Coronary heart disease belongs to the category of chest pain, true heartache and heartache in traditional Chinese medicine. There are descriptions of "heart disease, chest pain, hypochondriac fullness, hypochondriac pain, pseudoscapular back pain and pain in both arms" in the book, which are very similar to the dialectical points of coronary heart disease.
Chest pain is one of the important heart diseases that threaten the life and health of middle-aged and elderly people. With the change of lifestyle and diet structure in modern society, the incidence of chest pain is increasing gradually, so people pay more and more attention to this disease. Because the disease is characterized by deficiency in substance and excess in substance, and its clinical manifestations and pathological changes are complex, the treatment of traditional Chinese medicine has been widely concerned because of its comprehensive advantages.
I. Etiology and pathogenesis
The name of "chest obstruction" first appeared in Neijing, which can be divided into two types: heart obstruction and lung obstruction. Record the etiology, general points of syndrome differentiation and pain manifestations of this disease. The name of "heartache" was first found in Fifty-two Prescriptions for Diseases unearthed from Mawangdui ancient Han tomb. The synopsis of the golden chamber records the manifestations of chest obstruction, which is characterized by "chest obstruction is urgent", that is, heartburn occurs from time to time and attacks slowly, and its pathogenesis is yang failure and yin failure, so there are Gualou Scallion Pinellia Decoction, Gualou Scallion Liquor Decoction and ginseng soup to treat this disease. Later physicians, such as Su Hexiang Pill used in Wei Yilin's A Good Prescription for World Doctors in Yuan Dynasty, Shixiao Powder used in Wang Kentang's Standard for Treatment Based on Syndrome Differentiation in Ming Dynasty, and large dose of safflower and Dalbergia odorifera used in Wang Qingren's Gaicuo in Qing Dynasty, all have good curative effects on this disease.
Su Wen's Theory of Regulating Classics: "Cold accumulates in the chest without diarrhea, but it warms the qi without diarrhea. If it stays alone, it will coagulate and cry, and the pulse will be blocked." Syndrome and treatment of chest pain, heartache and shortness of breath in synopsis of the golden chamber: "those with chest pain are stuffy in their hearts." Qi stagnation in the chest, chest full, heart robbed under threat. Fructus Aurantii Immaturus, Bulbus Allii Macrostemon and Ramulus Cinnamomi are the main decoctions. Ginseng chicken soup is also the main "; "heartache cuts the back, waist soreness cuts the heart, and aconite red stone fat pills are the main ones"; "Symptoms include chest pain, wheezing, expectoration, chest and back pain, shortness of breath, delayed pulse, and tight closure, mainly with Gualou onion soup"; "Chest pain, can't lie down, heartburn in the back, and Gualou Scallion Pinellia Decoction is the main one." "Taiping Sheng Hui's Prescription for Treating Heart Bi": "If a husband thinks too much, it will damage his heart, while if he is guilty, he will take advantage of his weakness, and if evil accumulates, it will harm his diet. If his heart is full, it will hurt, which is called heart Bi." "Jade Machine Slightly Heartaches": "However, there are also people who have been ill for a long time, who are powerless and heartbroken, and all of them are also painful." "Medical Law Cold Door": "Chest obstruction and heartache are always due to yang deficiency, so yin can take advantage of deficiency."
(1) Old and frail
The disease mostly occurs in middle-aged and elderly people, who are over half a year old, and the kidney qi has gradually weakened. Deficiency of kidney-yang can not stimulate the yang of the five internal organs, leading to deficiency of heart-qi or heart-yang, loss of warm pulse, weak motivation and blockage; Deficiency of kidney yin can not nourish the yin of the five internal organs, which can cause internal friction of heart yin, deficiency of heart yin and moistening of pulse channels; Or the heart fire is on the high side, burning body fluid into phlegm, phlegm and blood stasis blocking the heart pulse, causing chest obstruction and heartache.
(B) improper diet
Eating too much fat and sweet, hurting the spleen and stomach for a long time, losing the sense of transport, accumulating dampness into phlegm, committing in the area of enlightenment, not clearing yang, not flowing qi, and not being able to pass through the heart and pulse, leading to the disease; Or the phlegm stays for a long time, and the phlegm and blood stasis are blocked, which also consumes the disease; Or a full meal hurts the qi, the promotion is weak, and the blood circulation is not smooth, leading to this disease.
(3) Emotional disorder, anxiety impairs the spleen, spleen deficiency and qi stagnation, abnormal transport and transformation, body fluid can not be transported, accumulated as phlegm, phlegm and blood stasis, qi stagnation and blood stasis, heart pulse obstruction, resulting in chest obstruction and heartache. Or depressed anger hurts the liver, the liver loses its function of dispersing qi, the liver stagnates for a long time, the body fluid burns into phlegm, and qi stagnation and phlegm turbidity block the heart pulse, resulting in chest obstruction and heartache. Because liver-qi and heart-qi are interlinked, stagnation of liver-qi leads to deficiency of heart-qi, and excessive seven emotions are the common causes of this disease.
(4) invasion of cold pathogen
The disease is caused by deficiency of yang in the body, weakness of chest yang, evil of yin and cold, stagnation of cold, unstable chest yang and poor blood circulation.
"Cold Door of Medical Law" said: "Chest obstruction and heartache are always due to yang deficiency, so yin can take advantage of deficiency." This paper expounds that the disease is caused by yang deficiency and cold, and it is easy to die of heartache due to weather change and sudden cold.
The main pathogenesis of chest obstruction and heartache is deficiency of essence and qi, obstruction of pulse consolidation, and the location of the disease is mainly in the heart. However, its incidence is mostly related to the dysfunction of liver and kidney, such as kidney deficiency, liver depression and spleen dysfunction. The pathological changes of this disease are mainly manifested as deficiency in essence and solid in essence. Its intrinsic deficiency can be qi deficiency, yang deficiency, yin deficiency and blood deficiency, and it can also damage yang, and Yang Can can damage yin, which is characterized by deficiency of both qi and yin, deficiency of both qi and blood, deficiency of both yin and yang, and even exhaustion of yang. In fact, qi stagnation, cold coagulation, phlegm turbidity and blood stasis can be mutually diseases, such as qi stagnation, blood stasis, cold coagulation and qi stagnation, phlegm and blood stasis, etc. Clinically, it is often manifested as the combination of deficiency and excess, such as phlegm-heat due to yin deficiency and phlegm-drink due to yang deficiency. During the attack, excess is the main manifestation, especially blood stasis. In the remission stage, the deficiency of yin and yang in heart, spleen, kidney, qi and blood is the main one, and qi deficiency is the most common one.
Second, dialectical medication
In view of the fact that the pathogenesis of this disease is characterized by deficiency in essence and excess in substance, deficiency in substance in attack period and deficiency in substance in remission period, its treatment should supplement its deficiency and release its essence. This deficiency should be supplemented, and the deficiency of heart, qi, blood, yin and yang should be weighed, whether there is deficiency of liver, spleen and kidney at the same time, regulating yin and yang to replenish qi and blood, and regulating the decline of viscera, especially paying attention to the deficiency of heart and qi; It should be diarrhea, aiming at qi stagnation and blood stasis, cold coagulation and phlegm turbidity, regulating qi and promoting blood circulation, warming phlegm, especially promoting blood circulation and dredging collaterals. Because the disease is mostly mixed with excess and deficiency, although the attack period is dominated by excess, it often hides deficiency at the source; In the remission period, the essence is mainly insufficient, but evil spirits can also be seen at the same time. Therefore, in the treatment, it is necessary to make up the middle energizer, but also to make up the middle energizer. Attacks are not allowed, but the principle is that correction does not hinder evil, and eliminating evil does not hurt right. As for the amount of reinforcing and reducing, it depends on the specific clinical situation. In the treatment of chest pain, especially true heartache, it is more important to be vigilant within three or four days before the onset to prevent the occurrence of syndrome separation, which is more important to reduce mortality and improve the cure rate. In order to distinguish the order of syndromes, once the premonitions of syndromes are found, such as severe pain, persistent incomprehension, cold limbs, spontaneous sweating, mental fatigue or restlessness, shortness of breath, rapid pulse, late knot, heartbroken, etc., it is necessary to put into use the products of invigorating qi and strengthening the bowels as soon as possible.
(A) syndrome differentiation and classification
1. Heart pulse condensation
【 Key points of syndrome differentiation 】 Sudden heartache, such as strangulation, cold, even tepid hands and feet, cold sweat, palpitation and shortness of breath, heartburn and backache, is often caused or aggravated by cold weather, thin and white fur and tight or rapid pulse.
[Treatment] Dispel cold and promote blood circulation, and promote arthralgia and yang.
[Prescription] Danggui Sini Decoction: 9 grams of Cinnamomum cassia twig, 6 grams of Asari, 9 grams of Angelica sinensis, 9 grams of Paeonia lactiflora, 6 grams of Glycyrrhiza uralensis Fisch, 6 grams of medulla tetrapanacis and 6 Chinese dates.
Cinnamomum cassia twig and asarum were used in the prescription to warm and disperse cold pathogens, activate yang and relieve pain; Angelica sinensis and Paeonia lactiflora nourish blood and promote blood circulation, and Paeonia lactiflora with Glycyrrhiza uralensis Fisch has analgesic effect; Cao Tong entered the meridian and opened the pulse; Jujube nourishes the spleen and harmonizes the camp. The whole prescription has the effects of dispelling cold, promoting blood circulation, activating yang and relieving pain.
If the pain is severe and the limbs are not warm, you will spontaneously sweat, that is, containing Huasuhexiang Pills or Guanxinsuhexiang Pills, which will be fragrant and turbid, and adjust the temperature to start resuscitation. Each Poria can immediately relieve pain.
Because cold pathogens are easy to attack people with yang deficiency, and yang deficiency is easy to feel cold outside, resulting in yin-cold pathogens. Therefore, the cold coagulation of the upper heart pulse is often accompanied by yang deficiency, so it is advisable to cooperate with the agent of warming yang and dispelling cold, rather than blindly dispelling cold, so as not to damage yang qi.
2. Qi stagnation in the heart
【 Key points of syndrome differentiation 】 Chest and hypochondriac distension, dull pain, pain without a fixed place, easily induced or aggravated when you want to breathe more, or full and tight chest and hypochondriac distension, which will be relieved when you are belching or suffocating, with thin or greasy fur and thin pulse.
[Treatment] Expelling wind, promoting blood circulation and dredging veins.
[Prescription] Chaihu Shugan Powder: Chaihu 12g, Fructus Aurantii 10g, Radix Paeoniae Alba 10g, and Radix Glycyrrhizae 10g.
This prescription uses Sini powder (changed from Fructus Aurantii Immaturus to Fructus Aurantii) to soothe the liver and regulate qi, in which Bupleurum and Fructus Aurantii are lifted, Radix Paeoniae Alba and Radix Glycyrrhizae are used to relieve pain, and Xiangfu and Pericarpium Citri Tangerinae are added to enhance the function of regulating qi and relieving depression. The whole prescription has the functions of regulating qi, promoting blood circulation and dredging veins.
Qi stagnation, chest pain and heartache can be treated with fragrant products such as Radix Aucklandiae, Lignum Aquilariae Resinatum, Lignum Dalbergiae Odoriferae, Lignum Santali Albi, Rhizoma Corydalis, Fructus Amomi, Cortex Magnolia Officinalis, Fructus Aurantii Immaturus and Fructus Aurantii Immaturus, but they can only be used temporarily, not for a long time, so as to avoid dispersing healthy qi.
3. Obstruction of phlegm and turbidity
【 Key points of syndrome differentiation 】 Chest tightness leads to mild heartache, obesity leads to weight, excessive phlegm and shortness of breath, and it is easy to attack or aggravate in rainy days, accompanied by fatigue, anorexia, sticky mouth, nausea, spitting, greasy or slippery fur and slippery pulse.
[Treatment] Clearing yang and removing turbidity, resolving phlegm and resolving hard mass.
[Prescription] Fructus Trichosanthis Bulbus Allii Macrostemon and Pinellia Decoction: Fructus Trichosanthis 30g, Bulbus Allii Macrostemon 10g, and Pinellia tuber 6g.
The prescription uses Trichosanthes kirilowii and Bulbus Allii Macrostemonae to resolve phlegm, promote yang, promote qi circulation and relieve pain; Pinellia ternata with Magnolia Officinalis and Fructus Aurantii Immaturus is difficult to warm and transform qi and break phlegm; Cinnamomum cassia twig is added to warm yang, remove qi and promote blood circulation, and Poria cocos and Glycyrrhiza uralensis Fisch are added to strengthen spleen and promote diuresis. Add dried ginger and asarum to warm yang and relieve pain. The addition and subtraction of the whole prescription has the functions of activating yang, removing turbidity, resolving phlegm and resolving hard mass, and relieving pain.
If the patient's phlegm is thick, yellow, the stool is dry, and the fur is yellow and greasy, which is like phlegm, blood stasis and heat dissipation, Huanglian Wendan Decoction and Yujin are used to clear phlegm and heat, regulate qi and promote blood circulation, Banxia, Poria, Orange and Glycyrrhiza of Erchen Decoction are used to clear phlegm and regulate qi, Huanglian, Zhuru and Fructus Aurantii Immaturus are used to clear phlegm and heat, and Yujin is used to enhance the function of regulating qi and promoting blood circulation. Chest pain and phlegm obstruction can be commonly used as appropriate, such as concretio silicea bambusae, Rhizoma Arisaematis, Rhizoma Pinelliae, Fructus Trichosanthis, Caulis Bambusae, Rhizoma Atractylodis, Radix Platycodi, Semen Raphani, and Fritillaria thunbergii. However, since the spleen is the source of phlegm, the products of invigorating spleen and eliminating dampness should be used in clinic in time.
4. Blood stasis block
【 Key points of syndrome differentiation 】 The chest pain is severe, such as tingling, and the pain is localized. Even the pain in the heart is through the back, the back pain is through the heart, or the pain reaches the shoulder and back, and the rage can be aggravated for a long time. The tongue is dark red or purplish red, with ecchymosis, hypoglossal muscle stasis, thin coating, unsmooth pulse or multiple knots.
[Treatment] Promoting blood circulation and removing blood stasis, dredging the pulse and relieving pain.
[Prescription] Xuefu Zhuyu Decoction: peach kernel 12g, safflower 9g, angelica 9g, rehmannia 9g, Chuanxiong 5g, Radix Paeoniae Rubra 6g, Achyranthes bidentata 9g, Bupleurum 3g, Fructus Aurantii 6g and Glycyrrhiza 3g.
This prescription is basically composed of Taohong Siwu decoction and Sini powder plus Achyranthes bidentata and Platycodon grandiflorum. Radix Angelicae Sinensis, Rhizoma Chuanxiong, Semen Persicae and Flos Carthami are used for promoting blood circulation and removing blood stasis. Radix Bupleuri and Radix Platycodi are compatible with Fructus Aurantii and Radix Achyranthis Bidentatae, one liter and one drop, which can smooth qi, promote qi and promote blood circulation. Follows blindly in hometown, and drives away blood arthralgia. Materia Medica believes that it has the function of "cooling blood and removing blood stasis" and can nourish yin and moisten dryness. These drugs together form a medicine for removing blood stasis, promoting qi circulation and relieving pain.
If blood stasis is severe and chest pain is severe, frankincense, myrrh, Radix Curcumae, Rhizoma Corydalis, Lignum Dalbergiae Odoriferae, Radix Salviae Miltiorrhizae, etc. Can be added to strengthen the function of promoting blood circulation and regulating qi. If blood stasis and qi stagnation are equally important, and chest pain is very serious, you can add incense such as Aquilaria Resinatum, Sandalwood, and long pepper to relieve pain and swallow Sanqi; If blood stasis due to cold is caused by yang deficiency, blood stasis or blood stasis, accompanied by cold in limbs, and the pulse is thin or late, Asari, Ramulus Cinnamomi or Cortex Cinnamomi and Alpinia officinarum, or Ginseng and Radix Aconiti Lateralis can be added to replenish yang and replenish qi at a constant temperature. If accompanied by shortness of breath, fatigue, spontaneous sweating, slow pulse or stagnation, it is necessary to replenish qi and promote blood circulation, add and subtract Ginseng Angelababy Decoction and Taohong Siwu Decoction, and reuse Ginseng and Astragalus to replenish qi and remove blood stasis.
When blood stasis is blocked, drugs for promoting blood circulation and removing blood stasis can be used clinically, such as Notoginseng Radix, Rhizoma Chuanxiong, Radix Salviae Miltiorrhizae, Radix Angelicae Sinensis, Carthami Flos, Lignum Sappan, Radix Paeoniae Rubra, Herba Lycopi, Achyranthis Radix, Semen Persicae, Herba Leonuri, Hirudo, Semen Vaccariae, Cortex Moutan, Fructus Crataegi, etc., but drugs for invigorating qi, warming yang, dispelling cold, resolving phlegm and regulating qi must be combined according to clinical conditions to enhance the efficacy of removing blood stasis. In addition, the disease is mostly mixed with excess and deficiency, and the condition is lingering. Therefore, blood-breaking products should be used with caution and should not be used for a long time, so as not to damage healthy qi. When applying drugs to promote blood circulation and break blood, it is necessary to see whether there is bleeding tendency or signs. Once found, stop using it immediately and deal with it accordingly.
5. Lack of courage
【 Key points of syndrome differentiation 】 There is dull pain in the chest, chest tightness and shortness of breath, which is beneficial to exercise, palpitation and fatigue, laziness in speaking, pale complexion, easy sweating, red tongue, fat tongue, teeth marks on the edge, thin and white fur, weak and slow pulse or knotted pulse.
[Treatment] Nourish the heart qi and encourage the heart pulse.
[Prescription] Baoyuan Decoction and Ganmai Jujube Decoction: ginseng 10g, astragalus 15g, licorice 10g, cinnamon 6g and ginger 9g.
The prescription uses ginseng and astragalus to replenish vitality and help the heart; Glycyrrhiza uralensis Fisch is a baked product, which is warm in nature, beneficial to qi, dredging meridians, promoting blood circulation and dredging collaterals, and treating palpitation; Cinnamon is pungent and hot, which can tonify yang, dispel cold, cure heartache, and also can absorb qi and return to kidney to relieve shortness of breath; Or cassia twig, has the function of activating yang and promoting blood circulation, and can be used to treat the symptoms of heart-qi deficiency and heart-blood stasis; Remove ginger, add Salvia Miltiorrhiza or Angelica sinensis, and Ganmai Jujube Decoction to benefit the heart, calm the heart and moisten dryness. Both of them play the role of nourishing the heart and inspiring the heart.
If the heart-qi is insufficient, accompanied by qi stagnation, blood stasis and phlegm turbidity, the heart-tonifying drugs should be mild and mild, and the drug reaction should be observed, and the dosage of the qi-invigorating drugs should be increased or decreased as appropriate, accompanied by drugs for regulating qi, promoting blood circulation and resolving phlegm. However, the blood-breaking and resolving phlegm drugs should always be used with caution or not. If you see mental fatigue, fatigue, anorexia, insomnia, dreaminess, etc. , you can use Baoyuan soup to ginger heart. Adding Poria cocos, Poria cocos, Cortex et Radix Polygalae and Pinellia Fermentata, invigorating spleen and regulating stomach, nourishing heart and tranquilizing mind; Semen Ziziphi Spinosae and Fructus Schisandrae Chinensis converge the mind, nourish the heart and soothe the nerves; Angelica sinensis and Ligusticum chuanxiong promote qi and blood circulation, and the whole prescription has the effects of tonifying the heart and spleen, nourishing the heart and calming the nerves. If palpitation, shortness of breath, dizziness, fatigue, chest tightness, dull pain, dry mouth and throat, upset and insomnia, and red tongue with tooth marks all belong to deficiency of both qi and yin, use Shengmai Powder and Guipi Decoction to add and subtract.
Ginseng, Radix Codonopsis, Radix Astragali, Fructus Jujubae, Radix Pseudostellariae, etc. It is often used as a medicine for tonifying heart and benefiting qi. If qi deficiency is obvious, cinnamon can be added less to replenish internal heat, and Ophiopogon japonicus, Polygonatum odoratum and Polygonatum sibiricum can also be added to replenish qi and nourish yin.
6. Loss of heart yin
【 Key points of syndrome differentiation 】 Chest pain is characterized by paroxysm, burning pain, stuffy pain, palpitation, fever of the five senses, dry mouth and night sweats, hot flashes on the face, pale tongue, thin or peeling fur, rapid pulse or knot generation.
[Treatment] Nourishing yin and clearing heat, promoting blood circulation and nourishing heart.
[Prescription] Tianwangbuxin Dan: Radix Rehmanniae120g, Fructus Schisandrae Chinensis, Radix Angelicae Sinensis, Radix Asparagi, Radix Ophiopogonis, Semen Platycladi and Semen Ziziphi Spinosae each 30g, and Radix Ginseng, Radix Scrophulariae, Radix Salviae Miltiorrhizae, Poria, Radix Polygalae and Radix Platycodi each15g. Boil honey into small pills.
The prescription of Radix Rehmanniae, Radix Scrophulariae, Radix Asparagi and Radix Ophiopogonis can nourish yin and replenish water, and purge deficiency fire; Ginseng and poria cocos are good for the heart, suggesting yin. Semen Platycladi, Semen Ziziphi Spinosae, Fructus Schisandrae Chinensis, and Radix Polygalae nourish the heart and soothe the nerves, nourish yin and astringe sweat; Salvia miltiorrhiza and Angelica sinensis nourish the heart and promote blood circulation; Platycodon grandiflorum is an inducer.
This can revive the heart yin, calm the deficiency fire, benefit the blood vessels and relieve the burning pain in the chest.
7. The heart is weak.
【 Key points of syndrome differentiation 】 Palpitation and pain, chest tightness and shortness of breath, spontaneous sweating exercise, mental fatigue and fear of cold, pale face, no temperature or edema in limbs, fat tongue, white or greasy fur, and slow pulse.
[Treatment] Tonifying Yang Qi and warming heart yang.
[Prescription] Shenfu Decoction: ginseng 12g, aconite root 9g, cassia twig 6g, licorice root 10g.
Ginseng and aconite in the prescription greatly replenish vitality and warm and replenish true yang; Ramulus Cinnamomi and Radix Glycyrrhizae. Warming yang and transforming qi can tonify heart yang. Both sides have played a role in warming the sun.
If the heart and kidney are yang deficiency, it can be treated with Shenqi Pill. In the prescription, aconite and cassia twig (or cinnamon) are used to replenish the fire in the water, and Liuwei Dihuang Pill is used to induce yin and yang. For warming and tonifying kidney and yang, it can be used with the upper part to warm the heart and kidney and eliminate gloom. Kidney yang deficiency combined with drinking water can lead to cardiopulmonary edema, shortness of breath and palpitations. Zhenwu decoction uses aconite to tonify kidney and yang to drive away cold pathogens, and is compatible with Radix Paeoniae Alba, which can break the yin knot, astringe the yin, strengthen the spleen and promote diuresis with Poria and Atractylodes macrocephala, and warm and disperse moisture with ginger. With the above compatibility, it can warm kidney and yang, and relieve cold. If the heart and kidney are yang-deficient, and Yang-deficiency wants to be eliminated, ginseng chicken soup is used to warm the yang and replenish qi, and return the yang to save the inverse. If you see the symptoms of yang death such as sweating and broken pulse, apply Shenfu decoction, increase the dose of Cornus officinalis, warm the yang and replenish qi, and strengthen the body. If yang deficiency and cold congeal the heart pulse, causing severe heartache, cornu Cervi, Fructus Evodiae, Fructus Piperis Longi, Rhizoma Alpiniae Officinalis, Asari, Radix Aconiti, and Halloysitum rubrum can be added as appropriate. For those with yang deficiency, cold coagulation and qi stagnation and blood stasis, drugs for regulating qi and blood can be used, such as Allium macrostemon Bunge, Aquilaria Resinatum, Lignum Dalbergiae Odoriferae, Lignum Santali Albi, Rhizoma Cyperi, Caulis Spatholobi, Herba Lycopi, Rhizoma Chuanxiong, Semen Persicae, Carthami Flos, Rhizoma Corydalis, Olibanum and Myrrha.
(2) Chinese patent medicines
1. Quick-acting Jiuxin Pills (Chuanxiong, Borneolum Syntheticum, etc. ) Take 4-6 capsules three times a day, and take 10- 15 capsules each time during acute attack. Efficacy: promoting blood circulation and regulating qi, increasing coronary flow, relieving angina pectoris, and treating coronary heart disease, chest tightness and precordial pain.
2. Su Hexiang Pills (Taiping Huimin and Jiji Fang Ju) take 1 ~ 4 capsules each time, and use it when it hurts. It has the effects of aromatic warming middle warmer, regulating qi and relieving pain, and can be used for treating chest obstruction, heartache, cold coagulation and qi stagnation.
3. Subing Dripping Pills (Styrax, Borneolum Syntheticum) are taken orally, 2-4 pills each time, 3 times a day. It has the effects of inducing resuscitation, regulating qi and relieving pain, and treating chest obstruction and heartache. True heartache belongs to the syndrome of cold coagulation and qi stagnation.
4. Guanxin Suhe Pill (Styrax, Borneolum Syntheticum, Cinnabar, Radix Aucklandiae, Sandalwood) is taken every time 1 pill (3g). It has the effects of inducing resuscitation, regulating qi and relieving pain. It can be used for chest pain, heartache, stagnation of qi and cold coagulation, and also for true heartache.
5. Buxinqi oral liquid (Radix Astragali, Ginseng, etc.). ) every time 10ml, twice a day. It has the effects of invigorating qi, nourishing heart and relieving pain, and can be used for patients with chest obstruction and obvious qi deficiency.
6. Zixinyin oral liquid (Ophiopogon japonicus, Adenophora adenophora, etc. ) Every time 10 1, twice a day. It has the effects of nourishing yin, nourishing blood and relieving pain, and can be used for patients with chest obstruction and obvious yin deficiency.
(3) Eliminating joint pain
Chest pain is a medical emergency, which starts quickly and easily worsens into real heartache. In the acute attack period, the first task should be to eliminate pain, and the following measures can be selected or combined:
1. Cold syndrome heartache aerosol (Cinnamomum cassia, Rhizoma Cyperi, etc. ) It is used to warm channels and dispel cold, regulate qi and relieve pain. For patients with heartache and white fur, spray it under the tongue every time 1 ~ 2 times.
2. Heat-induced heartache aerosol (Cortex Moutan, Rhizoma Chuanxiong, etc.). ) can cool serum fever, promote blood circulation and relieve pain. For patients with heartache and yellow fur, spray 1 ~ 2 times under the tongue each time.
3. Musk Baoxin Pills (musk, toad venom, ginseng, etc.). ) are all fragrant and warm, benefiting qi and strengthening the heart. Take or swallow 1 ~ 2 capsules each time.
4. Huo Xin pills (ginseng, ganoderma lucidum, musk, bear gall, etc.). Nourish the heart and promote blood circulation, take or swallow 1 ~ 2 capsules each time.
5. Angina ointment (Danshen, safflower, etc. ) promoting blood circulation and removing blood stasis, aromatic resuscitation. Suitable for intimate front area. Ligustrazine injection, Danshen injection and Shengmai injection are used for intravenous drip.
6. Applying drugs to the skin can directly affect internal organs through meridians. At present, commonly used drugs are drugs for promoting blood circulation, removing blood stasis, warming and tonifying, such as angelica, frankincense, myrrh, safflower, borneol and so on.
Third, acupuncture treatment Up to now, the research on acupuncture treatment of coronary heart disease system is not complete. The following points are commonly used and effective in clinic:
Xinshu, Jueyinshu, Zusanli, Tongli, and combination of acupoint selection based on syndrome differentiation, 10 ~ 20 times as a course of treatment,/kloc-0 once a day or/kloc-0 once every other day. Generally, it can take effect after 3 ~ 5 times.
Fourth, other therapies.
(1) Massage rehabilitation therapy
Commonly used acupoints: Shu Fei, Xinshu, Shu Ge, Neiguan, Shenmen, Zhongshan, Xue Hai, Jueyinshu, Fenglong, Zusanli and Qihai.
Specific operation methods: pressing, kneading, finger meditation, kneading, etc. The patient sat down and pressed Shu Fei, Xinshu, Shu Ge and Neiguan. Both sides should be operated at the same time, the manipulation should be gentle and gentle, and the patient should feel slight pain, and each acupoint should be rubbed for 2min. Then massage or one-finger Zen massage was used to treat the cervical spine for about 4min. Then treat the bladder meridian on both sides of the upper back with gentle methods for about 4 minutes. Then directly rub the bladder meridian and the back du meridian on both sides of the back, which are mainly based on heat penetration.
For those who freeze blood vessels, massage Shenmen and Zhongshan. For those with qi stagnation and blood stasis, points Xuehai and Jueyinshu should be massaged. Phlegm turbidity blocking collaterals:
Press and knead Fenglong and Zusanli points. For those with deficiency of viscera, point Qihai and Zusanli should be massaged.
Treatment should not be too heavy, depending on the patient's pain, which will aggravate the symptoms. The treatment of angina pectoris should be coordinated with internal medicine, and special attention should be paid to the changes of the condition in clinic.
(2) Daily life, diet and daily life
1. Emotional abnormality will lead to visceral dysfunction, which is closely related to heart disease. Therefore, to prevent and treat this disease, we must attach great importance to psychological adjustment, avoid excessive excitement or emotional excitement, and maintain a calm and happy mood.
2. The weather changes in hot and cold summer, sunny and rainy days also have obvious influence on the onset of this disease. According to "various pathogens and symptoms of heartache", "people with heartache are also affected by pathogenic wind and cold", so this disease should not feel cold. In addition to quiet ventilation, we also need to pay attention to the appropriate cold temperature.
3. Diet adjustment should not be too fat and too sweet. You should give up smoking and drink less. You should eat a low-salt diet, eat more fruits and foods rich in fiber, keep your stool unobstructed, and have a light diet, and don't eat too much. Patients should stay in bed immediately during the attack period, pay attention to proper rest during the remission period, adhere to activities within their power, keep quiet during exercise and ensure adequate sleep.
(3) Traditional exercise methods
The passive treatment mentioned above should be combined with the patient's own active exercise, but the active exercise should be scientific and carried out under the guidance of a doctor. See the corresponding chapter for the rehabilitation of acute coronary heart disease. Tai Ji Chuan can be used for TCM rehabilitation in convalescence.
Tai Ji Chuan is widely spread in China and easy to popularize. Its movements are relaxed and natural, combining rigidity and softness, and seeking quietness while moving, which is more suitable for patients with hypertension and coronary heart disease. Tai Ji Chuan seldom takes exercise. According to reports, the maximum heart rate can reach 105 beats/min when practicing the simplified Tai Ji Chuan, and 134 beats/min when practicing the old Tai Ji Chuan, and its intensity does not exceed 50% of the maximum oxygen uptake. Because of more isometric exercise in old Tai Ji Chuan, the heart rate during exercise is 26% higher than that in simplified Tai Ji Chuan, but it does not hinder the application of patients with coronary heart disease. Generally, the simplified Tai Ji Chuan is adopted. Taiji Chuan, Baduanjin and Wuqinxi can all be used accordingly.