Danggui Shaoyao San for Postoperative Rectal Syndrome
Danggui Shaoyao San was formulated by Zhang Zhongjing for “women’s abdominal pain.” Composed of Danggui (Angelica sinensis), Shaoyao (Paeonia lactiflora), Chuanxiong (Ligusticum chuanxiong), Fuling (Poria cocos), Baizhu (Atractylodes macrocephala), and ZeXie (Alisma orientale), it has the functions of nourishing blood, soothing the liver, strengthening the spleen, and transforming dampness. The author has used this formula to treat postoperative rectal syndrome with remarkable results. Here is a case example:
Li XX, female, 52 years old. Initial consultation on November 12, 1994. The patient had experienced abdominal pain for three days, worsening intermittently, accompanied by dizziness. Six months prior, she underwent rectal surgery. Three months postoperatively, abdominal distension and pain recurred frequently. Multiple hospital examinations diagnosed her with postoperative rectal syndrome, but treatment with both Chinese and Western medicine yielded no improvement. Three days before presentation, abdominal distension and pain worsened, prompting her to seek care at our hospital. Symptoms included emaciation, pale complexion, fatigue, poor appetite, dizziness, numbness in hands and feet, loose stools, pale moist tongue, thin white coating, and deep fine weak pulse. Diagnosis: deficiency of qi and blood, disharmony of liver and spleen, and impaired qi movement. Treatment plan: soothe the liver, nourish blood, strengthen the spleen, and transform dampness. Prescription: Bai Shao 50g, Bai Zhu 20g, Fu Ling 10g, Chao Dang Gui 10g, Chuan Xiong 10g, Ze Xie 6g, Huang Qi 15g, Gui Zhi 20g, Gan Cao 10g, Huai Shan Yao 30g, Mu Xiang 10g, Hong Teng 30g. Ten doses, decocted in water, taken in two portions daily. On the 20th day of follow-up, abdominal pain disappeared, stools became solid, and general condition improved. Numbness in limbs decreased. Continuing the original prescription for 15 additional doses, followed by adjustment with Danggui Shaoyao Lujunzi Tang, the patient has remained symptom-free since.
Comment: The patient, after rectal resection, remained chronically anxious, leading to liver qi stagnation, disrupting spleen and stomach digestion. Post-surgery, qi and blood deficiency deprived tendons and vessels of nourishment. Prolonged stagnation disrupted qi flow, causing obstruction and pain. In the formula, Bai Zhu and Gan Cao soothe the liver and relieve pain; Danggui, Chuan Xiong, and Hong Teng nourish blood, activate blood, and unblock collaterals; Huang Qi and Huai Shan Yao tonify qi and strengthen the spleen; Mu Xiang regulates stagnation in the middle jiao. The treatment matched the syndrome perfectly, yielding significant results.