Role of Chinese Herbal Medicine in the Treatment of Cardiovascular Diseases - Case Study Example

Role of Chinese Herbal Medicine in the Treatment of Cardiovascular Diseases: A Case Study of Hypertension Name Institutional Affiliation Role of Chinese Herbal Medicine in the Treatment of Cardiovascular Diseases: A Case Study of Hypertension Introduction Hypertension has emerged as a significant global disorder, affecting individuals of all races and socioeconomic backgrounds. There are numerous treatment regimens aimed at treating the disorder, but according to Wang and Xiong (2013), the limitations and concerns raised about the modern treatment procedures for hypertension have seen many patients revert to traditional treatment regimes. Wang and Xiong (2013) point out that many patients in Asia have turned to Traditional Chinese Medicine (TCM) as an alternative to Western Medicine in treating hypertension. From the western medicine perspective, the disorder is closely linked to other diseases such as Diabetes and heart failure. According to Western medicine, the disease is highly asymptomatic in nature, with as many as one-third of patients with the disorder being unaware that they have the disorder (Mutnick, 2004). Given the asymptomatic nature of the disease, western medicine now advocates for increased awareness of the disease in the general population. According to Weir (2005), early identification of patients who are at risk and early implementation of treatment is one of the effective ways through which the disorder can be countered. The Chinese traditional medicine views high blood pressure as an imbalance in the body’s natural state. TCM views hypertension as a warning sign that a patient needs to change certain aspects of their lifestyle to restore the body to its original state of balance (Xiong et al., 2013). This case study seeks to discuss one clinical case in which TCM was successfully used to treat hypertension. Case Presentation On 13th October 2015, a 69-year-old patient was admitted to our hospital with her chief complaint being dizziness for three days. The patient also presented other symptoms relevant to the chief complaint which included Blurred vision, tinnitus, insomnia and easy anger. The patient medical history revealed that she had hypertension, diagnosed in September 2008 and for which she was on antihypertensive drugs. At the time of the diagnosis, the patient’s BP was 160/100 mm Hg. Starting from October 2008, the patient was placed on a daily dose of levamlodipine 5 mg. A few months later, the patient’s BP remained at 160/100 mm Hg with the patient reporting other symptoms such as palpitations and flushing. In May 2009, the patient was switched to a daily dose of irbesartan 150 mg. Her BP readings dropped to 140/85 mm Hg, but the patient kept reporting other side effects including fatigue and diarrhoea. These side effects made the patient stop taking her medication starting from June 2013. The patient denied any family history of cardiovascular disease and alcoholism and reported that she engages in physical exercise, at least, two hours each day. Additionally, she pointed out that she had no particular preference for salty foods. Physical Examination and Investigation The patient pulse examination revealed a wiry and rapid pulse. Examination of the tongue showed a red tip and tongue body with both the sides of the tongue having a yellow coating. Further physical examination revealed reduced high-density cholesterol at 0.88 mmol/L and mild hypocalcaemia. The patient’s BP was 160/100 mm Hg. A Transcranial cerebral Doppler was also conducted, and it showed a high rate of blood flow in the right intracranial internal carotid artery and normal flow in the other cerebral vessels. The investigation also included a carotid artery ultrasound, which showed a 2.00 mm thick plaque in the left common carotid artery wall. The ultrasound also revealed that left ventricular posterior wall depth was 9.7 mm, and the interventricular septum thickness was 10.9 mm. The relative wall thickness was found to be 0.39 mm, and the left ventricular mass index was 12 g/m2 The disease and differential diagnosis revealed Liver Yang hyperactivity Treatment and Outcome The treatment objectives for the current patient were to smooth the liver, subdue yang and lower blood pressure. To achieve this objective, a number of Chinese herbal treatments were administered, and a lifestyle modification was suggested. The following list shows the Chinese herbal medicines that were used: Shi Jue Ming 15 g Mu Li 15 g Long Gu 15 g Xia Ku Cao 15 g Sang Ji Sang 15 g Gou Teng 15 g Du Zhong 12 g Tian Ma 12 g Niu Xi 12 g Ju Hua 9 g Huang Qin 9 g The treatment plan included three follow-ups during which the physician evaluated the patient for progress. Following the first treatment on 13th October 2015, the next follow-up was on 20th October 2015 during which the investigation revealed less dizziness and a drop in the patients’ BP to 145/90. However, the patient still reported tinnitus and insomnia. The final follow-up was on 27th October 2015, in which the patient showed no signs of dizziness, the absence of insomnia and less tinnitus. Discussion Various scholars agree that hypertension is one of the leading causes of mortality and disability around the globe and as such, it has become a significant public health challenge around the world. The modern western treatment options for hypertension have various limitations and concerns, including side effects and the overall costs involved in such treatment regimens. This has seen patients, especially in Asia, opt for Traditional Chinese medicine (Wang and Xiang, 2013). Wang and Xiong point out that physicians who utilize TCM in treating hypertension utilize a variety of approaches which are based on Chinese medicine principles. They are of the view that there has been a growing interest from the rest of the world in Chinese Medicine and that the available empirical evidence on the effectiveness of TCM in treating hypertension shows that TCM is effective in the treatment of hypertension. However, Wang and Xiong (2013) opine that the clinical evidence on the effectiveness of TCM, when compared to Western Medicine, is weak given the poor quality of primary studies. Xiong et al. (2013) also acknowledge the fact that the prevention and treatment of hypertension have posed a major public health challenge worldwide. Xiong et al. point out that TCM has emerged as one of the most significant regimes in complementary and alternative therapies. In this systematic review of Chinese and English articles, Xiong et al. seek to investigate the emerging therapeutic strategies from a TCM perspective and their effectiveness in treating hypertension. They report that some of the TCM approaches that have been found to be effective in hypertension treatment include acupuncture, Chinese herbal medicine, moxibustion, Tai Chi and Qigong. Wang and Xiong (2012) describe the hypertension control strategy from the Traditional Chinese medicine perspective. They opine that Chinese medicine has proved to have a significant impact on the treatment of hypertension. They point out that hypertension is a relatively new concept in Chinese medicine and that prior to the interaction between western medicine and Chinese medicine, hypertension used to be diagnosed through differentiation of symptoms with the focus being directed towards relieving symptoms and improving a patient’s quality of life. According to Wang and Xiong (2012), hypertension from a TCM perspective belongs to the “Vertigo” group of disorders. Vertigo disorders are characterised by a number of pathogenesis that include excess liver yang, stagnation of the phlegm, yin deficiency in the liver and kidney as well as deficiency of qi and blood. Wang and Xiong conclude that the pathogenesis of hypertension from the TCM perspective is quite complex, but the distribution of both herb and formula syndromes is quite regular. Xiong et al. (2015) sought to investigate the effectiveness of Chinese Herbal medicine in the treatment of resistant hypertension. They describe Chinese herbal medicine as one of the most prominent components of Traditional Chinese Medicine and which has been in use for over 3000 years. Xiong et al. (2015) report that many researchers have shown interest in finding out the role of Chinese herbal medicine in hypertension management, with most reporting that CHM, when used together with contemporary western medicine, has the potential to treat hypertension. Xiong et al. (2015) report that the effectiveness of CHM in the treatment of hypertension is challenged by the lack of randomized control tests that are of high quality and which utilize large samples. Researchers in western medicine have also directed their efforts towards understanding the nature of hypertension and how to best manage the disease. Weir (2005) is of the view that clinical evidence shows that hypertension increases the mortality and morbidity rates associated with diseases such as congestive heart failure, stroke, end-stage kidney disease and coronary heart disease. Weir also states that hypertension prevalence rates have been on the rise, thanks to increased incidences of obesity as well as an increase in the size of the ageing population. Mutnick (2004) is of the view that hypertension was first acknowledged as a disease more than 100 years ago and that since that time, great advances have been made in the understanding and treatment of the disease. From the current case and the evidence in the above literature, it is quite clear that hypertension is a life-threatening disease. The disorder is quite common among middle-aged to older individuals, with females being at a higher risk of developing the disorder compared to males. Weir (2005) reports that approximately 65 million Americans have hypertension and that the probability of acquiring antihypertensive treatment is approximately 60%. This means that most patients diagnosed with the disorder in modern hospitals would first be put on antihypertensive drugs. Mutnick (2004) points out that patients with hypertension are usually asymptomatic during the early stages of the disease with the main symptoms, including elevated blood pressure, fatigue and dizziness as well as headaches. Mutnick is of the view that these symptoms are not specific to hypertension, hence the need for regular visits to physicians for checkups. The utilization of hypertensive in the treatment of hypertension has been undermined by certain limitations and concerns as evident in the current case. Despite leading to a significant reduction in the symptoms associated with hypertension, hypertensive has proved to be not always effective in the treatment of hypertension. Most patients suffer even more from the side effects associated with hypertensive drugs, a fact that motivates them to try out other therapies. Traditional Chinese medicine has been in use for over 3000 years and has proved to be quite effective in the treatment of numerous disorders (Zhang, Shen & Wang, 2013). The concept of hypertension is quite new from the TCM perspective. However, the disorder falls under the “Vertigo” category of diseases which share similar pathogenesis (Blush, 2013). Numerous studies have reported that TCM approaches such as acupuncture and Tai Chi are effective in the treatment of hypertension. However, the effectiveness of Chinese herbal medicine is under scrutiny given the poor quality of clinical studies that have been conducted so far. However, the current case clearly shows that Chinese herbal medicine has the potential to treat hypertension. Conclusion Hypertension has emerged as a significant global disorder, affecting individuals of all races and socioeconomic backgrounds. According to Western medicine, the disease is highly asymptomatic in nature, with as many as one-third of patients with the disorder being unaware that they have the disorder. The Chinese traditional medicine views high blood pressure as an imbalance in the body’s natural state. TCM views hypertension as a warning sign that a patient needs to change certain aspects of their lifestyle to restore the body to its original state of balance. In the current case involving the 69-year-old patient, the utilization of Chinese herbal medicine together with changes in the patient’s lifestyle proved to be quite successful in treating the disorder. There has been a growing interest from the rest of the world in Chinese Medicine and that the available empirical evidence on the effectiveness of TCM in treating hypertension shows that TCM is effective in the treatment of hypertension. Some of the TCM approaches that have been found to be effective in hypertension treatment include acupuncture, Chinese herbal medicine, moxibustion, Tai Chi and Qigong. However, the effectiveness of TCM approaches is still being challenged by the lack of quality clinical evidence. More randomized control trials utilizing large sample sizes need to be conducted to find out the real value of TCM in the treatment of hypertension. References Blush, J. (2013). Integrative treatment of hypertension. New York: CRC Press. Mutnick, A. (2004). Hypertension management for the primary care clinician. Bethesda, Md.: American Society of Health-System Pharmacists. Wang, J., & Xiong, X. (2012). Control Strategy on Hypertension in Chinese Medicine. Evidence-Based Complementary and Alternative Medicine, 2012, 1-6. http://dx.doi.org/10.1155/2012/284847 Wang, J., & Xiong, X. (2013). Evidence-Based Chinese Medicine for Hypertension. Evidence-Based Complementary and Alternative Medicine, 2013, 1-12. http://dx.doi.org/10.1155/2013/978398 Weir, M. (2005). Hypertension. Philadelphia: American College of Physicians. Xiong, X., Li, X., Zhang, Y., & Wang, J. (2015). Chinese herbal medicine for resistant hypertension: a systematic review. BMJ Open, 5(1), e005355-e005355. http://dx.doi.org/10.1136/bmjopen-2014-005355 Xiong, X., Yang, X., Liu, W., Chu, F., Wang, P., & Wang, J. (2013). Trends in the Treatment of Hypertension from the Perspective of Traditional Chinese Medicine. Evidence-Based Complementary and Alternative Medicine, 2013, 1-13. http://dx.doi.org/10.1155/2013/275279 Zhang, L., Shen, P., & Wang, S. (2013). Acupuncture treatment for hypertension: a case study. Acupuncture in Medicine, 32(1), 73-76. http://dx.doi.org/10.1136/acupmed-2013-010407 Read More