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: duan syndrome differentiation and treatment of obstruction of heartache

2017年03月30日

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: duan syndrome differentiation and treatment of obstruction of heartache

 

Time: the 2016-07-20 source: China's traditional Chinese medicine to the author: "literature discusses" duan

 

Obstruction of heartache this disease, the earliest can be found in the synopsis, and use it as a special article discusses. In the obstruction of heartache shortness of breath was pulse license and cure "article yue:" pulse when taking too much less than with his fame Yin string, obstruction and pain, why, and responsibility for its extremely empty also. Today know Yang deficiency in the upper energizer, so the obstruction of heartache, with its Yin string also." Here, put forward "obstruction and pain" and "obstruction of heartache", this paper also "heart skips back, back ache thorough heart. Here, I believe, include chest pain, obstruction of heartache, and weiwantong, or obstruction of heartache LianJi weiwantong.

In neijing, not the disease of obstruction of heartache, among them "heartburn" disease, something like "obstruction of heartache. In the tang dynasty "s daughter" in ten 3 columns have a "heart abdominal pain" and "obstruction", basic repetition of neijing and the synopsis, but increased, there are plenty of prescription and acupuncture treatment.

Since then, the generations of the family, most of all to chest pain, weiwantong, heart, abdominal pain, obstruction of heartache, mixed treatment. Yuan, by streams in the Dan brook, use cases, pain, more explicitly pointed out: "heartache, namely weiwantong." No obstruction, chest pain, recorded in the book. During the Ming and qing dynasties, draw a distinction between heartache and weiwantong in succession. Such as "certificate for the criterion, heartache weiwantong" cloud: "or ask, Dan brook heartache weiwantong, likelihood? Yue: heart and stomach a dirty, its disease form different. Because of the diagnosis pain in heart, is a careful and pain in the name of, or weiwantong zai that heartache." Think in addition to the "sincerity" in the book, the rest are weiwantong, but attack on weiwantong also have to heartache. The certificate for the criterion of setting up "chest pain", "obstruction" separately presented in the "new" card a, its content is very simple, only several text column of the golden chamber. And will be difference between the new and the obstruction, "under the full and pain for the new heart, heart filled with pain for obstruction". And mistake obstruction due to the new, disease is due to heart.

Higher colleges and universities of Chinese medicine in the internal medicine of TCM notes, "only" stomach "and" chest pain ". "Chest pain" in the cloud: "we are talking about chest pain, real or obstruction of the study of" golden "." But only two syndrome, is a "cold evil indicates sheng", the second is "phlegm turbidity congestion," with the party is the obstruction from synopsis of party.

Teaching on the seven-year TCM internal medicine ", a "stomach" and "obstruction", no chest pain. In "obstruction" explain "the disease with the medicine in the coronary atherosclerotic heart disease, angina, hypertension, heart disease, cardiomyopathy, such as heart disease". In the basic classification and treatment of syndrome differentiation, divided into Yin cold stagnate, phlegm turbidity resistance, blood stasis and qi stagnation, closed heart kidney Yin deficiency, qi and Yin deficiency, sun be the spirit virtual failure type.

In 1995 established the law of the People's Republic of China industry standard of traditional Chinese medicine, Chinese medicine disease diagnostic efficacy standards "(hereinafter referred to as the" standard ") in the list of "weiwantong" obstruction of heart ", "not set" chest pain ". "Obstruction of heart disease" pointed out: "qi and blood obstruction of heartache is by the evil heart collaterals certification, not free to chest pain, what is the heart skips back, shortness of breath breathing may not lie as the primary symptom of disease of heart arteries and veins. See more at coronary atherosclerosis sex heart disease". On classification of syndrome of blood stasis resistance, haemorrheological nature heart arteries and veins, phlegm turbidity resistance, weak a better mousetrap, heart kidney Yin deficiency and Yang six classes. Compared with the practical internal medicine of traditional Chinese medicine, including "haemorrheological nature heart pulse" "blood stasis bizu" "phlegm turbidity resistance" "lack of a better mousetrap" shall have the same four, no "evil fire heat knot" and "qi and mind", have two Yin deficiency and Yang deficiency syndrome, heart deficiency of Yin and Yang, "standard" is added a "kidney", namely, heart kidney Yang deficiency and kidney Yin deficiency.

"Syndrome differentiation"

Chest obstruction of heartache refers to heartache, very heart skips back, back pain, breathing may not lie as the primary symptom of a heart disease. What often accompanied by heart palpitations, shortness of breath, breath not free, shortness of breath. Much by fatigue, and induce feast, cold, or emotion. Main pathogenesis for heart arteries and veins bizu, the pathological changes of the virtual to real, factors. Its the qi deficiency, blood deficiency, Yin deficiency and Yang deficiency, as well as blood stasis, phlegm turbidity, and qi stagnation, haemorrheological nature. Acute phase is given priority to with the real, remission is given priority to with the virtual. Sick in mind, and closely related to liver, spleen, and kidney.

Diagnosis in the shan or the area before the heart pain, oppressed for primary symptom. Performance for retrosternal or chest full of paroxysmal pain, often for colic, stabbing pain or dull pain; The pain may radiate to the left shoulder and left arm medial, neck and throat area, when make when check, repeated attacks; The pain lasts several seconds to more than 10 minutes, generally no more than 30 minutes, rest or relieved after taking this medicine. More with palpitations palpitation, shortness of breath, fatigue, breathing disorders, palpitations, pale face, spontaneous perspiration, etc. Clinical with qi deficiency, blood deficiency, Yin deficiency and Yang deficiency, blood stasis, and qi stagnation, phlegm turbidity and haemorrheological nature of pathogenesis, visible corresponding tongue, pulse condition. Elderly people see more, often because of overwork, seven emotions ultra, climate change, drinking factors such as feed and induce. The part has no obvious inducement or quiet.

Relevant examination showed low ecg ST segment and T wave flat or inverted, variant angina pectoris related lead ST segment elevation. Electrocardiogram (ecg) have no change to do load test. Attack is not typical, to observe the curative effect of nitroglycerin and electrocardiogram (ecg) changes during the attack. If still not confirmed, can multiple reexamination electrocardiogram, load test or 24-hour dynamic ecg monitoring. Have difficulty diagnosis for radionuclide examination or coronary angiography.

The basic pathogenesis of two kinds of points and the actual situation, deficiency of qi deficiency, blood deficiency, Yin deficiency and Yang deficiency, empirical and qi stagnation, blood stasis and phlegm obstruction and haemorrheological nature. Card really weak in yangxin tonga, virtual card with four tonga, less effort heart Yin deficiency syndrome with adjustment of arteries and veins, heart Yang deficiency syndrome and attached to the soup and cassia twig to peony tonga, blood stasis resistance with therapeutic tonga, and heartache card with fructus scallions decoction and orange white liquor definite ginger soup to add and subtract, phlegm turbidity resistance syndrome with fructus scallions white pinellia tonga, haemorrheological nature heart pulse syndrome with fructus scallions white liquor decoction and four inverse tonga unclogged arteries. Often witness waiting for qi deficiency and blood stasis syndrome, qi and Yin deficiency syndrome, sun be the spirit deficiency syndrome, qi and blood stasis, nitrogen within syndrome, qi and Yin deficiency syndrome, blood stasis syndrome.

Add: evidence-based medicine prescription rule

Evidence-based medicine is the essence of TCM, we speak of the French medicine, is actually the process of evidence-based medicine. Is dialectical, determined by syndrome differentiation, disease, illness, disease, etiology and pathogenesis. Bian card is very important, the disease is the focus of the bian card now, is what is currently a situation, the current evidence. A type certificate is obtained by differentiation, on the basis of the model to determine the corresponding treatment, namely "law in the state". Treatment is determined, in accordance with the law to choose medicine formula, namely "out of the law".

A good doctor, I think is two, the first is the accurate syndrome differentiation, the second is the prescription. Syndrome differentiation to be very accurate, a doctor to accurate syndrome differentiation, should have considerable experience, skilled and theory. I can't emphasize in thinking, theory of TCM syndrome differentiation, west with Chinese medicine, also cannot according to syndrome differentiation of traditional Chinese medicine, treatment with the method of western medicine. TCM treatment is to treat people, different people, the same disease with different prescription, whether men or women, young and old, all have the difference. Different regions, different time, different characters, although is a certificate, a method, prescription medication use is also different.

Determine the card type, after treatment, the key is the prescription, prescription medication. Prescription law, involves the fujin made, fujin is prescription rule. The determination of the fujin make position of party is it as the core, the efficacy of different drug, its position in the party.

Gentleman medicine

Your medicine is the main medicines in prescriptions, plays a main role. Gentleman medicine for disease is against the Lord, the Lord be fixed, choose medicine in anything mean maximum, the prince of the plays a main role. "The main disease of" gentleman "is good, is right, is must be respected. On the premise of main disease is called gentleman, should add "power supplied for the prince, only plays a main role, big drug Lord the major treatment for this disease. If in the wrong, not cure the disease. Want it to do your medicine, must let it biggest drug, make it play a major role.

Gentleman medicine for party of other drugs, the dominant role, command the other drugs, other drugs are in the service of the gentleman medicine. Plays a role of main treatment drugs, other drugs have auxiliary gentleman medicine, should choose official medicine, medicine official medicine must obey the king. Your medicine efficacy of biggest, strength ones for you. How to determine the size of the drug, we proposed a horrible judgment formula, namely = medicinal drug dose + + compatibility.

Clear the medicinal properties, also depends on quantity. Dose is to identify the medicine, prescription have dosage, no drug dosage can't adjust, no quantity to determine the efficacy of size, can't distinguish fujin. Generally speaking, in the medicinal properties of two drugs under the condition of the same basic, quantity is big, it is big. Prescription dose must have, no dose not let party. General medicine quantity is big, the prince of the large quantity big powers.

Official medicine

Official medicine efficacy must be younger than gentleman medicine, "thou shalt not make I too gentleman", than gentleman medicine efficacy, it is the gentleman medicine. Official medicine help gentleman medicine treatment effect. The traditional Chinese medicine are biased, partial to correct the body of the partial with medicine, this is called heal, with partial cure slant. Should make full use of its superiority, at the same time, to reduce or alleviate the adverse effects. Gentleman medicine, with the help of official medicine if official medicine the same as the gentleman medicine medicinal properties, this is called positive help. Another case, official medicine is different from gentleman medicine medicinal properties, can strengthen the role of gentleman medicine after the compatibility, the help from the side. Official medicine can also direct treatment and certificate. From the medicine point of view, as official medicine efficacy must be younger than gentleman medicine, smaller than gentleman medicine is the official medicine, official medicine is to obey the direction of your medicine to help your medicine.

adjuvant

Adjuvant drug is less than the official medicine. Adjuvants can cure and card, and syndrome also called time, time card also points. Of heavy, it is a bit bigger, of light, it is a little bit small, tit for tat, just right. Adjuvant treatment can help you, official medicine. Adjuvant of monarch, minister medicine can also be restricted role, can eliminate or ease the monarch, minister medicine toxicity and spirited. An adjuvant, it is to point to, in contrast to the gentleman medicine medicinal properties, and other role in the treatment of drug is opposite each other. Especially when the disease is severe, such as wu Yang syndrome, with a big sheen of aconite root, dried ginger, back to Yang save inverse, and, is the sun be the spirit fails, Yin cold inside, can appear not refuse drugs, then add a small amount of urine and pig bile, bring sheen of hot product direct Yin cold place. Human urine, pig bile is an adjuvant.

The medicine

The drug efficacy, similar to the adjuvant. The drug efficacy of not too big, no major therapeutic effect in the party. The medicine have led, harmonic medicinal effects. By the drugs have their own return, if the party of the patient's drug cannot then can add led by the medicine.

Prescription compatibility, is the regulation of drugs in the efficacy of size and function to indirect factors. Through compatibility, can increase the efficacy of, anything can also slow down, also can change the quantity change trend. Itself has a variety of actions, compatibility directly influence its express what effect in the party.