Treatment of Esophageal Variceal Bleeding Due to Liver Cirrhosis on August 13, 1995

Treatment of Esophageal Variceal Bleeding Due to Liver Cirrhosis on August 13, 1995

Although this is a type of upper gastrointestinal bleeding, it is different from gastric bleeding. Tang Rongchuan said: "Purging the heart is purging fire, and purging fire is stopping bleeding." He believed that the rhubarb-coptis purge heart soup is a powerful remedy for gastric bleeding. Rhubarb alone has the power to "push down walls and pull out the bottom of the pot," making it a top choice for treating hematemesis. However, it turns out that if rhubarb is used in excessive amounts to treat esophageal variceal bleeding, it can actually increase the amount of bleeding. Only when used in moderate doses does it effectively stop the bleeding. In cases of liver cirrhosis, bleeding usually occurs in the esophageal veins, with some also originating from the gastric fundus veins. Therefore, the recommended dose of rhubarb for such cases is 6g, and if there is no rhubarb, intestinal qi will not flow smoothly, leading to the absorption of intestinal waste and increasing the risk of hepatic encephalopathy. Based on this mechanism, I formulated the Liver Cirrhosis Hemostasis Powder.

Prescription: Calcined flower stone 30g, cinnamon 3g, raw ochre 30g, han san qi 3g, rhubarb powder 20g. All ingredients are ground into powder, sieved into 20 packets, one packet per dose, two packets per day. The total amount is 86g, with each packet containing 4.3g, including 1g rhubarb, 0.15g san qi, 1.5g raw ochre, and 0.15g cinnamon.

The main function of this formula is to reverse the upward flow and stabilize the downward flow. From a modern medical perspective, it aims to calm the stomach; when the stomach is calm, the bleeding stops on its own. Han san qi 0.15g has local hemostatic effects, and calcined flower stone also has local hemostatic effects.