Common clinical symptoms include retrosternal paroxysmal pain, which may radiate to the shoulder, the upper limb or the back, especially radiate to the left shoulder or left upper limb or even directly to the little finger and the ring finger along the medial side of the forearm. Sometimes, symptoms of cold limbs, shortness of breath and cyanosis are also present.
Coronary heart disease is the simplified term of coronary atherosclerotic heart disease, and can often be seen in middle-aged and aged people. According to modern medical science, it is induced by myocardiac ischemia and hypoxia of different degree due to coronary atherosclerosis, while TCM holds that insufficiency of heart-qi, stagnation of pathogenic cold in the meridians, or internal injury by seven emotions, which cause block of qi, and obstruction of blood vessels, can all lead to the occurrence of coronary heart disease.MAIN POINTS FOR DIAGNOSIS
The principle of tuina treatment is activating the flow of qi and promoting blood circulation, relieving stuffiness in the chest and regulating qi.
For patients with severe angina pectoris, press additionally Zhiyang (GV 9), which is located in the midline of the back and between the seventh and the eighth thoracic spinous processes for 1 - 3 minutes.
The patient takes a sitting or prone position, and the doctor presses and kneads Xinshu (BL 15), and squeezes and pushes from it toward Geshu (BL 17) with the thumb for 1 - 3 minutes respectively.
Pat the back and the shoulders of the patient with a slightly-bent palm for one minute. The manipulations should be light, gentle with appropriate force.(4) Press-knead Neiguan (PC 6) on beth sides for one minute respectively.
The patient lies on his back, the doctor places the palm on the patient's superior thoracic region, and does pushing manipulation through the anterior area of the shoulder to the medial side of the upper limb 10 times and repeat the above operation on the other side of the body. Then knead-twists the cardiac region with the palm rapidly for 3 - 5 minutes.
Grasp-knead the muscles in the medial aspect of the upper limb 3 - 5 times, and digitally-press Jiquan (HT 1) with the index and the middle fingers for one minute.
MODIFIED MANIPALTIONS WITH SYNDROME DIFFERENTIATION
For patients with severe palpitation, chest distress and insomnia, the following manipulations may be added.
Digitally-press Shenmen (HT 7) and Tongli (HT 5) for one minute respectively.
Press-knead Danzhong (CV 17) for 1 - 3 minutes, combined with palm-rubbing manipulation.
Press-knead and scrub Yongquan (KI 1) till a hot sensation is achieved.
Rub the abdomen clockwise and counterclockwise for 3 - 5 minutes.
Press-knead Taiyang (EX-HN 5), Yintang (EXHN 3) and Zusanli (ST 36) for one minute respectively.
For patients with dizziness, nausea, or poor appetite, the following manipulations may be performed additionally.
Press-knead Zhongwan (CV 12) for one minute.
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