9. Auriculoventricular BlockName: Bian.
Sex: Male.
Age: 24 years.
0ccupation: An accountant.
Chief Complaint: Palpitation and shortness of breath for 1 and a half years.
History of Present Illness: One and a half years ago, the patient got palpitation and shortness of breath when he was overwrought. There were not amaurosis, coma, faint convulsion and so on. After being treated in the local hospital, there was no obvious curative effect on him. In the recent half a year, the above syndrome became worse and worse, his severe palpitation always caused an attack of precardium pain, furthermore, his shortness of breath got severer and severer day by day, it was always accompanied hy excessive night sweat. Usually he got fatigue and lassitude, short breath and disinclination to walk. Then he came to our hospital for treatment on December 10,1995.
Physical Examination: The patient was weak with a normal general condition. The pulse was thready and rapid. The tongue was pale with a thin layer of white fur. Both lungs were normal. HR was 110 heats/rain, the cardiac rhythm was regular, there were not systolic murmur and diastolic murmur. The abdomen was normal. There was not other abnormal sign.
Examination of Electrocardiogram: HR was 108 beats/rain. P-R period was 0.24s. It indicated the illness was sinus tachycardia and auriculoventricular block.
Diagnosis: Arrhythmia: Sinus Tachycardia and Auriculoven-tricular Block.
Differentiation: This disease, in TCM, belongs to the category of "XinJi ZhengZhong (severe palpitation). " It's caused by deficiency of heart-Yang and retention of phlegm-dampness inside the pericardium. The dampness evil caused there were stagnation of qi and blood stasis in the heart, then the patient got palpitation, chest oppression and precardium pain. In addition, the deficient heart Yang could not effectively firm the superficies and couldn't normally control the heart-Yin and heart-blood, then it caused the excessive night sweat. Because the illness had persisted over a year, the flowing of qi and blood would become unsmooth and irregular. So the patient got lassitude and fatigue and so on.
Therapeutic Principle: Invigorating heart-qi and tranqulizing the mind, warming heart Yang and activating blood to resolve stasis.
Recipe:
RenShen, Ginseng
ZhiFuZi,Prepared Aconite Root fig
GanJiang,Dried Ginger
DanShen,Red Sage Root
6uiZhi, Cinnamon Twig
TanXiang, Sandalwood
HuangLian,Coptis Root
ChuanXiong, Chuanxiong Rhizome
XieBai, Macrostem Onion
ZhiGanCao,Prepared Liquorice Root
Ali the above drugs were to be decocted in water for oral taking,10 doses were prescibed. Fat and greasy food, drinking and smoking were all forbidden during the treatment. In the same peroid,acupoint injection was used, there were 2 groups of used points,the 1st group was both sides of Shentang(BI.39),the 2nd group was both sides of Xinshu (BL15). Each group was alternatively used in the every other day, 2ml of Red Sage Root injection was injected into the used points, lml per point.
Effect Observation: After 10 days' treatment, his precardium pain and night sweat disappeared, palpitation and shortness of breath were all relieved greatly, lassitude and fatigue disappeared too. Reeamination of electrocardiogram showed HR was 60 beats/min,P--R peroid was 0.24s. Then he was told to pay attention to getting adequate rest and avoid overworking, drinking and smoking. After 10 months' follow up, there was not recurrence of the illness, then it's ending.
