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I am writing this post based on this study.

Chronic heart failure (CHF) is a severe public health problem with increasing morbidity and mortality, any treatment targeting a single session is insufficient to tackle this. CHF is characterized by reduced cardiac output resulting from neurohumoral dysregulation and cardiac remodeling, which might be related to oxidative stress, inflammation, endoplasmic reticulum stress, apoptosis, autophagy, mitochondrial function, and angiogenesis.

Chinese medicinal herbs have been widely applied in the treatment of CHF, and therapeutic effects of these herbs and their ingredients have been scientifically confirmed over the past decades.

In TCM (Chinese Medicine), Heart Failure is a syndrome characterized by a deficiency in origin and an excess in superficiality disease. The deficiency in origin can be qi deficiency, blood deficiency, yin deficiency, or yang deficiency, with heart qi deficiency as the fundamental basis. Heart qi deficiency can affect either yin or yang, resulting in a dual deficiency of qi and yin or qi and yang, respectively. As Heart Failure worsens, yin deficiency affects yang, leading to the syndrome of dual yin and yang deficiency, or, in severe cases, the syndrome of yin exhaustion and yang collapse. Moreover, the excess in superficiality is primarily blood stasis, which is frequently accompanied by phlegm-retained fluid and other factors. The interaction between excessive superficiality and deficiency in qi, blood, yin, and yang contributes to the progression of HF, both in acute and chronic settings.

During centuries, from ancient Chinese Medicine texts to our modern times, the cause of Heart failure has been designed by different roots around the Heart and “Water”. According to the latest guidelines and consensus on TCM treatment for Heart Failure in China, he fundamental syndrome of HF is the qi deficiency with blood stasis, which can be accompanied by other factors of deficiency in origin. There are three commonly observed syndromes in clinical practice: “qi deficiency with blood stasis,” “dual deficiency of qi and yin with blood stasis,” and “a dual deficiency of qi and yang with blood stasis,” all of which can coexist with phlegm-retained fluid. Each HF syndrome can be distinguished by the presence of two main symptoms and two secondary symptoms, as well as specific tongue manifestations and pulse conditions.
Generally speaking, chronic heart failure has the basic pathological characteristics of “heart-kidney yang deficiency.” which turns into Blood Stagnation if untreated.

Best treatment for Heart-Kidney Yang deficiency must focus on strengthen heart qi and activate blood circulation. Best Herbal Medicine to provide this effect would be the following formulas:

 Zhen Wu Tang: True Warrior Decoction. Treats debilitated Yang and exuberant Yin. It warms the yang and promotes water metabolism to treat water collecting in the interior. The excess of water (which quells fire) is as important here as the deficiency of yang. Therefore it helps for problems of fluid metabolism due to Kidney yang deficiency.

– Bu Shen Huo Xue: Uncommon formula in the Western but commonly used in China, apparently. Needs to be carefully prescribed. Anti-inflammatory properties convert this formula an option for the treatment of coronary heart disease, and to evaluate the benefits to patients with coronary heart disease from both cardiac and renal indicators.

– Shen Fu Tang: Restores the yang, strongly tonifies the source qi, and rescues the qi from collapse due to devastated yang. It is a strong tonic so needs to be taken temporally as a booster till Yang Qi is restored and the acute phase has passed (after a heart failure).

– Si Ni San Wan:  Strengthens the yang of both the gate of vitality and the middle burner without injuring the yin. Therefore it eliminates the internal heat. 

– Qi li Qiang xin: commonly used to treat congenital heart failure in China. Cardioprotective effect.

Proper diagnosis first is required before prescribing these formulas plus some require further studies to reach clinical conclusions.

Image by cookie_studio on Freepik

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