Tilo Medical and Acupuncture

Hypertension

Hypertension Treated from the Point of View of a Liver-spleen Disharmony

abstracted & translated by

Bob Flaws, Dipl. Ac. & C.H., Lic. Ac., FNAAOM, FRCHM

Keywords: Chinese medicine, Chinese herbal medicine, hypertension, high blood pressure

In the last couple of years, I have come to conclusion that much of the Chinese medical literature on hypertension starts from an erroneous assumption and that this is why the current Chinese medical treatment of this condition is not stellar. This assumption is that all hypertension involves ascendent liver yang hyperactivity. It is based on the repeated identification of hypertension with the traditional Chinese disease categories of headache and dizziness. However, the majority of patients with hypertension are asymptomatic and do not have headaches and dizziness. Therefore, I have been on the look-out for other Chinese doctors who have come to the same or similar conclusions regarding this condition. One such is Geng Shuan-zhu of the Internal Medicine Department of the Drum Tower (Gu Lou) Chinese Medical Hospital affiliated with the Chinese Medicine College of the Capital Medical University. In issue #3, 2003 of Bei Jing Zhong Yi Za Zhi (Beijing Journal of Chinese Medicine) , Dr. Geng has published an article titled, "The Application of the Methods of Supporting Earth & Repressing Wood in the Treatment of Hypertension," on page 38 of that journal. His views are based on a clinical trial involving 100 patients as described below.

Cohort description

Among the 100 patients enrolled in this study, there were 73 males and 27 females aged 41-70 years, with an average age of 55. Fifteen of these patients were 41-50, 55 were 51-60, and 30 were 61-70 years old. Twenty-five had stage I hypertension, 54 had stage II hypertension, and 21 had stage III hypertension as described by criteria published in 1979 as the outcome of a national symposium on the prevention and treatment of cardiovascular diseases. These patients had suffered from hypertension from 0.5-30 years, with an average disease duration of 14.2 years. The main clinical symptoms included: dizziness, heavy-headedness made worse by stirring and brought on by taxation, heart palpitations, shortness of breath, vexation and agitation, lassitude of the spirit, disinclination to speak and/or a weak, faint voice, insomnia, somnolence, devitalized eating and drinking or scanty appetite and loose stools, a fat, pale tongue with slimy, white fur, and a fine, weak or bowstring, fine pulse.

Treatment method

The basic formula prescribed by Dr. Geng consisted of: Radix Codonopsitis Pilosulae ( Dang Shen ), 12g, stir-fried Rhizoma Atractylodis Macrocephalae ( Bai Zhu ), 15g, Sclerotium Poriae Cocos ( Fu Ling ), 25g, Semen Plantaginis ( Che Qian Zi ), 10g, Lumbricus ( Di Long ), 10g, Spica Prunellae Vulgaris ( Xia Ku Cao ), 10g, Rhizoma Gastrodiae Elatae ( Tian Ma ), 10g, and Ramulus Uncariae Cum Uncis ( Gou Teng ), 15g. If there was simultaneous headache and deafness, red eyes, and a bitter taste in the mouth, 10 grams each of Flos Chrysanthemi Morifolii ( Ju Hua ) and Radix Scutellariae Baicalensis ( Huang Qin ) were added and the dose of Xia Ku Cao was raised to 15 grams. If the face was occasionally flushed red with vexatious heat in the five hearts, 10 grams of Plastrum Testudinis ( Gui Ban ) and 30 grams of Concha Haliotidis ( Shi Jue Ming ) were added. If insomnia was more severe, 30 grams each of stir-fried Semen Zizyphi Spinosae ( Suan Zao Ren ) and Caulis Polygoni Multiflori ( Ye Jiao Teng ) were added. If there was ductal oppression and torpid intake with relatively exuberant phlegm dampness, 10 grams of Pericarpium Citri Reticulatae ( Chen Pi ) and 12 grams of Rhizoma Pinelliae Ternatae ( Ban Xia ) were added. If there was coronary artery disease with angina pectoris, then 15 grams of Radix Salviae Miltiorrhizae ( Dan Shen ) and six grams of Radix Pseudoginseng ( San Qi ) were added. If there was concomitant cerebrovascular disease, 10 grams each of Semen Pruni Persicae ( Tao Ren ) and Flos Carthami Tinctorii ( Hong Hua ) were added. One packet of these medicinals was decocted in water two time per day and 300ml of the resulting medicinals liquid was administered warm three times per day, monrining, noon, and night. One month equaled one course of treatment.

Treatment outcomes

Marked effect was defined as disappearance of any symptoms plus lowering of diastolic pressure 10mmHg or more, with blood pressure becoming normal or lowering of diastolic blood pressure 20mmHg or more but blood pressure still not yet normal. Some effect meant that the clinical symptoms basically disappeared and diastolic blood pressure decreased less than 10mmHg but was still not normal, it decreased 10-19mmHg and was still not normal; or systolic blood pressure decreased 30mmHg or more compared to before treatment. No effect meant that there was no improvement in signs and symptoms or the disease condition got worse. Based on these criteria, after two courses of treatment, 31 cases (31%) got a marked effect, 61 cases (61%) got some effect, and eight cases (8%) got no effect, for a total effectiveness rate of 92%.

Discussion

According to Dr. Geng, many previous doctors have treated hypertension via the liver. However, based on Dr. Geng's experience, many patients with this condition display signs and symptoms of spleen vacuity due to the stresses of the modern lifestyle, such as thinking and anxiety, taxation fatigue, overeating fatty, sweet, thick-flavored foods, uncooked, and chilled foods, and acrid, peppery foods. Therefore, there is spleen vacuity with liver assailing. In this case, Dr. Geng believes that it is necessary to fortify the spleen and repress the liver in order to lower the blood pressure. This is, likewise, my own experience.