Blood pressure and TCM

tutor

Taking blood pressure is one of the standard procedures performed to virtually any patient in Western medical or physiotherapeutic practice. In the article by [i:8e56f3060e]Wei-Yen Chang, LAc, Dipl. Ac. and Tina Chen, MS, LAc[/i:8e56f3060e] called [b:8e56f3060e][i:8e56f3060e]Interpreting Blood Pressure Readings by Eight-Principle Diagnostic Standards[/b:8e56f3060e][/i:8e56f3060e] ([i:8e56f3060e]Acupuncture Today[/i:8e56f3060e] 2004, Volume 05, Issue 10) blood pressure is analysed from the TCM point of view. Below are some excerpts from this article.

"One objective way to find out exactly whether the patient is truly suffering from deficiency, excess, heat or cold is to take the blood pressure and note the heart rate".

"Below is a brief summary of the patterns representing the most commonly seen complex types in the clinic.

[b:8e56f3060e]Type 1: Systolic pressure (high) + Diastolic pressure (high) + Heart rate (fast) = Excess Heat [/b:8e56f3060e]

Patients with both high blood pressure and a fast heart rate are, without exception, suffering from an excess heat condition. Please note that these patients may complain that they are tired and depressed. However, if they have high blood pressure and a fast heart rate, tonic herbs should never be used, despite the fact that the patient complains of tiredness. The diagnosis is excess fire. This should be addressed with heat-clearing herbs.

[b:8e56f3060e]Type 2: Systolic pressure (low) + Diastolic pressure (low) + Heart rate (slow) = Yang Deficiency [/b:8e56f3060e]

Patients who have low blood pressure and a slow heart rate are experiencing deficiency, mostly qi or yang deficiency. These deficiencies are best helped by tonic herbs; never give these patients sedating herbs.

[b:8e56f3060e]Type 3: Systolic pressure (high) + Diastolic pressure (normal) + Heart rate (slow) = Deficiency Heat + Blood Stasis [/b:8e56f3060e]

Patients who belong to this category usually suffer from blood stasis, which may be the result of an old injury or surgery. The heart rate is slow because of blood stasis/obstruction of the blood flow. In turn, systolic pressure is increased, as the body attempts to maintain balance. The increased pressure and lack of flow result in heat from deficiency. Carefully selecting appropriate blood-moving and stasis-resolving herbs with herbs to clear deficiency heat will be the most helpful strategy for treating these patients.

[b:8e56f3060e]Type 4: Systolic pressure (low) + Diastolic pressure (low) + Heart rate (fast) = Yin Deficiency Heat [/b:8e56f3060e]

The last group might appear to reflect heat because of the rapid rate, but the low blood pressure tells a different story: the insufficient quantities of blood and yin in circulation require a rapid heart rate to maintain positive circulation. This is similar to a car engine running with insufficient oil: eventually, heat begins to build up from the deficiency of lubricating yin. These patients are suffering from yin deficiency heat, and must be treated with herbs that tonify yin and sedate the deficiency heat.

This approach can provide a guideline to follow when confronted with a confusing presentation in the patient. Tongue and pulse diagnoses should be combined with this approach to reach an accurate diagnostic conclusion".

[b:8e56f3060e][i:8e56f3060e]Do you think using blood pressure readings might help to make the TCM diagnosis easier?[/i:8e56f3060e][/b:8e56f3060e]

tutor

Maybe. But it's hard to say!
Personally I still repy on the four diagnostic methods. And more and more, I would do more observation.

Pulse diagnosis of course is very important.

Many hypertensive cases of the Type 1 could be differentiated as liver fire resulting from Yin deficiency.

So, BP could be taken into consideration, but to make a good differential diagnosis of syndromes, one should be concentrating more on the real traditional way, I think.

In fact, in China, many TCM physicians had got very good background of western medicine, and they were required to study TCM, and many of them were successful in the practice of TCM, but they failed to find a real pattern to make traditional Chinese and western medicine diagnostics all together, it's not so easy.
So, on one hand they would use traditional Chinese medicine to make diagnosis of syndromes for the prescription of Chinese herbal medicines and meanwhile they would use the real western medicine diagnostic ways to see some concrete changes in the patients' body.

Personally I don't reject any good info of western medicine, but I do rely on the traditional ways. It could tell you much more.

tutor

Thank you very much for your answer.

tutor