[Concept]

Syndrome/pattern of yin deficiency and yang hyperactivity refers to the deficiency of yin fluid, the restriction of yang and excessive hyperactivity, with dizzy vision, tidal fever night sweat, headache tinnitus, dysphoria insomnia; red tongue, less fluid, thready and rapid pulse as the main clinical symptoms. Symptom and sign are mostly caused by old age and physical weakness, prolonged external contraction of heat, chronic illness, emotional imbalance, sexual indiscretion, etc.

The main clinical manifestations are: insomnia, flushing of cheekbones, dry mouth and throat, dizziness, dizzy vision, tinnitus deafness, tidal fever night sweat, red tongue texture, thready and rapid pulse, etc.

Syndrome/pattern of yin deficiency and yang hyperactivity is commonly seen in diseases such as "insomnia", "vertigo", "headache", "apoplexy", and "tinn itus deafness".

This syndrome should usually be distinguished from "syndrome/pattern of yin deficiency and internal heat", "liver yin deficiency syndrome/pattern", and "syndrome/pattern of yin deficiency and wind stirring".

[Identification Processing]

Syndrome/pattern of yin deficiency and yang hyperactivity The clinical manifestations of different diseases have certain characteristics, and the treatments are also different, so they must be differentiated and analyzed.

• If this syndrome can be seen in insomnia, on the one hand, there are many factors such as physical weakness, uncontrolled sexual desire, or chronic illness, kidney yin is consumed and injured, the upper body cannot be worshiped in the heart, water and fire are not effective, and the heart yang is alone. Hyperactivity, as stated in Jingyue Quanshu ‧ insomnia": "The true yin menstrual blood is insufficient, the yin-yang does not communicate, and the spirit is uneasy and its chamber ears." On the other hand, due to emotional injuries, the liver Failing to act freely, depression turns into fire, internal consumption of essence and blood, yin deficiency with yang hyperactivity, disturbs the mind, and causes insomnia. The pathological changes are generally yin deficiency with yang hyperactivity, yin-yang loss of communication, symptoms such as insomnia, palpitation, restlessness, dizziness, tinnitus, vexing heat in chest, palms and soles, night sweat, red cheeks, dry mouth and desire to drink, and backache. amnesia, red tongue, thready pulse; the treatment is suitable for nourishing yin and reducing fire, nourishing heart and tranquilizing mind. Use Coptis and Ass Hide Glue Decoction (Waitai Miyao) and Cinnabar Spirit-Tranquilizing Pill (Neiwaishang Bianhuo Lun).
• In vertigo disease, there are two reasons for yin deficiency with yang hyperactivity. One is kidney yin deficiency, water failing to nourish wood, and liver failure to nourish, resulting in liver yin deficiency and ascendant hyperactivity of liver yang. Vertigo; First, the emotions are depressed for a long time, and the depression turns into fire, causing the liver yin to be consumed, the wind and the sun to rise, disturbing the seven orifices, and it becomes vertigo. Symptoms include vertigo tinn itus, headache and bloating, aggravated by fatigue or irritation, tidal fever, irritability, bitter taste in mouth, dry throat, insomnia dreamfulness, red tongue texture, yellow fur and stringy pulse. Treatment is suitable for nourishing yin and For subduing yang, nourishing liver and kidney, use Major Yin-Tonifying Pill (Danxi Xinfa).
• For example, in headache disease, the syndrome/pattern of yin deficiency and yang hyperactivity is mostly seen due to insufficient innate endowment, long-term loss of kidney essence, or indulgence in sex, old age, and decreased essence and blood after the disease, resulting in consumption and injury. Liver kidney essence blood is caused by yin not controlling yang. Symptoms include head swelling and pain, dizzy vision, irritability, feverish feeling in palms and soles, soreness and weakness in the waist and knees, dry and astringent eyes, seminal emission, red tongue, thin and weak pulse. The treatment is suitable for nourishing the kidneys and reducing fire. Anemarrhena, Phelloendron and Rehmannia Pill ( Yifangkao ).
• If this syndrome is seen in apoplexy, the body is yin deficient due to multiple factors, water failing to nourish wood, and due to emotional injuries, the liver yang is violently expanded, yin is deficient at the bottom, yang is hyperactive at the top, and yang transforms into wind. , bleeding following qi counterflow, carrying phlegm and fire, running through the tunnel, blinding seven orifices, and forming upper excess and lower deficiency, yin-yang critical symptom and sign that are not maintained with each other, the symptoms are dizziness, tinn itus, insomnia dreamfulness. , sudden onset of headache, worsening dizziness, squinting mouth and eyes, strong tongue, heavy stagnation of hands and feet, or even hemiplegia, red tongue texture, greasy coating, thready pulse, suitable treatment is nourishing yin and subduing yang, extinguishing wind. Network, use Liver-Settling Wind-Extinguishing Decoction ( Yixue Zhongzhong Canxilu ).
• For example, in the tinnitus deafness disease, the syndrome/pattern of yin deficiency and yang hyperactivity is seen. Most of the patients are old and frail, with decreased essence and blood after the disease, or excessive indulgence, which damages the liver kidney essence blood. For example, Yixue Xinwu, Er Yun said: "The ear is outside the kidney." Zhongcang Jing said: The kidney is the home of the spirit, the root of life, and is connected externally to the ear. The gallbladder meridian of foot Shaoyang is connected to the ear. "It also says: "If you suffer from deafness for a long time, it is kidney deficiency. The essential qi is insufficient and cannot go up to the ear. It is appropriate to use Six-Ingredient Rehmannia Pill plus Barbary Wolfberry Fruit, Ginseng, Acorus, Milkwort Root and the like. "It can be seen that when the kidney essence is full, the ears are deaf, when the kidney essence is depleted, the marrow sea is empty and cannot moisten seven orifices, and when the fire without roots rises, it causes tinnitus deafness. Symptoms include tinnitus or deafness, dizziness, dizzy vision, red cheeks, dry mouth, feverish feeling in palms and soles, soreness and weakness in waist and knees, seminal emission, spontaneous seminal emission, red tongue, thready and weak pulse, or weak and large ulnar pulse. Treatment is to nourish the kidneys and lower the blood pressure. Fire, collect essential qi, use Zuoci's Deafness Pill (Xiao'er Yaozheng Zhijue). This prescription is based on Liuwei Rehmannia Decoction, which means "to strengthen the master of water to control sunlight".

syndrome/pattern of yin deficiency and yang hyperactivity Although the clinical manifestations of different diseases have similarities, they also have their own distinctive clinical characteristics.

This syndrome is mostly seen in those with yin deficiency, old age and physical weakness, excessive drinking and sexual intercourse, women before and after menopause, or long-term depression and anger, when yin essence is exhausted and yin does not control yang. The elderly often suffer from tinnitus, deaf ness, soreness in the waist and legs, apoplexy, heel pain, etc.; young people suffer from deficiency of essence, frenetic stirring of ministerial fire, which manifests as semen discharge due to color, which means it is easy to excite yang, and it is easy to see yang. Discharge of semen, irritability and lack of sleep, impatience and irritability; women are about to die, kidney qi is gradually declining, blood sea is gradually drying up, Chong Ren is exhausted, symptoms include disordered menstruation, sometimes backward movement, and scanty menstruation. Symptoms include amenorrhea, irritability, bloated eyes and dizziness, spontaneous night sweat, tinnitus deafness, dry eyes, flushed face and vexing heat in chest, palms and soles.

Yin deficiency with yang hyperactivity will not be cured after long-term treatment, and it is easy to cause Yang to rise and wind to move, and Qi and blood to reverse, often with the evil of wind, fire, phlegm, and heat, leading to seven orifices, developing into a syndrome/pattern of obstruction, that is, Suwen-Tiaojing Lun said: "When blood and Qi go together, it is a major syncope." It manifests as sudden fainting, unconsciousness, body heat, face red, lockjaw in hand, thick breath, fetid mouth Odor, constipation disease, with yellow and greasy coating and stringy pulse, should be treated with nourishing yin and subduing yang. Use antelope horn decoction (Yichun Shengyi) combined with Peaceful Palace Bovine Bezoar Pill (Wenbing Tiaobian I> ). If the yin fluid is depleted for a long time, or if it is not treated incorrectly, the yang floats above and the yin is exhausted below, there is a tendency of yin-yang separation, yang qi is the sign of collapse, and it develops into a syndrome/pattern of collapse, and the symptoms appear suddenly. Fainting, unconscious, mouth open and eyes closed, snoring, tongue atrophy, loose stools after hands are withdrawn, profuse sweating, cold limbs, weak pulse, the appropriate treatment is tonifying qi restoring yang, to save the yin and solid prolapse, use Ginseng and Aconite Decoction ( Furen Liangfang ) combined with Pulse-Reinforcing Powder ( Neiwaishang Bianhuo Lun ).

[Type Evidence Identification]

syndrome/pattern of yin deficiency and internal heat and syndrome/pattern of yin deficiency and yang hyperactivity: Both are symptoms of deficiency of yin fluid and failure of yin to control yang, but one is mainly caused by internal heat deficiency,... it is caused by hyperactivity of yang The main thing is above. In terms of disease cause, yin deficiency with internal heat is mostly due to insufficient congenital endowment, excessive alcohol and cheese the day after tomorrow, or serious illness and long-term illness that cannot be treated, or mistreatment, which causes damage to yin liquid, water does not control fire, and fever occurs. Syndrome/pattern of yin deficiency and yang hyperactivity. In addition to the damage to yin described in syndrome/pattern of yin deficiency and internal heat, the disease cause is also caused by emotional disorders such as anger, thinking, and melancholy, and the depletion of yin fluid. Yin does not control yang, resulting in yin deficiency with yang hyperactivity. In terms of clinical manifestations, the syndrome/pattern of yin deficiency and internal heat often includes low-grade fever that is difficult to recede, dry mouth, flushing, vexing heat in chest, palms and soles, short yellow urine, dry and hard stools, etc. In the case of internal heat deficiency, low-grade fever, and fever in the afternoon. It is characterized by intensification at night. The syndrome/pattern of yin deficiency and yang hyperactivity includes dizziness, dizziness, tinnitus, deafness, insomnia, etc. The main symptoms are yang hyperactivity. In terms of treatment, enriching yin and clearing heat are suitable for one treatment, nourishing yin and subduing yang are suitable for another treatment. Although the two have many similarities in terms of disease cause mechanism of disease, clinical manifestations, and treatment principles and methods, they each have unique characteristics and are not difficult to distinguish clinically.

liver yin deficiency syndrome/pattern and syndrome/pattern of yin deficiency and yang hyperactivity: Both syndromes have yin deficiency, and their clinical manifestations are quite similar, including vertigo, headache, tinnitus, dry mouth and throat, and cheekbones. Red eyes, vexing heat in chest, palms and soles, tidal fever night sweat, insomnia dreamfulness, upset and irritable, red tongue with less coating, thready and rapid pulse. In terms of disease, the syndrome/pattern of yin deficiency and yang hyperactivity is mostly caused by weak endowment, excessive indulgence, loss of blood damage to yin, or internal damage to emotions, depletion of essence and blood, and yin does not control yang; Liver yin deficiency syndrome/pattern often develops from liver blood deficiency syndrome/pattern, or it may be caused by depression and fire, or the dark consumption of liver yin. The liver governs tendons, resuscitation is in the eyes, its flowers are in the claws, and the meridians are distributed in the fat. If liver yin is insufficient, it cannot nourish the tendons, pulses, claws, nails, eyes, orifices, such as Jingui Yi ‧The general theory of rib pain: "liver deficiency" "Liver yin deficiency means that the pulse is short and urgent, and the liver veins pass through the diaphragm and run through the ribs. If yin deficiency causes blood dryness, Jingmai will suffer from malnutrition." Therefore, the claws and nails are not prosperous. Photophobia, dry eyes, night blindness, hypochondriac pain, etc. The location of disease is in the liver, which is different from yin deficiency with yang hyperactivity. Liver and kidney come from the same source. When liver-kidney yin deficiency develops over time, their lesions often interact with each other. This syndrome can also be caused by liver-kidney yin deficiency, water failing to nourish wood, and liver yang rising and excessive. Causes ascendant hyperactivity of liver yang, or uncontrolled rise of liver yang, depletion of essence and blood, and loss of nourishment of tendons and veins, then wind arises from within and develops into internal stirring of liver wind.

syndrome/pattern of yin deficiency and wind stirring and syndrome/pattern of yin deficiency and yang hyperactivity: Although both syndromes have the manifestation of yin deficiency, the disease cause and clinical manifestations are different, syndrome/pattern of yin Deficiency and wind stirring refers to the symptoms and signs of warm disease, heat evil damage to yin, loss of nourishment of muscles and veins, and internal movement of wind due to deficiency. In addition to the symptoms of yin deficiency, it also manifests in dry wrinkles on the skin, scorched lips, wriggling of limbs, Or even palpitation, severe palpitation, mental fatigue, blindness in the eyes, constant desire to take off the tongue, a crimson tongue with less coating, and a weak or thready pulse. Wenbing Tiaobian ‧ lower energizer chapter" said: "The heat evil has been restrained for a long time, sucking and burning the true yin, either due to misexpression, or due to reckless attack, tiredness and convulsion, the vessel qi is weak, the tongue is red and has less coating, "Major Wind-Stabilizing Pearl syndrome/pattern of yin deficiency and wind stirring is the most severe form of yin fluid injury if you want to take it off from time to time, especially if it develops from syndrome/pattern of yin deficiency and yang hyperactivity." Difficult to distinguish.

[Documentation]

• Jingui Yaolue ‧ blood impediment consumptive disease disease": "consumptive disease is caused by fatigue and insomnia, sour Jujube Decoction dominates."
• Jingyue Quanshu ‧ insomnia》: "The true yin essence and blood are insufficient, the yin-yang does not communicate, and the spirit is restless." It ranks in the eighth and ninth, and those with both fire and phlegm are only one or two out of ten." Injury, or excessive drinking and sex, first damages the true yin of the five zang-organs,...yin-essence impairment as prodrome face yang loss in the back, yin-fluid exhaustion in the lower and yang qi insufficiency in the upper, so that yin-yang phase loss , essential qi did not pay, so he suddenly fainted and suddenly fell down."
• Linzheng Zhinan Yi'an ‧‧ Vertigo Gate": "The Sutra says: All wind with vertigo and shaking is ascribed to the liver. The head is the head of all Yangs, and the ears, eyes, mouth and nose are all clear The orifices suffering from vertigo are not external evils, but the wind and yang of the liver and gallbladder, and there is a risk of falling down. "Linzheng Zhinan Yi'an ‧ apoplexy": "Ye's invention today." Internal wind is the change of yang qi in the body. The liver is the wind organ. Due to the depletion of essence and blood, water failing to nourish wood, the wood is less nourishing, so the liver yang is overactive. When internal wind arises, the treatment is to nourish the liquid by extinguishing wind. , nourishing the collaterals, tonifying yin subduing yang."
• "Medicine: Vertigo": "The kidney is the mother of the liver, and the kidney stores essence. Deficiency of essence means empty mind and heaviness of head. Therefore, Neijing refers to kidney deficiency and insufficient marrow sea. The theory is consistent. He talks about the root cause of the disease and the symptoms of the disease. "
• Yixue Xinwu ‧Ear: "Ear refers to symptoms outside the kidney, Zhongcang. Jing said: The kidney is the home of the spirit and the root of life. It connects externally to the ear, and the foot Shaoyang gallbladder meridian is connected to the ear. If it cannot reach the ears, it is better to use Six-Ingredient Rehmannia Pill plus Barbary Wolfberry Fruit, Ginseng, Acorus, Milkwort Root, etc."