After years of clinical practice, He has explored the dialectical treatment rules of traditional Chinese medicine for some arrhythmias, which has important guiding significance for clinical practice.
First, heart and kidney yang deficiency is the pathogenic essence of pathological sinus syndrome
The main role of the heart yang is to encourage the heart to beat, and the warm blood veins circulate; the kidney yang is the foundation of the yang, and it plays a warm and promoting role in the various organs of the human body. Therefore, the rise and fall of the heart and kidney yang qi directly affects the speed of the heart rate, the profit and loss of the blood veins, and the virtual reality of the pulses. For example, heart and kidney yang deficiency can appear late, knot, generation and other pulses of heart and yang, chest tightness, chest pain, dizziness, fainting, limbs are not warm and other kidney yang does not rise, heart and yang do not declare, turbidity coherence, qi and blood disorder of the disease evidence.
The main clinical manifestations of pathological sinus syndrome are persistent and severe sinus bradycardia, chest tightness, dizziness, fainting, etc., which are basically consistent with the pathology and evidence of heart and kidney yang deficiency. Although rapid arrhythmias can sometimes occur, its essence still belongs to the yang deficiency can not be hidden in the yin, yin sheng yang, yang floating outside, yin and yang phase loss, cathode like yang a kind of illusion, indicating that the degree of yang deficiency is more serious. In addition, in the development of sick sinus syndrome, it is often seen that the phenomenon of yin deficiency, phlegm wetness and blood stasis is that the yang deficiency damages the yin, the yang deficiency cannot turn wet, the qi deficiency cannot be bloody, and the evidence caused by the void is not the essence of the disease.
The treatment of sick sinus syndrome should be based on the premise of warming the heart and kidneys, according to the degree of yang deficiency, the transformation of specimens and the presence or absence of evidence, flexible prescription medication. Yang deficiency is light, supplementing qi is the mainstay, Wenyang is secondary, Baoyuan soup is the main party; Yang deficiency is heavy, Wenyang is the mainstay, supplementing qi is secondary, four inverse plus ginseng soup is the main party; Yang deficiency cannot be hidden in yin, it is advisable to participate in the dragon bone oyster soup; fainting, use the four reverse plus ginseng soup to send the reverse scatter (musk, deer antler, quan shi, calamus); Yang deficiency yin, with ginger gui gui soup or six flavors back to the yang drink; Yang deficiency cold people with ephedra appendage soup; and phlegm wet, plus half summer, poria, white art, and blood stasis Gardan ginseng, raw hawthorn, crane grass.
Second, yin deficiency can not be yang is the main cause of atrial fibrillation
The yin and yang of the human body are "mutually rooted and mutually restrictive", and the partial prosperity and decline of either party is bound to lead to the relative prosperity or decline of the other party. The physiological state of "yin and yang secrets" is destroyed, and the pathological phenomenon of "yin wins yang disease, and yang wins yin disease" will appear. Normal heart rate and blood circulation must also be maintained by the relative balance of the heart and the heart, and if it is not maintained, it will cause disease. When the yang is strong or yin, the heartbeat is accelerated; when the yin or yang is weak, the heartbeat is slowed down; if the increase or slowdown of the heart rate reaches the degree of non-alignment of yin and yang, or because of qi stagnation, blood stasis, phlegm dampness to prevent the heart yang, there will be a "three-way irregular" pulse or pecking pulse. The heart rhythm that occurs during atrial fibrillation is a specific manifestation of this type of pulse. Combined with the symptoms of the patient's palpitations, chest tightness, shortness of breath and fatigue, etc., it can be fully proved that the main reason for atrial fibrillation is that the yin deficiency cannot absorb the yang, and the yin and yang are not in line. The therapeutic effect of the Yin-Yang Method also confirms this conclusion.
The basic method of treating atrial fibrillation is to cultivate yin and yang, nourish blood and re-pulse. Adding or subtracting compound pulse soup or triathlon compound pulse soup is a more effective prescription. Those who have a weak qi and a slow heart rate should use licorice soup; those with a faster rate of enthusiasm in yin deficiency should use huanglian ejiao soup; those with yin deficiency and inner heat and qi deficiency should use angelica six yellow soup; palpitations and insomnia, plus night vine, sour jujube kernel, and cypress kernel; those with blood stasis plus crane grass, salvia, and raw hawthorn. The above treatment is mainly used for atrial fibrillation caused by renal yin deficiency and hypercardioticism. If it is a blood deficiency that cannot contain qi, it should replenish the blood and nourish the heart, strengthen the spleen and improve the qi, and it is advisable to return to the spleen soup or the heart soup.
Third, paroxysmal supraventricular tachycardia is often disturbed by sputum fire
Paroxysmal supraventricular tachycardia has the characteristics of sudden onset, sudden recovery, and recurrent attacks, with a heart rate of 160 to 200 beats per minute, and the patient feels palpitations, chest tightness, irritability, panic, sometimes nausea and vomiting, dizziness, and even fainting. These characteristics of the clinical manifestations are very similar to what the medicine of the motherland calls "phlegm and fire disturbing the heart".
There are many reasons for the generation of phlegm fire, including those who are injured by the seven emotions, qi depressed and fire, and have phlegm; there are those who are damp and hot due to smoking, drinking tea, and drinking, and phlegm fire; and there are also fatigue, excessive saturation that damages the spleen and stomach, and accumulates sputum. No matter what the reason, in the process of phlegm fire, there must be factors of stagnation, liquid siltation, and fire at the same time, that is, the so-called "gas surplus is fire" and "liquid surplus is phlegm". After the phlegm fire is generated under certain conditions, "the phlegm rises with the fire, the fire leads the phlegm to go, the mind is dry, and the evidence is transformed." The onset of paroxysmal supraventricular tachycardia is a specific manifestation of sputum fire, upper clearing, and interference with the mind. As for the red tongue, the yellow lichen and the arteries, slippery veins, and disease pulses that appear during the attack, they are also important evidence of sputum fire. Therefore, according to the pulse evidence of paroxysmal supraventricular tachycardia, the diagnosis of "sputum fire disturbing the heart" is relatively accurate.
In the treatment of phlegm fire, the predecessors have practical experience, "the treatment of phlegm will reduce its fire, and the fire will go along with its qi." Therefore, clearing heat, reducing phlegm, lowering qi and calming the mind are the basic principles of treating this disease. Specific application, it is necessary to use the main and secondary drugs for the weight of sputum, fire and qi. If phlegm is the main evidence, it is advisable to choose Huanglian warm bile soup or polyester phlegm soup; the fire evil is heavier, and it is advisable to use rolling phlegm pills or bamboo lida phlegm pills; if the qi depression is obvious, it is appropriate to use spiral overlaid ochre soup or liuyu soup. Practice has proved that the above methods are used to prevent and treat paroxysmal supraventricular tachycardia and some sinus tachycardia patients, and the efficacy is quite reliable.
Fourth, the liver qi is depressed, the middle qi deficiency cold, the incidence of early beats is the highest
Clinically, the occurrence of premature beats is mostly due to liver qi depression, poor qi machine, cold deficiency of middle qi, and chest yang.
Patients with hepatic qi depression have a long history of mental stimulation and emotional illness, and there are obvious causes of mental emotions. The number of premature beats increases or decreases due to the quality of mental emotions, and early beats are often reduced after activity. Common symptoms include chest tightness, bloating, bloating, bloating, belching, pharyngeal infarction, and veins of the sinking strings, knots, and generations caused by unfavorable qi, and changes in mental emotions include mental depression or impatience.
Those who are cold in the middle of the qi have a history of external evil or internal injuries and strains, and there are causes of hunger, hunger and fatigue. Premature beats increase during activity or exertion and decrease at rest or rest. Clinical manifestations include fatigue and weakness, shortness of breath, low voice, sweating dizziness, cold limbs and other symptoms of insufficient yang qi, as well as knots, generations or urges weakness of cold pulses.
Relieve liver depression, adjust the qi machine, replenish the temperature, and publicize the heart and yang, which are the two major treatment methods for the treatment of early beats. For those who are depressed in liver qi, Chai Hu loose liver scattering as the main party, qi depressed fire plus skullcap, gardenia, Danpi; fiery wound Yin plus raw land, mai dong, mulberry parasitism; liver qi offender stomach plus generation ochre, tangerine peel, half summer; liver and spleen discord plus whitening, poria and ginseng. For those with cold deficiency in qi, astragalus jianzhong soup is the main party, and those with obvious qi deficiency are added ginseng, yellow essence, and schisandra; those with obvious yang deficiency are added to the appendages, dried ginger, and psoralen; phlegm is wet plus half summer, Cangshu, and Magnolia.
The above is the dialectical treatment of arrhythmias. He believes that in the process of the development and change of any disease, there will be a variety of different "evidences", and in turn, the use of dialectical methods to identify diseases and treat diseases is more comprehensive and profound than the method of simple dialectical treatment or simple treatment of diseases, and the means of diagnosis and treatment are more abundant and effective. Although Chinese medicine and Western medicine have developed under different historical conditions, the objects of their research are both human bodies, and there are always commonalities between them, and there is the same difference, which can fully communicate with each other and integrate with each other. This is of great theoretical and practical significance for effectively promoting dialectical theory and treatment and deeply understanding the nature of diseases.
Source: Zhou Ciqing Academic Experience Compendium" network related literature.
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