Ling Gui Zhu Gan Tang and Shengmai Decoction are used in the treatment of elderly patients with chronic pulmonary heart disease. Symptoms include chest fullness, irritability, palpitations, restlessness, thirst, sore throat, difficulty in urination, red tongue tip and sides, yellow or greasy coating, rapid or slippery pulse. The treatment aims to expel phlegm-heat and simultaneously soothe the lung and calm the heart. Medicinal ingredients include Poria, Cinnamon Twig, Atractylodes, Licorice, Radix Ophiopogon, Schisandra, Huang Qin, gypsum, Fritillaria bulb, and others. For yin deficiency type, additional Lily and Anemarrhena may be added.
In cases of phlegm obstructing the lung, symptoms include coughing, shortness of breath, palpitations, cyanosis of the lips, chest oppression, difficulty in expectorating phlegm, hemoptysis, mild swelling of the lower extremities, and notable discomfort in the afternoon. The tongue is dark purple or has ecchymosis, with a greasy coating, and the pulse is wiry or fine. Treatment involves expelling phlegm stagnation, combining yang restoration and asthma relief. Medicines include Poria, Cinnamon Twig, Atractylodes, prepared licorice, red ginseng, Ophiopogon, flavors, Salvia examples, Pinellia, Alisma, aconite, and Dragon Bone.
Four typical cases include a 67-year-old female treated by Professor Zhou Liang for cirrhosis using Liu Wei Di Huang Wan to regulate kidney functions. Another case involved a 67-year-old male diagnosed with early cirrhosis on March 7, 1997. He had chronic hepatitis B for 10 years with repeated hospitalizations. Symptoms included right hypochondriac pain, abdominal distension, poor appetite, fatigue, poor sleep, yellow urine, loose stools, dark complexion, emaciation, and a dark red tongue with yellow and greasy fur. Physical examination revealed a soft abdomen, liver palpable 2 cm below the costal margin and 4 cm below the xiphoid process, with evident tenderness, wiry pulse, and Western diagnosis of hepatitis B and early cirrhosis.
Treatment aimed at promoting blood circulation, softening the liver, and resolving spleen qi stagnation. Prescriptions included Red Sage Root, peach kernel, gun Shanjia, fried turtle, Astragalus, Atractylodes, Codonopsis, rhubarb, Ligustrum lucidum, and ink Eclipta. After seven doses, the patient experienced relief from hypochondriac pain and improved bowel movements. Further treatment significantly improved the condition, leading to a stable state after over 100 doses, with no recurrence during follow-up.
Chronic hepatitis and early cirrhosis involve complex pathogenesis with both blood stasis and toxin invasion. Treatment should balance nourishment and attack, avoiding overly aggressive or cold medications. Modern pharmacological studies show that Salvia promotes liver function recovery and hepatosplenomegaly softening, while gun Shanjia and fried turtle have good effects on endometriosis and liver cirrhosis. Combined with Astragalus, Atractylodes, and Codonopsis for strengthening the spleen and boosting qi, this aligns with traditional medical principles. Ligustrum lucidum and Eclipta lotus benefit liver and kidney yin. This combination effectively addresses both supplementation and attack.
A 27-year history of repeated coughing with wheezing, chest tightness, palpitations, and shortness of breath for five years was exacerbated in January. Symptoms included white-yellow sputum, increased palpitations, supine position preference, early morning headaches, facial edema, leg swelling in the afternoon, abdominal distension, poor appetite, and a dark tongue with gray coating. Physical examination revealed a barrel-shaped chest, drum sound on percussion, weak lung breath sounds, rales at the lung bases, prolonged expiration, and a heart rate of 90 beats per minute. The electrocardiogram showed right atrial hypertrophy, and blood tests indicated Hb 118 g/L, white blood cells 12.8 × 10^9/L, N83%, L17%. X-ray films showed chronic bronchitis and emphysema and pulmonary heart disease.
The treatment plan combined Ling Gui Zhu Gan Tang and other formulas to address dampness, qi, warmth, coolness, and attacks while considering the balance of good and evil. This approach is suitable for co-senile pulmonary heart disease characterized by virtual real evil and mixed yin-yang pathogenesis, resulting in satisfactory outcomes.