Traditional Chinese medicine understanding and treatment of acute myocardial infarction complicated with acute upper gastrointestinal bleeding.
10.19540/j.cnki.cjcmm.20241112.501
- Author:
Xing-Jiang XIONG
1
;
Fu-Kun LUO
1
;
Xiao-Ya WANG
1
;
Yu LAN
1
;
Peng-Qian WANG
2
Author Information
1. Guang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing 100053, China.
2. Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences Beijing 100700, China State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs Beijing 100700, China.
- Publication Type:Review
- Keywords:
Guipi Decoction;
Huangtu Decoction;
acute myocardial infarction;
acute upper gastrointestinal bleeding;
etiology and pathogenesis
- MeSH:
Humans;
Gastrointestinal Hemorrhage/etiology*;
Myocardial Infarction/drug therapy*;
Drugs, Chinese Herbal/therapeutic use*;
Medicine, Chinese Traditional;
Acute Disease
- From:
China Journal of Chinese Materia Medica
2025;50(7):1969-1973
- CountryChina
- Language:Chinese
-
Abstract:
Acute myocardial infarction and acute upper gastrointestinal bleeding are both critical internal medicine conditions. The incidence of acute upper gastrointestinal bleeding in patients with acute myocardial infarction ranges from 5.31% to 8.90%, with a mortality rate as high as 20.50% to 35.70%. The pathogenesis may be related to the use of antiplatelet and anticoagulant drugs, as well as stress-induced injury. In treatment, the contradiction between antiplatelet/anticoagulation therapy and bleeding has made this disease a significant challenge in modern medicine. Therefore, re-exploring the etiology, pathogenesis, treatment principles, and methods of traditional Chinese medicine(TCM) for acute myocardial infarction and acute upper gastrointestinal bleeding is of great clinical importance. The research team has been working year-round in the coronary care unit(CCU), managing a large number of such severe patients. By revisiting classic texts and delving into the foundational theories of TCM and historical medical literature, it has been found that this disease falls under the category of "distant blood" in the Synopsis of the Golden Chamber. In terms of etiology, it is primarily associated with weakness of healthy Qi and damage caused by drug toxicity. In terms of pathogenesis, in the acute stage, it mainly manifests as insufficient spleen Yang, deficiency of spleen Qi, and failure of the spleen to control blood. In the remission stage, it is characterized by deficiency of both heart Qi and spleen blood. For treatment, during the acute stage, Huangtu Decoction is used to warm Yang and restrain blood, while in the remission stage, Guipi Decoction is administered to tonify Qi and nourish blood. During the treatment process, for patients with acute myocardial infarction complicated with acute upper gastrointestinal bleeding, it is crucial to flexibly apply the treatment principles of "Nil per os" in western medicine and "where there is stomach Qi, there is life; where there is no stomach Qi, there is death" in TCM. Early intervention with Huangtu Decoction can also prevent bleeding, with large doses being key to achieving hemostasis. It is important to address the pathogenesis of heat syndrome in addition to the core pathogenesis of Yang deficiency bleeding and to emphasize the follow-up treatment with Guipi Decoction for a successful outcome.
