A medicine for treating angina pectoris and chest distress caused by myocardial bridge and its preparation method

Abstract

The application discloses a medicine for treating angina pectoris and myocardial bridge, and the medicine is prepared from safflower, campion flower, panax notoginseng, kudzu flower, ginseng and rose flower. The medicine has the effects of benefiting qi and activating blood, and is used for treating chest distress and chest pain caused by angina pectoris and myocardial bridge, and is suitable for people with qi deficiency and blood stasis type angina pectoris and myocardial bridge.

Description

Invention Field

[0001] This invention relates to a drug for treating angina pectoris and chest tightness and pain caused by myocardial bridging, and its preparation method, belonging to the technical field of pharmaceuticals. Background Technology

[0002] Angina pectoris is a clinical syndrome characterized by paroxysmal chest pain or discomfort, caused by insufficient blood supply to the coronary arteries and acute, temporary ischemia and hypoxia of the myocardium. Angina pectoris is pain felt on the body surface as a reflection of ischemic heart disease; it is characterized by paroxysmal, squeezing pain in the anterior chest, which may be accompanied by other symptoms. The pain is mainly located behind the sternum and may radiate to the precordial region and left upper limb. It often occurs during exertion or emotional excitement.

[0003] Myocardial bridging is a congenital coronary artery developmental abnormality. The main coronary arteries and their branches normally run within the subepicardial fat or deep to the epicardium on the surface of the heart. However, during coronary artery development, a segment of the coronary artery or its branches may be covered by superficial myocardium and run within the myocardium. This segment of the coronary artery covered by myocardium is called the mural coronary artery, and the myocardium covering the coronary artery is called a myocardial bridge (MB). In medicine, myocardial bridging is classified into two types: superficial and deep. Superficial myocardial bridging has little impact on coronary blood flow and generally has no obvious symptoms, but will show significant changes on an electrocardiogram. Deep myocardial bridging has a greater impact on coronary blood flow and can lead to various conditions such as heart failure, angina pectoris, and atrioventricular block. The main symptoms of myocardial bridging include chest tightness, palpitations, and chest pain.

[0004] In treating angina, medications that improve ischemia and relieve symptoms are commonly used, such as beta-blockers, commonly metoprolol and bisoprolol. Nitrates, commonly nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate are also used. Calcium channel blockers, commonly verapamil, nifedipine, and amlodipine are also common. In treating myocardial bridging, verapamil, metoprolol, diltiazem, and bisoprolol are commonly used clinically. These medications effectively relieve symptoms such as angina, palpitations, and rapid heartbeat, and improve myocardial ischemia. However, Western medicine treatments for angina and myocardial bridging have significant side effects and are not suitable for long-term use. Besides drug treatment, percutaneous coronary intervention, coronary artery bypass grafting, myocardial bridging resection, and coronary artery bypass grafting can also be performed. However, surgical treatment also carries significant risks, including ventricular perforation or coronary artery injury during surgery, and the potential for scar tissue formation and compression of the heart post-surgery, leading to impaired cardiac function.

[0005] Traditional Chinese medicine (TCM) classifies angina pectoris and myocardial bridging into several types, including qi stagnation and blood stasis, qi deficiency and blood stasis, and qi stagnation and phlegm obstruction, and treats them accordingly. TCM treatment of angina pectoris and myocardial bridging can effectively relieve chest pain and tightness caused by these conditions, with fewer side effects. This invention, however, treats angina pectoris and myocardial bridging by tailoring the medication to the specific type of condition in each patient. This invention is specifically designed for individuals with qi deficiency and blood stasis type angina pectoris and myocardial bridging, possessing qi-tonifying and blood-activating effects, and treating chest tightness and pain caused by coronary heart disease, qi deficiency and blood stasis, angina pectoris, or myocardial bridging. The applicant's principle of "combining constitution, disease, and syndrome differentiation, and adapting treatment to the individual, time, and place" is a specialized formula for treating qi deficiency and blood stasis type angina pectoris and myocardial bridging. Summary of the Invention

[0006] The technical problem to be solved by this invention is to provide a drug for treating chest tightness and chest pain caused by angina pectoris and myocardial bridging, and a method for preparing the same. This invention has the effects of invigorating qi and promoting blood circulation, and is suitable for treating chest tightness and chest pain caused by angina pectoris and myocardial bridging, and is applicable to people suffering from angina pectoris and myocardial bridging due to qi deficiency and blood stasis.

[0007] To solve the above technical problems, the present invention adopts the following technical solution:

[0008] A drug for treating angina pectoris and chest tightness and pain caused by myocardial bridging, wherein the active ingredients are calculated by weight as follows: 50-150 parts of safflower, 50-150 parts of trumpet creeper flower, 50-150 parts of Panax notoginseng, 50-150 parts of kudzu flower, 70-170 parts of ginseng, and 50-150 parts of rose.

[0009] The aforementioned drug for treating angina pectoris and chest tightness and pain caused by myocardial bridging is composed of the following active ingredients by weight: 70-130 parts safflower, 70-130 parts trumpet creeper, 70-130 parts Panax notoginseng, 70-130 parts kudzu flower, 90-150 parts ginseng, and 70-130 parts rose.

[0010] Specifically, the aforementioned drug for treating angina pectoris and chest tightness and pain caused by myocardial bridging is composed of the following active ingredients by weight: 100 parts safflower, 100 parts trumpet creeper, 100 parts Panax notoginseng, 100 parts kudzu flower, 120 parts ginseng, and 100 parts rose.

[0011] The aforementioned method for preparing drugs for treating angina pectoris and chest tightness and pain caused by myocardial bridging involves taking the drugs from the formula, combining them with acceptable excipients, and processing them according to conventional methods to produce the corresponding drug formulation.

[0012] The aforementioned drug preparations are powders, decoctions, oral liquids, hard capsules, tablets, pills, or granules.

[0013] The aforementioned powder is prepared as follows: each medicinal material is weighed according to the prescription ratio, and then pulverized separately using ultra-low temperature grinding. The particle size of the pulverized material is 80-100 micrometers. After being mixed evenly, it is packaged separately to obtain the powder.

[0014] The aforementioned decoction is prepared as follows: Weigh each medicinal material according to the prescription ratio, crush them into coarse powder, soak them in 10 times the amount of water for 0.5 hours, and then decoct them twice, 1 hour each time. Combine the three decoctions, mix them well, and concentrate them to 80% of the original medicinal liquid. Filter them while hot, and concentrate the filtrate to an extract with a relative density of 1.05-1.10 at 70°C. Take 40% of the weight of the above extract of refined honey, slowly add it to the above extract, stir well, and continue to heat it over a low flame to reduce the paste. When a small amount can be drawn into a thread or dropped onto paper without leaving water marks, seal it in a sterile bottle to obtain the final product.

[0015] The aforementioned oral liquid is prepared as follows: Weigh each medicinal material according to the prescription ratio, soak in 8 times the amount of water for 0.5 hours, then decoct 3 times, 1 hour each time. Combine the three decoctions, mix well, and concentrate to 80% of the original medicinal liquid. Filter while hot, concentrate the filtrate to an extract with a relative density of 1.05-1.10 at 60℃, add 10% xylitol, stir well, let stand for 24 hours, centrifuge, filter, dilute the filtrate with 1000 ml of distilled water, and then package to obtain the final product.

[0016] The aforementioned hard capsules are prepared as follows: Weigh each medicinal material according to the prescription ratio, soak in 6 times the amount of water for 0.5 hours, then decoct three times for 0.5 hours each time. Combine the three decoctions, mix them well, and concentrate them to 80% of the original medicinal liquid. Filter while hot, concentrate the filtrate to an extract with a relative density of 1.05-1.10 at 70°C, dry it at 70°C to obtain a dry extract, pulverize it into a fine powder, add 10% of the prepared amount of starch and mix evenly. Granulate with 75% ethanol, dry, granulate, and fill into capsules to obtain the final product.

[0017] The aforementioned tablets are prepared as follows: Weigh each medicinal material according to the prescription ratio, soak in 10 times the amount of water for 0.5 hours, then decoct twice, 2 hours each time. Combine the three decoctions, mix well, and concentrate to 80% of the original medicinal liquid. Filter while hot, and concentrate the filtrate to an extract with a relative density of 1.05-1.10 at 70℃. Dry the extract at 70℃ and pulverize it into a fine powder to obtain a dry extract. Take the dry extract, add 10% dextrin, 2% sodium carboxymethyl cellulose and 1% magnesium stearate to make a mixture. Granulate with 70% ethanol as a wetting agent, dry, compress into tablets, and coat with a film to obtain the final product.

[0018] Compared with the prior art, the present invention has the following beneficial effects:

[0019] The medicine for treating angina pectoris and myocardial bridging described in this invention is prepared from safflower, trumpet creeper, Panax notoginseng, kudzu flower, ginseng, and rose. The properties and effects of each component are as follows: Safflower is the dried flower of *Carthamus tinctorius* L., a plant in the Asteraceae family. The flowers are harvested in summer when they turn from yellow to red, and then dried in the shade or sun. It has a pungent taste and warm properties; it enters the heart and liver meridians; it has the effects of promoting blood circulation, regulating menstruation, dispersing blood stasis, and relieving pain; it is used for amenorrhea, dysmenorrhea, lochia retention, abdominal masses, chest pain, abdominal pain due to blood stasis, chest and rib pain, traumatic injuries, and sores and swellings. The dried flowers of *Campsis grandiflora* (Thunb.) K.Schum. or *Campsis radicans* (L.) Seem. (family Bignoniaceae) are sweet and sour in taste, and cold in nature. They enter the liver and pericardium meridians and have the effects of promoting blood circulation, regulating menstruation, cooling blood, and dispelling wind. They are used for irregular menstruation, amenorrhea, postpartum mastitis, urticaria, itchy skin, and acne. The dried roots and rhizomes of *Panax notoginseng* (Burk.) FHChen (family Araliaceae) are sweet and slightly bitter in taste, and warm in nature. They enter the liver and stomach meridians and have the effects of dispersing blood stasis, stopping bleeding, reducing swelling, and relieving pain. They are used for hemoptysis, hematemesis, epistaxis, hematochezia, metrorrhagia, traumatic bleeding, chest and abdominal pain, and swelling and pain from falls. Kudzu flower is the flower of *Pueraria lobata* and *Pueraria truncata*, both belonging to the legume family. It has a sweet taste and cool properties; it enters the spleen and stomach meridians. It has the effects of relieving alcohol intoxication, invigorating the spleen, and stopping bleeding. It is used for symptoms such as thirst and irritability due to alcohol consumption, headache, dizziness, abdominal distension, nausea and vomiting of acid, loss of appetite, hematemesis, and hemorrhoids. Ginseng is the dried root and rhizome of *Panax ginseng* CAMey., a plant belonging to the Araliaceae family. It is mostly harvested in autumn, washed, and then sun-dried or oven-dried. Cultivated ginseng is commonly known as "garden ginseng"; ginseng grown naturally in the wild in the mountains is called "forest ginseng," also known as "seed ginseng." It tastes sweet and slightly bitter, and is slightly warm in nature; it enters the spleen, lung, heart, and kidney meridians; it has the effects of greatly replenishing vital energy, restoring pulse and consolidating the body, tonifying the spleen and lungs, generating fluids and nourishing blood, calming the mind and improving intelligence; it is used for weakness and collapse, cold limbs and weak pulse, spleen deficiency and poor appetite, lung deficiency and cough, thirst due to fluid depletion, internal heat and thirst, deficiency of qi and blood, chronic illness and emaciation, palpitations and insomnia, impotence and cold uterus. Rose is the flower of the rose (Rosa rugosa Thunb.), a plant of the Rosaceae family and Rosa genus; it tastes sweet and slightly bitter, and is warm in nature; it has the effects of regulating qi and relieving depression, harmonizing blood and dispersing blood stasis; it treats liver and stomach qi pain, new and chronic wind-dampness, hematemesis and hemoptysis, irregular menstruation, leukorrhea, dysentery, mastitis, and carbuncles.

[0020] Fang Jie

[0021] Safflower in this formula invigorates blood circulation, promotes menstruation, disperses blood stasis, and relieves pain, especially affecting the heart meridian. Panax notoginseng disperses blood stasis, stops bleeding, reduces swelling, and relieves pain. Ginseng greatly replenishes vital energy, restores pulse and consolidates the body, strengthens the spleen and lungs, generates fluids and nourishes blood, and calms the mind and improves intelligence. The three herbs combined promote blood circulation in the heart, remove blood stasis in the heart, and greatly replenish vital energy in the heart. They invigorate blood circulation and remove blood stasis without harming qi, and replenish qi to assist the heart in promoting blood circulation. Therefore, these three herbs are the principal herbs. Kudzu flower has the effects of relieving alcohol intoxication, invigorating the spleen, and stopping bleeding. Rose has the effects of regulating qi, relieving depression, harmonizing blood, and dispersing blood stasis. The two herbs combined assist the principal herbs in invigorating blood circulation and promoting qi circulation. Therefore, they are the assistant herbs. Campsis grandiflora enters the liver and pericardium meridians. It invigorates blood circulation, promotes menstruation, cools blood, and dispels wind. It assists the principal and assistant herbs in invigorating blood circulation and promoting menstruation. At the same time, it guides the herbs to the pericardium. Therefore, it is the adjuvant herb. The whole formula has the effects of removing blood stasis, clearing the meridians, replenishing qi and promoting blood circulation. It is used for people with qi deficiency and blood stasis, chest pain and heart pain. The clinical manifestations are: chest pain, chest tightness, stabbing pain, weakness of limbs, shortness of breath after slight activity, dark tongue with petechiae or ecchymosis, etc. It covers patients with coronary disease and myocardial bridging in modern medicine who have the above symptoms.

[0022] This invention has the effects of invigorating qi and promoting blood circulation, and can treat chest tightness and chest pain caused by angina pectoris and myocardial bridging. It is suitable for people suffering from angina pectoris and myocardial bridging caused by qi deficiency and blood stasis. Attached Figure Description

[0023] Figure 1 Typical Case 1 (Signed PDF Version);

[0024] Figure 2 Typical Case 1 (Signed PDF Version);

[0025] Figure 3 Typical Case 2 (Signed PDF Version);

[0026] Figure 4 Typical Case 2 (Signed PDF Version);

[0027] Figure 5 Typical Case 2 (Signed PDF Version);

[0028] Figure 6 Typical Case 2 (PDF signed version). Detailed Implementation

[0029] The present invention will be further described below with reference to embodiments, but these embodiments are not intended to limit the scope of the invention.

[0030] Example 1.

[0031] Prescription: Prepared from 10g safflower, 10g trumpet creeper flower, 10g Panax notoginseng, 10g kudzu flower, 12g ginseng, and 10g rose.

[0032] Process: Weigh each medicinal material according to the prescription ratio, pulverize them separately using ultra-low temperature grinding, and pulverize them to a particle size of 80-100 micrometers. After mixing evenly, package them to obtain the powder.

[0033] Example 2.

[0034] Prescription: 15g safflower, 5g trumpet creeper, 5g Panax notoginseng, 5g kudzu flower, 17g ginseng, and 5g rose.

[0035] Process: Weigh each medicinal material according to the prescription ratio, grind them into coarse powder, soak them in 10 times the amount of water for 0.5 hours, then decoct twice, 1 hour each time. Combine the three decoctions, mix them well, and concentrate them to 80% of the original medicinal liquid. Filter while hot, and concentrate the filtrate to an extract with a relative density of 1.05-1.10 at 70℃. Take 40% of the weight of the above extract of refined honey and slowly add it to the above extract. Stir well and continue to heat over a low flame to reduce the paste. When a small amount can be drawn into a thread or dripped onto paper without leaving water marks, seal it in a sterile bottle to obtain the decoction.

[0036] Example 3.

[0037] Prescription: Prepared from 5g safflower, 15g trumpet creeper, 15g Panax notoginseng, 15g kudzu flower, 7g ginseng, and 15g rose.

[0038] Process: Weigh each medicinal material according to the prescription ratio, soak in 8 times the amount of water for 0.5 hours, then decoct 3 times, 1 hour each time. Combine the three decoctions, mix well, and concentrate to 80% of the original medicinal liquid. Filter while hot. Concentrate the filtrate to an extract with a relative density of 1.05-1.10 at 60℃. Add 10% xylitol, stir well, let stand for 24 hours, centrifuge, filter, dilute the filtrate with 1000ml of distilled water, and package to obtain the oral liquid.

[0039] Example 4.

[0040] Prescription: Prepared from 8g safflower, 11g trumpet creeper, 15g Panax notoginseng, 5g kudzu flower, 9g ginseng, and 12g rose.

[0041] Process: Weigh each medicinal material according to the prescription ratio, soak in 6 times the amount of water for 0.5 hours, then decoct 3 times for 0.5 hours each time. Combine the three decoctions, mix well, and concentrate to 80% of the original medicinal liquid. Filter while hot, concentrate the filtrate to an extract with a relative density of 1.05-1.10 at 70℃, dry at 70℃ to form a dry extract, pulverize into a fine powder, add 10% starch of the prepared amount and mix evenly, granulate with 75% ethanol, dry, granulate, and fill into capsules to obtain hard capsules.

[0042] Example 5.

[0043] Prescription: 10g safflower, 15g trumpet creeper, 5g Panax notoginseng, 14g kudzu flower, 8g ginseng, and 9g rose.

[0044] Process: Weigh each medicinal material according to the prescription ratio, soak in 10 times the amount of water for 0.5 hours, then decoct twice for 2 hours each time. Combine the three decoctions, mix well, and concentrate to 80% of the original medicinal liquid. Filter while hot, and concentrate the filtrate to an extract with a relative density of 1.05-1.10 at 70℃. Dry the extract at 70℃ and pulverize it into a fine powder to obtain a dry extract. Take the dry extract, add 10% dextrin, 2% sodium carboxymethyl cellulose and 1% magnesium stearate to make a mixture. Granulate with 70% ethanol as a wetting agent, dry, compress into tablets, and film-coat to obtain tablets.

[0045] This invention has undergone extensive experimental research, and the results of this experimental research are as follows:

[0046] 1 Clinical Trial

[0047] 1.1 Source of cases

[0048] All cases in this study were from 30 patients (14 female patients, 16 male patients, and 10 elderly patients) who visited the Department of Cardiology at the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from January 2023 to December 2023, and met the inclusion and exclusion criteria.

[0049] 1.2 Diagnostic criteria

[0050] 1.2.1 Western Medicine Diagnostic Criteria:

[0051] Coronary angiography or coronary CT confirms any coronary artery stenosis ≥50%, or coronary angiography or coronary CT confirms the presence of myocardial bridging.

[0052] 1.2.2 Traditional Chinese Medicine Diagnostic Criteria:

[0053] According to the 2002 edition of the "Guiding Principles for Clinical Research of New Traditional Chinese Medicine Drugs", the diagnosis of Qi deficiency and blood stasis syndrome can be made if three main symptoms are present, or two main symptoms and two tongue and pulse symptoms are present.

[0054] Main symptoms: Chest pain and tightness, stabbing pain, shortness of breath, fatigue, purplish complexion, dark tongue with petechiae or ecchymosis. Secondary symptoms: Palpitation, shortness of breath after mild activity, spontaneous sweating, pale purple tongue, weak and hesitant pulse.

[0055] 1.2.3 Observation Methods

[0056] (1) General situation: A complete medical record is established for each patient, recording the patient's age, gender, medical history, contact information and treatment, etc.

[0057] (2) Triggering factors for angina attacks, the intensity and extent of physical activity, the frequency, intensity, and duration of pain, nitroglycerin use, and related symptoms. Records should be kept weekly.

[0058] (3) Relevant physical signs such as heart rate, heart rhythm, heart murmur, blood pressure, tongue texture, tongue coating, and pulse should be recorded once a week.

[0059] (4) Criteria for Evaluating the Therapeutic Effect of Traditional Chinese Medicine Syndromes: Referring to the Clinical Research Guidelines for New Traditional Chinese Medicine Drugs in the Treatment of Hypertension formulated by the State Food and Drug Administration, the proposed criteria are divided into three categories: significantly effective, effective, and ineffective.

[0060] ①Significant effect: Clinical symptoms and signs are significantly improved, and the syndrome score is reduced by ≥70%.

[0061] ② Effective: Clinical symptoms and signs have improved, and the syndrome score has decreased by ≥30%.

[0062] ③ Ineffective: Clinical symptoms and signs show no significant improvement, or even worsen, and the syndrome score decreases by less than 30%.

[0063] 1.3 Treatment Plan

[0064] Table 1 Treatment Methods

[0065]

[0066] 1.4 Efficacy observation indicators

[0067] 1.4.1 Research Indicators

[0068] Table 2 Traditional Chinese Medicine Symptom Scoring Table

[0069]

[0070]

[0071] 1.5 Comparison of treatment efficacy between the two groups

[0072] Table 3 Comparison of clinical efficacy between the two groups

[0073] Effective efficient invalid experimental group 14 1 0 control group 9 3 2

[0074] Criteria for significant efficacy: Clinical symptoms and signs are significantly improved, and the syndrome score is reduced by ≥70%.

[0075] Effective criteria: Improvement in clinical symptoms and signs, and a reduction in syndrome score of ≥30%.

[0076] Invalid criteria: No significant improvement or even worsening of clinical symptoms and signs, and a decrease in syndrome score of less than 30%.

[0077] 2 Typical Cases

[0078] Typical Case 1:

[0079] Patient Gu, male, 55 years old, visited the cardiology outpatient department of our Yangming Campus on October 30, 2023.

[0080] Chief complaint: Chest pain radiating to the back for 1 year, recurring 1 week ago.

[0081] Present Illness: For over 1 year, the patient experienced chest pain radiating to the back and underwent a diagnosis at the Second Affiliated Hospital of Guizhou Medical University. Coronary angiography revealed a myocardial bridge in the left anterior descending artery with 60% systolic compression. The patient was treated with oral diltiazem and bisoprolol half a tablet once daily. However, the chest pain recurred intermittently, and the patient felt the medication was ineffective, so the medication was discontinued intermittently. One week ago, the patient experienced another episode of chest pain radiating to the back, with the same nature of pain as before, but the severity was greater. The patient is now seeking further treatment at our outpatient clinic.

[0082] Previous history: None.

[0083] Allergy history: None.

[0084] According to the four diagnostic methods of Traditional Chinese Medicine: the pulse is choppy, and the tongue coating is dark purple with a yellow and greasy coating and ecchymosis on the edges.

[0085] Physical examination: BP: 130 / 81 mmHg, P: 75 bpm, mental status fair, no cyanosis of the lips, clear breath sounds in both lungs, no dry or wet rales heard in either lung; no abnormal bulging or depression in the precordial area, no thrill on palpation of the precordial area, heart size not enlarged on percussion, dullness on percussion of the apex 0.5 cm medial to the left midclavicular line at the 5th intercostal space, heart rate 75 bpm, normal heart sounds, regular rhythm, no pathological murmurs heard in any valve auscultation area; no edema in both lower extremities.

[0086] Auxiliary examinations: None.

[0087] diagnosis:

[0088] Traditional Chinese Medicine diagnosis: Chest pain and heart pain (Qi deficiency and blood stasis syndrome);

[0089] Western medical diagnosis: Myocardial bridging in the left anterior descending artery.

[0090] Treatment prescription (one dose): 10g of trumpet creeper flower, 10g of safflower, 10g of Panax notoginseng, 10g of kudzu flower, 12g of ginseng, and 10g of rose.

[0091] Take 7 doses of traditional Chinese medicine, one dose per day (divided into three times), orally.

[0092] Follow-up appointment date: November 8, 2023.

[0093] Department: Cardiology Outpatient Department, Yangming Campus.

[0094] Traditional Chinese Medicine diagnosis: Follow-up visit, the frequency of chest pain and back pain has decreased, the degree of pain has lessened compared to before, the tongue is dark red with a yellow and greasy coating, and the pulse is slippery.

[0095] Physical examination: BP: 123 / 79 mmHg, P: 83 bpm.

[0096] diagnosis:

[0097] Traditional Chinese Medicine diagnosis: Chest pain and heart pain (Qi deficiency and blood stasis syndrome);

[0098] Western medical diagnosis: Myocardial bridging in the left anterior descending artery.

[0099] Treatment prescription (one dose): 10g of trumpet creeper flower, 10g of safflower, 10g of Panax notoginseng, 10g of kudzu flower, 12g of ginseng, and 10g of rose.

[0100] Take 7 doses of traditional Chinese medicine, one dose per day (divided into three times), orally.

[0101] Follow-up visit date: November 22, 2023.

[0102] Department: Cardiology Outpatient Department, Yangming Campus.

[0103] According to the four diagnostic methods of Traditional Chinese Medicine: no chest pain, red tongue with a slightly yellow and greasy coating, and a thready and rapid pulse.

[0104] diagnosis:

[0105] Traditional Chinese Medicine diagnosis: Chest pain and heart pain (Qi deficiency and blood stasis syndrome);

[0106] Western medical diagnosis: Myocardial bridging in the left anterior descending artery.

[0107] Treatment prescription (one dose): 10g of trumpet creeper flower, 10g of safflower, 10g of Panax notoginseng, 10g of kudzu flower, 12g of ginseng, and 10g of rose.

[0108] Seven doses of traditional Chinese medicine were prescribed, one dose per day (divided into three administrations), taken orally. A follow-up phone call one week later confirmed no chest pain.

[0109] Typical Case 2:

[0110] The patient, Ms. Ran, a 30-year-old woman, visited the Department of Cardiology (Cardiovascular Medicine) of our hospital on October 12, 2023.

[0111] Chief complaint: Recurrent chest tightness for 1+ years, worsening for 10+ days.

[0112] Present Illness: Over a year ago, the patient experienced chest tightness after catching a cold. The symptoms were intermittent, a feeling of constriction, accompanied by left shoulder and back pain, palpitations, dizziness, nausea, and vomiting. There was no sweating and the extremities were cold. The patient sought medical attention at our hospital's emergency department, where an electrocardiogram revealed myocardial ischemia. No specific treatment was given at that time. Since then, the symptoms have recurred frequently after catching a cold, with similar severity and nature, and were relieved by rest. The patient did not receive standardized medical treatment. Over 10 days ago, the patient experienced left-sided chest tightness after catching a cold, occasionally shifting to the right chest, accompanied by left shoulder pain, dizziness, palpitations, nausea, and vomiting. There was no difficulty breathing or sweating. The symptoms gradually subsided after self-medication with "Danshen Dripping Pills and Shengsong Yangxin Capsules." Seeking systematic treatment with both traditional Chinese and Western medicine, the patient sought treatment at our outpatient department and was admitted to our department with a diagnosis of "chest pain and heart pain." Since the onset of the illness, the patient has not experienced severe chest pain, profuse sweating, cold extremities, orthopnea, or nocturnal paroxysmal dyspnea. The patient presented with the following symptoms upon admission: chest tightness, which was constricting and occasionally shifted to the right chest, accompanied by pain in the left shoulder and back, palpitations, dizziness, nausea, and vomiting; the patient was in fair spirits, had a good appetite but poor sleep, and normal bowel movements; the tongue was dark in color with a white and greasy coating, and the pulse was wiry and slippery.

[0113] Past medical history: 10+ years of history of urticaria; denies history of diabetes, hypertension, coronary heart disease, etc.; denies history of infectious diseases such as tuberculosis, hepatitis, typhoid fever, etc.; denies history of poisoning.

[0114] History of trauma, surgery and blood transfusion: The patient underwent a cesarean section at the Guiyang Maternal and Child Health Station 7+ months ago. She has not complained of any special discomfort and denies any history of trauma or blood transfusion.

[0115] Allergy history: None.

[0116] Menstrual history: Menarche at age 13, menstrual cycle 28-30 days, menstrual period 3-4 days, last menstrual period on September 20, 2023. Occasionally dysmenorrhea, no blood clots. No history of abnormal vaginal bleeding, normal vaginal discharge.

[0117] Family history: Denies any family history of heredity.

[0118] Other: None.

[0119] Traditional Chinese medicine diagnosis using observation, auscultation, and palpation: normal complexion, moderate physique, clear voice, normal breathing, pale tongue, normal tongue body, white and greasy tongue coating, and wiry and slippery pulse.

[0120] Physical examination: T: 36.7℃, P: 71 bpm, R: 20 bpm, BP: 130 / 86 mmHg. The patient's mental state is fair; there is no cyanosis of the lips; breath sounds are clear bilaterally, and no dry or wet rales are heard in either lung; heart rate is 68 bpm, heart sounds are normal and regular, and no pathological murmurs are heard in any of the valvular auscultation areas; there is no edema in the lower extremities.

[0121] General condition: Conscious, in fair spirits, moderately nutritious, able to maintain independent posture, cooperative during physical examination, and with a normal gait. Skin and mucous membranes are normal, no pressure sores are present, and no enlarged superficial lymph nodes are palpable.

[0122] Skull and facial features: no deformities; sclera: no jaundice; pupils: left 3.0mm, right 3.0mm, brisk pupillary light reflex; ears and nose: no deformities; lips: mild cyanosis; pharynx: no congestion; no purulent spots; tonsils: normal.

[0123] The neck is soft, the trachea is in the midline, the thyroid gland is symmetrical on both sides and no enlargement is palpable, the jugular veins are not distended or distended, and no abnormal pulsation is seen in the carotid artery.

[0124] Chest: The chest is symmetrical and without deformity; thoracic breathing is normal and consistent; palpation reveals no increase or decrease in vocal fremitus, no pleural friction rub; percussion reveals clear sounds in both lungs; auscultation reveals clear breath sounds in both lungs, and no dry or wet rales are heard in either lung; inspection reveals no abnormal bulges or depressions in the precordial area; the apex impulse is normal and no thrill is palpable; the cardiac borders are not enlarged on percussion; the apex is dull on percussion at the 5th intercostal space, 0.5 cm medial to the left midclavicular line; heart rate is 71 beats / minute, regular rhythm, strong heart sounds, and no murmurs. (Cardiotomy details:)

[0125] Right cm Interrib space Left cm 2 Ⅱ 2 3 Ⅲ 4 3 Ⅳ 6 Ⅴ 7.5 Ⅵ

[0126] The left midclavicular line is 8 cm from the anterior midline.

[0127] Abdomen: The abdomen is flat upon inspection. A surgical scar measuring approximately 8cm × 0.5cm is visible in the lower abdomen. No peristaltic waves or gastrointestinal tract are observed. Abdominal breathing is present. The umbilicus is normal, without protrusion or secretions. No abdominal wall varicose veins are observed. The abdomen is soft and flat upon palpation, without tenderness, rebound tenderness, or muscle guarding. No fluid waves or succussion splashes are felt. No abdominal masses are palpable. The liver is not palpable below the costal margin and there is no tenderness upon percussion. Hepatojugular reflux is negative. The gallbladder is not palpable, and Murphy's sign is negative. The spleen is not palpable below the costal margin. The kidneys are not palpable, and there is no ureteral tenderness. The liver dullness is normal, with the upper border located at the 5th intercostal space along the right midclavicular line. Shifting dullness is negative. There is no significant percussion tenderness in the bilateral renal areas. Bowel sounds are normal on auscultation, without metallic or high-pitched sounds. No vascular murmurs are heard.

[0128] Spine and limbs: The physiological curvature of the spine is present, and there is no tenderness or percussion pain in any vertebra or costovertebral angle. Movement is free and there are no deformities in the limbs. There is no clubbing of the fingers or toes, no varicose veins in the lower limbs, and no edema in both lower limbs.

[0129] Nervous system: Abdominal wall reflexes present, muscle strength of all four limbs grade 5, physiological signs present, pathological signs not elicited.

[0130] Specialist examination: T: 36.7℃, P: 71 bpm, R: 20 bpm, BP: 130 / 86 mmHg; patient is in fair condition, entered the ward, supine position, mild cyanosis of the lips, no jugular venous distension; symmetrical respiratory movements in both lungs, no increase or decrease in vocal fremitus, no palpable pleural friction rub, clear percussion sounds in both lungs, clear breath sounds in both lungs, no dry or wet rales heard in both lungs; no abnormal bulging or depression in the precordial area, no lifting apex impulse, no palpable thrill in the precordial area, normal heart size, apex impulse located 0.5 cm medial to the left midclavicular line in the 5th intercostal space, heart rate 71 bpm, regular rhythm, normal heart sounds, no pathological murmurs heard in any valve auscultation area, no edema in both lower extremities.

[0131] Ancillary examinations: The admission electrocardiogram showed: 1. Sinus arrhythmia; 2. No axis deviation; 3. Widespread T wave flattening; 4. ST segment depression of 0.05mV in segments II, III, aVF, V2-V6. Further details to be provided.

[0132] The admission electrocardiogram showed: 1. Sinus arrhythmia; 2. No axis deviation; 3. Widespread T wave flattening; 4. ST segment depression of 0.05mV in segments II, III, a, VF, V2-V6. Blood gas analysis: partial pressure of oxygen 80.60 mmHg, calcium ion concentration 1.07 mmol / L, blood carbon dioxide concentration 19.60 mmol / L, oxygenation index at patient's body temperature 379.00 mmHg, mean alveolar oxygen partial pressure at patient's body temperature 90.8 mmHg, mean alveolar oxygen partial pressure 90.3 mmHg, partial pressure of oxygen at patient's body temperature 79.6 mmHg, potassium anion gap 7.0 mmol / L, anion gap 3.1 mmol / L, chloride ion concentration 113 mmol / L; Complete blood count: hemoglobin 157.00 g / L, hematocrit 47.60%, platelet count 383.00 x 10^9 / L; Liver function (excluding CHE and ALP), electrolytes, renal function, complete lipid profile: total protein 87.08 g / L, triglycerides 2.27 mmol / L; BNP, myocardial markers, and coagulation panel showed no significant abnormalities. Echocardiography: Left ventricular wall motion, systolic function, and diastolic function are normal at rest. Mild scoliosis of the thoracic spine is present, but no obvious abnormalities are seen in the vertebrae. Further MRI examination may be necessary. Procedure Time: October 13, 2023, 14:17 Coronary Angiography Procedure: At 14:17 today, the patient was transferred to the cardiac catheterization lab for coronary angiography under ECG monitoring and C-arm imaging. The patient was placed in a supine position, and the left wrist joint was routinely disinfected and draped. After the 2% lidocaine local anesthesia took effect, the radial artery was successfully punctured, and an arterial sheath was successfully inserted through the puncture site. 3000 units of heparin were injected, and a pressure sensor was connected. Under invasive pressure monitoring, a J-wire guidewire successfully guided the insertion of a multi-functional catheter. The guidewire was adjusted, and the multi-functional catheter was successfully inserted to the left coronary ostium. Contrast agent was injected, and multi-position angiography showed no abnormalities in the left main coronary artery; an atherosclerotic plaque was seen in the proximal segment of the left anterior descending artery, and a myocardial bridge was seen in the mid-segment, with approximately 50%-60% systolic compression and forward flow TIMI grade 3. The circumflex artery was normal. The TIG catheter was adjusted to the right coronary ostium, and contrast agent was injected, and multi-position angiography showed that the right coronary artery was normal. After the procedure, the patient did not complain of any particular discomfort during or after the operation. The guidewire and angiography tube were removed, a tourniquet was applied for local compression, the arterial sheath was removed, and pressure bandaging was applied to stop the bleeding. The patient was sent back to the ward at 14:37.

[0133] Postoperative diagnosis: coronary atherosclerosis, myocardial bridging of the left anterior descending artery. The patient was discharged on October 14, 2023. After discharge, the patient still experienced chest tightness, accompanied by pain in the left shoulder, which could be transferred to the right shoulder. The patient visited the cardiology outpatient clinic on October 16, 2023.

[0134] Traditional Chinese Medicine diagnosis: The patient had chest tightness, accompanied by pain in the left shoulder, which occasionally shifted to the right shoulder. Three days ago, a coronary angiography performed in our department of our hospital showed myocardial bridging in the left anterior descending branch.

[0135] diagnosis:

[0136] Traditional Chinese Medicine Diagnosis

[0137] Traditional Chinese Medicine diagnosis: Chest pain and heart pain (Qi deficiency and blood stasis syndrome);

[0138] Western medical diagnosis: Myocardial bridging in the left anterior descending artery.

[0139] Treatment prescription (one dose): 10g of trumpet creeper flower, 10g of safflower, 10g of Panax notoginseng, 10g of kudzu flower, 12g of ginseng, and 10g of rose.

[0140] Take 10 doses of traditional Chinese medicine, one dose per day (divided into three times), orally.

[0141] The patient returned for a follow-up visit on November 16, 2023. The patient reported mild discomfort in the chest, sometimes on the left and sometimes on the right; red tongue with little coating; thready and rapid pulse; blood pressure 113 / 84 mmHg, pulse 90 bpm.

[0142] Treatment prescription (one dose): 10g of trumpet creeper flower, 10g of safflower, 10g of Panax notoginseng, 10g of kudzu flower, 12g of ginseng, and 10g of rose.

[0143] Ten doses of traditional Chinese medicine, one dose per day (divided into three times), taken orally.

[0144] Continue taking the above-mentioned prescription orally for 10 doses. Follow-up by telephone showed no chest pain or tightness.

Claims

1. A drug for treating angina pectoris and chest tightness and pain caused by myocardial bridging, characterized in that: Its medicinal active ingredients, calculated by weight, are made from 50-150 parts of safflower, 50-150 parts of trumpet creeper flower, 50-150 parts of Panax notoginseng, 50-150 parts of kudzu flower, 70-170 parts of ginseng, and 50-150 parts of rose flower.

2. The drug for treating angina pectoris and chest tightness and chest pain caused by myocardial bridging as described in claim 1, characterized in that: Its medicinal active ingredients, calculated by weight, are made from 70-130 parts of safflower, 70-130 parts of trumpet creeper flower, 70-130 parts of Panax notoginseng, 70-130 parts of kudzu flower, 90-150 parts of ginseng, and 70-130 parts of rose flower.

3. The drug for treating angina pectoris and chest tightness and chest pain caused by myocardial bridging as described in claim 2, characterized in that: Its medicinal active ingredients, calculated by weight, are made from 100 parts safflower, 100 parts trumpet creeper, 100 parts Panax notoginseng, 100 parts kudzu flower, 120 parts ginseng, and 100 parts rose.

4. A method for preparing a medicament for treating angina pectoris and chest tightness and chest pain caused by myocardial bridging as described in any one of claims 1-3, characterized in that: Take the medicines from the prescription, combine them with acceptable excipients, and process them according to conventional methods to produce the corresponding pharmaceutical preparations.

5. The method for preparing the drug for treating angina pectoris and chest tightness and chest pain caused by myocardial bridging according to claim 4, characterized in that: The pharmaceutical preparations are powders, decoctions, oral liquids, hard capsules, tablets, pills, or granules.

6. The method for preparing the medicament for treating angina pectoris and chest tightness and pain caused by myocardial bridging as described in claim 5, characterized in that: The powder is prepared as follows: each medicinal material is weighed according to the prescription ratio, and then pulverized separately using ultra-low temperature grinding. The particle size of the pulverized material is 80-100 micrometers. After being mixed evenly, the powder is packaged separately to obtain the final product.

7. The method for preparing the medicament for treating angina pectoris and chest tightness and chest pain caused by myocardial bridging as described in claim 5, characterized in that: The decoction is prepared as follows: Weigh each medicinal material according to the prescription ratio, crush them into coarse powder, soak them in 10 times the amount of water for 0.5 hours, and then decoct twice, 1 hour each time. Combine the three decoctions, mix them well, and concentrate them to 80% of the original medicinal liquid. Filter them while hot, and concentrate the filtrate to an extract with a relative density of 1.05-1.10 at 70°C. Take 40% of the weight of the above extract of refined honey, slowly add it to the above extract, stir well, and continue to heat over a low flame to reduce the paste. When a small amount can be drawn into a thread or dropped onto paper without leaving water marks, seal it in a sterile bottle to obtain the final product.

8. The method for preparing the medicament for treating angina pectoris and chest tightness and chest pain caused by myocardial bridging as described in claim 5, characterized in that: The oral liquid is prepared as follows: Weigh each medicinal material according to the prescription ratio, soak in 8 times the amount of water for 0.5 hours, then decoct 3 times, 1 hour each time. Combine the three decoctions, mix well, and concentrate to 80% of the original medicinal liquid. Filter while hot, concentrate the filtrate to an extract with a relative density of 1.05-1.10 at 60℃, add 10% xylitol, stir well, let stand for 24 hours, centrifuge, filter, dilute the filtrate with 1000 ml of distilled water, and then package to obtain the final product.

9. The method for preparing the medicament for treating angina pectoris and chest tightness and pain caused by myocardial bridging as described in claim 5, characterized in that: The hard capsules are prepared as follows: Weigh each medicinal material according to the prescription ratio, soak in 6 times the amount of water for 0.5 hours, then decoct 3 times for 0.5 hours each time. Combine the three decoctions, mix well, and concentrate to 80% of the original medicinal liquid. Filter while hot, concentrate the filtrate to an extract with a relative density of 1.05-1.10 at 70°C, dry at 70°C to obtain a dry extract, pulverize into a fine powder, add 10% starch of the prepared amount and mix evenly, granulate with 75% ethanol, dry, granulate, and fill into capsules to obtain the final product.

10. The method for preparing the medicament for treating angina pectoris and chest tightness and chest pain caused by myocardial bridging as described in claim 5, characterized in that: The tablets are prepared as follows: Weigh each medicinal material according to the prescription ratio, soak in 10 times the amount of water for 0.5 hours, then decoct twice for 2 hours each time. Combine the three decoctions, mix well, and concentrate to 80% of the original medicinal liquid. Filter while hot, and concentrate the filtrate to an extract with a relative density of 1.05-1.10 at 70°C. Dry the extract at 70°C and pulverize it into a fine powder to obtain a dry extract. Take the dry extract, add 10% dextrin, 2% sodium carboxymethyl cellulose, and 1% magnesium stearate to make a mixture. Granulate with 70% ethanol as a wetting agent, dry, compress into tablets, and coat with a film to obtain the final product.

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