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Coronary Heart Disease

1. Overview and Causes
2. Symptoms
3. TCM Effectiveness and Evaluation
4. Common Syndromes and Treatments in TCM
  a. Obstruction of the chest-yang
  b. Blood Stasis in the Heart-vessels
  c. Deficiency of Both Qi and Yin
5. Healing by Other Therapies
  a. Qigong and other
  b. Medicated diet
  c. Life style
6. Psychological Adaptation


1. Overview and Causes

Coronary heart disease is the abbreviation of coronary atherosclerotic (degenerative disease of the arteries) heart disease. The incidence is high in all the countries especially in the developed countries. The risk factors for coronary heart disease are hypertension (high blood pressure), hyperlipemia (excess fat in the blood) , diabetes mellitus and cigarette smoking. According to the diagnostic criteria made by WHO, coronary heart disease can be divided into: (a) Primary sudden cardiac arrest;
(b) Angina pectoris;
(c) Myocardial infarction;
(d) Heart failure due to coronary heart disease;
(e) Arrhythmia.(Irregular heartbeat) Angina pectoris and myocardial infarction are more often seen. So in this section only angina pectoris and myocardial infarction are described. This disease, in TCM, pertains to the categoris of “ xiong bi” (obstruction of qi in the chest), “ Xiong tong” (chest pain) “ zhen xin tong” (myocardiac infarction) and “jue xin tong” (pericardial pain with cold limbs).

Myocardial infarction is the death of heart muscle due to lack of blood supply to the muscle. Myocardial infarction can be complicated by arrhythmia, heart failure, and cardiogenic shock. In severe cases or in patients who are not treated in time, death usually ensues.

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2. Symptoms

(a) Premonitory symptoms of myocardial infarction: Some patients may have premonitory symptoms for a period of time prior to the onset of myocardial infarction. The patients may have frequent episodes of angina pectoris (chest pain), which last longer and are more severe or are accompanied by nausea, vomiting and arrhythmia. The episodes cannot be relieved by placing nitroglycerin tablet under the tongue. But many patients do not have premonitory symptoms prior to the episode.

(b) Clinical manifestation of myocardial infarction : Retrosternal or pericardial persistent pain occurs suddenly with a sensation of oppression. The pain may radiate to the neck and left shoulder. The patients commonly have profuse sweating, anxiety, pallor, thready pulse and lowering of blood pressure. In some senile patients, the pain may not be obvious but confusional state, shock and heart failure are commonly seen.

(c) In acute myocardial infarction the electrocardiogram (ECG) shows specific changes: In acute stage all the leads relevant to the site of infarction show arcuate elevation of ST segments, inversion of T waves and appearance of pathologic Q waves. Subsequently, as the disease becomes better, the electrocardiogram undergoes stereotyped changes.

(d) Serum enzyme studies are very valuable for the diagnosis of acute myocardiac infarction. Their accuracies are high. Creatinine phosphokinase (CPK) and MB isoenzyme are very valuable for diagnosing early myocardial infarction. Serum glutamic oxalacetic transiaminase (SGOT), lactic dehydrogenase (LDH) and isoenzymes are of value in the diagnosis of myocardial infarction. In addition, the examinations of leukocyte count; blood sugar and serum myoglobin are also helpful for diagnosis and the prognosis of the disease.

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3. TCM Effectiveness and Evaluation

Promoting blood circulation and removing stasis by herbal medication to treat CHD has obtained effect. The clinical researches demonstrated that the mortality due to myocardial infarction was lower with the combined treatment of TCM and Western medicine as compared to Western medicine alone.

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4. Common Syndromes and Treatments in TCM

This ailment, according to TCM, has different syndromes. The treatment for these syndromes using herbal medicine and acupuncture is shown below.

Syndrome (a)
Obstruction of the chest-yang

Oppressed feeling in the chest, paroxysmal (attacks of) chest pain with palpitation (noticeable and irregular heartbeat) and shortness of breath often brought out by the attack of cold, white greasy fur of the tongue, and taut pulse.

To treat by Herbal medicine
Therapeutic principle: By using herbal medicine you can warm up and benefit the chest-yang to remove obstruction of blood flow in the heart-vessels.

Prescription/Formula: Decoction of Trichosanthes, Macrostem and Pinellia with additional ingredients: trichosanthes fruit, Fructus Trichosanthis 20g, macrostem onion, Bulbus Allii Macrostemi 12g, pinellia tuber, Rhizoma Pinelliae 10g, cinnamon twig, Ramulus Cinnamomi 10g, red sage root, Radix Salviae Miltiorrhizae 30g, cat tail pollen, Pollen Typhae10g, trogopterus dung, Faeces Trogopterorum 10g

  

To treat by Acupuncture and Moxibustion

  

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Syndrome (b)
Blood Stasis in the Heart-vessels

Sharp pain in the chest radiating to the shoulder and back, stuffy sensation in the chest and shortness of breath, deep purple tongue with ecchymoses (purple mottling of skin), taut or uneven pulse.

To treat by Herbal medicine
Therapeutic principle: Promoting the flow of qi and blood, removing blood stasis and activationg the heart-vessels.

Prescription/Formula: Modified prescription of Red Sage Drink and Decoction of Four Ingredients with Peach Kernel and Safflower. red sage root, Radix Salviae Miltiorrhizae 30g sandalwood, Lignum Santali 3g amomum fruit, Fructus Amomi 10g green trangerine orange peel, Pericarpium Citri Reticulatae Viride 5g lindera root, Radix linderae 5 g Chinese angelica, Radix angelicae Sinensis 10g chuanxiong rhizome, Rhizoma ligustici Chuanxiong 10g red peony root, Radix Paeoniae Rubra 10g safflower, Flos Carthami 9g peach kernel, Semen Persicae 10g dalbergia wood, Lignum Dalbergiae Odoriferae 10g.

  

To treat by Acupuncture and Moxibustion

  

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Syndrome (c)
Deficiency of Both Qi and Yin
Indistinct pain in the precardiac (in front of the hear tregion, lassitude, palpitation, shortness of breath, spontaneous perspiration, dry mouth, red tongue with little fur, taut and weak pulse.

To treat by Herbal medicine
Therapeutic principle: Replenishing qi, nourishing yin and promoting blood circulation.

Prescription/Formula: Pulse-activating Powder with additional ingredients. astragalus root, Radix Astragali seu Hedysari 15g dangshen, Radix Codonopsis Pilosulae 12g opiopogon root, Radix Ophiopogonis 10g schishandra fruit, Fructus Schisandrae 10g Chinese angelica root, Radix Angelicae Sinensis 12g red sage root, Radix Salviae Miltiorrhizae 20g fragrant solomonseal rhizome, Rhizoma Polygonati Odorati 12g

  

To treat by Acupuncture and Moxibustion
Prescription: Neiguan ( P 6) and Xinshu ( B 15) or Jueyinshu ( B 14).

Supplementary Points: For stagnation of qi and blood stasis, Geshu ( B 17), Xuehai (Sp 10), Shangzhong ( Ren 17), Taichong (Liv 3) and Qimen ( Liv 14), are added; for obstruction of Yang-qi in the chest, Jianshi ( P 5), Daling ( P 7) and Shanzhong ( Ren 17);

For deficiency of qi and blood in the heart and spleen, Shenmen ( H 7), Zusanli (S 36), Sanyinjiao (Sp 6) and Pishu (B 20). Give the treatment once every day or every other day. 10 treatments make up a course.

Ear Acupuncture:
Prescription: Pt. Chest, Pt. Shenmen, Pt. Heart, Pt. Subcortex, Pt. Liver and Pt. Spleen. Give the treatment once or twice a day.

  

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5. Healing by Other Therapies

(a) Qigong and other therapies

For effect of Qigong on the Blood Circulation System, click here.

Generally speaking, Qigong is good for healing effect of this specific ailment, however individual results may vary. It improves the flow of the qi and the circulation of the blood, so you'll experience more energy, but, you won't see/ feel any immediate effects, as with many exercises and therapies, it takes a few weeks or even months of practice before you'll see any significant improvements.

The following types of Qigong may help:

For the information of different types of Qigong ,just click a link above.

This information is for education purpose only. We strongly advise you seek a licensed Qigong master to learn the correct ways to conduct these exercises before attempting them.


(b) Medicated diet
1. Prepared-Fleece Root(Zhishouwu) 12g, Chrysanthemum Flower(Juhua) 9g, cook them and drink as tea for heart disease with Hypertension.
2. Peach Kernel(Taoren) 6g, Hawthorn Fruit(Shanzha) 12g, Tangerine Peel(Chenpi) 3g, decoct them to make tea. Drink the tea for blood stasis in the Heart-vessels.
(c) Life style
1. Take precaution against Hypertension.
2. Take precaution against Diabetes.
3. Quit smoking and limit drinking wine.
4. Take less fatty food to prevent Hyperlipemia.
5. Keep good mood and do appropriate exercises.
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6. Psychological Adaptation to a Chronic and Severe Illness
One encounters different health problems in the course of one's life. Some problems are acute yet minor and often improve by themselves or yield to simple self-management. Severe and acute conditions often necessitate the help of health professionals who may provide fast relief with specific interventions. However, when the condition is chronic, the management required is quite different.

Please click the following button to learn "Psychological Adaptation to a Chronic and Severe Illness".

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Acknowledgments:
Healthphone.com greatly acknowledges the support and dedication of our
Healing Centre Panel, without whom this section would not be possible.

We also greatly acknowedge Ms. Najaf Munir, MBBS, for her editorial support. Ms. Munir simplified the highly technical medical documents into easy-to-read documents, for the enjoyment and education of our numerous visitors.