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Home > Education > Zang Fu > Spleen Qi not Governing Blood

Spleen Qi Not Governing Blood

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

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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

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Treatment Principle

Benefit Qi and Conserve Blood.

Common Acupuncture Points

SP-1 / Yinbai	Main point to strengthen SP's function of governing Blood.
UB-20 / Pishu	Reinforces SP.
ST-36 / Zusanli	Reinforces SP.
SP-3 / Taibai	Reinforces SP.

Other points are selected according to signs and symptoms.

Xu type uterine bleeding:
REN-4 / Guanyuan	Regulates Chong Mai and Ren Mai.
DU-20 / Baihui	Raises Yang Qi.
SP-1 / Yinbai	Main point for SP Not Governing Blood.
SP-4 / Gongsun	Promotes function of Chong Mai and Ren Mai in controlling Blood.
SP-10 / Xuehai	Used mainly for Hot Blood or extravasated Blood.
LI-11 / Quchi	Used mainly for Hot Blood skin rashes.
UB-17 / 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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