A 68 year old male patient has been experiencing right-sided limb paralysis for over 9 months and is still able to take care of himself. After a long period of illness, the conversation with the doctor seemed very detached, without any signs of depression. The pulse was heavy and thin, and there was no obvious string sign. It was learned from the family members that the patient rarely goes out of the house and rarely chats and communicates with others. Through consultation, we started with treating depression and made adjustments to the Xiaoyao San formula. So, what are the therapeutic effects of Xiaoyao San on post-stroke sequelae? Below, I will introduce to you that stroke is not only a life-threatening critical illness in clinical practice, but its sequelae can also torment patients' lives for a long time. Although Buyang Huanwu Tang is a classic formula for treatment, another very effective formula has been discovered in clinical practice, which is the well-known Xiaoyao San.
Xiaoyao San, the name of a traditional Chinese medicine formula. The source is from the "Tai Ping Hui Min He Ji Ju Fang", which is a reconciliation agent with the effects of harmonizing the liver and spleen, soothing the liver and relieving depression, nourishing blood and strengthening the spleen. Indicating liver stasis, blood deficiency, and spleen weakness syndrome. Pain in both sides, headache and dizziness, hemiplegia due to stroke, dry mouth and throat, fatigue and lack of food, irregular menstruation, breast swelling and pain, and weak pulse. Belonging to the weak spleen with liver stasis and blood deficiency.
【 Song Tip 】 Xiaoyao San uses Danggui Shao, Chailing Zhucao, and thin ginger; Liver stasis, blood deficiency, and weak temperament have excellent effects in harmonizing the liver and spleen.
【 Composition 】 Half liang (15g) of licorice (lightly roasted red), one liang (30g each) of Angelica sinensis (seedlings removed, filed, stir fried), Poria cocos (peeled), Paeonia lactiflora, Atractylodes macrocephala, and Bupleurum chinense (seedlings removed).
As the first treatment for post-stroke sequelae, Xiaoyao San formula will significantly improve its efficacy. The reason is simple, that is, patients with post-stroke sequelae often suffer from depression. Xiaoyao San formula is used to treat depression, and the formula and syndrome are consistent.
Before getting sick, the patient had flexible limbs and lived freely. However, unexpected lesions caused some limb movements to be impaired, and even made it impossible for the patient to take care of themselves. Naturally, the patient would feel depressed and unhappy. We rarely see post-stroke sequelae patients who are happy all day long. Moreover, patients may have long-term depression or severe emotional fluctuations before getting sick. After a long period of treatment after getting sick, it is reasonable for patients to suffer from depression due to the laborious and costly treatment, as well as the unsatisfactory therapeutic effect.
Therefore, the preferred treatment for post-stroke sequelae is of course to treat depression. After the treatment of depression is effective, the corresponding treatment method can be selected based on the syndrome differentiation results, such as promoting blood circulation, supplementing qi, nourishing yin, or filling essence, etc. Of course, in the long-term treatment process, depression syndrome may reappear at any time. Timely and effective treatment of depression can significantly improve the efficacy and shorten the course of treatment. Re evaluating Zhu Danxi's statement that "many diseases of the human body arise from depression" is indeed a clinical experience. There are many remedies for treating depression, and the first one is Xiaoyao Powder. In the treatment of post-stroke sequelae, Xiaoyao Powder is the most commonly used. Fei Boxiong said in "Medical Formula Examination": "Xiaoyao San... is the most effective remedy for relieving depression. If there is a deficiency of yin, add cooked land; if there is a deficiency of qi, add astragalus; if there is a deficiency of heat, add gardenia and peony bark; if there is phlegm dampness, add pinellia and coix seed. If the upper limbs are not smooth, mulberry branches or turmeric slices can be added to unblock the meridians and walk up. If the lower limbs are not smooth, Achyranthes and Coix seed can be added to unblock the meridians and walk down. Prolonged illness and persistent blood stasis can promote blood circulation and dredge collaterals by adding ground beetle beetles, earthworks, etc. Of course, addition and subtraction should have a degree and not be reversed. The essence of the cube is still to solve depression. If the tongue coating is yellow, white, and greasy, one often chooses to use the modified Yueju Wan formula instead of Xiaoyao San formula for treatment.
In short, over a long period of treatment, depression syndrome may recur at any time, not only after stroke, but also during recovery. Therefore, timely and effective treatment of depression can significantly improve the efficacy of stroke patients and shorten the course of treatment.