ABSTRACT
Neurogenic orthostatic hypotension （nOH） is a common neurodegenerative disease， and is usually differentiated as kidney-yang depletion syndrome in traditional Chinese medicine （TCM）. Fire needling on governor vessel （督脉） acupoints as well as Shenshu （BL 23） and Zhishi （BL 52） can dredge the qi and blood of governor vessel， so as to warm yang and unblock the channels， supplement essence and boost marrow. A case of elderly nOH treated by fire needling mainly at governor vessel points， Shenshu （BL 23） and Zhishi （BL 52） was reported. After nearly two months of treatment， the patient's orthostatic blood pressure difference and yang deficiency-related symptoms were significantly improved， and the results of blood pressure monitoring， TCM syndrome scale evaluation and Shenshu （BL 23） area infrared imager detection all showed definite clinical effect.
ABSTRACT
Orthostatic hypotension (OH) is defined as a drop of >20 mm Hg of systolic or >10 mm Hg of diastolic blood pressure (BP) within 3 min of standing from lying position. It is a common geriatric syndrome caused by impaired orthostatic response of BP. Its clinical manifestation can range from dizziness to syncope. It is a common cause of recurrent falls and fracture in older adults. Its etiology ranges from neurological causes such as Parkinson and diabetes to hypovolemia. Drugs, especially cardiovascular drugs are also frequently identified as the cause of OH. The management of OH is primarily nonpharmacological including medication review, dietary, and lifestyle modifications. However, in partially responsive or resistant cases, medications such as fludrocortisone, midodrine, droxidopa, etc., are also used.
ABSTRACT
Avaliar a prevalência de hipotensäo ortostática (HO) em idosos hospitalizados e os principais fatores de risco encovlvidos, assim como o tratamento efetuado. Cem idosos com idades iguais ou superiores a 60 (média = 69,2) anos, de ambos os sexos (66 mulheres e 34 homens). A pressäo arterial sistólica (PAS) foi medida com 1, 2, 3, 4 e 5 minutos estando o paciente de pé, após repouso em decúbito dorsal por 30 minutos. Considerou-se HO queda de PAS >= 20 mmHg, acompanhada ou näo por sintomas. Foi observado se havia fatores de risco para esta condiçäo, baseando-se em informaçös do prontuário, como também, se HO constava na lista de problemas e se havia algum tratamento. A prevalência de HO foi de 30% (30 pacientes), sendo que destes, 1/3 apresentou sintomas. Um ou mais fatores de risco foram encontrados em todos os pacientes com esta condiçäo. Hipotensäo ortostática neurogênica foi diagnosticada em 5 pacientes (5 em 30 pacientes). Dos 30 pacientes portadores de HO somente 1 foi previamente diagnosticado. Existe alta prevalência de HO em idosos hospitalizados, geralmente associado a vários fatores de risco. A maioria näo é diagnosticada e, conseqüentemente, näo recebe tratamento