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Introduction
Coronary arteriosclerosis is a form of myocardial ischemia, characterized by the thickening and loss of elasticity in the coronary artery walls. This results in cardiac dysfunction due to an imbalance between myocardial function and the capacity of the coronary vessels to supply sufficient blood flow. According to the diagnostic criteria made by the World Health Organization, coronary arteriosclerosis can be classified into five types: (1) primary sudden cardiac arrest, (2) angina pectoris, (3) myocardial infarction, (4) heart failure due to coronary heart disease, and (5) arrhythmia. In traditional Chinese medicine, the disease falls into the categories of xiong bi (obstruction of qi in the chest), xiong tong (chest pain), xin tong(precordialgia), zhen xin tong (myocardial infarction) etc.
Etiology/Pathogenesis
The risk factors for coronary heart disease are hypertension, hyperlipemia, diabetes mellitus, and cigarette smoking. According to traditional Chinese medicine theories, it is held that the pathologic sites are the heart and lung. The causative factors include pathogenic cold or heat invasion of heart, impaired functions of the internal organs due to emotional strain, improper diet, asthenia of qi and blood, and hepatic and renal yin deficiency. The pathogenesis of coronary heart disease is attributed to a deficiency in origin and excess in superficiality. The manifestations of excess in superficiality are qi stagnation, blood stasis, accumulation of pathogenic cold, and phlegm stagnation. The manifestations of deficiency in origin are deficiencies of heart-qi, heart-blood and heart-yang, and hepatic and renal yin deficiency. In conclusion, the main pathogenic mechanism of the disease is the obstruction of the heart vessels.
Primary Treatments with Chinese Medicinal Herbs
Guan Xin II
Zhu Guang Qiong, et al. treated 25 cases of coronary heart disease with Guan Xin II (Coronary Disease Formula No.2). This formula contained the following herbs: Dan Shen (Salvia), Chuan Xiong (Cnidium), Chi Shao (Peony Red), Hong Hua (Carthamus), and Jiang Xiang (Dalbergia Wood). One dose of the formula in a decoction was orally administered twice daily, once in the morning and again in the evening. If the patient suffered from frequent attacks, the formula was administered in a capsule. Doses of 2 to 6 g of the capsules were taken orally, three times a day. The results showed that: After treatment, 8 cases were resolved, 10 cases had significantly improved, 6 had improved, and the remaining case did not respond to the treatment. (1)
Other Treatments with Chinese Medicinal Herbs
Guo’s Coronary Arteriosclerosis Formula
Yang Da Guo, et al. treated 50 cases of angina pectoris with the methods of soothing-liver, regulating-qi, activating-blood, and dredging-collaterals. The formula used contained the following herbs: Chai Hu (Bupleurum), Zhi Qiao (Aurantium Fruit), Jie Gen (Platycodon Root), Yu Jin (Curcuma Root), Fu Shou (Finger Citron), Chuan Xiong (Cnidium), Dang Gui (Chinese Angelica Roots), Fang Feng (Siler), Qian Hu (Pencedanum), Mei Gui Hua (Rose Flower), Ge Gen (Pueraria), Dan Shen (Salvia), and Gan Cao (Licorice). The results of this treatment for angina pectoris were: the treatment was significantly effective in 17 cases, 29 cases had improved, and 4 cases did not respond to the treatment, with a total effectiveness rate of 92%. The treatment results of this formula to ST-T segment changes in ECG examination were that 13 cases had significantly improved, 22 cases improved slightly, and 15 cases did not respond to the treatment with a total effectiveness rate of 70%. (2)
Yi Qi Fu Mai Tang
Cao Chuan Ming, et al. used Yi Qi Fu Mai Tang (a decoction for replenishing qi and restoring pulse) in the treatment of 58 cases of senile coronary heart disease complicated with ventricular premature complexes. This formula contained the following herbs: Dang Shen (Codonopsis), Ku Shen (Sophora Root), Huang Qi (Astragalus), Dan Shen (Salvia), Suan Zao Ren (Ziziphus), Chi Shao (Peony Red), Chuan Xiong (Cnidium), Hong Hua (Carthamus), Jiang Xiang (Dalbergia Wood), Wu Wei Zi (Fructus Schisandrae), Gui Zhi (Ramulus Cinnamoni), and Zhi Gan Cao (prepared Licorice). Four weeks constituted one treatment course. No other anti-arrhythmia drugs were used during this time of treatment. The results showed that among the 58 cases treated, 30 cases were significantly improved, 22 improved, and the remaining 6 cases did not respond to the treatment, with a total effectiveness rate of 89.7%. (3)
Xue Fu Zhu Yu Tang
Geng Jun, et al. treated 30 cases of coronary heart disease with Xue Fu Zhu Yu Tang (a decoction for removing blood stasis in the chest). This formula contained the following herbs: Tao Ren (Persica), Hong Hua (Carthamus), Sheng Di (Rehmannia), Dang Gui (Chinese Angelica Root), Niu Xi (Achyranthes), Chi Shao (Peony Red), Chuan Xiong (Cnidium), Zhi Qiao (Aurantium), Jie Gen (Platycodon Root), Chai Hu (Bupleurum), and Zhi Gan Cao (prepared Licorice). One therapeutic course consisted of 28 consecutive days. A control group of 20 cases was treated with regular doses of nifedipine, sorbide nitrate, or nitroglycerol whenever an emergency occurred. The total effectiveness rates in the treated and the control groups were: for angina pectoris, 90% and 85% and for ECG improvement, 80% and 75%, respectively. (4)
Zhen Wu Tang
Hu Ye Bin used modified Zhen Wu Tang (a decoction for strengthening the spleen-yang) in the treatment of coronary heart disease complicated with heart failure. The formula used contained the following herbs: Hong Shen (Red Ginseng), Dan Shen (Salvia), Shou Fu Pian (prepared Aconitum), Fu Ling (Poria), Bai Shao (White Peony Rood), Bai Zhu (Atractylodes), and Sheng Jiang (Ginger). One dose of the formula in a decoction was administered daily at four takings. Two weeks constituted one treatment course. The results showed that among the 20 cases treated, 6 had significantly improved, 12 improved slightly, and 2 cases did not respond to the treatment, with the total effectiveness rate of 90%. (5)
Xiao Xian Xiong Tang
Li Yu Chao treated 28 cases of coronary heart disease with Xiao Xian Xiong Tang (a minor decoction for relieving stuffiness in the chest). This formula contained the following herbs: Ban Xia (Pinellia), Zhi Shi (Immature Bitter Orange), Huang Lian (Coptis), Gua Lou (Trichosanthes Fruit), Dan Shen (Salvia), Ge Gen (Pueraria), and Shan Zha (Crataegus). One treatment course continued for 30 days. The results were: After one course of treatment, 14 cases were significantly improved, 11 cases improved slightly, and 3 cases did not respond to the treatment with a total effectiveness rate of 89.3%. (6)
Guan Xing Nao
Feng Ying Xiang used a Guan Xing Nao capsule in the treatment of 33 cases of coronary heart disease complicated with encephalopathy. The formula contained the following herbs: Huang Qi (Astragalus), Dan Shen (Salvia), Dang Shen (Codonopsis), Dang Gui (Chinese Angelica Root), Chuan Xiong (Cnidium), Chi Shao (Peony Red), Shi Chang Pu (Grassleaved Sweetflag Rhizome), Yu Jin (Curcuma Root), Tian Ma (Gastrodia), Ban Xia (Pinellia), and Chen Pi (Citrus). The herbs were ground into a fine powder and then put into capsules to be taken 6-8 g three times a day. 10 days constituted one treatment course. The results were: 16 cases were resolved, 8 cases significantly improved, 5 improved slightly, and 4 cases did not respond to the treatment, with the total effectiveness rate of 87.8%. (7)
Fu Fang Dan Shen Di Wan
Ma Hai Yan, et al. used Fu Fang Dan Shen Di Wan (pills of Dan Shen compositae) in the treatment of 112 cases of angina pectoris. 10 pills were orally administered, 3 times a day. Before the beginning of the treatment, the use of all other anti-angina pectoris drugs was terminated for 5 plasma half-life periods. The results showed that, after 1-2 weeks of treatment, 42 cases had significantly improved, 56 cases had improved slightly, and the remaining 14 cases did not respond to the treatment. (8)
References
- Zhu Guang Qiong, et al. Treating 25 cases of coronary heart disease with Guan Xin II. Sichuan Journal of TCM. 1987;5(10):30.
- Yang Da Guo, et al. Using the method of soothing-liver, regulating-qi, activating-blood and dredging-collaterals to treat 50 cases of angina pectoris. Jilin Journal of TCM. 2000;20(1):23.
- Cao Chuan Ming, et al. Using Yi Qi Fu Mai Tang (Decoction for replenishing qi and restoring pules) to treat 58 cases of senile coronary heart disease with ventricular premature complexes. Journal of Applied TCM. 1999;15(4): 10.
- Geng Jun, et al. Clinical observation on Xue Fu Zhu Yu Tang’s treatment for coronary heart disease. Journal of Pharmacology and Clinical Application of TCM. 1999;15(2):43-44.
- Hu Ye Bin. Treating 20 cases of coronary heart disease complicated with heart failure with modified Zhen Wu Tang. AnHui Journal of Clinical Application of TCM. 1999;11(5):323.
- Li Yu Chao. Treating 28 cases of coronary heart disease with Xiao Xian Xiong Tang. National Journal of Medicine Forum. 1999;14(6):9.
- Feng Yin Xiang. Treating 33 cases of coronary heart disease with Guan Xing Nao. Henan Journal of TCM. 1999;19(1):41.
- Ma Hai Yan, et al. Therapeutic observation on treatment of 112 cases of angina pectoris by Fu Fang Dan Shen Di Wan. Journal of Chinese Materia Medica. 1999;30(50):364-365.
