Name: L¨¹.

Sex: Female.

Age: 47 years.

0ccupation: A peasant.

Chief Complaint: Chest oppression and shortness of breath for 3 years, edema of lower extremities for half a month.

History of Present Illness: Three years ago, the patient got chest oppression and shortness of breath. At the beginning it was often induced by overexertion, later on, it could be easily induced by little exertion or emotional excitement. Furthermore, it's always accompanied with palpitation and dizziness, but there weren't syncope and amaurosis. After several times of treatment in the local hospital, it became sometimes mild and sometimes severe. In the recent half a month, palpitation, chest oppression and shortness of breath became more and more severe, so that she would get an immediate asthma when she had a long walk or stepped upstairs to the 2nd floor. In addition, there was edema of lower extremities and paroxysmal orthopnea in the night. During her illness, she kept her appetite and stool normal all along. Her urine was scanty. There wasn't other complaint.

Physical Examination: The patient was spiritless with a normal general condition. The respiratory sounds were harsh. Systolic murmur of magnitude ¢ó could be heard at the apex area of heart. There was pitting edema of both lower extremities below her knees. The pulse was thready, the tongue was pale with a greasy layer of white fur. There was not other abnormal sign.

Diagnosis: Chronic Congestive Heart Failure.

Differentiation: It's deficiency of Yangqi of the heart, spleen and kidney. The deficiency of Yangqi of spleen and kidney directly caused the body fluid couldn't be transported and distributed normally, so that there was Yin-edema of both lower extremities; the deficiency of Yangqi of the heart caused the flowing ot7 qi and blood became unsmooth, then there was stagnation of qi and blood stasis, which caused palpitation, chest oppression and shortness of breath directly. Therapeutic Principle: Invigorating the Yangqi of spleen, kidney and the heart, activating blood to resolve stasis, smoothing the chest oppression and regulating qi, eliminating the pathogenic water and reinforcing spleen, warming and reinforcing kidney Yang.

Recipe:

DangShen,Pilose Asiabell Root 30g

ZhiFuZi,Prepared Aconite Root 8g

GanJiang,Dried Ginger 5g

GuiZhi,Cinnamon Twig 10g

ChuanXiong,Chuanxiong Rhizome 8g

FuLing, Tuckahoe 25g

ZhiHuangQi, Moxa-prepared Milkvetch Root 30g

DangGui,Chinese Angelica Root 10g

DanShen,Red Sage Root 15g

TanXiang, Sandalwood 8g

QuanGuaLou,Trichosanthes Fruit 15g

HanFangJi,Tetrandra Root 20g

YiYiRen,Coix Seed 30g

ZeXie,Oriental Water Plantain Rhizome 15g

ZhiGanCao,Prepared Liquorice Root 10g

All the above drugs were to be decocted in water for oral taking. 5 doses were prescribed.

Effect Observation: After taking the decoction, her edema disappeared, her chest oppression and shortness of breath were all relieved greatly. Then 15g of TaoRen (Peach Seed), 10g of YuanZhi(Polygala Root) and 10g of MuXiang(Aucklandia Root) were used instead of GanJiang (Dried Ginger) and HanFangJi (Tetrandra Root) and ZeXie(Oriental Water Plantain Rhizome).

She was told to take 5 doses of this changed prescription for 0ral taking. After taking this 5 doses, her chest oppression and shortness of breath all disappeared. After 2 months' follow up, the illness didn' t recur. Then it' s ending.