Chaihu and Longgu Muli Decoction has demonstrated significant efficacy in the treatment of tachyarrhythmia accompanied by anxiety and depression. However, there is a lack of standardized guidelines for its clinical application. In this study, the Chaihu and Longgu Muli Decoction was investigated through extensive research on ancient and modern literature, as well as a collection of clinical medical records. The basic information, medication details, and diagnostic information from medical records, personal experience literature, and clinical cases in the treatment of tachyarrhythmia accompanied by anxiety were extracted and analyzed to preliminarily identify the prescription characteristics and syndrome patterns. Subsequently, the Delphi method was employed to construct an item pool based on the data obtained in the first step. An expert questionnaire was prepared to collect scores and revision opinions from experts regarding these items. After statistical analysis and group discussions, a second round of questionnaires was formed by screening out certain items. This process was repeated until a final item set for the treatment of tachyarrhythmia accompanied by anxiety with Chaihu and Longgu Muli Decoction was determined. These findings provided guidance for clinical prescription practices. By extracting 71 syndromes and signs, as well as 33 tongue and pulse characteristics, the main syndrome features included palpitations, chest tightness, irritability, etc., which were basically consistent with the ancient syndromes. Through frequency analysis and group discussions, 71 items were screened out. After screening, modification, and primary and secondary division, 11 main diagnostic items and 10 secondary diagnostic items were determined. On this basis, the research team believes that Chaihu and Longgu Muli Decoction is mainly indicated for the following syndromes in the treatment of tachyarrhythmia accompanied by anxiety(palpitations, poor sleep, bitter taste, dry mouth, irritability/easily angered/anxiety/fearfulness/easily startled, red tongue with greasy yellow coating, rapid pulse, high work/life pressure, tachyarrhythmia on electrocardiogram/Holter monitor, and positive results on anxiety scale). Secondary syndromes include chest tightness, shortness of breath, feeling heavy and weak in the body, sweating, poor appetite, constipation, greasy white tongue coating, wiry pulse, slippery pulse, or knotted and intermittent pulse.
Drugs, Chinese Herbal/therapeutic use* ; Humans ; Delphi Technique ; Anxiety/complications* ; Tachycardia/psychology* ; Female ; Male ; Middle Aged ; Adult ; Aged

TCA are used for the treatment of major depression, anxiety disorders, eating disorders, chronic pain syndromes, and peripheral neuropathies associated with psychiatric and medical conditions that call for a higher rate of prescription drugs. Frequently observed toxic symptoms are sinus tachycardia and altered mental status. Severe toxic symptoms include altered mental status, dysrhythmia, seizure, and secondary complications. Serious cardiotoxicity can lead to ventricular dysrhythmia and a classic TCA electrocardiogram. Gluteal myonecrosis is reported in postoperative alcoholic states, unconscious conditions where patients remain in one position over a long period of time, strenuous physical training, or in crushing injuries. We report a case of gluteal myonecrosis after treatment with several drugs including TCA resulted in intoxication. The patient was mentally drowsy and had been lying down for 20 hours upon discovery. The patient presented on arrival to the ER with cardiotoxicity secondary to TCA intoxication and was treated. Two weeks following the incident, she complained of pain in the gluteal area. Subsequent management and investigation revealed that her gluteal myonecrosis was a result of delayed complication from a prolonged recumbent position and hemolysis due to drug interactions. She eventually recovered without the need for surgery (fasciotomy).
Alcoholics ; Antidepressive Agents ; Antidepressive Agents, Tricyclic ; Anxiety Disorders ; Chronic Pain ; Deception ; Depression ; Drug Interactions ; Feeding and Eating Disorders ; Electrocardiography ; Hemolysis ; Humans ; Necrosis ; Peripheral Nervous System Diseases ; Prescription Drugs ; Seizures ; Tachycardia, Sinus ; Unconscious (Psychology)

OBJECTIVETo evaluate the effect of alprazolam use on psychological status and hospitalization cost in patient with paroxysmal supraventricular tachycardia underwent electrophysiology studies or radiofrequency catheter ablation.

METHODSIn this prospective, randomized, double-blind, placebo-controlled study, 142 inpatients [77 males, mean age (43.1 +/- 14.5) years] were randomly assigned to receive alprazolam (0.4 mg qd at 10PM for 3 days, n = 72) or placebo (n = 70) 3 days before scheduled electrophysiology studies or radiofrequency catheter ablation. All patients were examined by the Chinese version of Symptom Checklist-90 (SCL-90) at 24 hours before the procedure.

RESULTSCompared with the placebo group, the scores of somatization (1.38 +/- 0.40 vs. 1.65 +/- 0.56, P < 0.01), anxiety (1.50 +/- 0.39 vs. 1.69 +/- 0.50, P < 0.05), phobic anxiety (1.24 +/- 0.36 vs. 1.47 +/- 0.57, P < 0.01), psychotism constructs (1.24 +/- 0.34 vs. 1.35 +/- 0.30, P < 0.05) and global severity index (1.36 +/- 0.35 vs. 1.49 +/- 0.37, P < 0.05) were significantly decreased in alprazolam group. The hospitalization costs were also significantly lower in alprazolam group (32 498 +/- 1170) yuan compared to placebo group (32 947 +/- 1096) yuan, P < 0.05.

CONCLUSIONThe alprazolam use before electrophysiology studies and radiofrequency catheter ablation can improve the patients' psychological status and reduce the hospitalization costs.

Adolescent ; Adult ; Aged ; Alprazolam ; therapeutic use ; Anti-Anxiety Agents ; therapeutic use ; Catheter Ablation ; economics ; psychology ; Double-Blind Method ; Female ; Hospitalization ; economics ; Humans ; Male ; Middle Aged ; Prospective Studies ; Tachycardia, Paroxysmal ; psychology ; therapy ; Tachycardia, Supraventricular ; psychology ; therapy ; Young Adult

This study was performed to identify the physiological and psychological variables related to successful weaning from a mechanical ventilator. The subjects of this study were 22 patients who received mechanical ventilation therapy for more than 3 days in intensive care units. Before the weaning trial, baseline data for following physiologic variables were obtained: spontaneous respiration rate, blood pressure, pulse rate, PaO2, PaCO2, PEEP, static compliance, minute ventilation, tidal volume, rapid shallow breathing index(f/VT), SaO2, PaO2/FiO2 and mean arterial pressure. During spontaneous breathing, physiologic and psychologic variables such as vital signs, ABG, perspiration, chest retraction, paradoxical respiration, dyspnea, anxiety, confidence and efficacy were measured. Successful weaning was defined as sustaining spontaneous respiration over 24 hours after extubation. Weaning failure was defined as the development of more than one of following signs: (1) hypoxemia, (2) CO2 retention or (3) perspiration, tachypnea, chest retraction, tachycardia, arrhythmia, hypotension or hypertension. Subjects (N=18) who successfully weaned from mechanical ventilator were compared with subjects (N=4) who failed. The results are as follows; Eighteen percents of the subjects failed during the weaning trial. Most subjects in the failed group were mechanically ventilated for long-time. This result shows that the success of weaning is more difficult in long-term ventilation patients. In the baseline data that was measured before weaning trial, the mean score of PaO2 in the successfully weaned group was 121mmHg. This is significantly higher than the mean score of PaO2 in the failed group(95mmHg). However, the scores of pH, tidal volume, f/VT, pulse rates, blood pressure, mean airway pressure, SaO2, and PaCO2 were similar between the two groups. Specially the scores of f/VT index as a predominant predictor for successful weaning were not significant (f/VT=44.4) and (f/VT=47). During spontaneous breathing, the scores of dyspnea and anxiety level in the successfully weaned group were less than those of the failed group. On the contrary, the scores of confidence and efficacy in the successful group were greater than those of the failed group. In conclusion, the baseline data that were measured before weaning trial were similar between the both groups, therefore future studies are needed to focus on searching other variables besides physiological parameters related to weaning outcome.
Anoxia ; Anxiety ; Arrhythmias, Cardiac ; Arterial Pressure ; Blood Pressure ; Compliance ; Dyspnea ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Hypertension ; Hypotension ; Intensive Care Units ; Psychology* ; Respiration ; Respiration, Artificial ; Respiratory Rate ; Tachycardia ; Tachypnea ; Thorax ; Tidal Volume ; Ventilation ; Ventilators, Mechanical* ; Vital Signs ; Weaning*

The authors studied depression in 5,869 college students (male: 3,893, female: 1,976) using Zung's Self-Rating Depression Scale (SDS). The results are as follows: 1) Female college students showed significantly higher total depression scores than male college students (p<0.001). 2) The items of confusion, indecisiveness, and psychomotor retardation were scored higher in both groups and the items of suicidal rumination, psychomotor agitation, constipation and tachycardia were scored lower in both groups. 3) 18.2% of male college students showed rather serious depression level of score 50 or higher, while 33.1% of female college students showed the same scores. 4) The psychosocial factors relating to pessimistic views to past, present & future self-images showed significantly high depression scores. 5) The depression items of fatigue, anxiousness, tachycardia, apprehension, fear, and body aches & pain were correlated significantly over 0.40 of correlation coefficient.
Constipation ; Depression* ; Fatigue ; Female ; Humans ; Male ; Psychology ; Psychomotor Agitation ; Tachycardia