abstracted & translated by
Bob Flaws, Lic. Ac., Dipl. Ac. & C.H., FNAAOM (USA), FRCHM (UK)
Keywords: Chinese medicine, Chinese herbal medicine, altitude sickness, high altitude low blood pressure, Bu Zhong Yi Qi Tang (Supplement the Center & Boost the Qi Decoction)
In issue #5, 2003 of the Yun Nan Zhong Yi Zhong Yao Za Zhi (Yunnan Journal of Chinese Medicine & Chinese Medicinals), Yao Yun-qing of the Hai Bei Municipal Second People’s Hospital in Qinghai published an article titled, "Observations on the Therapeutic Effect of Treating 24 Cases of High Altitude Low Blood Pressure with Bu Zhong Yi Qi Tang Jia Wei (Supplement the Center & Boost the Qi Decoction with Added Flavors)." This article appeared on page 17 of that journal. A summary of its main points is given below.
Cohort description:
All the patients in this study had moved from sea level to high altitude areas. The course of their disease ranged from 10 days to 1.5 years. There were nine males and 15 females 17-52 years of age. Twelve cases had headaches and dizziness as their main complaint, six were fatigued and had decreased appetites, two experienced mainly chest oppression and numbness of their limbs, and the other four complained of fatigue, insomnia, and a clear decreased in memory. All patients had their blood arterial blood pressure measured on their upper arms three times, and their blood pressure was as low as 12.0/8.0kPa.
Treatment method:
The basic formula consisted of: Radix Codonopsitis Pilosulae (Dang Shen), 30-50g, Radix Astragali Membranacei (Huang Qi), 30-50g, mix-fried Radix Glycyrrhizae Uralensis (Gan Cao), 10-20g, Radix Angelicae Sinensis (Dang Gui), 10-20g, Pericarpium Citri Reticulatae (Chen Pi), 6-10g, Rhizoma Cimicifugae (Sheng Ma), 10-15g, Radix Bupleuri (Chai Hu), 10-15g, uncooked Rhizoma Atractylodes Macrocephalae (Bai Zhu), 10-15g, and Herba Epimedii (Xian Ling Pi), 10-15g. If there was abdominal distention and torpid intake, Fructus Amomi (Sha Ren), Fructus Myristicae Fragrantis (Rou Dou Kou), and Fructus Citri Aurantii (Zhi Ke) were added. If there was insomnia, Sclerotium Pararadicis Poriae Cocos (Fu Shen), Semen Nelumbinis Nuciferae (Lian Zi), and Semen Zizyphi Spinosae (Suan Zao Ren) were added. If there was numbness of the limbs, Ramulus Cinnamomi Cassiae (Gui Zhi) and Cortex Cinnamomi Cassiae (Rou Gui) were added. If there was easy contraction of common colds, Radix Ledebouriellae Divaricatae (Fang Feng) was added and the amount of Huang Qi increased. If there was headache, Herba Asari Cum Radice (Xi Xin) and Radix Et Rhizoma Notpterygii (Qiang Huo) were added. One packet of these medicinals was decocted in water and administered per day, with 10 days equaling one course of treatment.
Treatment outcomes:
Cure was defined as normalization of blood pressure, disappearance of clinical symptoms, and no recurrence on follow-up after half a year. Improvement was defined as normalization of clinical symptoms and blood pressure. However, within one month of stopping the above medicinals, the condition returned. No effect meant that there was no obvious improvement in either the blood pressure or clinical symptoms. Based on these criteria, 16 cases were judged cured, six improved, and two got no effect, for a total effectiveness rate of 91.7%.
Discussion:
Although the title of the original article refers to high altitude low blood pressure, it may also be seen as what is called altitude sickness in the West. This occurs when people from sea level remove to 10,000 feet (3000 meters) or more in altitude. Most people acclimatize to altitudes up to 10,000 feet in a few days. The higher the altitude, the longer full acclimatization takes. The basic pathophysiology of altitude sickness is disturbance of water and electrolyte balance. Capillary permeability is increased, thus allowing fluid to accumulate in various locations. In addition, hypoxia increases pulmonary vascular resistance and pulmonary artery pressure, but systemic resistance and arterial pressure may decrease as was the case with the above patients. Altitude sickness is characterized by headache, nausea, dyspnea, and sleep disturbances, with exertion aggravating the symptoms. In the West, the first line of treatment of persistent altitude sickness is immediate descent to lower altitudes. In China, this is not possible for many persons moved to high altitude areas, such as Tibet and Qinghai, for political-social reasons. Eating frequent small meals high is easily digested carbohydrates improves altitude tolerance and is recommended for the first few days. As the above study shows, altitude sickness tends to manifest as spleen qi vacuity in terms of Chinese medical pattern discrimination. Therefore, its treatment with Bu Zhong Yi Qi Tang makes good sense. In this case, the headaches and dizziness of altitude sickness are caused not by the presence of some evil qi but inability of clear yang to ascend to nourish and fill the brain.
Copyright © Blue Poppy Press, 2004. All rights reserved.
