High Blood Pressure: Overview, Treatment & Diagnosis
By Karina • Nov 8th, 2008 • Category: CardiovascularWhat are the treatment goals?
- reduce and stabilize BP at normal level
- Reduce symptoms, improve quality of life
- Prevent tissue damage, and bingfazheng
- lengthen life
First Non-medical Intervention
- 合理膳食diet
- 适量运动exercise
- 戒烟限酒air
- 心理健康psychology
Differential Diagnosis
General idea is to first handle the yangkang symptoms of headache, easily angered. These replete symptoms are usually accompanied by ganshenyinxu symptoms of lumbar and knee weakness, 头肿足轻, eyes red, strong pulse.
use 天麻钩藤 as the main herbs to handle the head symptoms. Often use mineral herb like 代赭石，生龙牡 to bring down the sympathetic n. system… Can also use 真干熄风汤. If show signs of 实火 (火气重 – see 口苦口臭、便秘、舌老苔黄、脉有力) think 龙胆泻肝汤 with a focus on 清热 i.e. 龙胆草、黄芩、山栀子. As for the diuretics in the formula, use all if 苔腻，and less if not so much.
When the bp is maintained at the certain level, then we can start focusing on 肝肾阴虚，using 杞菊地黄丸, when goji and chrysanthemum are added for dry eyes.
For a fat person, check if head is heavy, but not exactly painful, and double check pulse and tongue for presence of phlegm. Think 半夏天麻柏术汤. Focusing on the metabolism of phlegm in body i.e. spleen. Think 四君子 and 二陈汤. Where 天麻 and 白术are for the head symptoms. If the phlegm is heavy, think spleen-化湿 medicines like 藿香、佩兰、石菖蒲 to get rid of fluid (please differentiate from the 利尿 herbs in 龙胆泻肝汤. Note to use spleen-化湿 medicines only if the heat-dryness is not too strong. If 火重, then it‘s 龙胆泻肝汤-type where diuretics are used. Remember that 柴胡 is a 肝用(气) medicine, as is 当归、川芎. While 熟地and 白芍 are 肝体 medicine. Use to 柴胡 is to clear the channels so that the fire can come down. Also, use 龙胆草 sparingly, and only upon the 山栀子、黄芩 base. Use 6g is enough.