Wen Tongxinyang is suitable for patients with coronary heart disease with syndrome differentiation of yang deficiency and cold coagulation. Its symptoms are severe chest pain, or colic, or cold, or severe cold pain, and the onset is rapid. It often happens at night or when you feel cold evil. Usually manifested as cold limbs, weak body, weak waist and knees, pale complexion, loose stool, long urination, chest tightness, pale or purple tongue, white fur, and delayed or tight pulse. Most of them are caused by heart yang deficiency, chest cold, qi obstruction or shortness of breath, loss of qi, inability to warm heart pulse and stimulate heart yang. Cold leads to coagulation, while warming leads to relaxation, which can warm yang, replenish qi, dispel cold, promote blood circulation and relieve pain, especially warm yang, heart and kidney. Shenfu Decoction and Guizhi Glycyrrhiza Decoction are often used for addition and subtraction: Ginseng 10g, Radix Aconiti Lateralis 10g, Radix Astragali 30g, Ramulus Cinnamomi 15g, Radix Paeoniae Alba 15g and Rhizoma Chuanxiong 65g. If the symptoms of kidney-yang deficiency are serious, such as backache and leg weakness, cold limbs, pale and fat tongue, and delayed pulse, etc., Radix Rehmanniae Preparata and auxiliary materials are added, and yin is used to seek yang, and the dosage of auxiliary materials is1/3 ~1/4 of Radix Rehmanniae Preparata; If there are severe symptoms of spleen-yang deficiency such as abdominal distension and anorexia in loose stool, dry ginger, Amomum villosum and Rhizoma Cyperi are added to warm up and disperse the stagnation; If chest tightness is the main symptom, it is mostly due to cold feeling that the heart yang fails, qi stagnation and blood stasis, and Fructus Trichosanthis and Bulbus Allii Macrostemi are added to promote yang and relieve arthralgia; If the chest tightness stings, it is blood stasis. Add Radix Paeoniae Rubra, Lignum Dalbergiae Odoriferae and Flos Carthami to promote blood circulation and dredge collaterals to relieve pain.
Yiqi Yangxin is suitable for patients with chronic coronary heart disease with deficiency of both qi and yin. Its symptoms are chest tightness, dull pain, intermittent rest, shortness of breath, slight pulse, accompanied by palpitation, shortness of breath, dizziness, spontaneous sweating due to shortness of breath, insomnia, dreaminess, pale tongue and less redness. Most of them are heart-yin deficiency, or overwork, or excessive consumption of essence in the elderly, or prolonged onset time and disharmony of heart and pulse. Supplementing Qi and Nourishing Heart, Baoyuan Decoction and Shengmai Powder were selected: Ginseng 10g (Radix Codonopsis for qi deficiency, Radix Ginseng for qi deficiency, Radix Pseudostellariae or Radix Panacis Quinquefolii for qi and yin deficiency), Radix Astragali 30g, Radix Glycyrrhizae Preparata 10g, Radix Ophiopogonis 12g, Fructus Schisandrae Chinensis 10g, and Atractylodis Rhizoma. Chest obstruction plus Radix Curcumae and Radix Salviae Miltiorrhizae for removing blood stasis and dredging pulse to relieve pain; Ruomai combined with Gancao decoction can replenish qi and nourish blood, nourish yin and restore pulse; Fructus Lycii, Radix Adenophorae, Radix Rehmanniae, Ecliptae Herba and Fructus Ligustri Lucidi can be added for patients with yin deficiency.
Resolving phlegm and removing turbidity is suitable for patients with coronary heart disease with phlegm and turbid internal resistance and unclear heart and yang. Its symptoms are obesity, chest distress and pain, excessive phlegm, turbid fur and slippery pulse. The treatment is to clear yang, remove turbidity, resolve phlegm and dissipate stagnation. The prescription is to take Trichosanthes kirilowii Macrostemon White Liquor Soup, Trichosanthes kirilowii Macrostemon Pinellia Soup, Fructus Aurantii Immaturus Macrostemon Guizhi Soup: 30g of Trichosanthes kirilowii Macrostemon, 30g of Trichosanthes kirilowii Macrostemon Guizhi Soup. If the chest tightness is serious, reuse Trichosanthes kirilowii chest to resolve phlegm; For those with heartbroken back, use Bulbus Allii Macrostemon to promote yang to declare arthralgia; If the yang is unclear, cassia twig is added to warm the chest yang; Adding Rhizoma Acori Graminei and Radix Curcumae to clear phlegm and resolve phlegm; Phlegm heat focuses on gardenia, gallbladder and bamboo shavings; Internal resistance of phlegm and turbidity can make blood stagnate into blood stasis, and blood stasis blocks pulse. Phlegm and blood stasis are mutually causal, so Chuanxiong and Yujin are often added to promote blood circulation and remove blood stasis. The method of removing blood stasis and dredging pulse is suitable for patients with coronary heart disease diagnosed as heart blood stasis. The patient showed chest pain, fixed pain point, dark purple tongue, dark lips and thick tortuous hypoglossal vein. Modern medicine believes that angina pectoris is mostly caused by coronary artery spasm on the basis of severe coronary artery stenosis, and its mechanism is related to plaque rupture, platelet aggregation and release of vasoconstrictor active substances and incomplete obstructive thrombosis, which belongs to blood stasis syndrome of traditional Chinese medicine and is treated by activating blood circulation to remove blood stasis and dredging pulse. Xuefu Zhuyu Decoction and Guanxin No.2 Formula can be added and subtracted: Salvia miltiorrhiza 30g, Paeonia Rubra 12g, Chuanxiong 12g, Peach Kernel 10g, Dalbergia odorifera 12g, Carthamus tinctorius 10g, Bupleurum chinense 12g, etc. Gan Song and Radix Sophorae Flavescentis are added for arrhythmia.
Relieving depression and promoting yang is suitable for patients with coronary heart disease with liver-qi stagnation. There are many cases of coronary heart disease pain manifested as chest pain, which radiates to the ribs, even to the back, shoulder blades and arms, and most of them are caused by emotions. Lingshu meridian is called "liver heartache". Depression and anger hurt the liver, and the liver qi is not comfortable, so the blood vessels are not harmonious. Its symptoms often occur at 5 ~ 7 in the morning (when the hair governs the liver) or when the mood fluctuates. Symptoms are atypical, but they occur frequently, often accompanied by severe chest tightness and mild pain, intermittent rest, hyperventilation, nervous discomfort, and tight pulse. The treatment should be soothing the liver and relieving depression, invigorating yang and relieving spasm. Commonly used Chaihu Shugan powder: Chaihu 12g, Yujin 12g, Radix Paeoniae Alba 15g, Rhizoma Chuanxiong 10g, Rhizoma Cyperi 12g, Fructus Toosendan 2g, Rhizoma Corydalis 10g and Pericarpium Citri Tangerinae/kloc-0g. If it is wet at the same time, add musk and Eupatorium odoratum to make it turbid. The medicine for soothing the liver has the functions of invigorating yang, benefiting the liver and gallbladder, promoting hair growth, facilitating the circulation of qi and blood, and relaxing the heart pulse contracture.
Western medicine treatment?
Drug therapy: refers to the use of nitrates, beta blockers, calcium antagonists, invertase inhibitors, blood lipid regulators, anticoagulants, etc. There are many drugs for treating coronary heart disease, and the commonly used ones are:
Nitrate preparation: mainly including nitroglycerin, isosorbide dinitrate, sorbitol 5- mononitrate, long-acting nitroglycerin preparation, etc.
Adrenaline β-blockers (β-blockers): Commonly used preparations include Propranolol, Enolol, Alloprolol, Indolol, Metoprolol, Atenolol and Nadolol.
Calcium channel blockers: commonly used preparations include verapamil, nifedipine, diltiazem, nicardipine, etc.
Antiplatelet drugs: aspirin, dipyridamole, bensulfuron, etc.
Drugs for regulating blood lipid: nicotinic acid, pravastatin, lovastatin, simvastatin, etc.
Thrombolytic drugs: such as warfarin, heparin, urokinase and streptokinase.
Interventional therapy: including percutaneous transluminal coronary angioplasty (mA), coronary plaque rotary cutting, coronary plaque rotary grinding, coronary plaque cutting and aspiration, percutaneous coronary laser angioplasty, coronary stent and thrombolytic therapy. At present, the most widely used interventional therapies are thrombolytic therapy, percutaneous transluminal coronary angioplasty and coronary stent implantation.
Surgical treatment: refers to coronary artery bypass grafting, that is, coronary artery bypass grafting.