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Saturday, 10 December 2011

Metabolic Syndrome and its TCM Food Therapy

Tiejun Tang
Last month I delivered two lectures, one for TCM Student Society of Middlesex University, the other for the annual general meeting of ATCM. In these two lectures I talked a same topic -- Metabolic Syndrome and its TCM Food Therapy. The audiences are very interested to my talk. Many people ask me for handout, somebody suggest me to publish this paper in ATCM journal. I prefer to put this article in my blog first, to share my knowledge to more readers all over the world.

Metabolic syndrome (MS) is a group of common diseases. It became more and more popular due to the life- style of modern society. Chinese medicine herbs have a good effect in the treatment and prevention of MS. Patients often need a long term treatment. Most of patients don’t like to take the herb decoction for too long time, many treatment have to be terminated for this reason. If we use herbs as a daily food therapy, that will be much more acceptable for most of the patients. In this paper I will introduce some TCM food therapy methods on the treatment of MS.
The definition of metabolic syndromeAlthough the conception of metabolic syndrome originated in late 1950s, but it used to have a different definition. Until Reaven (G.M Reaven 1988) noticed that hyperlipidaemia, hypertension and insulin resistance often cluster together, he put forward the conception of X-syndrome, nine years later Zimmet (P.Z. Zimmet 1997) suggested to use the conception of metabolic syndrome. In 1999 WHO gives the work definition of metabolic syndrome it refers to a clustering of cardiovascular disease risk factors, including type 2 diabetes, hyperlipidaemia, hypertension and obesity.
The diagnostic criteriaThe diagnostic criteria of MS are various in different countries. NCEP (National Cholesterol Education Program) criteria and IDF & AHA (International Diabetes Federation & America Heart Association) criteria are applied in America. EGIR (European Group for the study of Insulin Resistance) criteria are applied in most of the European countries. The WHO criteria (1999) is following:
Require presence of one of:
 > Diabetes mellitus
 > Impaired glucose tolerance
 > Impaired fasting glucose or
 > Insulin resistance
AND two of the following:
 > BP: ≥ 140/90 mmHg
 > Dyslipidemia:TG: ≥ 1.695 mmol/L & HDL-C ≤ 0.9 mmol/L (male),
≤ 1.0 mmol/L (female)
 > Central obesity: waist:hip ratio > 0.90 (male); > 0.85 (female),
or body mass index > 30 kg/m2
 > Microalbuminuria: urinary albumin excretion ratio ≥20 µg/min
or albumin:creatinine ratio ≥ 30 mg/g
The prevalence of MSThe prevalence of the MS varies with country, race and the definition used. One study in the USA found a prevalence of 44% in the over-60s. A study in the Shanghai found a prevalence of 17.14% (1/6) in the age of 20-74 (Lei Chen. 2003). A report showed that the prevalence of metabolic syndrome in western London is various in different races. South Asians have higher prevalence than African-Caribbeans and Europeans (T.Tillin.2005).
Traditional Chinese medicine’s philosophy about MSAccording to Chinese medicine’s theory MS falls within the category of Xiaoke (消渴) and Xuanyun (眩晕). The etiology of MS is due to: a) Improper diet causing by over eating fat and sweet food; b) Emotional disorder causing by stress work and depression ; c) Spleen deficiency due to many chronic disease; d) Kidney and liver deficiency due to ageing; e) Yin-Yang loose balance and phlegm obstruction; f) Sluggish qi and blood circulation due to lack of exercise; Commonly used treatment principle should be: a) Expel dampness and phlegm; b) Remove the qi stagnation; c) Activate qi and blood circulation; d) Invigorating the spleen; e) Tonify kidney.
Food therapy formulas:1. Gouqi Juhua Tea

Ingredients: Gouqizi (Fructus Lycii) 10g add 500ml water, boil 2 minute, add Juhua (Chrysanthemum) 10g, green tea 5g,Covered and soak for 30min. Drink once or twice daily.
Clinical application: hypertension, arteriosclerosis, coronary heart disease, diabetes, hyperlipemia, dry eyes and blurred vision.
2. Shanzha Jueming Tang
Ingredients: Shanzha (Hawthorn Fruit) 20g, Juemingzi (Semen Cassiae) 10, Prepare method : add 500ml water, boil for 30 min, drink once a day.
Clinical application: hyperlipemia, cholesterol or triglyceride, hypertension, arteriosclerosis, coronary heart disease, constipation, food retention.
3. Yumixu Tang
Ingredients: Yumixu (Corn Stigma) washed and soaked with boiled water for 5 min, or boil with water for 5 minute, drink once a day.
Clinical application: diabetes, hypertension, cholecystitis, hepatitis, nephritis.
4. Sanqi Shanyao Zhou
Ingredients: Sanqi (Radix Notoginseng)5g, Shanyao (Rhizoma dioscoreae) 60g, Jingmi (rice) 60g. Prepare method: above ingredients add water 500 ml, boiled for 1 hour,drinking the porridge.
Clinical application: diabetes, hypertension, anaemia, irregular menstruation, scanty menstruation.
5. Gegen Fen Zhou
Ingredients: Gegenfen (Radix Puerariae) 30g, Jingmi (rice) 50g; Prepare method :add water 500 ml, boiled for 1 hour, drinking the porridge.
Clinical application: diabetes, hypertension, coronary heart disease, hyperlipoidemia.
6. Shanzha Shouwu Tang
Ingredients: Shanzha (Hawthorn Fruit) 30g, Heshouwu (Radix polygoni multiflori) 18g, Zexie (Rhizome of Oriental Waterplantain) 12g; Prepare method:Above ingredients add water 600 ml, boiled for 1 hour. Drink the decoction twice a day.
Clinical application: hyperlipemia, Diabetes hypertension, coronary heart disease.
7. Ju Huai Cha
Ingredients: Juhua (Chrysanthemum) 3g, Huaihua (Flower of Japanese Pagodatree) 3g, Green tea 3g; Prepare method :Put above ingredients in a cup, add boiled water, soaked 5 minute, drink the tea once daily.
Clinical application: Hypertension,Headache,Dizzness.
8. Xiakucao Jiangya Cha
Ingredients: Xiagucao (Spike Prunella) 10g, Cheqiancao (Herba plantaginis) 12g; Prepare method: above ingredients washed, and put them in a cup, add boiled water, covered and soaked for 5 minute, drink the tea once a day.
Clinical application:Hypertension,Headache,Dizzness.
9. Danshen lvcha Yin
Danshen (Rdix salviae miltiorrhizae) 9g, Green tea 3g; Prepare method: Put Danshen power and green tea in a cup, add boiled water, covered and soaked 5 minute, drink the tea once or twice daily.
Clinical application:Coronary heart disease,Angina,Hyperlipoidemia. 
DiscussionWestern medicine is effective in treating MS but it has to use many tablets at the same time. Patient has to take one table for blood sugar, one for cholesterol, and one or two tablets for control blood pressure. Usually these medicines are quite effective to control sugar, cholesterol and blood pressure, but each medicine will cause some side effects if used long term. These side effects will lead to some new troubles, such as liver function damage, low libido, edema, dry cough, headache, and even heart failure. That is the biggest trouble of west medicine.

Pharmacological research showed the ingredients of Yumixu contains flavone, glycoside, trace element, organic acid, glucide, multi-vitamin. It showed a better effect than 2.5mg Glibenclamide in diabetic patients. There are many effective ingredients in these herbs like tanshinone in Danshen; flavone in Juhua; phytomelin in Huaihua; Notoginseng leaf saponins and flavone in Sanqi; lycium barbarum polysaccharide and Carotene in Gouqizi etc.

Shanzha, Juemingzi and Heshouwu can reduce blood lipid; Juhua, Xiakucao and Gouqizi are good for high blood pressure; Danshen, Sanqi and Gegen can improve coronary circulation and benefit heart. In clinical practice, according to patient’s diagnosis we can select one or two from the nine formulas above. Patients can take the tea or porridge every day or every other day. MS can be get control by daily food therapy. Some MS cases didn’t show a lot of symptoms, many patients didn’t paid enough attention to this disease, but MS put the patients in a high risk of heart attack or stroke. Taking action to reduce the potential risk is better than to wait until the attack has occurred. This is a very important treatment principle of traditional Chinese medicine.

Reference:

  1. Lei Chen. (2003). Prevalence of metabolic syndrome among Shanghai adults in China. Chinese Journal of Cardiology. 31(12): 909-912.
  2. Reaven GM.(1988). Role of insulin resistance in human disease. Diabetes. 37(12):1595-607.
  3. Tillin. T. (2005). Metabolic syndrome and coronary heart disease in South Asians, African-Caribbeans and white Europeans: a UK population-based cross-sectional study
  4. Diabetologia 48(4): 649-656.
  5. Zimmet PZ et al. (1997). The global epidemiology of non-insulin-dependent diabetes mellitus and the metabolic syndrome. Journal of Diabetes and its Complications. 11(2): 60-68.