[Concept]

Blood deficiency syndrome/pattern is a general term for symptoms and signs of systemic weakness caused by insufficient blood in the body and loss of nourishment of limbs and organs. It is mostly caused by overstrain internal damage, excessive thinking, secret consumption of Yin blood; spleen-stomach weakness, insufficient generation and transformation of Qi and blood, or excessive loss of blood. Prolonged illness may also cause late stage [third stage] warm disease.

The main clinical manifestations are: pale or shallow yellow face, pale lips, dizziness, dizzy vision, palpitation, insomnia, numbness in the hands and feet, small amount of menstruation in women, early stage, and even amenorrhea. Symptoms include weak tongue texture and weak and thin pulse.

blood deficiency syndrome/pattern is common in "palpitation", "consumptive disease", "vertigo", "headache", "convulsive disease", "blood syndromes/patterns", "constipation", "fever", "menstrual irregularities" ”, “amenorrhea”, “sterility” and other diseases.

This syndrome should usually be distinguished from "yin deficiency syndrome/pattern" and "blood collapse syndrome/pattern".

[Identification Processing]

Blood deficiency syndrome/pattern can appear in a variety of diseases. Each of its clinical manifestations has certain characteristics and treatment methods are also different, so they must be differentiated.

1. For example, blood deficiency syndrome/pattern is seen in palpitation disease. The clinical manifestations are characterized by palpitation, dizziness, insomnia dreamfulness, pale complexion, lack of strength, light red tongue texture, and thin and weak pulse. This is caused by overthinking, straining the heart and spleen, or due to physical weakness and insufficient Qi and blood, or due to excessive loss of blood and loss of heart function. To treat tonifying blood and nourishing heart, replenishing qi and tranquilizing spirit, use Returning to Spleen Decoction ( Jisheng Fang ) or Prepared Liquorice Decoction ( Shanghan Lun ).
2. If blood deficiency syndrome/pattern is seen in consumptive disease, the clinical manifestations are usually heart and liver. Blood deficiency symptoms:
   1. Heart blood deficiency: palpitation, severe palpitation, amnesia, insomnia Dreamfulness and complexion are characterized by lack of splendor, pale tongue, thready pulse or knotty pulse, mostly caused by insufficient endowment, weak essence and blood, thought that consumes the heart blood, loss of regulation after a serious illness, deficiency of yin and blood, which will not recover for a long time, and accumulation of deficiency Caused by damage. To treat nourishing blood and tranquilizing spirit, use Heart-Nourishing Decoction ( Zhengzhi Zhunsheng ) or Returning to Spleen Decoction ( Furen Liangfang). .
   2. liver blood deficiency: It is characterized by dizziness, dizzy vision, tinnitus, hypochondriac pain, restlessness, menstrual irregularities, amenorrhea, and even scaly skin, complexion, pale tongue texture, and stringy pulse. This is caused by emotions. Stagnation, hidden consumption of liver blood, or excessive loss of blood, loss of regulation after a long period of illness, deficiency of yin and blood, or even blood deficiency, which turns into dryness and does not return for a long time, accumulated deficiency and fatigue. To treat tonifying blood and nourishing liver, use Four Ingredients Decoction ( Taiping Huimin Heji Jufang ) with flavor.
3. If blood deficiency syndrome/pattern is seen in vertigo disease, clinical symptoms of vertigo usually occur or worsen after exertion, with pale face and pale lips and nails. Mental fatigue, lack of strength, shortage of qi and laziness are often seen together. In other words, palpitation insomnia is characterized by symptoms such as chronic illness, deficiency of both heart and spleen, or Rebing consumption of yin blood, blood deficiency, inability to moisten the whole body, and blood failure to supply the brain, or blood deficiency: Yin deficiency, caused by deficiency heat disturbing seven orifices. The treatment should be tonifying qi and nourish blood, and use Returning to Spleen Decoction (Furen Liangfang) with flavor.
4. If blood deficiency syndrome/pattern is seen in headache disease, the clinical manifestations are headache dizziness, dull pain, severe fatigue due to fatigue, palpitation insomnia, mental fatigue lack of strength, loss of appetite, which is caused by long-term illness or loss. It is caused by excessive blood, insufficient middle qi, failure of clear yang to rise, and deficiency of nutrient-blood, which cannot rise to the brain. It is suitable to treat tonifying and nourishing qi and blood, and add flavor with Eight Precious Ingredients Decoction ( Zhengti Leiyao ).
5. If blood deficiency syndrome/pattern occurs in constipation disease, the clinical manifestations include large constipation, lack of strength, complexion, pale lip and tongue color, dizziness, dizzy vision, palpitation, and thin pulse. This is caused by chronic illness, physical weakness due to old age, postpartum hemorrhage, or blood deficiency, loss of moisturizing in the large intestine, or yin deficiency with internal heat due to lack of blood. Use Intestine-Moistening Pill ("Shen Shi Zunsheng Book").
6. If blood deficiency syndrome/pattern is seen in bleeding diseases, the clinical manifestations are epistaxis, gingival hemorrhage, or even epistaxis, complexion, dizziness, palpitation, mental fatigue, lack of strength and other characteristics. This is due to excessive loss of blood, blood deficiency and lack of qi, and failure of qi to control blood, so the bleeding will not stop. The treatment should be tonifying qi and controlling blood, and Ginseng Returning to Spleen Decoction ( Furen Liangfang ) should be used.
7. If blood deficiency syndrome/pattern appears in fever disease, the clinical manifestations will be fever, heavy at night and light in the day, palpitation lack of strength, complexion, pale tongue and thready pulse. It is mostly caused by chronic illness, heart-liver blood deficiency, the spleen not producing blood, or excessive loss of blood. Treatment should be to clear away heat and nourish blood, and use Angelica Blood-Tonifying Decoction ( Lanshi Micang ).

In short, although the symptoms and signs are the same, they have different characteristics in different diseases. Clinical diagnosis and treatment can be based on the characteristics of each disease and syndrome.

blood deficiency syndrome/pattern occurs more often in women. Because menstruation and pregnancy are all based on blood. Its clinical manifestations are delayed menstruation, low menstruation, light color, thin texture, empty pain in the lower abdomen, and even amenorrhea. Diseases such as blood deficiency sterility and habitual abortion may also occur. Blood deficiency syndrome/pattern is also common in elderly and frail people. It is mainly related to the lack of sperm and blood in old age. The clinical manifestations are listlessness, complexion, palpitation insomnia, dizziness, tinnitus, deafness or constipation.

Blood is yin, qi is yang, blood is the mother of qi, and qi is the commander of blood. The two are interdependent and use each other. Qi has the function of warming the muscles and joints, transforming into essence and blood, and controlling the blood; while blood has the functions of carrying yang qi and nourishing the muscles and joints. The two are closely related, so blood deficiency syndrome/pattern is often accompanied by two situations in the evolution of its mechanism of disease:

• First, blood deficiency cannot carry Qi, so the Qi will also be reduced, resulting in Qi. Evidence of blood deficiency. It manifests as complexion, palpitation insomnia, shortage of qi, lack of strength spontaneous sweating, pale and tender tongue, and thin and weak pulse.
• The second is due to long-term chronic loss of blood, or sudden massive loss of blood, empty blood sea and insufficient true yin, leading to blood collapse syndrome/pattern. Symptoms include pale face, dull appearance, dizziness, cold limbs, and empty pulse.

Due to excessive loss of blood and blood collapse, the qi has no attachment, and the qi bursts out, which can also form a syndrome/pattern of qi collapse following bleeding. Symptoms include complexion, pale skin, sweating, cold skin, and even lukewarm limbs. syncope, pulse is fine or weak, etc. Treatment can be based on the theory that "tangible blood cannot grow quickly, and invisible qi must be urgently consolidated." It is advisable to tonifying qi and secure collapse to prevent yang exhaustion.

[Type Evidence Identification]

1. Yin deficiency syndrome/pattern and blood deficiency syndrome/pattern: Both are deficiency syndrome/pattern. Blood belongs to yin, and essence, body fluid and liquid also belong to yin, and "essence and blood from the same source", "fluid and blood from the same source". Yin deficiency syndrome/pattern has a wider range than blood deficiency syndrome/pattern. In terms of disease cause, blood deficiency syndrome/pattern is caused by spleen-stomach weakness, insufficient chemical sources, stagnation of seven emotions, secret consumption of yin blood, long-term illness, and excessive loss of blood. blood deficiency If the head cannot be nourished, the person will feel dizzy; if the face is not nourished, the complexion will be pale or shallow yellow, and the lip color will be pale; if nutrient-blood is insufficient, the heart will not be nourished, then palpitation insomnia will occur; blood deficiency if the tendons and veins are not nourished, the hands and feet will become numb , or even convulsion; if the sea of ​​blood is insufficient and the Chong Ren is empty, there will be menstrual irregularities, or even amenorrhea; if blood deficiency is not present on the tongue, the tongue will appear pale and white; if the pulse is not full. The pulse will be thin and weak. Yin deficiency syndrome/pattern is mostly caused by chronic illness, insufficient yin, Rebing damage to fluid consumption, or excessive sweating, vomiting, or diarrhea. Yin leading deficiency to internal heat, internal disturbance of deficient heat will lead to vexing heat in chest, palms and soles, afternoon tidal fever; deficiency of heat will cause body fluids to leak out, and night sweat will appear; deficiency of body fluids in the body will lead to oral Dry throat, short and red urine; yin deficiency with effulgent fire, a red tongue with little or no coating, and a thready and rapid pulse. In summary, it can be seen that the main difference between blood deficiency syndrome/pattern and yin deficiency syndrome/pattern is that: blood deficiency syndrome/pattern highlights the word "color", that is, complexion, pale lips, pale nails, etc.; while yin deficiency syndrome/pattern highlights the word "color". Pattern lies in the word "heat", that is, feverish feeling in palms and soles, tidal fever, night sweat, etc. This can be used for identification.
2. blood collapse syndrome/pattern and blood deficiency syndrome/pattern: Both belong to the category of blood deficiency in the body. Blood collapse syndrome/pattern is more severe than blood deficiency syndrome/pattern. Blood collapse syndrome/pattern can be a further development of blood deficiency syndrome/pattern, or it can also be caused by sudden massive bleeding. Due to the mutual rooting of yin and yang, the loss of yin can reach yang. If there is too much loss of blood, the qi will lose its attachment, and the blood collapse will also cause the qi to collapse. Therefore, qi collapse following blood loss often occurs after blood collapse. Symptoms include pale complexion, lukewarm limbs, cold spontaneous sweating, weak breath, thin or weak pulse, and even syncope. It is obviously different from blood deficiency syndrome/pattern and is not difficult to distinguish.

[Documentation]

1. "Danxi Yifa‧ palpitation due to fright severe palpitation": "Severe palpitation means blood deficiency, severe palpitation is absent, and blood deficiency means more."
2. Zhengyin Maizhi ‧Volume 1: "The symptoms of blood aspect fever are: quiet during the day and feverish at night, scorched lips, dry mouth, not drinking water, sweating during the night, these are the symptoms of blood aspect fever. The cause of blood aspect fever, or Rebing, there is heat in the blood, or there is a deficiency of yin and blood, or blood deficiency and fire are strong, both of which become blood aspect fever. "
3. Zhengzhi Huibu ‧Tip: "Blood is the match of Qi, the beauty of Qi, and blood is the pride. In metrorrhagia and metrostaxis, postpartum yin exhaustion, the liver family cannot absorb the vitality, causing all the blood to go out of its way. This vertigo is born from blood deficiency. "
4. Zhengzhi Huibu ‧ blood syndromes/patterns": "For blood deficiency, the symptoms include coolness in the morning and heat in the evening, feverish feeling in palms and soles, dry skin, white lips, menstruation before and after. If the pulse is irregular and thin, it should be remedied."