Traditional Chinese Medicine (TCM) Approach to Coronary Heart Disease: Theoretical Research, Treatment Strategies, and Drug Recommendations

Introduction
Coronary heart disease (CHD), a leading cause of cardiovascular mortality, is addressed in Traditional Chinese Medicine (TCM) through a holistic framework that emphasizes balancing Qi, blood, and internal organs. TCM offers complementary therapies to modern medicine by targeting the root causes of CHD, such as Qi stagnation, blood stasis, and phlegm-dampness obstruction. This article explores TCM’s theoretical insights, treatment modalities, and a broader range of recommended medications for CHD.

Theoretical Research
In TCM, CHD is classified under "chest obstruction" (Xiong Bi) or "heart vessel stagnation." Its pathogenesis is linked to:

  1. Qi Stagnation and Blood Stasis: Emotional distress or physical strain disrupts Qi flow, leading to blood stasis in coronary vessels.
  2. Phlegm-Dampness Obstruction: Poor diet or weakened spleen function generates phlegm-dampness, blocking heart meridians.
  3. Yang Deficiency and Cold Coagulation: Weakened kidney or heart Yang allows cold pathogens to invade, constricting vessels.
  4. Qi-Yin Deficiency: Chronic illness depletes Qi and Yin, resulting in palpitations and fatigue.

Treatment Strategies
TCM employs a multi-pronged approach combining herbal medicine, acupuncture, and lifestyle adjustments:

  1. Herbal Therapy
    • Formula Selection: Tailored to syndrome differentiation (e.g., Blood Stasis, Phlegm-Dampness).
    • Key Herbs:
      • Dan Shen (Salvia miltiorrhiza): Activates blood circulation.
      • Hong Hua (Carthamus tinctorius): Enhances blood flow.
      • Ren Shen (Panax ginseng): Tonifies Qi and strengthens the heart.
  2. Acupuncture
    • Primary Points:
      • Neiguan (PC6): Regulates heart Qi.
      • Xinshu (BL15): Strengthens heart function.
      • Zusanli (ST36): Boosts Qi and improves digestion.
  3. Lifestyle Modifications
    • Diet: Avoid greasy/spicy foods; consume heart-nourishing foods (e.g., jujube).
    • Exercise: Gentle practices like Tai Chi.
    • Emotional Balance: Meditation or Qigong to manage stress.

Recommended TCM Medications
TCM offers a diverse array of medications for CHD. Below are 10 widely used options, categorized by efficacy and clinical application:

  1. Fufang Danshen Tablets (复方丹参片)
    • Ingredients: Dan Shen, San Qi, Bing Pian.
    • Actions: Activates blood, resolves stasis, alleviates pain.
    • Indications: Angina pectoris, chest tightness due to blood stasis.
  2. Shexiang Baoxin Pill (麝香保心丸)
    • Ingredients: She Xiang, Ren Shen, Su He Xiang.
    • Actions: Warms the heart, activates Qi, relieves pain.
    • Indications: Acute chest pain from cold coagulation.
  3. Tongxinluo Capsule (通心络胶囊)
    • Ingredients: Ren Shen, Shui Zhi, Quan Xie.
    • Actions: Tonifies Qi, unblocks meridians, prevents thrombosis.
    • Indications: Post-MI recovery, microvascular angina.
  4. Xuefu Zhuyu Capsule (血府逐瘀胶囊)
    • Ingredients: Tao Ren, Hong Hua, Dang Gui.
    • Actions: Activates blood, resolves stasis.
    • Indications: Chronic chest pain, hypertension.
  5. Wenxin Keli (稳心颗粒)
    • Ingredients: Dang Shen, San Qi, Hu Po.
    • Actions: Tonifies Qi, nourishes Yin, stabilizes heart rhythm.
    • Indications: Palpitations, arrhythmia, fatigue.
  6. Xinkeshu Capsule (心可舒胶囊)
    • Ingredients: Dan Shen, Ge Gen, San Qi.
    • Actions: Activates blood, lowers blood pressure.
    • Indications: Hypertension-associated chest pain.
  7. Guanxin Suhe Wan (冠心苏合丸)
    • Ingredients: Su He Xiang, Bing Pian, Ru Xiang.
    • Actions: Warms meridians, disperses cold.
    • Indications: Cold-induced chest pain, shortness of breath.
  8. Shensong Yangxin Capsule (参松养心胶囊)
    • Ingredients: Ren Shen, Mai Dong, Wu Wei Zi.
    • Actions: Tonifies Qi, nourishes Yin, calms the heart.
    • Indications: Palpitations, insomnia,心悸.
  9. Qili Qiangxin Capsule (芪苈强心胶囊)
    • Ingredients: Huang Qi, Ren Shen, Fu Zi.
    • Actions: Replenishes Qi, warms Yang, reduces edema.
    • Indications: Chronic heart failure with Yang deficiency.
  10. Buxinqi Oral Liquid (补心气口服液)
    • Ingredients: Huang Qi, Ren Shen, Shi Chang Pu.
    • Actions: Tonifies heart   Qi, relieves pain.
    • Indications: Fatigue, dizziness, heart pain due to Qi deficiency.

Conclusion
TCM provides a distinctive paradigm for managing CHD by addressing both symptoms and underlying imbalances. Integrative approaches combining TCM herbs, acupuncture, and Western medicine may enhance outcomes, though close monitoring by qualified practitioners is essential. Patients should consult healthcare providers before initiating TCM therapies to ensure safety and compatibility with conventional treatments.

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