[Recognition and treatment of coronary microcirculation dysfunction with TCM].

Coronary microcirculation dysfunction refers to a pathological syndrome characterized by abnormal structural and/or functional changes of the vessels in the microcirculatory systems, including arterioles, venules, and capillaries, which further affect myocardial microperfusion. Although modern medicine has made progress in controlling risk factors and alleviating symptoms, several clinical challenges in treatment remain unresolved, such as low drug response rates, suboptimal therapeutic efficacy, and adverse reactions. TCM can treat the coronary microcirculation dysfunction and achieve the effects of alleviating angina pectoris syndrome, delaying disease progression, improving prognosis, and enhancing patients' quality of life through multiple targets such as regulating neuroendocrine function, improving vascular endothelial function, inhibiting inflammation and oxidative stress, and regulating glucose and lipid metabolism, as well as the holistic regulation. Coronary microcirculation dysfunction falls into the categories of "chest Bi syndrome" and "heart pain" in TCM. Its etiologies include exogenous pathogenic cold, emotional disorders, improper diet, and chronic illness-related debility, while the core pathogenesis involves Qi stagnation, blood stasis, and phlegm turbidity. In terms of treatment strategies, Chaihu Longgu Muli Decoction is recommended for Qi stagnation syndrome, Guizhi Fuling Pills and Xuefu Zhuyu Decoction for blood stasis syndrome, and Gualou Xiebai Banxia Decoction and Wendan Decoction for phlegm turbidity syndrome. In clinical practice, the principles of "combining pathogenesis with pathology, and medicinal properties with pharmacology" should be adhered to, along with the theory of correspondence between formula and syndrome. Flexible selection and combination of formulas are essential to enhance therapeutic efficacy.