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.
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