Guest guest Posted May 12, 2003 Report Share Posted May 12, 2003 Christine asked: Has anyone had any experience with treating atrial fibrillation? With this particular case there seems to be Heart/Kidney qi deficiency only after over-exertion. Epsiodes of Epsiodes of atrial fibrillation occur in the early morning, after over-exertion the day prior. __________ I too have a patient (actually two right now) with atrial fibrillations. From the TCM perspective, it simply feels like a rapid, irregular pulse. The term " palpitations " is, to my understanding, considered in TCM to be heart beats that can be felt in the chest or abdomen as opposed to any particular issue of speed or regularity. Still, when looking at this through my TCM eyes, I have to begin by calling them palpitations just to at least get on the map here. My patients both have a significant amount of red color in their faces which does point toward the Fire element/ Heart organ. One is of nordic descent and so I wrote it off at first. Some people are simply red in their faces, especially when having to lie on their stomachs for a needling session on their back. But the other has a significant amount of red on her face too. Not only that, but she laughs a lot. Not in a hysterical or weird way, but laughter is a significant aspect of her outward personality. Again, pointing to the Fire element. Both of them are in their 70's. They've both been through the fibriliation therapy in the hospital which I guess involves one of those shock things that you see in television dramas. They both have large tongues that really fill their mouths. The tongues are on the red side of pink and dry. Little coating. Pulses too are similar in that neither are thready, but their both somewhat slippery on the right side and more wiry on the left. They both hang out about 90 to 100 bpm, though the pulse is irregular. Fast, then slow, or you could also think of it as fast with mixed beats. Both patients suffer from ankle edema. One of them has me a bit worried too, as he is also having shortness of breath. He is having trouble sleeping too because of it. I'm torn between calling it Qi stagnation and Kidney Qi not Grasping. He doesn't have any specific stress in his life. He reports that he feels like there's a knot or some obstruction below his stomach that prevents him from completely breathing in. He feels like his lungs are fine. I treated him for both with acupuncture and he reported feeling better for about a day, which I found encouraging, though when I treated him today he didn't seem any better by the end of the treatment, unlike last time. As for the palpitations/fibriliations, I'm calling both cases Kidney Yin deficiency. As for this guy's labored breating, I'm still on the fence between Qi Stagnation and Kidney Qi deficiency. I'm also concerned that his cardiac output may be compromised giving rise to pulmonary edema and breathing issues. I admit that my biomedical knowledge is sketchy at points and I may have nothing to be concerned with here, still I told him to be sure and tell his general practitioner about the labored breathing when he went in for his check up today. I include this point for a new r on the acupuncture-students list for additional input. From the book Clinical Handbook of Traditional (Maclean/Lyttleton) we have the following guiding principles for herbal formulas (for palpitations) which also gives us a sense of what the key differentiations are for acupuncture point prescriptions: Heart Qi deficiency, which is what yours looks like Christine: Wu Wei Zi Tang Heart Yang deficiency: Gui Zhi Gan Cao Long Gu Mu Li Tang Heart and Kidney Yang deficiency with pulmonary edema: Zhen Wu Tang Kidney Yang predominant: Jin Kui Shen Qi Wan (aka Jin Gui Shen Qi Wan) Heart Yin Def: Tian Wang Bu Xin Dan Heart Yin Def following a febrile disease: Huang Lian E Jiao Tang Heart Yin Def with anxiety and insomnia: Zhu Sha An Shen Wan Heart Yin Def Liver/Kidney Yin def. predominant: Yi Guan Wan Heart Blood and Spleen Qi def: Gui Pi Tang with qi and yin deficiency, with severe palps and an irregular pulse: Zhi Gan Cao tang Heart blood and GB qi deficiency: Ding Zhi Wan as a result of (emotional) shock: gui zhi jia long gu mu li tang Phlegm heat: wen dan tang Spleen and Kidney Yang deficiency: Ling Gui Zhu Gan Tang with severe fluid accumulation: zhen wu tang Blood stagnation: Xue Fu Zhu Yu Tang -- Pain is inevitable, suffering is optional. -Adlai Stevenson Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2003 Report Share Posted May 13, 2003 Thanks for the info & encouragement Hugo! The pattern differentiation is Heart & Kidney qi deficiency. This deficiency is only marked when the qi has been exhausted by too much exercise or over-exertion. The atrial fibrillation typically occurs during the night after a physically exhausting day. The atrial fibrillation ALWAYS occurs between midnight and 6am - the time when the amount of qi in the Heart & Kidney channels is at it's lowest according to the Chinese clock. Other than the atrial fibrillation, this person is healthy, there are no other signs or symptoms of Heart or Kidney deficiency except for the pulse. The tongue has no coat but otherwise is unremarkable.... Chris The New Search - Faster. Easier. Bingo. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 14, 2003 Report Share Posted May 14, 2003 Thank you for the feedback guys, I will keep you updated with this case. Someone mentioned the hebal formula Yang Xue An Shen Wan, but I cannot find it in Bensky. Is there another name that it is known by? Christine Quote Link to comment Share on other sites More sharing options...
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