I. Overview
Vertigo is a combination of two symptoms, vertigo and dizziness. The lighter one is like sitting in a boat, and the attack is short-lived, but the heavy one is feeling spinning, unable to stand, sometimes nauseous, and even fainting; the dizziness is dizziness, which is the feeling of unstable head movement.
In modern medicine, vertigo is mostly seen in patients with hypertension, arteriosclerosis, anemia, neurosis, otogenic diseases, cervical spondylosis, etc.
According to Chinese medicine, vertigo can be caused by wind, phlegm, dampness and deficiency, so it is said that “no wind does not make vertigo”, “no phlegm does not make vertigo” and “no deficiency does not make vertigo”. Here we mainly talk about otogenic vertigo.
Symptoms, signs and treatment
The characteristics of vertigo are sudden onset of vertigo, the patient feels spinning, tinnitus, deafness, nausea and vomiting, spontaneous nystagmus, afraid to move the position, and vertigo worsens when the position is changed. In addition, during the attack, patients often have panic attacks, pale face, cold sweat and other symptoms.
In clinical practice, patients with vertigo can be treated according to the type of vertigo
1. Hyperactivity of liver and yang. This type of dizziness is mostly aggravated by mood swings, mood discomfort and worries, and may be accompanied by headache, bitter and dry mouth, red eyes, restlessness, sleeplessness and dreaminess, red tongue with yellow coating, and stringy pulse. To treat this type of dizziness, it is recommended to calm the liver and calm the wind, nourish yin and submerge yang, using Tianma and Hooked Vine Drink plus or minus. The composition of the formula is Tian Ma, Hooked Vine, Gardenia, Scutellaria, Shijiao Ming, Chuan Niu Kne, Eucommia, Nightshade, Xia Ku Cao, and Gentian Cao. Tianma, hooked vine and stone cassia pacify the liver and subdue the yang and calm the wind, and at the same time, nourish the yin by benefiting the kidney with cow knee, dulcimer and mulberry, treating the root of the problem; scutellaria and gardenia can clear the fire in the liver. Take one dose daily with water decoction.
2. Phlegm and turbidity in obstruction type. This type of vertigo is mostly caused by the patient’s poor diet, which damages the spleen and stomach, and the spleen loses its health, so that the water and grain are not properly transported and transformed, and the dampness gathers and generates phlegm, and the phlegm blocks the middle jiao, so that the clear yang does not rise and the turbid yin does not descend.
The main clinical manifestations of vertigo with phlegm obstruction are dizziness and heaviness, fullness in the chest and diaphragm, nausea and vomiting, inability to think about eating and drinking, heaviness in the limbs, white and greasy tongue coating, and moist and smooth pulse.
To treat this type of dizziness, it is recommended to dispel phlegm and resolve dampness, which can be done by using Han Xia Bai Zhu Tian Ma Tang. The formula is composed of Radix et Rhizoma Atractylodis Macrocephalae, Rhizoma Atractylodis Macrocephalae, Rhizoma Tangerine, Poria, Licorice, Ginger and Jujube. The formula is based on the principle that Han Xia dries dampness and dissolves phlegm, reduces rebellion and stops vomiting, Tian Ma calms the liver and stops dizziness; Bai Zhu carries the spleen and dries dampness, Fu Ling strengthens the spleen and permeates dampness as the minister; Orange Red regulates qi and dissolves phlegm, ginger and jujube harmonize the spleen and stomach as the adjuvant; Licorice cooperates with all the medicines as the messenger. The combination of the herbs together can dry dampness, resolve phlegm and calm the liver and wind. One dose is taken daily with water decoction. If the patient shows symptoms of phlegm stagnation and heat, such as head and eyes pain, bitterness and distress, yellow and greasy moss, slippery pulse, the patient should use drugs to clear heat and resolve phlegm, and can use Warm Gall Bladder Soup (Radix Panax, Chen Pi, Poria, Citrus Aurantium, Bamboo Roo, Ginger, Jujube, Licorice) with Huang Lian and Scutellaria. Take one dose daily with water decoction.
3. Insufficient middle qi type. This type of vertigo mostly develops due to the patient’s overexertion and injury to the vital energy, or due to the weakness of the spleen and stomach and deficiency of the middle energy. As stated in Ling Shu – Mouth Questions, “Insufficient upper qi makes the brain dissatisfied, the ears ringing bitterly, the head tilting bitterly, and the eyes dazzling.”
The main clinical manifestations of vertigo with deficiency of middle qi are dizziness and weakness, shortness of breath and sleepiness, aggravated by exertion, laziness and laziness in speech, spontaneous sweating, pale face, loose stools, pale tongue with white fur and weak pulse.
For the treatment of this type of dizziness, it is recommended to tonify the middle and benefit the qi, and we can use tonifying and benefitting qi soup with addition and subtraction. The formula consists of Astragalus, Ginseng, Glycyrrhiza glabra, Atractylodes macrocephala, Angelica sinensis, Chen Pi, Sheng Ma and Chai Hu. In this formula, Astragalus nourishes the middle and benefits the qi and elevates the yang to fix the surface as the ruler; Ginseng, Rhizoma Atractylodis Macrocephalae and Glycyrrhiza Macrocephala benefit the qi and nourish the spleen and stomach as the subjects; Chen Pi regulates the qi and Angelica nourishes the blood and harmonizes the ying as the adjuvants; Sheng Ma and Chai Hu work together with Ginseng and Astragalus to elevate the clear yang as the messengers. The whole formula, on the one hand, tonifies the qi and strengthens the spleen, so that there is a source of biochemistry in the latter part of the body and the spleen and stomach can be cured; on the other hand, it elevates the middle qi and restores the function of lifting and lowering of the middle jiao, so that the evidence of lowering and prolapse can be restored to its position. Take one dose daily with water.
4. Kidney essence deficiency type. This type of vertigo mostly develops due to the patient’s congenital deficiency of kidney qi or weakening of kidney qi in old age, or due to excessive intercourse and deficiency of kidney essence. As it is said in the “Spiritual Pivot – Sea Theory”, “Insufficient medulla oblongata will result in brain spinning and tinnitus, sore shins and vertigo, no vision in the eyes, and slackness and rest.”
The main clinical manifestations of vertigo with deficiency of kidney essence are dizziness and tinnitus, mental depression, memory loss, soreness and weakness of the waist and knees, eye blossoms, seminal emission, impotence, thin and light red tongue, and sunken and thin pulse.
For the treatment of this type of dizziness, it is advisable to tonify the kidney and fill the essence, and Zuo Gui Wan can be used, taking 9 grams each time, twice a day. The composition of the formula is Shu Di, Yam, Fructus Lycii, Cornu Cervi Pantotrichum, Niubizi, Semen Cuscutae, Deer Antler Gum and Turtle Board Gum. In this formula, rehmannia nourishes the kidneys and fills the essence, nourishing the true yin, and is the ruling herb. The herb is used to nourish the liver and nourish the kidney, astringent essence and astringent sweat; the herb is used to nourish the spleen and benefit the yin, nourish the kidney and fix the essence; the herb is used to nourish the kidney and benefit the essence, nourish the liver and brighten the eyes; the herb is used to nourish the blood and flesh and nourish the essence; the herb is used to nourish the yin and the herb is used to nourish the yang; the herb is used to nourish the yin and the herb is used to nourish the yang. Cuscuta sinensis and Chuan Niu Knee benefit the liver and kidneys, strengthen the waist and knees, and strengthen the muscles and bones, both of which are adjuvants. The combination of all the herbs can nourish the yin and tonify the kidney and fill in the marrow. If the patient has symptoms of kidney yang deficiency, such as cold form and cold limbs, clear and long urine, pale tongue, sunken pulse, etc., Zuo Gui Wan can be used with Radix et Rhizoma Polygonati, Cinnamon, Angelicae Sinensis and Dulcimer.
5. Acupuncture treatment. I generally apply the “Xiang Cong stabbing method” combined with different types of evidence and then select the corresponding acupuncture points for treatment, which is very effective.
III. Diet and health care
1, black beans 30 grams, 30 grams of wheat, water decoction, treatment of night sweats and vertigo.
2, black sesame seeds, made shouwu, wolfberry 25 grams each, Hang chrysanthemum 15 grams, water decoction, a daily dose, to treat kidney deficiency vertigo, premature gray hair.
3, treatment of kidney Yang deficiency headache, dizziness: 250 grams of dog, 10 grams of asparagus, 15 grams of Radix et Rhizoma Ginseng, 10 grams of Radix et Rhizoma Polygonati, water decoction to remove the dregs, drink the juice and eat the dog, daily 1 material.
4, treatment of weak blood deficiency, malnutrition, dizziness: 100 grams of tomato, 100 grams of pig liver, 100 grams of round-grained rice, 3 slices of ginger. First, wash and slice the pig liver, stir with salt, soy sauce, cornstarch, rice wine; tomatoes, cut; ginger washed, peeled, shredded; clean japonica rice into a pot, add an appropriate amount of water, boil for 20 minutes, add tomatoes, ginger, cook for 10 minutes, then add the pig liver, boil for a few minutes until the pig liver just cooked, seasoning with meals.
5, fresh celery 500 grams of pounded juice, boiled water, serve a daily dose, cure hypertension, headache dizziness.
What is good for patients to eat?
In terms of diet, it is advisable to eat more light and moist products, such as winter melon, corn, millet, lotus leaf porridge, radish, beans and soy products, black fungus, eggplant, pea seedlings, tomatoes, lettuce, oranges, grapefruit, peaches, soybean oil, tea, carp, jellyfish and so on. Among them, special emphasis is placed on eating more kumquats, orange cakes and radishes. Kumquat can regulate qi, relieve depression and resolve phlegm. The orange cake can resolve phlegm, broaden the middle and lower the qi, phlegm in the blocked dizzy people should eat. In addition, orange peel, orange red and orange luo all have the function of resolving phlegm and relieving qi, which are suitable for people with dampness and phlegm dizziness. Radish has the function of resolving phlegm and heat and eliminating stagnation. The Materia Medica Classic also says that it “removes phlegm fetishes, resolves phlegm and eliminates dysfunction”. It is suitable for those who suffer from vertigo caused by phlegm and dysfunction.
What is not suitable for patients to eat?
People who suffer from vertigo should avoid the following foods according to their respective conditions.
Avoid cold fruits and melons, sweet food and greasy food to avoid phlegm and dampness.
1.Honey
Honey is flat and sweet in nature, but it has the effect of tonifying the middle and benefiting the qi, but it has the disadvantage of being sticky and congested. Therefore, it is suitable for those who have vertigo, but it is not suitable for those who have vertigo caused by phlegm.
2.Da Zao
It is warm in nature and sweet in taste, which can nourish the qi and benefit the blood, so it is suitable for those who have vertigo with insufficient qi and blood. But jujube nourishes and helps phlegm. In “Introduction to Medicine”, it is believed that “more food moves the wind”. For those who suffer from dizziness caused by phlegm, eating it will aggravate phlegm and dampness, so it should be avoided.
3.Chili
Food taboo” says it is “hard and hot”, so it is easy to consume yin and help heat on fire. The “Drug Examination” pointed out that “chili pepper, eat more dazzling spin, fire is also.” This indicates that the hyperactive liver Yang, liver fire, including hypertension, vertigo, should be avoided.
4, lychee
Warm, sweet and sour. “Yulan medicine” that “litchi, sweet warm nourishing.” “Compendium of Materia Medica” has said: “fire patients are especially contraindicated.” The ancients also believed that: eating too much lychee meat will be intoxicated, with dizziness, nausea, weakness, which is due to eating too much in the body caused by disorders of sugar metabolism. Therefore, the liver fire vertigo and phlegm vertigo people, the law when to avoid eating.
5, betel nut
It is a food that consumes qi. The “Classic of the Materia Medica” has warned: “The disease is a gas deficiency is contraindicated. Where the yin and yang deficiency, deficiency in the qi, …… all in the contraindicated.” Therefore, anyone who is deficient in qi and blood and has vertigo in a weak body should not take it.
In addition, those who have vertigo with physical deficiency should avoid eating onion, ginger, chili pepper, pepper, cinnamon, radish, tea, white wine and other spicy and dry things that break the qi and consume qi; those who have vertigo with phlegm and dampness should also avoid eating cinnamon, fatty meat, astragalus, goose meat and other nourishing and greasy products that help dampness and produce phlegm; those who have vertigo with liver and yang should also avoid eating dog meat, rooster, chili pepper, cinnamon, ginseng, Chuanxiong, Zihecha and other sweet and spicy foods that help heat and fire.
Prevention and care
1.Prevention:
① Pay attention to rest, participate in physical exercise appropriately, and combine work and rest.
②Adjust the mood and avoid mental stimulation.
(3) For those with phlegm disturbance, a light diet is recommended.
2.First aid
①In case of vertigo, rest quietly in bed immediately and loosen the clothes buttons and belt of the patient. Take Valium 5mg orally, 3 times/day.
Do not shake the patient’s head to avoid aggravation of vertigo. Ice pack or cold water towel can be put on the patient’s head. Ask doctor to treat if the cause is unknown.
3. Other precautions:
①Patients should be in a relaxed mood; doctors should do more explanation work to eliminate patients’ tension and concerns.
②The patient should rest in bed during seizures, the room should be quiet, the air should be clear, and the light should be as dark as possible. Avoid stimulating food, tobacco and alcohol, and eat with less salt.
③It is not advisable to go out alone during the interictal period to prevent accidents.
4.Care
How should patients with vertigo be cared for?
(1) General care
(1) Instruct patients with vertigo to rest in bed or move appropriately according to medical advice. The ward should be close to the nursing station.
②Explain the causes of vertigo; instruct the patient to avoid strenuous activities and emotional excitement; when sitting up in the prone position or standing up in upright hypotension, the movement should be slow and invasive; when there is dizziness, blackness and other aura of vertigo, squat or lie down immediately to prevent falling. When you feel that you are rotating or things around you are rotating, you should squat down slowly.
(2) Normal care
Pay attention to exercise and strengthen the body. Those who have a weak qi and blood should pay attention to the combination of work and rest, maintain sufficient sleep time, and do not over-starve. For those with mental deficiency and fragile feelings, do not participate in hanging and mourning to avoid bad influence and fainting pang. In the heat of the season, or high-temperature operations, to take effective measures to prevent heatstroke. It is necessary to eat and drink in moderation, and to control the room reasonably.
V. Complications of vertigo
1. Patients with vertigo will experience rotation and vomiting during the attack period, and also cause damage to the vagus, vestibular and cochlear organs, resulting in death of cochlear hair cells and loss of vestibular function, which in turn causes tinnitus, deafness, ataxia and other harmful effects. If left untreated, it can easily cause decline in thinking, headache dementia, cerebral thrombosis, cerebral hemorrhage, hemiplegia, stroke and hemiparesis, and even sudden death.
2, middle-aged and elderly patients, multiple attacks can affect the cerebrovascular regulation function and brain microcirculation, aggravate the cerebral blood supply deficiency, inducing cerebral infarction and other diseases.
3, affect social intercourse, life circle shrinkage, mental stress increases, etc.
4.The normal activities such as pit, well, crossing the road, traveling and climbing become dangerous activities due to the fear of sudden attack of Meniere’s syndrome. Therefore, doctors remind middle-aged people must pay special attention to rest and sleep to avoid overexertion. Patients with Meniere’s syndrome need to pay attention to careful activities in the acute period and try to rest in bed, so as to avoid the danger of falling and fracture due to vertigo.