🌿 Folk Prescriptions

Coronary heart disease angina is a common and increasingly prevalent clinical condition, posing a growing threat to human health. While modern medicine offers effective drugs to relieve angina, recurrence is common, and correcting ECG ischemic changes often proves unsatisfactory. Recently, we adopted Yiqi Huoxue Tongmai Tang (Tonifying Qi, Activating Blood, and Unblocking Meridians Decoction) for this condition, achieving remarkable results.
Formula Composition: *Astragalus* 30g, *Ginseng* 15g, *Salvia Miltiorrhiza* 30g, *Ligusticum Chuanxiong* 10g, *Angelica Sinensis* 10g, *Paeoniae Rubra* 15g, *Carthamus Tinctorius* 10g, *Persicae Semen* 10g, *Panax Notoginseng* 6g, *Trichosanthes Kirilowii Root* 10g, *Allium Fistulosum* 10g, *Curcuma Aromatica* 15g, *Rehmanniae Praeparata* 15g, *Bupleuri Radix* 10g, *Honey-Fried Glycyrrhizae Radix* 6g. One dose daily, decocted and taken in two doses.
Typical Case
Mr. Yang, male, 58 years old, cadre, visited in October 2002. Chief complaint: recurrent substernal dull pain and shortness of breath for one year, worsened over the past week. Recently, after overwork, he felt intermittent dull pain in the precordial area during work, radiating to the left shoulder and back, occurring 2–3 times daily, lasting 1–3 minutes each time. Accompanied by chest tightness, shortness of breath, dyspnea on exertion, palpitations, fatigue, pale complexion, cold sweats, dark purple tongue with ecchymoses, cyanotic sublingual veins, fine, wiry, or irregular pulse. Electrocardiogram during attacks showed: horizontal ST segment depression of 0.1–0.2 mV in leads V1–V3, inverted T waves in lead aVF, flattened T waves in leads V1–V3. Echocardiography revealed coronary heart disease changes. Lipid profile showed elevated cholesterol, triglycerides, and β-lipoprotein. Western diagnosis: coronary heart disease, stable effort-induced angina. TCM diagnosis: Chest Obstruction (Xiong Bi), pattern: Heart Qi deficiency with blood stasis obstructing the vessels. Treated with Yiqi Huoxue Tongmai Tang, one dose daily, divided into two servings. After one week, angina largely resolved. ECG showed: T wave inversion in aVF became shallower; ST segment depression in V1–V3 returned to normal. After three weeks, symptoms disappeared; repeat ECG was nearly normal; lipid profile normalized.
Discussion
Coronary heart disease and angina fall under the TCM categories of "Xiong Bi" and "Zhen Xin Tong." The etiology and pathogenesis relate to Qi deficiency and blood stasis. Traditional Chinese medicine holds that Qi and blood are fundamental substances. Qi governs blood; when Qi moves, blood flows. Qi deficiency leads to weak blood. Overwork damages Heart Qi, weakening the Heart Yang, reducing blood propulsion force, causing blood stagnation in the Heart vessels. The lesion site is the Heart, mostly a condition of deficiency with excess manifestations. Thus, treating the symptom focuses on "unblocking," while treating the root requires "tonifying." Commonly used methods include tonifying Qi, activating blood, removing stasis, and unblocking collaterals.
The formula uses *Astragalus*—sweet, warm, pure Yang—exceling at tonifying Qi deficiency. Modern pharmacological studies show *Astragalus* enhances myocardial contractility, improves cardiac function, reduces blood viscosity, and improves microcirculation. *Ginseng* greatly replenishes primordial Qi, calms the spirit, and nourishes blood; paired with *Astragalus*, it enhances Qi-tonifying effects. *Salvia Miltiorrhiza* acts similarly to the Four Substances Decoction, uniquely capable of both activating blood and nourishing blood. It improves oxygen tolerance, enhances microcirculation, inhibits platelet aggregation, promotes fibrinolysis, and reduces blood viscosity. *Ligusticum Chuanxiong*, pungent and warm, promotes Qi movement, relieves depression, activates blood, and relieves pain. Pharmacological studies indicate it inhibits vascular smooth muscle contraction, increases coronary blood flow, and improves myocardial ischemia. *Carthamus Tinctorius* activates blood and removes stasis, opens collateral vessels. Research shows it moderately increases coronary flow, lowers serum total cholesterol, triglycerides, and lipids, improves microcirculation, prevents thrombosis, and promotes its dissolution. Combined with *Bupleuri Radix*, it facilitates Qi movement, opens the chest, and warms the Yang. *Rehmanniae Praeparata*—as recorded in *Shen Nong Ben Cao Jing*—"expels blood stasis, cools blood, and eliminates stasis," while also nourishing Yin and moistening dry blood.