Traditional Chinese Medicine for Cardiovascular HealthMary Xiumei Wu November 1, 2007
Atherosclerosis, hypertension, coronary heart disease, heart attack and stroke are a group of cardiovascular diseases that have similar pathogenesis. Atherosclerosis is the narrowing of the arteries due to the hardening of the blood vessels and deposit of fatty tissue. Hypertension is abnormally elevated blood pressure. Coronary heart disease, including angina pectoris, is the disturbance of blood supply to the heart. Heart attack is the sudden death of part of the heart muscle due to blockage of blood supply to the heart. Stroke is the interruption of blood supply to the brain. It is obvious that these diseases are related to the dysfunction of blood circulation in the vascular system, the heart and the brain. All these conditions are related to the abnormal blockage of blood circulation.
According to Traditional Chinese Medicine (TCM), normal blood circulation depends of the driving force of Heart Qi, smooth flow of Liver Qi, normal transformation and transportation of blood and body fluids or Spleen Qi, and balance of Yin and Yang. Qi is the commander of Blood, and Blood is the mother of Qi. The main pathological changes that affect blood circulation include: Heart Qi and Yang deficiency with accumulation of coldness, Spleen Qi deficiency with Phlegm obstructing the Heart and Vessels, Liver Qi stagnation and Blood Stasis.
COMMON PATTERNS OF CARDIOVASCULAR DISEASES
Disease prevention and treatments in TCM are highly individualized according to the diagnosis of the disease and the differentiation of patterns. Only the most common patterns of cardiovascular diseases are discussed here with the intention of providing readers with some basic knowledge about the cause, treatments and prevention of these conditions according to TCM. Remedies are for your information only. Please consult qualified practitioners for professional TCM care.
1. Heart Yang Deficiency with Coldness
Blood circulation relies on the driving force of Heart Qi and the warmth of Heart Yang. When qi is deficient and unable to maintain sufficient and smooth blood circulation, the patient will have palpitations, oppression of the chest or chest pain, spontaneous sweating and shortness of breath with pale tongue and pale face, deep and weak pulse. These symptoms usually occur while performing physical activities and get worse with overexertion. When Yang is deficient, the body loses its warmth, the blood gets cold and thick, circulation slows down, and the Heart and blood vessels become contracted and obstructed. In such cases, patients have more severe chest pain described as a strangling or constrictive pain that radiates from the chest to the back. These patients usually feel extremely cold with cold extremities, pale face or purple lips and tongue, and the pulse becomes tight, tense and uneven.
The treatment principle is to strengthen Heart Qi, warm Heart Yang and expel coldness. Herbs such as Ginseng (Renshen), Astragalus (Huangqi), Prepared Aconite Root (Fuzi), Cinnamon Twig (Guizhi), Trichosanthes Fruit (Gualou), Licorice (Gancao), Fresh Ginger (Shengjiang) are used in formulas with other herbs suitable for individual patients. Acupuncture with moxibustion on Ren-4, Ren-6, Ren-17 and St-36 will help to warm yang and strengthen qi. Simple remedies such as Guizhi decoction can be made. Combine Cinnamon Twig 3g (Guizhi), White Peony Root 3g (Baishaoyao), Fresh Ginger 3g (Shengjiang), Licorice 2g (Gancao) and Jujube 3 pieces (Dazao). Boil mixture in 3 cups of water for 30 minutes and drink the tea warm. Stop taking the decoction when the body feels warm and soak the feet in hot water for 20 minutes before bed on a daily basis to help to warm yang and expel coldness.
2. Spleen Qi Deficiency with Phlegm
The concept of phlegm covers a range of conditions in TCM. It manifests with many distinct symptoms and signs. Phlegm that is retained over a long period of time becomes itself a cause of disease. There are two types of Phlegm: substantial and non-substantial. Substantial Phlegm can be seen, such as sputum, mucus and phlegm in the lungs and throat that can be expectorated through coughing or spitting. Non-substantial Phlegm may retain subcutaneously or in the channels and collaterals, and in internal organs. It can obstruct Heart orifices and vessels. When Phlegm accumulates under the skin, it takes the form of lumps and nodules such as nerve ganglia swelling, swelling of lymph nodes, and swelling of the thyroid. It may also take the form of dampness and water retention and shows as excess accumulation of fat tissue and heaviness of the body.
When phlegm accumulates in the channels, it is not visible as swelling or touchable as nodules, but causes numbness, pain and paralysis that are commonly seen in the elderly and people with Bell’s palsy and hemiplegia. When Phlegm obstructs the heart orifices and the mind, this may give rise to mental illness such as confusion, difficulty in concentration, depression or anxiety in mild cases, or schizophrenia, manic depression, epilepsy and even stroke in serious cases. When phlegm accumulates and aggregates in the vessels, it causes hardening and thickening of artery walls and narrowing of vessels. With excess Phlegm or fat in the blood, it can increase its viscosity and thickness, therefore causing high cholesterol, atherosclerosis, hypertension, heart attack – even stroke.
The main cause of formation of phlegm is Spleen deficiency. If the Spleen fails to transform and transport body fluids, they will accumulate and change into Phlegm. Excess intake of fatty, greasy, dairy and sweet foods may all cause over-production of phlegm. Overwork and over-thinking weakens the Spleen’s function which may result in accumulation of phlegm. Long term emotional disturbance and stress may also affect the Spleen and cause phlegm.
TCM treatments focus on the root cause of illness and emphasize disease prevention. Strengthening the Spleen and resolving Phlegm are very important for prevention and treatment of many serious illnesses including cardiovascular diseases. Proper diet with sufficient nutrients and balanced food, proper exercise, reduced intake of fatty, greasy, dairy and sweet foods, as well as avoiding both physical and mental overstrain are all important measures to maintain normal functional activity of the Spleen and to reduce the chances of Phlegm formation.
Regular energy exercise such as self-tuina massage will improve qi and blood circulation and metabolism of bodily fluids. This exercise includes simple patting of the arms, legs, front and back of the body from top to bottom and patting on the head 2 to 3 times daily. This exercise will bring about better circulation, better nourishment of the body and better health both physically and mentally. Pressing and kneading on acupuncture points Ren-12, St-36, Sp-6 and St-40 helps to improve the functional activity of the Spleen and Stomach for better digestion, and transportation and transformation of food and water. St-40 is the point famous for resolving phlegm. Studies have shown that regular acupuncture on St-40 has the effect of lowering blood cholesterol level.
Chinese herbal medicine such as Ginseng (Renshen), White Atractylodes (Baizhu), Poria (Fuling), Licorice (Gancao), Tangerine Peel (Chenpi), Pinellia Tuber (Banxia), and Hawthorn Fruit (Shanzha) are often used by TCM doctors. Studies have shown that Phlegm-resolving herbs have the effect of lowering cholesterol levels in the blood and benefiting cardiovascular health. Drinking simple remedies such as Tangerine Peel 10g (Chenpi) and Hawthorn Fruit 10g (Shanzha) boiled in 3 cups of water for 30 minutes can be done on a daily basis. I teach my patients to do self-tuina on the abdomen by pushing 100 times along the midline of the abdomen and rubbing around the umbilicus 100 times clockwise every night before going to sleep at night and before getting up in the morning. Some patients find that self-tuina helps their digestion as well as their sleep. They also have better energy when they do it. Some patients even lose weight after a few weeks of regular self tuina.
3. Liver Qi Stagnation with Blood Stasis
Smooth circulation and sufficient strength of qi is the primary condition of normal blood flow. The Liver is the primary organ responsible for smooth flow of qi for the entire body. Liver qi flow is easily affected by emotional disturbance, especially mental stress. In stressful situations, the qi flow may be suppressed and gradually become stagnant which can cause blood stasis. Qi deficiency may also cause blood stasis because of the lack of driving force. Blood and yin deficiency cause blood stasis because of the insufficient volume of fluid in the blood vessels that hinders its circulation. Coldness retained in the meridians and vessels will cause the aggregation of blood and the contraction of blood vessels. Excess heat of the body may consume the body’s fluid, thickening the blood and causing blood stasis. Excess phlegm may also cause blood stasis.
The most important factor determining safe and effective treatment is the diagnosis of the individual and differentiation of specific patterns according to TCM. For qi deficiency, treatment should focus on strengthening qi moving blood. For qi stagnation, treatment is focused on invigorating qi circulation and improving blood flow. For coldness, treatment with warm methods such as moxibustion and hot herbs are used to warm the body and move blood. For Blood and Yin deficiency, herbs that tonify blood and nourish yin should be used. For excess heat, cooling herbs should be used. While all the above treatments deal with the primary cause of blood stasis, herbs that invigorate blood circulation and remove stasis are also used. Red Sage Root (Danshen), Pseudoginseng (Sanqi), Peach Kernel (Taoren) and Safflower (Honghua) are often prescribed. Sp-6, Sp-10 and UB-17 are the three most important acupuncture points to regulate blood and to improve blood circulation.
Research has shown that Chinese herbs that invigorate the blood and remove stasis may have cardiovascular benefits for both humans and animals. Red Sage Root (Danshen) decoction showed a marked vasodilatory effect on the coronary arteries of guinea pig and rabbit heart specimens. In a study of 323 patients given a preparation of this herb for one to nine months, there was marked clinical improvement in 20.3% and improvement in 62% of the cases. Some 52% showed improvement based on ECG in this study. Danshen also has an effect on cholesterol metabolism. Clinical studies showed that injections of Danshen have lowered the serum cholesterol levels in some patients. Pseudoginseng (Sanqi), an herb that can stop bleeding, invigorate blood circulation, reduce swelling and relieve pain according to the TCM pharmacopeia, has been reported to markedly raise coronary artery blood flow, reduce blood pressure, and relieve angina pain.
TCM EMPHASIZES PREVENTION AND TREATS THE ROOT CAUSES OF DISEASE
Although patients may be diagnosed with different diseases according to western medicine, if the cause of the disease is the same according to TCM diagnosis and differentiation, their treatment principle will be the same. For example, all patients will be prescribed herbal medicine that tonifies the Spleen and resolves Phlegm if they are identified as having Spleen Deficiency with Phlegm. On the other hand, patients with coronary heart disease according to western medicine may be treated differently if they present different TCM patterns.
Traditional Chinese Medicine is a distinct and comprehensive medical paradigm composed of fundamental theory, unique diagnostic methods and a variety of treatment modalities. Acupuncture, Chinese herbal medicine, and Tuina massage are the three primary modalities that provide significant help to cardiovascular diseases. TCM can strengthen the energy, balance yin and yang, improve circulation, stimulate the functional activity of internal organs and eliminate the pathogenic factors. It emphasizes health promotion and disease prevention. With regular TCM treatments, individuals can have better energy, smooth qi and blood circulation, balanced Yin and Yang and stable emotions. Minor weakness, imbalances or obstructions can be treated completely at the early stage even before any noticeable and disturbing symptoms and signs manifest. TCM treatment is also natural and non-invasive.
Well-trained and experienced TCM practitioners will provide effective and safe treatments that can complement conventional medicine for serious illness. Acupuncture and tuina massage can help to relax the mind and calm the spirit which have been shown to lower blood pressure. Chinese herbal medicine helps to strengthen the vital energy, resolve phlegm and blood stasis, and improve blood circulation. Some patients may be able to reduce or even stop medication after regular TCM treatments. TCM also helps patients to recover faster after surgery with reduced complications and it helps to prepare patients before surgery. Studies have shown that acupuncture treatments shorten the stroke rehabilitation period by approximately 50%. Patients who received acupuncture were also able to perform physical activities better.
Readers may now be able to understand something about TCM and cardiovascular disease. Some may have trouble accepting the concept of phlegm, cold and blood stasis. It is only convincing when one has been helped and has witnessed the power and benefit of TCM. One of my patients has been receiving regular treatments for over 10 years. Her sister had five bypass surgeries before the age of 60. My patient had a heart attack three years ago and rapidly recovered at age 78. She gives the credit to TCM.
According to Statistics Canada (1997), diseases of the heart and cerebrovascular diseases are the second and third leading causes of death respectively, just after cancer. Both diseases together account for 34% of deaths compared to 27.2% from cancer. It is clear that cardiovascular and cerebrovascular diseases are the number one killer in Canada. Traditional Chinese Medicine can help to prevent and to treat these diseases and to bring better health and longevity to people.