用中医阴阳理论治疗白血病 Treating Chronic Lymphocytic Leukemia Through Yin and Yang Theory

Cathay Toronto Acupuncture & Herbs Clinic

500 Sheppard Ave. E. Unit 302, Tonronto. 416-733-9888

女性，49岁，初诊日期2021-08-17

主诉：患慢性淋巴细胞白血病9年多，头几年没有症状，近2年经常咳嗽，哮喘，尿道感染。诉自从完全接种covid 疫苗后，从2021年3月中开始出现全身关节痛，髋部为主，行走困难，午后低热（37.5-37.8°C），体重减。服用类固醇后，咳嗽哮喘好转。

现每天下午低热，右肺有5cm结节,少许咳，白痰，夜重日轻，遇冷加重，咽痒即咳，疲倦乏力。经期准，经前乳胀，经期头晕头痛。

舌像：舌红，少苔，裂纹舌，舌体厚大，舌下络脉中度粗紫

脉象：左沉细滑稍数；右沉滑稍数

分析：阴虚，稍有火，是其白血病之本，但现在外感症状仍存在，外感是标，先治疗标病，标病解除再治本。

处方：射干麻黄汤合千金苇茎汤

二诊：2021-08-20

主诉：药后咳嗽减，哮喘减，痰稍增多，色白

舌像：如一诊

脉象：沉细滑

处方：一诊方+滋阴药（麦冬，沙参，女贞子，墨旱莲）

几次治疗后外感除，转而专门治疗其慢性白血病，根据其发热特点：午睡即发热，睡醒而热退，不午睡则没有出现下午发热，夜睡不发热但脚热。得出其为阴虚发热的结论，所以治疗主要以滋阴为主，主要是六味地黄汤系列和大补阴丸等滋阴药方，或加味或原方，5个月后病情稳定，午睡不再发热，夜间睡觉足部也不会发热，尿路感染基本消除。从初诊至今已超过2年，其慢性白血病病情稳定，淋巴细胞从最高时的21 降低到现在的11左右。

从阴阳理论分析此案：午睡发热，不午睡即下午不发热来看，她的情况不属于午后发热，根据“阳入阴则寐”的理论，睡觉时阳气入阴，由于其本身阴虚，阳气入阴而令到阴的相对量更少而阳气更多，阳盛则热，所以她午睡时发热，醒后由于阳出阴，不在阴中，所以热退。那为什么要夜晚入睡不发热？那是因为夜晚属阴，她入睡时阳气是入阴了，但因为有夜晚阴的支持，令到阴阳几乎平衡，所以夜睡不发热，但足底仍发热，也就是还有一点阳胜之意。明白病的根源后，无论用药或针灸，都遵循滋阴为主，偶尔滋阴加清热的原则，这一慢性白血病的治疗就取得了不错的效果。

这就是中医阴阳理论指导下进行用方遣药，或针刺或针灸的治疗法则的来源。

Patient: female, 49 years old

Initial visit: August 17, 2021

 Patient History

Patient has been suffering from chronic lymphocytic leukemia for more than 9 years. She did not show any symptoms in the first few years, but has been experiencing frequent coughing, asthma, and urinary tract infections in the past 2 years. After receiving the second dose of COVID-19 vaccine, in March 2021, she started experiencing joint pain all over the body especially in her hips which affected her walking, low-grade fevers in the afternoon (37.5-37.8°C), and weight loss. After taking steroids, her cough and asthma improved.

 Current Symptoms

Patient still complains of low-grade afternoon fevers, low energy, slight cough with white sputum that worsens at night, with the cold, and can be triggered by itchiness in her throat. She also has a 5cm nodule in her right lung. Her period cycle is regular, but experiences swelling of the breasts before her period, dizziness, and headaches during her period.

 Tongue

Red and swollen with little coating, cracks all over the tongue body with a deep vertical crack in the middle, moderately thick sublingual veins.

 Pulse

Left: deep, slippery, slightly rapid.

Right: deep, thin, slippery, slightly rapid.

 Diagnosis and Analysis

The primary root cause (the “ben”) of leukemia is yin deficiency . However, the patient is also presenting with external pathogenic invasion symptoms (the “biao”). Therefore, the treatment principle is to first treat the external pathogen followed by treating the root.

 Herbal Formula

She Gan Ma Huang Tang + Qian Jin Wei Jing Tang

Second visit: August 20, 2021

 Chief Complaint

After taking the herbs, patient reports improvement in coughing and asthma. There was also a slight increase in the amount of white sputum.

 Tongue

Same as first visit.

 Pulse

Deep, thin, slippery.

 Herbal Formula

She Gan Ma Huang Tang+ Qian Jin Wei Jing Tang + Mai Dong, Sha Shen, Nu Zhen Zi, Mo Han Lian

 Treatment of Leukemia

Following the recovery from external pathogenic symptoms after a few more treatments, the treatment plan switched to treating the root cause of the symptoms of leukemia. The patient presented with low-grade fever only during her afternoon naps that subsided once she woke up. During nighttime sleep, only her feet felt hot. These symptoms led to the diagnosis of yin deficiency, and the main treatment principle was to nourish yin. Her symptoms showed improvement after five months of treatment using the Liu Wei Di Huang Tang series, Da Bu Yin Wan and other yin-nourishing formulas. She no longer had low-grade fevers during her afternoon naps nor did her feet feel hot in the nighttime. The frequent urinary tract infections also subsided. After two years of continuous care, the symptoms from leukemia are stabilized and the patient’s peripheral blood absolute lymphocyte count has dropped from the highest of 21 x E9/L to the lowest of 9 x E9/L. Her  current lymphocyte count stays between 9 and 12 x E9/L.

Analysis Through Yin and Yang

This chronic lymphocytic leukemia patient presenting with low-grade fevers only during naps does not classify as having afternoon fevers, but rather, indicates a yin deficiency in the body.

 In the concept of yin and yang, sleep is the result of the body’s yang energy moving back to the core to be nurtured by its yin energy. When yin and yang are in balance, the patient will have no problem sleeping. However, when yin is deficient, it causes the relative amount of yang energy to be greater than yin. This is when yin is unable to contain yang, thus creating heat during her naps. Once she awakes, yang is no longer in the core and the relative difference between yin and yang is reduced. Therefore, heat symptoms dissipate.

 Yin and yang can also be understood as night and day respectively. When nighttime comes, yin energy is strong. Rather than the whole body, the patient only feels hot in her feet during nighttime sleep as there is environmental yin at night to support her constitutional yin. Despite the help from nighttime’s yin energy, it is still insufficient to control the yang entirely. Therefore, heat is still experienced in the patient’s feet. Acupuncture and herbal medicine were administered to mainly nourish yin, and occasionally clear heat as required. This chronic lymphocytic leukemia case has demonstrated the importance of understanding the root cause of a disease in creating an effective treatment plan and thus yielding good results for the patient.

 This has showcased the origins of the treatment principles of using herbal medicine and acupuncture under the guidance of the yin and yang theory of Traditional Chinese Medicine.

Acupuncture & Chinese medicine can increase e GFR, 针灸和中药有效提高肾指数

Case 1：Male，67.5ys old, initial visit day: 2016-04-17

Complaint: eGFR dropping continuously for a few years. It was 53 in April 2016.

General information about the patient: The patient had frequency of urination in daytime, 3–4 times of urination / night, tinnitus, aversion to cold, and had been taking high blood pressure pills for more than 24 years.

Tongue reading: enlarge tongue with teeth marks on sides, dull color, thick tongue coating, thick and twist sublingual veins.

Pulse feeling: Left-deep and tense, heart point weak. Right- string like.

Diagnosis: blood and liver stagnation, kidney deficiency

Treatment Method: promote kidney, disperse blood stasis to promote blood flow, soothe liver.

Process and result: after half year Chinese medical treatment, including 22 sessions of acupuncture and herbs, the report on October 2016 showed this patient’ eGFR from 53 increase to 60.

Case 2: female, 79 year and 9 months old, initial visit day :2021-04-30.

Complaint: report on 2021-04-20 showed eGFR 51

General information about the patient: The patient felt tired easily, aversion to cold, has a pacemaker, sleep quality is so so, diabetes.

Tongue reading: dull color with teeth marks on sides, thick and twist sublingual veins.

Pulse feeling: not even

Diagnosis: blood stagnation, kidney and pancreas deficiency

Treatment Method: promote kidney , pancreas and heart.

Process and result: after 16 sessions of acupuncture visits along with some herbs, the report on 2021-09 showed her eGFR from 51 increase to 59.

现在报告2例经中医治疗后肾指数止跌转升的医案。

医案1 是67.5岁的男士，长期服用降压药，平素尿频，夜尿3-4次，畏寒。舌像显示：舌质暗，舌体肥大，边有齿痕，苔厚，舌下络脉曲紫。脉象显示：左脉沉紧、心脉弱，右脉弦。诊断为：肝郁血瘀肾虚。经过半年22次针灸和中药治疗，2016年10月报告肾指数由2016年4月的53 上升到2016年10 月的60。

医案2是近80岁女士，糖尿病史，装有心脏起搏器。平素易累，畏寒，睡眠质量一般。舌质暗，边有齿痕，舌下络脉曲紫。脉象不均匀。诊断为脾肾两虚，血瘀。经过近5个月的治疗，肾指数由2021年4月的51 上升到2021年9月的59。

Chinese medicine is very effective in treating fever, chills, cough, sore throat and lost of taste

My experience using herbs to treat patients who have symptoms of cough, sore throat, lost of taste, and fever with chills lately is highly successful and worth further research.

I have used remote diagnosis to prescribe herbs to three patients.  

One of them had cough, sore throat and lost of  taste. She took herbs right away when these symptoms started. She recovered after just one day of herbs treatment. The herbal formula that she used is: Fangfeng, Jingjie, Suye, Bohe, Jiegeng, Gancao, Qianghuo, Huangqi, Yinhua.  

The second patient had a high fever, sore throat and felt chilly for 2 days. She recovered in 5 days of herb treatment using 2 different formulas.  The first formula she took two days was: Maxingshigantang+pingweisan+huoxiang +shegan+jiegeng. 

Her chills disappeared after two days of herbs but she still had fever. The second formula she used was: Yinqiaosan+Zihuadiding+Shegan+Tiandong+Tianhuafen+Danpi+Huoxiang .

The third patient, who is the daughter of the second patient, had a sore throat and a swollen lymph node in the right side of her neck. It took her just 2 days to recover with herbs. 

The formula she took was: Yinqiaosan + Shegan+Huoxiang+Peilan

近来远程看了3个病人有发烧兼发冷，咳嗽，咽痛，吃东西没有味道等症状。一个病人1天治愈，1个2天治愈，1个5天。

第一例：2020年 4月21日，病人报告工作劳累一天后第二天起床即出现喉咙痛，咳嗽，吃东西没有味道的症状，她正在月经期。马上服用一剂中药，成分有：防风，荆芥，苏叶，薄荷，银华，甘草，桔梗，羌活，黄芪。一剂后第二天症状全消。

第二例： 2020-06-13。她两天前发高烧39度兼见发冷，咽痛。自行服用西药退热，热退后不久又起。现见发烧39度兼发冷，喉咙痛，咽部红肿，见白色脓头。苔白厚腻，脉95/分。予麻杏石甘汤合平胃散加藿香，射干，桔梗2付。6月14日2付药尽后报告发冷除，仍发烧兼喉咙痛，予银翘散加紫花地丁，天花粉，射干，天冬，丹皮，藿香。

3剂后烧退咽喉肿消9成。嘱其休息两天看看，期间可以用菊花泡茶饮。

第三例：2020年6月13日。与第二例是母女。病人报告前两天月经期时劳累了一天，当天天气很热。之后就发烧兼喉咙痛，自行服用咸金桔水和覆被焗汗。现烧退，但喉咙痛，右边腮肿，小便黄。苔白，脉数，90次/分。

辩证：风热感冒。

中药如下：射干, 桔梗 ,甘草, 荆芥, 淡竹叶, 银花, 连翘, 藿香, 佩兰,牛蒡子。

2剂药后6月14号下午报告肿消咽痛除。

Acupuncture for glutes and leg pain 针灸治疗臀部和大腿痛

Acupuncture for glutes and leg pain (case from 2016)

Male, 46y 8months. First visit date was March 12, 2016.

Main complaint: he limped into my clinic, could not sit normally on a chair (only half of his body touching the chair). He reported that on May 24 the year before that after golfing, he felt pain on the right side of his bottom, and his right leg. A CT scan indicated he had a bulging disc in L4 and L5. He started physio treatment from July 20, 2015 to March 2016. He felt better in December of 2015, but unfortunately the pain returned in January. On March 5^th of that year, it got worse even though he was doing physio during that time. On that day when he first came in to my clinic, he reported that after he gets up in the morning, for a few minutes he feels pain on the right side of his bottom, and in his right leg. 

 Examination: Straight leg raising test, negative.  It means his pain did not come from a bulging disc. Instead, when pressure was applied to the affected areas, the pain seemed to be caused by muscle spasms in the upper region of the right M Gluteus maximus, at the L2 level of the right M. latissimus dorsi, and some points along the tractus iliotibialis and the right calf .

Treatment: Acupuncture

Points were used: Pishu, Weishu, Huantiao , Yanglingquan, Huanzhong(R) , Chengfu (R) , fengshi(R),Chengjin(R), chengshan(R)

Result:  Right after acupuncture, he walked normal already. In his second visit date which was March 14, 2016, he told me that he felt 50% of his pain was gone. After only 4 sessions of acupuncture, he felt 95% recovered.  On his 6^th visit which was April 12, 2016 he said he did not feel pain on his right buttock and right leg anymore which means he recovered after five sessions of acupuncture.

男性，46岁8个月。 初诊日期2016年3月12日。

主诉：他一瘸一瘸地走进我诊所，坐姿成保护状态，就是说半边身子落座，因为屁股和腿痛的原因。他说自从2015年5月24号打高球后他的右侧臀部和右腿外侧和右腿后面 开始疼痛，CT检查发现腰4和腰5椎间盘突出。同年7月20日开始物理治疗直到2016年3月来我诊所就医前。2015年底短暂好转，不幸2016年新年开始又有疼痛，虽然一直做物理治疗但3月5号起疼痛加重。现每天起床后几分钟右臀部和右大腿即开始痛，严重影响工作和生活，经人介绍来我诊所寻求针灸帮助。

查：直腿抬高试验阴性。排除椎间盘突出引起的疼痛。检查腰部，臀部和腿部，在右侧肾俞，环跳，环中，风市，承山穴处有压痛。

治疗：针灸

穴位： 脾俞，胃俞，肾俞，环跳，阳陵泉。以下穴位均取右侧：环中，承扶，风市，承筋，成山。

结果：1次针灸下地后则不再瘸行。隔天来针灸时告知疼痛已好转50%。4次针灸后说好了95%，2016年4月12号第6次来就诊时说5次后就全好了。现来就诊时为了巩固效果。

Chinese herbs cure allergy 中药治疗水肿

On January 24^th 2019, ther was a woman who visited my clinic with a swollen right eye.  The day before, she suddenly had swelling in her forehead in an area about as big as half of an egg. She took Cetirizine. The next day, the swelling moved from her forehead to her right eye. She visited her general physician, who believed her case was severe, and she might need to take Apo Prednisone. The physician suggested  that she take one day of Cetirizine and if the swelling did not disappear, she would need to come back to her GP and the GP will decide whether or not to prescribe her Apo Prednisone.  She did not want to take Apo Prednisone after doing some research on its side effects online so she decided to come see me.  Below is a photo of her taken on her first visit to me.

首诊：2019-01-24
主诉：右眼周围水肿。她一天前前额正中忽然出现一个半个鸡蛋大的肿起。她自行服用敏感药物Cetirizine。 第二天额肿消失，但右眼周围却肿了。她今早去看了医生。她的医生认为她较严重，建议她再服一天Cetirizine，如果还是肿的话就服用Prednisone. 病人问是否服用了Prednisone就会消肿，医生答肿起可能会转移到别处。病人看了服用Prednisone的副作用，不想用西药，就过来看中医寻求帮助。
下图为当时病人的眼睛情况。

I told her to stop taking any pills, and only take the herbs that I prescribed for her. I gave her two days of herbs. After one day, her right eye was like the second photo. The photo was taken on January 25th, 2019. 
我建议她停服西药，只用中药。服用1副后情况如下图。

She went to see her physician on Friday, January 25^th.  Her physician thought   she still had swelling on her eyes so the GP made a decision she needed to take APO. She didn’t want to take that so she just continued taking the herbs for another day. Below was the photo taken on her second visit me on Saturday morning (2019-01-26) after two days of herbs
第二天1月25号她去看西医复诊，西医认为她的眼睛周围还有肿，就叫她服用Prednisone。她不想用西药，就继续服用第二副中药。下图为两副中药后在1月26日她来我诊所复诊时所拍的。

I did my diagnosis again by using four diagnosis steps and modified her formula a little.  She took one bag of herbs on Saturday and one on Sunday. Here was the photo she sent to me on Sunday afternoon, January 27,2019.
根据她当时的情况，稍微调整了一下中药。再给她两副。她服用后就完全好了。如下图。

我的诊断主要是基于她平时很难出汗，看病时是脉浮。所以中医诊断是“风水相搏”。 用小汗法则愈。

How Chinese herbs and acupuncture prevent miscarriage中医治疗先兆流产

Cathay Toronto Acupuncture & Herbs Clinic

500 Sheppard Ave. E. Unit 205, Toronto Ontario

647-296-3226

40 years old and 11 months.  First visit date is March 14 ^th, 2018.

Her main complaint is two miscarriages which happened in Dec.2016 and Nov.2017 respectively. She has had multiple fibroids since 2012. And the ultrasound in March 22th, 2018 shows she has polyps in the uterus.  Aversion to cold   in general. Frequent urination and urinary incontinence since the first miscarriage.  Stool has hard head and soft end.

Menstrual history:  once /month, 25 days per cycle before second miscarriage, after second miscarriage is 30 days per cycle. 5-6 days per cycle, normal amount, red color, has small amount of blood clots. Recent period was March 7-12.

Tongue: reddish tongue, thick tongue body with teeth marks on sides, white coating. Sublingual veins have prominent branches, purple colour.

Pulse: Left hand- deep with cùn weak. Right hand- deep, weak, taut and uneven

Diagnosis:   Deficiency of spleen and kidney, blood stagnation and blood deficiency

Treatment method: Use herbs and acupuncture to promote spleen and kidney, disperse stasis to build up blood level and promote blood flow. Also, the patient should not try to get pregnant for 6 months.

Process and Result: After 4 sessions of acupuncture and herbs, in the fifth visit on March 29^th, frequency of urination dramatically decrease, and no more incontinence. the seventh visit is on April 5^th, which was the fourth day of her period, she told me that there was a lot of blood clots this time (it is a sign that her blood stasis is dissipating). On April 11^th, she went to surgery of remove polyps, however the doctor told her they did not find any polyps. It was some tissue from her second miscarriage, so the doctor removed that. From the day of surgery to April 19, she reported a small amount of bleeding. On April 20^th, I gave her herbs to clean the stasis. From April 24-26, her period was heavy with a lot of dark colored blood with blood clots. After that, bleeding stopped. She had period on May 18-21 and June 12-17, both periods were red in colour, regular amount with a small amount of blood clots. On July 6^th, report showed she was four weeks pregnant. However, she showed miscarriage symptoms again, and there was small amount of brownish liquid that came out. Right away, I used acupuncture and herbs to prevent her from having another miscarriage. She even had red blood came out one day when she worked on her feet a whole day. I modified the herbal formula for her, and she took those herbs until 16 weeks into her pregnancy.  Her expected date is next month, February 2019.

Congratulations！

初诊日期：2018-03-14

年龄：40岁11月

主诉：2016年12 月孕5周和2017年11 月 孕4周自然流产两次。自2012年起查出有子宫肌瘤。2018年2 月的报告显示三个肌瘤，直径分别为2.5，2.9，3.8。报告还显示有子宫息肉。平时怕冷，第一次流产后开始出现尿频现象和憋不住尿感觉。大便头硬尾软。

月经史：1次/月，以前是25天一个周期，自从第二次流产后是30天一个周期。5-6天/次，量中，色红。少量血块。末次月经: 3月7-12 号。

舌诊：舌质淡红，舌体厚。边有齿痕，苔白。舌下络脉多，色紫。

脉象：左手沉，左寸弱            右手沉弱，弦，不均匀

诊断：血瘀血虚，脾肾不足                        

治疗：祛瘀温经，健脾益肾。针灸中药并施。医嘱病人避孕半年后才尝试怀孕。

 结果： 经过4次治疗，3月29日第五诊时告知尿频大减，憋不住尿的感觉消失。

             2018年4 月5日第7次就诊时适逢月经第4天，告知本次月经比以前血块多。此是淤血外排的好现象。

            4月11日去做手术切除息肉，医生告知没有发现息肉，但发现有第二次流产时遗留的少量胚胎组织，予以手术清除。术后4月11-19有少量血排出。4月20号来诊所就诊给与生化汤加红花，刘寄奴，益母草祛瘀生新。药后24-26号排出较多黑色血，夹杂大量血块。

        继续中药加针灸治疗。5月周期是18-21号；6月经期在12-17号，两次月经均色红，量正常，少量血块，2018年7月6日证实怀孕4周+。刚怀孕，又出现了流产现象，看到一点棕色液体排出。马上用针灸加中药保胎，期间她因为工作几乎连续站立1天而出现出血较多现象。调整中药继续安胎致16周。

      她的预产期是今年2月，恭喜她！

Chinese herbs cure serious case of constipation 中药治愈便秘

Female, 27 years old.  First visit date is March 5^th, 2011

Her main complaint is chronic constipation, which she’s had since she was a young child. Once in her adolescence, she fainted in school because she had not had a bowel movement for one month. The teacher sent her to the hospital and the doctor there had to use an enema to clean her bowel.

When I first saw her, she needed to induce a bowel movement every 3-5days by taking an herb that acts as a laxative, or taking glycerin enema, but there was only a small amount every time.  She felt hungry and thirsty easily, so she ate a lot and drank a lot. She had insomnia, was prone to forgetfulness, and had a strong aversion to heat. She bled 3-5 days when menstruating but the color of her period on the first day was darker than normal.  She had an appendectomy at age 12.

Observation:  thin body type, abdomen felt soft when pressure is applied.

Tongue: bright red, the tongue body is smaller and thinner than normal, red spots on the tongue surface, deep red at the tip of the tongue, white coating.

Pulse: Deep and thin

Analysis: The state of her tongue and her complaint of thirstiness indicates yin deficiency. Her large appetite is one of symptom of hyperactivity of fire, Darker period colour is a symptom of blood stasis.

Diagnosis: Hyperactivity of fire due to yin deficiency, insufficiency of good fluids and blood stasis.

Treatment principle:  Nourish yin to decrease the fire, promote good fluids, circulate the blood and resolve stasis.

Formula:  Zeng Ye Cheng Qi Tang plus Liu Wei Di Huang Tang, and Tianqi, Danggui, Danshen, for five days.

Second visit: March 13th, 2011

Reported: Almost had bowel every day, but not solid. Her body smelled like stool for five days. She still had insomnia and bad memory at this point in the treatment process.

Formula: Zeng Ye Tang plus Suanzaoren, shashen,Yuzhu, Danggui, and rock suger, for three days.

Third visit: March 21th, 2011

Reported: Stool almost once per day, better sleep.

 Formula:  Modification based on Zen Ye Tang, 5 days.

April 3rd, 2011:

 The patient came to visit and reported in the past week she didn’t use herbs , and her bowel was good, once every two days.

After that, the patient came to visit weekly or bi- weekly until May 4^th, 2011. That day she reported her constipation was gone. Since then until now 7 years past, she did not have constipation once.

女性，27岁，2011年3月5日初诊。自述记事起就便秘。中学时曾经有一个月没有大便，在学校晕倒后被送去医院洗肠。现在情况是3-6天才大便一次，吃番泻叶或用开塞露也只能去一点。易饿，口渴，怕热，睡眠差，记性差。月经周期3-5天，量时多时少， 第一天经血色黑。12岁做了阑尾切除手术。

望诊：体型偏瘦，腹部按诊柔软

舌诊：舌质红，舌体廋，红星舌，尖深红，白苔

脉诊 ：沉细

诊断：阴虚火旺 ，津亏血瘀

治疗：滋阴降火，增液祛瘀

中药：增液承气汤合六味地黄汤加田七，当归，丹参 5副

二诊： 2011年3月13日

药后几乎每天有大便，稍稀，同时身体散发粪便一样的味道，持续5天。睡眠记性仍差。

中药：增液汤加沙参，玉竹，酸枣仁，甘草，当归，冰糖。三副

三诊：2011年3月21日

大便基本每天1次，睡眠好转。

中药：仍用增液汤加减 5副

4月3日患者来复诊报告说一周没有用中药，大便也通畅，2天1次。之后一周或两周来复诊一次，每次3-5副中药，5月4日是最后一次复诊报告说便秘已痊愈。现在7年过去了也没有复发。