Heart disease is mainly caused by the presence of external evils or pathological products. External evils are mainly fire, heat and cold, which are easy to cause excessive heart fire and cold condensation of the heart veins, while pathological products can be phlegm turbidity, water stagnation, and obstruction of the heart and mind. In addition, phlegm and fire can also disturb the mind, and qi stagnation and blood stasis can block the heart pulse. However, these factors are only one of the factors that cause the heart to be solid, and there must also be an exuberance of the heart qi and heart yang in order to compete with the evil qi and produce a solid pathogenesis change with hyperactivity and excess function. Therefore, the understanding of the pathogenesis of the heart needs to comprehensively consider various factors such as phlegm, fire, cold, qi, and stasis, as well as the role of heart qi and heart yang.
1) Hyperactivity: Heart Qi is the main driving force and prerequisite for promoting the normal operation of blood, and it is also an important material basis to ensure the normal development of people's spiritual, thinking and consciousness activities. If the heart qi is in harmony, if it is violated by evil qi or disturbed by pathological products, it will be overly excited, but it will be harmful, causing abnormal heart pulse or mental function. "Lingshu: Lustful Dreams" says: "If the heart is vigorous, the dream is good at laughing, and the fear is afraid." "It was the first to propose the pathogenesis of hypercardia. "The Origin of Diseases: Heart Syndrome" says: "The heart is dirty, and in the Lord, the heart is full of energy, and there is more than enough for God, then the pain in the sick chest, the flank is full, the flank is painful, the armpit pain in the arms, the pain in the arms, and the laughter is endless, which is the truth of the heart." The various clinical manifestations caused by the pathogenesis of hypercardiac qi are elaborated in detail. The pathogenesis of hypercardiac qi can be divided into three aspects: stagnation of heart qi, phlegm obstruction of heart qi, and cold condensation of heart qi.
(1) Qi stagnation and heart qi: The heart qi is constantly circulating, and it cannot be stagnant for a moment. Injuries caused by the seven emotions and poor qi can make the heart and qi stagnant, causing qi stagnation and other pathologies such as heart pulse or qi closure of the mind.
Qi stagnation of the heart: emotional depression, or long-term and long-lasting mental stimulation, disturbing the mood, poor mood, and causing stagnation of heart qi. For example, "Cause and Pulse Treatment: Heart Paralysis" cloud: "The cause of heart paralysis is anxiety and fatigue, and the heart is injured." "The heart qi cannot promote the blood flow, the blood flow is stagnant, and the heart and pulse are blocked, and if it is not passed, it will be painful. It is manifested as chest suffocation and pain, traction of the shoulders and back, sometimes stopping, and good rest. This kind of heartache is mainly distention, which is closely related to changes in mental and emotional factors. As the "Lingshu Oral Question" says: "If you are worried, your heart is anxious, and if you are anxious, your airway will be about it, and if you are about it, you will be unfavorable, so you will stretch it out." "The Source of Miscellaneous Diseases: The Source of Heart Disease" even more clearly pointed out: "The cause of the seven emotions is heartache." ...... In addition to the joy of the qi can be dispersed, the rest is enough to make the heart stagnant, and it is painful. ”
Breath-shutting mind: strong mental stimulation, anger and fright, or grief-stricken, over-emotional, suppressing heart qi, mild cases can be seen chest congestion, chest congestion, chest tightness, shortness of breath and other symptoms. This is due to the fact that the heart is dominated by the mind and the emotions are excessive, and the heart qi is suppressed, which in turn affects the lung qi unfavorably, and the heart and lung qi are blocked at the same time, and the qi stops in the chest, and the upward reversal is formed. The heavy ones are chaotic in qi and blood, blinded by their minds, their minds are not conscious, and they suddenly faint and are delirious. "Jing Yue Quanshu, Miscellaneous Evidence, Mo and Convulsion" cloud: "Those who are solid and convulsive, their shape is angry, their pulse is heavy and slippery, and their chest is full, and this qi is also reversed." This is the evidence of qi convulsion caused by the stagnation of qi and organs, and it is closely related to the stagnation of mental qi. The chest and diaphragm are full of breath, which is caused by qi depression hurting the liver and damaging the heart, stagnation of liver and heart qi, loss of lung stagnation, and reversal of lung qi; It shows that the heart is strongly stimulated, and the heart qi is suddenly blocked and reversed, and then the mind is out of control, resulting in fainting.
(2) Phlegm obstructs heart qi: phlegm turbidity is a pathological product formed by fluid imbalance in the body. Phlegm turbidity stops internally, blocking the heart qi, which can not only paralyze the heart pulse, but also close the mind.
Phlegm obstructs the heart pulse: People who are obese or have phlegm and dampness in the body, due to the evil of phlegm turbidity, are sticky and difficult to walk, increase the resistance of heart qi, and can make heart qi sluggish and stagnant. The qi is not smooth, the heart blood flow is delayed, and the heart pulse is gradually blocked. It can be seen that the heart and chest are suffocated and painful, palpitations and shortness of breath, the body is sleepy, and the tongue coating is thick and greasy. "Cause and Pulse Treatment: Chest Paralysis" points out: "The cause of chest paralysis is poor diet, hunger and satiety injury, phlegm coagulation and blood stagnation, and medium focus and turbidity, and the symptoms of closed food and stuffiness are the cause." "Jin Kui Yaolu: Chest Paralysis Heartache and Shortness of Breath Disease" said: "Those who are not allowed to lie down with chest paralysis and have heartache through their backs are the main ones of the white and half summer soup." "Jin Kui Yao Brief Heart Dictionary" commented on Shi Yun: "Chest paralysis cannot lie down, because the lung qi goes up but does not go down; Therefore, there is phlegm to drink to help, so the chest paralysis medicine is added to Banxia to chase phlegm to drink. "The pathogenesis of heart and pulse obstruction caused by phlegm turbidity and congestion of heart and lung qi is explained in detail.
Traditional Chinese medicine believes that qi deficiency and blood stasis are the root cause of cardiovascular diseases. The occurrence of diseases often affects the normal circulation of qi and blood, resulting in an imbalance of qi and blood, and the internal organs are not adequately nourished. On this basis, the viscera gradually weakens, and the essence and energy are gradually depleted, which eventually leads to the decline of the function of the viscera and the dying of life. With the increase of age, the body's righteous qi is continuously depleted, and qi deficiency leads to weak blood flow and aggravates the blockage of blood stasis. This situation has formed a complex situation, that is, "the mixture of virtual and real", "qi deficiency and blood stasis", which further exacerbates the development of cardiovascular diseases. For the treatment of cardiovascular diseases, TCM emphasizes the regulation of qi and blood, blood circulation and blood stasis. By adjusting the balance of qi and blood, the function of the viscera is enhanced to restore the body's health.
Blood congestion is a factor that leads to cardiovascular disease, and if it is simply removed, it will hurt the positive qi and make the righteous qi more weak; If it is simply supplemented, it will become more and more sluggish for some geriatric diseases, and the more it is replenished, the more it will become more and more deficient. The most appropriate way is to consolidate the root and clear the source, that is, to invigorate qi and invigorate blood. Because qi travels, blood travels, and qi is beneficial to stasis.
Traditional Chinese medicine (TCM) delves into the causes of qi deficiency and blood stasis and believes that it stems from two aspects. On the one hand, qi deficiency causes blood to not function properly, resulting in blood congestion, and on the other hand, the obstruction of blood congestion impairs qi and blood and prevents the production of new blood, resulting in qi deficiency. In terms of treatment, in addition to replenishing qi and blood, we should also skillfully use drugs that can dissolve blood congestion. However, it should be noted that many anti-stasis drugs will deplete the righteous qi, so for patients with blood stasis, even if they do not have symptoms of qi deficiency, we should also appropriately add qi-replenishing drugs at the same time as removing blood stasis to maintain the balance of the body.