Seventh clinical experience on diagnosis and treatment of heart failureTalk about the clinical aspects of heart failureI and you talk about
Seventh clinical experience on diagnosis and treatment of heart failure
Talk about the clinical aspects of heart failure
I and you talk about my experience in clinical treatment of heart failure. Only simple words.
First, the pathogenesis of the disease, heart failure is the virtual reality
A certificate from the heart failure after a long illness or wrongly treated, in several years, a department of organ damage caused by serious illness. The key point of pathogenesis is superficiality, deficiency Qi deficiency, Yang deficiency, yin deficiency, blood deficiency are also. A heart, lung, heart, coronary heart, hypothyroidism to see more Qi Yang deficiency; hyperthyroidism to heart failure are often found in the Yin, blood deficiency anemia or renal failure (due to their lack of erythropoietin decreases due to anemia) this is probably not jiaozhuguse.
Yin deficiency syndrome and the current use of Western medicine diuretic, we can recall the clinical, as long as the use of diuretics for a few days, generally more than red tongue without fur, thirst and other evidence, which is caused by drugs, when remember.
The subject is water, blood stasis, phlegm, wet four words, refer to related medical books, this is not difficult to understand, not to say.
Qi, Yang deficiency is the most important aspect of heart failure, keep in mind, not easy to damage the Yang consumption of gas, this is the key.
The disease of the lung, spleen, kidney, heart, TCM syndrome differentiation and treatment in lung and kidney to a shortness of breath, swollen syndrome, heart failure clinical performance of the most prominent, starting from the lung and kidney! Chuanping BZX, starting from the spleen and lung, spleen, lungs and spleen or invigorating spleen and benefiting qi.
Two, the treatment of the solid gas for the first Yang
The treatment of heart failure, multiple treatment from lung distension, dyspnea, wheezing, edema, the treatment of the key, the most important is not damage Yang gas consumption, why? Heart failure over time, no consumption of Qi and Yang, the clinical manifestations of heart and kidney yang deficiency, heart and lung qi deficiency, Yang deficiency, spleen qi deficiency of heart and lung, or with water, blood stasis, phlegm and dampness. There is a water stop or cloud of yin deficiency syndrome, yin deficiency syndrome, but no one pure, just imagine the clinical heart failure, a few people can not move, shortness of breath, shortness of breath to rest? The heart and Lung Qi at any time, not to be forgotten, thus supporting the heart should always keep in mind, this is my experience!
"Chronic illness will be poor in the kidney", where swollen, shortness of breath, shortness of breath and shortness of breath are related with the kidney, more swollen kidney yang deficiency Qi dysfunction, asthma and acute syndrome of kidney yang deficiency of Qi can not be water, that water evil Ling connected heart and lung, asthma, shortness of breath, shortness of breath or slow card when duty at kidney qi deficiency, lung kidney qi is not the main gas.
"Five AC loss, which should be treated", he also, spleen and stomach qi. Heart failure over time, the dirty syndromes are visible, western medicine and heart failure syndromes refer to the most easy to understand. So the treatment should always forget care Zhongzhou, condition of "edema treatment, the cure in the spleen", "save a stomach, a branch of life"!
Another deficiency of lung qi for clinical manifestation, however, Gu Yixin gas temper, tonifying kidney qi medicine is beneficial lung role, the medication can be reduced.
The most important place: can not be used when the drug is easy to use the drugs. Heart failure over time, gas consumption per see Yang exhausted. This case can refer to treatment failure in my top two, 3 in the past, when the attention.
Three, the experience, when the language is easy to see the wrong card
The clinical treatment of heart failure, especially for beginners, the following error is easy to appear, this is my 20 years of clinical experience, a word or two, hope to help you!
1 mistakes: pulmonary heart disease, outside in the cold drink without thinking, use of small Qinglong Decoction
Pulmonary heart disease often due to cold induced increase, more performance for the outside in the cold drink, small Qinglong for political parties, but in asthma pulmonary heart cough for a long time, with all dissipation, not light with ephedra, should be used instead of Su Hua, ginkgo dispersing lung qi and relieving asthma.
2 error two: pulmonary heart disease, cold in the heat, he used cold medicine
They are often the heart kidney yang deficiency of pulmonary heart disease. If the feelings of evils, as a fever in the sputum, thick yellow, dry mouth disease, not rash using large dose of bitter cold, should not hurt Ganliang, damaged Qi Yang, medication is the key in the disease lasts, tabulatior to Qi Fang junior into mulberry, Houttuynia flavor.
3 error three: on the hot cold syndrome, governance and forget
Heart failure by pulmonary infection aggravated, clinically, cough yellow sputum, fever syndromes, and lower extremity edema, limbs cold, cold and hot under cold syndrome, this. Beginners, view of the lung heat syndrome of acute lung heat and clear solution, forget Jiao Yang deficiency, cold medication has been disabled to extinguish the sun, this taboo! Qingjie lung goods Irisa for transportation of yin and Yang Fang, I like to use a "golden" clinical temperature by Tonga Houttuynia, wild buckwheat, Trichosanthes, in addition and subtraction Fritillaria, mulberry stalk, orange flavor. Or with Suzi Jiangqi decoction, while the syndrome differentiation.
4 error four: see the swelling is diuretic, unknown physical metabolism of body fluid
Edema is the most common heart failure, beginners see edema on the use of diuretics. But, with the kidney yang deficiency Qi can not form edema, spleen deficiency, lung qi deficiency can not transfer through water, one of the most important in the kidney, gas to the water from where the foot of kidney yang, Yang Yang of gas, the gas into the spleen with Dafa, Xuan lung medicine. "Jing Yue book" cloud: "warming treatment of edema so that gas, gasification and recovery, the natural elimination of; so by evil, evil and gradually recovered, more just. This one is really more a false, more, there is also more and more false really? ! "" Danxi Xinfa "cloud:" because the spleen can not edema water, water Wang Xing, while in ginseng spleen, to temper it, since Jianyun, since the lifting movement of the cardinal, the water on its own! I like to assist in clinical Zhenwu Decoction in Huangqi, agent poria. Guizhi transforming Qi when properly used. Of course, we should not forget to choose the prescription.
5 error 5: see the red tongue without moss that Yin, dare not use Wenyang Yiqi drugs
This is the third point in discant said in fourth, see, I like to use the quanzhenyiqi decoction.
Error 6: 6 generation of Codonopsis ginseng Qi, unknown efficacy
Treatment of heart failure, often need to use ginseng to use solid gas, clinical beginners often like to use dangshen instead, this is improper, Qi Ming without Codonopsis solid off effect, cheap and can not take, I found that the curative effect was significantly higher than that in the use of ginseng dangshen clinical test! Say ginseng herbal Nourishing Qi effect for more, dangshen tonic temper, two efficacy difference far! Modern pharmacological studies have shown that ginseng has good myocardial metabolism and enhance myocardial contractile force!
Four, a case of heart failure to appreciate
I am currently working in the heart, but I do not say that I am in the hospital treatment of heart failure cases. Now I say a pure Chinese medicine treatment of congestive heart failure for everyone.
In a year, I returned home, a big mountain, there is a more than 50 years old in the village, a poor treatment effect of rural doctors, disease heavy, the villagers were said to the palace wood, I went back, large hospital doctor, so only a apprentice, the Chinese village to want me give him a treatment (he had given a diagnosis and treatment of patients with multiple, is the hope can be optimistic about the patient, two I want to learn the trick, oh ~):
The patient lying in bed, breathing not supine, chest tightness shortness of breath, cough, phlegm thin foamy, severe edema of lower extremities, the temperature does not have to take the children of Ammon, palpitations, urinate less. Physical examination: dark complexion, jugular venous engorgement, ear to chest wall could be heard and two large pulmonary moist rales, heart sounds different, arrhythmia (without a stethoscope), abdominal swelling, percussion shifting dullness positive liver ribs 2, severe edema of lower extremities. Pale tongue, with scalloped edges, knotted pulse, very thin.
Asked questions about its history, diagnosed as coronary heart disease, heart failure 3, atrial fibrillation, pulmonary infection. Oh, I can only say that this is suspected, the basic way of traditional Chinese medicine, western medicine did not check any of the mountains of mourning!
Then for the syndrome, the heart kidney yang deficiency, water drink stop, the evil spirit of the water to drink the lungs, heart Yang want to take off the elephant. Treated by Wenyang Huayin, Xuanbi Yang
With the Zhenwu Decoction Combined Gualou Xiebai Guizhi Tang Fang
Tablets 20 grams (first fried) ginseng 15 grams 10 grams Atractylodes peony 10 grams of ginger, 15 grams of cassia twig 10 grams 15 grams of Trichosanthes Xiebai Poria 10 grams 30 grams 50 grams of astragalus. 3 agent.
Oh ~ this breach of eighteen, why should I use, see the love you can answer!
With good medicine, fried in 6 at night is the night service, constantly coughing a lot of patients with thin phlegm, phlegm phlegm accumulation to morning a large basin, as there are more than 1000 ML, the urine volume increased, nearly 2000ML, the next day, wheezing cough greatly reduced, the lower extremity edema has reduced the check half. 3 agent run ahead with Gualou, 10, 3, Balloonflower Asarum Schisandra 10, Cornus 20 grams, 10 grams of red ginseng is changed, and then five agents, patients with cough, increase appetite, edema of lower extremity to disappear, but slightly carefree. When the return of the medicine, and face-to-face party Dafa, talk about this case and its return home, after treatment, the disease turn flat, recurrent heart failure and death after a year.
This, say no more, are personal clinical experience, not a system written in plain, look dull, but it is not easy! I think this little experience on your friends may help to clinical, so is our hearts.