Connotation and Clinical Application of Tong （Dredging） Method in Treatment of Coronary Heart Disease / 中国实验方剂学杂志

ABSTRACT

Tong （dredging） method in traditional Chinese medicine （TCM） emphasizes soothing the stagnated Qi， blood， and body fluid in zang-fu organs， meridians， and collaterals to remove pathogens， reinforce vital Qi， and balance Yin and Yang of the human body. Tong method can be adopted to disperse sweat pore， attack pathogenic Qi， harmonize Yin and Yang， as well as tonify deficiency， and resolve stagnation. It has been proved effective in treating coronary heart disease （CHD）， which falls into the category of "chest impediment and heart pain" in TCM， with the key pathogenesis lying in blood vessel obstruction. Therefore， dredging blood vessels is the primary therapeutic principle for CHD. Specifically， there are four aspects. The first is dispersing and dredging the sweat pore of the heart. If the sweat pore is occluded by pathogenic cold， which makes Yang-qi undissipated， Cinnamomi Ramulus， Piperis Longi Fructus， Alpiniae Officinarum Rhizoma， and Asari Radix et Rhizoma can be prescribed for warming and dredging heart Yang. If the Yang-qi of the heart and chest stagnated in the body， which hinders Qi and blood to nourish the myocardium， resulting in chest pain， Poria and Alismatis Rhizoma can be prescribed. For CHD due to atherosclerosis and inflammation， heat-clearing， toxin-removing， and inflammation-resisting Chinese medicinal herbs such as Coptidis Rhizoma and Rhei Radix et Rhizoma are recommended. The second is attacking and dredging the collaterals of the heart. Salviae Miltiorrhizae Radix et Rhizoma， Chuanxiong Rhizoma， Notoginseng Radix et Rhizoma， etc. can be prescribed for blood stasis， Trichosanthis Fructus， Allii Macrostemonis Bulbus， Pinelliae Rhizoma， etc. for phlegm， and Aquilariae Lignum Resinatum， Euodiae Fructus， etc. for pathogenic cold. Since the chronic disease can affect collaterals， Moschus and Santali Albi Lignum can be added to promote blood circulation and remove the obstruction of collaterals of the heart. The third is harmonizing and dredging the mind. Cinnamomi Ramulus， Coptidis Rhizoma， Cinnamomi Cortex， etc. are selected for restoring the coordination between the heart and the kidney. According to the specific syndrome， the methods of nourishing the mind and calming the nerves through tranquilizing the mind， calming down the mind， and inducing resuscitation can be selected using such Chinese medicines as Ziziphi Spinosae Semen， Polygalae Radix， and Draconis Ossa. The fourth is tonifying and dredging the Qi and blood of the heart. The deficiency syndrome of CHD is divided into Qi deficiency and kidney deficiency. Invigorating Qi and strengthening the heart are the first essentials for the treatment of CHD. In Qi invigoration， Qi and blood must be strengthened simultaneously to strengthen the heart and clear the pulse. Hence， Bazhentang modified by Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos can be chosen. In kidney Qi tonifying， kidney and heart must be strengthened simultaneously， and the methods of tonifying kidney and activating blood can be used. Ginseng Radix et Rhizoma and Astragali Radix are considered as the first choice for tonifying heart Qi， and Epimedii Folium and Morindae Officinalis Radix for tonifying kidney Qi， which are added with Salviae Miltiorrhizae Radix et Rhizoma and Rehmanniae Radix Praeparata to obtain the kidney-tonifying and blood-activating prescription. It is suitable for treating CHD due to kidney deficiency and blood stasis. Simultaneous treatment of heart and kidney is more suitable for middle-aged and elderly patients and chronically ill patients. Tong method can be used in various clinical diseases as well as CHD.