Traditional Chinese Medicine is Really “Quick, Sharp and Accurate” in Treating Myocardial Infarction

The symptoms of acute myocardial infarction are similar to true heart pain in traditional Chinese medicine and are a common emergency and critical disease in clinical practice. Many famous contemporary Chinese medicine practitioners have explored their own treatment experiences based on the knowledge inherited from the ancients. These experiences can be used as a reference for the clinical treatment of acute myocardial infarction.

Most of the famous old Chinese medicine practitioners agree that the pathogenesis of this disease is that the root is deficiency and the superficial is excess. The underlying deficiency may be one or more of the deficiency of heart qi, blood, yin and yang, while the apparent deficiency may be qi stagnation, blood stasis, turbid phlegm, cold coagulation, exogenous evil toxins, alone or in combination, which may eventually lead to blockage of the heart vessels and cause heart pain. The famous old Chinese medicine practitioners have different characteristics in their treatments, such as emphasizing syndrome differentiation, being good at prescribing medicine, using medicine for a long time, and following the stage. The details are as follows:

1. Shi Jinmo: Promotes Qi and blood circulation, strengthens the heart and nourishes Yin

Shi Jinmo (1881-1969) believed that the recovery period of this disease is characterized by deficiency of the root and excess of the superficial symptoms. Deficiency syndrome is mostly characterized by deficiency of both Qi and Yin, with occasional cases of Yang deficiency; excess syndrome is mainly characterized by stagnation of Qi and blood stasis. The characteristics of medication during the recovery period are: "Decoctions focus on promoting qi and blood circulation, while pills focus on strengthening the heart and nourishing yin." On the premise of treating both diseases, the key points are highlighted. Danshen Drink and Siwu Decoction are often used to harmonize the blood, Gualou Xiebai Decoction and Erchen Decoction are used to resolve phlegm, Sini Powder, Xiangsu Drink, Zhike and Platycodon are used to regulate Qi, Baizi Yangxin Pills and Shengmai Powder are used to invigorate Qi and nourish Yin, nourish blood and tonify the heart, Codonopsis pilosula, American ginseng, Polygala tenuifolia, longan meat, calamus, herb of cranesbill and herb of wormwood are used to strengthen the heart and calm the mind.

2. Pu Fuzhou: To supplement the body and to promote circulation

Pu Fuzhou (1888-1975) formulated the treatment principle of "focusing on tonification and using unblocking as the method" to target the pathogenesis of poor blood circulation, imbalance of Ying and Wei, and the combination of phlegm, fire and blood stasis. This can strengthen the heart, tonify the deficiency and eliminate the excess, thus avoiding damaging Qi and blood and injuring the vital energy. Shuanghe Powder (ginseng, poria, polygala, licorice, calamus, salvia miltiorrhiza, cyperus rotundus, myrrh, amber, dragon's blood clotting, Millettia reticulata) was created to promote blood circulation and relieve qi, so as to unblock the heart qi and regulate the nutrient and defensive systems, avoiding the disadvantages of simply attacking blood stasis and damaging the body's health, thereby making the heart qi even weaker.

3. Yue Meizhong: Excessive evil blocking the pulse

Yue Meizhong (1900-1982) believed that this disease was caused by deficiency of heart yang or insufficient heart qi, which led to the obstruction of the meridians by pathogenic factors. Severe deficiency could lead to collapse. : : : : : : : : : : : : : : :

4. Guo Shikui: replenishing qi and activating blood circulation

Guo Shikui (1915-1981) believed that the main pathogenesis of this disease is qi deficiency and blood stasis, and the treatment is mainly to invigorate qi and promote blood circulation. The decoctions used are "healing-promoting mixture" (raw astragalus, angelica, salvia miltiorrhiza, cinnamon twig, tangerine peel) or "embolism mixture" (raw astragalus, codonopsis, polygonatum, salvia miltiorrhiza, red peony root, cinnamon twig, tangerine peel). Injections can be used with Qi-invigorating needles (Codonopsis pilosula, Astragalus membranaceus, Polygonatum sibiricum) and blood-activating needles (Danshen miltiorrhiza, Paeonia lactiflora, Curcuma aromatica), and the amount of injection can be increased or decreased according to the condition of the disease. For patients with severe pain, more blood-activating needles are given, for patients with obvious qi deficiency, more qi-invigorating needles are given, for chest pain, chest-opening aerosol, xintong pills, acupuncture, etc. are used for treatment, and for patients without complications, intravenous drip of qi-invigorating and blood-activating needles is used for 7-10 days, and then oral Chinese medicine treatment is switched.

5. Ren Jixue: Treatment by stages

Ren Jixue (1926 - ) adopted the treatment approach of stages. In the early stage, the main symptoms are invasion of evil toxins and internal obstruction of blood stasis. The treatment is to activate the meridians, remove blood stasis, clear the heart and detoxify. Use Simiao Yong'an Decoction from "New Edition of Proven Prescriptions". In the middle stage (>15 days), the main symptoms are deficiency of both Qi and Yin, and malnutrition of collaterals. The treatment is to invigorate Qi and nourish Yin, activate collaterals and harmonize blood circulation. Use the Yin-nourishing and Shengmai Powder from "Yi Zong Cui Yan" with modifications: Ophiopogon japonicus, Rehmannia glutinosa, Chinese angelica, raw liquorice, red peony root, Schisandra chinensis, raw sun-dried ginseng, and donkey-hide gelatin. The recovery period (generally >35 days) is mainly characterized by deficiency of vital energy, and the treatment is to invigorate qi and harmonize the middle, nourish the heart and harmonize the blood, and use Shengmai Jianzhong Decoction from "Shang Han Da Bai": raw sun-dried ginseng, Ophiopogon japonicus, Schisandra chinensis, white peony root (use red peony root instead), cinnamon twig, and raw licorice.

6. Chen Keji: Activating blood circulation and removing blood stasis, strengthening the body and replenishing qi

Chen Keji (1930 -) believed that this disease is often manifested as qi deficiency, qi stagnation, turbid obstruction, qi and yin deficiency, and heart yang deficiency, and all types are related to internal obstruction of blood stasis. Treatment should treat both the symptoms and the root cause, and combine both purgation and tonification. He is good at using the method of promoting blood circulation and removing blood stasis, as well as prescriptions and medicines that can strengthen the body, replenish qi, regenerate muscles, promote qi and blood circulation, relieve pain, remove blood stasis, resist clots, unclog the meridians, and clear turbidity and dampness, and clear the bowels and reduce adverse reactions. Self-made Yugeng Tongyu Decoction: raw sun-dried ginseng, raw astragalus, salvia miltiorrhiza, angelica, Corydalis yanhusuo, Ligusticum chuanxiong, patchouli, Cymbidium orientale, tangerine peel, Pinellia ternata, and raw rhubarb.