What is the TCM syndrome differentiation and treatment principle along with the corresponding herbal prescriptions for chest obstruction (thoracic bi syndrome)?

The TCM syndrome differentiation and treatment of chest obstruction includes patterns such as obstruction due to blood stasis in the heart, Qi stagnation in the chest, phlegm turbidity blocking the chest, cold congealing the heart meridian, and deficiency of both Qi and Yin. If any concerns exist, it is recommended to seek medical advice in advance. Detailed analysis is as follows:

1. Obstruction Due to Blood Stasis in the Heart

(1) Syndrome Differentiation: Main manifestations include stabbing or constricting chest pain with fixed location, worsening at night, severe cases may present with pain radiating from the chest to the back and vice versa, or pain extending to the shoulders and back, accompanied by chest oppression. The condition may persist for a long time and can be exacerbated by sudden anger or fatigue. The tongue appears purplish-dark with ecchymosis, thin coating, and the pulse is taut and涩 (choppy).

(2) Treatment Principle: Activate blood circulation to resolve stasis, unblock the meridians, and relieve pain.

(3) Prescription: Xue Fu Zhu Yu Tang (Blood Mansion Stasis-Resolving Decoction), modified as appropriate. Commonly used patent medicines include Xue Fu Zhu Yu Wan and Fufang Danshen Dripping Pills.

2. Qi Stagnation in the Chest

(1) Syndrome Differentiation: Main manifestations include oppressive or mild intermittent chest pain with fixed location, frequent sighing, easy induction or exacerbation upon emotional distress, possibly accompanied by abdominal distension and discomfort, which is relieved by belching or flatulence. The coating is thin or slightly greasy, and the pulse is taut.

(2) Treatment Principle: Soothe the liver, regulate Qi, activate blood circulation, and unblock the meridians.

(3) Prescription: Chai Hu Shu Gan San (Bupleurum Liver-Soothing Powder), modified as appropriate. Commonly used patent medicines include Xiao Yao Wan (Free and Easy Wanderer Pills) and Qi Zhi Wei Tong Ke Li (Qi Stagnation Stomach Pain Granules).

3. Obstruction Due to Phlegm Turbidity

(1) Syndrome Differentiation: Main manifestations include significant chest oppression with mild pain, excessive phlegm, shortness of breath, heavy limbs, obesity, easy onset or exacerbation during rainy weather, possibly accompanied by fatigue, poor appetite, loose stools, and expectoration of phlegm. The tongue is swollen with tooth marks on the edges, with a turbid, greasy, or white slippery coating, and the pulse is slippery.

(2) Treatment Principle: Promote yang, resolve turbidity, expel phlegm, and relieve obstruction.

(3) Prescription: Gua Lou Xie Bai Ban Xia Tang (Trichosanthes Bulb Allium and Pinellia Decoction) combined with Di Tan Tang (Phlegm-Resolving Decoction), modified as appropriate. Commonly used patent medicines include Guan Xin Su He Wan and Xue Zhi Kang Capsules.

4. Cold Constriction of the Heart Meridian

(1) Syndrome Differentiation: Main manifestations include sudden, constricting chest pain radiating to the back, dyspnea with inability to lie down, often triggered or exacerbated by sudden cold exposure or cold invasion. Symptoms may include cold extremities, spontaneous cold sweats, chest oppression, shortness of breath, palpitations, and pallor. The tongue coating is thin and white, and the pulse is deep and tight or deep, fine.

(2) Treatment Principle: Warm and disperse cold with acrid herbs, promote heart yang.

(3) Prescription: Zhi Shi Xie Bai Gui Zhi Tang (Tangerine Peel Allium and Cinnamon Twig Decoction) combined with Dang Gui Si Ni Tang (Chinese Angelica Four-Warmth Decoction), modified as appropriate. Commonly used patent medicines include Shen Fu Zhusheye (Ginseng and Aconite Injection) and Su He Xiang Wan (Storax and Musk Pill).

5. Deficiency of Both Qi and Yin

(1) Syndrome Differentiation: Main manifestations include dull chest pain, occurring intermittently, palpitations, shortness of breath, worsening with exertion, accompanied by fatigue, weak voice, pallor, and spontaneous perspiration. The tongue is pale red, swollen with tooth marks on the edges, with a thin white coating, and the pulse is weak, fine, slow, or irregular.

(2) Treatment Principle: Tonify Qi and nourish Yin, activate blood circulation and unblock the meridians.

(3) Prescription: Sheng Mai San (Life-Pulse Powder) combined with Ren Shen Yang Rong Tang (Ginseng Nourishing-Rong Decoction), modified as appropriate. Commonly used patent medicines include Sheng Mai Yin and Shen Mai Zhusheye (Ginseng and Ophiopogon Injection).

While undergoing TCM regulation, it is also important to maintain a healthy lifestyle, improve dietary habits, engage in appropriate physical exercise, and enhance overall physical health.