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Spleen Qi Not Governing Blood

Used with permission from Zang Fu Syndromes, By McDonald and Penner.

*Etiology
*Clinical Manifestations
*Complications
*Associated Western Conditions
*Differential Diagnosis
*Treatment Principle
*Common Acupuncture Points
*Common Herbal Formulae

Etiology

SP Qi Xu or SP Yang Xu causes failure of SP's function of keeping Blood flowing within the vessels. This is intimately connected with Qi's function of "leading" or "commanding" Blood, hence this condition can also be called Qi Not Governing Blood.

Clinical Manifestations

Sallow complexion

Abdominal and epigastric distention after eating

Physical and mental exhaustion

Maybe acid regurgitation or vomiting

Anorexia

Loose or unformed stools

Four limbs feel tired and heavy

Shortness of breath

Dizziness

Palpitations

The above symptoms occur with bleeding, which can manifest as any of the following:

Functional Uterine Bleeding

Hematuria

Purpura

Menorrhagia

Epistaxis

Metrorrhagia

Hemafecia

T: Pale and flabby - may have teethmarks
C: White
P: Thready and weak
Complications

Bleeding of the Xu type (or indeed any bleeding) can cause Blood Xu conditions such as:

*LIV Blood Xu.
*HT Blood Xu (usually HT Blood and SP Qi Xu).

Associated Western Conditions

Functional Uterine Bleeding

Allergic purpura (Schoenlein-Henoch purpura)

Bleeding hemorrhoids

Hemophilia

Thrombocytopenic purpura

Differential Diagnosis

Bleeding of the Xu type (SP Not Governing Blood) must be differentiated from other types of bleeding such as Hot Blood bleeding or bleeding due to extravasated Blood:

Qi Xu	Heat in Blood	Extravasated Blood
Qi Xu signs	Shi Heat signs	Stuck blood signs
Rarely epistaxis,	Heavy bleeding	Recurrent bleeding
hematemesis or hemoptysis.	Bright red blood	Often post partum or menstrual bleeding
Purpura	Can be any type of bleeding	Dull purple blood with clots
	Urticaria

Treatment Principle

Benefit Qi and Conserve Blood.

Common Acupuncture Points

SP1 (Yinbai) - Main point to strengthen SP's function of governing Blood.

UB20 (Pishu) - Reinforces SP.

ST36 (Zusanli) - Reinforces SP.

SP3 (Taibai) - Reinforces SP.

Other points are selected according to signs and symptoms.

Xu type uterine bleeding:

REN4 (Guanyuan) - Regulates Chong Mai and Ren Mai.

DU20 (Baihui) - Raises Yang Qi.

SP1 (Yinbai) - Main point for SP Not Governing Blood.

SP4 (Gongsun) - Promotes function of Chong Mai and Ren Mai in controlling Blood.

SP10 (Xuehai) - Used mainly for Hot Blood or extravasated Blood.

CO11 (Quchi) - Used mainly for Hot Blood skin rashes.

UB17 (Geshu) - Used mainly for extravasated Blood.

Common Herbal Formulae

Gui Pi Tang / Decoction to Strengthen the Heart and Spleen

Bu Zhong Yi Qi Tang plus E Jiao and Ai Ye / Decoction for Reinforcing the Center and Benefiting Qi plus Donkey-Skin Glue and Artemisia Argyi

Gui Pi Tang plus Jiao Ai Tang / Decoction to Strengthen the Heart and Spleen plus Decoction of Donkey-Skin Glue and Artemisia

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