Chinese medicine does not have a specific disease name for "stirred pulse" inflammation, but based on its clinical manifestations, it can generally be categorized under the disease patterns of "vessel impediment," "syncope," "hidden pulse," "deficiency damage," or "vertigo" in Chinese medicine. The disease cause and mechanism involve constitutional deficiency, compounded by exposure to wind, cold, dampness, or heat pathogens, leading to blood stasis and even obstruction of the heart orifices. This results in impaired circulation of qi and blood, causing the zang-fu organs and tissues to lose warmth and nourishment, manifesting in various symptoms such as vertigo, insomnia, fainting, numbness and pain in the limbs, or cold extremities, deep and hidden or absent pulses. However, blood stasis is the fundamental pathological basis.

bubble_chart Modern Research

Takayasu's arteritis is a chronic inflammatory vascular disease that predominantly affects the aorta and its major branches. The disease can involve all layers of the artery, leading to varying degrees of stenosis or occlusion, which in turn causes various clinical symptoms. The most prominent sign of this disease is the disappearance of upper limb pulses, hence it is also known as pulseless disease, Takayasu's disease, aortic arch arteritis, or aortic coarctation arteritis syndrome.

The exact cause of this disease remains unclear, but immune mechanisms, particularly autoimmune abnormalities, are involved in its pathogenesis. The disease may be associated with other collagen vascular diseases, hypergammaglobulinemia, and positive lupus cells. Gamma globulins are present in the affected aortic regions, and anti-arterial wall antigen antibodies are found in the blood. This disease is more common in young female patients.

1. Ischemic symptoms in one or both limbs (coldness, numbness, weakness, intermittent claudication), accompanied by weakened or absent pulses, reduced or unmeasurable blood pressure in the affected limb, or a significant difference in blood pressure between the two upper limbs (>2.6 kPa), or higher blood pressure in the upper limbs compared to the lower limbs.
2. Cerebral ischemic symptoms (dizziness, syncope, visual disturbances), along with weakened or absent carotid pulses on one or both sides, and vascular bruits in the corresponding areas.
3. Persistent hypertension of unknown cause in young individuals, with grade II or higher vascular bruits heard in the abdomen or renal area (excluding congenital renal artery stenosis).
4. Typical Takayasu's fundus changes.
5. Increased erythrocyte sedimentation rate, elevated C-reactive protein, positive antinuclear antibodies, and anti-aortic arteritis antibodies.
6. Abnormal arterial ultrasound flow patterns, renal scans, and angiography.

bubble_chart Pattern Analysis

1. Heat Toxin Obstructing Collaterals︰Seen in the acute inflammatory active phase, symptoms include fever, thirst, fatigue, emaciation, muscle and joint pain, cold and numb limbs. The tongue is red with a yellow coating, and the pulse is rapid or absent. Treatment involves clearing heat and removing toxins, invigorating blood and resolving stasis, with modifications of Four Wonderful Herbs Resting Hero Decoction. Ingredients include Scrophularia Root, Lonicera, Salvia, Suberect Spatholobus Stem, and Dandelion, 30g each; Chinese Angelica, 15g; Cinnamon Twig, Liquorice Root, and dried Earthworm, 10g each.
2. Deficiency of Both Qi and Blood︰Pale complexion, pale lips and nails, dizziness, blurred vision, insomnia, palpitations worsening with movement, shortness of breath, reluctance to speak, mental fatigue, lack of strength, spontaneous sweating, limp and weak or numb limbs. Pale tongue with white coating, faint or imperceptible pulse. Tonify qi, nourish blood, unblock meridians, and restore pulse. Modified Astragalus and Cinnamon Twig Five Ingredients Decoction combined with Prepared Licorice Decoction. Ingredients: Astragalus Root, Prepared Rehmannia Root, Salvia, Suberect Spatholobus Stem (30g each), Cinnamon Twig, Peony Root, Tangshen, Prepared Licorice Root, Donkey-hide Gelatin (melted), Chinese Angelica (15g each), Chinese Date (6 pieces). For cold limbs, add 10g of Prepared Aconite and 10g of Degelatined Deer-horn. For blurred or double vision, add Feather Cockscomb Seed or Buerger Pipewort Flower as needed. For yin deficiency with low-grade fever, night sweats, dry mouth, and throat, add Scrophularia Root, Barbary Wolfberry Fruit, Starwort Root, or Chinese Wolfberry Root-bark as appropriate.
3. Yin Deficiency with Yang Hyperactivity︰Dizziness, or even head distending pain, tinnitus, dizzy vision, dysphoria, irritability, palpitation, insomnia, dry mouth and throat, soreness and weakness of the waist and knees, weakness and coldness of the lower limbs, or intermittent claudication, constipation, yellow urine. Elevated blood pressure in the upper limbs, red tongue with little coating, wiry, tight, and rapid or thin and rapid wrist pulse, weak or absent dorsalis pedis pulse. Nourishing yin and subduing yang, unblocking collaterals, Modified Pulse-Restoring Decoction. Ophiopogon Tuber, Unprocessed Rehmannia Root, Donkey-hide Gelatin (melted), Tortoise Carapace (to be decocted first), Turtle Carapace (to be decocted first), Peony Root, Tail of Chinese Angelica, each 15g; Sour Jujube, Hemp Seed, each 10g; Magnetite (to be decocted first), Nacre (to be decocted first), Salvia, each 30g. For decreased vision and severe tinnitus, optionally add Cornus Officinalis, Phellodendron Bark, Anemarrhena, etc.; for nasal congestion and loss of smell, optionally add Magnolia, Dahurian Angelica, Loquat Leaf, etc.; for obvious vertigo, optionally add Tribulus Terrestris, raw Hawksbill Shell; for edema of the lower limbs or face, additionally add Plantain Seed, Alisma, Poria; for coldness and numbness of the limbs, optionally add Cinnamon Twig, Chinese Starjasmine Stem, Earthworm, Suberect Spatholobus Stem, etc.
4. Qi Stagnation and Blood Stasis︰Commonly seen in those with aortic stenosis. Symptoms include dizziness, vertigo, distending pain in the eyes, blurred vision, irritability, weakness and coldness in the limbs, insomnia with dreamfulness, a dark tongue texture or ecchymosis, and a choppy or absent pulse. Treatment involves regulating qi and resolving stasis to unblock the collaterals, using the modified Blood House Stasis-Expelling Decoction. Ingredients include Chinese Angelica, Peach Kernel, Carthamus, Red Peony Root, and Moutan Bark, 15g each; Unprocessed Rehmannia Root and Achyranthes Root, 30g each; Submature Bitter Orange, Sichuan Lovage Rhizome, Bupleurum, Gardenia, and Liquorice Root, 10g each.