37. Aggregation And Accumulation Syndrome (Ji Ju)
Definition
Ji ju---palpable or impalpable abdominal mass accompanied by pain or distention.
Ji---substantial masses with pain at a fixed location, disorder of blood level and yin organs
Ju---insubatantial masses with distention greater than pain, disorder of qi level and yang organs
Relevant diseases of western medicine
1. Hepatosplenomegaly肝脾肿大
2. Abdominal tumor---
3. Pyloric stenosis幽门狭窄---
4. Partial bowel obstructure---
5. Intussuception intussusception肠套叠---
6. Intestinal volvulus肠扭转---
Etiology & pathogenesis
1. Emotional stress
2. Improper diet
3. Exterior pathogen
4. Liver related pathogen
Spleen and liver are involved
Qi and blood stagnation, danpness and phlegm accumulation, deficiency of righteous qi are pathogenesis
Differential diagnosis
1. Focal distention
2. Tympanic abdominal distention
Classification & treatment
A. Ju syndrome
1. Liver qi stagnation
Xiao yao san
Chai hu---
Dang gui---
Bai shao---
Bai zhu, fu ling, gan cao---
Bo he---
2. Food retention and phlegm obstruction
Liu mo tang
Da huang---
Zhi shi, Bing lang---
Chen xiang, Mu xiang, Wu yao---
B. Ji syndrome
1. Qi stagnation obstructing blood circulation
Jin ling zi san
Chuang lian zi---
Yan hu suo---
2. Blood stasis
Ge xia zhu yu tang
Tao ren, Hong hua, Chuan xiong, Chi shao, Dang gui, Wu ling zhi, Mu dan pi, Yan hu suo---
Xiang fu, Wu yao, Zhi qiao---
3. deficient righteous qi with pathological aggregation
Ba zhen tang + Hua ji wan
Ba zhen tang ( si jun zi tang + si wu tang )
Ren shen , fu ling , bai zhu, gan cao (si jun zi tang )---
Dang gui, bai shao, chuang xiong, shu di huang (si wu tang )---
Hua ji wan
San leng, E zhu, Fu hai shi, Xiang fu, Xiong huang, Bing lang, Su mu, Wa leng zi, Wu ling zi---
Acupuncture treatment
RN 12 Zhong wan, PC 6 Nei guan, GB 34 Yang ling quan, BL 18 Gan shu, Extra 20 Pi gen
Reference
1. Hepatosplenomegaly肝脾肿大--- enlargement of the liver and spleen to a degree that they are clinically palpable. There are a large number of causes in childhood, many of which overlap the causes of isolated hepatomegaly and splenomegaly. A list of conditions is given in Table 1. Any cause of chronic liver disease may cause portal hypertension and so is a possible cause of hepatosplenomegaly. Splenic enlargement displaces the stomach medially and the splenic flexure downward, liver enlargement is not reliably assessed on radiographs. Spleen size as measured on ultrasound can be compared with normograms. Hepatic size is not reliably assessed on radiographs.
Metabolic
Haematologic
myeloproliferative disorders
myelofibrosis
Oncologic
Leukaemia
Lymphoma
Infective
Viral
Hepatitis
Rubella
Cytomegalovirus Disease
Cytomegalovirus Disease
Parasitic
Malaria
Leischmaniasis
1. Lysosomal storage diseases溶酶体贮积症--- a family of over 30 disorders that result from different defects in lysosomal function. Lysosomes溶酶体 are cytoplasmic胞浆的 organelles细胞器 containing acid hydrolases水解酶 that degrade macromolecules大分子,高分子 to their basic building blocks: peptides, amino acids, monosaccharides单糖, nucleic acids核酸, and fatty acids.
2. Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma---
3. Aplastic anemia--- a disorder of hematopoiesis血细胞生成 characterized by marked reduction or absence of erythroid红色的, granulocytic粒细胞, and megakaryocytic巨核细胞 cells in the bone marrow with resultant pancytopenia全血细胞减少症.
2. Abdominal tumor---
3. Pyloric stenosis幽门狭窄---
4. Partial bowel obstructure---
5. Intussuception intussusception肠套叠---
6. Intestinal volvulus肠扭转---
Ji ju---palpable or impalpable abdominal mass accompanied by pain or distention.
Ji---substantial masses with pain at a fixed location, disorder of blood level and yin organs
Ju---insubatantial masses with distention greater than pain, disorder of qi level and yang organs
Relevant diseases of western medicine
1. Hepatosplenomegaly肝脾肿大
2. Abdominal tumor---
3. Pyloric stenosis幽门狭窄---
4. Partial bowel obstructure---
5. Intussuception intussusception肠套叠---
6. Intestinal volvulus肠扭转---
Etiology & pathogenesis
1. Emotional stress
2. Improper diet
3. Exterior pathogen
4. Liver related pathogen
Spleen and liver are involved
Qi and blood stagnation, danpness and phlegm accumulation, deficiency of righteous qi are pathogenesis
Differential diagnosis
1. Focal distention
2. Tympanic abdominal distention
Classification & treatment
A. Ju syndrome
1. Liver qi stagnation
Xiao yao san
Chai hu---
Dang gui---
Bai shao---
Bai zhu, fu ling, gan cao---
Bo he---
2. Food retention and phlegm obstruction
Liu mo tang
Da huang---
Zhi shi, Bing lang---
Chen xiang, Mu xiang, Wu yao---
B. Ji syndrome
1. Qi stagnation obstructing blood circulation
Jin ling zi san
Chuang lian zi---
Yan hu suo---
2. Blood stasis
Ge xia zhu yu tang
Tao ren, Hong hua, Chuan xiong, Chi shao, Dang gui, Wu ling zhi, Mu dan pi, Yan hu suo---
Xiang fu, Wu yao, Zhi qiao---
3. deficient righteous qi with pathological aggregation
Ba zhen tang + Hua ji wan
Ba zhen tang ( si jun zi tang + si wu tang )
Ren shen , fu ling , bai zhu, gan cao (si jun zi tang )---
Dang gui, bai shao, chuang xiong, shu di huang (si wu tang )---
Hua ji wan
San leng, E zhu, Fu hai shi, Xiang fu, Xiong huang, Bing lang, Su mu, Wa leng zi, Wu ling zi---
Acupuncture treatment
RN 12 Zhong wan, PC 6 Nei guan, GB 34 Yang ling quan, BL 18 Gan shu, Extra 20 Pi gen
Reference
1. Hepatosplenomegaly肝脾肿大--- enlargement of the liver and spleen to a degree that they are clinically palpable. There are a large number of causes in childhood, many of which overlap the causes of isolated hepatomegaly and splenomegaly. A list of conditions is given in Table 1. Any cause of chronic liver disease may cause portal hypertension and so is a possible cause of hepatosplenomegaly. Splenic enlargement displaces the stomach medially and the splenic flexure downward, liver enlargement is not reliably assessed on radiographs. Spleen size as measured on ultrasound can be compared with normograms. Hepatic size is not reliably assessed on radiographs.
Metabolic
Haematologic
myeloproliferative disorders
myelofibrosis
Oncologic
Leukaemia
Lymphoma
Infective
Viral
Hepatitis
Rubella
Cytomegalovirus Disease
Cytomegalovirus Disease
Parasitic
Malaria
Leischmaniasis
1. Lysosomal storage diseases溶酶体贮积症--- a family of over 30 disorders that result from different defects in lysosomal function. Lysosomes溶酶体 are cytoplasmic胞浆的 organelles细胞器 containing acid hydrolases水解酶 that degrade macromolecules大分子,高分子 to their basic building blocks: peptides, amino acids, monosaccharides单糖, nucleic acids核酸, and fatty acids.
2. Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma---
3. Aplastic anemia--- a disorder of hematopoiesis血细胞生成 characterized by marked reduction or absence of erythroid红色的, granulocytic粒细胞, and megakaryocytic巨核细胞 cells in the bone marrow with resultant pancytopenia全血细胞减少症.
2. Abdominal tumor---
3. Pyloric stenosis幽门狭窄---
4. Partial bowel obstructure---
5. Intussuception intussusception肠套叠---
6. Intestinal volvulus肠扭转---