Slow arrhythmia is one of the common clinical symptoms, with palpitations, dizziness, fatigue, or even syncope and sudden death as the main clinical manifestations, which belongs to the category of “palpitations” and “late pulse evidence” in Chinese medicine.
It includes sinus bradycardia, sinus arrest, sinus block, pathological sinus node syndrome, atrioventricular block, etc. in Western medicine. At present, there are no effective treatment drugs in Western medicine, and in serious cases, artificial pacemakers are placed, but they are expensive and invasive, which is difficult for many patients to accept. In recent years, many advances have been made in the treatment of slow arrhythmias in Chinese medicine. Chinese medical theory has discussed a lot about the etiology and treatment of this disease. The clinical manifestations are mainly symptoms of weakness of heart qi such as chest tightness, palpitation, shortness of breath and fatigue, accompanied by symptoms of deficiency of heart and kidney yang such as white face and fear of cold, dizziness and syncope, soreness and weakness of waist and knees, etc. It is generally believed that deficiency of heart and kidney yang is the common pathological basis of this disease. The main pathogenesis is due to deficiency of heart and kidney yang, weakness of heart qi, stagnation of qi and blood, and weakness of blood flow.
I. Research on empirical formulae.
The literature reports that cardiac arrhythmias can be treated in three types.
1, heart and kidney Yang deficiency type: to warm Yang and benefit Qi, activate blood circulation, ephedra, fine spice and eucalyptus soup combined with Sijunzi Tang plus Salvia, safflower, decoction with water, and with 40-60 ml of ginseng injection intravenous drip.
2.Qi deficiency and blood stasis: to benefit Qi and blood circulation, warming the meridians and activating the collaterals, Ma Huang, Fine Pungent and Conjugate Soup combined with Si Jun Zi Tang and Blood Mansion and Blood Stasis Soup, decocted in water and taken warm, with Dan Shen Injection 20-40ml intravenous drip.
3. Qi and Yin deficiency: to benefit Qi and nourish Yin, nourish Blood and harmonize Ying, Shengveisan combined with Ginseng nourishing Ying Tang, warmed with water decoction, and 40-60ml of Shengveisan injection for intravenous infusion. Results: The effective rate was 91 49%.
Some TCM scholars took warming yang and dispersing cold, benefiting qi and nourishing the heart as the main method, and formulated their own warming yang and ascending rhythm soup (made of Radix Aconiti, cinnamon, deer horn gum, bone marrow, eucommia, yam, rehmannia, cornelian, astragalus, codonopsis, poria, chenpi, danshen, red peony) to treat 60 cases of heart-kidney yang deficiency and spleen-yang deficiency type of this disease, and the total effective rate was 90 1%. It is proposed that this formula has a bidirectional regulating effect on cardiac arrhythmia, increasing the pacing frequency of the sinus node and improving atrioventricular conduction function. There is also the method of warming Yang, dispersing cold and invigorating blood, with Yang He Tang as the main formula: Shu Di Huang, Deer Antler Gum, Cinnamon, Licorice, Gunnison, White Mustard Seed, Ephedra and Chuan Xiong, with addition and subtraction according to the evidence, treating 41 cases with a total effective rate of 95%.
II. Research on single herbal medicine
Clinical and experimental studies have confirmed that traditional Chinese medicine can not only improve myocardial blood supply, reduce myocardial oxygen consumption and treat coronary heart disease, but also many kinds of traditional Chinese medicines have better anti-arrhythmic effects, and more researches include roasted licorice, bitter ginseng, Huang Lian, Artemisia, Astragalus, Ginseng, Ephedra, Radix et Rhizoma, Mai Dong, Wu Wei Zi and Hossein. Therefore, clinicians often add these potent single herbs on top of the evidence-based prescriptions.
Roasted licorice has the pharmacological effects of cardiac diuretic, anti-shock and anti-arrhythmia, which can reduce the excitability of ectopic pacing points, regulate cardiac conduction function, reduce atherosclerosis and improve the stress capacity of the body.
Bitter ginseng has good effect on tachycardia, bradycardia, atrial premature, ventricular premature and atrial fibrillation. The bitter ginseng alkaloid has quinidine like effect, which can reduce myocardial stress by affecting the potassium and sodium ion transport system of cardiomyocyte membrane, thus can resist cardiac arrhythmia.
Berberine in Huanglian inhibits sodium channels and reduces early post-depolarization; blocks calcium channels and reduces calcium overload; inhibits potassium inward flow and increases the action potential time in Purkinje fibers and ventricular myocytes.
Artemisia annua inhibits inward rectifier potassium channels in isolated cardiomyocytes, thereby decreasing cardiomyocyte autoregulation and prolonging action potential duration.
Modern pharmacological studies have shown that Astragalus and Ginseng can exert their cardiac strengthening and improving cardiac function by inhibiting Na+ K+ ATPase.
Ephedrine in ephedra can cause coronary vasodilation and increase coronary flow and cardiac output.
One of the active ingredients of Ephedra has R-receptor agonist effect, which can improve the autoregulation of sinus node, improve and accelerate sinus and atrioventricular conduction.
Mai Dong has significant anti-rhythm disturbance and regulates myocardial excitability.
Wu Wei Zi has the function of strengthening and regulating the energy metabolism of cardiac muscle cells and improving myocardial nutrition and function.
Slow cardiac arrhythmia is one of the common clinical symptoms, with palpitation, dizziness, fatigue, or even syncope and sudden death as the main clinical manifestations, which belongs to the category of “heart palpitation” and “late pulse” in Chinese medicine. It includes sinus bradycardia, sinus arrest, sinus block, pathological sinus node syndrome, atrioventricular block, etc. in Western medicine. At present, there are no effective treatment drugs in Western medicine, and artificial pacemakers are placed in serious cases, but they are expensive and invasive, which is difficult for many patients to accept. In recent years, many advances have been made in the treatment of slow arrhythmias in Chinese medicine.
Chinese medical theory has discussed a lot about the etiology and treatment of this disease. The clinical manifestations are mainly symptoms of weakness of heart qi such as chest tightness, palpitation, shortness of breath and fatigue, accompanied by symptoms of deficiency of heart and kidney yang such as white face and fear of cold, dizziness and syncope, soreness and weakness of waist and knees, etc. It is generally believed that deficiency of heart and kidney yang is the common pathological basis of this disease. The main pathogenesis is due to deficiency of heart and kidney yang, weakness of heart qi, stagnation of qi and blood, and weakness of blood flow.
I. Research on empirical formulae.
The literature reports that cardiac arrhythmias can be treated in three types.
1, heart and kidney Yang deficiency type: to warm Yang and benefit Qi, activate blood circulation, ephedra, fine spice and eucalyptus soup combined with Sijunzi Tang plus Salvia, safflower, decoction with water, and with 40-60 ml of ginseng injection intravenous drip.
2.Qi deficiency and blood stasis: to benefit Qi and blood circulation, warming the meridians and activating the collaterals, Ma Huang, Fine Pungent and Conjugate Soup combined with Si Jun Zi Tang and Blood Mansion and Blood Stasis Soup, decocted in water and taken warm, with Dan Shen Injection 20-40ml intravenous drip.
3. Qi and Yin deficiency: to benefit Qi and nourish Yin, nourish Blood and harmonize Ying, Shengveisan combined with Ginseng nourishing Ying Tang, warmed with water decoction, and 40-60ml of Shengveisan injection for intravenous infusion. Results: The effective rate was 91 49%.
Some TCM scholars took warming yang and dispersing cold, benefiting qi and nourishing the heart as the main method, and formulated their own warming yang and ascending rhythm soup (made of Radix Aconiti, cinnamon, deer horn gum, bone marrow, eucommia, yam, rehmannia, cornelian, astragalus, codonopsis, poria, chenpi, danshen, red peony) to treat 60 cases of heart-kidney yang deficiency and spleen-yang deficiency type of this disease, and the total effective rate was 90 1%. It is proposed that this formula has a bidirectional regulating effect on cardiac arrhythmia, increasing the pacing frequency of the sinus node and improving atrioventricular conduction function. There is also the method of warming Yang, dispersing cold and invigorating blood, with Yang He Tang as the main formula: Shu Di Huang, Deer Antler Gum, Cinnamon, Licorice, Gunnison, White Mustard Seed, Ephedra and Chuan Xiong, with addition and subtraction according to the evidence, treating 41 cases with a total effective rate of 95%.
II. Research on single herbal medicine
Clinical and experimental studies have confirmed that traditional Chinese medicine can not only improve myocardial blood supply, reduce myocardial oxygen consumption and treat coronary heart disease, but also many kinds of traditional Chinese medicines have better anti-arrhythmic effects, and more researches include roasted licorice, bitter ginseng, Huang Lian, Artemisia, Astragalus, Ginseng, Ephedra, Radix et Rhizoma, Mai Dong, Wu Wei Zi and Hossein. Therefore, clinicians often add these potent single herbs on top of the evidence-based prescriptions.
Roasted licorice has the pharmacological effects of cardiac diuretic, anti-shock and anti-arrhythmia, which can reduce the excitability of ectopic pacing points, regulate cardiac conduction function, reduce atherosclerosis and improve the stress capacity of the body.
Bitter ginseng has good effect on tachycardia, bradycardia, atrial premature, ventricular premature and atrial fibrillation. The bitter ginseng alkaloid has quinidine like effect, which can reduce myocardial stress by affecting the potassium and sodium ion transport system of cardiomyocyte membrane, thus can resist cardiac arrhythmia.
Berberine in Huanglian inhibits sodium channels and reduces early post-depolarization; blocks calcium channels and reduces calcium overload; inhibits potassium inward flow and increases the action potential time in Purkinje fibers and ventricular myocytes.
Artemisia annua inhibits inward rectifier potassium channels in isolated cardiomyocytes, thereby decreasing cardiomyocyte autoregulation and prolonging action potential duration.
Modern pharmacological studies have shown that Astragalus and Ginseng can exert their cardiac strengthening and improving cardiac function by inhibiting Na+ K+ ATPase.
Ephedrine in ephedra can cause coronary vasodilation and increase coronary flow and cardiac output.
One of the active ingredients of Ephedra has R-receptor agonist effect, which can improve the autoregulation of sinus node, improve and accelerate sinus and atrioventricular conduction.
Mai Dong has significant anti-rhythm disturbance and regulates myocardial excitability.
Schisandra has the function of strengthening and regulating the energy metabolism of cardiac muscle cells and improving myocardial nutrition and function.
The volatile oil of Schisandra can significantly increase the coronary flow of the heart, and has a significant excitatory effect on the heart with positive inotropic and positive frequency effects.