Hong Kong Chunlinxuan Medicine Information Exchange Center
Thinking disorder, the name of modern medicine, is a kind of neurosis. This is very common among women. In recent years, the number of children suffering from this disease is increasing day by day. Its clinical manifestations are autism, paranoia, irritability, palpitation and fear, and shortness of breath, dyspnea and dyspnea are common at the onset, and the symptoms are cardiopulmonary dysfunction. Traditional Chinese medicine believes that this disease is closely related to heart, lung and liver, and can also involve spleen and kidney. .
Neurosis is a group of functional diseases of nervous system, including neurasthenia, hysteria, neurosis and various visceral neurosis (such as cardiovascular neurosis and gastrointestinal neurosis). ). It belongs to traditional Chinese medicine; Depression syndrome, fatigue, lily, dirty impatience, syncope syndrome, dumb wind, plum blossom, running dolphins and other categories. Most of them are caused by the injury of seven emotions, accumulation of damp heat and other reasons, and sadness, lung, spleen, liver and kidney.
Due to the high development of society, there are contradictions between material civilization and spiritual civilization in some ethnic groups in modern society, the disparity between the rich and the poor, the disharmony of interpersonal relationships and the deepening of contradictions. In addition, children's work pressure, adults' work pressure and environmental pressure: for young people with weak body and low self-confidence, when the internal and external causes of this syndrome form favorable conditions, it will become ill. The common clinical manifestations are heart, lung and organ diseases. It is more common in suspicious, anxious and neurotic female patients, and it is a syndrome of neurasthenia. Pathological anatomy showed no obvious organic lesions, and the prognosis was good. From the clinical manifestations, it is similar to the description of fright, dizziness, shortness of breath and insomnia in traditional Chinese medicine, so the pathogenesis of traditional Chinese medicine is mainly reflected in abnormal blood circulation and consciousness.
This paper mainly expounds the explanation of high dynamic heart syndrome in neurosis; Summarized as follows
(1) Sensory disorder: It mostly occurs in immature young men and women. The clinical symptoms are autism, paranoia, palpitation, palpitation, fear, overeating, or nausea, vomiting, anorexia, weak or knotted pulse, red tongue and thin white fur in a few cases. Traditional Chinese medicine believes that it belongs to the category of "palpitation, palpitation and asthma". It is one of the heart and lung diseases. It is caused by heart-blood deficiency, yang deficiency, internal friction of yin and blood, water and drink stopping under the heart, water and gas occupying the heart, or heart fatigue, or lung failure and qi stagnation.
The disease is mostly female, but it can also be seen in adolescents clinically. This disease is also called hyperventilation syndrome in children, which belongs to a type of cardiac neurasthenia. This is an increasing number of children's psychosomatic diseases in recent years. It can be divided into four types: first, mental disorder type: mainly manifested as palpitation, palpitation, panic and insomnia. A few patients are accompanied by nausea, vomiting, anorexia, thin and white tongue coating, weak pulse or knotting. Treatment should be determined to nourish the heart and soothe the nerves. Second, the heart-yang deficiency is weak and upset: palpitation, inattention, obvious decline in academic performance, insomnia, dizziness, mental fatigue, white tongue coating and heavy pulse. It is advisable to warm the heart and yang and set your mind at ease. Phlegm-heat disturbance type: symptoms include palpitation, chest tightness, dizziness, shortness of breath, irritability, anorexia and loose stool. The fur is greasy and the pulse is slippery. Treatment should clear liver and stomach, regulate qi and eliminate phlegm. The fourth is the heart and spleen? Deficiency syndrome: clinical manifestations include palpitation, insomnia, dreaminess, forgetfulness, loss of appetite, listlessness, sallow complexion, abdominal distension, loose stool, pale tongue with white fur and thready pulse. Treatment should benefit qi and nourish blood, strengthen spleen and nourish heart.
(2) For adult patients, the clinical manifestations are paranoia, anxiety and nervousness, which are common in female patients, and the etiology belongs to the category of hyperdynamic heart syndrome. The disease often worsens after fatigue or emotional excitement. Patients are often in a state of excitement, and they are more prone to dizziness, palpitation, shortness of breath and fatigue, often accompanied by insomnia, dreaminess, sweating, shaking hands, memory loss, and sometimes dull pain or tingling in the precordial area, which is characterized by poor breathing. Clinically, patients like to take deep breaths, but breathe more and breathe less, and their breathing deepens and accelerates, resulting in shortness of breath, chief complaint of suffocation or chest tightness and chest pain. The disease can be classified as depression syndrome, asthma syndrome or hysteria in traditional Chinese medicine, which is closely related to liver and lung. When the liver loses its qi and the lung loses its qi, it will cause disease. Because the symptoms of this disease are shortness of breath and hyperventilation, the treatment should start from the liver and lungs; Therefore, at ordinary times, soothing the liver and relieving depression, calming the heart and calming the nerves are the main methods, and the method of clearing the liver and purging the lungs is used when the disease occurs. .
(3) If it happens in healthy young men, it is called β -adrenergic syndrome (also called idiopathic hyperdynamic heart syndrome, or you are primary hypercardiac output syndrome, etc. ). The disease is a group of clinical syndromes with cardiovascular system dysfunction and autonomic nervous dysfunction as the main symptoms, which are mostly caused by increased sympathetic nerve excitability, decreased vagus nerve tension and β receptor dysfunction. There is no organic heart disease, which is similar to high dynamic heart syndrome. Its clinical features include: low fever, palpitation, hyperhidrosis, chest pain, dizziness, poor sleep, dyspnea, and even sitting breathing. Others can be regarded as emotional excitement, anxiety, increased heart rate, hyperactivity of heart sounds and slight increase of blood pressure. Electrocardiogram showed sinus tachycardia, ST segment moving down, or T wave inversion and low level. Therefore, its TCM treatment can refer to the syndrome differentiation and classification of hyperdynamic heart syndrome.
Traditional Chinese medicine believes that the heart and meridians are handsome in blood, plus gallbladder depression and phlegm disturbance. β -adrenergic syndrome is mostly caused by the decline of heart qi and blood and the imbalance of yin and yang. Clinically, it can be divided into three types: deficiency of heart and spleen, deficiency of qi and yin, and stagnation of liver qi.
1. Deficiency of both heart and spleen: good symptoms, hyperventilation, dreaminess, sallow complexion, loss of appetite, loose or dry stool, pale tongue and light tooth marks. Weak pulse, female patients may be accompanied by menstrual disorders. Treatment should benefit the heart and spleen.
Second, deficiency of both qi and yin: symptoms are too good to breathe, fatigue, shortness of breath, five upset, insomnia, easy to be surprised, bitter mouth and dry mouth, constipation. Red tongue, little or thin coating, and thin pulse. Treatment should benefit qi, soothe the nerves and nourish yin.
Third, liver qi stagnation type: symptoms are long time, excessive breathing, chest tightness, abdominal distension, irritability, less picky eaters, normal or dry stools. The tongue is pale or pale, the coating is thin, white or yellow, and the pulse is slippery. Treatment should be based on soothing the liver, relieving depression and regulating qi.
To sum up the above symptoms, according to the clinical manifestations, it is similar to the description of fright, syndrome, shortness of breath, breathlessness and insomnia in traditional Chinese medicine. Its pathological pathogenesis is mainly reflected in abnormal qi and blood circulation and consciousness. It is closely related to heart, liver, spleen and lung. Therefore, in the treatment, we should use the methods of invigorating heart and clearing gallbladder, strengthening spleen and regulating qi, and choose Tianwang Buxin Dan, Gualou Bulong Bai Banxia Decoction, Wendan Decoction and Guipi Decoction according to the symptoms.
Take two patients treated by doctors in our hospital in the medical center as examples: a boy patient aged 15 and an adult female patient;
One: Male patients: mainly autistic, fidgety and overeating. When you are in a bad mood, you often lose your temper with your parents and sisters, and it is even more violent to your mother. Everyone in your family endures it. I have been seeking medical treatment in the western medicine department for three years, and I was treated with integrated traditional Chinese and western medicine before March, and the effect was satisfactory. I'm still seeing a doctor. The prescription is Tianwang Buxin Dan, Baohe Pill and Longdan Xiegan Decoction.
Second, female adult patients: too tired, poor health, insomnia, exercise, so lack of self-confidence, less social activities, strong vigilance against men, menstrual disorders. When I first came here, I was skeptical. I didn't want to come with my friends, let alone have a girl around me. After treatment in April, I became cheerful and willing to talk to girls. The prescription is Tianwang Buxin Dan combined with Guipi Decoction and Shenqi Pill. I'm still seeing a doctor.
Respondent: tzbinc-Jinshi was born on August 218: 03, grade 9.
* * * * What is myocarditis?
Myocarditis refers to myocardial localization or diffuse inflammation caused by various reasons. Although some myocarditis is considered as secondary cardiomyopathy by some scholars because it can be transformed into congestive or restrictive cardiomyopathy at the end stage, it is a distinguishable disease type in pathogenesis. There are many reasons for myocarditis, such as virus, bacteria, fungi, parasites, immune response, physical and chemical factors and so on.
* * * * How to prevent viral myocarditis?
Viral myocarditis is a kind of heart disease that people began to pay attention to in recent years. The vast majority of patients are teenagers.
Viral myocarditis is a virus that directly invades the heart after a cold, damages the myocardium and affects its blood supply, or a toxin produced locally by the virus, which involves the central nervous system and causes secondary damage to the myocardium. The disease has no obvious seasonality, and most patients are sporadic, which rarely causes epidemic.
Viral myocarditis is caused by many viruses, and Coxsackie virus is an important source of infection. Influenza virus, mumps virus, enterovirus and poliovirus can all cause myocarditis. In addition, the disease is also related to smoking, drinking, malnutrition, fatigue, trauma and exposure to toxic substances. Viral myocarditis usually has cold symptoms before onset. So it is often mistaken for a cold, which delays the diagnosis and treatment of myocarditis.
A few days before the onset of viral myocarditis, in addition to cold symptoms, there are persistent palpitation, shortness of breath, hypotension, hyperhidrosis, fatigue, chest tightness and a sense of oppression in the precordial area. In severe cases, dyspnea and heart failure may occur. During the examination, we can find that the first heart sound is weakened and the fourth heart sound appears. On ECG, the heart may beat slowly or excessively, and the T wave may be flat, sharp or inverted. It may also be accompanied by different degrees of atrioventricular block.
At present, there is no special treatment for viral myocarditis, which mainly emphasizes early rest and symptomatic treatment. In the acute phase, antitoxic drugs such as amantadine, cytarabine and interferon can be used. Choosing vitamin C, inosine, adenosine triphosphate, coenzyme A and cytochrome C can promote the metabolism of myocardial cells. In addition to introduction, Radix Isatidis, Radix Glycyrrhizae, Ramulus Cinnamomi and Radix Salviae Miltiorrhizae all have therapeutic effects on viral myocarditis.
In order to prevent viral myocarditis, we should first prevent colds and enterovirus infections, often take part in physical exercise, improve the body's disease resistance, and often open windows for ventilation to keep the air fresh. In the cold season, go to crowded places as little as possible, and pay attention to prevent various virus infections. Once you find a virus infection, you should pay attention to rest to avoid excessive fatigue, and it is not suitable for smoking and drinking.
Treatment of viral myocarditis
At present, there is no specific treatment for viral myocarditis, which mainly depends on comprehensive treatment measures. General treatment includes: ① After resting myocarditis, there are diffuse lesions in the myocardium, especially in the left ventricle. Bed rest can reduce heart load, reduce myocardial oxygen consumption, help the absorption of myocardial inflammation and repair diseased cells. The time of bed rest depends on the severity of the illness. Generally, you should rest for 2-3 months in the acute phase, and then gradually increase your activity after your condition improves. If you have heart enlargement or heart failure, you should stay in bed until the heart shrinks to normal size and the heart function returns to normal and stable, and then start to get out of bed slightly, and gradually increase the activity according to the recovery of the disease. 2 Diet should give foods rich in vitamins and easily digested by protein. Eat less and eat more, avoid overeating, so as not to increase the heart load; ③ Sedation and oxygen inhalation: those who are crying and fidgety should be sedated, and those who have symptoms of hypoxia should be given oxygen inhalation. Cardiomyocyte activating drugs can be used for comprehensive treatment, and vitamin C and fructose diphosphate can be injected intravenously in acute stage. Oral coenzyme Q 10, inosine, vitamin c, vitamin e, VitBC0, etc. ④ The anti-infection treatment of viral myocarditis should actively control the existing infection to avoid being infected by virus or bacteria again and aggravating the condition. To improve immunity and prevent recurrent respiratory tract infection, thymosin, transfer factor and traditional Chinese medicine can be used for treatment.
The incidence of viral myocarditis is mostly mild to moderate. After long-term follow-up, most of them were cured, a few were delayed and a few died. The main factors affecting the prognosis are: (1) Early treatment of mild myocarditis, mild clinical symptoms, only abnormal changes in ECG, rare abnormal results of X-ray and echocardiography, which are not easy to be found by parents. Clinicians may also ignore the diagnosis and fail to rest and treat in time, thus delaying and aggravating the condition and even developing into chronic diseases. Lose the best opportunity for treatment. (2) The clinical manifestations of not paying attention to rest and not insisting on treating myocarditis are often lighter than the actual condition, which makes some parents not pay attention to it. After a period of discharge or outpatient treatment, it will delay or aggravate the illness if you stop taking medicine and participating in all sports activities. (3) After repeated infection of myocarditis, some children's immune function is reduced, especially cellular immune function, which is easy to be infected by bacteria or viruses, which may lead to the aggravation and recurrence of myocarditis. Therefore, in the course of myocarditis, we should pay attention to enhancing the immune function of the body. If there is a cold or other infection, we should take active treatment measures. (4) Do not insist on long-term follow-up and regular outpatient follow-up system to observe the condition and get the guidance of doctors. If the condition changes, adjust the treatment plan in time. Make the illness recover smoothly. (5) It is related to the severity of the disease. Most light and medium-sized cases can fully recover after regular rest and treatment; Severe cases are more acute because of their extensive and serious lesions. Even if they are actively rescued and treated, their condition is easily delayed or left with sequelae, or even death.
* * * * What is cardiac neurosis?
The so-called cardiac neurosis refers to a series of symptoms related to the heart, although there is no obvious heart disease. This disease mostly occurs in young and middle-aged women.
Symptoms include palpitations, dyspnea and chest pain. For patients with heart disease, palpitations are almost always caused after exercise, while neurosis is mostly caused when they are quiet, especially
Cause irritability at night and can't sleep. Pain in precordial region was misdiagnosed as angina pectoris. In fact, there is an essential difference between pain and angina pectoris, which is often felt by touching the drumming part under the left breast. The pain of the disease is characterized by needle-like and burning pain, in addition, there is tenderness in some areas, and fatigue persists. Although it cannot be cured after rest, it is accompanied by headache, tinnitus and insomnia. These patients are often in poor mental state and are prone to excessive tension.
The etiology of this disease is mostly based on physique and heredity, plus some worry and fatigue. In addition, smoking a lot or drinking a lot of coffee stimulants may also hide some diseases inside the body. There are also symptoms caused by hypertension.
First, a reliable doctor should do a series of reliable tests. After making the diagnosis of neurosis, we should listen to the doctor's guidance and mainly carry out psychological treatment.
There are many people who are easily called cardiac neurosis without adequate examination. When chest pain, palpitation and shortness of breath occur, it is best to do ECG examination. If the ECG results are normal, it can be diagnosed as cardiac neurosis.
Just telling patients that the symptoms they were worried about before are not really sick can simply cure many people's diseases. However, there are also quite stubborn symptoms among these people. Therefore, absolutely no one died of illness. As long as you have a clear understanding of the nature of the disease and are not anxious, it can be cured, and you must get sympathy and assistance from people around you. Don't laugh at it, or it will make the disease worse.
* * * * Cardiac neurosis
In the daily diagnosis and treatment of patients, we often meet some patients who complain of chest tightness, palpitation and chest pain. They thought they had a "heart attack" and came to the hospital with anxiety. However, most patients were examined by X-ray, electrocardiogram and ultrasonic electrocardiogram. This is not an organic heart disease, but a dysfunctional cardiac neurosis with cardiovascular symptoms as the main symptom.
Why does the heart have neurosis? Due to anxiety, tension, emotional excitement, trauma and other factors, the excitement and inhibition of the central nervous system are disturbed, and the cardiovascular system regulated by autonomic nerves is also disordered, thus causing a series of symptoms of excessive tension of sympathetic nerves. In addition, overwork, too little physical activity, and lack of proper exercise in the circulatory system make it impossible to adapt to a little activity or fatigue, thus producing excessive cardiovascular reactions and causing this disease.
Cardiac neurosis is a kind of generalized neurosis, which mostly occurs in women aged 20-40. Its symptoms are varied. The most common symptoms are palpitation, dyspnea, precordial pain and general fatigue, as well as irritability, insomnia, sweating, trembling, dizziness and dreaminess.
Once you suffer from cardiac neurosis, you don't need to be too nervous or stay in bed. The following measures can be taken: First, you can often participate in sports activities within your power, such as playing Tai Ji Chuan and exercising to strengthen your physique; Second, the law of life, reasonable arrangement of life, try to combine work and rest; Third, avoid excessive tension, and should not engage in work that lasts too long and has high concentration; Four, severe insomnia can choose diazepam, hypnotics and other oral, rapid heartbeat can be treated with low-dose metoprolol or propranolol.
* * * * What is cardiac neurosis?
It is an indisputable fact that neurosis is common, although our doctors are cautious and seldom diagnose it. Neurosis can be manifested as a variety of physical symptoms, such as chest tightness, palpitation, shortness of breath and other cardiac symptoms, so it is called cardiac neurosis, or cardiac neurosis for short.
Cardiac neurosis can appear alone or accompanied by heart diseases:
1. After comprehensive examination, the patient has no organic heart disease or other organ diseases, but the above heart symptoms persist or recur.
2. Although the patient has common coronary heart disease or other heart diseases, he has serious heart symptoms, which is obviously difficult to explain with primary heart disease.
3. Patients with heart symptoms but no heart disease but suffering from chronic diseases such as stroke, diabetes or tumor are often in a state of depression.
A cardiologist in China pointed out before his death that cardiac neurosis is very common, especially in patients with original heart disease.
Clinically, it is often found that patients over middle age have slightly higher blood pressure and blood lipid, slight ST-T changes in electrocardiogram or positive exercise test, such as obesity and slightly higher blood sugar. Whether there are symptoms or not, it is logical to diagnose coronary heart disease because there are several risk factors and some ECG changes. With the popularization of medical knowledge and mutual psychological induction between patients, it is well known that the heart is an extremely important organ. Many patients have new symptoms or aggravated the original symptoms after learning about heart disease. The most common is chest tightness and chest pain. After careful identification, most of them are not true angina pectoris and often have the following characteristics:
1, dull pain for a long time or even all day, which can be temporarily relieved after a big sigh. Some of them are very short thorns, only a few seconds.
2, the location is wide and changeable, but it is more common in heartbeat.
3. Boredom doesn't happen when you are working (such as being in a hurry, going upstairs, etc.). ), but after housework and other fatigue.
4, chest tightness is often tender and has other emotional functional colors. It must be noted that chest tightness and chest pain in patients with coronary heart disease are not angina pectoris. We attach importance to evidence and "confession" (symptom statement). Many people are accompanied by cardiac neurosis because of long-term depression and anxiety.
Sudden severe shortness of breath with chest tightness in young women is one of the common types of cardiac neurosis, which has no basis in cardiopulmonary diseases.
Understanding these has great practical significance.
1, which breaks the vicious circle of patients' symptoms aggravated by anxiety and depression and liberates their spirit.
2. Avoid wasting a lot of unnecessary and ineffective drugs. As for the cardiac neurosis that can't be cured for a long time, please consult the psychiatric department. Maybe antidepressant treatment can cure this disease.
Interviewee: Anonymous 8-3 17: 14