Clinical indications for Bupleuri Radix treatment encompass a syndrome marked by fullness and discomfort in the chest and hypochondrium, a bitter taste in the mouth, dry throat, dizziness, insomnia, anxiety, depression, susceptibility to fright, upset, dreaminess and other psychiatric symptoms. This is accompanied by a red tongue, a thick and yellow coating, and a wiry, hard, and powerful pulse. Further investigation revealed the concurrent use of this formula with other well-known formulas, such as Gualou Xiebai Decoction, Wendan Decoction, Zhizhu Pills, Juzhijiang Decoction, Suanzaoren Decoction, and Banxia Baizhu Tianma Decoction.
A heavy and frequent occurrence of the cardiovascular disease arrhythmia negatively impacts China's public health sector. Pharmacological and surgical approaches are employed to treat the estimated 20 million individuals in China afflicted by this malady. Antiarrhythmic drugs, unfortunately, can sometimes produce arrhythmias as a side effect, and surgical procedures carry the risk of failure and the recurrence of the problem. Therefore, the clinical benefits of treating arrhythmia are not yet optimal. Palpitations, or arrhythmia, are, according to traditional Chinese medicine (TCM), linked to seven conditions: liver qi stagnation and depression, accumulation of turbid phlegm, heart-damaging fluid retention, fire-heat disrupting the heart, stasis obstruction within the heart vessels, cold congealing within the heart vessels, and deficiency in Qi, blood, Yin, and Yang. This study, therefore, proposed seven distinct TCM arrhythmia syndromes, characterized by palpitations resulting from depression, phlegmatic accumulation, fluid retention, heat, blood stasis, cold, and deficiency. The recommended treatment strategies for palpitation are: Chaihu Longgu Muli Decoction for palpitation associated with depression, Wendan Decoction for palpitation related to phlegm, Linggui Zhugan Decoction for palpitation caused by fluid retention, Sanhuang Xiexin Decoction for palpitation due to fire, Xuefu Zhuyu Decoction for palpitation due to blood stasis, and Mahuang Fuzi Xixin Decoction for palpitation due to cold. Further, Guizhi Gancao Decoction, Guizhi Gancao Longgu Muli Decoction, Huanglian Ejiao Decoction, Zhigancao Decoction, and Guipi Decoction are suggested for palpitation stemming from Qi, blood, Yin, or Yang deficiency. When a patient displays multiple Traditional Chinese Medicine syndromes, their corresponding formulas should be combined. This study, leveraging the correspondence between formula and syndrome, and employing a treatment approach encompassing both the pathogenesis and pathology, and herbal properties and pharmacology, developed a holistic 'pathogenesis-pathology-nature-pharmacology' model to optimize the clinical benefits of classic herbal formulas in treating arrhythmias.
Among classic herbal formulas, Xiao Chaihu Decoction and Maxing Shigan Decoction are frequently employed together in a time-tested approach. ZHANG Zhong-jing's Treatise on Cold Damage (Shang Han Lun) is the origin of all of these sentences. By combining these elements, lesser yang is harmonized, exterior syndrome is relieved, lung heat is cleared, and panting is mitigated. This remedy is predominantly used to treat illnesses involving the triple-Yang combination, characterized by a buildup of pathogenic heat in the lungs. The therapeutic effect of Xiao Chaihu Decoction and Maxing Shigan Decoction is well-recognized in addressing exogenous diseases that affect the triple-Yang. Exogenous illnesses, particularly those prevalent in northern China, frequently utilize these. read more In the case of coronavirus disease 2019 (COVID-19) marked by fever and cough, this combined treatment approach remains a key strategy. Maxing Shigan Decoction, a tried and true herbal formula, is a standard treatment for the obstructing lung syndrome caused by phlegm-heat. textual research on materiamedica The body's response to sweating, evidenced by dyspnea, may be linked to the presence of excessive pathogenic heat in the lungs. Symptoms such as cough and asthma, coupled with forehead perspiration, might be observed in patients with mild symptoms; those with severe conditions might experience full-body perspiration, predominantly on the anterior chest. Modern medicine suggests that the preceding circumstance is directly linked to an infection of the respiratory system, primarily impacting the lungs. The concept of 'mild fever' is fundamentally tied to patterns of symptoms, not to the specific disease mechanism. Heat syndrome's moderate manifestation should not overshadow the critical level of heat and inflammation. The combined application of Xiao Chaihu Decoction and Maxing Shigan Decoction exhibits the following indications. In the realm of respiratory diseases, this treatment option is applicable for viral pneumonia, bronchopneumonia, lobar pneumonia, mycoplasma pneumonia, COVID-19, measles complicated by pneumonia, SARS, avian influenza, H1N1 influenza, exacerbations of chronic obstructive pulmonary disease, pertussis, and other influenza and pneumonia-related infections. Among the various syndromes, this treatment is applicable to cases involving bitter mouth, dry throat, vertigo, loss of appetite, irritability, vomiting, and a feeling of fullness and heaviness in the chest and hypochondrium. central nervous system fungal infections This treatment option can effectively manage intermittent episodes of chills and fever, diverse degrees of fever, as well as chest constriction, coughing, asthma, phlegm production, dry mouth, a desire for cold drinks, agitation, sweating, yellow urine, hard stools, a scarlet tongue, yellow or white coating, and a powerful, floating pulse, particularly in the right radial pulse.
Zhang Zhong-jing, a distinguished physician from the Han dynasty, detailed the Zhenwu Decoction in his authoritative text, Treatise on Febrile Diseases. Edema caused by yang deficiency is primarily addressed by Zhenwu Decoction, whose action involves warming yang, transforming Qi, and facilitating urination. Pathophysiological mechanisms, coupled with examination of severe and critical cases, confirm that Zhenwu Decoction in Treatise on Febrile Diseases accurately illustrates the clinical symptoms and therapeutic approach in acute heart failure. The syndrome this formula intends to cure may originate from errors in diagnosis and inappropriate therapeutic applications. In cases where cardiogenic and pulmonary dyspnea are difficult to distinguish, high doses of Ephedrae Herba might be misused to induce sweating. This misuse could potentially lead to acute aggravation of heart failure, electrolyte imbalances, and pulmonary infection. Ancient physicians' lack of expertise in handling acute heart failure is clear from studying the syndromes addressed by Zhenwu Decoction. The clinical presentation of heart failure, an upgraded form of trembling and shaking, may include trembling and shivering, a condition often treated with Linggui Zhugan Decoction. In the realm of diseases, Zhenwu Decoction proves effective in treating acute or chronic heart failure, cardiorenal syndrome, and conditions characterized by diuretic resistance. For the management of whole heart failure, acute heart failure, heart failure with reduced ejection fraction, and heart failure manifesting the syndrome of cold and dampness, the decoction stands out as a particularly suitable remedy. On top of that, it is designed to address both type and type cardiorenal syndrome cases. Zhenwu Decoction is applicable to patients presenting with chest tightness, palpitations, lower limb edema, difficulties with urination (increased or decreased), cold intolerance, a tongue that is pale with tooth marks, a tongue coating that is white and slippery, and a deep or slow pulse. According to modern medicine, Zhenwu Decoction's pharmacological approach to heart failure involves the principles of promoting urination, expanding blood vessels, and invigorating the heart. The foremost herb in the formula is Aconiti Lateralis Radix Praparata, with a dosage recommendation of 30-60 grams. High doses of Aconiti Lateralis Radix Praparata can potentially trigger arrhythmias, requiring a cautious and measured approach to its administration. During the recovery phase, Zhenwu Decoction, Shenqi Pills, Renshen Decoction, Wuling Powder, and Fangji Huangqi Decoction, which invigorate the spleen, replenish Qi, warm the Yang, and promote urination, are also beneficial. Yang reinforcement therapy remained as the last resort for severe cases, complicated by a lack of specific medical conditions and an ambiguous clinical history, requiring impartial assessment.
Zhang Zhong-jing's Essentials from the Golden Cabinet (Jin Kui Yao Lue), compiled during the Han dynasty, first described Huangtu Decoction's application in treating distal bleeding. The syndrome of blood sugar control failure, caused by a deficiency of spleen-yang, is the principal target of this treatment. The connotation of distal bleeding significantly extends beyond the usual scope of upper gastrointestinal bleeding, including peptic ulcers, gastrointestinal tumors, gastric mucosal lesions, vascular abnormalities, esophageal and gastric varices, and pancreatic/biliary injuries, to encompass diverse anorectal diseases like colon and rectal cancers, polyps, hemorrhoids, and anal fissures, and other potential bleeding sites, such as nosebleeds, low platelet counts, irregular uterine bleeding, threatened pregnancies, and unexplained hematuria. Syndrome of distal bleeding may also include failures of maintaining fluid and warmth in interior body, which include nocturia, enuresis, rhinorrhea, excessive sweating, coldness of tears, leucorrhea; additionally, problems involving excessive gastrointestinal bleeding resulting from anti-platelet or anticoagulant drugs, positive fecal occult blood tests with unknown reasons, and other novel clinical problems. Traditional Chinese medicine's Huangtu Decoction is indicated for a variety of conditions, including, but not limited to, lower blood, pre-blood defecation, distant blood, hematemesis, epistaxis, and other maladies; concurrently, it addresses three clinical presentations: bleeding, deficiency, and stagnation-heat syndromes.