How to do dizziness for a long time? -this kind of consultation is "Chinese medicine!

Guide: How to consider the "dizziness" that has not been cured for a long time? How to treat it? Follow the footsteps of the sages to see the consultation record of this vertigo case!

This case has been dizzy for six years, and many treatments have failed.

Before the onset of syndrome, hot air rushed from the abdomen to the top of the head, followed by dizziness, tinnitus, nausea and vomiting, accompanied by yellow constipation, red tongue, yellow and greasy fur and heavy and slippery pulse. What is the pathogenesis?

It seems that all kinds of statements can be considered.

For example, "all wind dazzles, all belong to the liver", and the wind makes a fire;

"No phlegm and dizziness", weak soil, clear Yang Can does not rise, turbid yin does not fall;

"If there is no deficiency, it will not dazzle", and if there is kidney deficiency and empty marrow, it will be up and down deficiency;

Deficiency is the root of the disease, but water does not contain wood and liver yang is disturbed, so deficiency is the symptom of the disease.

However, the attending doctor has the foresight to think that the disease is neither a simple wind, fire, phlegm and deficiency, nor a syndrome of yin deficiency and hyperactivity of yang, but a syndrome of "yin deficiency and blood stasis leading to phlegm and drink". Therefore, the treatment should be nourishing yin, relieving depression and clearing heat, resolving phlegm and reducing fire, adding Wendan decoction, Radix Paeoniae Alba, Radix Glycyrrhizae Preparata and bitter almond to eliminate yin, clearing yang of Prunella vulgaris to eliminate stagnation, and eliminating yin with mother-of-pearl and mirabilite.

Three doses of dizziness will stop, and the effect is like a bifurcated drum, which can solve this stubborn disease. This method is difficult to determine for a well-educated famous doctor.

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Case introduction

Patient Liu xx, male, 33 years old, worker, outpatient number 6746 1,196465438+1October 65438+4.

Asking:

The patient has suffered from paroxysmal and rotational vertigo for more than six years. Great changes have taken place in the past two years. The number of vertigo attacks has increased from several times in the past month to 3-4 times a week now. Before each attack, I feel a hot air rushing from my abdomen to my head, and then the surrounding scenery shakes, my body rotates, my eyes turn black, or I fall down, but I am conscious.

Meniere's disease was diagnosed in Peking Union Medical College Hospital. I took a variety of western medicines, which were effective at first, but gradually became ineffective after taking them, so I came to our hospital for treatment.

Inscription:

Dizziness, tinnitus, deafness (mild), obvious memory loss, nausea and vomiting, irritability, palpitation, shortness of breath, bitter taste and dry tongue, constipation or constipation, yellow urine, morning sickness, sometimes palm fever, backache. I often smoke and drink, but I don't drink much. /kloc-I suffered from typhoid fever and deafness 0/0 years ago, nothing special.

Please visit:

The tongue is slightly fat, red, thin and yellow, greasy with fur, thick in body, gray in face and moderate in nutrition.

Odor diagnosis:

Voice as usual, breathing slowly and evenly.

Pulse diagnosis:

The pulse is heavy and steady.

Check:

Pigment 1 1.9g, red blood cells 3.96 million, white blood cells 6,700, blood pressure 120/80mmHg. Heart and lung (-), liver and spleen (-).

Otolaryngology examination: the eardrums of both ears were slightly congested and the cone of light disappeared. Otolith reaction: The patient sweated, tilted 90 degrees, almost fell down, and his face was slightly pale and disgusting, which was consistent with the reaction, suggesting moderate vestibular allergy. Electrical audiometry showed mild neurological deafness (bilateral).

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course of treatment

According to the above pulse conditions, we diagnose vertigo, which is caused by yin deficiency of liver and kidney and hyperactivity of liver yin. We adopted the method of nourishing yin and calming the liver. First, Qiju Dihuang Pill failed, and then we changed it to the method of calming the liver and calming the wind.

Medicinal: Uncaria, Chrysanthemum, Concha Haliotidis, Mint, Scutellaria baicalensis, Cibotii, Achyranthes bidentata, Alpinia oxyphylla, raw and cooked land, Radix Paeoniae Alba, Fructus Amomi, Pericarpium Citri Tangerinae, etc. After taking many doses, it still doesn't get better. It is a product that aggravates liver depression, inhibits yang and lowers wind, and can also be used for purging liver and stomach.

Medicines: Gastrodia elata, Uncaria rhynchophylla, Chrysanthemum, Tribulus terrestris, Poria, Anemarrhena asphodeloides, Ziziphus Spinosae Seed, Dendrobium, Ligustrum lucidum, Pericarpium Citri Tangerinae, Concha Haliotidis, Magnetite, Mother of Pearl and Glycyrrhiza uralensis.

The patient is strong and young, and his condition is paroxysmal, which is often caused by body position change, anger, anxiety or hot weather. Nagujia, the stool is often dry, the urine is yellow, the mouth is dry, and the heat rises during the attack, causing dizziness and nausea. The pulse on the right side is thin and the mouth on the left side is wide, indicating that the deficiency of liver and kidney yin is not obvious and it is not suitable for tonic.

Liver-fire is different from liver-yang, and it is liver-gallbladder excess fire. Although Longdan Xiegan Pill has been used, it is not a decoction. Should be treated first, take Longdan Xiegan decoction, and then step into tonifying liver and kidney yin deficiency, such as Baizhi Dihuang Pill and Qiju Dihuang Pill.

Vertigo is characterized by deficiency and excess, and the principle of treatment. Generally, the method of tonifying kidney yin and calming liver yang is adopted. Poria cocos and Radix Paeoniae Rubra have certain curative effect on reducing labyrinthine edema, so they can be selected.

According to the syndrome differentiation of deficiency, excess, cold and heat in eight categories, the symptoms of deficiency of spleen and kidney are: hot air upwelling before onset, dizziness, nausea and vomiting, uncertain onset time, aversion to cold, bitter taste, preference for heat or drinking, backache, wet scrotum, hard stool at first, turbid urine, dull complexion, cold feet and hot palms.

Kidney deficiency leads to liver-yang imbalance, so it is a deficiency syndrome. Distinguish between cold and heat, with more cold and heat and less heat; What is said outside is the evidence inside. The tongue is not red and the moss is thin and white; Four to more than one pulse, five to at least one pulse, plus tongue pulse, is often deficiency cold.

Dizziness, deficiency is more than reality. The deficiency of dizziness is not serious, but this patient is very serious.

According to excessive internal heat, bitter taste, dry tongue, impatience, etc. Before the onset, it was related to liver fire; Yellow urine is like fire; Abdominal distension, when the stool is hard at first, it will soften.

Judging from the deviation of pulse condition, red tongue and less tongue coating, the pathogenesis is liver heat. When clearing liver and stomach, Sini powder should be added to regulate stomach qi.

Agree with the diagnosis of dizziness. Jueyin liver pulse is on the upper side, and the symptoms of liver meridian are obvious, but it is not caused by hyperactivity of liver yang due to yin deficiency.

Phlegm and blood stasis in the liver cause liver depression. In ancient times, there was a saying that "no phlegm and no dizziness". Combined with symptoms, most patients are phlegm and blood stasis, so the treatment can be considered from phlegm. Banxia Baizhu Tianma Decoction should be used together with herbs for calming liver-yang hyperactivity.

For vertigo syndrome with a long course of disease, its treatment generally starts with liver and kidney.

The patient is strong, ruddy, irritable, thirsty and nauseous. During the attack, there were excessive internal heat, constipation, yellow urine, red tongue tip, thin white fur and thin pulse, and no obvious symptoms of kidney deficiency, all of which were caused by excess fire in liver and gallbladder, and also manifested as liver yin deficiency. Longdan Xiegan Decoction is used to relieve excess heat, and there are also yin-nourishing drugs in the prescription. Gentiana can be reused.

The TCM diagnosis of vertigo is correct. Two syndromes of dizziness: blackness in front of eyes means dizziness, and rotation means dizziness. Although the disease is at the head, its pathogenesis of triple energizer can be seen.

Mostly due to upwind phlegm, clearing yang and turbid stagnation. Followed by liver and kidney deficiency.

Combined with this case, the pathogenesis is in the middle and upper jiao, not in the lower jiao. Those who are really weak are often dizzy and sometimes it is difficult to have an attack.

Therefore, this case should be phlegm-turbid vertigo, and its pathogenesis lies in dizziness caused by spleen-yang deficiency, clearing yang and stagnation, and turbidity and stagnation.

The spleen dominates the four ends, and the spleen yang does not reach the four ends, so the patient's limbs are cold. If the chest is clear, it will be yang, but it will not rise. If the chest is tight, it will be upward.

Furthermore, patients vomit a lot in the morning, the spleen is the source of phlegm, and the lung is the reservoir of phlegm. Personally, I think "no phlegm and no dizziness" has some truth.

Sometimes, patients with phlegm attack are very rustic, easy to get wet, gloomy, and

Another cloud: "The source of this disease is liver wind, which should be combined with liver wind, stroke and scalp flap."

Xu Ling said: "Dizziness, clearing fire and nourishing liver are the main indications, but the yang is rising. As for the body can not be independent, this is not the ratio of floating fire. The ancients must use the products of Jin Shizhen. "

In this case, the symptoms seem to be yin deficiency and excessive fire, such as irritability, bitter taste, dry tongue, constipation, yellow urine and so on. The stomach is turbid with phlegm, such as nausea and vomiting, thin and yellow fur, and hard before vomiting, which belongs to the so-called liver wind with phlegm syndrome in the above-mentioned leaf case. If it is used together with warm tonics, it will hinder phlegm and turbidity; If it is used together with warm dryness, it will damage liver yin and make it difficult to take medicine.

It is suggested that Waitai Fuling decoction should be used to remove ginseng and Atractylodes macrocephala, and Pinellia ternata, Amomum villosum and Coicis Semen should be added to treat stomach, and Qiju Dihuang Pill should be used to nourish liver and kidney.

1963 February, I suffered from Meniere's disease. Symptoms are deafness and tinnitus. I use the method of nourishing yin to help clear phlegm fire, such as Radix Rehmanniae Preparata, Rhizoma Dioscoreae, Corni Fructus, Magnetite, Tortoise Shell, Achyranthes bidentata, Acorus calamus, Fritillaria, Poria and Pericarpium Citri Tangerinae. How many doses have you taken? Let me talk about it for your reference.

There are many reasons for dizziness, but this patient's water does not contain wood, and yang deficiency is the main factor.

The disease is located in the kidney, with dizziness caused by rising deficiency heat as the standard and deficiency of kidney yin as the root, treating both the symptoms and root causes.

Vomiting and excessive internal heat are caused by the upwelling of kidney qi.

Danxi Dabuyin Pills should be used for treatment: tortoise plastron 15g, turtle shell 15g, Cornus officinalis 3 1g, Cortex Phellodendri 6g (decocted in salt water), Rhizoma Anemarrhenae 6g (decocted in salt water), Os Draconis 15g and Oyster 15g.

Water can contain wood, and liver yang does not disturb it. This side focuses on nourishing water and containing wood, calming the liver and suppressing yang. In the future, you can take Dabuyin Pill, Qiju Dihuang Pill and Baizhi Dihuang Pill for a long time to relieve dizziness with fire.

Generally speaking, vertigo never leaves the liver and kidney, its disease is in the liver and its source is in the kidney.

As the saying goes, "every wind falls dizzy and returns to the liver." The so-called wind, the liver is the viscera of Jueyin Feng Mu, the liver is used by Yin and Yang, and Yang is driven by the wind. Although there is dizziness caused by external wind, there are many internal factors.

In addition, wind, phlegm, qi and fire can all cause dizziness, each with phlegm deficiency and phlegm excess.

Clinically, we must master the pathogenesis, analyze it with three causes, four diagnoses and eight categories, and apply the principle of syndrome differentiation and treatment.

In this case, the pulse is deep and slippery on the right side, thin on the left side, red tongue and slightly yellow and greasy in the center of the tongue. Combined with pulse, tongue and symptoms, the disease is yin deficiency, heat depression and phlegm turbidity. The treatment should be nourishing yin to relieve depression, clearing away heat and resolving fire, that is, clearing shaoyang, purging jueyin and purging Yangming, and modifying Wendan decoction.

Prescription: 6 grams of Poria, 9 grams of Faxia, 6 grams of Pericarpium Citri Tangerinae, 4.5 grams of fried Fructus Aurantii Immaturus, 3 grams of Acorus calamus, 6 grams of bamboo shavings, 9 grams of Prunella vulgaris, 3 grams of Rhizoma Cyperi, 6 grams of Radix Paeoniae Alba, 6 grams of Radix Glycyrrhizae Preparata/0.5 grams of Kloc-,and 6 grams of Natrii Sulfas (taken twice).

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postscript

After consultation and discussion, according to teacher Pu Fuzhou's opinion, we adopted the methods of nourishing yin, relieving depression, clearing heat, resolving phlegm and reducing fire. The prescription prescribed by teacher Zong Pu stopped dizziness after three doses, and the symptoms were obviously relieved.

Add a penny of Rhizoma Coptidis in front and take 19 to relieve symptoms. Follow-up to June 8, dizziness did not recur.

In order to consolidate its curative effect, the dosage is still 10 times higher than the original prescription, and it is ground into coarse powder and uniform powder, with a small dosage of18g. A packet (18g) is decocted in water every day, twice in the morning and evening.

At present, there is no effective way to prevent the recurrence of this disease.