Dr. Guo Shikui, a veteran TCM practitioner, has accumulated extensive experience in the prevention and treatment of coronary heart disease. He specializes in using methods such as invigorating blood circulation, resolving blood stasis, warming and promoting circulation, and tonifying Qi to treat angina pectoris and myocardial infarction. For moderate to severe angina pectoris, in addition to using decoctions for syndrome differentiation, he often employs powdered formulations, which are effective and convenient for patients.
The powdered formulations developed by Dr. Guo for alleviating angina pectoris are characterized by their unique selection of herbs, which are categorized as follows:
1. Invigorating Blood and Resolving Stasis Powders
Indicated for blood stasis pain. Symptoms include sharp, stabbing chest pain, pain localized to a specific area, wiry pulse, and a dark purple tongue or presence of stasis spots, with a generally robust physique.
1. Xuejie Powder (Dragon’s Blood Powder): 1.5 grams, taken in two doses.
2. Ruxiang Powder (Frankincense Powder): 1.5 grams of Ruxiang and 1.5 grams of Moye (Myrrh), ground into a fine powder, mixed well, taken in two doses.
3. Ruxiang 1.5 grams, Moye 1.5 grams, Xuejie 1.5 grams, Bingpian (Borneol) 1.5 grams, ground together, taken as 1 gram per dose.
2. Tonifying Qi and Invigorating Blood Powders
Indicated for Qi deficiency and blood stasis, with a weak constitution and accompanying chest pain. Symptoms include fatigue, shortness of breath, chest pain, thin or weak pulse, and a dull tongue.
1. Hongshen Sanqi Powder (Red Ginseng and Notoginseng Powder): Equal parts of Hongshen (Red Ginseng) and Sanqi (Notoginseng), mixed well, taken as 1 gram per dose.
2. Hongshen Sanqi Xuejie Powder: Equal parts of Hongshen, Sanqi, and Xuejie, mixed well, taken as 1 gram per dose.
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: Equal parts of Hongshen and Yuanhu (Cyperus), mixed well, taken as 3 grams per dose.
5. Hongshen 1.5 grams, Sanqi 1.5 grams, Yuanhu 3 grams, mixed well, taken as 2 grams per dose (the last two formulas are for Qi deficiency with phlegm and Qi stagnation).
3. Qi-Invigorating and Blood-Invigorating Powders
Indicated for Qi stagnation and blood stasis. Symptoms include chest pain, chest tightness, and a wiry pulse, with a dark tongue or stasis spots.
1. Yuanhu Powder: 3 grams, taken in two doses.
2. Guangmuxiang Powder (Aromatic Wood Powder) 1.5 grams, Yuanhu Powder 1.5 grams, mixed as a daily dose, taken in two doses.
3. Sanqi Yuanhu Powder: 1 gram of Sanqi and 3 grams of Yuanhu, mixed well, taken in two doses.
4. Aromatic Warming and Promoting Powders
Indicated for chest pain due to cold stagnation. Symptoms include chest tightness, severe chest pain that worsens with cold, tight wiry pulse, and thin white tongue coating.
1. Dinggui Powder (Clove Powder) 1.5 grams, Rougui (Cinnamon) 1 gram, Tanxiang (Sandalwood) 0.5 grams, ground together, taken as a daily dose, divided into two doses.
2. Chenxiang Powder 1 gram, Gongdian Powder (Clove) 1 gram, Amber Powder 1 gram, mixed as a daily dose, taken in three doses (for those with chest tightness and insomnia).
5. Warming and Promoting Blood Powders
Indicated for chest pain due to cold and blood stagnation. Symptoms include chest tightness and stabbing chest pain, with pain localized to a specific area, worsening with cold, dark tongue, and thin tongue coating.
1. Chenxiang Powder 1 gram, Gongdian 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 Promoting Blood Powders
Indicated for those with Qi deficiency and blood stasis accompanied by cold stagnation. Symptoms include fatigue, shortness of breath, chest tightness, chest pain that worsens with cold, wiry pulse, dark tongue, and thin white coating.
Hongshen Powder 2 grams, Chenxiang Powder 0.5 grams, Xuejie Powder 1 gram, Sanqi Powder 1 gram, Amber Powder 0.5 grams, Bingpian Powder 0.5 grams, mixed as a daily dose, taken in five doses.
All of the above powders are to be taken with warm water in divided doses throughout the day, and can also be taken temporarily during episodes of chest pain for pain relief.
7. Insights
The use of powdered herbal formulations for treating angina pectoris has advantages such as small dosage, ease of preparation, convenience of administration, and rapid pain relief, making them popular among patients and of practical value, warranting promotion.
Dr. Guo’s formulation for treating angina pectoris reflects the principle of syndrome differentiation and treatment. As stated in the “Su Wen: Bi Lun”, “Heart obstruction leads to unimpeded pulse”; Dr. Guo believes that the direct causes of true heart pain and obstructed heart pain are due to unimpeded blood vessels, leading to pain. Therefore, he emphasizes invigorating blood circulation and resolving stasis as the fundamental treatment for heart pain.
All of the above powders essentially embody the principle of invigorating blood and relieving pain.
Moreover, since blood “congeals when cold and flows when warm”, Dr. Guo also places great importance on the role of aromatic warming in alleviating angina pectoris, considering it a key aspect of treatment.
Dr. Guo’s formulations pay close attention to the relationship between Qi and blood, as “when Qi flows, blood flows; when Qi stagnates, blood stagnates”. Thus, Qi invigorating aids in blood invigorating, leading to the creation of Qi-invigorating and blood-invigorating powders; and since “Qi is the commander of blood”, Qi deficiency leads to blood stasis, hence the creation of Qi-tonifying and blood-invigorating powders; and because “cold Qi leads to blood congealing, warm Qi leads to blood flowing”, we have warming and promoting blood powders.
In summary, although most of the powdered formulations are concise, they are rigorously composed, addressing both the root and the branch, and while the dosages are small, their efficacy is remarkable.
Source: Xianxing Medical Society
The content published by this public account is mostly extracted from publicly available online sources for reference and learning purposes only, and should not be used as a basis for diagnosis or treatment. Please consult a physician for guidance. If there are any copyright issues, they will be removed.
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