CN114848775B

CN114848775B - Traditional Chinese medicine composition for treating acute myocardial infarction as well as traditional Chinese medicine preparation and application thereof

Info

Publication number: CN114848775B
Application number: CN202210358477.1A
Authority: CN
Inventors: 李军; 汪燕红; 谭雨晴; 武佶; 王雪娇; 杨春昆; 邵祯
Original assignee: Guanganmen Hospital of CACMS
Current assignee: Guanganmen Hospital of CACMS
Priority date: 2022-04-07
Filing date: 2022-04-07
Publication date: 2023-09-05
Anticipated expiration: 2042-04-07
Also published as: CN114848775A

Abstract

The invention discloses a traditional Chinese medicine composition for treating acute myocardial infarction, a traditional Chinese medicine preparation and application thereof. The traditional Chinese medicine composition is prepared from the following raw materials in parts by weight: 9-30 parts of astragalus membranaceus, 6-12 parts of bighead atractylodes rhizome, 5-10 parts of allium macrostemon, 9-15 parts of snakegourd fruit, 3-9 parts of pinellia ternate, 3-10 parts of cassia twig, 10-20 parts of poria cocos, 6-12 parts of Chinese angelica, 9-15 parts of radix scrophulariae, 6-15 parts of honeysuckle, 3-10 parts of turmeric, 3-15 parts of rheum officinale, 5-10 parts of stiff silkworm, 3-10 parts of immature bitter orange and 2-10 parts of liquorice. Through the selection of raw materials and the control of raw material additives, the traditional Chinese medicine composition has strict formula, can well treat acute myocardial infarction, has the effects of tonifying qi, activating blood, clearing heat, resolving phlegm, releasing arthralgia and relieving pain, can particularly improve symptoms and signs of acute myocardial infarction including chest stuffiness and pain, heart pain, back, pale or purple tongue with tooth marks, thin or greasy tongue coating, sublingual vein tortuosity, wiry or astringent pulse, thin, rapid pulse and the like, and can well make up the deficiency of western medicines.

Description

Traditional Chinese medicine composition for treating acute myocardial infarction as well as traditional Chinese medicine preparation and application thereof

Technical Field

The invention relates to the technical field of traditional Chinese medicines. More particularly relates to a traditional Chinese medicine composition for treating acute myocardial infarction, a traditional Chinese medicine preparation and application thereof.

Background

Acute myocardial infarction refers to the necrosis of myocardial cells caused by acute ischemia, which is caused by acute reduction or complete interruption of coronary blood supply and causes severe and persistent acute ischemia of corresponding cardiac muscle. Acute myocardial infarction refers to the period from the onset of acute myocardial infarction to 14 days after intervention and revascularization. The key of the treatment is that the early rapid open infarction related coronary artery is subjected to reperfusion treatment, and the reperfusion treatment mainly comprises drug treatment, percutaneous coronary intervention treatment and coronary artery bypass grafting. The incidence rate of acute myocardial infarction in China is high, the reperfusion therapy proportion of hospitals at all levels is low, the time from onset to reperfusion therapy is long, and prognosis is worse. How to fully utilize the existing research results of traditional Chinese medicine and western medicine, effectively control the incidence of AMI in China, improve the overall treatment level, reduce complications, improve prognosis, and lighten social burden, and becomes a difficult problem which must be solved by Chinese doctors. The acute phase of myocardial infarction can be classified as heart disease, heart arthralgia, syncope and heart pain, chest stuffiness and pain, heart pain or true heart pain in traditional Chinese medicine. Treatise on the preparation of primordial and visceral qi methods: the clinical manifestations of myocardial infarction (or angina pectoris) are clearly recorded in the heart disease patients, chest pain, hypochondriac fullness, pain in the back and shoulder, pain in the arms and the back and the nails. In "Su-Bao Lun: the clinical manifestations of heart failure are recorded in the heart arthralgia syndrome, with the symptoms of pulse obstruction, vexation, heart-lower-drum, sudden upward of qi and dyspnea. "Lingqiang-syncope disease" in: the patients with severe symptoms are indicated for bad prognosis due to the' real heart pain, green hands and feet to joints, severe heart pain, and premature death. The Chinese and Zhang Zhongjing, the treatment of the short qi disease and pulse syndrome of the chest stuffiness and heart pain, is more comprehensive discussion on the chest stuffiness and heart pain, establishes the basic pathogenesis of the yang and yin chord, and creates prescriptions such as ginseng decoction, aconite root Dan Zhiwan, snakegourd fruit and allium macrostemon white wine decoction, snakegourd fruit and allium macrostemon and pinellia tuber decoction and the like aiming at different pathogenesis. The method of activating blood and dissolving stasis is applied to the treatment of chest stuffiness and pain, and the books of Taiping Sheng Hui Fang and Sheng Ji Zong Lu and the like are loaded with a plurality of prescriptions for treating chest stuffiness and pain by the method of activating blood and dissolving stasis.

Clinically, the symptoms of heart-qi deficiency or deficiency of both qi and yin are marked by shortness of breath, spontaneous perspiration, palpitation, listlessness, pale complexion, low and slight voice, etc., and the lips are purple and dark, the tongue is purple or has ecchymosis, and the pulse is weak or astringent, and the pulse is knotted. As mentioned above, in the acute stage, the phlegm, blood stasis, heat and toxin are excessive, and the treatment should be to replenish qi, activate blood, regulate pulse and relieve pain, so that the patient is free from pain. Although new western medicines which are continuously developed are applied to the treatment of clinical acute myocardial infarction, the truly satisfactory effect still cannot be achieved. Therefore, research on a traditional Chinese medicine composition for treating acute myocardial infarction has very important significance in effectively interfering the occurrence of adverse events of acute myocardial infarction, relieving clinical symptoms, improving survival quality and the like.

Disclosure of Invention

Based on the above drawbacks, a first object of the present invention is to provide a traditional Chinese medicine composition for treating acute myocardial infarction. The traditional Chinese medicine composition can well treat acute myocardial infarction, can benefit qi and activate blood, clear heat and resolve phlegm, and disperse arthralgia and relieve pain, can particularly improve symptoms and signs of acute myocardial infarction including chest stuffiness and pain, heart pain with back, pale tongue with dark purple or dark purple, tooth marks on the edge, thin or greasy tongue coating, tortuosity of sublingual veins, wiry or unsmooth pulse, thin, rapid pulse and the like, and can well make up the deficiency of western medicines.

The second aim of the invention is to provide a traditional Chinese medicine preparation for treating acute myocardial infarction.

The third aim of the invention is to provide an application of a traditional Chinese medicine composition or a traditional Chinese medicine preparation in preparing a traditional Chinese medicine for treating acute myocardial infarction.

In order to achieve the first object, the present invention adopts the following technical scheme:

the invention provides a traditional Chinese medicine composition for treating acute myocardial infarction, which is prepared from the following raw materials in parts by weight: 9-30 parts of astragalus membranaceus, 6-12 parts of bighead atractylodes rhizome, 5-10 parts of allium macrostemon, 9-15 parts of snakegourd fruit, 3-9 parts of pinellia ternate, 3-10 parts of cassia twig, 10-20 parts of poria cocos, 6-12 parts of Chinese angelica, 9-15 parts of radix scrophulariae, 6-15 parts of honeysuckle, 3-10 parts of turmeric, 3-15 parts of rheum officinale, 5-10 parts of stiff silkworm, 3-10 parts of immature bitter orange and 2-10 parts of liquorice.

The disease treated by the traditional Chinese medicine composition is acute myocardial infarction, and the symptoms mainly aim at the symptoms of heart qi deficiency and heart vessel blockage, wherein the pathogenesis of the main disease is related to the heart qi deficiency, and the symptoms of the deficiency and the excess are represented by taking the excess as the center. The excessive symptoms are qi and blood obstruction, blood stasis, phlegm stagnation, qi stagnation and heat generation, etc., which cause qi and blood dysfunction and unsmooth running; this deficiency is the factor of deficiency of the essence, fatigue, or emotional distress, which leads to deficiency of both qi and blood, yin and yang, dysfunction of viscera, accumulation of heart-qi, and deficiency of heart-qi. Therefore, it should be effective in invigorating qi, promoting blood circulation, clearing heat, eliminating phlegm, dispersing arthralgia and relieving pain.

In the technical proposal of the invention, the device comprises a plurality of control units,

monarch drug: astragalus root, white atractylodes rhizome;

ministerial drugs: fructus Trichosanthis, rhizoma Pinelliae, bulbus Allii Macrostemi, ramulus Cinnamomi, poria, radix Angelicae sinensis, radix scrophulariae, and flos Lonicerae;

adjuvant drug: turmeric, rhubarb, stiff silkworm and immature bitter orange;

the preparation method comprises the following steps: licorice root.

Specifically, the recipe is used for treating acute myocardial infarction in the period of onset, which is caused by heart qi deficiency and phlegm turbidity blocking heart vessels. The deficiency of the essence and the loss of diet of the patient, or the deficiency of the yin and yang of qi and blood, viscera dysfunction, accumulation of heart qi and heart qi deficiency, the "yellow emperor' is called as" principal organ ", palm qi and blood are operated, and heart qi has the function of promoting the normal operation of blood in vessels due to the reasons of fatigue injury, internal injury and seven emotions; deficiency of heart qi, weak agitation, unsmooth blood circulation, poor pulse, malnutrition, chest distress and chest pain, fixed stink; while the heart is in five elements and belongs to fire, the heart is deficient, the heart vessels are not smooth, the fire is not in order to release, the body fluid is decocted, the fluid is collected into phlegm, the heart vessels are blocked, the qi is not smooth, chest is stuffiness and chest pain is caused, the chest pain is back, the pain is inappetence, and the effects of tonifying qi and activating blood, clearing heat and resolving phlegm and releasing arthralgia and relieving pain are achieved.

In the formula, astragalus and bighead atractylodes rhizome are monarch drugs, and have the effects of sexual warmth, invigorating qi and yang, consolidating superficial resistance and arresting sweating, inducing diuresis and relieving edema, promoting fluid production and nourishing blood, promoting stagnancy and relieving arthralgia, and having sweet nature and moderate warmth, bighead atractylodes rhizome has the effects of invigorating spleen and tonifying qi, drying dampness and promoting diuresis, and having bitter and sweet taste and moderate warmth; spleen is the source of qi and blood, the acquired root, and the dredging of the pulse is dependent on the supply of acquired sources, which is sufficient to assist the heart-qi to promote. Fructus Trichosanthis has effects of eliminating phlegm, opening chest and resolving hard mass, ramulus Cinnamomi has effects of activating yang and relieving arthralgia, bulbus Allii Macrostemi has effects of activating yang and promoting qi circulation and relieving pain, and rhizoma Pinelliae has effects of lowering adverse qi and eliminating phlegm and expelling pathogenic wind; poria and Atractylodis rhizoma are used together, and the auxiliary drugs are used for strengthening spleen and replenishing qi, and Poria and cortex Cinnamomi are used together, so as to warm yang and promote qi, strengthen spleen and promote diuresis, and improve body fluid operation; note that typhoid treatises: all the blood belongs to the heart, and the pulse-invigorating patient has to tonify the heart and replenish the blood … by using the bitter temperature of the Chinese angelica to help the heart blood, so the Chinese angelica is used for replenishing blood and activating blood, assisting the heart to promote blood circulation, improving the blood stasis condition, the figwort is used for clearing heat and cooling the blood, and the honeysuckle is used for clearing heat and purging fire from the exterior and the interior; the eight drugs are taken as ministerial drugs, are taken as exterior and interior simultaneously, are taken as interior and exterior simultaneously, are suitable for cold and heat, regulate and smooth qi, blood and body fluid, are taken as auxiliary monarch and ministerial simultaneously, tonify primordial qi greatly, take account of the removal of pathological products such as phlegm dampness, blood stasis and the like, and have the effects of tonifying qi, activating blood, clearing heat, resolving phlegm, dispersing arthralgia, relieving pain, drying dampness and promoting diuresis, and the effects of treating based on the basic pathogenesis of the disease based on syndrome differentiation, suppressing the progress of the disease early and reducing the occurrence rate of heart failure caused by myocardial infarction. The stiff silkworm has thin and light smell and ascends, and can lift the clear yang in yang and clear pathogenic qi; turmeric has the advantages of being pungent and bitter in taste, warm in nature, good in eliminating evil and reducing blood stasis, regulating qi in blood, being Huang Wei bitter and cold in nature, purging excessive heat in blood, and being capable of reducing gastrointestinal stagnation, promoting aging to cause new, resolving phlegm and losing knots, and simultaneously 'lowering turbid yin in yin', four medicines are adjunctive, internal and external ventilation and lifting and cold dispelling and warming are combined, and ascending and descending are mutually related, so that qi and blood of the whole body are regulated; glycyrrhrizae radix is old in China and harmonizes the medicines. The whole formula has the effects of tonifying qi, activating blood, clearing heat, resolving phlegm, dispersing arthralgia and relieving pain. Radix Aconiti lateralis Preparata, cortex Cinnamomi, and rhizoma Ligustici Chuanxiong can be added for patients with yang deficiency and qi deficiency, and for patients with qi stagnation and blood stasis.

In the prior art, the radix codonopsis pilosulae and the astragalus are taken as similar prescriptions for treating myocardial infarction by using monarch drugs, the radix codonopsis has the effects of strengthening spleen and tonifying lung, nourishing blood and promoting fluid production, and is sweet in taste, and the radix codonopsis pilosulae and the bighead atractylodes rhizome have the effects of strengthening spleen and tonifying qi, but the radix codonopsis pilosulae has the effects of nourishing blood and promoting fluid production, the bighead atractylodes rhizome has the effects of warming, drying dampness and promoting diuresis, and the bighead atractylodes rhizome has the effects of reinforcing qi and yang and inducing diuresis and detumescence when being used together with the astragalus; on the basis of strict adherence to the treatment rules, since the recipe is used for treating heart qi deficiency and phlegm turbidity blockage in the acute attack stage of myocardial infarction caused by heart vessels, the bighead atractylodes rhizome has the effect of drying dampness and phlegm, and can play the effect of drying dampness and phlegm together with ministerial medicines such as snakegourd fruit, allium macrostemon and pinellia tuber, the recovery of diseases is facilitated, and therefore the monarch medicine is the best of astragalus and bighead atractylodes rhizome.

In the above proportion range, the traditional Chinese medicine composition can achieve the aim of treating acute myocardial infarction, and in order to facilitate the blending and the use, the inventor further prefers the following raw material medicine formula, and the curative effects of the treatment are determined:

(1) 30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 12g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange and 10g of liquorice;

(2) 30g of astragalus, 10g of bighead atractylodes rhizome, 10g of allium macrostemon, 15g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 12g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 10g of immature bitter orange and 9g of liquorice;

(3) 30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 9g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 10g of Chinese angelica, 10g of radix scrophulariae, 9g of honeysuckle, 10g of turmeric, 9g of rheum officinale, 10g of stiff silkworm, 9g of immature bitter orange and 10g of liquorice;

(4) 28g of astragalus, 10g of bighead atractylodes rhizome, 9g of allium macrostemon, 9g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 14g of poria cocos, 10g of Chinese angelica, 10g of radix scrophulariae, 9g of honeysuckle, 10g of turmeric, 10g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange and 10g of liquorice;

(5) 29g of astragalus, 10g of bighead atractylodes rhizome, 10g of allium macrostemon, 15g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 10g of Chinese angelica, 10g of radix scrophulariae, 9g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 10g of stiff silkworm, 10g of immature bitter orange and 9g of liquorice;

(6) 30g of astragalus, 10g of bighead atractylodes rhizome, 9g of allium macrostemon, 9g of snakegourd fruit, 9g of pinellia tuber, 10g of cassia twig, 14g of poria cocos, 11g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 10g of immature bitter orange and 10g of liquorice;

(7) 30g of astragalus, 10g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 11g of Chinese angelica, 11g of radix scrophulariae, 10g of honeysuckle, 10g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange and 8g of liquorice.

In the specific embodiment of the invention, the composition of each raw material medicine of the traditional Chinese medicine composition can be adjusted according to clinical symptoms on the basis of the traditional Chinese medicine composition, and the composition comprises the following components in parts by weight:

(1) 10-15 parts of spina date seed is added for patients with poor sleep.

(2) For patients with symptoms greatly affected by emotion, 3-10 parts of radix bupleuri is added to soothe liver and relieve depression.

(3) For patients with yang deficiency, cortex Cinnamomi 1-3 parts and radix Aconiti lateralis Preparata 10-20 parts are added.

(4) Rhizoma Ligustici Chuanxiong 10-20 parts for patients with qi stagnation and blood stasis are added.

In the above adjustment, any one or a combination of a plurality of them may be selected according to the symptoms to be presented.

In the traditional Chinese medicine composition provided by the invention, the whole formula has the effects of tonifying qi, activating blood, clearing heat, resolving phlegm, dispersing arthralgia and relieving pain.

In order to achieve the second purpose, the invention provides a traditional Chinese medicine preparation for treating acute myocardial infarction.

When in use, the traditional Chinese medicine composition can be prepared into decoction according to the traditional preparation method of the prescription, for example, decoction is taken after being decocted with water. Or refining the effective components of the preparation with water or other suitable solvents, and making into various preparations such as granule, tablet, capsule, pill, powder, and oral liquid according to conventional preparation process. Experiments prove that the preparation method and the using method can realize the therapeutic effect of the medicament.

In order to achieve the third purpose, the invention also protects the application of the traditional Chinese medicine composition or the traditional Chinese medicine preparation thereof in preparing the traditional Chinese medicine for treating the acute phase of myocardial infarction.

If no special description exists, all the raw materials of the traditional Chinese medicine composition can be obtained through commercial market, and any range recorded by the invention comprises any value between the end values and any sub-range formed by any value between the end values, and the traditional Chinese medicine composition of any sub-range formed by any value between the end values can achieve the purpose of treating the acute phase of myocardial infarction.

The beneficial effects of the invention are as follows:

according to the traditional Chinese medicine composition provided by the invention, the formula of the traditional Chinese medicine composition is strict through the selection of raw materials and the control of raw material additives, so that the traditional Chinese medicine composition can well treat acute myocardial infarction, can tonify qi, activate blood, clear heat, resolve phlegm, disperse arthralgia and relieve pain, and particularly can improve symptoms and signs of acute myocardial infarction including chest stuffiness and pain, heart pain, back, pale tongue or purple dark, tooth marks on sides, thin or greasy coating, tortuosity of sublingual veins, wiry or unsmooth pulse, fineness, number and the like, and can well make up the deficiency of western medicines.

Detailed Description

In order to more clearly illustrate the present invention, the present invention will be further described with reference to preferred embodiments. It is to be understood by persons skilled in the art that the following detailed description is illustrative and not restrictive, and that this invention is not limited to the details given herein.

The pharmaceutical composition is used as an intra-hospital preparation, has obvious curative effect on myocardial infarction acute stage caused by heart qi deficiency and heart vessel blockage through the effect verification of thousands of clinical cases, and can achieve the purpose of treatment without being matched with western medicines. Especially for middle-aged and elderly patients with heart qi deficiency, the treatment effect of the invention and the target can be achieved by improving the function of the organism. The following are typical cases selected from the clinic.

Typical cases and efficacy:

case 1

Wang Mou Male, 72 years old, 08 months of 2021, 08 first diagnosis.

Complaints: the intermittent precordial discomfort is 3 months and aggravated for a week.

The current medical history: patients do not relieve chest pain before 1 week, and go through coronary angiography in Guangan-Men hospitals of Chinese academy of traditional Chinese medicine, the preoperative descending branch is narrow more than 90%, the preoperative descending branch is placed into a bracket, and the preoperative precordial region still has discomfort, is accompanied with whole body hypodynamia and sweats, and is followed by the visit at my places.

The following symptoms: the symptoms of discomfort in precordial region, tiredness and emotional agitation are aggravated, the symptoms can be relieved after the administration of nitroglycerin for a few seconds, the symptoms of chest pain, chest distress, aversion to cold, general hypodynamia, easy sweating, insomnia, nocturia 1-2/night, foam urine and 1-2 times/day, and the preparation is shaped.

Tongue pulse: a dark red tongue with little coating and a wiry and thready pulse.

Past history of: hypertension is 10 years, type 2 diabetes mellitus, hyperuricemia is 7 years, hyperlipidemia is 7 years, and reflux esophagitis is 10 years.

Personal history: overrule smoking history, drinking history 20 years, 7-8 two/day.

Family history: father had a history of myocardial infarction.

History of allergies: overrule food and medical allergy history.

Auxiliary inspection: 2021.08.03 glycosylated hemoglobin measurement: 71% of glycosylated hemoglobin; biochemistry: creatine kinase 95U/L, creatinine 58umo1/L, glucose 8.22mmo1/L, low density lipoprotein 2.45mmo1/L, triglyceride 3.80 mmo/L, uric acid 471umol/1, urea 3.56 mmo/L, creatine isozymes 13U/L, [ HCY ]141umo1/L; electrocardiogram: sinus rhythm, nonspecific T wave abnormalities.

The medicine for the present application: metoprolol tartrate 25mgtid, rosuvastatin tablet 5mgqd, aspirin enteric tablet 100mg qd and the like.

Diagnosis:

western diagnosis: 1. coronary atherosclerotic heart disease stable angina pectoris cardiac function grade I (NYHA classification),

2. type 2 diabetes, 3, hypertension grade 1 (very high risk), 4, hyperlipidemia, 5, reflux esophagitis, 6, hyperuricemia.

Diagnosis of traditional Chinese medicine: chest stuffiness and pain (heart qi deficiency, heart vessel stuffiness syndrome).

The treatment method comprises the following steps: has effects of invigorating qi, promoting blood circulation, clearing heat, eliminating phlegm, dispersing arthralgia, and relieving pain.

Prescription: 30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 12g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange, 10g of liquorice and 3g of cinnamon.

And (3) square solution: the symptoms of the patient in the precordial region are in line with the diagnosis of chest stuffiness and pain, the morbidity is related to emotion and fatigue, and the symptoms of heart qi deficiency and heart vessel blockage are the symptoms of heart qi deficiency, the effects of tonifying qi, activating blood, clearing heat, resolving phlegm, releasing arthralgia and relieving pain are achieved, and the patient is averted to cold by plain, and cinnamon is added in the prescription, so that the patient is resuscitated for rescuing from adverse reaction by yang, and is warm for invigorating primordial yang.

Two diagnoses at 2021, 08 and 22 days:

the following symptoms: after two weeks above the clothes, the degree and the frequency of the occasional precordial discomfort are obviously reduced, the aggravated after the tiredness and the emotional agitation, the rest can be reduced by itself, the chest pain and chest distress are avoided, the aversion to cold is improved, the weakness of the whole body is reduced, the sweat is normal, the sleep is easy, the urine is 1-2 per night at night, the urine has foam, the excrement is 2 times per day, and the shaping is slightly not carried out.

Tongue pulse: a pale tongue with thin coating and a wiry and thready pulse.

Prescription: 30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange, 10g of liquorice and 3g of cinnamon.

And (3) square solution: the disease condition of the patient is relieved after taking the front part, and the discomfort of the precordial region of the patient is caused by heart qi deficiency and heart vessel blockage, so that the patient continues to use the front part to tonify qi, activate blood, clear heat, resolve phlegm, disperse arthralgia and relieve pain, and the patient has increased excrement times and removes Chinese angelica.

Case 2

Zhang Mou women, 67 years old, 09 months of 2020, 12 days of initial diagnosis.

Complaints: intermittent chest pain was severe for 12 years and for 1 week.

The current medical history: the patient has no obvious cause before 12 years of complaint, chest distress and chest pain, no obvious other discomfort, no attention of the patient, repeated attack of symptoms, and recently serious illness, and is in the hospital. Downlink coronary angiography + PCI procedure at 2021-09-09, results show: coronary artery blood supply right dominance type, left trunk without stenosis, anterior descending branch with 95% stenosis at the proximal segment, 30% -40% stenosis at the middle segment, forward blood flow TIMI3 grade; the circumflex is not significantly stenosed, forward blood flow TIMI3 grade; the right coronary artery was not seen to be significantly stenosed, flowing forward as TIMI grade 3. Coronary angiography conclusion: coronary atherosclerotic heart disease mainly involves anterior descending branches. The patient has no obvious discomfort after operation, and the wound dressing has no blood seepage and red swelling. The preparation is used for treating coronary heart disease with the effects of 2-level prevention (antiplatelet, lipid-lowering and freckle-stabilizing, glucose-controlling and blood pressure-reducing), coronary expansion, heart rate control, anticoagulation, potassium-magnesium supplementation, malignant arrhythmia prevention, acid-inhibiting and stomach-protecting, uric acid-lowering and liver-protecting, etc.

The following symptoms: patients feel chest pain even, have no palpitation, dizziness and headache, have sometimes acid regurgitation, anorexia, poor sleep, difficulty in falling asleep, difficulty in relieving dry stool, and 3-4 times of nocturia for one line on 3-4 days.

Tongue pulse: a pale tongue with thin and white coating, a pale tongue with a pale and thick tongue body and a wiry and thready pulse.

Past history of: the prior history of hypertension is 20 years, the highest is 170/100mmHg, the orally taken amlodipine besylate and bisoprolol fumarate are controlled at 120-130/70-80mmHg, the history of diabetes is 9 years, and the control is poor; the hyperlipidemia is controlled by regular oral administration of rosuvastatin calcium tablet for more than 8 years.

Family history: parents, brother's history of cerebrovascular disease (stroke, hemiplegia), mother, father's history of cardiovascular disease.

Auxiliary inspection: (2021.09.02) urine convention: occult blood 1+, urinary glucose (3+), non-squamous epithelium+; biochemistry: albumin 30.47g/L (+), glucose 8.97mmol/L, N-terminal sodium urine precursor assay: 4009pg/mL. ECG, sinus rhythm, nonspecific T wave abnormalities. Heart ultrasound: abnormal segmental ventricular wall motion, increased left atrium, decreased tricuspid annulus velocity and tame, may have reduced right ventricular systolic function, reduced left ventricular diastolic function, aortic valve degeneration and regurgitation (mild), mitral regurgitation (moderate), tricuspid regurgitation (mild), and ventricular septum thickening.

The preparation is taken orally: amlodipine besylate tablet 5mg oral qd, bisoprolol fumarate tablet 2.50mg oral qd, rosuvastatin calcium tablet 10mg oral qd, protamine recombinant human insulin injection (30R) 24iu before breakfast, 22iu subcutaneous qd before evening, acarbose tablet 50mg oral tid, adenosylcobalamin for injection 1.50mg intramuscular qd; clopidogrel hydrogen sulfate tablet 75mg orally administered qd.

Diagnosis:

western diagnosis: 1. coronary atherosclerotic heart disease stability angina pectoris coronary artery bypass surgery post cardiac function grade III (NYHA grade), grade 2, hypertension grade 3 (very high risk), type 3, type 2 diabetes, type 4, hyperlipidemia.

Prescription: 30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 12g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 15g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange, 10g of liquorice and 15g of spina date seed.

And (3) square solution: in old women, spleen and stomach are not smooth, qi and blood are not good enough to promote blood circulation, and qi is the mother of blood, so that the chest distress is caused by stagnation of heart vessels; the symptoms of chest stuffiness and heart pain are combined with pale tongue with thin and white coating, and the tongue body is slightly fat, the pulse is wiry and thin, four diagnostic methods are combined, and the symptoms belong to the symptoms of heart qi deficiency and heart vessel blockage. The illness state of the patient is related to insomnia besides emotion, the spina date seed is used for assisting insomnia, the patient is difficult to defecate, and the dosage of the rheum officinale is increased.

Two diagnoses in 2019, 02 and 12 days.

The following symptoms: chest distress is caused by palpitation, dizziness, no acid regurgitation, no dry mouth, bitter taste, general sleep, normal urination and defecation for 2 days, and shaping.

Tongue pulse: a pale tongue with thin and white coating, a tortuosity of the tongue bottom, a slightly fat tongue body and a wiry and thready pulse.

The prescription comprises the following components: 30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 12g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 15g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange, 10g of liquorice and 15g of spina date seed. And (3) square solution: the disease of the patient is obviously improved by treating the disease in the front, the cardiovascular symptoms of the patient are stable, the sleeping and the stool symptoms are improved, and the front treatment is continued.

Case 3

Li Mou first diagnosis of men, 80 years old, month 07, 20 days 2020.

Complaints: intermittent chest distress for 10 years, aggravated pain with two lower limbs for 1 week.

The current medical history: the patient has no obvious cause of chest distress, chest pain and can lie on the back at night after 10 years, and the patient can release the chest pain by himself after resting, and the patient does not pay attention to the chest pain and does not go to systematic treatment. Chest distress aggravates again before 7 years, and no obvious relief exists after rest, and the electrocardiographic diagram is checked in Xuan Wu hospitals: III, V1T wave low level; heart ultrasound shows: left atrial enlargement, left ventricular wall segmental motion abnormality, regurgitation of the second and third valves (mild), pulmonary valve regurgitation (mild). The diagnosis of coronary atherosclerotic heart disease is that symptoms are improved before treatment such as antiplatelet, coronary expansion, depressurization and the like, and the treatment is transferred to hospitalization of I family. The symptoms are improved and discharged after the conventional internal medicine treatment. The patient 7 months 2015 is more heavily hospitalized than me department due to chest distress, and coronary artery CTA is shown: coronary artery severe calcification, proximal non-calcified plaque and calcified plaque, lumen about severe stenosis, diagnosis of coronary heart disease, unstable angina pectoris, old lower wall myocardial infarction, arrhythmia, ventricular extra-systole, and relief of illness after symptomatic treatment. After that, the patient has repeated illness with chest distress and attack, and the patient has no obvious cause of chest distress and aggravation with pain of the two lower limbs before 1 week, so that the patient is required to further diagnose and treat the illness in our hospital.

The following symptoms: intermittent chest distress, no chest pain, lying on the back at night, occasional suffocation, pain of the lower limbs with moderate concave edema, severe right leg, cough and expectoration, white sputum, hypomnesis, dizziness, headache, gastric upset, impaired right limb movement, tongue extension, anorexia, poor sleep, weakness and defecation in 2-3 days and 1 line. Frequent urination and 4-5 times of nocturia.

Tongue pulse: a pale tongue with yellow and greasy coating, a swollen tongue with slippery and rapid pulse.

Past history of: the left limb is unfavorable in activity after 11 years of cerebral infarction, and is not treated by taking medicine at present; the blood pressure is up to 170/100mmHg in 10 years after the medical history of hypertension, and the orally taken amlodipine besylate tablet is 5mgqd, so that the blood pressure can be controlled; fatty liver history 21 years; the prior 10 years history of hyperlipidemia, 2mg of pitavastatin calcium tablets are orally taken 1/night.

Oral medicine: amlodipine besylate 5mg qd, pitavastatin calcium tablet 2mg oral qn, aspirin enteric-coated tablet 100mg qd, musk heart-protecting pill 45mg tid.

Auxiliary inspection: biochemistry: creatinine 91umo1/L, glucose 6.38mmol/1, uric acid 340umo1/L, troponin I (TnI) assay: whole blood troponin I0.003 ug/L; 33.2g/L albumin, 54.2g/L total protein and 25.0U/L glutamic pyruvic transaminase. Electrocardiogram: lower wall infarct. Ultrasonic bedside ultrasound: EF 56%, left ventricle enlargement, aortic valve degeneration and regurgitation (mild), mitral regurgitation (mild), tricuspid regurgitation (mild), left ventricle diastolic dysfunction.

Diagnosis:

Western diagnosis: 1. coronary atherosclerotic heart disease unstable angina pectoris old lower wall myocardial infarction cardiac function II (NYHA grade) precordial systole 2, hypertension 3 (very high risk) 3, hyperlipidemia 5, reflux esophagitis 6, old cerebral infarction 7, fatty liver.

The prescription comprises the following components: 30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 12g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange, 10g of liquorice and 10g of aconite.

And (3) square solution: the patient is an aged male, and heart vessel is blocked, so chest stuffiness and heart pain accords with the diagnosis of traditional Chinese medicine, the patient is in the form of qi deficiency, dizziness, expectoration and edema of two lower limbs, and is sometimes suffocated at night, and is in the form of long-term heart qi deficiency, qi deficiency and yang, and yang deficiency water flooding, so the prescription is specially used for acute myocardial infarction in treatment, and additionally comprises aconite root, radix aconiti carmichaeli, poria cocos, and poria cocos in the prescription for invigorating spleen and promoting diuresis.

Two diagnoses in 2020, 08 and 14 days:

the following symptoms: the Chinese medicinal composition has the advantages of clear spirit, simple spirit, chest distress, no chest pain, alleviation of chest distress degree, alleviation of pain when lying on two lower limbs at night, obvious alleviation of edema of the two lower limbs, alleviation of cough and expectoration, dizziness, headache-free, alleviation of gastric upset, aversion to cold, unfavorable movement of the right limb, tongue extension, right deviation, anorexia, poor sleep, weakness of defecation, frequent urination and yellow color.

Tongue pulse: pale red tongue, thin coating and wiry pulse.

The prescription comprises the following components: 30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 12g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange, 10g of liquorice, 10g of aconite root and 3g of cinnamon.

And (3) square solution: the chest distress symptoms of the patient are relieved, but the chest distress symptoms still exist, the patient is afraid of cold, the symptoms of eliminating the pathogenic factors and the body resistance are eliminated, the patient continues to take the front part, and the cinnamon is added on the basis of the front part, so that the primordial yang is warmly reinforced.

Case 4

Wang Mou male, 68 years, first visit 08 months, 2020.

Complaints: intermittent chest distress and pain for 2 months, aggravated for 6 days.

The current medical history: the patient has no obvious incentive to start to appear chest distress in 6 months in 2020, and the needle-stick pain in precordial region can be relieved by oneself after a few seconds, and the patient can visit a community hospital, and electrocardiographic examination shows that: coronary atherosclerotic heart disease, myocardial ischemia, without special treatment, suggested coronary CTA examination. After which the patient has intermittent onset of chest distress and chest pain symptoms. The patient has no obvious cause of chest distress and chest pain symptoms which are aggravated before 6 days, has no shoulder and back radiation pain, and is in need of further system diagnosis and treatment, so that the patient is taken into the department of I from the clinic. Hospitalization period angiography shows: coronary artery blood supply right dominance type, calcification on left trunk, calcification on middle section near anterior descending branch, irregular, forward blood flow TIMI3 level; calcification of the proximal middle segment of the circumflex, tortuosity, 50% -70% stenosis, forward blood flow TIMI3 grade; the whole course of the right crown is irregular, the proximal segment is 30% -40%, the tumor-like expansion of the middle and distal segments is carried out, the middle segment of PDA is 70% -80% narrow, the PLA is 50% narrow, and the forward blood flow is TIMI3 grade. Coronary angiography conclusion: coronary atherosclerotic heart disease. And (5) withdrawing the contrast catheter, and ending the operation. The right radial artery puncture site is pressed by a compressor after operation.

The following symptoms: intermittent chest distress and shortness of breath, chest distress with needle stick-like pain in precordial region, lasting about several seconds, no shoulder and back radiation pain, tiredness and symptoms aggravated after emotional agitation, plain dysphoria and irritability, palpitation, shortness of breath, sweating, dizziness, transitional amaurosis, headache-free, cough and white phlegm, acid regurgitation and burning heart, anorexia, poor sleep, easy awakening, defecation for 1 time in 2-3 days, difficult defecation and urination.

Tongue pulse: a pale and dark tongue with cracks, a yellow and thick coating and a wiry pulse.

Past history of: the prior history, namely the history of hypertension is more than 10 years, the highest blood pressure reaches 160/90mmHg, valsartan capsules (80 mg oral qd) and nifedipine controlled release tablets (30 mg oral qd) are used for reducing blood pressure, and the nifedipine controlled release tablets are stopped due to the over-low recent blood pressure, so that the blood pressure is controlled to be 110-120/70-80mmHg. For 15 years of history of type 2 diabetes mellitus, metformin hydrochloride tablets (0.5 g for 3/day orally) and dapagliflozin tablets (10 mg for qd orally) are given, fasting blood glucose is controlled to be about 7mmol/L, and postprandial blood glucose is controlled to be 13-14mmo1/L. Diagnosis of the multi-lacunar cerebral infarction focus and leukoencephalopathy in the brain is carried out 3 months in 2020. Fatty liver disease was 6 years old. Gall bladder stones were 6 years old. The right kidney cyst history was 2 months. The history of repudiation of hepatitis, malaria, tuberculosis, mental illness, trauma, blood transfusion, allergy and vaccination is not detailed.

Personal history: the Chinese medicinal composition is applied to Beijing, jujuxtant local places, epidemic situation contact history and epidemic water contact history. A history of repudiation. 20 years of drinking, mainly drinking white spirit, on average 2 two/day, without stopping drinking. Smoking for 50 years, 10 cigarettes/day on average, without stopping smoking.

History of wedding: married, married in the age of the fit, and raised 1 child, child and partner.

Family history: a history of parental hypertension, diabetes, coronary heart disease, sister diabetes, and hypertension, overruling family other genetic history.

Auxiliary inspection: chest CT shows: 1. there are many small calcification foci in the lung. 2. Aortic and coronary arteriosclerosis. Troponin I assay: 0.000ug/L; creatinine: 90umol/L, 9.20mmol/L glucose, 378umol/1 uric acid and 312mmol/L lactic acid; NT-proBNP:77.8pg/ml. Electrocardiographic examination shows: sinus rhythm, 92 beats/minute heart rate, T wave abnormalities, suggest a coronary CTA examination.

The existing oral medicine: valsartan capsule 80mg oral qd, metformin hydrochloride tablet 0.5g oral tid, dapagliflozin hydrochloride tablet 10mg oral qd, trimetazidine hydrochloride tablet 20mg oral tid, aspirin enteric coated tablet 100mg oral qd, isosorbide mononitrate 20mg oral tid.

Diagnosis:

western diagnosis: 1. coronary atherosclerotic heart disease stable angina pectoris cardiac function grade I (NYHA classification), grade 2, hypertension grade 3 (extremely high risk), type 3, type 2 diabetes, 4, multiple lacunar infarction, 5, fatty liver, 6, gall bladder calculus, 7, right kidney cyst.

The prescription comprises the following components: 30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 12g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 12g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange, 10g of liquorice and 12g of radix bupleuri.

And (3) square solution: the patients are middle-aged men, the pain is stinging, the pain is caused by blood stasis blockage of heart vessels, and palpitation, shortness of breath and sweating are all manifestations of heart qi deficiency. Therefore, the syndrome differentiation is that the heart qi is deficient and the heart vessels are blocked, so that the patient is in the acute phase of myocardial infarction, and the patient is plain, impatient and irritable, and the chest symptoms are affected by emotion, so that the bupleurum root is used for dispelling liver qi, and the patient is difficult to relieve constipation, and the dosage of the rheum officinale is increased for one line in 2-3 days.

22 nd diagnosis in 2020, 08 th month:

the following symptoms: the chest distress, chest pain, shoulder and back radiation pain are not caused temporarily, palpitation, short breath are obviously improved, no sweat is generated, dizziness and headache are not caused, excessive amaurosis is not caused, cough and white phlegm are relieved, and the cough and white phlegm are sometimes burned with acid, anorexia, poor sleep, easy waking and 1 time of daily excrement are caused, so that the cough and white phlegm are relieved.

Tongue pulse: a pale and dark tongue with cracks, a yellow and thick coating and a wiry and slippery pulse.

And (3) square solution: the chest pain symptoms of the patient are obviously relieved, and the recipe is continuously taken.

Case 5

Chen Mou first diagnosis of male, 59 years, month 07, 02, 2020.

Complaints: intermittent chest distress and pain for 5 years, aggravate for 5 days.

The current medical history: chest distress and chest pain are not obvious due to obvious causes before 5 years, and emotion fluctuation is obvious and is not considered and diagnosed. 2. Chest distress and chest pain of the patient is aggravated before the year, 160mg qd of aspirin is taken by the patient, and the chest distress and chest pain is slightly relieved after the patient takes the aspirin. Chest distress and chest pain of the patient are aggravated 5 days ago, the patient is in a dry hospital emergency, and the electrocardiographic diagram is checked, namely sinus rhythm. Cardiac ultrasound suggests 65% EF, enlarged left atrium (40 mm), aortic valve regurgitation (mild), tricuspid valve regurgitation (mild), and reduced left ventricular diastolic function. Whole blood troponin I0.571 ug/L, diagnosed: coronary atherosclerotic heart disease, acute coronary syndrome, 100mg of aspirin is orally taken to prevent platelet aggregation, so as to treat the coronary atherosclerotic heart disease and to be received into I' M department. Hospitalization coronary angiography shows: coronary artery blood supply right dominance type, left trunk without stenosis, anterior descending branch near middle section with unsmooth, forward blood flow TIMI3 level; the circumflex is not significantly stenosed, forward blood flow TIMI3 grade; the tumor-like expansion of the proximal middle section of the right crown has no obvious stenosis and forward blood flow TIMI3 grade. Coronary angiography conclusion coronary atherosclerosis.

The following symptoms: intermittent chest distress and chest pain, pain with pain in the throat, obvious after emotion fluctuation, relief after rest, chest distress and shortness of breath, sour regurgitation, easy sleep and convenient use.

Past history of: the highest blood pressure of 170/100mmHg is not treated by the medicine for 2 years after the history of hypertension, and is not treated by the medicine for 2 years after the hyperlipoidemia. Carotid arteriosclerosis was not treated systematically for 2 years. Reflux esophagitis is for years and is not treated. Hernia operation was performed in 1977. The history of repudiation of hepatitis, malaria, tuberculosis, diabetes, cerebrovascular and mental diseases, trauma, blood transfusion, allergy and vaccination is not detailed.

Personal history: in Henan, local for a long time, epidemic water is denied, and the epidemic source is in contact with the history. The history of exposure to the novel coronavirus was denied. A history of repudiation. 20 cigarettes per day for 20 years. The history of drinking is 20 years, and the white spirit is mainly 2 two times daily.

Auxiliary inspection: 2020.06.30 troponin I assay: whole blood troponin I0.01ug/L; biochemistry: 39.5g/L albumin, 648g/L total protein, six heart peduncles were not seen. Electrocardiographic representation: sinus rhythm, T wave changes.

The existing oral medicine: 100mg of aspirin enteric-coated tablet is orally taken qd, 75mg of clopidogrel hydrogen sulfate tablet is orally taken qd; atorvastatin calcium tablet 20mg oral qn in combination with ezetimibe tablet 10mg qn; metoprolol tartrate 6.25mg oral qd; trimetazidine hydrochloride tablets 20mg oral tid, isosorbide mononitrate 20mg oral tid.

Tongue pulse: a pale tongue with white and moist coating and a deep and astringent pulse.

Diagnosis:

western diagnosis: 1. acute coronary syndrome of coronary atherosclerosis heart disease, 2, high blood pressure and high risk group, 3, hyperlipidemia, 4, carotid arteriosclerosis, 5, reflux esophagitis.

The prescription comprises the following components: 30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 12g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange, 10g of liquorice and 10g of ligusticum wallichii.

And (3) square solution: in middle-aged men, the spleen and stomach are damaged due to improper diet, spleen and stomach deficiency, and the spleen and stomach deficiency, the body fluids and blood are excreted, the stagnation is phlegm, the stagnation is stasis, and the phlegm and the stasis mutually combine with each other to form heart and chest, so chest oppression and chest pain can be seen. The four diagnostic methods are combined with the symptoms of pale tongue, white and moist coating, and deep and astringent pulse, and the four diagnostic methods are combined with the symptoms of chest stuffiness and pain, and the symptoms of phlegm and blood stasis are obstruction of heart vessels, so the symptoms of heart qi deficiency and heart vessel obstruction are distinguished. The disease location is at the heart, the disease nature is mainly true, the special prescription is used for the acute phase of myocardial infarction, and the pain of patients is stinging, and the rhizoma ligustici wallichii is used for promoting qi and activating blood.

Two diagnoses in 2019, 11 and 22 days:

The following symptoms: all symptoms are relieved after the upper part of the medicine is taken, the blood pressure is controlled, the frequency and the degree of chest distress and chest pain are all relieved before the medicine is taken, the mouth is dry and bitter, the sour and heartburn are avoided, the sleeping is easy, and the convenience is improved.

Tongue pulse: a dark red tongue with thin and yellow coating and a wiry and rapid pulse.

The prescription comprises the following components: 30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 12g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange, 10g of liquorice, 10g of ligusticum wallichii and 12g of radix bupleuri.

And (3) square solution: the patient's condition is improved, and the disease is controlled by the front of the patient, and the bupleurum is used for soothing liver and relieving depression.

Example 1

The traditional Chinese medicine composition for treating the acute phase of myocardial infarction is characterized by comprising the following raw material medicines in parts by weight: 30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 12g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange and 10g of liquorice.

The traditional water decoction method is adopted, and decoction is taken after decoction.

Example 2

The traditional Chinese medicine composition for treating the acute phase of myocardial infarction is characterized by comprising the following raw material medicines in parts by weight: 30g of astragalus, 10g of bighead atractylodes rhizome, 10g of allium macrostemon, 15g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 12g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 10g of immature bitter orange and 9g of liquorice.

Cutting the Chinese medicinal materials into pieces, placing in a container, adding water to cover the medicinal materials, soaking for 3 hr, heating with fire, decocting, separating, decocting the residue twice, filtering the separated medicinal liquid, collecting the rest ointment, oven drying, and granulating.

Example 3

The traditional Chinese medicine composition for treating the acute phase of myocardial infarction is characterized by comprising the following raw material medicines in parts by weight: 30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 10g of Chinese angelica, 10g of radix scrophulariae, 9g of honeysuckle, 10g of turmeric, 9g of rheum officinale, 10g of stiff silkworm, 9g of immature bitter orange and 10g of liquorice.

Pulverizing the Chinese medicinal materials into powder, adding appropriate amount of starch, and making into tablet.

Example 4

Pulverizing the above materials into fine powder, sieving, mixing, adding 90-110g refined honey into 100g powder, and making into small honeyed pill.

Example 5

The traditional Chinese medicine composition for treating the acute phase of myocardial infarction is characterized by comprising the following raw material medicines in parts by weight: 28g of astragalus, 10g of bighead atractylodes rhizome, 9g of allium macrostemon, 9g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 14g of poria cocos, 10g of Chinese angelica, 10g of radix scrophulariae, 9g of honeysuckle, 10g of turmeric, 10g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange and 10g of liquorice.

Pulverizing the above Chinese medicinal materials, decocting in water for 2 hr, separating and filtering to obtain residue, decocting the residue in water for 2 hr again, separating and filtering to obtain residue, mixing the two medicinal liquids, centrifuging at high speed (10000 r/min-15000 r/min) for 20min, and collecting supernatant.

Example 6

The traditional Chinese medicine composition for treating the acute phase of myocardial infarction is characterized by comprising the following raw material medicines in parts by weight: 29g of astragalus, 10g of bighead atractylodes rhizome, 10g of allium macrostemon, 15g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 10g of Chinese angelica, 10g of radix scrophulariae, 9g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 10g of stiff silkworm, 10g of immature bitter orange and 9g of liquorice.

The granule preparation is prepared by decoction. Cutting the Chinese medicinal materials into pieces, placing in a container, adding water to cover the medicinal materials, soaking for a period of time, heating with fire, separating, decocting the residue twice, collecting the separated medicinal liquid, filtering, collecting the rest ointment, oven drying, and granulating.

Example 7

The traditional Chinese medicine composition for treating the acute phase of myocardial infarction is characterized by comprising the following raw material medicines in parts by weight: 30g of astragalus, 10g of bighead atractylodes rhizome, 9g of allium macrostemon, 9g of snakegourd fruit, 9g of pinellia tuber, 10g of cassia twig, 14g of poria cocos, 11g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 10g of immature bitter orange and 10g of liquorice.

Example 8

The traditional Chinese medicine composition for treating the acute phase of myocardial infarction is characterized by comprising the following raw material medicines in parts by weight: 30g of astragalus, 10g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 11g of Chinese angelica, 11g of radix scrophulariae, 10g of honeysuckle, 10g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange and 8g of liquorice.

Decocting in water for 2 times, 10 times of water for 1.5 hr, and 8 times of water for 1 hr, mixing filtrates, concentrating under reduced pressure to obtain paste, adding conventional adjuvants, and making into capsule.

Clinical trial

1 study method

1.1 object: 30 patients with acute myocardial infarction who were treated in home at 2021 month 1 to 2021 month 12 were selected.

1.2 diagnostic criteria: reference is made to 2021, clinical guidelines for acute myocardial infarction, 2020TSOC: management of ST elevation myocardial infarction (updated version); the heart qi deficiency and heart vessel obstruction refers to the ninth edition of Chinese medicine diagnosis published by Chinese medical science and technology Press and the guiding principle of clinical study of new Chinese medicine published by Chinese medical science and technology press.

1.3 inclusion criteria: (1) Acute myocardial infarction is diagnosed according to the diagnostic criteria of the international heart disease society and WHO for ischemic heart disease, and pump dysfunction is graded according to Killip; (2) complete clinical data; (3) 18-80 years old, unlimited sex, patient signed informed consent.

1.4 exclusion criteria: (1) lack of cognitive ability; (2) severe liver and kidney visceral diseases or active bleeding; (3) severe hypotension, blood pressure below 80/50mmHg; (4) those with severe infections; (5) those with uncorrectable hypoxia or electrolyte disturbance; (6) pregnant or lactating women; (7) allergic constitution, allergic to various drugs; (8) Researchers consider there are other situations that are not suitable for participating in clinical trials.

1.5 treatment method: all patients are treated by secondary prevention and treatment of coronary heart disease, including antiplatelet, statin, depressurization, blood glucose and lipid reduction, and the like, and heart failure treatment such as diuretics and the like are properly applied, and the prescription treatment of the patent example 1 is simultaneously used on the basis, and the treatment course is 8 weeks.

1.6 observations index: troponin (cTnI), creatine kinase (CK-MB) as major outcome indicators, N-terminal B-type natriuretic peptide (NT-proBNP), and Left Ventricular Ejection Fraction (LVEF) as minor outcome indicators. Alanine Aminotransferase (ALT) and creatinine (Cr) are safety indicators.

1.7 statistical methods: data processing and metering data using SPSS 25.0 softwareThe difference is statistically significant by using the t test, and P <0.05.

2 results of the study

2.1 clinical efficacy:

for clinical curative effect, the preparation has obvious improvement before and after treatment, and can obviously reduce cTnI and CK-MB NT-proBNP value (P > 0.05), improve cardiac function and improve ejection fraction (P > 0.05) by combining with basic conventional treatment. The clinical effects are shown in Table 1.

TABLE 1 clinical efficacy

Note that: * P <0.05 compared to before treatment.

2.2 Security monitoring

Glutamic pyruvic transaminase (ALT) and creatinine (Cr) are within normal range without difference (P > 0.05) before and after treatment. The safety monitoring is shown in table 2.

Table 2 safety monitoring

Note that: * P >0.05 compared to before treatment.

Conclusion 3

The patent can effectively improve the electrocardiogram curative effect and laboratory index of patients with acute myocardial infarction, has no obvious influence on the liver and kidney functions of the patients, and has better safety.

It should be understood that the foregoing examples of the present invention are provided merely for clearly illustrating the present invention and are not intended to limit the embodiments of the present invention, and that various other changes and modifications may be made therein by one skilled in the art without departing from the spirit and scope of the present invention as defined by the appended claims.

Claims

1. The traditional Chinese medicine composition for treating acute myocardial infarction is characterized by being prepared from the following raw materials in parts by weight: 9-30 parts of astragalus membranaceus, 6-12 parts of bighead atractylodes rhizome, 5-10 parts of allium macrostemon, 9-15 parts of snakegourd fruit, 3-9 parts of pinellia ternate, 3-10 parts of cassia twig, 10-20 parts of poria cocos, 6-12 parts of Chinese angelica, 9-15 parts of radix scrophulariae, 6-15 parts of honeysuckle, 3-10 parts of turmeric, 3-15 parts of rheum officinale, 5-10 parts of stiff silkworm, 3-10 parts of immature bitter orange and 2-10 parts of liquorice.

2. The traditional Chinese medicine composition according to claim 1, wherein the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight:

30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 12g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange and 10g of liquorice.

3. The traditional Chinese medicine composition according to claim 1, wherein the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight: 30g of astragalus, 10g of bighead atractylodes rhizome, 10g of allium macrostemon, 15g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 12g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 10g of immature bitter orange and 9g of liquorice.

4. The traditional Chinese medicine composition according to claim 1, wherein the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight: 30g of astragalus, 12g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 10g of Chinese angelica, 10g of radix scrophulariae, 9g of honeysuckle, 10g of turmeric, 9g of rheum officinale, 10g of stiff silkworm, 9g of immature bitter orange and 10g of liquorice.

5. The traditional Chinese medicine composition according to claim 1, wherein the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight: 28g of astragalus, 10g of bighead atractylodes rhizome, 9g of allium macrostemon, 9g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 14g of poria cocos, 10g of Chinese angelica, 10g of radix scrophulariae, 9g of honeysuckle, 10g of turmeric, 10g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange and 10g of liquorice.

6. The traditional Chinese medicine composition according to claim 1, wherein the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight: 29g of astragalus, 10g of bighead atractylodes rhizome, 10g of allium macrostemon, 15g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 10g of Chinese angelica, 10g of radix scrophulariae, 9g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 10g of stiff silkworm, 10g of immature bitter orange and 9g of liquorice.

7. The traditional Chinese medicine composition according to claim 1, wherein the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight: 30g of astragalus, 10g of bighead atractylodes rhizome, 9g of allium macrostemon, 9g of snakegourd fruit, 9g of pinellia tuber, 10g of cassia twig, 14g of poria cocos, 11g of Chinese angelica, 10g of radix scrophulariae, 10g of honeysuckle, 9g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 10g of immature bitter orange and 10g of liquorice.

8. The traditional Chinese medicine composition according to claim 1, wherein the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight: 30g of astragalus, 10g of bighead atractylodes rhizome, 10g of allium macrostemon, 10g of snakegourd fruit, 9g of pinellia tuber, 9g of cassia twig, 15g of poria cocos, 11g of Chinese angelica, 11g of radix scrophulariae, 10g of honeysuckle, 10g of turmeric, 9g of rheum officinale, 9g of stiff silkworm, 9g of immature bitter orange and 8g of liquorice.

9. The traditional Chinese medicine composition according to claim 1, wherein the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight: 9-30 parts of astragalus membranaceus, 6-12 parts of bighead atractylodes rhizome, 5-10 parts of allium macrostemon, 9-15 parts of snakegourd fruit, 3-9 parts of pinellia ternate, 3-10 parts of cassia twig, 10-20 parts of poria cocos, 6-12 parts of Chinese angelica, 9-15 parts of radix scrophulariae, 6-15 parts of honeysuckle, 3-10 parts of turmeric, 3-15 parts of rheum officinale, 5-10 parts of stiff silkworm, 3-10 parts of immature bitter orange, 2-10 parts of liquorice and 10-20 parts of prepared aconite root.

10. The traditional Chinese medicine composition according to claim 1, wherein the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight: 9-30 parts of astragalus membranaceus, 6-12 parts of bighead atractylodes rhizome, 5-10 parts of allium macrostemon, 9-15 parts of snakegourd fruit, 3-9 parts of pinellia ternate, 3-10 parts of cassia twig, 10-20 parts of poria cocos, 6-12 parts of Chinese angelica, 9-15 parts of radix scrophulariae, 6-15 parts of honeysuckle, 3-10 parts of turmeric, 3-15 parts of rheum officinale, 5-10 parts of stiff silkworm, 3-10 parts of immature bitter orange, 2-10 parts of liquorice and 10-15 parts of spina date seed.

11. The traditional Chinese medicine composition according to claim 1, wherein the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight: 9-30 parts of astragalus membranaceus, 6-12 parts of bighead atractylodes rhizome, 5-10 parts of allium macrostemon, 9-15 parts of snakegourd fruit, 3-9 parts of pinellia ternate, 3-10 parts of cassia twig, 10-20 parts of poria cocos, 6-12 parts of Chinese angelica, 9-15 parts of radix scrophulariae, 6-15 parts of honeysuckle, 3-10 parts of turmeric, 3-15 parts of rheum officinale, 5-10 parts of stiff silkworm, 3-10 parts of immature bitter orange, 2-10 parts of liquorice and 3-10 parts of radix bupleuri.

12. The traditional Chinese medicine composition according to claim 1, wherein the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight: 9-30 parts of astragalus membranaceus, 6-12 parts of bighead atractylodes rhizome, 5-10 parts of allium macrostemon, 9-15 parts of snakegourd fruit, 3-9 parts of pinellia ternate, 3-10 parts of cassia twig, 10-20 parts of poria cocos, 6-12 parts of Chinese angelica, 9-15 parts of radix scrophulariae, 6-15 parts of honeysuckle, 3-10 parts of turmeric, 3-15 parts of rheum officinale, 5-10 parts of stiff silkworm, 3-10 parts of immature bitter orange, 2-10 parts of liquorice and 1-3 parts of cinnamon.

13. The traditional Chinese medicine composition according to claim 1, wherein the traditional Chinese medicine composition is prepared from the following raw materials in parts by weight: 9-30 parts of astragalus membranaceus, 6-12 parts of bighead atractylodes rhizome, 5-10 parts of allium macrostemon, 9-15 parts of snakegourd fruit, 3-9 parts of pinellia ternate, 3-10 parts of cassia twig, 10-20 parts of poria cocos, 6-12 parts of Chinese angelica, 9-15 parts of radix scrophulariae, 6-15 parts of honeysuckle, 3-10 parts of turmeric, 3-15 parts of rheum officinale, 5-10 parts of stiff silkworm, 3-10 parts of immature bitter orange, 2-10 parts of liquorice and 10-20 parts of ligusticum wallichii.

14. A traditional Chinese medicine preparation for treating acute myocardial infarction, which is characterized in that the traditional Chinese medicine composition of any one of claims 1-13 is prepared into decoction, granules, capsules, tablets, powder, pills or oral liquid.

15. Use of a traditional Chinese medicine composition according to any one of claims 1-13 or a traditional Chinese medicine preparation according to claim 14 for the preparation of a traditional Chinese medicine for the treatment of acute phase of myocardial infarction.