Article 31: Atherosclerosis Complicated with Sexual Dysfunction (Formula for Liver and Kidney Yin Deficiency Syndrome)

Atherosclerosis is a major type of arteriosclerosis. Arteriosclerosis is a non-inflammatory, degenerative, and proliferative disease that leads to thickening and hardening of the arterial walls, loss of elasticity, and narrowing of the lumen. Atherosclerosis is caused by lipid deposition in the arterial intima due to elevated blood lipids, resulting in proliferative changes.

It most commonly affects large and medium-sized arteries, often causing narrowing, occlusion, or even rupture and bleeding of the lumen. This disease mainly occurs in middle-aged and elderly people, with men being more frequently affected. It manifests as ischemic changes in the affected organs. For example, coronary artery sclerosis can cause chest pain, palpitations, and chest tightness; cerebral arteriosclerosis can cause headaches, dizziness, drowsiness, and epileptic seizures; and peripheral arteriosclerosis can cause intermittent claudication, muscle pain, and cold hands and feet.

Laboratory tests will show elevated blood lipids (especially cholesterol, triglycerides, and lipoproteins), and X-ray angiography will show signs of arterial stenosis. This condition is mostly related to a lack of physical activity, obesity, smoking, intense mental work, hypertension, and diabetes. Therefore, treatment should first address or improve these underlying causes, and appropriately use vasodilators and lipid-lowering drugs.

If atherosclerosis occurs in the aorta, internal pudendal artery, dorsal penile artery, or deep penile artery, the blood supply to the penis is affected due to intimal hyperplasia, medial fibrosis, calcification, luminal narrowing, or even occlusion. This prevents blood from reaching the corpora cavernosa of the penis, resulting in insufficient and ineffective erection and the formation of vascular erectile dysfunction.

Many scholars, through statistical analysis, believe that the vast majority of organic erectile dysfunction is related to arterial disease. With age, especially in those with secondary peripheral vascular disease, blood flow in the pudendal arteries decreases or disappears to varying degrees. International research indicates that the vascular bed of middle-aged and elderly patients with erectile dysfunction often exhibits a series of pathological changes, and occlusive vascular disease is considered a major cause of erectile dysfunction in this age group.

Traditional Chinese medicine considers atherosclerosis to be a condition of deficiency in the root and excess in the branch. The deficiency is due to insufficiency of the liver and kidneys, while the excess is due to obstruction by phlegm, blood stasis, wind, and fire. Clinically, treatment should differentiate between the root cause and the branch, and between deficiency and excess. In patients with atherosclerosis complicated by decreased sexual function, common syndromes include liver and kidney yin deficiency, spleen deficiency with phlegm and dampness, blood stasis and qi stagnation, and kidney essence deficiency.

I. Liver and Kidney Yin Deficiency

The clinical manifestations of this syndrome include dizziness and headache, tinnitus and blurred vision, insomnia and excessive dreaming, memory loss, premature graying of hair, palpitations or pain, irritability and fever, weakness in the lower back and knees, numbness and tingling in the limbs, sexual desire but weak erection and premature ejaculation, constipation, red tongue with little coating, and a thready, wiry, and rapid pulse. Treatment should focus on nourishing the liver and kidneys, and replenishing yin and suppressing yang. Formulas such as He Shou Wu Liu Wei Tang, Ling Wu Er Xian Gao, Hu Ma San, and Chu Shi Wan can be used.

1. Polygonum multiflorum Six-Ingredient Soup

Source: Practical prescriptions for cardiovascular and hematological diseases.

Composition: 60g of prepared Polygonum multiflorum, 10g of Epimedium, 15g of Ligustrum lucidum, 24g of Taxillus chinensis, 10g of Curculigo orchioides, and 30g of dried Rehmannia glutinosa.

Usage: One dose per day, decocted in water three times, taken warm in the morning, noon and evening.

Functions: Nourishes the liver and kidneys, strengthens the lower back and enhances male virility. Used to treat arteriosclerosis due to liver and kidney yin deficiency, with symptoms such as dizziness, tinnitus, soreness and weakness in the lower back and legs, precordial pain, impotence, and premature ejaculation.

Note: The formula contains Polygonum multiflorum, Rehmannia glutinosa, and Ligustrum lucidum to nourish the liver and kidney yin and blood; Taxillus chinensis to tonify the kidneys and strengthen the lower back; and Epimedium and Curculigo orchioides to both invigorate kidney yang and strengthen muscles and bones. Experimental studies show that rabbits fed both cholesterol and Polygonum multiflorum exhibited less atherosclerotic lesions and lower serum cholesterol levels compared to the control group fed only cholesterol, demonstrating that Polygonum multiflorum has the effect of lowering blood lipids and resisting atherosclerosis. Furthermore, experiments have shown that Ligustrum lucidum can significantly reduce serum cholesterol and triglycerides, and has a regressive effect on the formation of experimental aortic lipid plaques, especially on the formation of coronary atherosclerotic plaques.

2. Lingwu Erren Gao (a type of ointment)

Source: New Interpretations of Medical Prescriptions.

Composition: 500g of prepared Polygonum multiflorum, 500g of Ganoderma lucidum, 250g of walnut kernels, and 250g of Coix seed.

Usage: First, decoct the Polygonum multiflorum, Ganoderma lucidum, and Coix seed repeatedly until concentrated, then add honey to form a paste; finally, grind the walnut kernels and mix them in. Take 15 ml each time, 3 times a day.

Functions: Nourishes the liver and kidneys, replenishes essence and blood, and harmonizes the spleen and lungs. Used to treat arteriosclerosis due to liver and kidney yin deficiency and depletion of essence and blood, with symptoms such as dizziness, headache, insomnia, dreaminess, palpitations, forgetfulness, constipation, and chronic cough and asthma.

Note: The formula contains Polygonum multiflorum to nourish the liver and kidney yin and blood; Ganoderma lucidum to invigorate qi, nourish the heart, calm the mind, astringe the lungs, stop coughing, and relieve asthma; walnut kernels to tonify the kidneys, benefit the lungs, and relieve asthma; and Coix seed to strengthen the spleen and benefit the lungs. Experimental studies have shown that Ganoderma lucidum can lower blood cholesterol, triglycerides, and β-lipoprotein, and delay the formation of atherosclerotic plaques.

3. Flax powder

Source: *Shengji Zonglu*.

Ingredients: 250g sesame seeds (fried), 250g Poria cocos, 250g Rehmannia glutinosa (dried), 250g Asparagus cochinchinensis.

Usage: Grind the above-mentioned medicines into a fine powder and mix well. Take 5-10 grams each time, 3 times a day, with warm water.

Functions: Nourishes the liver and kidneys, calms the mind and soothes the nerves. Used to treat arteriosclerosis due to liver and kidney yin deficiency, with symptoms such as restlessness, dizziness, irritability, premature graying of hair, and impotence.

Note: In this formula, sesame seeds are the main ingredient for nourishing the liver and kidney yin and blood. Asparagus root and dried rehmannia root are added to enhance their nourishing effect on the liver and kidneys, while poria cocos is used to nourish the heart and calm the mind. Modern research has shown that sesame seeds are rich in vitamin E and linoleic acid, which have anti-aging effects, thus playing a role in prolonging life and maintaining sexual function.

4. Paper Mulberry Pills

Source: "Aphrodisiac Therapy".

Ingredients: 250g of paper mulberry fruit, 120g of yam, 30g of wolfberry, and 30g of mantis egg case.

Usage: Grind the above-mentioned herbs into powder, mix well, and form into pills the size of a paulownia seed with refined honey. Take 6 grams each time, 3 times a day, before meals with salt water.

Functions: Nourishes the liver and kidneys, and replenishes essence and qi. Used to treat arteriosclerosis due to liver and kidney yin deficiency and insufficient essence and qi, with symptoms such as dizziness, palpitations, impotence, and lower back pain.

Note: The main ingredient in this formula is Broussonetia papyrifera, which nourishes the liver and kidneys and strengthens yang. It is combined with Dioscorea opposita and Lycium barbarum to enhance its yin-nourishing and essence-boosting effects, while Mantis egg case strengthens its essence-strengthening and yang-boosting effects. Modern research suggests that cobalt deficiency can lead to atherosclerosis, and chromium deficiency can damage arterial walls. Dioscorea opposita contains both cobalt and chromium, which are highly beneficial for preventing and treating atherosclerosis.

(Due to space limitations, the 31st article ends here. Subsequent articles will continue to be output in the same format.)