Long term study of the chronic Hyperviscosity-Syndrome (Bloodstasis) in the animal model
Gunter R. Neeb, Zhang Bo-li at Tianjin College of TCM and Medical Engineering Research Institute
The syndrome of bloodstasis in TCM corresponds in its pathological signs almost completely to the hyperviscosity-syndrome (HVS), defined by hemorheology. It shows definite pathologic changes in blood viscosity, viscoelascity, plasmaviscosity, erythrocyte deformability, thixotropy, leucocyte flow characteristics, erythrocyte- and thrombocyte aggregation. It occurs clinically as a presyndrome as well as sequel of diseases like apoplectic insults, diabetes, cardiac infarction, chronic hepatitis, thrombophlebitis a.o. mostly chronic vascular-, dermatological and metabolic diseases.
In the last 30 years Chinese medicine has completed its empiric traditional experience in the treatment of the bloodstasis by applying scientific research from hemorheology, pharmacology and other areas to it and has such achieved significant success in this field.
However no sufficient clinical and experimental research of the fundamental physiological and pathological changes were to be found in the chronic occurrence of either the bloodstasis syndrome -defined by TCM- or the HVS, defined by hemorheology.
Therefore the following animal model was developed:
60 rabbits (long-ear type, white) were divided by statistic methods into five equal groups:
1. Control group: twice weekly an injection in of 20ml 0.9% physiological saline into the outer auricular vein, as well as monthly i.m. injection of 10ml physiological saline into the main muscle of the hind leg and three injections (each one month apart) of 10ml physiologic saline into the outer auricular vein. Standard compound food was fed.
2. HVS-Group: twice weekly an injection in of 20ml 15% standardized macromolecular dextrane solution (molecular weight 40000, solved in physiological saline) into the outer auricular vein, as well as monthly i.m. injection of 10ml 0.2% adrenaline into the main muscle of the hind leg and three injections (each one month apart) of bovine serum albumin into the outer auricular vein. Standard compound food was fed.
3. Blood-quickening group: all Injections as described in HVS group, but nutrition was different due to the addition to the compound food of the ingredients from the FDA registered Chinese medicament "Fu Fang Dan Shen Pian" (Rx. Salvia, Rx. Notoginseng), used for the treatment of bloodstasis/HVS.
4. Qi-tonifying group: Injections same as HVS group, but a mixture of Chinese herbs for treatment of bloodstasis and Qi depletion (Rx. Astragalus, Rx. Ligusticum etc.) was fed by mixing them into the compound food.
5. Yin-tonifying group: Injections same as HVS group, but a mixture of Chinese herbs for treatment of bloodstasis and Yin depletion (Rx. Rehmannia, Rx. Ligusticum etc.) was fed by mixing them into the compound food.
After 112 days each animal was examined for microcirculation, pO2, ECG, pulse-rate and scleroscopy (i.e. of the vessels), 25ml blood sample was taken, the animals were terminated by a vasal injection of 25ml air and a macroscopic and microscopic pathologic examination (incl. EM) of heart, lung, liver, spleen, brain, aorta, testicles or ovaries and uterus was applied.
The blood sample was subject to a complete hemorheological examination (five shear rates), with relative and serum viscosity, erythrocyte deformability, BSG, haematocrit and complete bloodcount was made, including evaluation of blood lipids, ions, heart-, kidney- and liver-functions (LDH, CK, CKMB, a -HBDH, BUN, CRE, UA, ALT, AST, TBA, PALB, TBIL), as well as an immunological analysis (TXA, prostaglandine etc.), all in all 75 parameters, which were meant to be signifying the effects of chronic HVS/bloodstasis in combination with multiple noxes (stress, immunopathological factors) and to show pathophysiological changes, both systemic and to the single organ. Furthermore the efficiency of the herbal compounds in the three different therapy groups could be evaluated. All results were statistically evaluated and related to known data from clinical research in the area of HVS/bloodstasis.
The results were giving detailed evidence to the fact, that chronic bloodstasis causes definite pathologic changes mainly in liver, kidneys and heart, and to a lesser degree also in spleen and lungs. The detailed evaluation and its description is a further subject to this abstract.
The results of the three treatment groups showed different improvements according to the group: while the yin-nourishing/blood-quickening group showed protective effects on the liver and in the functional improvement of some organs, the blood-quickening group had several positive effects on the blood and hemopoesis, bloodcell deformability, microcirculation and some restorative function on the organs. However, the strongest restorative effects on most organs were seen in the qi-tonifying/ blood-quickening group.
As long as the syndrome-differentiation is applied, Chinese medicine proofs to be effective on prevention and treatment of the HVS/bloodstasis-syndrome, thus giving us one more tool to treat the plenty of diseases related to bloodstasis.
Diagnosis and etiology of bloodstasis and the hyperviscosity syndrome (HVS) and their relationship in western and traditional chinese medicine
Yeh Bi-Hsia, Zhang Bo-li at Tianjin College of TCM and Medical Engineering Research Institute
The hyperviscosity-syndrome (hereafter short HVS) is a pathological phenomenon of the blood, characterized by an increased viscosity and other viscosity related hemorheological parameters. The modern lifestyle with high stress levels and changing nutritional habits has a great impact on the increase of HVS occurrences of the whole population. Although HVS is responsible or related to a great deal of serious diseases, it is often overlooked since its symptomless presence in early stages is often unknown to the patient. If it progresses to an advanced stage, it causes a big damage to the society, by its contribution to the occurrence of most cerebrovascular, cardiovascular and metabolic diseases.
Due to the overlapping of the HVS with the syndrome of bloodstasis, defined by traditional Chinese medicine (TCM), there are good chances for the prevention and treatment of HVS with TCM. Nevertheless, present research still lacks of sufficient references to the clinical symptomatology of HVS, contributing factors to its occurrence and the relationship between HVS, resp. its hemorheologically defined parameters and the syndrome patterns of bloodstasis as defined in TCM. For these reasons we established a research project in which 928 persons, both in healthy and diseased condition, all aged above 50 years, were examined with DME and hemorheological laboratory diagnosis. These patients were also subject to a survey, which was conducted to find HVS-related factors in lifestyle, as well as clinical symptoms and typical patterns of the bloodstasis syndrome in TCM. The results are as follows:
?Lifestyle factors contributing to the HVS
Among a great amount of contributing factors, smoking, regular alcohol consumption, stress and prolonged emotional distress (suppressed anger, nervousness etc.) were found to have the greatest impact on the occurrence of the HVS.
?Clinical symptoms of HVS and/or the bloodstasis syndrome
Since no difference was made between early and advanced stages, the symptoms which accompany the HVS were found in a wide range. However, the most common among general symptoms is dizziness, followed by dry eyes, insomnia, cyanotic tongue color etc. Among symptoms which seem to be more specifically related to the bloodstasis syndrome were sublingual varicosis, fixed, stabbing pain, raised temperature in circadian cycles, meteorism, constipation and abdominal fullness.
?The relationship between HVS and syndrome patterns in Chinese medicine
The mostly overlapping, but not absolute relationship between HVS and the TCM defined bloodsitasis syndrome could be confirmed, specifically the following syndrome patterns had the highest occurrence of HVS: The "Yang/Qi deficiency bloodstasis" was found to occur with HVS in most patients, followed by "Yin deficiency bloodstasis" and finally "Qi and Yin deficiency bloodstasis".
?The relationship between pathologic changes of the blood and the bloodstasis syndrome
The plasma viscosity was significantly raised in most of the TCM defined groups, i.e. "Yang deficiency bloodstasis", "Yin deficiency bloodstasis" and "phlegm-bloodstasis".
The whole blood viscosity was significantly raised in the "general bloodstasis" group, and the "phlegm-bloodstasis" group, while it was lowered in the "Yang deficiency bloodstasis".
The hematocrit was found significantly higher in the "general bloodstasis" group, and the "phlegm-bloodstasis" group, while it was slightly lower in the "Yin deficiency bloodstasis" group.
Erythrocyte agglutination was raised in the "Yin deficiency bloodstasis" group, while erythrocyte deformation capability decreased in the "Qi deficiency bloodstasis" group.
The bloodclotting tendency was raised int the "Yang deficiency bloodstasis" group and the "phlegm bloodstasis" group.
These findings show, that the various combinations of the bloodstasis syndrome patterns in TCM show different changes in hemorheological parameters, such indicating a more specific way in the therapy of the HVS with traditional Chinese medicine.
A more specific symptomatology and combined diagnosis of TCM syndrome patterns and hemorheological parameters can furthermore contribute to the recognition, prevention and exact treatment of the hyperviscosity syndrome, such reducing the occurrence of many serious diseases beforehand.
Chronic cough in children with a weak physiological constitution and its treatment with TCM
Wu Zhong-hua et al. at at Tianjin College of TCM and the first affiliated hospital
Children with a weak constitution have a lower resistance against diseases than normal children. Hence, when they are diseased, the course of the disease will be lengthened or the disease will easily occur again after the first recovery.The method of "supplementing the qi and quickening the blood, releasing the lung and stopping coughing" (Yi qi huo xue, xuan fei zhi ke fa) is Doctor Qiu Shi-Yuans proven method based on many years of clinical experience. Its therapeutic principle is the combination of root and branch treatment with strengthening the weakened constitution while simultaneously treating the pathogenic factors.
The research topic represents a new method for the herbal treatment of bronchopneumonia in children with a weak constitution. It has been tested in the study of 30 children. The control group consisted of 20 children treated with western medicine (i.e. antibiotics etc.). The results show that this method is more effective in stopping cough and crepitation than in the control group. Furthermore, the treatment lowered the recurrence rate. After the research of the degree of weakness and the length of the disease period, the results show that the above method is obviously more effective in shortening the course of the disease in comparison to the control group.
The results of this research topic show a different approach in the treatment of bronchopneumonia in children with a weak constitution, using the method of "supplementing the qi and quickening the blood, releasing the lung and stopping coughing" (Yi qi huo xue, xuan fei zhi ke fa). In this way the herbal treatment in paediatric pneumonia has made one step further into therapeutic progress.
Keywords: Yi qi huo xue, xuan fei zhi ke fa
Children with weak constitution