Overview of blood stasis in traditional Chinese medicine: analysis of primary and secondary structures

Blood stasis is an important pathological concept in the theory of traditional Chinese medicine. It refers to the pathological products formed when the blood does not flow smoothly or is stagnated in the meridians and organs. It is not only the result of the disease, but also a causative factor. Its main manifestations are pain, fixation, mass, and dull complexion, etc., which partially overlap with the microcirculatory disorders and thrombosis of modern medicine. The content will revolve aroundThe definition, causes, symptoms, treatment methods and representative Chinese patent medicines of blood stasisExpand and focus on analyzing the logic of TCM syndrome differentiation and treatment to avoid confusion with modern medicine.

Definition and core characteristics of blood stasis

Traditional Chinese medicine believes that blood stasis is"Absence of menstrual blood" or "loss of blood flow", that is, the blood deviates from the normal circulation path or the flow rate is abnormal. The classic work "Huangdi Neijing" mentions that "bad blood should be purged but not purged, and the blood should be retained to stop", describing its retention characteristics. Blood stasis can be caused by external factors such as trauma, qi stagnation, and cold coagulation, as well as internal factors such as qi deficiency and blood heat. Its core characteristics include: pain like acupuncture with a fixed position, dark purple tongue or ecchymosis, onychomycosis (dry and flaky skin), etc. Wang Qingren, a physician in the Qing Dynasty, emphasized in "Yilin Correction" that "blood stasis causes nine out of ten diseases" and developed the treatment method of promoting blood circulation and removing blood stasis.

Common causes and pathological mechanisms of blood stasis

The formation of blood stasis mainly involves three mechanisms:Qi stagnation, cold coagulation, deficiency of vitality. Emotional depression leads to stagnation of liver qi, which makes the blood unable to move (qi stagnation and blood stasis); exogenous cold evil causes the blood vessels to contract and stagnate (cold coagulation and blood stasis); long-term illness or old age leads to deficiency of qi and blood and slow blood flow (qi deficiency and blood stasis). "The Synopsis of the Golden Chamber" records that the pathogenesis of "blood paralysis" is "yang deficiency and blood coagulation". Modern research has found that this type of state is often accompanied by microscopic changes such as increased blood viscosity and platelet aggregation. However, traditional Chinese medicine emphasizes the overall syndrome differentiation of individual differences. For example, those with blood stasis and yang deficiency need to warm yang and activate blood circulation, rather than simply anticoagulation.

Treatment ideas and typical prescriptions for blood stasis

Traditional Chinese medicine regulates blood stasis to"Activating blood circulation and removing blood stasis" is the general principle, use medicine according to the syndrome type. For qi stagnation and blood stasis, Xuefu Zhuyu Decoction (containing peach kernel and safflower) is commonly used; for cold coagulation and blood stasis, Danggui Sini Decoction (Guizhi, Asarum Wenton) is used; for qi deficiency and blood stasis, Buyang Huanwu Decoction (astragalus mixed with blood-activating drugs) is used. External treatment methods such as pricking and bloodletting, acupuncture at Geshu points, etc. also have auxiliary effects. It should be noted that simply activating blood circulation may consume qi and impair health, so it needs to be combined with tonic drugs. For example, "Compendium of Materia Medica" records that Salvia miltiorrhiza "can activate blood circulation and nourish blood". Common Chinese patent medicines are as follows:

The modern value and precautions of blood stasis theory

The theory of blood stasis in traditional Chinese medicine provides a unique perspective for chronic and painful diseases, such as coronary heart disease, dysmenorrhea, etc. But please note: blood-activating drugs are contraindicated for pregnant women, such as safflower and turmeric; long-term use requires the guidance of a physician to prevent the risk of bleeding. Modern research has confirmed that tanshinone, ligustrazine and other ingredients can indeed improve microcirculation (Chinese Pharmacopoeia 2020 Edition), but they cannot replace standard treatment. You can exercise moderately every day to promote the circulation of qi and blood, or drink hawthorn rose tea (which is not too strong to promote blood circulation) to avoid eating cold, greasy foods that aggravate blood stasis.

Quote sources:1. "Yellow Emperor's Internal Classic" Suwen·Tiaojing treatise 2. Wang Qingren's "Yilin Correction" (Qing Dynasty) 3. Zhang Zhongjing's "Synopsis of the Golden Chamber" (Eastern Han Dynasty) 4. Li Shizhen's "Compendium of Materia Medica" (Ming Dynasty) 5. "Chinese Pharmacopoeia" 2020 edition (State Pharmacopoeia Commission)