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 brain and heart has a tight relationship upon physiology and pathology during the development of cardiovascular and cerebrovascular diseases with clinical conditions interacting with each other and complex pathological mechanisms. Clinical studies prove that cerebral diseases such as stroke usually happen with cardiac diseases as complications， and cardiac diseases such as atrial fibrillation can also cause cerebral diseases， which can even aggravate brain atrophy and lead to cognitive impairment. Traditional Chinese medicine （TCM） also believes that “the substance of Shenming is located in the brain and the function in the heart.” Specifically， Yuanshen is in the brain and Shishen is in the heart， which thus makes the heart and brain closely related. If Shenming in any of them is impaired， the other one would also be injured. Therefore， the pathological mechanisms of brain-heart mutual damage have become one of the current research hotspots. This paper， combined with the clinical research status of the brain-heart mutual damage， summarized its pathological mechanisms from the perspectives of inflammatory responses， dysregulation of autonomic nervous system， apoptosis， energy metabolism and oxidative stress. The necessity of “brain-heart concurrent regulation” was proposed and the research progress on the treatment of cerebral and cardiac diseases with TCM represented by Naoxintong capsule was profiled in the light of heart and brain function described by TCM and the holistic concept of TCM treating cerebral and cardiac diseases. This paper reviews the pathological mechanisms of brain-heart mutual damage and the research progress on its treatment with TCM， which can provide reference for the prevention and treatment of cardiovascular and cerebrovascular diseases and further research on them.
ABSTRACT
Depression is a serious threat to human health. There are grave difficulties in its prevention and treatment. At present, Western medicine has not yet found a definitive and effective therapy for depression. By virtue of its holistic view, rich clinical practice plus less side effects, traditional Chinese medicine(TCM) may have potential advantages in the prevention and treatment of depression. Single-herbal TCM or TCM compound is one of the main methods for TCM to treat depression. The chemical composition of natural medicine is quite complicated, moreover, the composition of TCM compound is more complicated. Therefore, this paper focuses on the role of single-herbal TCM in preventing and treating depression. Many researchers have discovered more TCM with the effect in preventing depression from historical literatures or clinical experience of different doctors. There are four main causes in the pathogenesis of depression: the first is the abnormal expression of monoamine neurotransmitters and their receptors, the second is the depression of nerve cells and relevant signaling pathways, the third is the hypothalamus-pituitary-adrenal axis that continuously intensifies to cause dysfunction and depression, and the fourth is the abnormal secretion of cytokines. Which mechanism does TCM work through? The meridian tropism theory is an important guiding principle in the clinical use of TCM. Is there a certain relationship between the different meridian tropisms and different pharmacological mechanisms of TCM? To solve these two basic problems, this paper systematically summarizes all the literatures on the mechanism of TCM in the prevention and treatment of depression, and uses the chi-square test to analyze the relationship between the TCM and the four mechanisms of action. This exploration may contribute to further clinical and experimental research on the prevention and treatment of depression with TCM.