For bone diseases, use Hei Bai Tong (Black Atractylodes), and for skin diseases, use Huo Yang Oil!
Although Traditional Chinese Medicine (TCM) does not have a specific term for coronary atherosclerotic heart disease (commonly known as coronary heart disease), this condition has long been objectively recognized. TCM literature describes various terms such as “Zhen Xin Tong” (true heart pain), “Xiong Bi” (chest obstruction), “Xin Ji” (palpitations), and “Zheng Chong” (sudden fainting), which collectively summarize the diagnostic and therapeutic content related to coronary heart disease.
Patients with coronary heart disease often present with primary symptoms of chest tightness, heart pain, and shortness of breath, along with palpitations, dizziness, limb numbness, and fatigue. TCM believes that individuals over 40 years old often experience a decline in vital energy (Qi) and physical strength. This condition is more prevalent after the age of 40, as the Yang energy diminishes, and some patients may suffer from prolonged illness leading to deficiency, resulting in weakened Qi and blood. Therefore, Qi deficiency is one of the common pathophysiological mechanisms of coronary heart disease.Additionally, according to the principle that Qi governs blood and the interdependence of Yin and Yang, some patients may also develop the condition due to insufficient heart Yin. Symptoms such as chest tightness, heart pain, dizziness, limb numbness, or a dark red tongue with a greasy coating are manifestations of Qi stagnation and blood stasis, as well as phlegm and turbidity obstructing the heart vessels.These factors pathologically form a pattern of deficiency of Zheng Qi (upright Qi) internally, with phlegm and stasis obstructing the heart. Zheng deficiency (heart Qi deficiency and heart Yin deficiency) is the internal cause of this condition—its essence, while phlegm and stasis are factors that continue to develop the disease—its manifestation. The former belongs to deficiency, while the latter belongs to excess, indicating that coronary heart disease is a condition characterized by deficiency and excess, with Qi deficiency, Yin deficiency, phlegm turbidity, and blood stasis constituting the four main aspects of its pathophysiology.Based on the understanding of the pathophysiology of this condition, the treatment principle should be to unblock and supplement, combining both approaches.The proposed treatment principles include tonifying Qi, resolving phlegm, and unblocking stasis.Due to the author’s long-term work in Guangdong, where the climate is humid, patients are prone to phlegm accumulation, thus emphasizing phlegm treatment in the early stages. However, whether resolving phlegm or unblocking stasis, the goal is to smooth the meridians and restore balance.Given the emphasis on the principles of tonifying Qi and resolving phlegm and unblocking stasis, treatment measures should focus on the spleen and stomach.Based on the author’s experience, Wen Dan Tang (Warm Gallbladder Decoction) with modifications is often used in clinical practice.The basic prescription includes: Fa Xia (Pinellia) 9g, Yun Ling (Poria) 12g, Ju Hong (Tangerine Peel) 6g, Zhi Qiao (Bitter Orange) 6g, Gan Cao (Licorice) 5g, Zhu Ru (Bamboo Shavings) 9g, Dang Shen (Codonopsis) 15g, Dan Shen (Salvia) 12g.Wen Dan Tang resolves phlegm and benefits Qi, regulating the Qi mechanism. The inclusion of Dang Shen tonifies Qi and supports the upright Qi; Dan Shen invigorates blood and unblocks stasis. The use of Zhi Qiao instead of Zhi Shi (Bitter Orange) is to gently regulate the middle and lower Qi, as Zhi Qiao is milder and avoids excessive Qi depletion and obstruction.If Qi deficiency is significant, Huang Qi (Astragalus) and Wu Zhua Long (Five Clawed Dragon) can be added, or 6g of Jilin Ginseng can be cooked separately, or 1.5g of Ren Shen (Ginseng) can be chewed, which also yields good results. However, Dang Shen should not be used excessively, generally not exceeding 15-18g, as this condition involves a mix of deficiency and excess, and excessive use may lead to stagnation, which is not conducive to resolving phlegm and unblocking stasis. If heart pain is prominent, it can be combined with Shi Xiao San (Sudden Smile Powder) or San Qi (Notoginseng) powder. If there is spleen Qi deficiency, it can be combined with Si Jun Zi Tang (Four Gentlemen Decoction); if there is concurrent Yin deficiency, Sheng Mai San (Generate Pulse Powder) can be used; if there is hypertension, add Cao Jue Ming (Cassia Seed), Sang Ji Sheng (Mulberry Mistletoe), and Zhen Zhu Mu (Mother of Pearl); if there is hyperlipidemia, add Shan Zha (Hawthorn), He Shou Wu (Fo-Ti), and Mai Ya (Barley Sprout); if there is kidney deficiency, add Yin Yang Huo (Epimedium); if there is blood deficiency, add Ji Xue Teng (Spatholobus).Regarding the principles of TCM treatment for coronary heart disease, various regions are continuously exploring and summarizing. Generally speaking, in terms of treatment methods, phlegm and stasis obstruction should emphasize “unblocking,” such as aromatic opening methods, promoting Yang and unblocking methods, and invigorating blood and resolving stasis methods. Zheng Qi deficiency (including Qi deficiency and Yin deficiency) should emphasize “tonifying,” such as Qi tonification methods, warming Yang methods, and nourishing Yin methods.Practical experience has proven that the principles of tonification and unblocking are inseparable in the treatment of coronary heart disease. Clinically, whether unblocking first or tonifying first, unblocking more and tonifying less, or tonifying more and unblocking less, or alternating unblocking and tonifying, should be determined based on the specific type of coronary heart disease and the individual situation. One should not only focus on tonifying deficiency while neglecting the need to resolve phlegm and stasis, nor should one excessively unblock without supporting the foundation and upright Qi.
Summary of TCM Courses
01
All Courses by Ni Haixia
02
Complete Guide to TCM Treatment of Common Diseases
03
Wang Hongmo’s Face Diagnosis Course
04
“Entering the Door of TCM” Complete Book