Hypertension is a clinical syndrome characterized by an increase in arterial blood pressure (systolic and/or diastolic) in the body circulation, which may be accompanied by functional or organic damage to the heart, brain, kidneys and other organs. There is no name for hypertension in Chinese medicine. According to the main symptoms of this disease and its development process, it belongs to the scope of “vertigo”, “headache”, “liver wind” and “stroke” in TCM. The disease belongs to the scope of “vertigo”, “headache”, “liver wind” and “stroke” in Chinese medicine.
I. Liver is the organ of wind and wood
From the manifestation of hypertension, the diseased organ mainly belongs to the liver. The characteristics of the liver, Ye Tianshi has this description: “The liver is the organ of wind and wood, because there is a phase of fire within the host, the body Yin with Yang. Its nature is rigid, active in the main ascension, all rely on the kidney water to contain it, blood to moisten it, the lung gold to clear the descending order to calm it, the middle palace Dun Fu of the earth to cultivate it, then the rigid quality, get a soft body, so that its stripes and smooth nature, what disease?” (Clinical Guide to Medical Cases – Liver Wind). It is clear that if the Yin and Yang of the liver are relatively balanced, there is no disease. The balance of Yin and Yang of the liver is closely related to other internal organs.
Second, the relationship between the liver and the five viscera
As mentioned above, the balance of liver yin and yang and the coordination of the five organs is disease free; however, if the mood is out of order, the mood is not smooth, irritation and mental tension are enough to hurt the liver, can appear hyperactive liver yang hypertension. If the hyperactivity of liver yang continues to develop, it can turn into wind and fire and lead to stroke symptoms (cerebrovascular accident). If Liver-Yang is over-exuberant, it can injure Yin and Kidney, which in turn can lead to deficiency of both Yin and Yang.
The relationship between the liver and the kidney is the closest, and the relationship between the mother (kidney) and the son (liver) has been used to describe the relationship between the two. The deficiency of kidney yin due to congenital deficiency or life disorders, and the inability of kidney yin to contain wood leads to hyperactivity of liver yang, resulting in hypertension with yin deficiency and hyperactivity of yang. If the heart and spleen are damaged by worry, labor and fatigue, the heart and spleen may be disturbed by phlegm and turbidity, and the liver may lose its control and become hypertensive. In this type of hypertension, the evidence of heart and spleen is often seen.
Identification and treatment
Based on the above pathogenesis, after the diagnosis of hypertension is confirmed, the evidence can be divided into the following four types.
1. Hyperactive liver yang
Headache, dizziness, irritability, restless sleep at night, bitter or dry mouth, red tongue (or as usual), white or yellow fur, and strong string pulse.
2.Yin deficiency of liver and kidney
Dizziness, mental weakness, memory loss, tinnitus, insomnia, palpitation, weakness of waist and knees, or night sweating, red and tender tongue, little moss, thin or fine pulse.
3.Yin and Yang deficiency
Dizziness, blurred vision, tinnitus, lumbago, impotence, seminal emission, nocturnal urination, or night sweating, with light tender or tender red tongue, thick white or thin white moss, weak or tight pulse or sunken thin ruler.
4.Qi deficiency and phlegm turbidity
Dizziness, lack of clarity of mind, chest tightness, little food, tiredness and weakness, or nausea, spitting up phlegm, fat and tender tongue, tooth marks on the edge of the tongue, white thick moss or cloudy greasy, smooth pulse string, or large and slippery deficiency.
The disease is closely related to the liver, and liver regulation is an important part of the treatment of hypertension, but the treatment of the liver is not necessarily limited to the medicine of the liver meridian. In the Qing Dynasty, Wang Xugao’s “Xixi Shuya Night Talk Record” has a total of 30 methods for the treatment of liver qi, liver fire and liver wind, with a wide range of medicines, which is worthy of reference.
Fourth, the method of treating the liver
Wang Xugao’s treatment of liver is based on the identification of liver qi, liver wind and liver fire. Wang said, “The internal wind is mostly from the fire, the gas has a surplus is fire, the surplus is called liver gas, liver wind, liver fire, three different names for the same evidence, but for different diseases, the treatment is also different.” Although Wang’s method of treating the liver is many, it is biased towards clearing and nourishing. The evidence of liver qi, liver wind and liver fire is not the same as only belonging to hypertension, but some of these treatments have been adopted by later generations. For example: “liver wind at the beginning, dizziness of the head and eyes, with the rest wind and Yang method, antelope, Dampi, chamomile, hooked vine, decisive, Tribulus terrestris, that is, cool the liver is also …… such as rest wind and Yang is not effective, when the rest wind and submerged Yang, such as oyster, raw earth, chasteberry, Xuan Shen, white peony, chrysanthemum, Agaricus, that is, nourishing the liver method is also …… such as water deficit and liver fire, clear should not, when the benefit of kidney water, is deficient is the law of the mother, such as six flavor pills, large tonic Yin pill and so on, but also the same source of the meaning of the E and Kui.”
The Qing dynasty doctor Ye Tianshi has rich experience in the treatment of liver wind and other diseases. For example, Hua Xiuyun for Ye Tianshi medical case set up “liver wind” a certificate, summarizing Ye’s treatment of liver wind method. Hua said: “Mr. treatment, the so-called slow liver of the urgent to rest wind, nourishing the kidney fluid to drive away the heat …… is the medium to submerge the, acid to collect the, thick taste to fill the, or use the method of clear on the real down. If by thinking and worrying about physical and mental over-activity, wind and yang internal disturbance is used such as sour date soup; if by moving anger and depression, phlegm and fire cross-incense is used two Chen Long Hui of the genus. Wind and wood over-activated must be violated in the Palace, then vomit and not eat, the law with drain liver and stomach, or fill Yang Ming. Others, such as pungent sweet wind, sweet and sour Yin, clear gold and flat wood, all kinds of treatment method failed to be prepared.” All these treatises are worthy of attention and reference for the treatment of hypertension.
In short, treatment of hypertension, treatment of the liver is an important part, but the disease is varied, can not stick to one, should be discriminatory treatment.
V. Anti-hypertensive prescriptions
1. Shijiao Oyster Soup
It is advisable to calm the liver and submerge the yang in the liver, using Shijian Oyster Soup (self-defined formula).
This formula uses Shijian and Oyster to calm the liver and lower blood pressure and subdue Yang as the main medicine, Hooked vine and White peony to calm the liver and calm the wind as auxiliary medicines, Lotus heart to clear the heart and calm the liver, Lotus beard to benefit the kidney and consolidate essence as adjuvant, and Cow knee to act as an enabler. If the moss is yellow and the pulse is strong, add Scutellaria baicalensis; if the constipation is accompanied by Yangming real heat, add Huang and other diarrhea actually heat; thick and greasy moss, remove the lotus beard, add Poria, Zedekiah; headache is very hot, add chrysanthemum or gentian grass; dizziness is very plus Ming Tianma; insomnia plus nightshade or sour date.
2.Lian mulberry soup
Liver and kidney yin deficiency, should nourish the kidney and liver, with lotus mulberry soup (self-defined formula), drug composition: lotus beard 12 grams, mulberry 12 grams, chasteberry 12 grams, dry lotus grass 12 grams, yam 15 grams, turtle plate 30 grams (first decoction), cow knee 15 grams.
This formula uses lotus root, mulberry, lady’s mantle and dry lotus herb to nourish the liver and kidney as the main herbs, yam, tortoise board and raw oyster as auxiliary herbs, and cow knee as the enabling herbs. Add prunus ginseng for qi deficiency; add maitong and raw earth for glossy tongue without moss; add sour date palm and cypress seed for insomnia and palpitations.
3.Liver and kidney double tonic soup
For yin and yang deficiency, it is advisable to supplement the liver and kidney to submerge yang.
If there is also Qi deficiency, add 30 grams of Astragalus. If kidney yang deficiency is the main cause, use the Ten Flavors of Annexed Gui Soup (Cinnamon 3g, Radix et Rhizoma Polygonatum 10g, Huang Jing 20g, Mulberry 10g, Dan Pi 9g, Yun Fu Ling 10g, Ze Di 10g, Lian Shu 12g, Zea mays 30g, Niu Kne 9g). If the kidney Yang deficiency is very swollen, use Zhen Wu Tang with 30 grams of Astragalus and 12 grams of Du Zhong.
4.Ochre Decisive Seven Flavors Soup
For Qi deficiency and phlegm, it is advisable to strengthen the spleen and benefit Qi, using Ochre Determination Seven Flavors Tang (self-defined formula). Huang Qi and Liu Jun Zi Tang are used to tonify Qi to remove phlegm and turbidity, with ochre and cassia to lower the rebellion and calm the liver. If the liver and kidney are deficient in yin, add Shou Wu, Mulberry, and Lady’s Mantle; if the kidney is deficient in yang, add cinnamon, Xian Mao, and Epimedium; if the blood is stagnant, add Chuan Xiong and Dan Shen.
Sixth, life conditioning
The above are some of the experiences of the diagnosis and treatment, but in terms of prevention and more systematic and thorough treatment, comprehensive measures should be taken to address the causes and mechanisms of the disease, while daily life conditioning is also an important aspect.
1.Regulate the emotion
This disease is related to mental factors, work tension, the patient’s mental environment and work arrangements are very important. Of course, the patient’s internal factors are the decisive factor, so do a good job in the patient’s mind and pay attention to the combination of work and rest, is an important measure. Diet and life regulation are very important.
2.Sports therapy
Such as guidance techniques, taijiquan, has been proven to be effective methods, regardless of prevention and treatment, have a reliable role.
3.Combination of Chinese and Western
The combination of Chinese and Western treatment is also necessary, Western medicine to take effect quickly, but can not cure the root, Chinese medicine to take effect slowly but the effect is more consolidated, can be used in combination. If you see hypertensive crisis, first use western medicine or acupuncture to control, and then identify the evidence to treat. For stubborn hypertension, Chinese and Western medicines can also be used, and only after a certain period of time, purely Chinese medicine is used. Deng’s does not advocate the long-term use of Western medicine, long-term use of Western medicine has side effects against the body; advocate the measurement of blood pressure, distinguish between urgent and light, urgent and heavy is to cure the symptoms, slow and light is to cure the root.