Three Widely Used Formulas for Cardiac Fibrosis Compared (Study)

Chinese Medicine is used for a wide range of cardiovascular issues including hypertension, high cholesterol and others that are increasingly common in modern times.  Cardiac fibrosis, about which we will discuss today, is an abnormal thickening of the heart valves.  Cardiac fibrosis can be both a contributor and a cause of issues such as heart attacks (study).  While poor lifestyle is often a consideration in these types of cardiovascular issues, many recent studies have also found excessive exercise can contribute to patchy cardiac fibrosis as well (study).

It is clear that limiting and, of course, eliminating cardiac fibrosis is of great clinical significance that can potentially save people from serious medical issues such as sudden cardiac death.  Accordingly, researchers from the School of Traditional Chinese Medicine at Southern Medical University in Guangzhou China recently conducted a study evaluating the biochemical effects of 3 classical Chinese herbal formulas that would typically be involved in treating these types of issues.

In Chinese Medicine diagnostic terms the factors that lead to fibrosis is often was we call qi and/or blood stagnation (stasis).  While the acute version of this diagnostic concept (i.e. trauma/bruising) is fairly easy to see from a common sense perspective.  There are less obvious, deeper internal aspects to this diagnostic concept which less commonly come to mind for the average layperson.

Some of the basic aspects of what we call the "blood" in Chinese Medicine can be found in my article - "The Concept of Blood (Xue) in TCM Acupuncture Theory".  Blood (Xue) Stasis (Yu) generally involves the liver system in Chinese Medicine (both the physical organ, but the spreading/circulatory functions of the liver more directly).  This stagnant circulation can lead to a number of issues depending on where it stagnates - orthopedic issues, headaches/migraines, certain psychiatric issues and, of course, cardiovascular issues.

For blood stasis from a TCM diagnostic perspective, Chinese herbal formulas from the functional grouping that will "invigorate the blood to dispel blood stasis" would be chosen.  Clinically, of course, these methods would most often be combined with other approaches to best deal with the patients overall set of symptoms.  Particularly as blood stasis is often more of a result of other imbalances than it is a cause, although it can become a strong contributing factor over time.

In this case the researchers looked at the following formulas:

• Xue Fu Zhu Yu Wan - which translates as "dispel blood stasis pills".  From the "invigorate blood and dispel blood stasis" category and commonly used for a range of cardiovascular issues, certain types of headaches, among other issues.
• Tian Ma Gou Teng Wan - "Gastrodia and uncaria formula".  From the "extinguish internal wind" category is often used for issues such as migraines, stroke recovery as well as cardiovascular issues.
• Wen Dan Wan - The "warm the gallbladder formula".  From the "clear heat and transform phlegm" category, wen dan wan is a widely used formula for a range of psychiatric issues, vertigo, cardiovascular issues such as palpitations and more.

Using a rat model of induced hypertension researchers in this study divided the rats into treatment and control groups and treated them over a 16 week period.  Researchers watched changes in systolic blood pressure and used various blood and tissue tests to try to understand the underlying biochemical mechanisms which led to the changes in cardiac fibrosis.

Perhaps not entirely a surprise to practitioners at least, the researchers found a superior effect from Xue Fu Zhu Yu Wan - "the dispel blood statis formula" when compared with the other two formulas.  In layman's terms they found that the dispel blood stasis formula demonstrated a "superior ability to reverse myocardial fibrosis" when compared with the other two formulas.  In scientific terms they found:

• Xue Fu Zhu Yu Wan decreased TGF-β1 mRNA expression - known as "transforming growth factor 1" the increased expression of this protein leads to the excessive tissue growth known as fibrosis - in this case cardiac fibrosis - although it does function in other parts of the body as well.

All things considered this is an important finding to aid in the reversal of processes often years in the making that can have disastrous effects.  Again, in a true clinical setting this type of formula would rarely be used alone, rather combined with other herbs or formulas to deal with the entire range of imbalances in the body contributing to these issues.  This type of deep biochemical analysis, however, aids in the proper selection of combinations and approaches that a practitioner will take with each individual patient to ameliorate this range of disease process.