产后完谷不化者,因产劳倦脾伤,而转输稽迟也。夫水谷入胃,必因于脾,方散于肺,
而通
调水道,乃能布气四脏以养人。今产劳倦脾伤,故失转输之职,致冲和之气不能化,而冷物
完出也,病名飧泄,又饮食太过,脾胃受伤,亦致完谷不化,俗呼为水谷痢也。然产方三日
内,血块未散,患此脾败胃弱症,未可遽加 、术,宜服生化汤,加益智、香砂,以少温胃
气,俟血块消散,可加人参、 、术以补气,肉果、木香、砂仁、益智以温胃,柴胡、升麻
以引胃中清气,泽泻、陈皮、茯苓,以利水为上策也。
加味生化汤 治产后三日内,完谷不化,胎前人素弱,患此症用。
川芎(一钱) 当归(四钱) 炮姜(四分) 桃仁(十粒) 益智(二钱) 茯苓(一钱五分)
参苓生化汤 治产后血块散,可服此补方。
川芎(二钱) 当归(二钱) 炮姜(四分) 炙甘(五分) 白芍(一钱) 益智(一钱,炒)
茯苓(一钱) 人参(二钱) 白术(二钱) 莲子(八个) 肉果(一个,制)
泻水,加泽泻八分,木通八分。
加减法∶腹痛,加砂仁八分。渴,加麦冬二钱,五味子十粒。水泻寒,加干姜一
钱,木香四
分。食积黄色,加神曲二钱,麦芽二钱,以消面食,砂仁二钱,山楂五粒,以消肉食。若泻
痢日久,胃气虚弱,完谷不化,宜温助胃气,六君子汤加木香五分,制肉果一个。
产后出现食物未经消化即排出(完谷不化)的情况,是因为分娩时的劳累和疲倦损伤了脾气,导致脾胃的运化和转输功能迟缓。水谷进入胃中,必须依赖脾气的运化,才能散布到肺脏,进而通调水道,将气布散至五脏六腑以滋养人体。如今因产程劳累疲倦导致脾伤,所以失去了转输的功能,致使冲和之气不能正常运化,冷物便原样排出,这种病名为飧泄(大便稀溏且含有未消化食物)。另外,如果饮食过量,损伤了脾胃,也会导致完谷不化,俗称水谷痢。然而,在产后三天内,恶露血块尚未消散,此时若患此脾败胃弱的病症,不可立即加入白术、苍术等燥湿健脾之品,适宜服用生化汤,加入益智仁、砂仁,以轻微温养胃气,等到血块消散后,可以加入人参、白术、苍术来补气,加入肉豆蔻、木香、砂仁、益智仁来温胃,加入柴胡、升麻来引胃中清气上升,加入泽泻、陈皮、茯苓以利水渗湿,这是上策。
加味生化汤:治疗产后三日内,出现完谷不化,且胎前身体素来虚弱者患有此症时使用。
川芎(一钱) 当归(四钱) 炮姜(四分) 桃仁(十粒) 益智仁(二钱) 茯苓(一钱五分)
参苓生化汤:治疗产后血块已消散,可服用此补益方剂。
川芎(二钱) 当归(二钱) 炮姜(四分) 炙甘草(五分) 白芍(一钱) 益智仁(一钱,炒制) 茯苓(一钱) 人参(二钱) 白术(二钱) 莲子(八个) 肉豆蔻(一个,制过)
加减法:腹痛,加砂仁八分。口渴,加麦冬二钱,五味子十粒。水泻伴有寒象,加干姜一钱,木香四分。食积导致面色发黄,加神曲二钱,麦芽二钱,以消面食积滞;加砂仁二钱,山楂五粒,以消肉食积滞。如果泻痢日久,胃气虚弱,完谷不化,宜温助胃气,用六君子汤加木香五分,制肉豆蔻一个。
Postpartum indigestion with undigested food in stool (Wangu Buhua) occurs due to spleen injury caused by labor fatigue, resulting in delayed transportation and transformation. When water and grain enter the stomach, they must be processed by the Spleen to disperse to the Lung, thereby regulating the water passages, so that Qi can be distributed to the five Zang organs to nourish the body. Now, due to postpartum fatigue injuring the Spleen, the function of transportation is lost, causing the harmonious Qi to fail in transformation, leading to cold substances being excreted intact. This condition is named Sun Xie (diarrhea with undigested food). Additionally, excessive diet damaging the Spleen and Stomach can also lead to indigestion with undigested food, commonly known as Shuigu Li (water-grain dysentery). However, within three days postpartum, when blood stasis has not yet dissipated, if this syndrome of Spleen failure and Stomach weakness occurs, one should not abruptly add Atractylodis Rhizoma (Baizhu) or Atractylodis Macrocephalae Rhizoma (Canshu). It is appropriate to administer Shenghua Tang (Life-Restoring Decoction) added with Alpiniae Oxyphyllae Fructus (Yizhi) and Amomi Fructus Rotundus (Xiangsha) to slightly warm the Stomach Qi. Wait until the blood stasis dissipates before adding Ginseng Radix (Renshen), Atractylodis Rhizoma (Baizhu), and Atractylodis Macrocephalae Rhizoma (Canshu) to tonify Qi; Mu Dou Kou (Nutmeg), Aucklandiae Radix (Muxiang), Amomi Fructus Rotundus (Sharen), and Alpiniae Oxyphyllae Fructus (Yizhi) to warm the Stomach; Bupleuri Radix (Chaihu) and Cimicifugae Rhizoma (Shengma) to guide clear Yang from the Stomach upward; and Alismatis Rhizoma (Zexie), Citri Reticulatae Pericarpium (Chenpi), and Poria (Fuling) to promote diuresis. This is the superior strategy.
Jiawei Shenghua Tang (Modified Life-Restoring Decoction): Treats postpartum indigestion with undigested food within three days, used for patients who were constitutionally weak before delivery and suffer from this syndrome.
Chuanxiong Rhizome (Chuanxiong) (1 qian)
Angelica Sinensis Root (Danggui) (4 qian)
Prepared Ginger (Paojiang) (4 fen)
Peach Seed (Taoren) (10 grains)
Alpiniae Oxyphyllae Fructus (Yizhi) (2 qian)
Poria (Fuling) (1.5 qian)
Shenling Shenghua Tang (Ginseng-Poria Life-Restoring Decoction): To be taken after postpartum blood stasis has dissipated, as a tonic formula.
Chuanxiong Rhizome (Chuanxiong) (2 qian)
Angelica Sinensis Root (Danggui) (2 qian)
Prepared Ginger (Paojiang) (4 fen)
Prepared Licorice Root (Zhigancao) (5 fen)
White Peony Root (Baishao) (1 qian)
Alpiniae Oxyphyllae Fructus (Yizhi) (1 qian, stir-fried)
Poria (Fuling) (1 qian)
Ginseng Radix (Renshen) (2 qian)
Atractylodis Rhizoma (Baizhu) (2 qian)
Lotus Seed (Lianzi) (8 seeds)
Nutmeg (Rougu) (1 piece, processed)
If there is a need to drain water, add Alismatis Rhizoma (Zexie) 8 fen and Akebia Stem (Mutong) 8 fen.
Modifications: For abdominal pain, add Amomi Fructus Rotundus (Sharen) 8 fen. For thirst, add Ophiopogonis Radix (Maidong) 2 qian and Schisandrae Fructus (Wuweizi) 10 grains. For watery diarrhea with cold signs, add Dried Ginger (Ganjiang) 1 qian and Aucklandiae Radix (Muxiang) 4 fen. For food stagnation presenting with yellow complexion, add Medicated Leaven (Shenqu) 2 qian and Hordeum Vulgare Sprout (Maiya) 2 qian to digest wheat-based foods; add Amomi Fructus Rotundus (Sharen) 2 qian and Crataegi Fructus (Shanzha) 5 grains to digest meat-based foods. If diarrhea and dysentery persist for a long time, with weak Stomach Qi and indigestion with undigested food, it is advisable to warm and assist Stomach Qi using Liujunzi Tang (Six Gentlemen Decoction) added with Aucklandiae Radix (Muxiang) 5 fen and processed Nutmeg (Zhi Rougu) 1 piece.