Raynaud's Disease
Common in young and middle-aged
women and usually affecting the upper limbs but less involving the lower one,
this disease is due to over excitement or cold stimulus an manifested as symmetrical
and paroxysmal sudden pallor of the finger or toe followed by light purple, hectic
and sensation of pain and numbness.
Etiology and Pathogenesis
failure
of the tendons to be nourished by blood due to insufficiency of the liver-Yin
resulting from stagnation of the liver qi results in numbness and spas of the
limbs. deficiency of qi and blood due to stagnation of qi and shortage of blood
leads to pale fingers. Absence of enough heat due to Yang-deficiency of the spleen
and kidney is responsible for very cold hands and feet. Accumulation of cold,
Yin pathogen, in the channels causes grayish purple extremities of he limbs. Blood
stasis is due to stagnation of qi, obstruction is due to blood stasis, and pain
is due to obstruction. Inability of the tendons and vessels to be nourished due
to stagnation of qi and blood brings about withered skin, myophagism and even
ulcer. In short, insufficiency of the liver-Yin, yang-deficiency of the spleen
and kidney and stagnation of qi and blood are the original causes of this disease,
while exogenous cold, the external pathogenic factor.
Clinical Manifestations
After
sudden anger or rage, the skin of fingers or toes symmetrically and paroxysmally
becomes pale, greyish purple and finally hectic and then returns to normal, which
is accompanied by cold, numbness and dysesthesia of the finger which are relieved
by warmth but aggravated by cold, and distending thin smaller pointed extremity
of the limb wit dry skin and myophagism or superficial small ulcers in severe
cases, with the arterial pulse of the affected limb being normal.
Type and
Treatment
1. Internal Treatment
(1) Type of Yin-Cold
Main Symptoms: Cold
extremities whose color is changed symmetrically by cold, thin white tongue coating,
and deep thready pulse.
Therapeutic Method: warming the channels to disperse
cold, promoting blood circulation t remove obstruction form the vessels.
Prescription:
Danggui Sini Tang (Decoction with Chinese Angelica for Restoring Yang).
Ingredients:
Danggui
Radix Angelicae Sinensis
Shaoyao radix Paeoniae
Guizhi Ramulus Cinnamomi
Xixin
Herba Asari
Zhigancao Radix Glycyrrhizae Preparata
Tongcao Medulla Tetrapanacis
Dazao
Fructus Jujubae
Administration: Decocted in water twice for the decoction,
which is taken warm in the morning and evening, 1 dose daily.
Modification:
In case of severe cold, the herbs added are Shufuzi Radix Aconiti Lateralis Preparata,
Paijiang Rhizoma Zingiberis Preparata. For contracture, the herbs added are Gouteng
Ramulus Uncariae Cum Uncis, Quanxie Scorpio.
(2) Type of Stagnation:
Main
Symptoms: Symmetrical color change in the extremity of the limb occurring after
mental depression or excitement, which is accompanied by distension and stabbing
pain, ecchymosis on the tongue, and deep taut uneven pulse.
Therapeutic Method:
Soothing the liver and promoting the flow of the liver-qi, removing blood stasis
from the vessels.
Prescription: Modified Care-Free Decoction.
Ingredients:
Radix
Bupleuri
Baishao radix Paeoniae Alba
Poria
Baizhu Rhizoma Atractylodis
Macrocephalae
Danggui Radix Angelicae Sinesis
Bohe Herba Menthae
Zhigancao
radix Glycyrrhizae Preparata
Weijiang Rhizoma Zingiberis Preparata
Taoren
Semen Persicae
Honghua Flos Carthami
Jixueteng Caulis Spatholobi
Guizhi
Ramulus Cinnamomi
Dilong Lumbricus
Tubiechong Eupolyphaga seu Stelephaga
Administration:
Decocted in water twice for the decoction, which is taken warm in the morning
and evening, 1 dose daily.
(3) Type of Deficiency of Both Qi and Blood
Main
Symptoms: Pale and num affected limb with abnormal color, superficial ulcer and
pale granulation which grows slowly, light red tongue, and thready weak pulse.
Therapeutic
Method: Reinforcing qi, nourishing blood, promoting blood circulation and removing
blood stasis in the vessels.
Prescription: Modified Renshen Yangrong Tang (Ginseng
Decoction for Nourishing Blood).
Ingredients:
Renshen Radix Ginseng
Baizhu
Rhizoma Atractylodis Macrocephalae
Poria
Baishao Radix Paeoniae Alba
Chenpi
Pericarpium Citri Reticulatae
Yuanzhi Radix Polygalae
Rougui Cortex Cinnamomi
Danggui
Radix Angelicae Sinensis
Shudi Radix Rehmanniae Preparata
Huangqi Radix
Astragali
Gancao Radix Glycyrrhizae
Administration: decocted in water twice
for the decoction, which is taken warm in the morning and evening, 1 dose daily.
Modification:
If the upper limbs are affected, the herb omitted is Rougui Cortex Cinnamomi;
the herb added is Guizhi Ramulus Cinnamomi.
If the lower limbs are affected,
the herb added is Niuxi Radix Cyathulae.
For insufficiency of the liver-yin,
the herb added are Shanyurou Fructus Corni, Nuzhenzi Fructus Ligustri Lucidi.
Dr. Ming's TCM Medical Center,
Hua Xi Xiao Yuan, Hutian Developing Area,
Huaihua
city, Hunan province
China