胸痹
Alias胸闷心痛
Traditional Chinese Medicine Definition
Xiongbi (chest oppression and chest pain) is one of the diseases within the TCM (Traditional Chinese Medicine) category of heart-related syndromes. According to the records in "Internal Medicine of Traditional Chinese Medicine," Xiongbi refers to a condition characterized by chest oppression and pain, resulting from the obstruction of the heart's meridians, which leads to the impairment of Qi and blood circulation. The pathogenesis of this condition is often associated with the dysfunction of the heart, liver, spleen, and kidney, with the obstruction of the heart's meridians being the primary pathogenic factor.
In clinical practice of TCM, the core pathogenesis of Xiongbi is the obstruction of the heart's meridians and the impairment of Qi and blood circulation. Common precipitating factors include emotional disturbances, irregular diet, and overexertion. During the process of differentiation, the following key points should be noted:
1. Phlegm-damp obstruction syndrome: Manifested by chest oppression as if blocked, with abundant sputum, shortness of breath, and heavy limbs.
2. Blood stasis syndrome: Characterized by sharp, fixed chest pain, which worsens at night.
3. Qi and Yin deficiency syndrome: Primarily manifested by intermittent chest oppression and pain, palpitations, and shortness of breath.
Overall treatment approach: TCM treatment of Xiongbi focuses on harmonizing Qi and blood and unblocking the meridians. According to different patterns, treatment methods such as promoting blood circulation and removing blood stasis, promoting Yang and expelling turbidity, and invigorating Qi and nourishing Yin can be adopted. Based on the principle of differentiation and treatment, and considering individual differences, a corresponding treatment plan should be formulated.
Common Syndrome Types and Key Points of Differentiation
心血瘀阻证
Main Manifestations：胸部刺痛，固定不移，入夜更甚
Management Approach：活血化瘀，通络止痛
痰浊内阻证
Main Manifestations：胸闷如窒，痰多气短，肢体沉重
Management Approach：通阳泄浊，豁痰宣痹
气阴两虚证
Main Manifestations：胸闷隐痛，时作时止，心悸气短
Management Approach：益气养阴，活血通络
The above syndrome information is based on traditional Chinese medicine textbooks and clinical standards. Specific differentiation should be completed by a practicing traditional Chinese medicine physician in person.
Physician's Clinical Insights
In clinical practice, chest oppression and pain in Xiongbi patients should pay attention to the interrelationship between the obstruction of the heart's meridians and the impairment of Qi circulation.
— 唐玉兰 中医执业医师（师承）
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参考文献：《中医内科学》（十三五规划教材）、《中医病证诊断疗效标准》(ZY/T001.1-94)、《中医病证分类与代码》(GB/T 15657-2021)