🌿 Folk Prescriptions

Heart failure is a critical condition, corresponding to "palpitation," "dyspnea," and "edema" in traditional Chinese medicine. These three cases involved patients with heart disease who showed poor response to comprehensive Western medicine treatment. Thus, we adopted a method combining traditional Chinese medicine, imitating Zhang Zhongjing’s "disease-syndrome integration" and "pulse-symptom correlation" approach, resulting in excellent outcomes.
The first case was a rheumatic heart disease patient with heart failure, complicated by cardiogenic liver cirrhosis and atrial fibrillation. After 26 days of initial treatment, symptoms persisted. Dr. Guo Shikui was consulted. Based on symptoms including palpitations, insomnia, shortness of breath, reduced urination, edema, loose stools, hepatosplenomegaly, white greasy tongue coating, and intermittent pulse, the diagnosis was qi-yin deficiency with spleen yang deficiency. Treatment used Qi-Nourishing and Yin-Nourishing plus Spleen-Strengthening and Dampness-Removing methods. Formula: Shengmai Yin combined with Yinchen Wuling San with modifications: Codonopsis pilosula 24g, Ophiopogon japonicus 15g, Schisandra chinensis 10g, Yinchen 24g, Poria 20g, Cinnamon twig 12g, Poria 10g, Alisma 12g, Amber 3g (mixed), decocted and taken once daily. After five doses, symptoms improved; after 15 doses, condition stabilized, edema disappeared, cough and dyspnea reduced, allowing ambulation. Continued modification of the formula for over 70 days, then noted obvious stasis signs, so switched to Qi-Nourishing and Yin-Nourishing plus Blood-Activating and Stasis-Resolving therapy using Shengmai Yin combined with Xuefu Zhuyu Tang with modifications. Condition remained stable. Later, due to severe complications such as infection, the patient succumbed. This case of rheumatic heart failure, treated with TCM syndrome differentiation and formula modification, achieved stabilization for over six months—possibly due to enhanced cardiac contractility, improved myocardial ischemia, and oxygenation.
Case two involved a patient with pulmonary heart disease complicated by coronary heart disease, who failed to improve after over two months of comprehensive Western medicine treatment. Symptoms included inability to lie flat due to cough and dyspnea, abdominal distension, constipation, dark yellow urine, yellow greasy tongue coating, widespread wet rales in both lungs, and lower limb edema. Based on the concept of lung and large intestine being exterior-interior partners, Da Chaihu Tang combined with Gan Mai Da Zao Tang with modifications was used to purge the yangming fu-organ: Bupleurum chinense 12g, Citrus aurantium 12g, Rheum palmatum 10g, Scutellaria baicalensis 12g, Pinellia ternata 15g, Jujube 5 pieces, Floating Wheat 30g, Red Peony root 20g, Magnolia bark 12g, decocted once daily. After four doses, symptoms improved with bowel movement, mental clarity, and ability to walk. ECG also improved. Switched to Consolidate Cough and Asthma Tablets and Coronary Heart Two Tablets for maintenance. After discharge, the condition remained stable for three years. Pulmonary heart disease with coronary heart disease often presents as deficiency with excess, but whenever there are indications for purgation, downward elimination is permissible. Given the complex mixture of deficiency and excess, acute cases should treat the symptoms first; chronic cases should support the root and consolidate the foundation.
Case three was a hypertensive heart disease patient with coronary heart disease and angina pectoris. Symptoms included palpitations, chest pain radiating to the back, cold extremities, thin yellow coating, intermittent pulse, wet rales in both lungs, heart rate 125 beats/min, ECG showing ST-T changes, atrial fibrillation, arrhythmia. Despite comprehensive Western medicine treatment, results were suboptimal. Thus, Chinese medicine was added using Qi-Nourishing and Yin-Nourishing plus Blood-Activating and Stasis-Resolving therapy. Formula: Zhi Gancao Tang combined with Guallu Xiebai Banxia Tang with modifications: Fried Glycyrrhiza 10g, Codonopsis pilosula 15g, Ginger 6g, Ophiopogon japonicus 15g, Raw Rehmannia glutinosa 12g, Cinnamon twig 10g, Donkey-hide gelatin 10g (melted), Trichosanthes 30g, Allium macrostemon 10g, Pinellia ternata 15g, Corydalis yanhusuo 10g, Citrus reticulata 12g, Salvia miltiorrhiza 30g, decocted once daily. After four doses, symptoms improved; after 14 additional doses, only headache and dizziness remained. ECG ST-T changes normalized. Continue modifying the formula. One month later, blood pressure rose to 150/94mmHg, triggering angina recurrence. Again applied Qi-Nourishing and Yin-Nourishing plus Blood-Activating and Stasis-Resolving therapy, switching to Shengmai Yin combined with Xuefu Zhuyu Tang with modifications. After seven doses, symptoms improved. This patient had previously undergone comprehensive treatment elsewhere with poor results. Using TCM syndrome differentiation and adapting formulas from Zhang Zhongjing’s Zhi Gancao Tang and Guallu Xiebai Banxia Tang yielded excellent results.
Zhang Zhongjing’s approach—using disease as the framework and syndrome as the focus, integrating disease and syndrome, correlating pulse and symptoms, closely linking differentiation and treatment—is the fundamental method for treating various syndromes and the core for inheriting and promoting his medical theories.