ABSTRACT
As China is about to enter an era of deep aging， the coexistence of multiple diseases is gradually increasing. Coronary heart disease （CHD） and cognitive dysfunction also show increasing incidence year by year. The two diseases affect and cause each other， becoming the major chronic diseases harmful to the health of the elderly. It is of great clinical significance to explore the methods integrating traditional Chinese and western medicine for the prevention and treatment of the two diseases. The relationship between CHD and cognitive dysfunction in traditional Chinese medicine （TCM） was first recorded in Huangdi’s Internal Classic （Huang Di Nei Jing）. As the understanding of CHD and cognitive dysfunction is deepening， the influences of stasis and toxin on both diseases have attracted increasing attention. According to the theories of TCM， CHD and cognitive dysfunction have common points in the etiology and pathogenesis. Therefore， the theory of treating different diseases with same method provides a theoretical basis for the clinical treatment of different diseases with the same pathogenesis. Moreover， this theory conforms to the principle of integrated and individualized prevention and treatment of multi-disease coexistence in modern medicine. This paper systematically proposed that the coexistence of stasis and toxin is a major pathogenesis of CHD and cognitive dysfunction. We then explored the possible mechanisms of the blood-activating and toxin-removing method in the treatment of CHD and cognitive dysfunction based on the theory of treating different diseases with same method. The mechanisms include the regulation of ceramide metabolism， activation of silent mating-type information regulation 2 homolog 1 （SIRT1）， inhibition of pyroptosis， regulation of mitogen-activated protein kinase/nuclear factor-κB （MAPK/NF-κB） signaling pathway， inhibition of mitochondrial division， and regulation of DNA methylation. We hope this paper will provide an idea for the future research on the prevention and treatment of CHD and cognitive dysfunction with TCM.
ABSTRACT
Cognitive impairment secondary to cardiovascular disease is a common complication in the elderly population， which seriously threatens the health of patients and affects the long-term quality of life. Cardiovascular diseases can lead to vascular endothelial injury， cerebral hypoperfusion， and brain lesions， and then cause cognitive impairment. Cardiovascular risk factors also increase the risk of secondary cognitive impairment in patients. It is particularly important to seek for early diagnosis and traditional Chinese medicine （TCM） and western medicine prevention and treatment. Based on the "holistic concept"， TCM puts forward the theory of "the connection of heart and brain". The heart and brain are connected and both are in charge of mental activities. Heart injury affects the brain， resulting in abnormal consciousness， which is considered to be the pathogenesis of cognitive impairment secondary to cardiovascular disease in TCM. Later generations of doctors propose the theory of "simultaneous treatment of the heart and the brain" on the basis of "treating different diseases with the same treatment" and "the connection of heart and brain". The theory contains two meanings. One is that different diseases can be treated by the same method because of the same etiology and pathogenesis. The other is the coexistence of different diseases and the treatment should be targeted to the same risk factors. This paper systematically discussed the TCM pathogenesis of cognitive impairment secondary to cardiovascular disease and the prevention and treatment strategy of "simultaneous treatment of the heart and the brain". In this paper， the deficiency of qi and blood was the foundation， and the interaction of blood stasis and poison and the obstruction of the pulse and the loss of the body were the key factors. Activating blood， detoxifying arteries， and connecting the orifices were the main treatment method for the disease. This paper is expected to enrich the connotation of "simultaneous treatment of the heart and the brain"， and provide new ideas for the prevention and treatment of cognitive impairment secondary to the cardiovascular disease with TCM.
ABSTRACT
The high morbidity and fatality rates of cardiovascular and cerebrovascular diseases seriously harm human health，greatly affect the quality of life and increase the burden of disease. Thus， more and more attention has been paid to the relationship between heart and brain. "Simultaneous treatment of heart and brain" is the continuous deepening and development of the theory of "simultaneous treatment of different diseases" in traditional Chinese medicine （TCM）， and exploring the relationship between heart and brain as well as the current situation of Chinese medicine treatment has important clinical significance for the establishment of integrated traditional Chinese and western medicine diagnosis and treatment programs of cardiovascular and cerebrovascular diseases. Through a systematic theoretical tracing of the "simultaneous treatment of heart and brain"，the authors held that cardiovascular and cerebrovascular diseases had the same origin，and that heart and brain took blood as the material basis and governed mind jointly. They also expounded the modern biological relationship of the simultaneous treatment of heart and brain. In other words，the pathogenic factors of cardiovascular and cerebrovascular diseases were the same， with complicated comorbidities， and the disorders of neurohumoral reflex and endocrine system and immune system regulation could affect each other's function. Additionally，the present situation of clinical application of Chinese medicine for simultaneous treatment of heart and brain and its intervention effect on cardiovascular and cerebrovascular diseases were discussed. It was found that these Chinese medicines could protect cardiovascular and cerebrovascular diseases through multi-target，multi-pathway and multi-link regulation. Combined with the existing problems in the current research，the authors thought and looked forward to the practical strategies of treating cardiovascular and cerebrovascular diseases with Chinese medicine by paying attention to key groups，focusing on dominant diseases，giving full play to the value of Chinese medicine，and scientifically explaining the connotation of simultaneous treatment of heart and brain， in order to provide ideas and reference for the follow-up transformation application research and better guidance of clinical practice.