Professor Wang Zhentao’s sharing of typical cases in the diagnosis and treatment of chest pain and heart pain (380)

General:LiXX, female, 72 years old, retired worker, from Zhengzhou. No history of drug allergy was found. 2018year06month15day.

Complaint: span>Paroxysmal palpitations and shortness of breath for more than 20 years, aggravating for 15 days.

History of present illness: 10 years ago with palpitations, Shortness of breath, diagnosed as “coronary heart disease“, usually take Qili Qiangxin Capsule, Baoxin Pill, Qu Metazidine, Irbesartan, etc. There are still palpitations, shortness of breath, paroxysmal, aggravated after activity, accompanied by dizziness, edema of both lower extremities, sleeplessness, normal urination, and loose stools. Past hypertension 30years, hyperlipidemia30years. Pale red tongue, thin white fur, thin pulse.

Traditional Chinese Medicine Diagnosis: chest pain disease

Syndromes:Heart and Kidney Yang Deficiency Syndrome

Treatment: span>Benefits the heart and kidney

Preliminary prescription:

Two June 29, 2018 After taking the medicine, palpitations and shortness of breath improved compared with before, fear of cold in the epigastric area, easy diarrhea after cold, pitting edema of both lower extremities, irritability, headache, occasional Nausea, poor appetite, poor sleep, difficulty falling asleep, less urination, loose stools, red tongue, thin white coating, deep and thin pulse.

Treatment:On June 15, Fang Chao Atractylodes was changed to 24g and added Ginger 12g, psoralen 20g, tuckahoe 30g. 10 Chinese medicines, one dose per day, decoct in water.

Note:Coronary heart disease belongs to “chest paralysis” in traditional Chinese medicine , “palpitations” and other categories. Heart failure is a common complication of coronary heart disease, which belongs to the categories of “palpitations”, “chest pain” and “edema” in traditional Chinese medicine. At the time of probation, attention should be paid to examining the actual and virtual changes of the pathogenesis, each with its own emphasis. The patient in this case is very old and has a long course of disease. The so-called “prolonged illness must be deficient”. Although the tongue sees purple and dark, his palpitations, shortness of breath, dizziness, and lower extremity edema are all manifestations of heart and kidney deficiency and yang deficiency and flooding. When the treatment method is to warm the heart and kidney, diuresis and dampness, the prescription is the addition and subtraction of Wuling Powder. In the recipe, Poria, Alisma, Polyporus diuresis diuresis dampness and swelling, cinnamon twig and cinnamon tonify Yang and transform Qi, Poria, stir-fried Atractylodes to strengthen the spleen and dry dampness. “Compendium of Materia Medica”:“Aconite is the main medicine of the gate of life. It can be recruited into its caves, and the fire will return to its original state.” Gong, astragalus and five-clawed dragon to invigorate the spleen, replenish qi, solidify the surface, diuresis and reduce swelling, white peony root nourishes yin, to control the disadvantages of dampness, tea tree root clears heat and activates blood, Huixin grass soothes the nerves and calms the mind, myrobalan and gorgon fruit astringent intestines and stop diarrhea , Gu Ya strengthens the spleen and stomach, and licorice harmonizes various medicines. During the second consultation, the patient complained of chills, adding ginger to help yang to disperse cold, psoralen to tonify spleen and kidney yang, and adding tuckahoe to enhance the power of diuresis and swelling in the front.