What Is the Emergency Care for a Stroke?

Stroke, the name of the disease of Chinese medicine, is divided into external and internal wind. External wind is caused by feeling external evil (wind evil). It is called stroke in the Treatise on Febrile Diseases (also known as Guizhi Decoction); internal wind is an internal injury. Card, also known as stroke, stroke. In modern times, it is generally called stroke, which usually refers to strokes of internal injury and disease syndromes, which are mostly caused by qi and blood rebellion, cerebral pulse obstruction, or blood overflowing to the brain. The main manifestations of mental illness are sudden fainting, half-leggedness, numbness of the limbs, lingering tongue, skewed tongue, and numbness. And has the characteristics of rapid onset, rapid changes, such as wind evil and good deeds characteristics. The stroke type (stroke) is described here.

Basic Information

nickname: Stroke
English name: apoplexy
Visiting department: Emergency department, ICU, neurosurgery, neurology, traditional Chinese medicine

Common causes: Emotional depression, inadequate diet, overwork, climate change, blood stagnation
Common symptoms: Squint eyes, unfavorable language, paraplegia

Causes of stroke

The cause of this disease is more, from the clinical point of view, most of the causes caused by internal causes. The occurrence of stroke can be summed up in terms of deficiency (yin deficiency, qi deficiency), fire (liver fire, heart fire), wind (liver wind, external wind), sputum (wind sputum, wet sputum), qi (qi reverse), and blood ( Blood stasis) six ends.

Emotional depression

Wuzhi is extremely extreme, and his heart is violent, which can cause internal wind and cause stroke. Most of the clinical anger is liver damage, because of anger, the liver yang will be extremely high in an instant, the anger will rise, and the forced blood will surge. As for worry and sorrow, emotional tension is the cause of the disease.

2. Inadequate diet

Excessive consumption of fatty alcohol alcohol, spleen loss of health, accumulation of wet sputum, phlegm depression and heat, provoke liver wind, sputum pinch and disturbance, can cause illness, especially the most induced by alcoholism.

3. Overworked

"Su Wen · Ang Tong Tong Tian Lun" said: "Yang Qi, if you are troubled, then Zhang" means physical yang, if it disturbs too much, it will not get excited. The disease can also be caused by excessive manipulation and loss of form, resulting in dark blood consumption and disturbance caused by the deficiency of yang. In addition, if you want to injure sperm, it is also the cause of the disease.

4. Climate change

The disease can occur all year round, but it is related to seasonal climate change. Suddenly cold in winter, cold invasion can affect blood circulation. Just as "Su Wen · Tiao Jing Lun" said, "If the cold stays alone, the blood coagulates, but the coagulation is not connected ...". Secondly, in the early spring, when the temperature suddenly warmed, it was the main command of Jue Yin Feng Mu, which should be in the liver, and Feng Yang moved darkly, which could also cause the disease.

5. Blood Stasis

The formation of blood stasis is usually due to qi stagnation, poor blood flow or insufficiency of qi stasis, or blood anger caused by anger, or coagulation due to cold, or stagnation of blood due to hot Yin fluid. Most commonly, anger, blood stasis or blood deficiency of qi deficiency are the most common.

Stroke clinical manifestations

According to the severity of the disease and the depth of the disease, strokes use the classification method of "Jin Kui Qiu Lue" to distinguish between meridians and viscera. Generally without conscious changes, it is manifested by sudden symptoms such as oblique mouth and eyes, unfavorable language, and paraplegia without going through fainting. It is a stroke and meridian. TCM syndrome differentiation is based on the syndrome differentiation method of stroke and meridian in the "Guiding Principles for Clinical Research of New Chinese Medicine" formulated and issued by the Ministry of Health in 1993. It is divided into liver-yang hyperactivity, wind-fire disturbance syndrome; wind-phlegm stasis and blood-blood obstruction syndrome; There are five types of syndromes such as hot stagnation, wind and phlegm disturbance; qi deficiency and blood stasis syndrome; yin deficiency and wind stasis syndrome. The clinical manifestations of the five types are shown in the syndromes in the dialectical treatment of each type.

Stroke Syndrome Treatment

1. Liver-yang hyperactivity, disturbance on fire

Symptoms: Hemiplegia, skewed tongue, linguistic or lingering tongue, numbness, dizziness, headache, red face, red eyes, bitter throat, upset, irritability, dry urine, red or red tongue, tongue coating Thin yellow, strong pulse string. Rule: Zhenganxifeng, Ziyin Qianyang. Main formula: Zhengan Xifeng Decoction. Recipe: pregnant with Achyranthes bidentata, ochre, keel, oyster, white scallion, black ginseng, turtle plate, Asparagus, Yinchen, Chuanxiongzi, raw malt, licorice.

For example, those with hyperactivity of liver yang can add gastrodia elata and crocodile to enhance the power of calming the liver and quenching wind; those who are upset can add crickets and scutellaria baicalensis to clear away heat; those with severe headaches can add antelope horns, stone cassia and prunella to clear Extinguish the wind and yang; those with severe phlegm and heat, add gallbladder, bamboo leaches and Fritillaria chuanxiong to clear phlegm and heat.

2. Wind phlegm and blood stasis

Syndromes: Hemiplegia, skewed tongue, tongue stubborn or silent, leaning numbness, dizziness, dull tongue, thin white or greasy tongue coating, slippery pulse strings. Rule: expelling wind, nourishing blood, promoting blood circulation, resolving phlegm and clearing collaterals. The main party: Daqin Tongtang addition and subtraction. Recipes: Qin , live, solitary live, windproof, angelica, Baiji, cooked land, Chuanxiong, Atractylodes, Poria, Scutellaria baicalensis, plaster, raw land.

Such as the elderly and frail, add astragalus to benefit qi. Such as vomiting and sputum Sheng, greasy fur and slippery pulses, go to Rehmannia, add Pinellia, Nanxing, Baifuzi, Quanxie and other expelling wind and phlegm, pass through the meridians. Those without internal heat can go to gypsum and scutellaria.

3. Phlegm is hot, and wind and phlegm are disturbing

Symptoms: Hemiplegia, skewed tongue, tongue stinging or not speaking, numbness, bloating, dry constipation, dizziness, sputum or sputum, red or dull tongue, yellow or greasy fur, veins String slip or hemiplegia is large and slippery. Rule: Huatantongtuo. The main party: Xingying Chengqi Decoction "Examination Formula" addition and subtraction. Recipes: Bile Nanxing, Whole Melon, Raw Rhubarb, Glauber's Salt.

If the stool is unobstructed after the medicine, the qi will pass, the phlegm and heat will decrease, and the condition will improve to some extent. The dosage of nitrate used by this party should be determined according to the condition and physical condition. Generally, it should be controlled at about 10 to 15 grams. The degree of fecal laxative and phlegm heat accumulation should not be excessive to avoid injury. After qi-passing, phlegm-heat and blood circulation-reinforcing drugs should be cleared, such as Dannanxing, Quanguayan, Salvia miltiorrhiza, red chrysanthemum and chicken blood vine. If dizziness is heavy, you can add hook rattan, chrysanthemum, mother of pearl. If the tongue is red and irritable, and those who do not sleep all night are phlegm-heat-contained and yin-deficiency, you can choose to add fresh ground, sand ginseng, Ophiopogon japonicus, black ginseng, Poria, Yejiao, etc. Should not be too much, otherwise it will prevent the phlegm removal.

4. Qi deficiency and blood stasis

Syndromes: Hemiplegia, skewed tongue, astringent or silent speech, numbness, white complexion, shortness of breath, drooling, spontaneous sweating, palpitations, swollen hands and feet, dull tongue, thin white or greasy tongue coating , The pulse is thin, slow or thin. Rule: Yiqi Huoxue. The main party: Buyang Huanwu decoction. Recipe: Raw Astragalus, Angelica Sinensis, Chuanxiong, Red Radix, Peach Kernel, Safflower, Dilong.

For example, if hemiplegia is worse, add mulberry branches, pangolins, leeches and other medicines to increase blood circulation, clear blood stasis, and remove new stasis effects. If the language is not good, add calamus or Polygala to reduce phlegm and open consciousness. If the swelling of the hands and feet is obvious, add Poria, Zexie, Coix seed, prevent Has been soaked with dampness; those who have bowel movements go to peach kernels plus fried atractylodes and yam to strengthen the spleen.

5. Yin deficiency and wind movement

Symptoms: Hemiplegia, skewed tongue, tongue stinging or not speaking, leanness, numbness, irritability, insomnia, dizziness and tinnitus, hot hands and feet, red or dark red tongue, little or no moss, thin or thin strings number. Rule: Nourish Yin and wind. The main party: Dading Fengzhu plus or minus. Recipe: Chicken yellow, Ejiao, Rehmannia glutinosa, Ophiopogon japonicus, Paeonia lactiflora, turtle plate, scallops, Schisandra chinensis, Zhigancao.

If hemiplegia is severe, you can add products such as Achyranthes bidentata, papaya, earth dragon, hoe, mulberry, etc .; such as dark red tongue, astringent pulse, etc. with salvia syndrome, chicken blood rattan, peach kernel, ground maggot Waiting for blood circulation and removing blood stasis; those who are not good at language can add calamus, turmeric, and Polygala tones.

Stroke prevention and care

1. Timely treatment of induced diseases

Diseases that may cause stroke, such as arteriosclerosis, diabetes, coronary heart disease, hyperlipidemia, hyperviscosity, obesity, cervical spondylosis, etc. should be treated early; hypertension is the most dangerous factor for stroke, and it is also a center for stroke prevention In the link, blood pressure should be effectively controlled, long-term medication should be adhered to, and blood pressure changes should be observed for long-term treatment.

2. Pay attention to the aura signs of stroke

Stay aura signs

Watch out for dizziness, headaches, numbness, lethargy, and abnormal personality. Once a minor stroke occurs, you should go to the hospital for treatment.

3. Eliminate the Causes of Stroke

Such as mood swings, excessive fatigue, excessive force and so on. Pay attention to psychological prevention, keep the spirit happy, and emotional stability. Promote a healthy lifestyle, regular life and rest, maintain smooth stool, and avoid sharp rises in blood pressure caused by forced defecation, leading to cerebrovascular disease.

4. Reasonable diet

To low salt, low fat, low cholesterol is appropriate, eat more soy products, vegetables and fruits, quit smoking, drinking and other bad habits. Eat fish at least three times a week, especially those rich in omega-3 fatty acids, or take deep-sea fish oil. Omega-3 fatty acids can regulate the state of the blood, make blood less likely to form clots, and prevent cerebral infarction.

5. Attention outdoor activities

Should gradually adapt to the ambient temperature, the indoor air-conditioning temperature should not be too high, to avoid sudden transfer from a higher temperature environment to a lower temperature outdoor (especially the elderly), pay attention to keep warm when going out. Patients with a history of stroke should also pay more attention to walking to prevent falls; in addition, daily activities such as getting up and lowering their shoes to tie their shoes should be slow; bathing time should not be too long.

6. Diet and nutrition

The patient's condition is serious, with or without complications, whether he can eat normally, digestion and absorption, weight, blood lipids, blood sugar, electrolytes and other factors, and propose different diet and nutrition treatment options. Diet treatment in the acute phase is to allow patients to pass the critical stage and create conditions for recovery. During the recovery period, suggestions for a reasonable diet should be made to correct undernutrition or malnutrition, promote recovery and prevent recurrence.

(1) Dietary treatment for severely ill patients. If severe or comatose patients have vomiting or gastrointestinal bleeding within 2 to 3 days after onset, they should fast and supplement their nutrition from the vein. Nasal feeding was started after 3 days. In order to adapt to the absorption function of the digestive tract, rice soup and sucrose were the main products in the first few days, 200 to 250 ml each time, 4 to 5 times a day. When it is already tolerated, give mixed milk to increase heat energy, protein and fat. Milk, rice soup, sucrose, eggs, and a small amount of vegetable oil can be used. For those who have been in a coma for a long time and have complications, they should provide high-energy, high-fat mixed milk to ensure that they can have 90 to 110 grams of protein, 100 grams of fat, 300 grams of carbohydrate, and a total heat energy of 10.46 MJ (2500 kcal). The total liquid volume is 2500ml, 300 ~ 400ml each time, 6 ~ 7 times a day. Nasal feeding should be slow to prevent reflux into the trachea. If necessary, choose a homogenized diet or an elementary diet.

(2) The thermal energy for dietary treatment of general patients can be supplied according to 125.52 167.36kJ (30 40kcal), and those who are overweight are appropriately reduced. Animal protein is not less than 20 grams / day, including fish, poultry, lean meat with low fat and high protein, and legumes are not less than 30 grams per day. Fat should not exceed 30% of total thermal energy, and cholesterol should be less than 300 mg / day. Should try to eat less fatty meats high in saturated fatty acids, animal fats, and animal viscera. Overweight people should account for less than 20% of total thermal energy and limit cholesterol to 200 mg. Carbohydrates are mainly cereals with a total thermal energy of not less than 55%. Limit the intake of table salt to within 6 grams per day, but it can be appropriately increased when using dehydrating agents or diuretics. In order to ensure that sufficient vitamins are obtained, more than 400 grams of fresh vegetables should be provided daily. The meal system should be regularly quantified, small meals, 4 meals a day, dinner should be light and easy to digest

7. Chinese herbal medicine single prescription

(1) Huaihua Tea Anti-stroke Huaihua Tea 6 grams. Usage: Boil water for tea. It has the effect of preventing stroke.

(2) 2 cloves of garlic without garlic in stroke . Usage: Peel garlic cloves and mash them like mud. Apply to the root of the tooth. Have the effect of Xuanqiao Tongcun, silent with stroke.

(3) 1 kg of pine hair wine and 1.5 kg of wine. Soak the pine hair in the wine for 7 days, take 1 cup each time, take 2 times a day. It is used for the eyes of the stroke to be crooked, and the symptoms are pain in the feet, back pain, and the feet cannot stand.

(4) Angelica sinensis Angelica sinensis, Nepeta sinensis. Stir-fried black, finely divided, 9 grams each, 1 cup of water, a little wine, fried. It is used for stroke unconsciousness, foaming in the mouth, and postpartum wind paralysis.

(5) Asarum powder (also known as Du Heng) is in proper amount, ground into fine powder, and blown into the nostrils. Unconscious for stroke.

(6) The right amount of vegetable soup is red and white radish. Peel the washed carrots and white radishes and cut them into irregular pieces. Cook the cut vegetables with an appropriate amount of water for about 15 minutes. Use a mesh sieve to remove the vegetables and drink only the soup.