Breakdown 1: Overview
First, the concept and origin of palpitation
1. The concept of palpitation
Palpitation refers to the patient's conscious heart throbbing, frightened and uneasy, or even involuntary. The mild condition is fright, and the severe condition is palpitation.
2. The origin of palpitation
The name of palpitation was first seen in synopsis of golden chamber and treatise on febrile diseases, and it was called? Heart palpitations? 、? Have a nervous heart? 、? Fear in your heart? And? Scared? It is believed that the main causes are disturbance, drinking water, fatigue and pathogenic factors after sweating, etc., and the basic treatment principles and common prescriptions for treating palpitations such as Zhigancao Decoction are put forward.
In the Qing Dynasty, Yilin Gaicuo paid attention to palpitation caused by internal resistance of blood stasis, and recorded that every time Xuefu Zhuyu decoction was used, it was more effective.
Second, the relationship between palpitation and the names of diseases in western medicine
Breakdown 2: Etiology and pathogenesis
First, the common causes of palpitations
Internal causes: deficiency of physique, fatigue of diet, injury caused by seven emotions, improper medicine and food.
External cause: feeling external evil.
Second, the main pathogenesis of palpitation and the different characteristics of deficiency and excess.
The location of palpitation is in the heart, which is closely related to the liver, spleen, kidney and lung.
Pathological changes mainly include deficiency and excess. Deficiency is the loss of qi, blood, yin and yang, which makes the heart lose nourishment and leads to palpitation. The excess is mostly caused by phlegm-fire disturbing the heart, excessive drinking of water or blood stasis, and poor qi and blood circulation.
Third, the relationship between deficiency, phlegm, blood stasis and palpitation
This disease is based on deficiency of qi, deficiency of yang and deficiency of yin and blood. It is marked with qi stagnation, blood stasis, phlegm turbidity, water drinking and so on. Yin deficiency is often accompanied by excessive fire or phlegm heat; Yang deficiency is easy to drink water and phlegm; People with deficiency of qi and blood are prone to stagnation of qi and blood and phlegm.
Breakdown III: Diagnosis and Syndrome Differentiation
First, the diagnosis points of palpitation
1. Consciously abnormal heartbeat, either fast or slow, or beating too hard, or suddenly jumping and stopping. Paroxysmal or persistent confusion, nervous, flustered, unable to make decisions.
2. Accompanied by chest tightness, irritability, upset sleep, trembling fatigue, dizziness and other symptoms. Middle-aged and elderly patients may be accompanied by chest pain, even shortness of breath, sweating and cold limbs, or syncope.
3. Visible pulse conditions such as number, acceleration, knot, generation, slow, heavy and late.
4. It is often induced by emotional stimulation, panic, tension, fatigue, drinking, satiety and other factors.
Second, the identification of fright and palpitation
The onset of fright is mostly related to emotional factors, which can be induced by sudden panic, worry, anger, extreme sorrow or excessive tension. Most of them are paroxysmal, although the disease comes quickly, the disease is mild, and the disease is mostly empirical, and the disease is mild and shallow, which can be relieved by itself, without being like ordinary people.
Palpitation is mostly caused by chronic illness, physical weakness and heart damage, which can also occur without mental factors. Palpitation often persists, and it can't be controlled. After exercise, it is aggravated, mostly due to deficiency syndrome, or deficiency with excess. Although the disease comes gradually, the condition is serious, and symptoms of viscera deficiency can also be seen when it doesn't occur.
Palpitation can also form if it persists for a long time.
Third, the identification of palpitation and running dolphin
When the running dolphin attacks, I also feel restless. The main points of differentiation between this disease and palpitation are as follows: palpitation is a violent beating in the heart, originating from the heart; The dolphin is rushing up and down, originating from the abdomen.
Breakdown 4: Syndrome Differentiation and Treatment
First, the key points of syndrome differentiation of palpitation
Syndrome differentiation of palpitation should distinguish between deficiency and excess. Deficiency refers to deficiency of viscera, qi, blood, yin and yang, while excess refers to phlegm, blood stasis and fire evil.
Second, the treatment principle of palpitation
The treatment of palpitation should be divided into deficiency and excess, and deficiency syndrome should be treated with invigorating qi, nourishing blood, nourishing yin and warming yang respectively; The empirical evidence should be expectorant, drinking, clearing fire and removing blood stasis. However, it is common for this disease to be mixed with excess and deficiency, and the priority and urgency of excess and deficiency are different, so the treatment should be taken into account accordingly.
At the same time, because palpitation is characterized by restlessness, the method of calming the heart and calming the nerves should be added as appropriate.
Architecture diagram to keep in mind
Third, the main symptoms, treatment methods and prescriptions of syndromes such as guilty conscience and timidity, lack of heart blood, heart yang deficiency, water drinking and soul-stirring, yin deficiency and excessive fire, and blood stasis blocking the heart pulse.
1. Guilty and timid syndrome
Main symptoms: palpitation, restlessness, restlessness, restlessness, insomnia and dreaminess, easy to wake up, unpleasant smell and sound, eating less and being dull, thin and white fur, thready pulse.
Treatment: calm the mind, nourish the heart and soothe the nerves.
Representative: Anshen Dingzhi Pill.
Commonly used drugs: Cinnabar, Dragon's Tooth, Amber, Ziziphus Spinosae Seed, Cortex et Radix Polygalae, Poria, Ginseng, Poria, Yam, Asparagus, Radix Rehmanniae, Radix Rehmanniae Preparata, Cinnamomum cassia and Schisandra chinensis.
2. Heart-blood deficiency syndrome
Main symptoms: palpitation, shortness of breath, dizziness, insomnia, forgetfulness, dull complexion, fatigue, anorexia, reddish tongue and thready pulse.
Treatment: nourishing blood and heart, benefiting qi and calming the nerves.
Representative: Guipi Decoction.
Commonly used drugs: Radix Astragali, Ginseng Radix, Atractylodis Rhizoma, Radix Glycyrrhizae Preparata, Radix Angelicae Sinensis, Arillus Longan, Poria, Cortex et Radix Polygalae, Semen Ziziphi Spinosae and Radix Aucklandiae.
3. Deficiency of heart-yang syndrome
Main symptoms: palpitation, chest tightness and shortness of breath, especially when moving, pale complexion, cold limbs, pale tongue with white coating, weak or heavy pulse.
Treatment: Warming the heart and yang, calming the nerves and calming the nerves.
Representative: Guizhi Gancao Longgu Muli Decoction and Shenfu Decoction.
Commonly used drugs: Ramulus Cinnamomi, Radix Aconiti Lateralis, Ginseng, Radix Astragali, Radix Ophiopogonis, Fructus Lycii, Radix Glycyrrhizae Preparata, Os Draconis and Oyster.
4. Water-drinking Lingxin syndrome
Main symptoms: palpitation, dizziness, chest tightness, thirst, scanty urine, edema of lower limbs, cold limbs, nausea, vomiting, salivation, pale and fat tongue, white and slippery fur, and thready or heavy and slippery pulse.
Treatment: invigorating the heart yang, transforming qi into water, calming the heart and calming the nerves.
Representative: Linggui Shugan Decoction.
Commonly used drugs: Alisma orientalis, Polyporus, Plantaginis Semen, Poria, Ramulus Cinnamomi, Radix Glycyrrhizae Preparata, Ginseng Radix, Atractylodis Rhizoma, Radix Astragali, Cortex et Radix Polygalae, Poria, and Semen Ziziphi Spinosae.
5. Syndrome of yin deficiency and excessive fire
Main symptoms: palpitation, restlessness, insomnia, feverish sensation, dry mouth, night sweats, anxiety and fatigue, aggravated symptoms, tinnitus, backache, dizziness, impatience and irritability, red tongue with scanty body fluid, little or no coating, and thready pulse.
Treatment: nourishing yin and clearing fire, nourishing heart and calming nerves.
Representative: Tianwang Buxin Dan and Zhusha Anshen Pill.
Commonly used drugs: Radix Rehmanniae, Radix Scrophulariae, Radix Ophiopogonis, Radix Asparagi, Radix Angelicae Sinensis, Radix Salviae Miltiorrhizae, Ginseng Radix, Radix Glycyrrhizae Preparata, Rhizoma Coptidis, Cinnabaris, Poria, Radix Polygalae, Semen Ziziphi Spinosae, Semen Platycladi, Fructus Schisandrae Chinensis and Radix Platycodi.
6. Syndrome of blood stasis blocking heart pulse
Main symptoms: palpitation, discomfort in chest tightness, heartache from time to time, pain like acupuncture, cyanosis of lip nail, dark purple tongue or ecchymosis, unsmooth pulse or knot or generation.
Treatment: promoting blood circulation and removing blood stasis, regulating qi and dredging collaterals.
Representative: Taoren Honghua Decoction and Guizhi Gancao Longgu Oyster Decoction.
Commonly used drugs: peach kernel, safflower, salvia miltiorrhiza, red peony root, chuanxiong rhizome, corydalis tuber, Cyperus tuber, green tangerine peel, dried rehmannia root, angelica sinensis, cassia twig, licorice root, keel and oyster.
Four, the common syndrome treatment changes.
Heart-blood deficiency syndrome, such as fever, sweating, night sweats, chest tightness and upset, red tongue with little coating, thready pulse or knot generation, is deficiency of both qi and yin. The treatment is to replenish qi and nourish blood, nourish yin and soothe the nerves, and add and subtract the decoction of roasted licorice.
For the syndrome of yin deficiency and excessive fire, if the kidney yin is deficient, the deficiency fire moves wildly, and the nocturnal emission is sour, tortoise plastron, Radix Rehmanniae Preparata, Rhizoma Anemarrhenae, and Cortex Phellodendri are added, or Zhibai Dihuang Pill is added; If yin deficiency is not obvious, Tianwang Buxin Dan can be used alone.
If you see edema, oliguria, paroxysmal cough and asthma at night or sitting and breathing due to cardiac insufficiency, you should reuse products that warm yang and promote diuresis, such as Zhenwu Decoction.