Pectoral Pain & Stuffiness TCM Diagnoses and Treatments Obstruction of Qi & blood in the chest. Main Symptoms: Chest & back pain, short breathing, asthma, even disability to lie down In mile case: Feels chest pain & breath with difficult In more serious case: chest pain & palpitation, pericardial pain, back pain, cold limbs Organs: Heart & Lung Western medicine disease related: coronary; atherosclerotic cardiopathy; angina pectoris, myocardiac infarction, pericarditis Etiology & Pathology:

A) Def. & Excess Main Points for differentiation Most case: includes both Def. : Ht. Qi, Ht. Blood, Ht. Yang, Sp & kid yang, Liv. & Kid Yin, Excess: Qi Stag. , Blood stasis, phlegm, cold heat B) Properties of pain 1) Oppressive Pain 2) Stabbing pain 3) Burning pain 4) Colick or twisting pain 5) Dull pain

Pectoral pain & stuffiness Stomach-ache Chest pain Location Left chest pain spreading to back Stomach area Not in the left chest Other sym. Palpitating, short breathing, difficult to lie down Belching, acid regurgitation, fullness or distention of abdomen, related to diet Usually caused by tuberculosis cough, asthma, cold & heat

Treating the superficiality first & the origin second Main Points for therapeutic Principles Treating the superficiality first & the origin second But: if superficiality is not severe & origin has been def. already, should treat by both reinforcement & resolving

Treatment 1). Heart blood stag. Signs & Symptoms: Main Sym. : Stabbing pain in the chest, fixed, worse at night Concurrent sym.: palpitating, restlessness, oppression in the chest, feel comfortable after massage Tongue: dark purple Pulse: deep & uneven Treatment Protocol: Prompting blood circulation Remove blood stasis & stop pain

Modifications: Chest Pain -- Jiang Xiang, San Qi, Yu Jing, Yan Hu So Formula: Modifications: Chest Pain -- Jiang Xiang, San Qi, Yu Jing, Yan Hu So Oppressed feeling -- Xuan Fu Hua, Gua Lou Pi, Qing Pi, Sha Ren Palpitation -- Long Gu, Mu Li, Dai Zhe Shi Xue Fu Zhu Yu Tang Dang Gui Sheng Di Tao Ren Hong Hua Zhi Ke Cai Hu Gan Cao Niu Xi Chi Shao Chuan xiong

2) Phlegm accumulate in the chest Treatment 2) Phlegm accumulate in the chest Signs & Symptoms: Main Sym. : Oppressed & asphyxia feeling & pain in the chest, pain sometime spreading to shoulder & back Concurrent sym.: obesity, excessive sputum, fullness feeling in St. Tongue: Mucous & greasy coating Pulse: slippery Treatment Protocol: Activating Yang to eliminate phlegm Relieving Stag.

Gua Lou Xie Bai Ban Xia Tang Formula: Modifications: Smooth Qi to relieve phlegm -- Su Zi, Su Geng, Zhi ke, Chen Pi, Fu Ling Fullness in the St. nausea, no appetite, bitter taste -- Huang Lian Weng Dan Tang Gua Lou Xie Bai Ban Xia Tang Gua Lou Xie Bai Ban Xia

Treatment 3) Cold Accumulation Signs & Symptoms: Main Sym. : Chest pain spreading to back, worse by cold, onset after infect by cold Concurrent sym.: oppressed feeling in the chest, short breathing, palpitation, asthma in severe case, disable to lie down, pale complexion, cold limbs. Tongue: white coating Pulse: deep thready & tense Treatment Protocol: Warm up Yang to release cold Stop pain

Gua Lou Xie Bai Bai JiuTang Formula: Modifications: Warm Upper Jiao & move Qi -- Tan Xiang Move Heart Blood -- Dan Sheng Move Stag. Qi -- Zhi Shi Cough with abundant sputum -- Sheng Jiang, Ju Pi, Fu Ling, Xin Ren Severe cold symptom -- Fu Zi, Wu Tou, Rou Gui, Gan Jiang, Shu Jiao Gua Lou Xie Bai Bai JiuTang Gua Lou Xie Bai Bai Jiu

Treatment 4) Kid. & heart Yin Def. Signs & Symptoms: Main Sym. : Dull pain in the chest Concurrent sym.: palpitation, night sweating, restlessness, sleeplessness, sore lower back, weakness of knee joints, dizziness, tinnitus Tongue: red thin body, less coating Pulse: thready & rapid Treatment Protocol: Nourish Yin & tonify Kid. Nourish heart to calm down the mind

Modifications: Tonify Kid Yin: Formula: Modifications: Tonify Kid Yin: -- Nu Zheng Zi, Han Lian Cao, Tian Dong, Mai Dong, Tonify Ht. blood: -- Dan Shen, Wu wei zi Restlessness: -- Dan Pi, Ze Xie, Mai dong, Wu wei zi, Bo zi ren, suan zhao ren Dizziness due to empty fire goes up -- Shou Wu, Gou Teng, Shi Jue Ming, Sheng Mu Li Oppressed feeling in chest & pain -- dang gui, Dan Shen, Chuan Xiong, Yu Jing Zuo Gui Yin Shu Di Shan Yu rou San Yao Gou Qi Zi Fu Ling Gan Cao

Treatment 5) Qi & Yin Def. Signs & Symptoms: Main Sym. : Oppressed feeling & dull pain in chest Concurrent sym.: palpitation, short breathing, lassitude, don’t want to talk, dim complexion, dizziness, constipation or loose stools Tongue: light red body with or without teeth mark Pulse: thready & weak or knotted & intermittent Treatment Protocol: Nourish Qi & Yin Prompting blood circulation & open the channels

ren shen, mai dong, wu wei zi Formula: Modifications: tonify Yin: ren shen, mai dong, wu wei zi Ren shen yang rong Tang Ren shen Gan cao Dang gui Bai shao Shu di Rou gui Da zhao Huang qi Bai zhu Fu ling Wu weizi Yuan zhi

Treatment 6) Yang Qi Def. Signs & Symptoms: Main Sym. : Oppressed feeling & dull pain in chest, getting worse by cold attacking Concurrent sym.: palpitation, short breathing, cold limbs pain or sore on lower back or knee joints, pale complexion Tongue: light whitish or dark purple body Pulse: thready & deep Treatment Protocol: Warm yang Qi Prompting blood circulation

Modifications: Yin def. -- Mai dong, wu wei zi Formula: Modifications: Yin def. -- Mai dong, wu wei zi Kid yang def. cause water accumulation in the chest -- Zhen Wu Tang You Gui Yin Shu di Tu Si Zi Rou Gui Wu Wei Zi Lu Rong Gan cao Shen Fu Tang Ren shen Fu zi