Chest Pain

Chest Pain

Coronary heart disease, pleurisy, pulmonary inflammation, lung cancer, pleural mesothelioma, intercostal neuralgia, chronic pancreatic disease, liver disease, heart valve disease, arrhythmia, and other conditions can all cause chest pain. First, a Western medical diagnosis should be made to determine the cause of the pain, followed by TCM syndrome differentiation. Coronary heart disease falls under the category of "chest obstruction" in TCM, with treatment focusing on relieving chest tightness, regulating qi, dispersing depression, and promoting yang circulation. The formula Gualu Xiebai Banxia Tang is recommended, along with recent studies on the integration of Chinese and Western medicine in treating coronary heart disease, incorporating blood-activating and stasis-resolving drugs such as Guanxin II Hao and Guanxin Suhé Wan. Pleurisy belongs to the categories of "suspended fluid" and "chest constriction" in TCM; clinicians can choose among formulas like Shizao Tang, Daxianxiong Tang (pill), and Xiaoxianxiong Tang. Some patients may present with pathogenic factors invading Shaoyang, in which case Xiaochaihu Tang and Dachaihu Tang with adjustments can be used. Pulmonary infections include lobar pneumonia, bronchial pneumonia, viral pneumonia, chronic bronchitis, emphysema, cor pulmonale, bronchial asthma, and bronchiectasis, among others. In TCM, all types of pneumonia are collectively referred to as "real fire accumulating in the lungs" and "phlegm-heat cough," requiring selection from formulas such as Maxing Shigan Tang, Daqinglong Tang, Xiebai San, and Tingli Dazao Xiefei Tang. When necessary, Wumei Xiaodu Yin can be added to enhance heat-clearing and detoxifying effects. Inflammation of the trachea is typically caused by wind-heat or wind-cold, with options including Sangju Yin, Jingfang Baidu San, Su Xing San, Ma Huang Tang, and Guizhi Jia Houpu Xingzi Tang. Bronchial asthma falls under the category of "lung distension" and "phlegm wheezing" in TCM, requiring selection from Maxing Shigan Tang, Xiaoqinglong Tang, Suzi Jiangqi Tang, and Houpu Ma Huang Tang. Emphysema is related to kidney qi failing to contain qi; if accompanied by infection, it becomes a case of "upper excess, lower deficiency," with formulas such as Suzi Jiangqi Tang and Duqi Wan being suitable choices. Bronchiectasis can be caused by wind-heat or wind-cold and also falls under the category of lung distension; if hemoptysis occurs, it should be treated based on either "blood heat running rampant" or "qi deficiency unable to control bleeding." Cor pulmonale is classified as "fluid retention" in TCM, requiring treatment to eliminate phlegm, drain water, and calm the spirit, with formulas such as Linggui Zhugan Tang, Zhenwu Tang, and Baizi Yangxin Tang being recommended. Intercostal neuralgia is caused by qi stagnation and blood stasis in the Shaoyang region, requiring addition of qi-moving and blood-activating herbs to Chaihu Shugan San, or use of Fuyuan Huoxue Tang, Taohong Siwu Tang, Huoluo Xiaoling Dan with pangolin scales, soapberry spines, frankincense, and myrrh. Chronic pancreatic disease is often linked to liver qi stagnation and liver wood overcoming earth, with formulas such as Chaihu Shugan San, Xiaoyao San, and Dajianzhong Tang being recommended; for severe pain, add Yuanhusuo and Chuanlianzǐ. Liver disease focuses on treating the liver itself, with emphasis on regulating liver function. TCM syndrome differentiation still mainly identifies liver qi stagnation and liver wood overcoming earth, with formulas such as Chaihu Shugan San, Danzhi Xiaoyao San, and Qianggan Tang being preferred. Additionally, as mentioned earlier, for those with significant turbidity in liver function, heavy use of astragalus, salvia miltiorrhiza, and polygonum multiflorum is recommended; for those with markedly elevated transaminases, dandelion, houttuynia cordata, white snake tongue grass, and banzhilian are favored. The former is due to decreased albumin, indicating deficiency, thus requiring tonification; the latter is due to increased transaminases, indicating excess, thus requiring heat-clearing and detoxifying treatment. Heart valve and arrhythmia conditions are often related to water qi overwhelming the heart, dampness hindering yang, blood failing to nourish the heart, and dual deficiency of qi and blood, with formulas such as Linggui Zhugan Tang, Zhenwu Tang, Baizi Yangxin Tang, Zhigancao Tang, and Shengmai San being chosen. Lung cancer and pleural mesothelioma require early consultation with Western specialists; if surgery opportunities are missed, chemotherapy and radiation therapy should be administered, with TCM supporting the body and strengthening its vital energy to reduce side effects of these treatments.