The essence of pulse paralysis is blocked blood vessels. The disease is mainly located in the pulse, involving the skin, muscles, joints, and is closely related to the heart, liver, spleen (stomach) and other organs. It is often caused by the feeling of external evil, qi stagnation and blood stasis, phlegm and blood stasis, and deficiency of qi and blood, resulting in organ dysfunction and insufficient healthy qi. This disease can be divided into deficiency and excess: excess is caused by wind, cold, dampness, heat, poison, qi stagnation, phlegm, and blood stasis; deficiency is caused by deficiency of qi and blood.
Symptoms of pulse paralysis are mainly pain in the limbs (sometimes accompanied by fatigue, swelling, numbness, and even intermittent claudication), changes in the skin color of the affected area (either purple or white), pulseless or Pulse is weak. Early intervention and treatment are necessary to achieve a better prognosis.
Someone asked: What will be the consequences if it is allowed to develop? If allowed to progress, in addition to the gradual rotting of the affected limb, prolonged pulse paralysis, the recurrence of external evils, and internal distress in the heart, it may also develop into heart paralysis, with symptoms such as palpitations, chest tightness, and shortness of breath, and eventually develop heart failure.
So how does Chinese medicine treat it?
In short, it is dialectical treatment.
When you have a patient with pulse paralysis, you must first identify the cold and heat: cold syndrome is mostly caused by insufficient yang energy in the body and repeated cold and dampness. The skin color of the affected area is pale or blue, the limbs feel cold, and nausea Cold or aversion to cold, onset or aggravation in winter or when encountering cold, heat syndrome relieved or alleviated, pale tongue, etc.; heat syndrome is mostly caused by yin deficiency in the body and relapse of heat evil, characterized by redness, swelling or flushing of the skin of the affected area, It is characterized by heat in the limbs or burning to touch, and red tongue. Secondly, it is necessary to distinguish the deficiency and excess: those with acute onset, short course of disease, swelling of the affected limbs, severe pain, skin ecchymosis, onychomycosis or stubborn numbness on the skin, dark tongue or ecchymosis, and thick and greasy coating are mostly syndrome; Those with slow disease, long course, physical weakness, soreness and weakness of the limbs, dull pain, and symptoms of asthenia are mostly deficiency syndromes, or mainly deficiency. Finally, the course of the disease must be distinguished: in the early stage of pulse paralysis, the disease is superficial, the lesions are localized, and the pain in the limbs is mild. The pain mostly occurs after activity and is gradually relieved after rest; in the middle stage, the pain worsens, often persists, and is light during the day and severe at night. The skin color of the limbs changes significantly, and skin swelling, ecchymosis, and loss of skin and nails can be seen. In the late stage, the condition is further aggravated, with diffuse lesions, severe and persistent pain, and even secondary ulceration. The syndrome is a mixture of deficiency and excess. Lord.
The principle of treatment for pulse paralysis is: unblocking collaterals and relieving pain. The main treatment for positive symptoms is to dispel evil and dredge meridians. Commonly used treatments include dispelling wind and cold, clearing away heat and dampness, dredging Qi, removing phlegm and dispersing stagnation. For deficiency syndrome, the main method is to strengthen the body and unblock the meridians. The commonly used methods for strengthening the body are to nourish qi and nourish blood, etc. . In addition, methods such as regulating yin and yang, nourishing yin and clearing heat, soothing the liver and regulating qi should also be used. During the treatment process, attention should be paid to protecting the heart qi, nourishing and activating blood, and severe cases should be treated with a combination of traditional Chinese and Western medicine. According to different causes and pathogenesis, our commonly used treatment classifications are as follows
1. Wind-cold-dampness syndrome
The clinical symptoms of this syndrome include: purple veins, cold and painful limbs; Pain in the joints, heaviness in the whole body, aversion to cold, fever, no sweating or sweating. The tongue is light red with thin white fur; the pulse is tight or slow.
Treatment should be: dispelling wind and cold, removing dampness and unblocking meridians.
Representative prescription: Juanbi Decoction ("Medical Enlightenment") addition and subtraction.
Prescription: Qianghuo, Duhuo, Genzi, Haifengteng, Guixin, Asarum, Atractylodes, frankincense, costus, chuanxiong, angelica, mulberry branch, licorice, the whole prescription is called Qufeng Powder It has the effect of removing cold, removing dampness and unblocking meridians.
If the pain is severe, add Clematis and Fangji; if there is aversion to cold and no sweat, add Schizonepeta, peppermint, and ephedra; if there is fever and excessive sweating, add Bupleurum, Anemarrhena, and Gypsum; if there is excessive dampness, add Bupleurum, Anemarrhena, and Gypsum. Add coix seed and coix seed.
2. Damp-heat Bistagnation Syndrome
Clinical symptoms include: red and swollen veins, hot and painful limbs, aversion to cold and fear of heat, and cord-like objects on the affected veins. Pain when pressed, or ulcers on the extremities, yellow water discharge, body heat, thirst and no desire to drink, chest tightness, anorexia, and yellow and red urine. Red tongue, yellow and greasy coating, slippery and rapid pulse.
Treatment should be: clearing away heat and removing dampness, removing paralysis and unblocking meridians.
Representative prescription: Danggui Nantong Decoction ("Medical Origins") plus or minus.
Prescription: Sophora flavescens, skullcap, artemisia, anemarrhena, Alisma, Polyporus, kudzu root, Cimicifuga, Atractylodes, Atractylodes, Qianghuo, Fangfeng, Angelica, and the antipyretic effect is to clear away heat and dampness, and to relieve pain. The effect of numbing and dredging collaterals.
For those with excessive dampness, add Smilax cocos and Plantain Seed; for those with obvious stasis, add Salvia Miltiorrhizae, Adenophora adenophora, Dilong, Wangbuliuxing, Soilbug, and Leech; for those with heat poisoning, add Dandelion, Purpurea striata and soybean grass.
3. Syndrome of phlegm, turbidity and blood stasis
Clinical symptoms include: dark purple veins, numbness in limbs, dizziness and heavy head; limb swelling, pain, coldness, dark and sluggish skin color or See the induration of phlegm cores, chest tightness, abdominal pain, anorexia, and general spitting and salivation. The tongue is fat and dark, or ecchymoses may be seen, and the coating is white and greasy; the pulse is deep, stringy and slippery.
Treatment should be: remove phlegm and dissipate stagnation, activate blood circulation and remove blood stasis.
Representative prescriptions: Shuanghe Decoction ("Miscellaneous Diseases Originate from Xi Zhu").
Prescription: dried ginger, tangerine peel, white mustard seed, bamboo drain, peach kernel, safflower, Ligusticum chuanxiong, angelica root, salvia, musk, earthworm, all the medicines are used to remove phlegm and dissipate knots, activate blood circulation and remove blood stasis. merit.
If the phlegm and blood stasis persists and the pain is unbearable, add cannon beetle, white-flowered snake, centipede, wood beetle, leech, cassia twig, aconite, asarum, and antler cream.
4. Qi stagnation and blood stasis syndrome
Clinical symptoms: dark purple veins, tingling in the limbs, fullness in the chest and hypochondrium; aggravated by emotion or slight activity, dark purple skin color , good breathing, dull appetite, irregular bowel movements, irregular menstruation, abdominal pain during menstruation and blood clots. The tongue is purple and dark, with thin white or yellow coating; stringy and astringent pulse.
Treatment should be: soothe the liver and relieve stagnation, activate blood circulation and disperse blood stasis.
Representative prescription: Xuefu Zhuyu Decoction ("Yi Lin Gai Cuo") addition and subtraction.
Prescription: Bupleurum, Cyperus rotunda, Radix Platycodon, Citrus aurantium, Bupleurum, peach kernel, safflower, red peony root, Chuanxiong rhizome, Achyranthes bidentata, Salvia miltiorrhiza, Wulingzhi, Corydalis Corydalis, Radix Rehmanniae, Angelica sinensis and licorice are all used to soothe the liver and relieve stagnation, activate blood circulation and disperse blood stasis.
5. Qi and blood deficiency syndrome
Clinical symptoms include: soft and weak pulse, sore limbs, dizziness and palpitations; numbness of limbs, muscle atrophy, dry and flaky skin, and sallow complexion. Weight loss, spontaneous sweating, weakness in limbs, shortness of breath, and pale lip and nail color. Pale tongue with thin white coating, slow and weak pulse.
The treatment should be: replenishing qi and nourishing blood, activating blood circulation and unblocking meridians.
Representative prescription: Sanbi Decoction ("Women's Prescription") plus or minus.
Prescription: Codonopsis pilosula, astragalus, angelica, white peony root, rehmannia root, licorice, Dipsacus root, Achyranthes bidentata, Salvia miltiorrhiza, Ligusticum chuanxiong, Duhuo, Asarum. All medicines can be used together to nourish qi and blood. The effect of promoting blood circulation and dredging collaterals.
If the stomach has poor appetite, add Shenqu, malt, Gallus gallus gallus L., and Jiaoshan hawthorn; if the limbs feel extremely cold, add Fu Pian, Guizhi, fenugreek, and Morinda officinalis; for severe blood stasis , add Trigonella, Curcuma, Leech, Dilong, and Earthworm.
If the pulse is numb and the startle is suddenly stable and sudden, ginseng pills ("Taiping Shenghui Prescription") are suitable; if the pulse is numb and the body is unkind, Huangqi decoction ("Shengji Zonglu") is suitable; If the pulse is blocked and the blood channel is blocked, Yibi Decoction ("Shengji Zonglu") is suitable; if the pulse is blocked and coughing causes heartache, the throat is like a blockage, or even pharyngeal swelling, panic and uneasiness, Fushen Decoction ("Yan Shiji") is suitable "Sheng Prescription"); if the qi is weak and the blood is scorched, angry, the lips are very red, the speech is unpleasant, the color is dull, and the food and drink are not good for the skin, you should take Maimendong Decoction ("Yanshi Jisheng Prescription").
In addition to the above dialectical treatment, it can also be combined with acupuncture, massage, physical therapy, dietary therapy, etc.
The outcome and prognosis of pulse paralysis mainly depend on the strength of the patient's righteousness, the severity of the pathogenic factors, and the extent of the disease. Generally, those with an acute onset are easy to detect early and attract attention, and the treatment is more timely. As long as the treatment is correct and thorough, the disease can often be cured without becoming chronic; those with a slow onset are mostly due to deficiency of the righteousness and not much sense of evil. Early diagnosis is difficult, and treatment is often not timely. The condition is often lingering, difficult to recover over time, and may even be complicated by ulceration and hemiplegia, and the prognosis is poor. In the middle and late stages of the disease or in severe cases, the following changes may often occur: Damp-heat accumulates toxins, enters the qi and blood, disturbs the mind, and can be complicated by delirium; Damp-heat is more severe, and the skin, veins, blood, and flesh are rotten, which can be complicated by the affected limbs. Ulcers; if the pulse paralysis does not heal over time, all the internal organs will be damaged. If the meridians are tight, it may cause acute and severe pain in the affected limbs or chest and abdomen, and may even be complicated by hemiplegia, resulting in the loss of use of the limbs.