Comprehensive treatment of hypertension and its complications in Chinese medicine
1. Key factors in the pathogenesis of hypertension in Chinese medicine
Hypertension is one of the most common cardiovascular diseases in the elderly, it is the primary risk factor for cardiovascular diseases, and one of the main risk factors for chronic kidney disease, heart and kidney failure and causing disability and death. Research data prove that active and reasonable comprehensive treatment for elderly patients with hypertension can bring blood pressure under control and significantly reduce the incidence of stroke and mortality.
The efficacy of Chinese medicine in the treatment of hypertension is definite, especially for elderly patients with hypertension and often combined with coronary heart disease, diabetes mellitus and metabolic disorder syndrome, which has a comprehensive treatment effect unmatched by Western medicine, and therefore Chinese medicine treatment has become an important choice for many elderly patients with hypertension.
The key to the pathogenesis of hypertension is “deficiency of the origin and the symptoms” and “long-standing disease with many stasis”. Deficiency of liver and kidney is the root of the disease, and hyperactivity of Yang is the symptom of the disease.
Long-term disease, poor Qi and blood flow, rain and snow memory. Most elderly hypertensive patients have clinical manifestations of blood stasis and ligament obstruction, such as numbness of the limbs and dark red or purple tongue. In conclusion, hypertension in the elderly is a deficiency of liver and kidney as the root of the disease, hyperactivity of Yang as the standard of the disease, and wind, fire, phlegm and stasis as the outline of the disease, forming the evidence of deficiency of the root and the standard of the disease, which are mutually causal and mixed with deficiency, leading to the development of the disease.
2. Difficulties in the treatment of hypertension and countermeasures
Hypertension is characterized by a long course, complex etiology and many comorbidities. The greatest difficulty in treating hypertension lies in improving patient compliance. Many patients believe that TCM treats the root cause and Western medicine treats the symptoms. It is believed that using Chinese medicine can cure hypertension. In addition, the propaganda of some inaccurate advertisements has further solidified this thinking of patients. Some patients often change their medications, and some patients take their medications only when they are uncomfortable. This all creates difficulties in the treatment of hypertension.
In this regard, we should take countermeasures mainly include the following aspects.
(1) To educate patients about hypertension, such as causes, symptoms, comorbidities, hazards, etc. To lay the foundation for good primary prevention and do the work for secondary prevention for patients.
(2) To promote non-pharmacological treatment of hypertension to patients, such as diet and exercise, smoking cessation, alcohol restriction and weight loss, so as to reduce the dosage of antihypertensive drugs.
(3) To establish a long-term stable relationship with patients and follow up with them regularly to understand their blood pressure and their comorbidities and guide them to adjust their medications.
3. Chinese medicine treatment rules for hypertension and the pharmacology and formula of Chinese medicine
Treatment: There are many treatments for hypertension, including nourishing the liver and kidney, pacifying the liver and submerging the yang, nourishing the heart and tranquilizing the mind, and soothing the liver and regulating the qi. However, in my opinion, the key lies in the hyperactivity of liver and yang, stagnation of qi and blood, and stagnation of water and dampness. Therefore, the principle of TCM treatment is inseparable from pacifying the liver, invigorating blood and promoting water.
After a long period of clinical practice, through the addition, subtraction and tailoring of several formulas, we have formed a formula that can be widely used for all types of
The Chinese herbal remedy for hypertension is —– Chrysanthemum capsule.
Pharmacology of Chinese medicine; Chrysanthemum, Hooked vine, Salvia, Eucommia, Shijiazhuang, Di Long 10.0
Fangji 10.0 fried jujube 30.0 raw oyster 30.0 30.0 raw licorice 6.0
Intention of the formula: In this formula, Chrysanthemum and Crotalus pacify the liver and subdue Yang, which are the ruling herbs; Salvia miltiorrhiza invigorates blood stasis, clears the heart and calms the mind.
It can not only remove blood stasis of long-standing disease, make the blood vessels flow smoothly to prevent stroke, but also calm the mind and calm the spirit to relieve clinical symptoms; Glycyrrhiza glabra moderates the medicinal properties of the medicine and is the enabling medicine. The whole formula focuses on pacifying the liver and submerging the yang, together with activating blood circulation and resolving blood stasis, diuresis and lowering blood pressure, thus having good and stable effects on lowering blood pressure, lipids and viscosity.
Clinical application: 1. For hypertension with Yin deficiency of liver and kidney, with obvious tinnitus, insomnia, hot flashes and night sweats, add Cornu Cervi Pantotrichum, Zhi Mu Huang Bai. 2. For obvious hyperactivity of Yang, such as red face and ears, dizziness, dry stool and yellow urine, add Scutellaria Baicalensis, Dan Pi Shan Yuan Yuan. 3.
Clinical observation: After a large number of clinical observations, it has been shown that: 1. Chrysanthemum capsule has obvious antihypertensive effect; 2. Chrysanthemum capsule can reduce the blood viscosity of patients; 3. Chrysanthemum capsule can reduce the dynamic pulse pressure, reverse the left ventricular hypertrophy and improve the left ventricular function in elderly hypertensive patients with left ventricular hypertrophy.