TCM constipation classification and treatment

Nowadays, many people suffer from constipation due to irregular work and rest schedules. However, Chinese medicine believes that constipation is mainly caused by the dysfunction of the large intestine's transmission function, so the key to solving constipation is to improve the large intestine's conduction function. In addition, due to the different causes of constipation, traditional Chinese medicine divides constipation into different types, so patients need to go to the hospital for examination to find out the specific type of constipation before targeted treatment.

The following types of secrets are available:

1. Constipation caused by heat accumulation in the stomach and intestines

Symptoms: dry and hard stools, abdominal distension and pain, flushed face and hot body, dry mouth and bad breath, irritability, short and dark urine, red tongue with dry yellow coating, and slippery and rapid pulse.

Treatment method: Clear heat and relieve stagnation; moisten and promote bowel movements.

Prescription: Ma Zi Ren Pills. The rhubarb, bitter orange, and magnolia bark in the formula clear the bowels and relieve heat, the hemp seed, apricot kernel, and white honey moisten the intestines and promote bowel movements, and the peony nourishes yin and harmonizes the circulation of blood. If body fluids are already damaged, add raw rehmannia, Scrophularia ningpoensis, and Ophiopogon japonicus to nourish yin and produce body fluids; if anger and depression damage the liver, and the patient is easily angered and has red eyes, take Gengyi Pills to clear the liver and promote bowel movements; if the dryness and heat are not severe, or if the patient feels uncomfortable after taking the medicine, take Qinglin Pills to clear the bowels and relieve constipation to avoid further constipation; if the heat is more severe, and the patient has fullness, dryness, and hard masses, use Dachengqi Decoction to expel the stool quickly and preserve yin. In addition, you can also choose Danggui Longhui Pills, Huanglong Decoction, Liangge Powder, etc. based on the syndrome differentiation.

2. Qi stagnation type constipation

Symptoms: Dry and hard stools, or not too dry and hard stools, inability to defecate, or uncomfortable defecation, rumbling in the intestines and loss of gas, bloating and pain in the abdomen, fullness and stuffiness in the chest and flanks, frequent belching, poor appetite, thin and greasy tongue coating, and a wiry pulse.

Treatment method: Regulate Qi and remove stagnation.

Prescription: Liumo Decoction. In the formula, costus root regulates Qi, lindera strychnifolia smoothes Qi, agarwood descends Qi, and rhubarb, areca catechu, and aurantium break up Qi and relieve stagnation. You can add Magnolia officinalis, Cyperus rotundus and Bupleurum chinense to assist in the function of qi. If qi is depressed for a long time and turns into fire, add Scutellaria baicalensis, Gardenia jasminoides, and Gentiana scabra to clear the liver and reduce fire; if there is qi reversal and vomiting, add Pinellia ternata, Inula frutescens, and Magnetite; if the seven emotions are stagnant and the person is depressed and taciturn, add White Peony Root, Bupleurum chinense, and Albizzia julibrissin to relieve depression; if there is a fall or injury, or after abdominal surgery, and constipation, which is due to qi stagnation and blood stasis, add peach kernel, safflower, red peony root and the like to promote blood circulation and remove blood stasis.

3. Yin-cold stagnation type constipation

Symptoms: difficult and dry bowel movements, abdominal pain and cramps, distension and resistance to pressure, pain in the hypochondrium, cold hands and feet, nausea and vomiting, greasy white tongue coating, and tight pulse.

Treatment method: Warm the interior and dispel cold, promote bowel movements and relieve pain.

Prescription: Rhubarb and Aconite Decoction. In the formula, aconite warms the interior and dispels cold, rhubarb eliminates stagnation, and asarum dispels cold and relieves pain. You can add Zhishi, Magnolia officinalis, and costus root to help with the laxative effect, and add dried ginger and fennel to enhance the effect of dispelling cold. If there is colic in the heart and abdomen, lockjaw and sudden fainting due to severe cold accumulation, you can use Sanwu Beiji Pills to expel the cold accumulation.

The following types of secrets are

1. Qi deficiency type constipation

Symptoms: The stool is not dry and hard. Although there is a desire to defecate, the patient is too tired to push and has difficulty in defecation. The patient sweats and is short of breath. He feels weak after defecation, has a pale face and is tired. He is lazy to speak and has a pale tongue with a white coating and a weak pulse.

Treatment method: Replenish Qi and moisten the intestines.

Prescription: Astragalus Decoction. In the formula, astragalus membranaceus replenishes the qi of the spleen and lungs, hemp seed and white honey moisten the intestines and promote bowel movements, and tangerine peel regulates qi. If the qi deficiency is more severe, add ginseng and white atractylodes; if the qi deficiency causes rectal prolapse, use Buzhong Yiqi Yang; if the lung qi is insufficient, add Shengmai San; if the kidney qi is insufficient for a long time, use Dabuyuan Jian.

2. Blood deficiency type constipation

Symptoms: dry and hard stools, dull complexion, palpitations and shortness of breath, insomnia and nightmares, forgetfulness, pale lips, pale tongue with white coating, and thin pulse.

Treatment method: Nourish blood and moisten dryness.

Prescription: Intestinal Runchang Pills. In the formula, angelica and raw rehmannia nourish yin and blood, hemp seed and peach kernel moisten and facilitate bowel movements, and Citrus aurantium guides qi downward. You can add Scrophularia, Polygonum multiflorum, and Lycium barbarum to nourish blood and moisten intestines. If there is blood deficiency and internal heat, add Anemarrhena asphodeloides, Coptis chinensis, etc. to clear the heat; if the yin blood has recovered but the stool is still dry, Wuren Pills can be used to lubricate the intestines.

3. Yin deficiency type constipation

Symptoms: dry and hard stools like sheep dung, weight loss, dizziness, tinnitus, red cheekbones, restlessness and insomnia, hot flashes and night sweats, sore waist and knees, red tongue with little coating, and weak pulse.

Treatment method: Nourish yin and promote bowel movements.

Prescription: Zengye Decoction. The Scrophularia, Ophiopogon and Rehmannia in the formula nourish yin and produce body fluid. You can add peony, polygonatum, and dendrobium to help nourish yin, and add hemp seed, cypress seed, and trichosanthes seed to enhance the effect of moistening the intestines. If the stomach yin is insufficient and the patient has dry mouth and thirst, Yiwei Decoction can be used; if the kidney yin is insufficient and the patient has soreness and weakness in the waist and knees, Liuwei Dihuang Pills can be used; if the yin is deficient and dryness is severe, and excessive heat damages the body fluid, Zengye Chengqi Decoction can be used to increase water content and relieve constipation.

4. Yang deficiency type constipation

Symptoms: Dry or not dry stool, difficult to pass, clear and long urine, pale complexion, cold limbs, cold pain in the abdomen, relieved by heat, cold pain in the waist and knees, pale tongue with white coating, and slow pulse.

Treatment method: Warming Yang and promoting bowel movements.

Prescription: Jichuan Decoction. In the formula, Cistanche and Achyranthes bidentata warm and nourish the kidney yang, moisten the intestines and promote bowel movements; Angelica sinensis nourishes blood and moistens the intestines; Cimicifuga heracleifolia and Alisma orientalis raise the clear and lower the turbid; and Citrus aurantium relaxes the intestines and relieves gas. If the elderly suffer from cold and constipation, Banliu Pills can be used; if the spleen yang is insufficient and there is cold accumulation of yin and cold, Wenpi Decoction can be used; if the kidney yang is insufficient, Shenqi Pills can be used. You can also choose Lizhong Pills, Sishen Pills, Yougui Pills, etc. according to syndrome differentiation.