obstructive sleep apnea syndrome generally refers to the collapse of upper airway blockage caused by lack of apnea and hypopnea, specifically refers to the adult in 7 hours of sleep at night time apnea at least 30 times, each time duration of apnea at least 10 seconds; intensity of respiratory airflow during sleep compared with baseline by 50%, and with arterial oxygen desaturation ≥ 4%; or apnea-hypopnea index (the average hourly breathing during sleep the number of suspension and low ventilation)> 5. In addition to obstructive sleep apnea, the clinic also central sleep apnea and mixed sleep apnea. The latter two have different levels of certain brain respiratory center damage and diseases such as traumatic brain injury, encephalitis, brain abscess, brain tumor, brain stem infarction.
The disease belongs to Chinese medicine, “snoring sleep” category.
one cause of pathological
1. Western cause pathological
(1) narrowing or blockage of the upper respiratory tract: larynx above the three sites prone to stenosis and obstruction, the nose and nasopharynx, oropharynx and soft palate, and the base of the tongue. Often in the throat blocking the three main left and right when the diameter and the anteroposterior diameter of pharynx or tongue base hypertrophy small elevation to the upper and lower angina smaller diameter, so that the suction caused when the lower edge of the soft palate, pharynx and palatal arch palatal tremor rapid vertical The issue of snoring. Clinical findings, the former nose, nasopharyngeal stenosis or atresia, nasal septum deviation, nasal polyps, hypertrophic rhinitis, nasal and nasopharyngeal carcinoma, adenoid or tonsillar hypertrophy, long uvula, pharyngeal arch broad palate, soft palate relaxation, submucosal pharyngeal wall fat deposition, pharyngeal muscle paralysis, tongue hypertrophy, jaw deformity, cervical softening and laryngeal cartilage malformations often cause the disease attack.
(2) obesity: Obesity was positively correlated with the disease. Prone to obesity may be caused by this disease as follows: ① tongue hypertrophy, and the soft palate, the palate and pharyngeal wall down excessive fat deposition, prone to cause airway blockage. ② significantly reduced the volume of the lung, resulting in obesity hypoventilation syndrome. (3) lipid metabolism disorder: the existence of lipid metabolism disorders in patients, a majority of dyslipidemia.
(4) endocrine disorders: such as acromegaly, caused by increased tongue, thyroid dysfunction caused by mucinous edema, post-menopausal women endocrine disorders.
(5) old age, tissue relaxation, decreased muscle tone, leading to pharyngeal wall relaxation, the shift caused by the collapse of the disease.
(6) Genetic factors: family history of the disease or familial aggregation.
TCM etiology and pathogenesis of this disease with Congenital and acquired causes of loss of support related to acquired factors such as improper diet, excessive work and rest, smoking, alcohol and so on. Disease location, mainly in lung, spleen, involving heart, kidney, and nasal orifices at the same time, the lesions are closely related to the throat. Disease of mostly the virtual real. The main pathological factors phlegm, phlegm, blood stasis, qi stagnation. The main pathogenesis for the phlegm resistance, or phlegm in obstruct, qi stagnation, lung and spleen kidney, heart yang and insufficient, especially loss of health movement spleen, lung negative for the key.
Second, classification type
1. lung spleen deficiency, phlegm obstruct within: sleep when snoring, loud snoring, intermittent, rude, false sleep soundly the night, early morning dry mouth, cough yellow sticky sputum, constipation, easy to sweat, fatigue. Tongue red, yellow or yellow greasy tongue coating, slippery pulse string.
2. Temper enough phlegm resistance: sleep when snoring, loud snoring, intermittent, body fat, morning dry mouth is not obvious, chest tightness, sputum white thin, Shenpi lethargy, sleep does not recover from fatigue, forgetfulness, abdominal swelling of the liver . Pink tongue, a scalloped edge, white or greasy fur or white slip, slide, or How slow pulse string.
3. Lung and spleen deficiency, phlegm and blood stasis: when sleep snoring, loud snoring, intermittent, night sleep soundly is not real, always wake up snoring, dry mouth, but do not want to drink, morning headache, chest tightness, looking dull, forgetful, shortness of breath, Shen Juan fatigue, weak waist. Dark red tongue, or ecchymosis petechiae, run a thin tongue, thready pulse astringent.
4. Heart and kidney deficiency, yang deficiency: sleep when snoring, snoring does not ring, intermittent, night sleep soundly is not real, always arousal, lethargy, sleep does not recover from fatigue, swarthy, aversion to cold, Shenpi lazy words night, more frequent urination, forgetfulness, chest tightness, weak waist. Tongue pale, tongue white slip, the pulse.
Third, Chinese medicine treatment
1. lung spleen deficiency, phlegm obstruct card within
[therapies] Qi and phlegm, Tongfu heat.
[prescriptions] Six Gentlemen Decoction Decoction plus or minus small.
2. Temper enough phlegm resistance card
[therapies] Spleen dampness, benefits gas expectorant.
[prescriptions] Six Gentlemen Decoction Decoction third son of Their Parents. If the dampness
more worse, can add herb, Alisma, Coix seed dampness dampness; if Qing Yang does not rise, could add astragalus, Cimicifuga, Bupleurum Shengqing Qi.
3. Lung and spleen deficiency, phlegm card
[therapies] replenishing yang, promoting blood phlegm.
[prescriptions] Sini plus Ginseng Decoction combined Xuefuzhuyu.
can soda son, Mustard Seed, Radish Seed phlegm awakened interest. If the deficiency than worse, may Astragalus to strengthen the power of qi.
4. Heart and kidney deficiency, yang deficiency card
[therapies] warming the kidneys, boost yang.
[prescriptions] Zhen Wu decoction. Yang
if more worse, can be added ginseng, ginger, Zhigancao strengthen the power of Wenbu Yang Qi; Alpine within the stop, could add white cardamom, Shichangpu Tongqiao dampness.
IV experience side
1. Phlegm stasis resuscitation side
[drug composition] orange 10 grams, 10 grams raw Pinellia, Poria 15 grams, 10 grams almonds, Mustard Seed 6 grams, 15 grams Atractylodes, Shichangpu 10 grams, 15 grams turmeric , Chuanxiong l0 grams, 20 grams of Salvia.
[effect] dampness phlegm, blood resuscitation.
[indication] of obstructive sleep apnea syndrome is a wet storm spleen, phlegm awakened card.
[Usage and dosage] day one, Shuijianbi.
[Use Note] need comprehensive treatment of this disease.
2. Suanzaoren Decoction side
[drug composition] Suanzaoren 20 grams, Chuanxiong 10 g, Poria 15 grams, Anemarrhena 10 grams, 10 grams licorice, dried tangerine peel 10 grams, Pinellia 10 grams.
[effect] blood and tone the liver, raising my heart to God, and heat Chufan, spleen expectorant.
[indication] of obstructive sleep apnea syndrome.
[Usage and dosage] cold water immersion on the drug 60 minutes, soaked fried twice, each time Jian Fei gently for 20 minutes later, two fried mix, about 500 ml, one dose per day, divided into 3 times service . Shengmai taking two capsules with 3 times a day. A month for a course of treatment.
V. Microwave ablation
1. Before treatment, routine blood test, electrocardiogram and fiber laryngoscopy to exclude patients with physical scars and blood, Zhu Huanzhe preoperative fasting.
2. Mouth and pharynx do routine disinfection of weeks, intermittent spray of 1% tetracaine pharyngeal anesthesia 3 to 5 times to 15 minutes of the pharyngeal mucosa after 6 ml lidocaine 2% 1% adrenaline to do a small amount of soft palate and palatal roots down 3:00 anesthesia, one milliliter of each point of injection.
3. The microwave ablation instrument power transferred to 40 ~ 50W, time is 8 seconds; adjusted snore gun, left hand holding a tongue depressor down to Sheqian 2 / 3, right hand holding the gun first snore snore gun grip the palate with a double vertical mast part of the foot pedal tight, 8 seconds after clamping mucosal see white, then you can; after the shift to the soft palate hypertrophy double folder with the same treatment of partial, lateral hypertrophy of the mucous membrane is closely aligns with a single folder hypertrophic mucosa after 6 seconds to achieve the same therapeutic effect.
4. After giving anti-inflammatory and hormone drugs, intravenous cefotaxime sodium pin 4 grams of pine needles dexamethasone 10 mg once a day, once every two days, with inhalation treatment: gentamicin to pin 80000 uR Sammy pine 5 mg once a day, spray a week.
5. After two days into the flow of food, mouth-tai (xylitol, chlorhexidine) mouthwash mouthwash once a day to come here to observe the effect.
[advantage] in the treatment of obstructive sleep apnea syndrome and stable, and can achieve more satisfactory in the short term therapeutic effect, and the symptoms quickly. Pharyngeal mucosa does not cause more scar and adhesion, local reaction was mild, 7 to 10 days the wound is completely healed, does not affect the work and effective.