Introduction：Mr. Guo Shikui has made significant contributions to the treatment of cardiovascular diseases. Academician Chen Keji has summarized six experiences of Guo’s powdered formulas for treating angina pectoris, which can serve as a reference for our clinical practice.。
Experience of Guo Shikui in Treating Angina Pectoris with Powdered Formulas Author/ Chen Keji
Old Chinese medicine practitioner Guo Shikui has accumulated rich experience in the long-term practice of preventing and treating coronary heart disease. He is skilled in using methods such as invigorating blood circulation and removing blood stasis, warming and unblocking, and tonifying qi to treat angina pectoris and myocardial infarction. For moderate to severe angina pectoris, in addition to using decoctions for syndrome differentiation treatment, he often employs powdered formulas, which are effective and convenient for patients to take. The powdered formula prescriptions developed by Guo for alleviating angina pectoris are quite distinctive, and are categorized as follows.1. Invigorating Blood and Removing Stasis PowderUsed for blood stasis pain. Symptoms include stabbing pain in the heart, pain with a fixed location, wiry pulse, and a dark purple tongue or stasis spots, with a generally robust physique.1. Xuejie San (Dragon’s Blood Powder): 1.5 grams of Xuejie (Dragon’s Blood), taken in two doses.2. Ruyue San (Frankincense and Myrrh Powder): 1.5 grams of Ruxiang (Frankincense) and 1.5 grams of Moye (Myrrh), ground into powder, mixed well, taken in two doses.3. Ruxiang 1.5 grams, Moye 1.5 grams, Xuejie 1.5 grams, Bingpian 1.5 grams, ground into powder, taken as 1 gram each time.2. Tonifying Qi and Invigorating Blood PowderUsed for qi deficiency and blood stasis, with a weak constitution and accompanying heart pain. Symptoms include fatigue, shortness of breath, heart pain, thin or weak wiry pulse, and a dull tongue.1. Hongshen Sanqi Fen (Red Ginseng and Notoginseng Powder): Equal parts of Hongshen (Red Ginseng) and Sanqi (Notoginseng), mixed well, taken as 1 gram each time.2. Hongshen Sanqi Xuejie San (Red Ginseng, Notoginseng, and Dragon’s Blood Powder): Equal parts of Hongshen, Sanqi, and Xuejie, mixed well, taken as 1 gram each time.3. Hongshen 1.5 grams, Sanqi 1.5 grams, Amber Powder 1 gram, mixed well, taken in two doses (for those with qi deficiency, blood stasis, and insomnia).4. Hongshen Yuanhu Powder (Red Ginseng and Corydalis Powder): Equal parts of Hongshen and Yuanhu (Corydalis), mixed well, taken as 3 grams each time.5. Hongshen 1.5 grams, Sanqi 1.5 grams, Yuanhu 3 grams, mixed well, taken as 2 grams each time (the last two formulas are for qi deficiency, blood phlegm, and qi stagnation).3. Regulating Qi and Invigorating Blood PowderUsed for qi stagnation and blood stasis. Symptoms include heart pain, chest tightness, and rib distension, wiry pulse, dark tongue or stasis spots.1. Yuanhu Powder: 3 grams of Yuanhu, taken in two doses.2. Guangmuxiang Powder (Wide Wood Fragrance Powder) 1.5 grams, Yuanhu Powder 1.5 grams, mixed as a daily dose, taken in two doses.3. Sanqi Yuanhu Powder (Notoginseng and Corydalis Powder): 1 gram of Sanqi and 3 grams of Yuanhu, mixed well, taken in two doses.4. Aromatic Warming and Unblocking PowderUsed for heart pain caused by cold evil stagnation. Symptoms include chest tightness, severe heart pain that worsens with cold, tight wiry pulse, and thin white tongue coating.1. Dinggui Xiang San (Clove and Cinnamon Powder): 1.5 grams of Dingxiang (Clove), 1 gram of Rougui (Cinnamon), and 0.5 grams of Tanshan (Sandalwood), ground into powder, taken as a daily dose in two doses.2. Chenxiang Powder 1 gram, Gongdingxiang Powder 1 gram, Amber Powder 1 gram, mixed as a daily dose, taken in three doses (for those with chest tightness and heart pain accompanied by insomnia).5. Warming and Unblocking Blood PowderUsed for heart pain caused by cold congealing and blood stagnation. Symptoms include chest tightness and stabbing heart pain, fixed pain location, worsens with cold, dark tongue, and thin tongue coating.1. Chenxiang Powder 1 gram, Gongdingxiang Powder 1 gram, Sanqi Powder 1 gram, Amber Powder 1 gram, mixed as a daily dose, taken in three doses.2. Chenxiang Powder 0.5 grams, Xuejie Powder 1 gram, Amber Powder 0.5 grams, Sanqi Powder 1 gram, Bingpian Powder 0.5 grams, mixed as a daily dose, taken in five doses.6. Warming and Unblocking Blood PowderUsed for qi deficiency and blood stasis with cold evil stagnation. Symptoms include fatigue, shortness of breath, chest tightness, heart pain that worsens with cold, wiry pulse, dark tongue, and thin white coating.2 grams of Hongshen Powder, 0.5 grams of Chenxiang Powder, 1 gram of Xuejie Powder, 1 gram of Sanqi Powder, 0.5 grams of Amber Powder, 0.5 grams of Bingpian Powder, mixed as a daily dose, taken in five doses.All of the above powdered formulas are taken with warm water in divided doses throughout the day. They can also be taken temporarily during episodes of heart pain for pain relief.7. InsightsUsing powdered formulas in traditional Chinese medicine to treat angina pectoris has advantages such as small dosage, ease of preparation, convenience of administration, and rapid pain relief, making it popular among patients and of practical value, worthy of promotion.Guo’s powdered formula prescriptions for treating angina pectoris reflect the principle of syndrome differentiation and treatment. As stated in the Su Wen: Bi Lun, “Heart obstruction leads to blocked pulse.” Guo believes that the direct causes of true heart pain and obstructed heart pain are the blockage of blood vessels, leading to pain. Therefore, he emphasizes invigorating blood circulation and removing blood stasis to treat heart pain, which is fundamental to the treatment.All of the above powdered formulas essentially embody the principle of invigorating blood and relieving pain.Moreover, since blood “congeals when cold and flows when warm,” Guo also places great importance on the role of aromatic warming and unblocking in alleviating angina pectoris, considering it a key aspect of treatment.Guo’s various powdered formula prescriptions pay close attention to the relationship between qi and blood, as “when qi moves, blood moves; when qi stagnates, blood stagnates.” Thus, regulating qi helps invigorate blood, leading to the creation of regulating qi and invigorating blood powders; and since “qi is the commander of blood,” qi deficiency leads to blood stasis, hence the creation of tonifying qi and invigorating blood powders; and because “cold qi leads to blood congealing, warm qi leads to blood flow,” warming and unblocking blood powders are also formulated.In summary, although most powdered formula prescriptions are concise, they are rigorously formulated, addressing both the root and the branch, and despite the small dosage, they are remarkably effective.Copyright Statement：This article is from：Chinese Medicine Journal, 1983, Issue 10 | Author/Chen Keji, Copyright belongs to the relevant rights holder. 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