Cerebrovascular disease includes hemorrhagic cerebrovascular disease and ischemic cerebrovascular disease, collectively known as stroke in Chinese medicine, which is a common and frequent disease in clinical practice. Chinese medicine has the advantages of “simple, convenient, inexpensive and experimental” in the treatment of stroke, especially in the family and community.
I. Staging and medication
Stroke is generally divided into acute, recovery and sequelae stages. Regardless of which phase, the basic idea is to treat with evidence. In the acute stage, we generally adopt the method of clearing heat and detoxifying toxins, promoting water and removing turbidity, activating blood circulation and removing blood stasis, and often apply the method of transforming phlegm and clearing liao, Xingbao Chengqi Tang, etc. We can consider the application of Qingkailing Injection, Waking Brain Jing Injection, Chuanxiong Xiongzin Injection and Dengjianxin Injection; in the recovery stage and sequelae stage, we mainly focus on tonifying qi and clearing liao, and appropriately supplement with tonifying kidney, resolving phlegm and activating blood, and often use the addition and subtraction of Tonic Yang Returning Five Soup.
1, wind-phlegm blocking ligament evidence: hemiplegia, distorted mouth and tongue, speech is hesitant or inarticulate, sensation is reduced or disappeared, dizziness and dizziness, phlegm is abundant and sticky, tongue is dull, tongue coating is thin white or white greasy, and pulse is stringent and slippery. The representative formula is to reduce the phlegm and Tongluo Tang with addition: Fuxianxia 9g, Atractylodes Macrocephala 9g, Tianma 12g, Zitangshen 15g, Xiangxiang 9g, Bile Nanxing 6g, Wine Rhubarb 6g, Panax Ginseng Powder 3g, etc. Or use compound Dilong capsule, Langshifu Suo tablets.
2.Phlegm-heat and internal organs evidence: hemiplegia, distorted mouth and tongue, speech or no speech, loss of sensation or disappearance, abdominal distension, dryness and constipation, headache and dizziness, phlegm or phlegm, dark red tongue, yellowish greasy coating, slippery pulse or slippery and large pulse on the side of hemiplegia. The representative formula is Xingguazhu Chengqi Tang with addition and subtraction: 30g of whole Guahu, 6g of Bile Nanxing, 9g of raw rhubarb under the back, 9g of Mannitropin, 15g of Danshen, etc. Or use Niuhuang Qingxin Wan, An Brain Pill.
3.Qi deficiency and loss of transportation: hemiplegia, distorted mouth and tongue, speech is astringent or inarticulate, decreased or absent sensation, white face, shortage of breath, salivation at the corners of the mouth, spontaneous sweating, palpitations and loose stools, swelling of hands and feet, dull tongue, white and greasy tongue coating with teeth marks, sunken and thin pulse. Representative formula: Huang Qi 30g, Angelica Sinensis 9g, Tao Ren 9g, Safflower 9g, Radix Paeoniae 15g, Chuan Xiong 9g, Di Long 9g, etc. Or use cerebral heartache, Tongxinluo, Qixin capsule.
4.Yin deficiency and wind movement evidence: hemiplegia, distorted mouth and tongue, speech is sluggish or inarticulate, decreased or absent sensation, vertigo and tinnitus, heat in the hands and feet, dry throat and mouth, red tongue and thin body, little or no moss, thin pulse. Representative formula of Yuyin Tongluo Tang with addition and subtraction: 15g of raw Dihuang, 9g of Cornu Cervi Pantotrichum, 15g of Crocus posterior hypoglossus, 9g of Tianma, 15g of Salvia, 15g of White Peony, etc. Or use Tianzhi granules, dizzying pain.
Second, acupuncture treatment, improve the efficacy
Acupuncture treatment can be carried out as soon as possible after the condition is stabilized, and the evidence can be divided into middle meridians and middle organs. In the middle meridian, acupuncture points are mainly taken from the hand and foot Yangming meridian points, supplemented by the Sun and Shaoyang meridian points; in the middle viscera, the Ren pulse point is used as the main point, and moxibustion with large moxa cones is used for the treatment; in the closed meridian, Shuigou and Twelve Wells points are taken as the main points. Middle meridians: upper extremity acupuncture points–Shoulder k, Quchi, Waiguan, Hegu, Neiguan, etc.
Lower extremity acupuncture points – Huanjiao, Chengfu, Fengshi, Foot Sanli, Blood Sea, Guizhong, Yanglingquan, Taichong, etc. Add Fengchi, Wanbone, Tianzhu, Tianrong for swallowing disorder; Lianquan, Jinjin, Yuyi, Mute Gate for unfavorable speech; Baxie and Houxi for finger grip; Qiuhui and Zhaohai for foot entropion; A choke point is needled for swallowing difficulty in pseudobulbar palsy. Methods: Acupuncture once daily. Middle visceral organs: acupuncture points for deconditioning – Guan Yuan and Foot San Li are selected, and large moxa cones are applied with moxibustion across ginger, and Shen Que is moxibustion across salt. Closed evidence points – Shuigou, Twelve Wells, Taichong, Fenglong, and Laogong. Method: Acupuncture or moxibustion once a day.
Third, exercise rehabilitation, perseverance
Rehabilitation training for stroke patients can be started after the stabilization of vital signs, usually 7 to 14 days after the disease. It includes rehabilitation of motor function, sensory disorders, spasticity, aphasia, dysarthria, swallowing disorders, etc. The program includes the setting of good limb position, passive joint mobility maintenance training, adaptation training for position change, balance response induction training, and spasticity inhibition. The principles and methods of “relaxation” and “stillness” are implemented in the rehabilitation process. “Relaxation” means relaxation of the mind and local relaxation of the hemiplegic limb, including the healthy limb. “In “quiet”, the patient’s mind should be quiet and calm, and overcome anxiety and depression. In the community, patients should be encouraged to carry out the necessary active training and be persistent, in order to achieve the harmonious circulation of qi, blood and tendons and prevent muscle contractures. For patients with milder disease, jogging, walking, taijiquan, qigong and other activities should be carried out appropriately, and not to lie down for a long time, which will slow down blood circulation and is not conducive to the recovery of body functions after stroke.
Fourth, psychological balance, relapse prevention
The so-called “emotion and will” actually refers to the mental state of the human spirit. The Yellow Emperor’s Classic of Internal Medicine repeatedly discusses the damage caused by poor mental and psychological states to the organs of the human body, saying that “anger hurts the liver”, “joy hurts the heart”, “thought hurts the spleen”, “sadness hurts the lungs”, and “worry hurts the spleen”. “Sadness hurts the lungs” and “Fear hurts the kidneys”. Many stroke patients are often accompanied by emotional disorders, such as depression, anxiety, etc., and this emotional disorder can aggravate or trigger the recurrence of stroke.
Psychological balance can be achieved through the following ways.
1.Be indifferent to fame and fortune
The Yellow Emperor’s Classic of Internal Medicine says: “If you are calm and void, your true energy will come from it; if you keep your spirit inside, you will be safe from illness.” The so-called “internal guard”, means that the spirit of peace in the internal, and not distracted by the outside, to “cultivate sex to protect God, peace of mind to the whole body” (Jikang “health theory”), in order to maintain the coordination of the internal environment and calm, so as to enter the best physiological state.
2.Smooth emotions
It is to try to change one’s negative emotions into positive emotions, so as to lay the necessary psychological foundation for a long and healthy life. The modern health practitioner Ding Fubao in the “Ding Fubao training”, then has a thorough discussion of this: “Cheerful bosom, then long life can be expected; if too much worry, it makes people easy to grow old. The feelings of ordinary people, suffering is sad, happy is laughing, sadness is the most hurtful, but the most beneficial pen of joy. Laughter can complement the brain marrow, live tendons and collaterals, Shu Qi and blood, eliminating food stagnation, better than taking medicine and bait, you must have a moment of leisure every day, the scene of the play, the mouth capital laughing, but also benefit the body.”
3.Discharge depression
When the patient is already in the sorrow, must try to excrete it as soon as possible, so as not to aggravate the disease. The Yellow Emperor’s Classic of Internal Medicine mentions that “tell the patient about his defeat”, “talk to him about his goodness”, “guide him to his convenience”, and “open him to his suffering “In essence, they all advocate the use of reasoning and enlightenment to vent the patient’s inner sorrow.
4.Be active and productive
While emphasizing a clear mind and tranquil emptiness, it in no way means that they advocate transcendence and escape from reality. In fact, spiritual peace and health are not contradictory to a positive attitude towards life. If a person can do something and make a contribution, it will not only benefit society and others, but also be beneficial to one’s physical and mental health. Our generations of health practitioners have been active, learning and doing something for the elderly as an important part of the method of regulating the emotions and health.
5.Nurture morality
Good moral cultivation is an important sign of mental health. A person only pay attention to moral cultivation, so that “lust can not labor its eyes, lust and evil can not confuse its heart”, it is possible to “end its natural life, a hundred years is to go.” (Yellow Emperor’s Classic of Internal Medicine).
V. Body identification and dietary treatment
Physique identification means that under the guidance of TCM theory, using the principle of balance of yin and yang of the human body and the five organs, the traditional four diagnoses of looking, smelling, asking and cutting are used to determine the TCM physique and current functional state of the examined person, and to give countermeasures for TCM treatment and guidance for daily regimen for different physiques, including dietary taboos, dietary therapy suggestions, attention to tonic matters in all seasons, and cultivation of healthy habits, etc. Prof. Wang Qi of Beijing University of Traditional Chinese Medicine (BJU) has widely used the nine types of physique identification method (calm, qi-vacant, yin-vacant, yang-vacant, phlegm-damp, damp-heat, blood-stasis, qi-yu, and special endowment) in clinical practice.
For stroke patients, you can refer to the above situation to identify and administer meals. For example
1, for patients with hyperactive liver Yang type can be considered to apply cold three shreds: 200 grams of young celery stalks, 100 grams of seaweed, 50 grams of black fungus. First, wash the celery stalks, cut into 3 cm long, with boiling water Nao 3 minutes and then pulled out; black fungus soaked in warm water for 2 hours, washed, and then soaked in cool water for 1 hour, shredded, with boiling water Nao cooked; soak the kelp in warm water for 1 hour, Nao clean, shredded, with boiling water cooked; then the three shreds cooled and mixed with seasonings. Eat with meals. This dietary prescription has the effect of calming the liver and resolving phlegm, lowering blood pressure and lipids, and can be used for stroke prevention, especially for patients with increased blood pressure, increased blood lipids and arteriosclerosis.
2. For patients with Qi deficiency and blood stasis, consider applying Ginseng and Radix Angelicae Sinensis porridge: 10 grams of ginseng, 30 grams of astragalus, 10 grams of Radix Angelicae Sinensis, 1 egg (remove the yolk), and 50 grams of millet. First, break the ginseng, add water and decoct the soup with a gentle fire, then add millet and cook the porridge, when it is ready, add egg white and Allium sativum and cook. Take it in 2 times in the morning and evening. It is suitable for those who suffer from stroke hemiplegia caused by deficiency of qi and blood, often accompanied by clinical manifestations such as partial exhaustion, limb impotence and weakness.
3, for patients with deficiency of kidney essence can be considered the application of asparagus pig brain soup: a pair of pig brain asparagus 2 grams. Powder the asparagus, and pig brain together with the right amount of water, cook and stew for 1 hour over low heat to form a thick soup. Drink the soup and eat pig brain, one dose per day, eaten in portions, can often eat. Efficacy and indications It can nourish the kidney and brain, nourish the blood and the luo. It is suitable for Alzheimer’s disease, forgetfulness due to stroke, vertigo and tinnitus. It is also good for cerebral arteriosclerosis.