Check the dist. cap and the rotor to make sure they are not carbon up and for cracks in the cap, also check the control module in the dist. Parts store can test it for you. In addition, check the coil to see if it is weak and test the pickup coil in the dist. You might want to change the etc by the thermostat housing, they can make a truck do strange things as they control the ecm signal, also if it has on check the crank sensor it maybe sending an intermittent signal to the ecm. .
I would take it to a good mechanic and have him check to see if it needs a tune up or if it has jumpt time. Sometimes the timming chain will stretch if the engene has a lot of miles on it.
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