Differentiation and Treatment for Coronary Artery Spasm Based on Theory of Liver Governing Sinews

MA Mingru; YANG Jie

doi:10.16295/j.cnki.0257-358x.2025.05.004

Abstract：Coronary artery spasm(CAS)is an important pathogenic mechanism of non-obstructive ischemic heart disease.It is a kind of vascular vasomotor dysfunction caused by the increased sensitivity of coronary artery vessels and microvascular smooth muscles under stimulation.Blood vessels and smooth muscles can correspond to the generalized sinews in traditional Chinese medicine in terms of function and structure.Therefore,CAS can be classified into the category of sinew diseases in traditional Chinese medicine.Under the guidance of the theory that the liver governs the sinews,CAS can be divided into two types,namely"sinew spasm"and"sinew impediment"based on the changes in the functional state of the sinews.The pathogenesis of"sinew spasm"can be divided into deficiency and excess.The deficiency types are commonly seen as liver yin deficiency and insufficient liver blood,and treatment adopts the method of nourishing yin,tonifying the liver,and enriching the blood.The excess types are mostly due to exuberant liver fire scorching yin fluid.The treatment requires clearing away the liver-fire,calming the liver,and soothing the liver on the basis of nourishing yin to restore the flexibility of the sinews and vessels.The pathogenesis of"muscular arthralgia"is mostly characterized by underlying deficiency and superficial excess.It is based on the deficiency of the liver meridian and is caused by exogenous wind,cold,and dampness pathogens.The pathogens invade the interior and the viscera,resulting in chest pain.The prognosis is of high-risk characteristics,and the treatment is mainly to warm the liver,resolve masses,and eliminate impediment.