Eight Effective Formulas for Treating Myocardial Infarction
1. Luo Xie Tao Ren Decoction
Source: Chai Guozhao, “Essence of Contemporary Famous Doctors’ Formulas” (Zhang Boyu’s formula)
Verse: Luo Xie Tao Ren Decoction with Yu Jin, Xiang Fu, Ban Xia, and Quan Dang Gui,
Ju Hong, Dan Shen, Fu Ling, and Shan Zha,
For emergency treatment of myocardial infarction, it is suitable.
Composition: 10g of Guo Luo (Trichosanthes), 9g of Tao Ren (Peach Kernel), 10g of Yu Jin (Curcuma), 10g of Xiang Fu (Cyperus), 10g of Quan Dang Gui (Angelica), 10g of Ban Xia (Pinellia), 6g of Xie Bai (Garlic Chives), 6g of Hong Hua (Safflower), 6g of Ju Hong (Tangerine Peel), 15g of Dan Shen (Salvia), 12g of Fu Ling (Poria), and 12g of Sheng Shan Zha (Hawthorn).
Usage: Decoction in water. One dose per day, taken twice daily.
Effects: Invigorates blood, dispels stasis, regulates qi, and alleviates pain.
Analysis: Acute myocardial infarction is a critical condition, with its location in the heart. Its onset is related to the dysfunction of the liver, kidneys, and spleen. It is often characterized by the invasion of yin over yang, leading to stagnation of qi and blood stasis, resulting in pain. This formula is based on the Guo Luo Xie Bai Ban Xia Decoction, enhanced with additional herbs to regulate qi, relieve depression, invigorate blood, and dispel stasis, thus increasing its efficacy. Due to the phlegm’s viscous nature, which obstructs the heart and chest, it can easily block yang qi and hinder blood circulation, often leading to phlegm and stasis intermingling. Therefore, while resolving phlegm and dispersing nodules, it is best to combine it with blood-invigorating and stasis-dispelling herbs. Thus, the formula includes Guo Luo, Xie Bai, Ban Xia, and Ju Hong to disperse nodules and clear phlegm; Tao Ren, Hong Hua, Dan Shen, Yu Jin, and Dang Gui to invigorate blood and dispel stasis; Xiang Fu to regulate qi and relieve depression. The combination of these herbs works together to invigorate blood, dispel stasis, regulate qi, and alleviate pain.
Indications: Acute myocardial infarction, characterized by chest pain radiating to the arm and back, chest tightness, shortness of breath, nausea upon drinking, white greasy tongue coating, and thin slippery pulse.
2. Tong Geng Decoction
Source: Chai Guozhao, “Essence of Contemporary Famous Doctors’ Formulas” (Shi Jinmo’s formula)
Verse: In Tong Geng Decoction, there are Jiu Xiang Chong, Xiang Fu, Dan Shen, and Wu Ling Zhi,
San Qi, Mu Xiang, and Yan Hu Suo,
Invigorate blood and open channels, timely treatment.
Composition: 10g of Jiu Xiang Chong (Maggot), 10g of Wu Ling Zhi (Flying Squirrel), 15g of Yan Hu Suo (Corydalis), 10g of Xiang Fu, 12g of Dan Shen, 3g of San Qi powder (ground and taken in two doses), and 6g of Mu Xiang (Saussurea).
Usage: Decoction in water. One dose per day, taken twice daily.
Effects: Invigorates blood and opens channels.
Analysis: Qi is the commander of blood, and blood is the mother of qi. When qi flows, blood flows; when qi stagnates, blood stasis occurs. Emotional distress can lead to qi stagnation and blood obstruction, resulting in pain in the precordial area. The treatment for this condition should combine qi-regulating and blood-invigorating herbs to ensure that qi can lead blood, allowing for unobstructed blood vessels and the absence of heart pain. The formula includes Mu Xiang, Xiang Fu, and Jiu Xiang Chong to regulate qi and relieve depression, while Dan Shen, Wu Ling Zhi, Yan Hu Suo, and San Qi powder invigorate blood and dispel stasis, opening channels. Together, they achieve the effects of regulating qi, relieving depression, invigorating blood, and opening channels.
Indications: Chronic myocardial infarction.
3. Yang Xin Decoction
Source: Chai Guozhao, “Essence of Contemporary Famous Doctors’ Formulas” (Zhang Boyu’s formula)
Verse: In Yang Xin Decoction, there is Bai Ren Shen, Guo Luo, Xie Bai, and Mai Dong,
Dang Gui, Hong Hua, Shan Yu Rou, Fu Pian, Ban Xia, and Sheng Chuan Jun.
Composition: 12g of Korean White Ginseng (cooked separately), 12g of Shan Yu Rou (Cornelian Cherry), 12g of Guo Luo, 6g of cooked Fu Pian (Aconite), 6g of Xie Bai, 6g of Hong Hua, 18g of Mai Dong (Ophiopogon), 18g of Dang Gui, 10g of Ban Xia, 9g of Sheng Chuan Jun (Corydalis), and 3g of Huang Lian (Coptis).
Usage: Decoction in water. One dose per day, taken twice daily.
Effects: Tonifies qi, warms yang, nourishes yin, and invigorates blood.
Analysis: The symptom of heart pain is characterized by recurrent pain in the sternum or left chest. Diagnosis and treatment can be divided into deficiency and excess, but excess can transform into deficiency, and deficiency can also have excess evil, leading to a complex interplay of deficiency and excess. For patients with such intricate symptoms, it is advisable to combine tonifying qi and warming yang, resolving phlegm and dispersing nodules, nourishing heart yin, and invigorating blood to achieve harmony between yin and yang, and balance of qi and blood, ensuring unobstructed blood vessels. Therefore, the formula includes Bai Ren Shen, Fu Zi, Mai Dong, and Shan Yu Rou to tonify qi and nourish yin; Guo Luo, Ban Xia, and Xie Bai to disperse nodules and clear phlegm; Dang Gui, Hong Hua, and Chuan Jun to invigorate blood and dispel stasis. Together, they can tonify qi, warm yang, nourish yin, and invigorate blood.
Indications: Myocardial infarction, characterized by chest tightness, fatigue, sweating upon exertion, aversion to cold, constipation, and a thin, slow pulse.
4. Yi Xin Huo Xue Decoction
Source: Yang Sishu, “Collection of Famous Doctors’ Formulas” (Yu Zhijiang’s formula)
Verse: Yi Xin Huo Xue with Gui Pi and Ren Shen,
Mai Dong, Chi Shao, Yu Jin, and all,
Hong Hua, Gui Zhi, Qing Ban Xia,
Chuan Xiong, Zhi Shi, and Zi Dan Shen.
Composition: 30g of Huang Qi (Astragalus), 10g of Ren Shen (Ginseng), 15g of Mai Dong, 15g of Dang Gui, 15g of Chi Shao (Red Peony), 15g of Yu Jin, 12g of Hong Hua, 9g of Gui Zhi (Cinnamon), 30g of Dan Shen, 10g of Chuan Xiong (Ligusticum), 10g of Zhi Shi (Bitter Orange), and 10g of Ban Xia.
Usage: Decoction in water. One dose per day, taken in two portions.
Effects: Tonifies heart qi and invigorates blood.
Analysis: The pathogenesis of myocardial infarction is characterized by deficiency of the root (qi deficiency) and excess of the branch (blood stasis). In treatment, the focus should be on “tonifying,” that is, invigorating qi and blood; the branch should focus on “opening,” that is, dispelling obstruction and promoting yang, combining tonification and opening to turn danger into safety. The formula uses Huang Qi, Huang Jing, Ren Shen, and Tian Mai Dong to tonify qi and blood, enhancing heart function; while Dan Shen, Chuan Xiong, Dang Gui, Hong Hua, Yu Jin, and Chi Shao invigorate blood and open channels, improving overall circulation. The combination promotes rapid recovery of overall function.
Indications: Myocardial infarction due to coronary heart disease, characterized by sudden, persistent severe pain in the precordial area, possibly accompanied by vomiting, profuse sweating, cold limbs, cyanosis, low blood pressure, weak pulse, reduced heart sounds, arrhythmia, or even heart failure.
Modifications: For yang deficiency, add Fu Zi and increase Gui Zhi; for yin deficiency, add Yu Zhu, Xuan Shen, and Sheng Di; for qi stagnation, add Su He Xiang and Jiang Xiang; for severe stasis, add Shi Xiao San; for severe pain, add Yan Hu Suo, San Qi, Ru Xiang, Mo Yao, or She Xiang; for constipation, add Fan Xie Ye or Sheng Da Huang; for both qi and yin deficiency, add Sheng Mai San; for arrhythmia, add Fu Mai Tang; for phlegm obstruction, add Wen Dan Tang or Xiao Xian Xiong Tang; for severe yang collapse, use Du Shen Tang or Shen Fu Tang combined with Sheng Mai San.
5. Yu Geng Tong Yu Decoction
Source: Li Baoshun, “Record of Famous Doctors and Famous Formulas” (Chen Keji’s formula)
Verse: Yu Geng Tong Yu with Sheng Bai Ren Shen,
Gui Pi, Xuan Hu, and Zi Dan Shen,
Ban Xia, Chen Pi, and Sheng Da Huang,
Xiong Teng, Pei Lan, and Guang Huo Xiang.
Composition: 10g of Sheng Bai Ren Shen (Fresh Ginseng), 15g of Sheng Huang Qi (Fresh Astragalus), 15g of Zi Dan Shen (Purple Salvia), 10g of Quan Dang Gui, 10g of Xuan Hu Suo (Corydalis), 10g of Chuan Xiong, 12g of Guang Huo Xiang (Patchouli), 10g of Pei Lan (Eclipta), 10g of Chen Pi, 10g of Ban Xia, and 6g of Sheng Da Huang (Fresh Rhubarb).
Usage: Decoction in water. One dose per day, taken in two portions. It can also be made into pills for use during the recovery period, taken three times a day, 3g each time.
Effects: Supports the righteous, tonifies qi, generates muscle, promotes qi, invigorates blood, alleviates pain, dispels stasis, and opens channels.
Analysis: Myocardial infarction is essentially a blockage of the heart channels, classified as an internal emergency. Clinically, it often presents with qi deficiency, qi stagnation, blood stasis, or a combination of qi and yin deficiency, leading to complex and dangerous symptoms. Therefore, the treatment should adopt a method that addresses both the root and the branch, combining tonification and opening. The Yu Geng Tong Yu Decoction includes Ren Shen and Huang Qi to support the righteous and tonify qi; Dang Gui and Dan Shen to regulate qi and nourish blood, ensuring that qi and blood are properly directed; Xuan Hu and Chuan Xiong enhance the effects of regulating qi and alleviating pain, dispelling stasis and opening channels. The formula is designed to support the righteous, tonify qi, generate muscle, promote qi, invigorate blood, alleviate pain, dispel stasis, and open channels.
Indications: Acute and recovery phases of myocardial infarction, promoting healing, dispelling stasis, preventing thrombosis, improving heart function, enhancing quality of life, and prolonging life.
Modifications: If blood pressure is very low or there is shock, simultaneously take Sheng Mai Si Ni Tang with Rou Gui; if sweating excessively, add Shan Yu Rou 12g, Wu Wei Zi 10g, and increase Huang Qi to 30g; if emotional distress, chest tightness, or side distension, use Si Ni San or Chai Hu Shu Gan San; for severe heart pain, take Su He Xiang Wan or add Xi Xin 3-6g and San Qi powder 3g; for constipation or dry stools, add Tao Ren 10g and Huo Ma Ren 10g; if bowel movements are smooth, switch to Fan Xie Ye 10g as tea; for restlessness, add Zao Ren 30g and Ye Jiao Teng 30g.
6. Xin Geng Jiu Ni Decoction
Source: Chai Guozhao, “Essence of Contemporary Famous Doctors’ Formulas” (Zhang Boyu’s formula)
Verse: Xin Geng Jiu Ni with cooked Fu Pian,
Red Ginseng, Dang Gui, and Quan Guo Luo,
Hong Hua, Long Gu, Shan Yu Rou,
Jiang Xiang, Xie Bai, and calcined Mu Li.
Composition: 15g of Red Ginseng (cooked separately), 15g of cooked Fu Pian, 10g of Shan Yu Rou, 18g of Dang Gui, 12g of Quan Guo Luo, 6g of Xie Bai, 6g of Hong Hua, 30g of calcined Long Gu (Dragon Bone), 30g of calcined Mu Li (Oyster Shell), and 6g of Jiang Xiang (Clove).
Usage: Decoction in water. One dose per day, taken twice daily.
Effects: Rescues yang, regulates qi, and invigorates blood.
Analysis: Insufficient yang qi of the heart and kidneys can lead to a critical condition of yang collapse. At this time, it is urgent to select Red Ginseng, Fu Zi, Long Gu, Mu Li, and Shan Yu Rou to rescue yang and stabilize collapse; simultaneously, Guo Luo and Xie Bai are used to resolve phlegm and disperse nodules, while Jiang Xiang, Dang Gui, and Hong Hua invigorate blood and dispel stasis, enhancing efficacy. Red Ginseng is the primary herb for treating deficiency and internal injury, thus it is used in large quantities to tonify qi and stabilize collapse. As stated in “Yao Xing Ben Cao”: “…tonifies the five organs and six bowels, protects the center and guards the spirit.”
Indications: Acute myocardial infarction, cardiogenic shock, characterized by sudden onset of precordial angina, dizziness leading to fainting, pale complexion, unclear consciousness, involuntary urination, cold sweat soaking clothes, cold limbs, pale tongue with thin white coating, and thin, weak pulse.
7. Yi Xin Huo Xue Decoction
Source: “Chinese Traditional Medicine for Emergencies” (5) 2002 (Luo Xinmin’s formula)
Verse: Yi Xin Huo Xue with Gui Pi and Ren Shen,
Bai Shao, Huang Qi, Ge Gen, and Xian Ling Pi,
Chuan Xiong, Dan Shen, Shan Zha, and Mai Dong,
Roasted Licorice, Xie Bai, and San Qi Ling.
Composition: 10g of Ren Shen, 10g of Gui Zhi, 12g of Bai Shao, 15g of Dang Gui, 10g of San Qi, 15g of Huang Qi, 12g of Ge Gen, 15g of Xian Ling Pi, 10g of Pu Huang, 10g of Chuan Xiong, 15g of Dan Shen, 15g of Shan Zha, 9g of Mai Dong, 15g of Ban Xia, 15g of Xie Bai, and 15g of Fu Ling.
Usage: Decoction in water. One dose per day, taken twice daily.
Effects: Tonifies heart, warms yang, and dispels stasis.
Analysis: Acute myocardial infarction is often characterized by deficiency of heart qi, and in severe cases, deficiency of heart yang. Blood stasis and phlegm turbidity obstruct the channels, leading to pain. Therefore, treatment should promptly dispel blood stasis and phlegm turbidity, tonify heart qi, and warm heart yang. This formula focuses on tonifying heart qi and warming yang, dispelling stasis and opening channels. The formula includes Ren Shen, Huang Qi, and roasted licorice to tonify qi; Gui Zhi, Bai Shao, and Xian Ling Pi to warm yang and open channels, invigorating heart yang; Mai Dong nourishes yin, seeking yang within yin; Dang Gui, San Qi, Dan Shen, Pu Huang, and Chuan Xiong invigorate blood and dispel stasis. The combination achieves the effects of warming yang, tonifying qi, dispelling stasis, and opening channels.
Indications: Acute myocardial infarction (heart qi deficiency, phlegm and stasis obstructing the channels).
Modifications: If there is significant cold obstructing the heart channels, add Fu Pian and Xi Xin to warm and disperse cold evil, opening yang and alleviating pain; if there is phlegm-heat accumulation, remove Xian Ling Pi and add Huang Lian, Zhu Ru, or Xiao Xian Xiong Tang to clear heat, transform phlegm, and drain fire; if there is emotional distress, add Chai Hu, Zhi Ke, and Yu Jin to regulate qi and harmonize the spleen and stomach; if there is hypertension due to liver yang hyperactivity, add Tian Ma, Gou Teng, and Shi Jue Ming to calm the liver and extinguish wind; if there is kidney yin deficiency with internal fire disturbance, consider Huang Lian and E Jiao Decoction to nourish yin and calm the spirit; if there is heat damaging body fluids leading to constipation, add Zeng Ye Cheng Qi Decoction to open the bowels and drain heat, nourish yin, and generate fluids; if there is arrhythmia with rapid heart rate, add Zi Shi Ying and Long Zhi; if there is atrial fibrillation, add Bai Zi Ren and Xian He Cao; if there is premature atrial contraction, add Ku Shen; if there is premature ventricular contraction, add Gan Song.
8. Shu Xin Xiao Tong Decoction
Source: Wang Canyun, “New Transmission of Famous Doctors’ Formulas: Cardiovascular Diseases” (Wang Canhui’s formula)
Verse: Shu Xin Xiao Tong with Guo Luo Ren,
Yu Jin, Dan Shen, and Su Luo,
Xi Xiong, Xuan Hu, and Shi Xiao San,
For myocardial infarction, it is highly effective.
Composition: 10g of Guo Luo Ren (Trichosanthes), 10g of Yu Jin (Curcuma), 10g of Su Luo Zi (Sour Jujube), 10g of Yan Hu Suo (Corydalis), 15g of Dan Shen, 10g of Chuan Xiong, and 12g of Shi Xiao San (a formula for dispelling stasis).
Usage: Decoction in water. One dose per day, taken in two portions.
Effects: Warms, disperses cold, transforms stasis, and opens channels.
Analysis: The formula includes Guo Luo Ren, Yu Jin, and Su Luo Zi to regulate qi and relieve depression, clear phlegm, and open obstructions; Dan Shen and Chuan Xiong invigorate blood and dispel stasis, promoting new growth; Xi Xiong and Shi Xiao San work together to alleviate pain while dispelling stasis. The combination of these herbs achieves the effects of regulating qi, clearing phlegm, dispelling stasis, alleviating pain, and promoting heart comfort.
Modifications: If there is significant qi deficiency, add Dang Shen, Huang Qi, Huang Jing, and Wu Wei Zi; if there is significant yin deficiency, characterized by dry mouth and red tongue, remove Xi Xin and Chuan Xiong, and add Chi Shao, Ge Gen, Sheng Di, He Shou Wu, and Yu Zhu; if there is heart and kidney yang deficiency with cold pain, cold limbs, and low back pain, add Gui Zhi, Xian Ling Pi, and Bu Guo Zhi.
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