Blood stasis

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Blood stasis (also blood stagnation and blood stasis syndrome) (BS) is a concept in traditional Chinese medicine (TCM), described as a slowing or pooling of the blood due to a disruption of heart qi. Blood stasis is also described by practitioners of TCM in terms of yin deficiency, qi deficiency and qi stagnation. For non-practitioners of TCM it is sometimes explained in terms of hematological disorders such as hemorrhage, congestion, thrombosis or local ischemia, and in terms of tissue changes. TCM practitioners believe it is an important underlying pathology of many disease processes [1] despite the fact that objective, consistent methods for measuring the presence of blood stasis syndrome are not readily available. [2] Blood stasis is associated with justifications for acupuncture and herbal treatments. [3]

Contents

History

Practitioners of TCM believe that descriptions of BS can be traced back to the Inner Canon of Huangdi (about 200 B.C.E. in China) [4] and understanding of it evolved with the practice of traditional East Asia medicine (TEAM), however there were no standard diagnostic criteria until the 1980s. [2] Despite this the diagnosis of BS was applied to both chronic internal diseases and external injuries with treatment involving "activating blood circulation to dissipate blood stasis." [5] [6]

Standard diagnostic criteria for BS were first established in 1982 in China [7] by the Specialized Committee of "activating blood circulation" and in Japan by Terasawa et al in 1983. [6] These criteria were revised in 1988 in China with the "diagnostic criteria of Blood-stasis symptom-complex" [8] and Terasawa revised the diagnostic criteria in Japan in 1989. [9]

Since 1989 research conducted by TCM practitioners on BS and its treatment has increased [2] and some of this research has shown correlations between BS and abnormal coagulation function, [10] inflammation, [11] and accelerated red blood cell senescence. [12] This increase in research has also highlighted the inconsistencies of BS diagnostic criteria. [13]

Amongst practitioners of TCM and related fields covered by the general term traditional East Asia medicine (TEAM) there is a large body of research on blood stasis. [14] A survey conducted in 2014 amongst practitioners of traditional Korean medicine found that more than half of the respondents still had difficulties with the diagnosis of BS because "objective measurement methods were not readily available" [2] despite, or perhaps because, the diagnostic criteria for BS is regularly revised. [15]

East Asian nations encourage and reward the use of TCM for all ailments[ citation needed ], including COVID-19. [16] [17] As an example, pharmacologist Li Lianda received a National Science and Technology Progress Award in 2018 from the People's Republic of China for his work on the scientific explanation of BS and the basic laws and mechanism of action of "activating blood circulation and removing blood stasis". [18]

Criticism

Blood stasis, as defined within TCM, is a pseudo-scientific concept and uses other pseudo-scientific or mystical concepts such as qi, meridians, acupuncture, yin and yang as part of its description. The concept of BS is also based on incorrect knowledge regarding human physiology, in particular the liver. "The Liver stores Blood ... when a person moves, Blood goes to the channels, when at rest it goes to the Liver" [19] and "Blood volume problems indirectly influences our resistance to external pathogenic factors. If this Liver function is normal, the skin and muscles will be well nourished by Blood and be able to resist attacks of exterior pathogenic factors." [19] Mark Crislip, infectious disease doctor, referred to these quotes as "gibberish" in a 2015 Science-Based Medicine article. [20]

Crislip also mentions that "Many researchers are trying to shoehorn BS into vascular diseases such as angina [21] and lipid [22] disorders." He referred to the characteristic symptoms of BS "such as pain in a fixed position, nyctalgia, dark-purple coloring of the tongue or face, infraorbital darkness, sublingual varicosis, blood spots under the skin or tongue, or an astringent pulse" and the attempt to link BS with conditions such as "ischemic heart disease, cerebral vascular accident, diabetes mellitus, chronic gastritis, chronic renal failure, chronic hepatitis, trauma, and dysmenorrhea" as nonsense. He stated that:

"Like so much of the TCPM research, time and money is being devoted to validate with modernity BS concepts that are fundamentally grounded in fantasy." [20]

Purported mechanism of action

In TCM, the spleen and kidneys govern the movement and transformation of qi and fluid and these organs cooperate with each other to participate in the metabolism of water. A functional disorder of the spleen or kidneys would lead to qi stagnation and blood stasis.

Some causes of blood stasis are believed to include: too little nutrients, too much sugar, too little sleep, too much alcohol, lack of movement, too much movement (over-training), emotional stress, trauma, heat in the body, and cold in the body. [3] Recommendations to improve blood flow include not eating while stressed, not eating too fast, breathing, focusing on gratitude while eating, not overeating, avoiding cold foods, avoiding damp foods (peanuts, soy and dairy), eating more of eggplants, cayenne, garlic, ginger, turmeric, shiitake, saffron, vinegar, etc. [3] Treatments include acupuncture, cupping, electrical acupuncture and herbal remedies. [3]

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References

  1. ↑ Bensky, Dan; Gamble, Andrew; Kaptchuk, Ted J. (1986). Chinese herbal medicine : materia medica (translated ed.). Seattle: Eastland Press. pp. 265–266. ISBN   978-0-939616-03-9. OCLC   14168397.
  2. 1 2 3 4 Park, B; Yun, KJ; Jung, J; You, S; Lee, JA; Choi, J; Kang, BK; Alraek, T; Birch, S; Lee, MS (2014). "Conceptualization and utilization of blood stasis syndrome among doctors of Korean medicine: results of a web-based survey". American Journal of Translational Research. 6 (6): 857–868. ISSN   1943-8141. PMC   4297353 . PMID   25628796.
  3. 1 2 3 4 "I Was Told I Have Blood Stasis. What Does That Mean? | Regionally Accredited Acupuncture" (PDF). AOMA Graduate School of Integrative Medicine. Retrieved 4 March 2022.
  4. ↑ Liao, Jiangquan; Wang, Jie; Liu, Yongmei; Li, Jun; Duan, Lian; Chen, Guang; Hu, Junyuan (2016). "Modern researches on Blood Stasis syndrome 1989–2015". Medicine. Ovid Technologies (Wolters Kluwer Health). 95 (49): e5533. doi:10.1097/md.0000000000005533. ISSN   0025-7974. PMC   5266019 . PMID   27930547.
  5. ↑ Chen, Ke-ji (2012). "Blood stasis syndrome and its treatment with activating blood circulation to remove blood stasis therapy". Chinese Journal of Integrative Medicine. Springer Science and Business Media LLC. 18 (12): 891–896. doi:10.1007/s11655-012-1291-5. ISSN   1672-0415. PMID   23238996. S2CID   40248520.
  6. 1 2 TERASAWA, Katsutoshi; SHINODA, Hiroyuki; IMADAYA, Akira; TOSA, Hiroyori; BANDOH, Miyuki; SATOH, Nobuhiko (1983). "The Presentation of Diagnostic Criteria for "Oketsu" syndrome". Kampo Medicine. Japan Society for Oriental Medicine. 34 (1): 1–17. doi: 10.3937/kampomed.34.1 . ISSN   0287-4857.
  7. ↑ "The First Term Conference of Chinese Association of Integrated Traditional and Western Medicine. Tentative diagnostic criterion for BSS". Chin J Integr Tradit West Med (in Chinese). 3. 1983.
  8. ↑ Wang, J; Chen, RJ (1988). "[Research on the diagnostic criteria of the blood-stasis symptom-complex]". Chinese Journal of Modern Developments in Traditional Medicine (in Chinese). 8 (10): 585–587, 589–590. ISSN   0254-9034. PMID   3255534.
  9. ↑ Terasawa, K. (1989). "The presentation of diagnostic criteria for "Yu-xie" (stagnated blood) conformation". Int J Oriental Med (in Chinese). 14: 194–213.
  10. ↑ Liu, Yue; Yin, Hui-Jun; Shi, Da-zhuo; Chen, Ke-ji (2012). "Chinese Herb and Formulas for Promoting Blood Circulation and Removing Blood Stasis and Antiplatelet Therapies". Evidence-Based Complementary and Alternative Medicine. Hindawi Limited. 2012: 1–8. doi: 10.1155/2012/184503 . ISSN   1741-427X. PMC   3292253 . PMID   22454656.
  11. ↑ Bi-qiong, Shen; Yi, Situ; Jian-ling, Huang; Xiao-mei, Su; Wei-tang, He; Mao-wei, Zhang; Qu-bo, Chen (2005). "A clinical study on the treatment of chronic pelvic inflammation of Qi-stagnation with blood stasis syndrome by Penyanqing Capsule". Chinese Journal of Integrative Medicine. Springer Science and Business Media LLC. 11 (4): 249–254. doi:10.1007/bf02835784. ISSN   1672-0415. PMID   16417773. S2CID   72015359.
  12. ↑ You, S; Park, B; Lee, MS (2015). "Accelerated RBC senescence as a novel pathologic mechanism of blood stasis syndrome in traditional East Asian medicine". American Journal of Translational Research. 7 (3): 422–429. ISSN   1943-8141. PMC   4448184 . PMID   26045884.
  13. ↑ Choi, Tae-Young; Jun, Ji Hee; Park, Bongki; Lee, Ju Ah; You, Sooseong; Jung, Jeeyoun; Lee, Myeong Soo (2016). "Concept of blood stasis in Chinese medical textbooks: A systematic review". European Journal of Integrative Medicine. Elsevier BV. 8 (3): 158–164. doi:10.1016/j.eujim.2015.09.137. ISSN   1876-3820.
  14. ↑ "Blood stasis - an overview | ScienceDirect Topics". Elsevier B.V. 2022. Retrieved 4 March 2022.
  15. ↑ Xu, Hao; Chen, Ke-ji (5 December 2016). "Practical diagnostic criterion of blood stasis syndrome". Chinese Journal of Integrative Medicine. Springer Science and Business Media LLC. 23 (4): 243–244. doi:10.1007/s11655-016-2400-x. ISSN   1672-0415. PMID   27921194. S2CID   3543008.
  16. ↑ Jakhar, Pratik (28 June 2020). "Covid-19: China pushes traditional remedies amid outbreak". BBC News. Retrieved 4 March 2022.
  17. ↑ Kumar, Sanjay (2000). "India's government promotes traditional healing practices". The Lancet. Elsevier BV. 355 (9211): 1252. doi:10.1016/s0140-6736(05)74695-x. ISSN   0140-6736. S2CID   54246061.
  18. ↑ "中药药理学家李连达院士逝世" [Academician Li Lianda, a Chinese medicine pharmacologist, passed away]. Sciencenet.cn (in Chinese). 18 October 2018. Retrieved 3 March 2022.
  19. 1 2 Dragon, Victoria. "All About Blood Stagnation". Acupuncture.Com. Archived from the original on 26 January 2021. Retrieved 4 March 2022.
  20. 1 2 Crislip, Mark (13 November 2015). "Acupuncture/TCPM Crapfest". Science-Based Medicine. Retrieved 4 March 2022.
  21. ↑ Qian, W; Zhao, FH; Shi, DZ; Wu, W; You, SJ (2013). "[Association study between Chinese medicine blood stasis syndrome and TIMI risk stratification of patients with unstable angina pectoris]". Zhongguo Zhong Xi Yi Jie He Za Zhi Zhongguo Zhongxiyi Jiehe Zazhi = Chinese Journal of Integrated Traditional and Western Medicine (in Chinese). 33 (8): 1042–1045. ISSN   1003-5370. PMID   24325050.
  22. ↑ Zhang, L; Zhang, Q; You, Y; Zhou, MX; Wang, LH; Chen, HB; Yan, XZ; Liu, XZ; Liu, WH (2015). "[Investigation of Evolution Rules of Phlegm and Blood Stasis Syndrome in Hyperlipidemia and Ath- erosclerosis by NMR-based Metabolic Profiling and Metabonomic Approaches]". Zhongguo Zhong Xi Yi Jie He Za Zhi Zhongguo Zhongxiyi Jiehe Zazhi = Chinese Journal of Integrated Traditional and Western Medicine (in Chinese). 35 (7): 823–833. ISSN   1003-5370. PMID   26380446.
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