Note: The following
text is selected from A Practical English-Chinese Library
of Traditional Chinese Medicine by
Prof.Dr. Enqin Zhang(Engin CAN), he was the chief
editor&author of the books, now lecturing and practising
Chinese medicine at The Asante Academy of Chinese
Medicine in the Middlesex University Archway Campus, 2-10
Highgate Hill, N19 5LW, London, U.K.For more information,
Coronary heart disease, also know as ischemic heart disease, is
commonly caused by atheromatous lesions of the coronary artery.
Its major clinical manifestations are angina pectoris and
Although the terms angina pectoris and acute myocardial
infarction were not used in ancient times, descriptions of the
clinical manifestations of coronary heart disease are contained
in the ancient texts of traditional Chinese medicine.
Etiology and Pathogenesis
Precordial pain is the most prominent feature of coronary heart
disease. According to traditional medical theory, obstruction in
the heart vessels usually causes this pain. The vessels may be
blocked by phlegm accumulation in the chest, which obstructs the
yang qi, and /or by blood stasis either due to qi deficiency or
due to qi stagnation.
Differential Diagnosis of Syndromes
1. Obstruction of yang qi in the chest due to accumulation of
Primary manifestations: A feeling of oppression over the chest
or chest pain radiating to the back, accompanied by shortness of
breath, white, thick, greasy coating of the tongue and smooth
pulse. (This condition is of the cold phlegm type; when the
tongue coating turns yellow and greasy, it becomes a phlegm-heat
2. Blood stasis caused by qi deficiency
Primary manifestations: Fatigue, shortness of breath,
palpitations accompanied by localized pain, dark purplish tongue
with thin coating and uneven pulse. (In cases with cold
extremities, intolerance of cold, pale and tender tongue and
slow pulse, the blood stasis is due to yang deficiency; in cases
with profuse sweating, deadly cold limbs, listlessness and
fading pulse or even coma, the yang is exhausted and shock
ensues. Some patients experience yin and qi deficiencies
together, manifested by a hot sensation in the palms and soles,
dry mouth, desire for cold drinks, reddened tongue with little
or no coating and thin, rapid pulse.)
3.Blood stasis caused by qi stagnation
Primary manifestations: A fullness sensation or pain in the
chest, dark purplish tongue with thin coating, but no symptoms
of qi deficiency, such as shortness of breath and fatigue.
1. Obstruction of yang-qi in the chest due to accumulation of
Principle of treatment: Relieve the obstruction of the yang qi
in the chest.
Formula for choice: Trichosanthes, Chinese Chive, and White
Liquor Decoction; in this prescription, trichosanthes fruit
eliminates phlegm and reverse the adverse ascending of the qi;
Chinese chive warms and activates the yang qi in the chest and
relieves pain; and white liquor acts as a guide drug.
2. Blood stasis caused by qi deficiency
Principle of treatment: Invigorate the qi and promote blood
Formula of choice: Yang-Invigorating and Recuperation Decoction;
in this recipe, astragalus root (huang qi) invigorates the qi to
promote blood circulation and strengthens the effect of the
other ingredients in removing blood stasis. Other ingredients
are tangkuei (dang gui), red peony root (chi shao), earth worm
(di long), ligusticum root (chuan xiong), peach kernel (tao
ren), carthamus flower (hong hua).
In cases with yang deficiency, add cuscuta seed (tu si zi),
prepared lateral root of aconite (fu zi), and psoralea seed (bu
gu zhi) to warm and replenish the yang qi.
If there is collapse, use Ginseng and Aconite Decoction
combining with Aconite Decoction (including prepared lateral
root of aconite, poria, ginseng, ovate atractylodes rhizome,
white peony root); in these prescriptions, prepared lateral root
of aconite and ginseng recuperate the depleted yang and
replenish the qi.
In cases of qi and yin deficiencies, add scrophularia root (xuan
shen), ophiopogon root (mai dong), schisandra berry (wu wei zi),
and fresh rehmannia root (sheng di ) to the above prescriptions.
3. Blood stasis caused by qi stagnation
Principle of treatment: Activate qi and remove blood stasis.
Formula of choice: Blood House Stasis-Expelling Decoction; in
this recipe, bitter orange (zhi ke) and bupleurum root (chai hu)
activate the stagnated qi; platycodon root (jie geng) acts as a
guide drug; and the other ingredients promote blood circulation
and remove blood stasis, including tangkuei (dang gui), fresh
rehmannia root (sheng di huang), peach kernel (tao ren),
carthamus flower (hong hua), red peony root (chi shao), licorice
root (gan cao), ligusticum root (chuan xiong), achyranthes root
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