Ni case. Heart disease (angina pectoris with diabetes)

This is a dangerous case of heart disease, which is angina pectoris in nine kinds of heartache. It is not 100% operable when going to western medicine. I can't have an operation because of poor kidney function and diabetes. The patient suffers from diabetes and hypertension. This situation can only be solved by Chinese medicine. Since Chinese medicine can cure angina patients with other diseases, angina patients without other diseases can certainly be cured, so there is no need for surgery.

This case will involve how to get rid of the blood stasis in the heart and restore the function of the heart, which symptoms prove that the patient has improved and which symptoms prove that the patient has fully recovered. Through this case, heart disease, whether mitral or tricuspid insufficiency or arrhythmia, can be treated in the same way. Through the study of this case, you will be very flexible when choosing drugs in the future.

There are only a few prescriptions for chest pain in Synopsis of the Golden Chamber. Although there is red and blue flower wine to treat tingling, it is still not enough. The red and blue flowers are safflower. There are two kinds: one is saffron and the other is Sichuan saffron. Clinically, saffron is light, produced in the plateau above 5000 meters, colorless and tasteless, so it enters the brain. Saffron is better than saffron for patients with cerebral hemorrhage. If the artery is near the heart, saffron is better than saffron. Saffron stinks, and the taste is strong. Any drug with a strong taste will enter the blood, and a weak taste will enter the gas. Other special drugs are introduced to you through this case. After learning about this case, other heart diseases are not difficult to treat.

First diagnosis

I. The case

A burly 60-year-old man complained of high blood sugar, severe chest pain, foot pain, rheumatoid arthritis in his hands, back pain, a lot of stomach acid and obesity, which was the reason for his visit. Western medicine report: the arterial blockage is very serious.

Consultation:

1, my hands are cold and my feet hurt. I don't know if it's cold.

2. Slow urination;

3. Poor sleep;

4, stool one line a day;

5. Numbness of hands and feet

The main symptom of the patient is severe heartache, and it is persistent pain, which represents a real disease. In fact, it's not necessarily the first time, but it also means that something is stuck in it, causing severe pain. If you only feel dull pain occasionally, it's just a heart blockage, and you don't need drugs to promote blood circulation and remove blood stasis. Can be removed by Euryale ferox, Allium macrostemon, Fructus Aurantii Immaturus, etc.

Blood pressure: 168-83. According to western medicine, his low blood pressure is normal, and his high blood pressure means heart disease. Some people have normal high blood pressure and low blood pressure, which means there is something wrong with the kidney.

Examination: there is strong tenderness in the center of the auricle and the fifth vertebra, suggesting that the heart artery is blocked. If such patients have poor sleep, chest numbness, numbness of hands and feet, irregular stool, a heart attack will go away. The only thing that benefits this patient is that the stool is OK (one line a day). The heart and the small intestine are both exterior and interior, and the beating speed of the heart and the small intestine is the same. The stool is normal every day, which means that even if there is blood vessel blockage, the heart beats well, and you can drive for 3 hours without losing that speed. This is an opportunity to treat the disease.

The patient came for an injection the next day, but he couldn't get it, so he prescribed a prescription and was completely cured at last. If you can do acupuncture continuously, you will recover quickly. For this kind of heart disease, the acupoints are Gongsun, Neiguan, Jutan, Guanyuan and Xinshu (Shu Mu Fa), and the needles are buried in the center of the ear. If you have angina pectoris, try hard. In addition to the above points, you can also choose to select points along the meridian: if the pain is in the middle (ren mai), you can choose to leak points; If the pain is near Ren meridian 1.5-2 inch (kidney meridian), you can stab the opposite Gu Ran point instead of Yongquan point. If you puncture Yongquan point in first aid, it is usually very painful and unnecessary. If it is on the stomach meridian, it is full (the heart of the well is full).

When doing acupuncture, whether the heart is blocked, the artery is blocked or the valve is not closed, the needle is the same.

How to distinguish symptoms? Quite simply, if a patient has valve insufficiency, his heart blood will return. In the words of traditional Chinese medicine, if the yang of the heart is insufficient, the yin will come back, come back, the blood will not circulate normally, and the chest (between the lungs and the heart) will lose its pressure balance. The lungs are like a canopy, separating the chest from the outside world. The pressure in the lungs is the same as that at sea level, so people are very comfortable at sea level. People will be uncomfortable when the pressure is high on the 5000-meter mountain. So is the human body. If the pressure of the heart and lungs is exactly the same when they are coordinated, if the blood from the heart flows back to the heart, the lungs will temporarily lose pressure. I don't usually feel it. When you get off the plane, you will feel your shoulders are very sore and you need to press them to feel comfortable. This is a sign that the standard valve (two valves/three valves) is damaged. Usually, if I am too tired, my shoulder hurts. The exploration of auricular-cardiac points mostly focuses on arterial obstruction or coronary atherosclerosis. If there is something wrong with the heart structure (arrhythmia, two valves and three valves), it is mostly manifested as tenderness of the fifth vertebra, but there is no tenderness at the auricular point. All heart diseases can be treated with Chinese medicine.

2. Prescriptions (5 prescriptions, 7 days)

In the treatment of vascular problems, there are three kinds of drugs that are necessary, whether it is arterial vascular dissection or vascular blockage, or blood problems. First, fix the blood vessels to prevent them from rupturing. Chuanxiong 3 yuan, Peony bark 3 yuan, Peach Blossom 3 yuan. These three drugs are like triplets, which are a group and can be used for systemic blood problems. For example, after taking aspirin or other western medicines, it is easy to bleed. These three medicines are enough to close your mouth quickly, or they can also be used for falls and injuries. I feel a sharp pain in the middle of my heart I used Sichuan safflower 1 money (1 money stinks). The above four flavors are used to dredge blood vessels, but blood doesn't work.

This patient is accompanied by tenderness of the fifth vertebra, and the prescription is Gualou 5 yuan (because the patient is very strong), Bulbus Allii Macrostemi 3 yuan and Guizhi 4 yuan. Trichosanthes kirilowii and Fructus Aurantii Immaturus both look like hearts, and Trichosanthes kirilowii is whiter than pericardium. Fructus Aurantii Immaturus is like a small orange, which is darker in color and stronger in taste, and enters the heart. This is the case with Fructus Aurantii Immaturus in Xiao Xiong soup. The color of Allium macrostemon is white, with the smell of garlic, and the color is pungent into the lungs, which is why Allium macrostemon is used. In addition, its taste is strong in the heart, so it will choose Allium macrostemon, not gypsum. Gypsum is light, only enters the lungs but not the heart, and the spleen is the mother of the lungs. Therefore, if the plaster goes down, it will affect the mother and reduce her appetite. Trichosanthes kirilowii, Allium macrostemon Bunge, and Cinnamomum cassia twig, together, have a sense of qi, and the qi can't pass, so there will be a dull pain. There is tenderness in the auricular points and the fifth vertebra, so you should use your heart and force.

Because my heart ached badly and I was afraid that my medicine was not strong enough, I added 3 yuan to the earthworm. Earthworms are earthworms, and they are very powerful everywhere. The reason why they are used is to hope that the patient's whole body is connected with blood, which is one of them. Second, the patient's feet hurt, the feet are the ground, the head is the sky, the saffron enters the sky, and the ground depends on earthworms. If only safflower and earthworm are opened, patients will faint on the spot after eating them, because they will only attack blood without replenishing blood, and their qi and blood will be weak, which will definitely be unbearable. Siwu decoction can be used for blood deficiency. Lumbricus is a powerful medicine for promoting blood circulation and removing blood stasis, which is suitable from foot to head, including blood stasis in brain. Buyanghuanwu decoction was very effective in treating cerebral apoplexy and blood stasis before, because there was earthworm in it, and all the blood stasis was discharged when it went in. Carthamus tinctorius only removes blood accumulated in blood vessels, and the blood that overflows between tissues outside blood vessels or remains in meninges depends on earthworms. Clinically, when blood stasis cannot be removed by drugs for promoting blood circulation and removing blood stasis, drugs for promoting blood circulation and removing blood stasis with heavier properties should be selected. At this time, we should consider using animal medicine. Veterinary drugs are very powerful, but don't use them casually. We must consider them comprehensively, otherwise people will be weak. If you roast earthworms, your legs will be soft after eating, because the blood is destroyed.

For fear of blood deficiency after using dragon, add 2 yuan Angelica. Angelica is a good name. If you can't come back after eating earthworm, use angelica. Achyranthes bidentata is 3 yuan for foot pain, Akebia stem is 3 yuan for heart qi, and Akebia stem is qi between heart meridian and small intestine. According to the normal drug selection, 1 Radix Paeoniae Alba (the patient is very strong), Fructus Trichosanthis, Bulbus Allii Macrostemonae and 3 yuan Fructus Aurantii Immaturus will be used. Ramulus Cinnamomi strengthens the strength of the heart, accelerates the beating speed of the heart, and the ejection force of blood will also be strengthened. When blood gushes out, cooperate with safflower and earthworm to remove blood stasis. At the same time, use Chuanxiong to repair blood vessels, for fear of blood vessel rupture, because blood vessels will be blocked when they rush in, and there is great pressure when they want to get through, so add Chuanxiong to protect blood vessels from rupture.

Fructus Aurantii Immaturus is used because of tenderness of the fifth vertebra, so Fructus Aurantii Immaturus, Fructus Trichosanthis and Bulbus Allii Macrostemi are the main prescriptions for treating thoracic obstruction, which refers to stagnation of heart-qi, and stagnation of heart-qi in traditional Chinese medicine refers to valve insufficiency in western medicine, which is a structural problem.

To treat heart disease, we will add Coptidis Rhizoma 2 yuan, Scutellariae Radix 2 yuan, Herba Asari 2 yuan and Radix Aconiti Lateralis 3 yuan. The reason for adding aconite is that the patient can't urinate, which has little to do with the heart. Although it has nothing to do with the lack of heart strength in old age, the main reason is that the small intestine is not hot enough and the lower coke is insufficient. Western medicine may say that it is prostatic hypertrophy or something. It doesn't matter. We use asarum to process aconite.

The patient took Hantang 77 at the same time, fearing that the pills were not strong enough, and then prescribed decoction. Hantang 77 is very simple, that is, Fructus Trichosanthis, Bulbus Allii Macrostemon, Ramulus Cinnamomi, Rhizoma Chuanxiong, Cortex Moutan, Semen Persicae and Flos Carthami.

Second diagnosis

Q: 1, sleep is still very poor, indicating that the heart has not fully recovered;

2, hand numbness to 80%, foot numbness is still there;

3, my heart hurts;

4. The belching is reduced.

Examination: There is still tenderness at the auricular point and the fifth vertebra, but only a little tenderness at the fifth vertebra.

Tongue coating: yellow, wet and thick.

Prescription: The original prescription stipulated that it should be paid 5 times in 7 days.

At the third diagnosis, blood pressure 168-82 (unchanged) and blood sugar 16 1.

Q: 1, the chest pain is all gone;

2, the belching has dropped a lot;

3, a little numb. The foot is the farthest place of centrifugation. You can know the initial heart problem from the cold numbness on your feet, so you can't stop taking medicine when you have no chest pain in the treatment of heart disease. Limbs are the first and most sensitive places where Yin and Yang meet. When the yin and yang in the body are unbalanced, the limbs can be felt first. That is to say, at the early stage of the disease, when there was no serious blockage, his hands and feet must have been numb years ago, but he didn't know it, so he went to see a western doctor, who told him to see a neurologist.

4. Sleeping will still wake up, but the patient feels a lot of progress;

5, hand temperature, numbness, but will feel swollen, because of rheumatoid arthritis.

Prescription: The original prescription stipulated that it should be paid 5 times in 7 days.

Fourth blood pressure: 143-67.

Q: 1, burp;

2, the feet are a little numb, the hands and feet are hot, and the hands are still swollen. Because there is no cure for rheumatoid disease, emergency treatment should be given first.

3, sleep is still not good. When treating heart disease, the patient's sleep did not recover, or night sweats or no sweating during exercise, indicating that the heart has not recovered, and the heart governs five fluids.

Prescription: The original prescription, plus Ziziphus jujuba seed 3 yuan. Ziziphus jujuba seeds can soothe the nerves, return blood to the liver and help sleep.

The prescription of the fifth consultation is the same as that of the fourth consultation.

At the sixth diagnosis, blood glucose 167 and blood pressure 168-73.

Q: 1, and belching, which has nothing to do with the heart, but stomach acid.

2, dysuria;

3, hands and feet are a little numb;

4. Can't sleep well

Prescription:

No candy, no artificial sugar.

Inula 3 yuan, ochre 3 yuan, Pinellia 3 yuan, Fructus Aurantii Immaturus 3 yuan, Coptis 2 yuan, plus: earthworm 2 yuan, Allium macrostemon 3 yuan, safflower 1 yuan. Determine whether there is blood stasis and press the ear center. My hands and feet are numb, and everything else is the same as before: Guizhi 4 yuan, Angelica 2 yuan, Achyranthes 3 yuan, Akebia 3 yuan, Paeonia lactiflora 1 two.

There is a kind of chest pain, which is Xiao Xiong Tang. There is nothing wrong with the heart. Gastric acid burned back to the chest, and the thoracic esophagus was burned. This is very sad. It looks like a heart attack, but it's not, so it's changed to a small chest soup.

Because the patient had a long journey, he took medicine for a month.

At the seventh diagnosis, blood pressure 130-80 and blood sugar 160.

Q: 1, all the pain in my heart; 2, the numbness of the hand is gone, only the joints are swollen (rheumatism); 3, there is often water in the ear, which is water disease.

Two months before and after this case, the arteries and blood vessels were completely opened, and the patient returned to normal and slept well. But if you don't change your living habits in the future, you will get sick. For example, I like to eat fried food (easy to cause blood vessel blockage), vitamins and other nutrients (which will damage heart valves), and eat a lot of sour food, sweets, cola and coffee (which will cause blood stasis on my feet and acid will accumulate on my feet). Many eating habits lead to this disease. There is nothing wrong with the heart itself. If I eat normally, exercise normally and live regularly, my heart will not get sick. If I get sick, it must be from outside.

This prescription is the most serious one for heart disease. If it wasn't so painful and a little painful, there would be no need to use such a strong prescription. Chest tightness plus Ligusticum Chuanxiong, Cortex Moutan, Peach Blossom, no pain or numbness in hands and feet. That's enough.

It stands to reason that Paeonia lactiflora is not used for chest tightness. In this case, the reason for using a lot of white peony root is that the patient's instep is very painful and there is blood stasis, so white peony root is used. If you use white peony root, you must use aconite root. Paeonia lactiflora does not promote blood circulation to remove blood stasis, but only pushes blood back to the heart, and may also push blood stasis back. According to the medical code, Paeonia lactiflora is sour, and many blood clots return to the aorta together. Without processed aconite, these blood clots will not melt without temperature. Therefore, when the feet are ice, when the white peony root is taken back, the prepared aconite root is heated, and the hot ice will melt. Therefore, the congestion on the feet really broke out, so hot drugs were used instead of drugs for promoting blood circulation and removing blood stasis. To treat heart disease, it is necessary to treat the patient until he can sleep, sweat, numb hands and feet, normal stool and no dull pain in the chest before stopping taking the drug.

Heartache and backache in the golden chamber are caused by phlegm moving on the mediastinum, which can also cause heart disease. Fuzi (Mei) Chishizhi Pill is the main prescription to dispel the phlegm in pericardium. Any heart disease, whether caused by phlegm, blood stasis or heart structural problems, is based on the principle that a good sleep, no pain in the heart and warm hands and feet are the right way. If the patient can't sleep after taking medicine or acupuncture, his chest is getting more and more painful, and his hands and feet are getting colder and colder, then let him go to another doctor quickly. An injection can relieve the pain immediately, but just open it, and you should take medicine afterwards and clean it all up. In fact, there is no need to go to western medicine for filming or examination, and patients will feel it themselves.

Take this case as the general principle and prescribe the right medicine. I repeat: blood vessel obstruction must be a stabbing pain, and stuffy pain is a matter of mind. It is not necessary to use drugs for promoting blood circulation and removing blood stasis, but if drugs for promoting blood circulation and removing blood stasis are used instead of blood stasis, patients will be deficient in blood. If the stabbing pain is treated with drugs for promoting blood circulation and removing blood stasis, some drugs for enriching blood should be added later, so that the patient will not be deficient in blood. This is the principle of treating diseases.

Later, I met a patient with heart disease, who had an operation, used anesthetic, took sedatives or vasodilators or rat poison. Her stomach is swollen and her whole body is yellow, which looks dangerous, but her heart pulse is ok, her voice is loud and she is full of gas, which shows that her illness was cured by western medicine and she is in good health. If the heart is open to the tongue, of course, heart patients can't talk. The principle of treatment is to ensure that her hands and feet are warm. If her hands and feet are cold, it means she is weak inside. So it costs 3 yuan to prescribe Sini decoction and raw aconite, so Sini decoction can also treat her heart.

Heart pulse is most afraid of touching kidney pulse, because water is fire, and pulse diagnosis is most afraid of touching phase pulse. For example, patients with liver disease feel that lung pulse is dead, patients with heart disease feel that kidney pulse is dead, and patients with spleen feel that string pulse of liver is dead.

In the solar terms, autumn and winter are unfavorable to heart patients and prone to heart disease.

Note: The prescriptions involved in this article are for learning and communication only and are not used for other purposes.