Abstract：Through tracing the origin of chest impediment and based on the data discussed by physicians in all dynasties， the difference between chest impediment and real heart pain of coronary heart disease is discussed combined with relevant research and analyses， in terms of name， location and mechanism of disease. It is pointed out that there is essential difference between chest impediment in Chinese medicine and coronary heart disease in modern medicine， and it is improper to use the same prescription metaphysically in treatment. According to the interpretation of the original prescritption of Zhishi Xiebai Guizhi tang and the analysis of its formula and medication，this paper further discusses the prescription and syndrome of Zhishi Xiebai Guizhi tang in theory，and points out that the original intention must be grasped in the application of the classical prescription in modern clinical practice，in order to achieve more accurate disease and synrome differentitation and treatment，thus giving full play to the maximum role of the classical prescription.