Don't neglect the special decocting method, hard herbs need to be broken and decocting first

Mr Zhu has a stomachache and abdominal distention recently He is also nauseous, vomiting and acid To see Chinese medicine in the outpatient department, the doctor applied the decoction of adding and subtracting Xuan Fu Dai zhe after syndrome differentiation, and asked him to decoct the price of replacing ochre for 30 minutes first, and decoct the price of Xuan Fu flower with gauze package After going home, Mr Zhu forgot to explain He fried all the traditional Chinese medicine for 30 minutes After pouring it out and taking it, he felt sick and vomited more seriously He coughed and itched He was afraid that the medicine was not right and went back to the doctor for consultation After checking and rechecking, the doctor asked the cause in detail and found that he didn't fry or package the medicine according to the doctor's instructions Li Gongying, a Chinese pharmacist and deputy director of the First Affiliated Hospital of Guangzhou University of traditional Chinese medicine, cautioned that some special Decoction methods given by doctors should not be ignored when making medicine, otherwise the efficacy would be damaged For example, the price of substitute ochre in Mr Zhu's prescription is hard, so it's hard to boil the effective ingredients without first frying, and the effect of reducing Qi and suppressing adverse reactions is broken; the Flos Rotundae that should be fried is covered with Tricholoma, and it's easy to suspend in the solution without frying Tricholoma, stimulate the digestive tract, cough and itch easily, and even aggravate nausea and vomiting According to Li Gongying, deputy director of Xianlie Dongmen clinic, the First Affiliated Hospital of Guangzhou University of traditional Chinese medicine, the improper Decoction of traditional Chinese medicine impairs the curative effect "Clinical observation shows that the correct decoction is directly related to the curative effect of traditional Chinese medicine." Li Gongying said that famous doctors and pharmacists of all ages in China attach great importance to the decoction of traditional Chinese medicine Li Shizhen, a great pharmacist in Ming Dynasty, said: "although the medicine in decoction is refined and the treatment is like the law, the decoction of the medicine is reckless and reckless, and the water and fire are not good, and the temperature is not high, then the medicine has no effect." How to correctly master the decocting method and use the special decocting method? Li Gongying believes that this requires "division of labor and cooperation" between medical staff and patients For example, clinicians should make "footnotes" or instructions to the traditional Chinese medicine or prescription that needs special Decoction according to the requirements of the texture, composition and efficacy of traditional Chinese medicine; pharmacists should package the traditional Chinese medicine that needs special Decoction according to the prescription requirements and inform the patients of the decoction method; the patients should correctly carry out the decoction operation according to the doctor's orders, and some Decoction prescriptions with special requirements More attention should be paid to the method It's better to fry it first, then fry it, then fry it, then fry it It's better to fry it, then close it "Only when they cooperate with each other, use medicine according to syndrome differentiation, and the patient cooks the medicine correctly, can the traditional Chinese medicine achieve good curative effect." Li Gongying stressed that although doctors can use drugs dialectically, they often fail to achieve the expected effect due to improper Decoction methods, and even have problems similar to those encountered by Mr Zhu, with adverse consequences Expert advice: the personalized treatment of various drugs should be based on Li Gongying's introduction The special decoction method of traditional Chinese medicine refers to the decoction method operated according to the special operation procedure These methods are a set of effective special decocting methods summarized in the long-term practice in order to give full play to the curative effect of traditional Chinese medicine Most of the traditional Chinese medicine in clinical application can be decocted at the same time, but some of them need different decocting time because of their different properties, performance and clinical use, and even the same traditional Chinese medicine has different performance and clinical application because of different decocting time "Therefore, it is necessary to understand and correctly operate the special Decoction methods of traditional Chinese medicine." Li Gongying introduces several common special Decoction methods of traditional Chinese medicine as follows: 1 Decoct first: add 400-500ml of water to the traditional Chinese medicine to be decocted first, boil it in a gentle fire for 20-30 minutes, and then reserve it; meanwhile, soak other Chinese medicine that can be decocted together for 20-30 minutes in a conventional water (reduce the amount of water as appropriate), and then mix it with the medicine residue liquid that was decocted first to continue decocting according to the conventional decocting method The traditional Chinese medicine that needs to be broken and fried first is roughly as follows: raw gypsum price, cold water stone price, magnetite price, substitute ochre price, white quartz price, purple quartz price, raw keel price, clam shell, raw stone Cassia price, corrugator, tortoise shell price, turtle shell price, Dragon tooth price, antler price, buffalo horn price and other minerals, shells, bones, nails, horns and hard and effective ingredients Traditional Chinese medicine that can be easily decocted In addition, there are the price of Aconitum, Shanglu, shengnanxing, shengbanxia and other toxic traditional Chinese medicine, long-term decoction can alleviate the toxicity It takes longer to fry first Reminder: when the hard material is broken and fried, the heat can be larger 2 Next step: put the Chinese medicine that needs to be next step aside, soak other Chinese medicine that can be co fried in water for 20-30 minutes according to the routine, then boil it in a gentle fire for another 20-30 minutes, and add the Chinese medicine that needs to be next step into the decoction for 5-10 minutes before the end of the decoction After the demand, the traditional Chinese medicine has the price of mint, Amomum, nutmeg, aloe, cinnamon and guangmuxiang In addition, there are Uncaria price, rhubarb price, senna leaf price, xuchangqing price and other traditional Chinese medicine that can not be fried for a long time Reminder: when adding the medicine, it should be fully stirred to ensure that the next Chinese medicine and other Chinese medicine are fully mixed 3 Bao Jian: wrap the traditional Chinese medicine to be Bao Jian in a clean gauze bag, soak it in water for 20-30 minutes with other traditional Chinese medicine that can be co fried, and then boil it in a gentle fire for another 20-30 minutes The traditional Chinese medicine that needs to be decocted roughly includes the price of lepidia seed, plantain seed, silkworm sand, convoluted covering flower, talcum powder, Liuyi powder, indigo naturalis price, Mabo price, raw Puhuang price and so on, which contain mucilaginous, fluffy and body floating easily Caution: it is not suitable to pack Chinese medicine too tightly in gauze bags 4 Additional Decoction: as the name implies, it is different from other traditional Chinese medicine mixed decoction, that is to say, the traditional Chinese medicine in the formula that needs to be further decoction is decocted for 1-2 hours according to the conventional decoction method, and the dregs are removed to take the juice and the co Decoction liquid can be taken The traditional Chinese medicine that needs to be fried separately includes ginseng, American ginseng, antler, bird's nest, tremella and other valuable drugs 5 Closing: put the traditional Chinese medicine to be closed for standby Take other Chinese medicine that can be decocted together and soak it in water for 20-30 minutes according to the routine, then boil it in a gentle fire for another 20-30 minutes, remove the dregs and take the medicine solution, add the Chinese medicine that needs to be closed, stir and dissolve it into a liquid dosage form, and heat and steam it if necessary The traditional Chinese medicine that needs to be closed up includes: donkey hide gelatin price, tortoise shell price glue, antler price glue, loquat leaf price paste, etc Note that when closing the "glue" traditional Chinese medicine, the traditional Chinese medicine that needs to be decocted together in the prescription shall be boiled well, then the liquid medicine shall be poured out, the clear liquid medicine shall be poured or filtered to obtain the clear liquid medicine, and then it shall be used for closing; if heating is needed, it is better to "stew in water" and stir continuously 6 Decocting soup instead of water: that is, decocting a dose of medicine twice In general, the traditional Chinese medicine with large volume and large water absorption capacity, such as the price of loofah complex, zaoxintu, the price of Lysimachia, the price of glutinous rice root, etc., is first decocted according to the conventional method After the dregs of the medicine juice are removed, the other part of other traditional Chinese medicine will be decocted with these solutions 7 Preparation: for precious Chinese medicine or Chinese medicine whose ingredients are easy to be destroyed, powder preparation is suitable Such as antelope horn powder, rhinoceros horn powder, buffalo horn price powder, pearl price powder, aloe price powder, etc Pay attention to this kind of traditional Chinese medicine, it is advisable to grind it into fine powder, the finer the absorption effect is, the better In principle, the traditional Chinese medicine powder used for preparation should pass at least 80 mesh sieve Experts suggest: it's best to choose the traditional method to cook medicine At present, many hospitals or pharmacies carry out the traditional Chinese medicine decocting service, which really provides a lot of convenience for the citizens who have no time to decocting medicine, have no decocting equipment, do not understand decocting medicine or the patients who need to carry traditional Chinese medicine on business But Li Gongying pointed out that the process production of decocting machine could not meet the requirements of individual decocting such as first decocting, then lower, etc., and could not meet the requirements of "first boil with fire (big fire) and then close it to light fire (small fire)", so it was difficult to achieve individual decocting Li Gongying suggested that patients should choose the traditional method of boiling medicine, especially for those who have special requirements for decoction of traditional Chinese medicine, they should also treat according to the special decoction method.