Treatment of senile tremor

Senile tremor is also a relatively common disease manifestation. The most common symptoms are tremors in the head or limbs, and shaking. Milder symptoms include shaking the head or slight tremors in the hands and feet. More serious symptoms are large shaking of the head and constant tremors in the limbs. This situation requires timely treatment, which is also very harmful to the patient and will cause strong psychological pain.

Treatment of senile tremor

1. Clinical Data

General information: Among the 25 patients with senile tremor, there were 18 males and 7 females. The youngest is 58 years old and the oldest is 75 years old.

Diagnostic criteria: The main manifestations are tremors and shaking of the head or limbs. In mild cases, there is only shaking of the head or slight tremors of the hands and feet. In severe cases, there is violent shaking of the head or constant shaking of the limbs.

2. Treatment Methods

1. Syndrome differentiation

This disease is mostly characterized by deficiency of the root and excess of the symptoms, with liver and kidney yin deficiency and qi and blood deficiency as the root and wind, fire, phlegm and blood stasis as the symptoms. The initial symptom of the disease is liver wind tremor, while long-term illness is mostly caused by qi deficiency and blood stasis. The patients were divided into the following types according to the clinical manifestations at the first visit: ① Liver-kidney yin deficiency and internal wind-fire movement type (11 cases). Symptoms include large-amplitude tremor, numbness of limbs, clumsy movements, which do not heal over time and are aggravated by fatigue or anger, dizziness, tinnitus, red tongue, and a thin and stringy pulse. ② Deficiency of Qi and blood, and loss of moisture in tendons and veins (8 cases). Symptoms include severe tremor of limbs, dull complexion, fatigue, dizziness, pale tongue, fat tongue or tongue with teeth marks on the edges, or petechiae on the edges of the tongue, and deep and thready pulse. ③ Qi stagnation, blood stasis, phlegm-heat internal disturbance type (6 cases). Symptoms include tremors in the hands and feet, difficulty in flexion and extension, irritability, which worsen when one is depressed and angry and gradually subside after activity. The tongue is purple or has ecchymosis, and the pulse is stringy, thin and wiry.

2. Treatment prescription

Deficiency of liver and kidney yin, internal movement of wind and fire type. The treatment principle is to nourish the liver and kidneys, nourish yin and extinguish wind, and use Zhengan Xifeng Decoction with added ingredients. Prescription: 12 grams each of dragon bone (pre-boiled), tortoise shell (pre-boiled), white peony root, Uncaria rhynchophylla, raw ochre (pre-boiled), asparagus cochinchinensis, and Scrophularia ningpoensis, 10 grams each of Achyranthes bidentata, Toosendan fruit, and earthworm, and 3 grams of whole scorpion.

Deficiency of Qi and blood, and loss of moisture in tendons and veins. The treatment principles are to invigorate Qi and nourish blood, harmonize the circulation of blood and extinguish wind, and use Bazhen Decoction with added flavors. Prescription: 20 grams of Lithospermum officinale, 15 grams of Salvia miltiorrhiza, 12 grams each of White Peony Root and Uncaria rhynchophylla, 10 grams each of Codonopsis pilosula, Atractylodes macrocephala, Poria cocos, Angelica sinensis, Rehmannia glutinosa and Gastrodia elata.

Qi stagnation, blood stasis, phlegm-heat internal disturbance type. The treatment principle is to promote blood circulation, remove blood stasis, unblock meridians and extinguish wind. Use Xuefu Zhuyu Decoction with added ingredients. Prescription: 12 grams each of Curcuma, Uncaria rhynchophylla, Pheretima, Achyranthes bidentata, 10 grams each of Peach Kernel and Red Peony Root, 9 grams each of Bupleurum and Cortex Moutan, 6 grams of Safflower, and 5 grams of Scorpio.

The above usage is decocted in water and taken in 3 doses, 1 dose per day, and 20 days as a course of treatment.

3. Treatment Effect

Efficacy standard: after one course of medication, the tremor basically disappears, which is considered to be markedly effective; after one course of medication, the tremor is significantly reduced by 1 to 2% or more, which is considered to be effective; after one course of medication, the tremor has no change, which is considered to be ineffective.

Treatment results: 9 cases were markedly effective, 13 cases were effective, 3 cases were ineffective, and the total effective rate was 88%.

4. Experience

Tremors belong to wind, so extinguishing the wind is the first thing to do. The Yellow Emperor's Classic of Internal Medicine states: "All wind-induced vertigo and dizziness are related to the liver." Tremors are related to wind and the liver. This syndrome is caused by internal wind, which has long been blamed on the liver. Therefore, calming the liver and extinguishing wind, harmonizing the blood circulation and extinguishing wind, and unblocking the meridians and extinguishing wind are the basic principles for the treatment of this syndrome. The increase or decrease of tremor is a direct measure of therapeutic efficacy. Therefore, regardless of the syndrome, wind-extinguishing products should be selected on the basis of treating the root cause. Wind-extinguishing medicines include plants, animals and minerals. It is best to use animal and mineral wind-extinguishing medicines, such as scorpions, earth dragons, dragon bones, oysters, magnets, hematite, stone cassia, mother of pearl, etc., which can indeed achieve the desired purpose.

For the elderly and those who have been ill for a long time, the treatment should be slow. Due to the physical weakness of old age, the weakened functions of internal organs and poor self-regulation ability, coupled with prolonged tremors, the imbalance of qi and blood in the internal organs and complex pathological changes. Therefore, it is necessary to stick to the prescription and treat the disease slowly, while also regulating emotions. When the symptoms are obvious at the beginning of the disease, choose wind-extinguishing drugs, and the dosage should not be too large. If the patient's vital energy is deficient, be cautious when using drugs that consume qi, blood, yin and yang, such as Curcuma zedoaria, Trillium, and Scolopendra subspinipes. The spleen is the foundation of acquired constitution and the source of qi and blood production. For the elderly with insufficient Qi and blood, while nourishing blood and calming wind, do not forget to strengthen the spleen and replenish Qi, and promote blood circulation and unblock collaterals. “Qi is the commander of blood”, it can both produce blood and transport blood.