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Syndrome differentiation of simultaneous disorder of qi and blood

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Updated: Tuesday, Sep 01,2009, 12:51:54 PM
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Qi and blood depend on each other to exist and promote each other to develop. Pathologically, qi and blood affect each other, blood disorder may involve qi and vice versa. If qi disorder and blood disorder appear at the same time, it is known as simultaneous disorder of qi and blood. Clinically, simultaneous disorder of qi and blood is divided into two major categories, asthenia of both qi and blood, loss of blood due to qi asthenia, qi depletion with blood in asthenia syndrome; qi stagnation and blood stasis in sthenia syndrome, and qi asthenia and blood stasis in syndrome of principal asthenia and secondary sthenia.

Asthenia of both qi and blood

Asthenia of both qi and blood refers to syndrome caused by simultaneous existence of qi asthenia and blood asthenia. This syndrome is usually caused by asthenia of qi and blood in chronic disease; or by asthenia of the spleen and stomach that affects the production of qi and blood ; or by qi loss of blood followed by depletion of qi; or by qi asthenia followed by blood asthenia.

Clinical manifestations: Lack of qi, no desire to speak, dispiritedness, fatigue, or spontaneous sweating, dizziness, palpitation, pale or sallow complexion, pale lips and nails, pale and tender tongue, thin and weak pulse.

Analysis of symptoms: Lack of qi, no desire to speak, dispiritedness, fatigue or spontaneous sweating are due to hypofunction of viscera due to qi asthenia; pale or sallow complexion as well as pale lips and nails are due to inability of qi and blood asthenia to nourish the body; dizziness, palpitation and insomnia are due to the inability of qi and blood asthenia to nourish the head and heart spirit; pale and tender tongue as well as thin and weak pulse are signs of qi and blood asthenia.

Key points for syndrome differentiation: Hypofunction of the viscera due to qi asthenia and inability to nourish viscera and body due to blood asthenia.

 Qi asthenia and hemorrhagia syndrome

Qi asthenia and hemorrhagia syndrome refers to syndrome caused by failure of asthenic qi to control blood. This syndrome is mainly caused by spleen asthenia due to chronic disease, or by inability of asthenic qi to control blood resulting from overstrain.
 
Clinical manifestations: Hematemesis, hematochezia, or muscular bleeding, or epistaxis, or profuse menstruation, metrorrhagia, accompanied by lack of qi, no desire to speak, lassitude, pale complexion, pale tongue and weak pulse.
 
Analysis of symptoms: Failure of asthenic qi to control blood and extravasation of blood lead to hematemesis, hematochezia, bleeding and metrorrhagia; lack of qi, no desire to speak and lassitude appearing at the same time or in advance of bleeding are due to hypofunction of the viscera resulting from qi asthenia; pale complexion and tongue as well as weak pulse are signs of asthenia of both qi and blood due to bleeding.

Key points for syndrome differentiation: Hypofunction of the viscera and bleeding.

Depletion of qi with bleeding syndrome

Depletion of qi with bleeding refers to syndrome in which qi depletes due to massive bleeding. This syndrome is usually caused by trauma, or by damage of the viscera, or by massive bleeding from uterus or in delivery of child.
 
Clinical manifestations- Massive bleeding accompanied by pale complexion, profuse sweating, cold limbs, weak breath, extreme dispiritedness, even coma, pale tongue, indistinct pulse, or hollow pulse, or scattered pulse.
 
Analysis of symptoms: Blood is the mother of qi, so loss of blood will lead to loss of qi at the same time; pale complexion and cold limbs are due to loss of qi and yang to warm the body; profuse sweating is due to sudden loss of yangqi which weakens the superficies and gives rise to leakage of fluid~ weak breath, extreme dispiritedness and even coma are due to loss of proper nutrition of the spirit resulting from depletion of qi and blood; indistinct pulse or hollow pulse or scattered pulse are due to loss of qi and blood that disperses primordial qi and fails to enrich the vessels; pale tongue is the sign of consumption of qi and blood which fail to nourish the head.

Key points for syndrome differentiation: Massive bleeding and simultaneous loss of qi and blood.

 Qi asthenia and blood stasis syndrome
 
Qi asthenia and blood stasis syndrome refers to syndrome caused by blood stagnation resulting from qi asthenia to transport blood. This syndrome is usually caused by qi asthenia to propel blood in chronic disease and gradual formation of blood stasis due to inhibited flow of blood.

Clinical manifestations: Dispiritedness, lack of qi, no desire to speak, or spontaneous sweating, fixed, unpalpable and stabbing pain over the chest, hypochondrium and other local regions, pale complexion, light purplish tongue or with petechiae, sunken, astringent and weak pulse.

Analysis of symptoms: Dispiritedness, lack of qi, no desire to speak, spontaneous sweating and pale complexion are due to hypofunction of the viscera and tissues; fixed, unpalpable and stabbing pain is due to inhibited flow of blood; light purplish tongue or with petechiae, sunken, astringent and weak pulse conditions are signs of qi asthenia and blood stasis.

Key points for syndrome differentiation: The syndrome is marked by the manifestations of both qi deficiency and stagnant blood circulation.

Qi stagnation and blood stasis syndrome

0i stagnation and blood stasis syndrome refers to syndrome caused by stagnation of qi and stasis of blood. This syndrome is usually caused by emotional upsets, or by invasion of pathogenic cold and stagnation of qi and blood. Qi can promote blood circulation and blood can carry qi. Since qi and blood circulate continuously inside the body, qi stagnation and blood stasis frequently affect each other and often appear at the same time.

Clinical manifestations: Depression or restlessness, distending pain or migratory pain over chest and hypochondrium, or accompanied by mass formation, unpalpable stabbing pain, purplish tongue or with purplish petechiae, taut and astringent pulse, distending pain of breast before or after menstruation, dysmenorrhea, purplish menstruation with blood clot, or amenorrhea, etc.
 
Analysis of symptoms: The symptoms in this syndrome vary due to the location of qi stagnation and blood stasis in different viscera and meridians. Clinically the common manifestations are qi stagnation and blood stasis due to stagnancy of qi activity and failure of liver to disperse and convey because the liver governs dispersion and conveyance and stores blood. Depression or restlessness, distending fullness of the chest and hypochondrium, migratory pain and distending pain of the breast are due to stagnation of liver qi and failure of the liver to disperse and convey; hypochondriac lumps and unpalpable stabbing pain are due to internal retention of blood stasis resulting from prolonged stagnation of qi and inhibited flow of blood; dysmenorrhea, purplish menorrhea with blood clot and even amenorrhea are due to qi stagnation and blood stasis; purplish tongue or with purplish petechiae as well as taut and astringent pulse are signs of qi stagnation and blood stasis.

 

Key points for syndrome differentiation: Stagnancy of qi activity, inhibited blood circulation and blood stasis.


Tags: Blood disorder

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