Article 32: Atherosclerosis (Formula for Spleen Deficiency with Phlegm-Dampness, Blood Stasis and Qi Stagnation)

II. Spleen deficiency with phlegm and dampness

The clinical manifestations of this syndrome include dizziness, drowsiness, palpitations, nausea, vomiting, chest tightness, and possibly epileptic seizures. Other symptoms include decreased appetite, weak digestion, irregular bowel movements, obesity, decreased libido, impotence, scrotal dampness, fatigue, and weakness, especially after sexual intercourse. The tongue coating is white and greasy, and the pulse is soft and slow. Treatment should focus on strengthening the spleen and stomach, and eliminating dampness and phlegm. Formulas such as Huatan Yanshou Dan (蔬痰延寿丹) and Shuling Jisheng Wan (术苓寄生丸) can be used.

1. Phlegm-resolving and Longevity-promoting Pill

Source: "Confucian Family Matters".

Composition: 20g Gastrodia elata, 100g Lycium barbarum, 30g alum (half raw, half dried), 60g processed Pinellia ternata (washed 7 times), 60g dried ginger, 40g ginseng.

Usage: Grind the above-mentioned herbs into powder and mix well. Mix with high-quality glutinous rice wine and sugar, add steamed bread, and pound into pills the size of small beans. Take 6-10 grams each time, 3 times a day, with ginger soup.

Functions: Resolves phlegm and calms wind, warms the middle and tonifies the spleen. Used to treat arteriosclerosis due to spleen deficiency and cold, with wind and phlegm disturbing the upper body, manifested as obesity, dizziness, nausea, and vomiting.

Note: In this formula, Pinellia ternata dries dampness and resolves phlegm; Lycium barbarum and Gastrodia elata nourish the liver and calm wind; Ginseng and dried ginger tonify the spleen and warm the middle jiao. Experimental studies have shown that Lycium barbarum can lower serum cholesterol and increase phospholipids, and can mildly inhibit the formation of experimental atherosclerosis in rabbits.

2. Shuling Jisheng Pills

Source: Experience-based prescriptions.

Composition: 2500g of Atractylodes macrocephala, 1500g of Poria cocos, and 2000g of Taxillus chinensis.

Usage: Decoction of Atractylodes macrocephala to obtain juice; separate powders of Poria cocos and Taxillus chinensis. Mix the above decoction with the powdered herbs until a paste forms, then form into pills the size of marbles. Take 1-2 pills each time, chew thoroughly, and swallow with warm water, 3 times a day.

Functions: Strengthens the spleen and eliminates dampness, harmonizes the stomach and calms the mind, tonifies the kidneys and strengthens yang. Used to treat arteriosclerosis due to spleen and stomach weakness and poor water metabolism, with symptoms such as palpitations, dizziness, and decreased sexual function.

Note: The formula contains Atractylodes macrocephala and Poria cocos to strengthen the spleen, eliminate dampness, harmonize the stomach, and calm the mind; and Taxillus chinensis to tonify the kidneys, invigorate yang, nourish blood, and strengthen muscles. Experimental studies have shown that Taxillus chinensis has a vasodilatory effect on isolated rabbit ear vessels with cholesterol-induced arteriosclerosis.

III. Blood stasis and Qi stagnation

The clinical manifestations of this syndrome include dizziness, vertigo, sharp or stabbing headache, palpitations, shortness of breath, depression, chest tightness and pain, numbness in the limbs and fingers, erectile dysfunction or short-lived erection, or inability to ejaculate during intercourse, a purplish-dark tongue with ecchymosis, and a choppy or wiry pulse. Treatment should focus on promoting blood circulation, removing blood stasis, regulating qi, and unblocking the meridians. Formulas such as Shuixiang Wan, Xinshu III, and Jiangzhi Yanshou Pian can be used.

1. Water scented pills

Source: Practical prescriptions for cardiovascular and hematological diseases.

Composition: 60g roasted leech, 60g worm, 60g Panax notoginseng, 20g cinnamon.

Usage: Grind the above-mentioned herbs into powder, mix well, add appropriate amounts of water and honey to form pills. Take 5 grams each time, after meals, 3 times a day.

Functions: Promotes blood circulation and removes blood stasis, regulates qi and relieves pain, tonifies the kidneys and strengthens yang. Used to treat hyperlipidemia, arteriosclerosis, and coronary heart disease with symptoms of internal obstruction of blood stasis, such as dizziness, chest tightness, paroxysmal chest pain, and impotence.

Note: In this formula, leeches and Panax notoginseng invigorate blood circulation, remove blood stasis, and relieve pain; *Symplocos edulis* regulates qi, relieves pain, tonifies the kidneys, and strengthens yang; cinnamon tonifies the kidneys, strengthens yang, and promotes blood circulation. Clinical studies have found that Panax notoginseng can lower serum cholesterol and triglycerides. Animal experiments have shown that Panax notoginseng powder can reduce total lipid levels in rabbits, and triglyceride content is significantly reduced, mainly due to inhibiting fat absorption in the rabbit intestines. Tissue sections also showed a significant reduction in fatty deposits on the arterial walls in the treatment group. However, there are also reports that cooked Panax notoginseng can increase serum lipid levels in rats fed a high-fat diet. Raw Panax notoginseng can, to some extent, reduce the increase in serum cholesterol. Furthermore, research indicates that the methanol extract of cinnamon can significantly inhibit lipid peroxidation, with an inhibition rate of over 70% against the auto-oxidation of dietary oils. Therefore, cinnamon may have a certain effect on the prevention and treatment of atherosclerosis.

2. Xinshu No. III

Source: Practical prescriptions for cardiovascular and hematological diseases.

Composition: 15g raw cattail pollen (wrapped and decocted), 15g Codonopsis pilosula, 6g safflower, 10g turmeric, 6g sandalwood.

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

Functions: Promotes qi circulation and blood flow, lowers lipids and relieves pain. Used to treat hyperlipidemia and arteriosclerosis due to qi stagnation and blood stasis, with symptoms such as chest tightness, chest pain, and numbness in the fingers and toes.

Note: The formula contains raw cattail pollen, turmeric, safflower, and sandalwood, which invigorate blood circulation, remove blood stasis, regulate qi, and relieve pain. It is combined with codonopsis to replenish qi and nourish blood. Clinical studies have shown that cattail pollen can significantly reduce serum total cholesterol, increase high-density lipoprotein, and reduce the atherosclerotic index, making it a good lipid-lowering drug. Animal experiments have demonstrated that cattail pollen can reduce serum cholesterol levels in rabbits with experimental atherosclerosis. It was also observed that this drug can inhibit the absorption of exogenous cholesterol in the animal intestines, increase fecal cholesterol content, and the degree of coronary atherosclerosis in experimental animals was milder than that in the control group. Other experiments have shown that oral administration of cattail pollen can increase the phagocytic rate of rat macrophages, increase their serum lysozyme activity, help the absorption of lipids in subcutaneous cholesterol granulomas, and promote the regression of atherosclerotic lesions. Modern research has shown that the alcoholic extracts of turmeric-turmeric volatile oil and curcumin-have a significant reducing effect on plasma total cholesterol, β-lipoprotein, and triglycerides in rats with experimental hyperlipidemia, and can also reduce the content of plasma total cholesterol and triglycerides in the aorta. Simultaneously, it was demonstrated that the alcohol extract and curcumin of turmeric inhibited platelet aggregation. Curcumin increased fibrinolytic activity, suggesting that turmeric has an anti-atherosclerotic effect. Turmeric preparations also significantly reduced serum cholesterol and β-lipoprotein in rabbits with experimental hyperlipidemia.

3. Lipid-lowering and life-prolonging tablets

Source: Jiangxi Journal of Traditional Chinese Medicine, 1983;4:46.

Composition: 200g of Salvia miltiorrhiza, 100g of processed Polygonum multiflorum, 100g of Pueraria lobata, 100g of Taxillus chinensis, 100g of Polygonatum sibiricum, and 60g of processed Glycyrrhiza uralensis.

Usage: Prepare 200 sugar-coated extract tablets from the above-mentioned herbs, each containing 3.3 grams of raw herbs. Take 6 tablets each time, 3 times a day. One course of treatment is 10 days. After a 3-day interval, start the next course of treatment. Take a total of 2 courses of treatment.

Functions: Lowers lipids and unblocks blood vessels, invigorates blood and removes blood stasis, nourishes yin and replenishes qi. Used to treat hyperlipidemia and arteriosclerosis with blood stasis and deficiency of both qi and yin, with symptoms such as dizziness, chest tightness and palpitations, fatigue, reddish tongue with a purplish tinge, and a thready and wiry pulse.

Note: In this formula, Danshen (Salvia miltiorrhiza) invigorates blood and removes blood stasis; Shouwu (Polygonum multiflorum), Gegen (Pueraria lobata), Sangjisheng (Taxillus chinensis), Huangjing (Polygonatum sibiricum), and Gancao (Glycyrrhiza uralensis) nourish yin, generate fluids, and replenish qi and blood. Modern research shows that Huangjing has the effect of inhibiting the activity of HMG-CoA reductase, a key enzyme in cholesterol biosynthesis, and has anti-lipid peroxidation effects. Scholars have reported that its aqueous extract can significantly reduce blood lipid levels in animals with experimental hyperlipidemia, and its alcohol extract can improve atherosclerotic lesions. Furthermore, glycyrrhizin contained in Gancao has a preventive effect on the development of arterial lesions in rabbits with experimental atherosclerosis.

(Due to space limitations, the 32nd article ends here. Subsequent articles will continue to be output in the same format.)