Coronary heart disease

Keywords: Chinese medicine, Chinese herbal medicine, cardiology, coronary heart disease (CHD), coronary artery disease (CAD)

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Coronary heart disease, also called coronary artery disease (CAD), refers to athero- and arteriosclerosis of the large and medium-sized arteries supplying the heart. Arteriosclerosis is a generic term for thickening and loss of elasticity of the arterial walls, thus restricting and reducing blood flow through those arteries. Atherosclerosis is the most common form of arteriosclerosis. The major complications of CHD are angina pectoris, myocardial infarction (MI), arrhythmia, and sudden cardiac death. The following clinical trials and case histories exemplifying the contemporary Chinese medical treatment of CHD are taken from a recently published book by Blue Poppy Press, The Treatment of Cardiovascular Diseases with Chinese Medicine, of which I am a co-author.

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Clinical trial 1

In this clinical trial, (1) 40 patients suffering from CHD were treated primarily employing the method of quickening blood and transforming stasis. Out of the 40 cases, 25 were male and 15 were female. Their age was 55-60 years in 10 cases, 61-65 years in 16 cases, and 66-70 in 14 cases. Their disease course had lasted less than one year in 10 cases, 1-3 years in 18 cases, and three years or more in 12 cases. Twenty-nine patients also suffered from hypertension and 11 cases also suffered from diabetes. All 40 cases were diagnosed with CHD according to the criteria published in Shi Yong Zhong Xi Bing Jie He Lin Chuang Shou Ce (Clinical Handbook of the Practice of Integrated Chinese-Western Medicine).

The patients were divided into two groups: cold phelgm stasis and hot phlegm stasis. The basic prescription for both groups consisted of Rhizoma Corydalis Yanhuso (Yan Hu Suo), Radix Ligustici Wallichii (Chuan Xiong), Fructus Crataegi (Shan Zha), Lignum Dalbergiae Odoriferae (Jiang Xiang), Fructus Trichosanthis Kirlowii (Gua Lou), and Flos Carthami Tinctorii (Hong Hua), 15g each. For patients suffering from cold phlegm stasis, Radix Codonopsitis Pilosulae (Dang Shen), 20g, Ramulus Cinnamomi Cassiae (Gui Zhi), 10g, and Bulbus Allii (Xie Bai), 15g, were added. For patients suffering from hot phlegm stasis, Radix Scutellariae Baicalensis (Huang Qin), and Radix Scrophulariae Ningpoensis (Xuan Shen), 15g each, were added. Furthermore, the following additions were made based on presenting symptoms and signs: For pronounced angina pain, 15 grams each of Feces Trogopterori seu Pteromi (Wu Ling Zhi) and Pollen Typhae (Pu Huang) were added. For pronounced hypertension, 25 grams of Ramulus Uncariae Cum Uncis (Gou Teng), 15 grams of Radix Achyranthis Bidentatae (Niu Xi), and 50 grams of Conchae Margaritiferae (Zhen Zhu Mu) were added. For insomnia with profuse dreams, 25 grams each of Semen Zizyphi Spinosae (Suan Zao Ren) and Caulis Polygoni Multiflori (Shou Wu Teng) were added. For pronounced chest oppression, 20 grams of Cortex Magnoliae Officinalis (Hou Po) were added. One packet of these medicinals was decocted in water and administered per day, with 10 days equaling one course of treatment. In addition, patients suffering from pronounced hypertension were administered Fu Fang Jiang Ya Pian (Compound Lower the [Blood] Pressure Tablets), and patients suffering from diabetes received phenethyldiguanide (Phenformin).

Marked improvement meant that, during normal daily activity, no angina was experienced and that the ECG returned to normal. Some effect meant that, after treatment, light activity did not lead to angina pain but more strenuous activity could still initiate a pain attack and that the ECG's S-T depression increased by at least 0.05mV but that the ECG overall did not return to normal. No effect meant that, after treatment, neither the disease symptoms abated nor the ECG improved. According to these criteria, 20 cases experienced marked improvement, 18 experienced some improvement, and two did not improve. In addition, prior to treatment, 16 cases presented with a dark tongue and 24 cases with a dark red tongue with static macules. After treatment, the tongue was pale red in 38 cases and still dark in two cases. Prior to treatment, 21 cases also presented with yellow fur and 19 cases with slimy, white fur. After treatment, the fur was thin and white in 38 cases and still yellow in two cases. Prior to treatment, the pulse was deep and fine in 21 cases and bowstring, fine, and rapid in 19 cases. After treatment, the pulse was harmonious and moderate in 38 cases and still deep and fine in two cases.

Clinical trial 2

All 70 patients in this clinical trial (2) suffered from CHD and were divided into two groups: a Xue Fu Zhu Yu Tang (Blood Mansion Expel Stasis Decoction) group of 40 cases (below referred to as the treatment group) and a Western medicine group of 30 cases (below referred to as the control group). Out of the 40 cases in the treatment group, 22 were male and 18 were female. The youngest was 35 years old, the oldest 72 years, with an average age of 49. Ten cases had suffered from the disease less than one year, 17 cases had suffered from the disease 1-5 years, and 13 cases had suffered from the disease for more than five years. Twenty cases also presented with hypertension, 15 with hyperlipidemia, 32 with abnormal blood rheology, nine with cardiac arrhythmias, and six with diabetes. Out of the 30 cases in the control group, 17 were male and 13 were female. The youngest was 34 years old, the oldest 74 years, and the average age was 50. Six cases suffered from the disease less than one year, nine cases suffered from the disease 1-5 years, and 15 cases suffered from the disease for more than five years. Nine cases also presented with hypertension, 11 with hyperlipidemia, 23 with abnormal blood rheology, three with cardiac arrhythmias, and four with diabetes.

The treatment group was prescribed the following formula: Radix Angelicae Sinensis (Dang Gui), Semen Pruni Persicae (Tao Ren), uncooked Radix Rehmanniae Glutinosae (Sheng Di), and Radix Rubrus Paeoniae Lactiflorae (Chi Shao), 15g each, Radix Achyranthis Bidentatae (Niu Xi) and Radix Ligustici Wallichii (Chuan Xiong), 12 g each, Flos Carthami Tinctorii (Hong Hua), Fructus Citri Aurantii (Zhi Ke), Radix Platycodi Grandiflorii (Jie Geng), and Radix Bupleuri (Chai Hu), 10g each, and Radix Glycyrrhizae Uralensis (Gan Cao), 6g. One packet of these medicinals was decocted in water and administered per day in two divided doses, morning and evening. Treatment was continued for three weeks. During treatment, all other medications were stopped. The control group was administered isosorbide dinitrate tablets, 10mg, and dipyridamole (Perssantine) tablets, 25 mg, three times daily for the period of three weeks.

In the treatment group, 24 patients suffered from angina. Of these, 12 experienced marked improvement, nine experienced improvement, and three experienced no effect. In the control group, 20 cases suffered from angina. Of these, seven experienced marked improvement, five cases improvement, and eight cases did not improve. Hence, control of angina in the treatment group was significantly better than in the control group (P < 0.05). As improvement of the ECG, out of the 40 cases in the treatment group, 14 showed marked improvement, 23 improvement, and three did not improve. In the control group, out of the 30 cases, 10 improved markedly, 15 improved, and five did not improve. Therefore, normalization of the ECG in the treatment group was significantly better than in the control group (P < 0.01). As for changes in blood rheology, 32 out of 40 cases in the treatment group presented with elevated blood viscosity prior to treatment, while 23 out of 30 cases in the control group showed elevated blood viscosity prior to treatment. After treatment, mean blood rheology values improved significantly in the treatment group (P < 0.01) but not in the control group.

Clinical trial 3

All patients selected for this clinical trial (3) suffered from angina pain at least twice weekly. Patients suffering from hypertension, pronounced pulmonary heart disease, cardiac arrhythmias, or other organic cardiac diseases were not enrolled. The 130 cases were then divided into three groups according to the applied treatment method: 1) integrated Chinese-Western medical treatment, 2) Chinese medicine only, and 3) Western medicine only. The integrated Chinese-Western medicine treatment group included 64 patients, 30 were males and 34 females. Their age ranged from 41-85 years, with an average of 56. Their disease had lasted between 2.5 months and 27 years, with an average of 6.4 years. Forty-one cases suffered from simple angina and 23 cases from unstable angina. The Chinese medicine treatment group included 35 patients, 21 males and 14 females. Their age ranged from 42-78 years, with an average of 54. Their disease had lasted between three months to 23 years, with an average of 5.6 years. Twenty-four cases suffered from simple angina and 11 cases from unstable angina. The Western medicine treatment group included 31 patients, 19 males and 12 females. Their age ranged from 41 to 80 years with an average of 56. Their disease had lasted between five months and 28 years, with an average of 5.7 years. Twenty-two cases suffered from simple angina and nine cases from unstable angina.

The Chinese medicine treatment group was administered self-composed Tong Mai Huo Xue Tang (Free the Flow of the Vessels & Quicken the Blood Decoction) which consisted of: Radix Panacis Ginseng (Ren Shen), 10g, Radix Puerariae (Ge Gen), 24g, Radix Astragali Membranacei (Huang Qi), 30g, Tuber Curcumae (Yu Jin) and Radix Angelicae Sinensis (Dang Gui), 15g each, Radix Lisgustici Wallichii (Chuan Xiong) and Radix Rubrus Paeoniae Lactiflorae (Chi Shao), 12g each, and powdered Radix Pseudoginseng (San Qi), 3g washed down with the decoction. One packet of these medicinals was decocted in water and administered orally per day. Modifications were made according to signs and symptoms. For marked blood stasis, Semen Pruni Persicae (Tao Ren) and Flos Carthami Tinctorii (Hong Hua) were added. For phlegm turbidity blockage and obstruction, Rhizoma Pinelliae Ternatae (Ban Xia) and Fructus Trichosanthis Kirlowii (Gua Lou) were added. For devitalized heart yang, Bulbus Allii (Xie Bai) and Ramulus Cinnamomi Cassiae (Gui Zhi) were added. For heart yin depletion and vacuity, the above prescription was combined with Sheng Mai San (Engender the Pulse Powder). The Western medicine group was administered isosorbide 5-mononitrate, 40mg once daily. The integrated Chinese-Western medicine combination group was administered both of the treatments outlined above. Treatment was administered for a total of six weeks. During treatment, all other anti-angina medicines were stopped, and patients were instructed to maintain a regular lifestyle. If angina occurred, sublingual nitroglycerine was administered. During treatment, the following parameters were monitored: frequency and intensity of the angina pain, amount of nitroglycerin used, ECG changes, and changes of other disease manifestations.

Treatment effect and ECG changes after treatment are illustrated in Tables 1 and 2.

Clinical trial 4

In this clinical trial, (4) all 74 patients were diagnosed with acute myocardial infarction (AMI) according to 1979 WHO diagnostic criteria. The patients were divided into two groups. One group was treated with the methods of boosting the qi and enriching yin, transforming stasis and eliminating stasis (below referred to as the treatment group). The other group was treated with the methods of transforming phlegm and eliminating stasis (below referred to as the control group). Each group consisted of 37 patients. Out of the 37 patients in the treatment group, 29 were male and eight were female. Their age ranged from as young as 38 to as old as 84 years. The average age was 64.4. Nine cases suffered from anterior myocardial infarction, 14 from anteriorseptal infarction, 10 cases from inferior myocardial infarction, and four from a no-Q-wave infarction. Out of the 37 patients in the control group, 28 were male and nine were female. Their age ranged from as young as 40 to as old as 82 years, with an average age of 64.5. Eleven cases suffered from anterior myocardial infarction, 12 from anteriorseptal infarction, nine cases from inferior myocardial infarction, and five from a no-Q-wave infarction.

All patients received regular Western medical care in the hospital, such as electrocardiographic and blood pressure monitoring, pain therapy, sedation, and coronary microcirculation enhancement. In addition, the treatment group was administered the following Chinese medicinals: Radix Codonopsitis Pilosulae (Dang Shen), 15g, Tuber Ophiopogonis Japonici (Mai Men Dong), 10g, Fructus Schisandrae Chinensis (Wu Wei Zi), 10g, Radix Astragali Membranacei (Huang Qi), 15g, Rhizoma Polygonati (Huang Jing), 15g, Semen Pruni Persicae (Tao Ren), 10g, Flos Carthami Tinctorii (Hong Hua), 10g, Radix Ligustici Wallichii (Chuan Xiong), 12g, Radix Rubrus Paeoniae Lactiflorae (Chi Shao), 12g, Fructus Trichosanthis Kirlowii (Gua Lou), 15g, Bulbus Allii (Xie Bai), 10g, Rhizoma Pinelliae Ternatae (Ban Xia), 10g, and alcohol-prepared Radix Et Rhizoma Rhei (Da Huang), 10g. The control group received the following prescription: Semen Pruni Persicae (Tao Ren), 12g, Flos Carthami Tinctorii (Hong Hua), 10g, Radix Ligustici Wallichii (Chuan Xiong), 12g, Radix Rubrus Paeoniae Lactiflorae (Chi Shao), 12g, Fructus Trichosanthis Kirlowii (Gua Lou), 15g, Bulbus Allii (Xie Bai), 10g, Rhizoma Pinelliae Ternatae (Ban Xia), 10g, alcohol-prepared Radix Et Rhizoma Rhei (Da Huang), 10g, Fructus Citri Aurantii (Zhi Ke), 10g, Caulis Bambusae In Taeniis (Zhu Ru), 10g, and Radix Angelicae Sinensis (Dang Gui), 10g. These formulas were prepared as water decoctions and one packet was taken daily. This treatment was continued for 30 days.

Treatment effects were analyzed by comparing frequency of cardiac arrhythmia, heart function, and post-infarction angina pain. In the treatment group, arrhythmia occured in 48.65% of patients prior to treatment and 8.11% after treatment. In comparison, in the control group, arrhythmia occured in 45.95% of patients prior to treatment and in 37.84% after treatment. In the treatment group, 21 patients improved from heart function II and III to heart function I. In the control group, five cases improved from heart function II and III to heart function I. Futher, six patients (16.2%) in the treatment group experienced angina pain following the 30 day period after the acute myocardial infarction. In the control group, 19 cases (51.4%) suffered from angina pain after the 30 days of treatment.

Clinical trial 5

All of the 32 cases in this clinical trial (5) suffered from cardiac ischemia according to WHO diagnostic criteria. Out of the 32 patients, 30 were male and two were female. Their age varied from as young as 46 to as old as 79. Nineteen cases suffered from work-induced angina, two cases suffered from spontaneous angina, and 11 cases suffered from unstable angina. Three cases suffered from post-infarction angina, one case from post-PTCA surgery angina, and seven cases from angina in combination with cardiac arrhythmia. The other 21 cases suffered from angina from other reasons.

Chuang Xiong Yin (Ligusticum Beverage) consisted of: Radix Ligustici Wallichii (Chuan Xiong), 15g, Pericarpium Trichosanthis Kirlowii (Gua Lou Pi) and Flos Carthami Tinctorii (Hong Hua), 12g each, Bulbus Allii (Xie Bai), 10g, and Radix Pseudoginseng (San Qi), 3-5g. If qi stagnation was the main pattern, Fructus Citri Aurantii (Zhi Ke), Fructus Meliae Toosendan (Chuan Lian Zi), Radix Aucklandiae Lappae (Guang Mu Xiang), Lignum Dalbergiae Odoriferae (Jiang Xiang), Lignum Santali Albi (Tan Xiang), Fructus Amomi (Sha Ren), and Pericarpium Citri Reticulatae Viride (Qing Pi) were added. If blood stasis was the main pattern, Semen Pruni Persicae (Tao Ren), Sanguis Draconis (Xue Jie), Pollen Typhae (Pu Huang), and Feces Trogopterori Seu Pteromi (Wu Ling Zhi) were added. For internal obstruction of phlegm turbidity, Rhizoma Pinelliae Ternatae (Ban Xia), Caulis Bambusae In Taeniis (Zhu Ru), Rhizoma Polygalae Tenuifoliae (Yuan Zhi), and Sclerotium Poriae Cocos (Fu Ling) were added. For qi vacuity, a large amount of Radix Astragali Membranacei (Huang Qi) and mix-fried Radix Glycyrrhizae Uralensis (Gan Cao) were added. For impediment and obstruction of chest yang, Ramulus Cinnamomi Cassiae (Gui Zhi) was added. In most cases, one packet of these medicinals was decocted in water and administered daily. In certain cases, two packets were administered per day. Treatment was continued for half a month. At the same time, patients were administered the ready-made medicine Guan Mai Ning (Coronary Vessel Quieting [Medicine]), (6) three tablets each time, three times per day. Once the condition stabilized, the amount was reduced to two tablets three times daily. During treatment, some patients also took calcium channel blockers. None of the patients took any nitroglycerin during the course of treatment.

Out of the 32 cases treated with the above method, 11 improved markedly. This meant that working-induced angina was reduced by 80% or more. Another 15 patients experienced some improvement. This meant that angina attacks reduced by 50-80%. Six cases did not experience any improvement. Their angina attacks reduced not at all or less than 50%. There was no worsening of the condition in any patient. Hence, the total amelioration rate was 81.3%.

Representative Case Histories

Case 1

The patient was a 54 year-old female (7) who came to the hospital on March 4, 1979. Three months prior to the visit, she had quarreled with her neighbors and was emotionally depressed and oppressed. Thereafter, she suddenly experienced heart pain. She was rushed to the hospital where she was diagnosed with angina due to coronary heart disease. However, her emotions kept fluctuating and she often felt precordial pain, continuous rib-side pain as well as chest oppression and inhibition. Only sighing relieved the pain a bit. Her tongue was dark with thin white fur and her pulse was bowstring. Hence, the diagnosis was heart pain and the pattern was qi stagnation. Thus, a combination of modified Xiao Yao San (Rambling Powder) and Tong Mai San (Free the Flow of the Vessels Powder) (8) was prescribed. Modified Xiao Yao San consisted of Radix Bupleuri (Chai Hu), 7g, and Radix Angelicae Sinensis (Dang Gui), Radix Albus Paeoniae Lactiflorae (Bai Shao), Sclerotium Poriae Cocos (Fu Ling), Flos Mume (Lu Mei Hua), Rhizoma Cyperi Rotundi (Xiang Fu), Tuber Curcumae (Yu Jin), Fructus Citri Sarcodactylis (Fo Shou), and Cortex Albizziae (He Huan Pi), 10g each. One packet of this prescription was prepared as a water decoction. In addition, the patient took six grams of Tong Mai San (Free the Flow of the Vessels Powder) soluble granules. After continuing this treatment for an entire month, the patient's emotional state opened up and her heart pain (angina) disappeared and did not recur.

Case 2

The patient was a 51 year-old male (9) who came for diagnosis on January 3, 1977. He had been diagnosed with coronary heart disease two years prior. Initially, he experienced retrosternal pain which radiated to the left neck, shoulder, and back. With every attack, the pain approached the precordial area. However, the pain resolved. During the recent two months, the retrosternal pain became fixed and took on a boring and stabbing nature. In addition, the patient began suffering from chest fullness and glomus as well as heart vexation and a dry mouth. His tongue was dark purple and the sublingual veins were static and purple. His pulse was choppy or rough. Hence, the disease diagnosis was heart pain and the pattern discrimination was blood stasis. He was prescribed a combination of Xue Fu Zhu Yu Tang (Blood Mansion Expel Stasis Decoction) as a bulk herb prescription and Tong Mai San (Free the Flow of the Vessels Powder) in soluble powder form. The bulk herb prescription contained the following medicinals: Semen Pruni Persicae (Tao Ren), Flos Carthami Tinctorii (Hong Hua), Radix Angelicae Sinensis (Dang Gui), Radix Ligustici Wallichii (Chuan Xiong), Radix Rubrus Paeoniae Lactiflorae (Chi Shao), Radix Achyranthis Bidentatae (Niu Xi), and Fructus Citri Aurantii (Zhi Ke), 10g each, uncooked Radix Rehmanniae Glutinosae (Sheng Di), 12g, Radix Bupleuri (Chai Hu), 7g, and Radix Platycodi Grandiflori (Jie Geng) and mix-fried Radix Glycyrrhizae Uralensis (Gan Cao), 6g each. This prescription was prepared as a water decoction and one packet was taken daily. In addition, six grams of Tong Mai San were administered daily. After taking these medicinals for a week, the frequency of the angina attacks markedly lessened and the stabbing nature of the pain disappeared. After taking the medicinals for a month, the symptoms of stasis had disappeared and the pain had stopped.

Case 3

The patient was a 60 year-old male (10) who came for diagnosis on January 15, 1975. The patient was admitted to the hospital with coronary heart disease and heart failure. At the time of admission, his blood pressure was low, his body temperature was 36[degrees]C, and his heart rate 48bpm. After having been in the hospital for more than one month, he still repeatedly suffered from heart palpitations, chest oppression, shortness of breath, and, although it was summer, aversion to cold. When he sweated, his fear of cold was very pronounced. He also suffered from dizziness with lack of strength, insomnia, frequent clear, long urination, and sometimes some low back soreness. His tongue fur was ashen black and his pulse was slow and moderate without force. Hence, his pattern discrimination was heart and kidney yang vacuity with loss of internal containment of the spirit. Treatment, therefore, focused on warming the kidneys and arousing yang, quieting the spirit and stabilizing fright. The prescribed formula contained: Radix Lateralis Praeparatus Aconiti Carmichaeli (Fu Pian), Herba Epimedii (Xian Ling Pi), Conchae Ostreae (Mu Li), Fructus Citri Aurantii (Zhi Ke), Semen Cuscutae Chinensis (Tu Si Zi), Fructus Schizandrae Chinensis (Wu Wei Zi), 9g each, Radix Astragali Membranacei (Huang Qi), Radix Salviae Miltiorrhizae (Dan Shen), Semen Zizyphi Spinosae (Suan Zao Ren), 15g each, and Caulis Polygoni Multiflori (Ye Jiao Teng), 30g. One packet of these medicinals prepared as a water decoction was taken daily. After seven days, the aversion to cold and sweating had improved, the heart palpitations had reduced, and the man's body temperature had increased to 36.5[degrees]C. However, his tongue was still black and he suffered from lack of strength. Hence, nine grams each of Radix Codonopsitis Pilosulae (Dang Shen) and Radix Angelicae Sinensis (Dang Gui) were added to the original formula and it was taken for another 14 days. Thereafter, all symptoms had disappeared, the man's blood pressure and the heart rhythm were normal, his tongue fur was thin and slimy, and his pulse was fine and moderate at 66bpm. Therefore, the patient was discharged from the hospital but was prescribed the following formula in order to secure the treatment effect (11): Radix Lateralis Praeparatus Aconiti Carmichaeli (Fu Pian), Herba Epimedii (Xian Ling Pi), Semen Cuscutae Chinensis (Tu Si Zi), Radix Codonopsitis Pilosulae (Dang Shen), Fructus Schizandrae Chinensis (Wu Wei Zi), Os Draconis (Long Gu), and Conchae Ostreae (Mu Li), 9g each, Radix Astragali Membranacei (Huang Qi), Radix Salviae Miltiorrhizae (Dan Shen), and cooked Radix Rehmanniae Glutinosae (Shu Di), 15g, Semen Zizyphi Spinosae (Suan Zao Ren), 12g, and Caulis Polygoni Multiflori (Ye Jiao Teng), 30g. Follow-up revealed that the disease condition had remained stable.

Case 4

The patient was a 78 year-old male (12) who was first examined by the author of this case history on February 22, 1978. The man had suffered from coronary heart disease for more than 10 years and from angina pain for even longer. Electrocardiogram revealed a third degree AV block. His main signs and symptoms were heart palpitations, chest pain with chest oppression, headache, trembling hands and red fingers, occasional constipation but sometimes two bowel movements per day, purple lips, and a crimson tongue with slimy, white fur and static speckles on the edges of the tongue. The pulse was bowstring and bound. The heart rate was 42bpm and there were irregularly intermittent beats. Hence, the pattern was discriminated as heart qi and blood stasis and stagnation due to congealed cold and constructive heat mutually binding and inhibiting the movement of the vessels. Hence, the treatment principles were to quicken the blood and transform stasis, course and free the flow of the heart network vessels. The formula administered consisted of: Radix Salviae Miltiorrhizae (Dan Shen), Fructus Trichosanthis Kirlowii (Gua Lou), and uncooked Radix Rehmanniae Glutinosae (Sheng Di), 15g each, Bulbus Allii (Xie Bai), Radix Rubrus Paeoniae Lactiflorae (Chi Shao), Radix Angelicae Sinensis (Dang Gui), and Semen Pruni Persicae (Tao Ren), 9g each, Flos Carthami Tinctorii (Hong Hua), Radix Ligustici Wallichii (Chuan Xiong), and Lignum Santali Albi (Tan Xiang), 6g each, and Pericarpium Zanthoxyli Bungeani (Chuan Jiao), 1.5g. One packet of these medicinals was taken daily in the form of a water decoction. After taking this prescription for 14 days, ECG analysis showed that the AV block had lessened to a first degree condition and that there was a sinus rhythm. Furthermore, the man's headache and the trembling of the hands had disappeared and his pulse was bowstring and forceful with a heart rate of 68bpm without intermittent beats. This showed that the disease condition had markedly improved. Hence, a formula to quicken the blood and transform stasis with the addition of qi-boosting medicinals was administered to further stabilize the treatment effect. Follow-up several months later showed no recurrences of the angina or the cardiac arrhythmia.

Case 5

The patient was a 84 year-old female (13) who came to the hospital because the frequent precordial pain she had been suffering from for five years had become more severe during the past week. For five years, she had been suffering from recurrent repressed emotions and taxation thinking with accompanying chest oppression, qi stifling, heart palpitations, sweating, cold limbs, and severe heart pain which radiated to the left shoulder, upper back, and medial arm as well as the little finger. Self-administration of isosorbide dinitrate was not effective. Diagnosis revealed a fat bodily shape, a dark facial complexion, an enlarged, fat, dark-colored tongue with static macules and speckles at the tip, teethmarks, purple, congested sublingual veins, and thin, white fur. The pulse was bound or regularly interrupted. Her blood pressure was 97/195mmHg, and an ECG showed the presence of 107 atrial fibrillations per minute and coronary vessel insufficiency. Based on the foregoing, the woman's Chinese medical diagnosis was chest impediment and her pattern was discriminated as cold congelation and phlegm turbidity with stasis obstructing the heart vessels. Her Western medical diagnosis was ischemic heart disease, angina, and atrial fibrillation. Treatment focused on warming yang and transforming turbidity, quickening the blood, expelling stasis, and freeing the flow of the vessels. Hence, the following prescription was administered: Radix Salviae Miltiorrhizae (Dan Shen), 30g, Rhizoma Nardostachydis (Gan Song), 25g, Fructus Trichosanthis Kirlowii (Gua Lou), Bulbus Allii (Xie Bai), Ramulus Cinnamomi Cassiae (Gui Zhi), and Rhizoma Pinelliae Ternatae (Ban Xia), 12g each, Semen Pruni Persicae (Tao Ren), Radix Ligustici Wallichii (Chuan Xiong), mix-fried Radix Glycyrrhizae Uralensis (Gan Cao), Radix Lateralis Praeparatus Aconiti Carmichaeli (Fu Zi), and Rhizoma Coptidis Chinensis (Huang Lian), 10g each, and Radix Platycodi Grandiflorii (Jie Geng), 6g. One packet of these medicinals was administered daily as a water decoction for six days. Thereafter, the chest oppression and qi stifling, heart palpitations, and heart and chest pain were all greatly reduced. The sweating and cold limbs were eliminated. Examination revealed a dark tongue with slightly slimy fur, and the pulse was only occassionally bound. Since the formula had been effective, it was not modified, and another six packets were prescribed. Thereafter, all this patient's symptoms were eliminated. Still, the medicinals were continued for another month to secure the treatment effect. Repeat ECG revealed a sinus rhythm of 76bpm and the ECG was normal. Follow-up half a year later revealed no recurrences of the angina.

References

1. Zuo Bi-hui, "The Treatment of 40 Cases of Coronary Heart Disease by the Methods of Quickening the Blood & Transforming Stasis," Si Chuan Zhong Yi (Sichuan Chinese Medicine), #8, 1996, p. 28

2. Xiao Jun-lu, "Xue Fu Zhu Yu Tang (Blood Mansion Expel Stasis Decoction) in the Treatment of 40 Cases of Coronary Heart Disease," Si Chuan Zhong Yi (Sichuan Chinese Medicine), #7, 1999, p. 30-31

3. Li Fu-xian, Wei Mao-chun & Sun Min, "The Integrated Chinese-Western Medical Treatment of 64 Cases of Angina Secondary to Cardiovascular Heart Disease," Si Chuan Zhong Yi (Sichuan Chinese Medicine), #7, 1999, p. 32-33

4. Zhang Jing-chun et al., "Observations on the Treatment of Early Complications in Coronary Heart Patients Suffering from Acute Myocardial Infarction with the Treatment Methods of Boosting the Qi & Enriching Yin, Transforming Phlegm & Eliminating Stasis," Zhong Yi Za Zhi (Journal of Chinese Medicine), #11, 1999, p. 671-672

5. Sun Xin-fang, "Chuan Xiong Yin (Ligusticum Beverage) plus Guan Mai Ning (Coronary Vessel Quieting [Medicine]) in the Treatment of 32 Cases of Angina Due to Coronary Heart Disease," Zhe Jiang Zhong Yi Za Zhi (Zhejiang Journal of Chinese Medicine), #6, 2000, p. 244

6. Guan Mai Ning (Coronary Vessel Quieting) tablets contain Radix Salviae Miltiorrhizae (Dan Shen), Caulis Milettiae seu Spatholobi (Ji Xue Teng), Rhizoma Corydalis Yanhusuo (Yan Hu Suo), Semen Pruni Persciae (Tao Ren), Flos Carthami Tinetorii (Tao Ren), Sanguis Draconis (Xue Jie), Resina Myrrhae (Mo Yao), resina Olibani (Ru Xiang), Radix Angelicae Sinensis (Dang Gui), Radix Polygoni Multiflori (He Shou Wu), Rhizoma Polygonati (Huang Jing), Radix Puerariae (Ge Gen) and Borneol (Bing Pian). These tablets quicken blood, transform stasis, move qi, and stop pain.

7. Gao Zhen-hua, "Gao Yong-jiang's Experience in the Discrimination & Treatment of Angina Secondary to Coronary Heart Disease," Zhong Yi Za Zhi (Journal of Chinese Medicine), #8, 1995, p. 460

8. Tong Mai San granules consist of the following medicinals: Lignum Aquillariae Agallochae (Chen Xiang), Lignum Santali Albae (Tan Xiang), Resina Olibani (Ru Xiang), Radix Pseudoginseng (San Qi). These medicinals are powdered and between 3-6g must be administered per day.

9. Gao Zhen-hua, op. cit., p. 461

10. Dai Ge-min, "Jiang Chun-hua's Experience in the Treatment of Coronary Heart Disease," Shan Xi Zhong Yi (Shanxi Chinese Medicine, #1, 2001, p. 3

11. The author of this case history does not state exactly how long the formula was continued; the Chinese orginal simply states "for an extended period of time."

12. Dai Ge-min, op. cit., p.4.

13. Zou Xin-ying, "The Treatment of 26 Cases of Angina Pectoris Due to Cold Phlegm & Stasis," Si Chuan Zhong Yi (Sichuan Chinese Medicine), #11, 1996, p. 32

abstracted & translated by Bob Flaws, LicAc, Dipl Ac & CH, FNAAOM

Copyright [c] Blue Poppy Press, 2004. All rights reserved.

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