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 TCM category of "chest obstruction," with treatment focusing on broadening the chest, regulating qi, dispersing depression, and promoting yang circulation. The formula Gualu Xiebai Banxia Tang is recommended, along with recent integrated Chinese-Western research on coronary heart disease, incorporating blood-activating and stasis-resolving drugs such as Guanxin II and Guanxin Suhé Wan. Pleurisy belongs to the TCM categories of "suspended fluid" and "chest constriction." Clinically, one can choose among Ten Zao Tang, Da Xianxiong Tang (pill), and Xiao Xianxiong Tang. Some patients present with pathogenic factors invading Shaoyang, in which case Xiao Chaihu Tang and Da Chaihu Tang with modifications are effective. 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, Da Qinglong Tang, Xiebai San, and Tingli Dazao Xiefei Tang. When necessary, Wuwei 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 Gui Zhi Jia Houpu Xingzi Tang. Bronchial asthma falls under the TCM categories of "lung distension" and "phlegm wheezing," requiring selection from Maxing Shigan Tang, Xiao Qinglong Tang, Suzi Jiangqi Tang, and Houpu Ma Huang Tang. Emphysema is related to kidney's inability 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. Bronchiectasis can be caused by wind-heat or wind-cold and also falls under lung distension; if hemoptysis occurs, it should be treated based on either "blood heat running wild" or "qi deficiency unable to control bleeding." Cor pulmonale falls under the TCM category of "fluid retention in the lungs," with treatment focusing on eliminating phlegm, draining water, and calming the spirit. Formulas such as Linggui Zhugan Tang, Zhenwu Tang, and Baizi Yangxin Tang are 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, and 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 effective; for severe pain, add Yuanhusuo and Chuanlianzǐ. Liver disease focuses on treating the liver, emphasizing regulation of 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 patients 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 typically caused by 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, Zhigan Cao Tang, and Shengmai San being suitable choices. 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 foundation to reduce side effects of these treatments.