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[Introduction]
Coronary heart disease is a kind of heart disease due to myocardial ischemia and hypoxia resulting from coro-nary atherosclerosis. The clinical manifestations are angi-na pectoris, myocardiac infarction, arrhythmia, heart failure and cardiectasis. The electrocardiogram may indi-cate myocardial ischemia or corresponding changes. Coro-nary heart disease is one of the commonly encountered heart vessel diseases among the middle aged and old people. It is similar to chest obstructive syndrome, angina pectoris and precordial pain in TCM. The occurrence of coronary heart disease is usually related to aging, weak-ness, improper diet and emotional factors that often lead to inactivation of chest yang, stagnation of cold and phlegm in the collaterals as well as qi stagnation and blood stasis.
[Syndrome differentiation]
1. Cold coagulation in the heart vessels
Attack of angina pectoris due to cold, pain in the heart radiating to the back, cold sensation in the body and aversion to cold, cold sweating, palpitation and shortness of breath, light-colored tongue with thin and white fur, taut and tense pulse.
2. Obstruction of phlegm
Pain and oppression in the chest, heaviness of limbs, shortness of breath and dyspnea, obesity, profuse phlegm, light-colored tongue with thick, white and greasy fur, taut and slippery pulse.
3. Stagnation of blood stasis in the collaterals
Fixed stabbing pain in the chest, aggravation of pain in the night, chest oppression and shortness of breath, palpitation, purplish tongue or tongue with ecchymoses, thin and unsmooth pulse.
4. Asthenia of both the heart and spleen
Oppression and dull pain in the chest, dizziness, am-nesia and insomnia, poor appetite, lassitude, lusterless complexion, light-colored tongue with thin and white fur, thin and weak pulse or slow pulse with irregular intervals and slow regular intermittent pulse.
5. Asthenia of heart and kidney yang
Oppression in the chest, palpitation and shortness of breath, spontaneous sweating, scanty urine and edema, light-colored tongue with thin and white fur, weak and thin pulse or slow pulse with irregular intervals and slow regular intermittent pulse.
[Treatment]
1. Body acupuncture
Prescription: Xinshu (BL 15), Juque (CV 14), Tanzhong (CV 17), Neiguan (PC 6) and Ximen (PC 4).
Modification. For coagulation of cold in the heart vessels, Guanyuan (CV 4) and Qihai (CV 6) are added; for obstruction by phlegm and turbid substance, Fenglong (ST 40) and Taiyuan (LU 9) are added; for retention of blood stasis in the collaterals, Geshu (BL 17) and Xuehai (SP 10) are added; for asthenia of the heart and spleen, Pishu (BL 20 ) and Sanyinjiao ( SP 6 ) are added; for asthenia of heart and kidney yang, Shenshu (BL 23) and Zusanli (ST 36) are added; for cold sensation in the body,aversion to cold and cold limbs, Shenque (CV 8) is added; for susceptibility to fright, Shenmen (HT 7) is added; for scanty urine and edema, Yinlingquan (SP 9) is added.
Performance: Juque (CV 14) is needled obliquely downward 0.5 - 1 cun. Tanzhong ( CV 17) is needled 1 curl obliquely toward the left breast root. The needles are retained for 30 minutes and manipulated at intervals. For severe cases, the retention of needles may be pro-longed for one or several hours. Back-Shu, Front-Mu acu-points and Qihai (CV 6), Guanyuan (CV 4), Shenque (CV 8) and Zusanli (ST 36) can be moxibusted after needling.
2. Ear acupuncture
Prescription: Heart (C015), Kidney (CO10), Spleen (C013), Sympathetic (AH
Performance: Each time 3 - 5 acupoints are selected. In the stage of attack, filiform needles are used with strong stimulation and retained for 30 60 minutes. The needles are manipulated once every 5 - 10 minutes. In the remission stage, filiform needles are used with mild stim-ulation, retained for 30 minutes and manipulated once every 10 minutes. Or Wangbuliuxingzi (Semen Vaccariae) is used for ear pressure.
