CHF is one of the common severe cases in the internal department. We have treated this disease by clearing lung, benefiting water and activating blood for 3 years and received satisfying curative effects in near term. All the cases are in-patient of our hospital among 53-81 years old, 66 years old on average, and the disease courses are 3-14 years. The clinical manifestations are cough, expectoration, breathlessness, palpitation, dark lip, dyspnoea, orthopnea, venous engorgement of neck, dry and moist rales of lungs, hepatomegaly and edema of both lower limbs, etc. The heart function (according to the NYHA Grading Standards): 10 cases are IV Grade, 21 cases are Ⅲ Grade and 7 cases are II Grade; 5 of which combine with pulmonary encephalopathy, 11 of which are acid-base imbalance and electrolyte disturbance, 3 of which are arrhythmia, 1 of which is shock and 2 of which are hemorrhage of upper digestive tract. CHF lasts for 1-14 months.
Treatment: the treat group mainly is treated by clearing lung, benefiting water and activating blood. The prescription: Zhi Ma Huang, Xing Ren, Sheng Shi Gao(decoct first), Yu Xing Cao, Tian Zhu Huang, Ting Li Zi, Da Fu Pi, Ze Xie, Che Qian Zi, Dan Shen, Chi Shao, Tao Ren and Sheng Gan Cao. Apply Sheng Da Huang(decoct last) for constipation; apply Xian Zhu Li for wheezy phlegm; apply Zi Xue Dan for restlessness; subtract Sheng Shi Gao, Ting Li Zi, Che Qian Zi, and apply Tai Zi Shen, Wu Wei Zi for deficiency of vital qi, excess of pathogen, sweating, coldness of limbs, throat congested with thick sputum; apply Fu Zi, Xi Yang Shen, Gan Jiang for grey appearance, coldness of four limbs, thread and weak pulse. And combine with normal therapy, resting therapy, dietotherapy, anti-infective therapy, oxygen therapy, dispelling phlegm, small dose atrial fibrillation, diuretics, vasodilator, and retrieving water-electrolyte disturbances and double acid-base disorders. In the 30 cases of control group, we treat the patients with western medicine only, and do intravenous drip with 40mg dobutamine mixed 10% glucose of 250ml, 15-30 drips for per minutes, twice a day and one treatment course is 7-14 days.
Results: in the treat group of 38 cases, 12 cases are cured, 15 cases are markedly improved, 7 cases improved and 4 cases failed, with the total effective rate of 89.47%. In the control group of 30 cases, 6 cases are cured, 11 cases are markedly improved, 5 cases improved and 8 cases failed, with the total effective rate of 73.3%.
Discussion: In this prescription, the Ma Huang, Xing Ren, Shi Gao and Gan Cao are used for clearing lung, dispelling phlegm and relieving asthma, Yu Xing Cao is used for clearing heat and toxin. Large numbers of data suggests that the herbs above can resist inflection, reduce respiratory secretions, resist internal toxin and inflammatory mediators, and increase the macrophage function. Tian Zhu Huang is the key medicine for clearing heat and dispelling phlegm, and especially good for the cough and asthma due to excess heat and phlegm in lung. Ting Li Zi is used for clearing lung heat and dispelling phlegm; Da Fu Pi for strengthening spleen, benefiting dampness and water; Ze Xie for opening the urine bladder to benefit water and relieve edema; Che Qian Zi for opening the triple energizers and benefiting water. The combination of herbs above can benefit water, relieve edema and strengthen heart. Tao Ren, Dan Shen, Chi Shao are used for activate blood circulation and eliminate blood stasis. The modern pharmacology suggests that these herbs can expand blood vessels, reduce the LAR of platelet to reduce impedance of PE, alleviate the fore & hind cardiac load and improve the heart function. According to different syndromes, open the zang-fu, clear heat in fu organs and heart, relieve irritability, benefit qi, nourish yin and rescue from collapse by restoring yang to dispel phlegm and heat, remove the water and blood stasis, descend lung-qi and clear both heart and mind. It is extremely effective.
Key Words: CHF, clearing lung benefiting water and activating blood therapy
Heqing Huang, Feng Lu, Xi Li, Huaguang Chen, Meiyu Peng
Internal Department 3, the Second People’s Hospital, Fujian Province (350003)
Gushan Traditional Chinese medicine, Fuzhou
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