In issue #2, 2002 of Ji Lin Zhong Yi Yao (Jilin Chinese Medicine & Medicinals), Li Yue-chun and Mao Gang published an article titled, "A Survey of the Therapeutic Efficacy of San Shen San Huang San Ren Tang Jia Jian (Three Sengs, Three Yellows & Three Seeds Decoction with Additions & Subtractions) in the Treatment of 117 Cases of Frequent Onset &/or Multifocal Premature Ventricular Beats.” This article appeared on page 17 of that journal, and a precis of it is given below.

Cohort description:
     The ages of the 117 patients in this study ranged from nine to 78 years. All were diagnosed with frequent onset and/or multifocal premature ventricular beats using a 24 hour electrocardiogram. Sixty-six of these cases had coronary heart disease, 32 had myocarditis, 13 had cardiomyopathy, and six had pulmonary heart disease. Seventy-nine cases had frequent onset, single focus premature ventricular beats, while 38 cases had frequent onset, multifocal premature ventricular beats. In addition, there were 101 patients in a comparison group, aged 15-72 years. These had also all been diagnosed using a 24 hour ECG. Sixty of these patients had coronary heart disease, 28 had myocarditis, seven had cardiomyopathy, and six had pulomonary heart disease. Seventy-seven of these patients had frequent onset, single focus premature ventricular beats, while 24 had frequent onset, multifocal premature ventricular beats.

Treatment method:
     The basic formula consisted of: Radix Codonopsitis Pilosulae (Dang Shen), 30g, Radix Salviae Miltiorrhizae (Dan Shen), 30g, Radix Sophorae Flavescentis (Ku Shen), 20g, Radix Astragali Membranacei (Huang Qi), 30g, Rhizoma Polygonati (Huang Jing), 30g, Rhizoma Coptidis Chinensis (Huang Lian), 15g, Semen Zizyphi Spinosae (Suan Zao Ren), 30g, Semen Pruni Persicae (Tao Ren), 15g, and Semen Biotae Orientalis (Bai Zi Ren), 15g. If there was heart yin vacuity, 30 grams of Radix Pseudostellariae Heterophyllae (Tai Zi Shen), 15 grams of Tuber Ophiopogonis Japonici (Mai Men Dong), and 12 grams of Fructus Schisandrae Chinensis (Wu Wei Zi) were added. If there was heart qi vacuity, 30 grams of Sclerotium Poriae Cocos (Fu Ling), 15 grams of Rhizoma Atractylodis Macrocephalae (Bai Zhu), and 12 grams of Fructus Schisandrae Chinensis (Wu Wei Zi) were added. If there was heart blood vacuity, 15 grams each of Radix Angelicae Sinensis (Dang Gui) and mix-fried Radix Glycyrrhizae (Gan Cao) and 12 grams of Arillus Euphoriae Longanae (Long Yan Rou) were added. If there was heart yang vacuity, 10 grams each of dry Rhizoma Zingiberis (Gan Jiang), Radix Lateralis Praeparatus Aconiti Carmichaeli (Fu Zi), and Ramulus Cinnamomi Cassiae (Gui Zhi) and 12 grams of Bulbus Allii Fistulosi (Cong Bai) were added. If there was insomnia and profuse dreams, 12 grams each of Sclerotium Poriae Cocos (Fu Ling) and Radix Polygalae Tenuifoliae (Yuan Zhi), 15 grams of Caulis Polygoni Multiflori (Ye Jiao Teng), and 30 grams each of uncooked Os Draconis (Long Gu) and Concha Ostreae (Mu Li) were added. If there was dampness obstructing internally, 12 grams each of Rhizoma Acori Graminei (Shi Chang Pu), Tuber Curcumae (Yu Jin), and Rhizoma Pinelliae Ternatae (Ban Xia) were added. If there was qi stagnation and blood stasis, 10 grams each of Radix Ligustici Wallichii (Chuan Xiong) and Lignum Santali Albi (Tan Xiang) and 12 grams of Tuber Curcumae (Yu Jin) were added. If heart fire was exuberant and hyperactive, 10 grams of uncooked Radix Rehmanniae (Sheng Di) and 12 grams each of Herba Lophatheri Gracilis (Dan Zhu Ye) and stir-fried Fructus Gardeniae Jasminoidis (Zhi Zi) were added. One ji of the above medicinals was decocted in water and administered per day, with 15-30 days equaling one course of treatment. Members of the comparison group received 100-150mg TID of Xin Lu Ping (Heart Rhythm Leveler [or Normalizer]; Western drug name unidentified) combined with 100mg TID of the Chinese ready-made medicine Xin Lu Ding (Heart Rhythm Calmer).

Treatment outcomes:
     Marked effect was defined as reduction in premature ventricular beats by 90% or more as determined by 24 hours ECG and basic disappearance of subjective symptoms. Some effect was defined as reduction in premature ventricular beats by 70% or more as evidenced by 24 hours ECG and reduction in subjective symptoms. No effect meant that there was less than a 70% reduction in premature ventricular beats and no improvement in subjective symptoms. Based on these criteria, of the 117 patients in the treatment group, 49 got a marked effect, 58 got some effect, and 10 got no effect. In the comparison group of 101 patients, 22 got a marked effect, 50 got some effect, and 29 got no effect. Therefore, the total amelioration rate in the treatment group was 91.45% as compared to 71.29% in the comparison group.

Discussion:
     According to the Chinese authors, this condition is categorized as heart palpitations and fearful throbbing in Chinese medicine, and it is mostly due to A) loss of regulation of viscera and bowel function, qi and blood depletion and vacuity, and heart spirit loss of nourishment; B) emotional stimulation causing the heart spirit to suffer harassment; and/or C) phlegm dampness and depressive fire resulting in disquietude of the heart spirit. In general, vacuity is the root of this condition and repletion causes the tips or branches. In terms of vacuities, these consist of qi and blood and yin and yang depletion and detriment. Repletions are mostly due to qi stagnation, blood stasis, phlegm rheum, and fire heat. San Shen San Huang San Ren Tang boosts the qi and nourishes yin, quickens the blood and frees the flow of the network vessels, nourishes the heart and quiets the spirit, clears the heart and drains fire. Depending on how this formula is modified, it can treat any of the root or branch disease mechanisms associated with premature ventricular beats.

Copyright © Blue Poppy Press, 2002. All rights reserved.

For more information on the treatment of cardiac problems with Chinese medicine, see Bob Flaws & Philippe Sionneau's The Treatment of Modern Western Medical Diseases with Chinese Medicine available from Blue Poppy Press.