According to epidemiological data, the prevalence of vertigo is 20%-30% in the general population, and its prevalence increases gradually with age, of which 50%-60% of the elderly have vertigo symptoms, and the survey shows that people over 40 years old are the population with high prevalence of vertigo.
Vertigo usually refers to the symptoms of dizziness, dizziness, blurred vision, etc. In mild cases, the symptoms can be rested with eyes closed, but in severe cases, the patient may feel spinning, unable to stand, or accompanied by nausea, vomiting, sweating, pale face and other symptoms, and may even suddenly fall down. It can seriously affect the daily life and even bring life threatening to the patient.
In real life, many people experience recurrent dizziness, but no abnormalities are found when they go to the hospital for examination.
Some time ago, 45-year-old Ms. Li said that she had repeatedly experienced dizziness, blurred vision, and even headache for more than 1 year, during which she took flunarizine hydrochloride capsules and diphenhydramine hydrochloride tablets orally, and her condition improved. Recently, the dizziness recurred, so he was examined for cranial MRI and TCD (MRI refers to magnetic resonance imaging, and TCD is transcranial Doppler ultrasound. These 2 techniques are commonly used for examination of the brain), no significant abnormality was seen, and oral betahistine hydrochloride tablets were administered without effect.
During the communication process, we learned that Ms. Li’s main symptoms were dizziness, visual rotation, inability to stand, tingling sensation in the posterior occipital area, pain with a fixed location, dry mouth but no desire to drink, difficulty sleeping, low menstrual flow, dull color with stasis, and her tongue was purple and dull, with several petechiae of different sizes on both sides of the tongue and thin white coating. Therefore, the evidence indicates that the dizziness is caused by obstruction of the brain and brain ligaments.
In fact, in cases of vertigo in middle-aged and elderly people, internal obstruction of blood stasis leading to blockage of brain channels is a common cause of vertigo. Some scholars have collected cases of vertigo from their hospitals and found that, among the TCM evidence of vertigo, liver and kidney deficiency is the most common, followed by internal obstruction of blood stasis.
Stasis of blood and loss of nourishment in the brain will lead to dizziness and dizziness!
The first systematic understanding of dizziness in Chinese medicine was found in the Yellow Emperor’s Classic of Internal Medicine, which called it “vertigo” and pointed out that the pathogenesis of the disease was mainly related to wind, fire, phlegm, deficiency and stasis.
In clinical practice, medical practitioners have also pointed out that the onset of vertigo in middle-aged and elderly people is characterized by multiple deficiencies and stasis, and is closely related to the dysfunction of three organs: liver, spleen and kidney.
According to Chinese medicine, the head is the “meeting of all the yang” and the brain is the sea of marrow, which depends on the enrichment of essence, qi and blood. If there is stagnation of blood and other tangible evil, the flow of qi is weak, the flow of blood is not smooth, and qi and blood, as well as qi and qi and yang, cannot reach the brain, thus leading to dizziness.
Just like a tree, it depends on countless roots to extract underground nutrients to grow properly, and these nutrients are mainly delivered to the whole tree through various tiny and dense “pipes” in the roots, if the pipes are blocked, the nutrient delivery will be obstructed, and over time, the tree will dry up because it does not receive sufficient nutrients.
The same is true for the human brain. If the blood does not reach the head due to stasis in the veins, the brain loses its nourishment, which can lead to the loss of nourishment of the clear orifices and cause vertigo, as stated in the “Essential Reading for Physicians”: “Stagnant blood, upward rushing for reversal, also makes vertigo”.
The typical clinical symptoms of this type of patients include dizziness and headache with fixed pain, forgetfulness, insomnia, palpitations, mental discomfort, tinnitus and deafness, purple lips, and petechiae or petechiae on the tongue.
Blood Mansions and Stasis Removal Tang with addition and subtraction, activating blood circulation and resolving blood stasis to treat vertigo!
If blood stasis is blocked internally, the blood vessels are blocked, and if blood stasis does not go away, new blood will not be generated and the brain will be deprived of nourishment. Therefore, the treatment is to invigorate blood and resolve blood stasis.
This formula is from “Medical Lin Correction” and is a famous formula for activating blood circulation and resolving blood stasis. Clinical practice shows that this formula is clinically effective in treating vertigo caused by internal obstruction of blood stasis. The ruling herbs in this formula are peach kernel and safflower, both of which can break blood stagnation and remove stasis. The three ministerial herbs are Chuanxiong, Radix Paeoniae and Niubizi, which can help the ruler to remove blood stasis and invigorate the blood, and induce the blood to move downward. Radix Rehmanniae has the function of clearing heat and cooling the Blood to nourish Yin, and Angelicae has the function of nourishing Blood with Yin; Radix Platycodon and Citrus Aurantium are combined with Chai Hu to raise Yang and clear Liver, so that Qi can move Blood. Radix et Rhizoma oryzaeum is the oar medicine, not only carries the medicine upward, but also has the function of making the medicine; licorice harmonizes all the medicines and is the making medicine. The combination of the above herbs can make the blood flowing and the qi moving, and the stasis can be dissolved.
Of course, it should be noted that since the production of blood stasis is closely related to the internal organs of the liver, spleen and kidney, this formula should not be directly copied and used in the treatment, but should be tailored according to the evidence on the basis of identification.
If there is Qi deficiency and body fatigue and weakness, less Qi and spontaneous sweating, it is advisable to add Huang Qi to improve the blood supply to the internal organs and replenish Qi and blood; if there is also internal heat deficiency, bone vapor and hot flashes, and wrong skin nail, add Dan Pi, Huang Bai, Zhi Mu and Xuan Shen, and reuse Dried Di Huang, and remove Radix Platycodon and Citrus Aurantium to clear heat and nourish Yin, eliminate stasis and create new blood. If the liver and kidneys are deficient, we can add Paeonia lactiflora, Salvia miltiorrhiza, Peach kernel, Radix Astragali, Eucommiae, Radix et Rhizoma moschatae, and Amanitae, etc. to benefit the liver and kidneys, so as to achieve overall regulation and treat the symptoms of dizziness as well as to improve the effect of the rest of the symptoms.
Therefore, the 45-year-old Ms. Li in the example cited earlier is suffering from brain stasis and brain ligament obstruction, so she was given Chuanxiong, Tao Ren, Radix Paeoniae, Angelicae dahuricae, Dilong, All Scorpion, Gynostemma, Aromatic Herb, Chen Pi, Mother of Pearl (first decoction), Green Dragon’s tooth (first decoction), and Salvia. One dose was taken daily for 7 doses. At the second consultation, according to him, dizziness was reduced, no more symptoms of rotating vision, he could stand up, headache was reduced, but he still had difficulty sleeping and dry mouth symptoms. At the time of the third consultation, reported that vertigo had disappeared, sleep slightly improved, and spirit turned better, so the above continued to take 3 weeks to consolidate the effect. Followed up for six months, no recurrence.
In this case, stasis of blood in the body is seen in the menstrual flow, dull color, stasis, tongue purple dull with petechiae; blocked in the head orifice is manifested as the back of the pillow tingling pain, pain has a fixed place, dry mouth does not want to drink and other symptoms. Therefore, in the treatment, the treatment should be based on the use of hen’s blood vine to promote blood circulation and activate the meridians, salvia to invigorate the blood and regulate the menstruation to remove annoyance, mother of pearl and green dragon’s tooth to calm the mind, and Chen Pi and Xiang Shen to regulate qi and relieve depression to prevent the aggravation of stasis due to unrestrained qi.