Connotation of deficiency-induced chest impediment and Renshen Decoction based on severe cases and modern pathophysiological mechanisms and its application in treatment of coronary heart disease, rheumatic heart disease, heart failure, hypotension, pulmonary arterial hypertension, and other critical illnesses.
10.19540/j.cnki.cjcmm.20241106.501
- Author:
Xing-Jiang XIONG
1
Author Information
1. Guang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing 100053, China.
- Publication Type:Review
- Keywords:
Renshen Decoction;
coronary heart disease;
deficiency-induced chest impediment;
heart failure;
hypotension;
pulmonary arterial hypertension
- MeSH:
Humans;
Drugs, Chinese Herbal/administration & dosage*;
Coronary Disease/physiopathology*;
Heart Failure/physiopathology*;
Hypertension, Pulmonary/physiopathology*;
Hypotension/physiopathology*
- From:
China Journal of Chinese Materia Medica
2025;50(6):1706-1714
- CountryChina
- Language:Chinese
-
Abstract:
Renshen Decoction is derived from the Synopsis of the Golden Chamber and is also known as Lizhong Pills or Lizhong Decoction, with the effects of warming the middle, dispelling cold, tonifying Qi, and strengthening the spleen, primarily treating spleen-stomach deficiency-cold syndrome. In modern clinical practice, Lizhong Pills and Lizhong Decoction are more frequently used, while Renshen Decoction is less common. Currently, this decoction is often applied in the treatment of gastric ulcers, infantile rotavirus diarrhea, chronic nephritis, autoimmune diabetes, allergic rhinitis, and other conditions, but reports on its use for coronary heart disease and angina pectoris are limited. Research has shown that in the original text, chest impediment(chest pain and stuffiness) includes not only coronary heart disease but also conditions such as coronary microcirculation disorders, X syndrome, coronary artery bridge, cardiomyopathy, heart valve disease, heart failure, chronic obstructive pulmonary disease, pulmonary heart disease, pulmonary arterial hypertension, hypotension, arrhythmia, and other diseases characterized by chest tightness. The name Renshen Decoction focuses on Panax ginseng without mentioning "Lizhong", indicating that its primary target is not the middle energizer but rather the deficiency of vital Qi and the collapse of the heart vessel. "Qi counterflow from the hypochondrium and rushing up to chest" encompasses acute inferior myocardial infarction combined with gastrointestinal irritation, and diseases with chest tightness as the main clinical manifestation combined with slow arrhythmias associated with vagus nerve excitement, nausea, and vomiting. Renshen Decoction is formulated for the deficiency-induced chest impediment, corresponding to the complication stage of coronary heart disease in modern clinical practice, which includes acute myocardial infarction with hypotension, cardiogenic shock, heart failure, and bradyarrhythmia. This differs from the excess-induced chest impediment addressed by Zhishi Xiebai Guizhi Decoction in the same article. The chest impediment treated by Renshen Decoction includes both the acute critical stage of cardiovascular diseases and the recovery phase of major illnesses. Pathophysiologically, the syndrome associated with Renshen Decoction may be closely related to ischemia, heart failure, hypotension, shock, and bradycardia. In terms of formula differentiation, Renshen Decoction must be distinguished from Zhishi Xiebai Guizhi Decoction and Chaihu Jia Longgu Muli Decoction. Renshen Decoction represents the ancient "Cardiac Triple Therapy".
