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Cilj tega članka je preiskava hiperholesterolemije z vidika kitajske medicine in vzpostavitev primerne strategije zdravljenja z zeliščno medicino in akupunkturo.
Ozadje konvencionalne medicine o holesterolu
Grobo gledano, ena četrtina holesterola v telesu izvira iz zaužite hrane, ostalo pa se ustvari v jetrih in drugih celicah. Holesterol je vitalna sestavina v celični membrani, telo ga uporablja za oblikovanje steroidnih hormonov, vitamina D in žolčne kisline, prav tako pa služi telesu kot prenašalec ostalih maščob v kri. Holesterol, kot ostale maščobe v krvi, ni topen. V kri se transportira z lipoproteini, ti pa nastopajo v dveh oblikah: lipoproteini z nizko gostoto (LDL), poznan tudi kot ‘slab holesterol’, in lipoproteini z visoko gostoto (HDL), poznan tudi kot ‘dober holesterol’.
Hiperholesteremija ima dva vzroka:
Primarni (genetičen): lastna prekomerna proizvodnja v jetrih ali defektivno izločanje v celicah
Sekundarni: sedeč življenjski slog s prekomernim vnosom hrane z nasičenimi maščobami, holesterolom (iz živalskih izdelkov) in transmaščobnimi kislinami (običajno rabljene v številnih procesiranih živilih), debelost, sladkorna bolezen, odvisnost od alkohola, kronično propadanje ledvic, hipotirodizem, staranje, menopavza itd. Živila, ki so rastlinskega izvora, ne vsebujejo holesterola, vendar nekatere vsebujejo transmaščobe, ki lahko povzročijo intenzivnejšo telesno proizvodnjo holesterola. [Preberite si več o prehranskih nasvetih]
Visoka raven holesterola v krvi zvišuje tveganje za periferno in koronarno arterosklerozo, kar vodi do srčnega infarkta, kapi ali periferne arterijske bolezni. Kakorkoli, niso vse vrste povišanega holesterola tveganje za pojav teh bolezni. LDL naj bi zvišal tveganje, medtem ko naj bi ga HDL znižal. Odvečen LDL se lahko kopiči v stenah žil, kjer se oksidira in spremeni na druge načine. Spremenjene komponenete nato spodbujajo vnetni odziv, ki progresivno in nevarno spremeni arterije, kar vodi do izoblikovanja arterosklerotičnih plakov.
Pogled tradicionalne kitajske medicine na visoko raven holesterola
V Su Wen-u (poznan kot Osnovna vprašanja - TKM klasika) piše: ‘’Bolezni, podobne diabetesu, s simptomi notranje vročine, nenadne omedlevice, hemiflegije, ošibljenimi in hladnimi okončinami, polnostjo energije, kar povzroči pritisk v smeri navzgor - to so simptomi bogatega prebivalstva, ki imajo navado uživati mastno in z okusom bogato hrano.’’
Torej opazno je, da že iz časa Su Wena izvirajo prvi dokazi škode, ki je danes povezana s holesterolom. Su Wen govori o bolezni, ki je povezana s prehrano in ne s holesterolom samim, saj kitajska medicina raje ohranja kvalitativen pristop kot pa kvantitativnega. Poudarek je na simptomih in znakih, ki jih opiše pacient, nato pa se na podlagi le-teh sestavi klinična slika, iz katere se nato izpeljeta diagnoza in zdravljenje. Glede na dejstvo, da visoka raven holesterola v osebi ne sproža nikakršnih znakov in simptomov, lahko pravimo, da se s pomočjo orodij kitajske medicine ne more predpisati nobene diagnoze (ali zdravljenje).
Tako se zgodi, da se s pomočjo kitajske medicine diagnosticira in zdravi previsoko raven holesterola na dva načina. Prvi je popolna diagnoza pacientovega stanja in zdravljenje glede na katerikoli diagnosticirani vzorec, brez da bi upoštevali še holesterol. Ta pristop predvidi, da se skupaj s povrnitvijo pacienta v uravnovešeno stanje pojavi tudi izboljšanje v ravni holesterola v krvi. Drugi pristop je poskus analize pričakovane škode zaradi hiperholesterolemije in energetične narave holesterola ter formulacija zdravljenja, ki bo temu primerna.
V drugem delu članka bomo govorili o obvladovanju in raziskavi o holesterolu v pravem primeru s pomočjo TKM.
Vir: Journal of Chinese Medicine • številka 89 • februar 2009
https://pdfs.semanticscholar.org/ad2c/1a41990ce900fc5d70493b175b6221f35252.pdf
Cholesterol and Traditional Chinese Medicine: Part 1 of 2 introduction
The aim of this article is to examine hypercholesterolemia from the perspective of Chinese medicine and to establish a suitable treatment strategy with herbal medicine and acupuncture.
Conventional medicine background about Cholesterol
Roughly one quarter of cholesterol in the body comes from consumed food and the rest is created in the liver and other cells. Cholesterol is a vital component in the cell membrane, used for the formation of steroid hormones, vitamin D and bile acids, as well as for fat transfer into the blood. Cholesterol, like other fats in the blood, is not soluble. It is transported into the blood by lipoproteins of which there are two kinds: low density lipoprotein (LDL), also known as ‘bad cholesterol’, and high density lipoprotein (HDL), also known as ‘good cholesterol’.
Hypercholesteremia has two causes:
Primary (genetic): Self overproduction in the liver or defective clearance in cells.
Secondary: Sedentary lifestyle with excessive dietary intake of saturated fat, cholesterol (from animal products) and trans fatty acids (commonly used in many processed foods), obesity, diabetes mellitus, alcohol abuse, chronic renal failure, hypothyroidism, aging, menopause etc. Foods of vegetable origin do not contain cholesterol, but some of them contain trans-fats that can cause an intensified production of cholesterol by the body. [Read more about dietary advice]
High levels of cholesterol in the blood increase the risk of peripheral and coronary atherosclerosis, leading to myocardial infarction, stroke or peripheral artery disease. However, not all types of cholesterol increase the risk for those diseases. LDL is thought to increase risk while HDL reduces it. Excess LDL can accumulate within the vessel walls, where it becomes oxidised and altered in other ways. The altered components then incite an inflammatory response that progressively and dangerously changes the arteries leading to the creation of atherosclerotic plaques.
Traditional Chinese medicine point of view on high Cholesterol
The Su Wen (Plain Questions--- an ancient TCM classic) said: “Diabetes‑like disease with internal heat, sudden fainting, hemiplegia, weakened and cold limbs, fullness of energy causing upward pressure, are the symptoms of rich people who are in the habit of consuming greasy and rich flavoured foods.”
It can be seen, therefore, that as early as the Su Wen we can find the first evidence of the damage that is today connected to cholesterol. The Su Wen speaks here of diseases linked to nutrition and not to cholesterol itself because Chinese medicine holds a qualitative approach rather than a quantitative one.
Emphasis is put on the signs and symptoms that the patient presents, which are gathered to compose a clinical picture, from which a diagnosis and treatment are produced. Due to the fact that high levels of cholesterol in themselves do not produce any signs and symptoms, we might suggest that no diagnosis (or treatment) can be offered using Chinese medicine tools.
Thus, it appears that diagnosing and treating cholesterol according to Chinese medicine has to be undertaken in two ways. The first approach would make a complete diagnosis of the patient and treat him according to any pattern/s diagnosed, without taking into account the cholesterol. This approach assumes that alongside the return of the patient to a balanced state, an improvement will also occur in the level of cholesterol. The second approach is to try and analyse the expected damage due to hypercholesterolemia and the energetic nature of cholesterol, and to formulate a treatment suitable to these.
In the second part of the article, we will talk about the management and case study of cholesterol with TCM.
Source of information: Journal of Chinese Medicine • Number 89 • February 2009
https://pdfs.semanticscholar.org/ad2c/1a41990ce900fc5d70493b175b6221f35252.pdf