The sick sinus syndrome is characterized by intrinsic inad-equacy of sinus node pacemaking and/or conduction failure be-tween the sinus node and the rest of the atrium. In the brady-cardia-tachycardia syndrome, recurrent supraventricular tach-yarrhythmias alternate with sinus bradycardia and/or subatrial bradyarrhythmias. Conduction disturbances are common in the atria, AV node, bundle branches, and ventricles, but ventric-ular ectopic activity is rare.
Symptoms in sick sinus syndrome may be intermittent, varied, and difficult to correlate with ECG changes. Syncope, dizziness, and palpitations are common, probably because these symptoms are used for case finding and diagnosis. Con-gestive heart failure or angina can be aggravated. Cerebral thromboembolism is common in the bradycardia-tachycardia syndrome.
Differentiation and Treatment of Common Syndromes in Traditional Chinese Medicine
1. Dificiency of the Heart-yang and Kidney-yang:
Clinical manifestations: Chest stuffiness, twinge in the precordial region, palpitation, shortness of breath, dizziness, occasional faint, fatigue and weakness, tinnitus, distress in the loins, aversion to cold, cold limbs, restlessness and insom-nia, pale thick or dark red tongue, thready, slow and uneven or intermittent pulse.
Therapeutic method: Warming yang and replenishing qi.
Recipe: Modified Prescriptions of Decoction for Protect-ing Primordial Qi and Decoction of Ephedra, Aconite and Asarum.
Ingredients :
Radix Aconiti Praeparata10-30g
Radix Ginseng Rubra20-40g
Radix Codonopsis Pilosulae30g
Radix Astragali seu Hedysari30g
Rhizoma Polygonati10g
Ramulus Cinnamomi 6-12g
Herba Ephedrae3g
Hera Asari 6-30g
Radix Gtycyrrhizae Praeparata 6-20g
Administration: The decoction of a dose is 200--300rnl. Take equal shares in the morning and in the evenling.
2. Deficiency of Both Qi and Yin :
Clinical manifestations: Chest stuffiness, shortness of breath, vague pain in the precordial region, dizziness, blurred vision, palpitation, insomnia, amnesia, spontaneous perspira-tion, dry mouth, pale or dark red tongue with thin and white fur, slow and thready or intermittent pulse.
Therapeutic method: Supplementing qi and nourishing yin.
Recipe: Modified Decoction of Prepared Licorice.
Ingredients :
Radix Glycyrrhizae Praeparata 12-30g
Radix Codonopsis Pilosulae15-30g
Radix Astragali seu Hedysari30g
Rhizoma Polygonati30g
Radix Rehmanniae20-30g
Radix Ophiopogonis 15g
Semen Sesami 12g
Ramulus Cinnamomi10g
Fructus Ziziphi Jujubae10 pieces
Fructus Schisandrae10g
Administration: The decoction of a dose is 200 -- 300ml. Take equal shares in the morning and in the evening.
Modification: The drugs for promoting blood circulation to remove blood stasis may be added to both the recipes men-tioned above, such as Radix Salviae Miliorrhizae 20g, Radix Angelicae Sinensis 12g, Flos Carthami 10g and Radix Paeoniae Rubra 12g. According to the patient's condition to select 1 or 2 ingredients each time to strengthen therapeutic effects.
