus stir-fried), Chao Shen Qu (Medicated Leaven stir-fried). Decoct with fresh ginger water.
(Verse Formula)
Modified Ping Wei San treats excess distension; Atractylodes, Magnolia Bark, Areca Peel; Licorice, Citrus Reticulatae Pericarpium, Raphani Semen; Crataegi Fructus, Hordei Fructus Germinatus stir-fried with Medicated Leaven.
(Xiao Cheng Qi Tang) See entry under "Food Pain" for the formula.
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