Hyperlipoproteinemia
Blood lipids are composed
of cholesterol, triglyceride, phospholipid and free fatty acid. Hyperlipemia mainly
implies the elevations of cholesterol and triglyceride in the plasma and is closely
related to atherosclerosis. As blood lipids are transported in the form of lipoprotein,
hyperlipemia also manifests as hyperlipoproteinemia. It is included in the categories
of "xuan yun" (vertigo), "tan zhuo" (phlegm syndrome) and
others in TCM.
Main Points of Diagnosis
1. Inquire closely about
positive family history, diabetes, gout, hepatic diseases, nephroses and juvenile
coronary heart disease.
2. During physical examination, pay attention to yellowish
papules, xanthomas, premature corneal arcus and peripheral vascular disorders.
3. Hyperlipoproteinemia can be divided into 5 types.
Type I is chylomicronemia,
a rare disorder due to congenital deficiency of lipoprotein lipase.
Type II
is hyperbetalipoproteinemia, which is commonly seen with marked elevation of plasma
cholesterol and the disorder closely related to atherosclerosis and coronary heart
disease. Some patients are inherited and others are due to high-cholesterol diet
or secondary to myeloma, nephrotic syndrome, hepatic disease, etc. Type II is
subdivided into Type IIa and Type IIb.
Type III is an autosomal dominant disorder
in which the plasma concentrations of cholesterol and triglyceride are both elevated.
The disease occurs mostly after middle age. Patients usually have obesity, disturbance
of carbohydrate metabolism, etc.
Type IV is the most common disorder, in which
endogenous plasma triglyceride is elevated due to the disturbance of carbohydrate
metabolism which plasma cholesterol is not necessarily elevated.
Type V is
very rare, a combination of Type I and Type IV and of little clinical significance.
Differentiation and Treatment of Common Syndromes
1. Deficiency of the
Liver-Yin and Kidney-Yin
Main Symptoms and Signs: Dizziness, tinnitus, blurred
vision, irritability, amnesia, soreness and weakness of the loins and knees, red
tongue with little fur, taut and thready pulse.
Therapeutic Principle: Nourishing
the liver-yin and kidney-yin.
Recipe: Modified Pill of Fleece-Flower for Longevity.
fleece-flower root
sesame seed
mulberry
glossy privet fruit
eclipta
honeysuckle
flower
chrysanthemum
loranthus mulberry mistletoe
Cherokee rose-hip
siberian
solomonseal rhizome
curcuma root
All the above herbs are to be decocted
in water for oral administration.
In addition to the above herbs, supplementary
ingredients are to be employed with respect to certain symptoms: cassia seed 30g,
uncaria stem with hooks 20g and pueraria root 20g for the case complicated with
hyperactivety of liver-yang marked by obvious headache and feeling of distension
in the head; astragalus root 15g and Chinese agnelica 1g for the case with deficiency
of both qi and blood marked by palpitation, insomnia, lassitude and anorexia;
gastrodia tuber 12g, mulberry twigs 30g and spatholobus stem 30g for the case
with numbness and soreness of the limbs.
2. Retention of Damp-Heat in the
Interior
Main Symptoms and Signs: Dizziness, heavy sensation in the chest,
fatigue and listlessness, bitter taste, dry throat, fat stature, or dry stools,
slightly red tongue with yellow and greasy fur, and smooth pulse.
Therapeutic
Principle: Eliminating pathogenic dampness and heat.
Recipe: Modified Decoction
of Gentian for Purging Liver-Fire.
plantain herb
water-plantain tuber
bupleurum
root
oriental wormwood
cassia seed
poria
rhubarb root (parched in
wine)
hawthorn fruit
All the above herbs are to be decocted in water for
oral administration.
Dr. Ming's TCM Medical Center,
Hua Xi Xiao Yuan, Hutian
Developing Area,
Huaihua city, Hunan province
China