Viral myocarditis is characterized by myocardial inflammatory changes resulting from viral infection, mainly caused by Coxsackie virus, ECHO virus, poliovirus and enterovirus. In the early stage, the pathologic changes are caused by viruses; no clinical symptoms can be seen. At the severe stage, cardiac muscle cell will be edema and necrosis, which caused arrhythmia, heart failure, developing into chronic stage, even sudden death. History of viral infection, Lab test, ECG and clinical manifestation, such as arrhythmia, gallop rhythm, enlarged cardiac, etc. will help diagnosis. VM belongs to “shi re du (epidemic dampness)”, “xin ji (palpitation)”, “zheng chong (severe palpitation)”, “xin bi (heart obstruction)” in TCM. The pathogenesis is healthy qi insufficient, which causes pathogenic factors’ invasion. Heart and lung are mainly involved; spleen, liver and kidney are also involved in prolonged stage. TCM doctors accumulated many experiences in treating VM.
Classic formulae to treat VM,
1. Modified Shengmai Yin and Yangxin Tang, including Hongshen 10g, Maidong20g, Wuweizi 15g, Huangqi 30, Danggui 15g, Chuanxiong 15g, Zhigancao 15g, Baiziren 20g, Suanzaoren 20g, Yuanzhi 20g. 1 does a day, 15 days in succession makes up a session of treatment.
2. Modified Daochi San, including Shengdi 15g, Mutong 6g, Gancao 6g, Zhuye 10g.
3. Yupingfeng San, Guizhi Tang, Zhigancao Tang and Huanglianwendan Tang are all effective formulae in clinical practice.
The experience of Dr. Jianhua Dong in treating VM,
Dr. Dong thinks that epidemic heat toxin is the pathogenic factor of VM. The clinical manifestation are fever, angina, and then palpitation, chest depression, vague pain, etc. these are caused by pathogenic heat transmitting from Qi phase to nutrient phase, and heat attacks cardiac muscle. This process is called Ni chuan (adverse transmission). Heart Qi, nutrient Qi and Yin are impaired, characterized by hot body in the night, deep-red and dry tongue, thin and fast pulse, or slow-intermittent pulse. The treating principle is clearing nutrient phase heat toxin of heart, and nourishing heart Qi and Yin at the same time.
1. Clearing heat and relieve exterior syndrome,
Indication: the early stage of VM.
Prescription: Yinqiao San, add Danshen, Banlangen, Yuzhu, etc.
2. Clearing heat and eliminating dampness,
Indication: seasonal contagious heat toxin impairing nutrient Qi and Yin of heart.
Prescription: Shigao Huashi Tang, including Shigao, Zhimu, Danzhuye, Qinghao, Baiwei, Yinhua, Lianqiao, Huashi, Guizhi, etc.
Dr. Dong thinks that clearing damp-heat will not be hurried, for it will induce to impair healthy Qi. Mild nourish Qi and Yin, plus clearing heat-dampness is the right way.
3. Replenishing Qi, nourishing Yin and clearing heat.
Indication: residual heat in the later stage of VM.
Prescription: Jiajian Fumai Tang (Modified Fumai Decoction), added Yinchaihu, Baiwei, Danshen, Longgu, Muli, etc.
4. Clearing away heat toxin,
Indication: VM, companied with recurrent angina.
Prescription: Yinqiao San, added Mabo, Banlangen, Xuanshen, Pugongying, etc. mild angina added Xuanshen, Gancao, Maidong, Jiegeng, Banlangen, Yinhua, Lianqiao, Chishao, etc.
5. Clearing heat and smooth collaterals,
Indication: VM in later stage, heat toxin impaired Qi and Yin, heart collaterals obstruction. Danshen, Chishao, Taoren, Honghua, Danggui, Guizhi, Yujin, Xuanfuhua can be added in your prescription.
There are some herbs pertaining to heart meridian, such as Danshen, Guizhi, Yinhua, Lianqiao, Maidong, Shengdi, Baiwei, Xuanshen, Suanzaoren, etc. so in VM treatment, clearing heart heat toxin, cooling nutrient phase heat, and then saving nutrient Qi and Yin, heart spirit will be normal, the patients will recover
Medboop.
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