[Concept]

kidney yang deficiency is also called life gate fire deficiency. This syndrome is a general term for the clinical manifestations of insufficient Yuanyang, failure in qi transformation, dereliction of warmth, excess of water and dampness, and weakness of sexual function. It is mostly caused by overwork, renal insufficiency in old age or chronic illness.

The main clinical manifestations are: fear of cold, complexion, soreness and coldness in the waist and knees, long and clear urine or enuresis, edema especially below the waist, impotence, spontaneous seminal emission, leukorrhea in women, cold sterility in the palace, and pale tongue. White coating, thin or late pulse.

kidney-yang deficiency syndrome/pattern is commonly seen in "consumptive disease", "impotence", "ischuria", "edema", "diarrhea", "leukorrhea", "asthma" and other diseases.

This syndrome should usually be combined with "kidney qi deficiency syndrome/pattern", "syndrome/pattern of dual deficiency of kidney yin and yang", "spleen-kidney yang deficiency syndrome/pattern", "syndrome/pattern of heart-kidney" "yang deficiency" phase identification.

[Identification Processing]

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

1. If chronic diarrhea develops kidney-yang deficiency syndrome/pattern, it will often show the characteristics of "diarrhoea before dawn" such as pain around the umbilicus before dawn, bowel sounds, pain relief after diarrhea, fear of cold in the limbs, etc. , this is caused by insufficient kidney yang, fire failing to generate earth, and poor spleen transportation. Zhang Jing-yue said: "If the yang qi in the kidney is insufficient, the life gate fire will be weak, and when the pudendal coldness is extremely strong, the People with through-flux diarrhea should treat it by warming the kidneys and strengthening the spleen, and use Four Miracle Pill ( Furen Liangfang ).
2. If kidney-yang deficiency syndrome/pattern appears in disease with edema, its clinical manifestations are edema all over the body, especially below the waist, with indentation when pressed, oliguria, soreness in the limbs, cold limbs, tongue It is characterized by "yin edema syndrome" such as tooth marks on the fat side. This is caused by weak kidney yang, poor opening and closing, abnormal bladder qi transformation, and water retention, resulting in overflow. Yu Jia-yan said: "kidney edema" When qi comes from yin, the door will close, and when the yin is too strong, the door will often close, and the water will not flow, causing swelling. "The treatment should be to warm the kidney, transforming qi and draining water, and use True Warrior Decoction ("Disease Caused by Cold"). 》).
3. If kidney-yang deficiency syndrome/pattern is seen in ischuria disease, it is often characterized by blocked urination or dripping, weak excretion, and soreness and coldness in the waist and knees. It is often caused by insufficient kidney yang and a decline in life gate fire. "Without yang, then "Yin cannot be transformed", bladder qi transformation is caused by dereliction of duty, the treatment should be to warm the kidney tonifying qi, tonify the kidney and relieving stuffy orifices, and use Life-Relieving Kidney Qi Pill ( Jisheng Fang ).
4. If kidney-yang deficiency syndrome/pattern is seen in impotence, it is characterized by male sexuality not being able to lift, or being unable to lift firmly, spontaneous seminal emission, listlessness, and soreness of waist and knees. This is mostly caused by indulgence in sexual desire, kidney essence Loss of life gate fire, caused by deficiency and cold of essential qi, should be treated with warming and tonifying kidney yang, and Jinyue Quanshu (Jingyue Quanshu) should be used.
5. If kidney-yang deficiency syndrome/pattern is seen in consumptive disease, it may manifest as aversion to cold, diarrhea, long and abundant urine, pain in the waist and spine, seminal emission, impotence and other symptoms. The cause is It is caused by long-term illness, accumulation of deficiency, the gradual decline of true yang, and the inability to warm zang-fu organs. The treatment is suitable for warming and tonifying life gates and nourishing essence and blood. Right-Restoring Pill ( Jingyue Quanshu ) and Tortoise Shell and Deer Horn Two-Divine-Ingredient Glue ("Lantai Standard").
6. If kidney-yang deficiency syndrome/pattern appears in ASTHMA, the clinical manifestations are qi deficiency panting, more breathing and less breathing, severe wheezing when moving, cold limbs, blue face, pale tongue, weak and floating pulse, etc. "failure of kidney to receive qi" " is characterized by kidney being root of qi, asthma, kidney qi loss over time, lower qi is not solid, and the qi is not absorbed. Zhengzhi Zhunsheng said: "The real qi is depleted, and the asthma arises. Kidney qi is on the rise. "It is advisable to arm kidney to improve qi reception. Use Ginseng and Walnut Decoction ( Jisheng Fang ) or Kidney Qi Pill ( Jingui Yaolue ).

In short, although the symptoms and signs are the same, the symptoms of different diseases have their own characteristics, and clinical analysis can be based on the characteristics of the above diseases and syndromes.

Also, kidney-yang deficiency syndrome/pattern is more common in the elderly and infirm. Due to the gradual decline of yang in old age, it is common to feel depressed, complexion, shortness of breath when moving, soreness and weakness in the waist and knees, and fear of cold. , symptoms such as excessive nocturia or residual discharge; in women with kidney-yang deficiency syndrome/pattern, the main symptoms include continuous and clear leukorrhea, menstrual bleeding or amenorrhea, and uterine cold sterility. This means that it varies from person to person, and treatment should be "treatment in accordance with individuality."

kidney being innate foundation contains the true fire (true yang) of the life gate, so the five zang-organs and various yangs in the human body all rely on the primary yang in the kidney to grow hair. When the disease develops into the kidney yang deficiency stage, it often indicates a serious condition. . In the evolution of the mechanism of disease, two situations are often seen:

• First, due to the weakening of the yang in the kidney, the yang qi is unlucky, the qi transformation is lost, and the opening and closing are unfavorable, resulting in water-dampness, phlegm, and turbidity. Static blood and other yin pathogens are retained, resulting in complexion, dullness, mental depression, and even mental confusion, vertigo, nausea, oliguria or anuria, general edema, tongue texture, dullness with blue and other turbid yin. Syndrome;
• The second is due to kidney deficiency, direct attack due to external evil, or excessive sweating, or the disease has been long-term and the yang is gradually scorpion, the yang is slightly exuberant, on the verge of divorce, great dripping sweating, and clear sweating. Thin and cold, fear of cold, crouching down, lukewarm limbs, mental confusion, weak pulse, etc. are signs of yang qi wanting to escape. When the disease reaches this point, it is advisable to save the dying yang. If you save yang qi, you will have a chance of life.

[Type Evidence Identification]

1. kidney qi deficiency syndrome/pattern and kidney-yang deficiency syndrome/pattern: Qi belongs to Yang, kidney qi deficiency syndrome/pattern belongs to the category of kidney-yang deficiency syndrome/pattern, and the disease cause mechanism of the two syndromes disease and clinical manifestations are very similar, but there are certain differences. The concept of kidney yang is broader than kidney qi, kidney-yang deficiency syndrome/pattern can include kidney qi deficiency syndrome/pattern, and kidney-yang deficiency syndrome/pattern can be a further development of kidney qi deficiency syndrome/pattern. In terms of disease cause, kidney-yang deficiency syndrome/pattern may be due to weak endowment and body yang deficiency; long-term illness may affect kidney yang; or excessive housework and loss of lower yang; or old age and physical weakness, insufficient yang Caused by. Yang deficiency means that the limbs cannot be warmed, so fear of cold means cold limbs; the waist is the home of the kidneys, and kidney Yang deficiency means the waist and knees are sore and cold; the kidneys store essence, and the yang is insufficient, essential qi is not solid, and impotence is seen. spontaneous seminal emission , women's leukorrhea is cold, and the palace is cold and sterile; the kidney governs water and controls the bowel movements. Yang deficiency causes difficulty in opening and closing, and failure in qi transformation. Water and dampness linger and cause edema; the ulnar pulse belongs to the kidney, so the ulnar pulse is thin or slow. Kidney qi deficiency syndrome/pattern can also be caused by congenital deficiencies, overstrain, long-term illness and kidney disease, but the disease has not yet reached the stage of damage to yang. The clinical manifestations include dizziness, tinnitus, hearing loss, soreness of waist and knees, nocturnal polyuria, spontaneous The main symptoms are seminal emission, premature ejaculation and thin and weak pulse. In addition to the above symptoms, kidney yang deficiency also has symptoms such as complexion, fear of cold, male sexuality, leukorrhea, edema of the lower limbs, white coating, slow pulse, etc. People with yang deficiency will see signs of cold, while people with qi deficiency will not have signs of cold, so this can be used to identify them.
2. syndrome/pattern of dual deficiency of kidney yin and yang and kidney-yang deficiency syndrome/pattern: According to the theory of mutual rooting of yin and yang, yin impairment affecting yang, yang impairment affecting yin. syndrome/pattern of dual deficiency of kidney yin and yang and kidney-yang deficiency syndrome/pattern are both related and different in mechanism of disease. The former can develop from kidney-yang deficiency syndrome/pattern or evolve from kidney-yin deficiency syndrome/pattern. If kidney yang is already deficient and cannot be treated, the yang will be damaged and the yin will not be able to transform, or if you take the crystals of warming kidney and assisting yang, which will cause warmth and shimmering yin, or if you feel heat evil, the kidney yin will be burned, resulting in kidney yin. Deficiency of both yang; or kidney yin is deficient first, and yang cannot be generated; it may also develop into a syndrome of kidney yin deficiency and yang deficiency. Clinical manifestations include fear of cold and feverish feeling in palms and soles, dry mouth and throat, but likes hot drinks, tinnitus night sweat, soreness and weakness in waist and knees, impotence and slippery syndrome. Long and clear urine or persistent leakage, white tongue coating, slightly red tongue texture, and thin or weak ulnar pulse are obviously different from the symptoms of simple kidney-yang deficiency syndrome/pattern of yin exuberance.
3. spleen-kidney yang deficiency syndrome/pattern and kidney-yang deficiency syndrome/pattern: The spleen belongs to earth, and the kidneys are zang-organs of water and fire. Earth can control water, and fire can generate earth. The physiological relationship between the spleen and kidneys. Extremely close. The formation of spleen-kidney yang deficiency is often caused by factors such as diet overtrain, chronic diarrhea and other factors that cause spleen yang damage, long-term failure to treat, spleen disease and kidney disease, resulting in both spleen and kidney yang deficiency; it can also be caused by kidney yang deficiency first, life If there is insufficient fire, fire failing to generate earth, and the earth movement is not healthy, and gradually the spleen yang will also lose. Clinical symptoms include mental fatigue lack of strength, complexion shallow yellow or paleness, anorexia abdominal distension and fullness, incessant diarrhea, undigested food in stool, general edema, heaviness in the waist and knees, white and slippery coating, and weak pulse. Kidney-yang deficiency syndrome/pattern focuses on life gate fire failure and qi transformation loss of division. Therefore, in addition to the clinical symptoms of water-dampness, there are also symptoms such as soreness and coldness in the waist and knees, impotence, spontaneous seminal emission, leukorrhea and coldness. Symptoms of spleen deficiency, such as cold energy and decline in sexual function, but no complexion, shallow yellow, anorexia, abdominal distension and fullness, undigested food in stool, etc. can help to identify the disease.
4. syndrome/pattern of heart-kidney yang deficiency and kidney-yang deficiency syndrome/pattern: heart governs fire, kidney governs fire, heart yang helps blood transportation, kidney yang controls qi transformation, under pathological conditions, the relationship between heart and kidney Yang can influence each other. syndrome/pattern of heart-kidney yang deficiency can be caused by factors such as labor, chronic illness, deficiency of this element, etc. Kidney yang deficiency, qi transformation loss, water dampness overflows, and then the heart yang is suppressed, causing the heart The yang of the kidneys is all deficient; or the heart yang is injured due to factors such as excessive sweating, overwork, phlegm, etc., which affects the kidneys. The primary fire is not strong and the relative fire is not sufficient, resulting in both heart and kidney yang being deficient. Clinically, symptoms such as cold appearance, fear of movement, pale face, severe palpitation, panting when moving, spontaneous sweating, difficulty in urination, edema that cannot be dented when pressed, dark tongue texture, white coating, weak or knotted pulse, etc. syndrome/pattern of heart-kidney yang deficiency and kidney-yang deficiency syndrome/pattern although both have the symptoms of yang deficiency and retention of water and dampness, the former also suffers from heart yang deficiency. The heart governs blood and is located in the chest. Deficiency of heart yang results in chest yang. Symptoms such as lack of expansion, poor blood circulation, or severe palpitation, shortness of breath when moving, dark tongue texture, etc. are different from those of simple kidney yang deficiency.

[Documentation]

1. Jisheng Fang ‧Treatment of Kidney Bladder Deficiency and Excess": "The kidney is the meridian of Foot Shaoyin, which is located in the north and belongs to Rengui Water. The left is the kidney. Meridian, the right side is the life gate, which corresponds to the exterior and interior meridian of the great yang bladder. The kidney essence is astringent, and the bladder is often prone to qi transformation. If the mood is excessive and indulgent, mental disease will damage the kidney, and it will be caused by taking elixirs. Its deficiency and excess are explained by Hanre. Deficiency causes cold, and cold causes pain in the lower back, inability to lean up, soreness in the foot meridian, and frequent aversion to wind and cold. Aversion to cold hands and feet, shortness of breath, joint irritability, umbilical and abdominal knot pain, complexion, ringing in both ears, dry muscles and bones, slippery and frequent urination, and a floating, thin and rapid pulse are symptoms of kidney deficiency. "
2. "Zangfu Specimen Medicinal Formula‧ life gate": "The kidney is a water reservoir, and True Yang resides in it. If water is deficient, True Yang will lose its cave home and have no place to rely on. Therefore, to strengthen Yang, water must be replenished first. "
3. "Bihua Medical Mirror‧Kidney": "If the kidney is cold or the kidney is deficient, the left and right pulses will be slow and heavy. The symptoms are life gate fire failure, anorexia, cock crow diarrhea, and Tianzhu bone inversion. , for lying down and feeling cold, for running-piglet."