The pathological region of the disease lies in the heart, but is related to the spleen, stomach, etc. The commonly-seen causes of the disease include internal invasion of pathogenic cold, improper diet, emotional disorder, old age, and weak constitution, etc. It is advisable to nourish yin and promote blood circulation.
1. Syndrome differentiation and treatment
(1) Yin deficiency intermingled with blood stasis
It manifests thoracic oppression and burning pain with intermittent stabbing pain, palpitation, night sweat, soreness of the waist and flaccidity of knees, dizziness, tinnitus, red tongue with a little fur and concurrent ecchymoses, thready and unsmooth pulse. The prescription used is the modified Zuogui Decoction in combination with Danshen Decoction (Red Sage Decoction). In the case of concurrent qi stagnation, add Gualou (Fructus Trichosanthis), Luemei (Flos Mume Albus) and Hehuanhua (Flos Albiziae). More information, please go on reading Myocardial Infarction in TCM.
(2) Yang deficiency intermingled with blood stasis
It manifests thoracic oppression and discomfort, or with oppressed pain, palpitation, short breath, aversion to cold, cold limbs, lumbar soreness, hypodynamia, whitish or cyanotic lips and nails, pale tongue with ecchymoses, deep, thready and unsmooth pulse. It is advisable to warm yang and remove blood stasis. The prescription used is the modified Yougui Decoction (the Kidney Yang-Reinforcing Decoction) in combination with CHD Prescription I. In the case of concurrent phlegm stagnation, add Gualou (Fructus Trichosanthis), Xiebai (Bulbus Allii Macrostemi) and Banxia (Rhizoma Pinelliae) to remove phlegm and blood stasis. More information, please go on reading Causes of Myocardial Infarction in TCM.
(3) Deficiency of qi and yin
It manifests dull and occasional precordial and thoracic pain and oppression, palpitation, short breath, lassitude, disinclination to speak, lustreless complexion, light-headedness worsened by overstrain, relatively red tongue with dental marks, thready and weak or knotted and intermittent pulse. It is advisable to supplement qi, nourish yin, promote blood circulation and dredge collaterals. The prescription used is the modified Shengmai Powder (Pulsation-Promoting Powder) in combination with CHD Prescription II.
2. Rehabilitation methods
(1) Regulating emotions
Use the enlightening method to remove the patients misgivings, inspire their enthusiasm and establish their self-confidence. It is also advisable to adopt the color therapy to make them exposed to the cold color environment. The patients with depression may place the fresh depression-removing flowers indoors. Besides, it is also advisable to combine the above methods with suggestion and behavior therapies.
(2) Recreation therapy
Take part in the recreational activities like appreciating music, calligraphy and painting, raising flowers and birds, visiting a park and fishing to increase joys of life and eliminate adverse emotional reactions. Musically, select the tunes of the musical prescriptions of "tranquilizing the mind" if the patients mainly suffer from anxiety; the tunes of the musical prescriptions of "expressing the emotions and removing depression" if the patients chiefly have depression. More information, please go on reading Symptoms of Myocardial Infarction in TCM.
(3) Physical training
Please refer to the relevant part of "Hypotension". In the case of overfatigue or worsened precordial discomfort after the training, reduce the amount of exercise properly or stop the training for a period of time.
(4) Acumox and massage
Acumox:
In the case of yin deficiency intermingled with blood stasis, select the acupoints of the heart meridian, kidney meridian and gallbladder meridian and conception vessel like Yinxi (HT 6), Shenmen (HT 7), Taixi (KI 3) and Danzhong (CV 17). In the case of vertigo, add Fengchi (GB 20); in the case of tinnitus, add Tinggong (SI 19). It is advisable to use the reinforcing manipulation and reducing manipulation simultaneously. In the case of yang deficiency intermingled with blood stasis, select the Back-Shu acupoints and the acupoints of the triple energizer meridian and pericardium meridian such as Xinshu (BL 15), Jueyinshu (BL 14), Shenshu (BL 23), Neiguan (PC 6) and Tongli (HT 5). Click here to read Arrhythmia in TCM.
In the case of lumbar soreness, add Mingmen (GV 4); in the case of aversion to cold and cold limbs, add Guanyuan (CV 4). It is advisable to use the reinforcing method and reducing method simultaneously. Besides, add moxibustion. In the case of deficiency of qi and yin, select Back-Shu acupoints and the acupoints of the heart meridian and spleen meridian like Xinshu (BL 15), Pishu (BL 20), Geshu (BL 17), Shenmen (HT 7) and Sanyinjiao (SP 6). In the case of short breath, add Qihai (CV 6). Mter acupuncture, add moxibustion. In the case of concurrent phlegm obstruction or qi stagnation, add Fenglong (ST 40) or Ganshu (BL 18). Click here to read Chinese medicine Treatment for Arrhythmia.
Ear acupuncture:
As for the ear acupuncture therapy, mainly select Xin, Xiaochang (MA-SC 2), Jiaogan (MA-AH 7) and Pizhixia (MA-AT 1), with the auxiliary selection of Naodian, Gan (MA-SC 5), Fei (MA-IC 1), Xiong (MA-AH 11), Jiangyagou, Xingfendian and Zhen. Select three to five acupoints each time and retain the needle for an hour once every other day. Two weeks constitute one course of treatment. Click here to read Causes of Rheumatic Heart Disease in TCM.
Massage:
In the case of yin deficiency intermingled with blood stasis, it is advisable to select Shenshu (BL 23), Ganshu (BL 18), Xinshu (BL 18), Sanyinjiao (SP 6) and Taixi (KI 3) and needle them with the pushing, kneading and pressing manipulations; in the case of yang deficiency intermingled with blood stasis, select Mingmen (GV 4), Pishu (BL 20), Xinshu (BL 18), and Neiguan (PC 6) and needle them with the pressing-kneading manipulation and the additional scrubbing method on Shenshu (BL 23), Dachangshu (BL 25) and Mingmen (GV 4); in the case of deficiency of qi and yin, add Zusanli (ST 36) and Qihai (CV 6) on the basis of the acupoints in case of yin deficiency intermingled with blood stasis. As for the patients who lie in bed for a long time, massage the whole body properly to dredge the general blood vessels, prevent venous thrombosis and bed sore. Click here to read Chinese medicine Treatment for Rheumatic Heart Disease.
(5) Dietary therapy
In the case of yin deficiency intermingled with blood stasis, select the combined use of Yuzhu Gruel (Gruel of Rhizoma Polygonati Odorati) with Shanzha Gruel (Gruel of Fructus Grataegi); in the case of yang deficiency intermingled with blood stasis, select the combined use of Xiebai Gruel (Gruel of Bulbus Allii Macrostemi) with Taoren Gruel (Gruel of Semen Persicae) ; in the case of deficiency of qi and yin, select the combined use of Renshen Gruel (Gruel of Radix Ginseng) with Baihe Gruel (Gruel of Bulbus Lily). More information, please go on reading TCM Diagnosis for Myocardial Infarction.
(6) External therapy
Make the small plaster weighing 1.5 g each with Jianghuang (Rhizoma Curcumae Longae), Wutou (Radix Aconiti) , Xuejie (Resina Draconis) , Hujiao (Fructus Piperis Nigri seu Albi), Sanqi (Radix Notoginseng), Guizhi (Ramulus Cinnamomi), Shexiang (Moschus), Chuanxiong (Rhizoma Ligustic Chuanxiong) and Xiebai (Bulbus Allii Macro ) respectively according to the ratios of l0 : 5 : 5 : 1 : 3 : 5 : 0.1 :5 : 10. Apply the plaster on Xinshu (BL 15) and Danzhong (CV 17) once every other day. Fifteen times constitute one course of treatment. It is also advisable to apply the Tongxin plaster.
(7) Nursing in daily life
The patients should prevent cold and keep the body warm at usual times. They should be more careful when getting up in the morning or going to WC at night in the very cold winter. Do not hold breathing or strain too much during defecation. In the case of constipation, it is advisable to take proper cathartics. More information, please go on reading Chinese medicine Treatment for Myocardial Infarction.