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3 Hypotension
The pathological region of senile hypotension involves the heart, spleen and kidney. The disease is mostly caused by old age, weak constitution, improper diet, physical and sexual overstrain. The pathogenesis mainly includes deficiency of healthy qi, or deficiency of healthy qi occasionally intermingled with pathogenic sthenia.
Syndrome differentiation and treatment
Asthenia of the heart and spleen
Vertigo and palpitation aggravated by moving and easily induced by overstrain, short breath, low voice, pale and lustreless complexion, or sallow complexion, pale tongue, thready pulse without force. It is advisable to tonify the heart, strengthen the spleen, promote qi flow and blood production. The prescription used is the modified Guipi Decoction (Decoction for Invigorating the Spleen and Nourishing the Heart) or Renshen Yangrong Decoction (Ginseng Nutrition Decoction).
Deficiency of the middle energizer qi
Occasional vertigo, mental fatigue, disinclination to speak, poor apetite, lassitude of limbs, loose stool, even down-bearing sensation of the lower abdomen in severe cases, pale tongue, slow or soft and thready pulse. It is advisable to supplement qi, strengthen the middle energizer and raise the pure yang. The prescription used is the modified Buzhong Yiqi Decoction (Decoction for Reinforcing Middle Energizer and Replenishing Qi).
Deficiency of the kidney yang
Dizziness, tinnitus, listlessness, soreness of the waist and flaccidity of legs, amnesia, pale or darkish complexion, cold body and limbs, pale tongue, deep and thready pulse particularly in the chi region. It is suitable to warm and strengthen the kidney yang. The prescription used is the modified Yougui Bolus (the Kidney Yang-Rein-forcing Bolus) or Jinkui Shenqi Bolus.
8.2.3.1.4 Phlegm stagnation in the middle energizer
Dizziness with a heavy sensation, chest tightness, nausea, even vomiting of phlegm and saliva in severe cases, white and greasy fur, soft and slippery pulse. It is advisable to resolve phlegm, strengthen the spleen and regulate the stomach. The prescriptions used include the modified Banxia Tianma Baizhu Decoction (Decoction of Pinellia, Gastrodia and Bighead Atractylodes) and Zexie Decoction (Decoction of Rhizoma Alismatis).
Rehabilitation methods
Physical training
Playing Taijiquan can make qi and blood sufficient, blood vessels full, pulsation harmonious, slow and forceful and is effective for hypotension. The patient with this disease has a poor adaptive capacity for physical training and is susceptible to fatigue. Therefore, it is advisable to select the walking activities with easily controllable amount of exercise and which can enhance the physical strength. At the beginning, walk for 1 km once, in the second week 1.5 km, in the third week 2 km, in one month 3 km, and maintain this final distance. Persisting in walking for 3 km a day is very beneficial to the improvement of the symptoms of hypotension.
Acumox
Acumox: In the case of asthenia of the heart and spleen, select Xinshu (BL 15), Pishu (BL 20), Zusanli (ST 36), Qihai (CV 6), Baihui (GV 20) and Neiguan (PC 6) and needle them with the reinforcing manipulation; in the case of deficiency of the middle energizer qi, select Baihui (GV 20), Qihai (CV 6), Pishu (BL 20), Zusanli (ST 36) and Guanyuan (CV 4) and needle (them) with the reinforcing method; in the case of deficiency of the kidney yang, select Shenshu (BL 23), Yingu (KI 10), Mingmen (GV 4), Baihui (GV 20) and Qihai (CV 6) and needle them with the reinforcing method; in the case of phlegm stagnation in the middle energizer, select Fenglong (ST 40), Zhongwan (CV 12), Touwei (ST 8), Neiguan (PC 6) and Jiexi (ST 41) and needle them with the uniform reinforcing-reducing method. Moxibustion can be coordinatively applied in all the above cases so as to enhance the therapeutic effects. Besides, it is advisable to select Fengchi (GB 20 ), Yiming ( EX - HN 14 ) and Neiguan (PC 6) with the acupoint injection of 3 ml to 5ml of 5% or 10% glucose solution, or 0. 5 ml of vitamin B12 in each acupoint once every other day.
Ear acupuncture: Insert a one-cun-long filiform needle into Shengyagou and twirl the needle towards one direction endlessly until the patient feels slightly warm in the body, distending and painful on the auricle. Then, retain the needle for 20 minutes and twirl the needle again during this period of time. Five to ten times constitute one course of treatment. Or insert a five-fen-long needle into Jiaogan (MA- AH 7), Shenshangxian, Xin and Ershenmen (MA- TF 1) with the brief and forceful stimulation method without retaining the needle once a day.
Dietary therapy
In the case of cardiosplenic asthenia, eat three to nine grams of Guiyuanrou (Cortex Cinnamomi ) every day, or Guiyuan Shenmi Paste (Paste of Cortex Cortex Cinnamomi , Radix Ginseng and Mel ) , Stewed Chicken with Danggui (Radix Angelicae Sinensis ), or Stewed Chicken with Tianma ( Rhizoma Gastrodiae ), Gouqizi (Fructus Lycii ), Huaishanyao ( Rhizoma Dioscoreae ) and Dangshen (Radix Codonopsis Pilosulae); in the case of deficiency of middle energizer qi, it is advisable to add Shengma ( Rhizoma Cimicifugae ) and Gegen ( Radix Puerariae); in the case of renal yang deficiency, drink three to five milliliters of Lurong Wine (Wine of Cornu Cervi Pantotrichum) three times a day. It is also advisable to cook gruel with polished glutinous rice and one or two ingredients from the following drugs. Renshen (Radix Ginseng), Dangshen (Radix Codonopsis Pilosulae ) , Huangqi (Radix Astragali seu Hedysari ), Huaishanyao ( Rhizoma Dioscoreae ), Hutaorou ( Semen Jugtandis ), Gegen ( Radix Puerariae ) and Chinese dates (Fructus Ziziphi Jujubae). This has better therapeutic effects, too. In the case of hypotension due to iron-deficiency anemia, it is advisable to use iron-enriched soy sauce.
In daily life, eat for more times with less amount at a time; for in the case of overeating, blood accumulates in blood vessels of the abdominal cavity, which reduces the cerebral blood supply, consequently inducing the occurrence of symptoms of hypotension.
Nursing in daily life
Avoid sitting and standing long. It is advisable to wear the tight elastic socks. This can prevent the onset and aggravation of varix of the lower limbs. The patients with postural hypotension are not advisable to change the posture too quickly and make the head too low during sleeping. They should wait for a while and then leave the bed when getting up at night and in the morning. Or they may exercise the hands and legs in the bed before getting up, with a transitional period of five to ten minutes. After leaving the bed, wait for a moment and then step forward.
Syndrome differentiation and treatment
Asthenia of the heart and spleen
Vertigo and palpitation aggravated by moving and easily induced by overstrain, short breath, low voice, pale and lustreless complexion, or sallow complexion, pale tongue, thready pulse without force. It is advisable to tonify the heart, strengthen the spleen, promote qi flow and blood production. The prescription used is the modified Guipi Decoction (Decoction for Invigorating the Spleen and Nourishing the Heart) or Renshen Yangrong Decoction (Ginseng Nutrition Decoction).
Deficiency of the middle energizer qi
Occasional vertigo, mental fatigue, disinclination to speak, poor apetite, lassitude of limbs, loose stool, even down-bearing sensation of the lower abdomen in severe cases, pale tongue, slow or soft and thready pulse. It is advisable to supplement qi, strengthen the middle energizer and raise the pure yang. The prescription used is the modified Buzhong Yiqi Decoction (Decoction for Reinforcing Middle Energizer and Replenishing Qi).
Deficiency of the kidney yang
Dizziness, tinnitus, listlessness, soreness of the waist and flaccidity of legs, amnesia, pale or darkish complexion, cold body and limbs, pale tongue, deep and thready pulse particularly in the chi region. It is suitable to warm and strengthen the kidney yang. The prescription used is the modified Yougui Bolus (the Kidney Yang-Rein-forcing Bolus) or Jinkui Shenqi Bolus.
8.2.3.1.4 Phlegm stagnation in the middle energizer
Dizziness with a heavy sensation, chest tightness, nausea, even vomiting of phlegm and saliva in severe cases, white and greasy fur, soft and slippery pulse. It is advisable to resolve phlegm, strengthen the spleen and regulate the stomach. The prescriptions used include the modified Banxia Tianma Baizhu Decoction (Decoction of Pinellia, Gastrodia and Bighead Atractylodes) and Zexie Decoction (Decoction of Rhizoma Alismatis).
Rehabilitation methods
Physical training
Playing Taijiquan can make qi and blood sufficient, blood vessels full, pulsation harmonious, slow and forceful and is effective for hypotension. The patient with this disease has a poor adaptive capacity for physical training and is susceptible to fatigue. Therefore, it is advisable to select the walking activities with easily controllable amount of exercise and which can enhance the physical strength. At the beginning, walk for 1 km once, in the second week 1.5 km, in the third week 2 km, in one month 3 km, and maintain this final distance. Persisting in walking for 3 km a day is very beneficial to the improvement of the symptoms of hypotension.
Acumox
Acumox: In the case of asthenia of the heart and spleen, select Xinshu (BL 15), Pishu (BL 20), Zusanli (ST 36), Qihai (CV 6), Baihui (GV 20) and Neiguan (PC 6) and needle them with the reinforcing manipulation; in the case of deficiency of the middle energizer qi, select Baihui (GV 20), Qihai (CV 6), Pishu (BL 20), Zusanli (ST 36) and Guanyuan (CV 4) and needle (them) with the reinforcing method; in the case of deficiency of the kidney yang, select Shenshu (BL 23), Yingu (KI 10), Mingmen (GV 4), Baihui (GV 20) and Qihai (CV 6) and needle them with the reinforcing method; in the case of phlegm stagnation in the middle energizer, select Fenglong (ST 40), Zhongwan (CV 12), Touwei (ST 8), Neiguan (PC 6) and Jiexi (ST 41) and needle them with the uniform reinforcing-reducing method. Moxibustion can be coordinatively applied in all the above cases so as to enhance the therapeutic effects. Besides, it is advisable to select Fengchi (GB 20 ), Yiming ( EX - HN 14 ) and Neiguan (PC 6) with the acupoint injection of 3 ml to 5ml of 5% or 10% glucose solution, or 0. 5 ml of vitamin B12 in each acupoint once every other day.
Ear acupuncture: Insert a one-cun-long filiform needle into Shengyagou and twirl the needle towards one direction endlessly until the patient feels slightly warm in the body, distending and painful on the auricle. Then, retain the needle for 20 minutes and twirl the needle again during this period of time. Five to ten times constitute one course of treatment. Or insert a five-fen-long needle into Jiaogan (MA- AH 7), Shenshangxian, Xin and Ershenmen (MA- TF 1) with the brief and forceful stimulation method without retaining the needle once a day.
Dietary therapy
In the case of cardiosplenic asthenia, eat three to nine grams of Guiyuanrou (Cortex Cinnamomi ) every day, or Guiyuan Shenmi Paste (Paste of Cortex Cortex Cinnamomi , Radix Ginseng and Mel ) , Stewed Chicken with Danggui (Radix Angelicae Sinensis ), or Stewed Chicken with Tianma ( Rhizoma Gastrodiae ), Gouqizi (Fructus Lycii ), Huaishanyao ( Rhizoma Dioscoreae ) and Dangshen (Radix Codonopsis Pilosulae); in the case of deficiency of middle energizer qi, it is advisable to add Shengma ( Rhizoma Cimicifugae ) and Gegen ( Radix Puerariae); in the case of renal yang deficiency, drink three to five milliliters of Lurong Wine (Wine of Cornu Cervi Pantotrichum) three times a day. It is also advisable to cook gruel with polished glutinous rice and one or two ingredients from the following drugs. Renshen (Radix Ginseng), Dangshen (Radix Codonopsis Pilosulae ) , Huangqi (Radix Astragali seu Hedysari ), Huaishanyao ( Rhizoma Dioscoreae ), Hutaorou ( Semen Jugtandis ), Gegen ( Radix Puerariae ) and Chinese dates (Fructus Ziziphi Jujubae). This has better therapeutic effects, too. In the case of hypotension due to iron-deficiency anemia, it is advisable to use iron-enriched soy sauce.
In daily life, eat for more times with less amount at a time; for in the case of overeating, blood accumulates in blood vessels of the abdominal cavity, which reduces the cerebral blood supply, consequently inducing the occurrence of symptoms of hypotension.
Nursing in daily life
Avoid sitting and standing long. It is advisable to wear the tight elastic socks. This can prevent the onset and aggravation of varix of the lower limbs. The patients with postural hypotension are not advisable to change the posture too quickly and make the head too low during sleeping. They should wait for a while and then leave the bed when getting up at night and in the morning. Or they may exercise the hands and legs in the bed before getting up, with a transitional period of five to ten minutes. After leaving the bed, wait for a moment and then step forward.
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