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Abstract
Background: the ancient classical formulae text Essential Prescriptions of the Golden Cabinet (Chin Gui Yao Lue, CGYL) is one of four Chinese medicine canons which are widely studied and used by clinical medicine practitioners. It was written by Chang Chung-Ching[张仲景] during the post Han dynasty. It was also called “ miscellaneous diseases”[杂病], basically a catch-all phrase for many internal conditions. This text is characterized as containing both diagnostic guidelines and etiological reasoning in addition to instructions for the treatment with herbal formulae.
Material and methods: in this classical text, there is a chapter specific to heart disease, which is “Chest Impediment, Heart Pain, and Shortness of Breath”[胸痹心痛短气篇]. Heart disease is the leading cause of death in Taiwan and northern America. One person dies every 176 seconds in the Taiwan from cardiovascular disease. By meta-analysis and comparative study of texts, this study shows the clinical usage and evidence for treating cardiovascular disease.
Results: the therapeutic goal of treating heart disease is to extend the patient’ s lifespan by delaying the progression of serious complications and reducing cardiovascular events. In addition, an increasing number of patients with heart disease have resorted to the use of Chinese medicine (CM) as an alternative or integrated treatment model from Taiwan National Health Insurance records. The efficacy and advantage of CM have been demonstrated in many clinical trials. Gwa Lou Xie Bai Ban Shia Tang can decrease the frequency of angina pectoris attacks and improve ECG; Zhi Shih Xie Bai Gui Zhi Tang integrated with west medicine can significantly improve angina attacks, EKG, blood lipid level, and the number of
adverse events. Zhi Gan Tsao Tang combined with conventional western medicine in the treatment of chronic heart failure. Meta-analysis results show that integrated Zhi Gang Tsao Tang and conventional western medicine have better therapeutic effects and safety than only using conventional medicine.
Discussion: this paper aims to present the clinical application of “Chest Impediment, Heart Pain, and Shortness of Breath” from CGYL in modern clinical practice for treating heart diseases and reducing risk factors for cardiovascular disease. Based on its patho-mechanisms of Chest Impediment, Yang Wei Yin Shian, the treatment principles for dispelling excess and strengthening deficiency along with main classic herbal prescriptions for heart diseases will be discussed; the associated evidence for tonify Heart Yang, strengthening Qi, invigorating blood stasis, dispel dampness herbal prescriptions will be presented.
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271.5经方金匮原典对治心病证候
