\High Blood Pressure - Chinese medicine can help
 

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高血压的中医治疗

Treatment of high blood pressure by Chinese medicine

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高血压的发病率愈来愈高,年龄也愈来愈小 。一旦被诊断为高血压,医生会要求你终身服药,否则,医生警告你,你会得中风,冠心病,肾衰等等。 高血压真的就这么难治,以至于需要终身服药吗?我们认为这种让病人终身服药的医学,只能说是医学的无能。服了一辈子降压药,一不服药血压就又会增高,而且最终还是得中风,或冠心病,或肾衰,那么这种终身服药的意义何在?

The incidence of high blood pressure (Hypertension) is higher and higher and the age of the sufferers is also younger and younger. Once being diagnosed as hypertension, doctors will ask and push you to take medicine for ever. Otherwise, they will warn you that you may get stroke, heart attack, kidney failure later in your life. Is this true that hypertension is so difficult to cure and we really need to take medicine, the artificial synthesized chemical tables for whole of our life?  If any medical system asks you to take their medicine for ever, it would mean that either they have not found the real reason for that disease, or they have no effective therapy for that disease yet, or both. People listened to them, taken the medicine for whole of life, but no one can guarantee the given person will not get stroke, coronary heart disease, neuropathy, or kidney failure due to the hypertension. What would be use to take these medicine for ever, yes, forever.   

人体血管里面的血压,是心脏的博出的血液向前运行过程中受到周围和前方的阻力所形成的。 如果前方阻力增大,比如说毛细血管收缩(如寒冷,疼痛,紧张焦虑时),周围组织(包括神经末端纤维)缺血缺氧,都会激活神经末端感受器,向大脑中枢传达信息,大脑则通过增强交感神经而降低副交感神经的活动,使得心跳加快,搏动增强,以增加血管内的血压,向周围组织供应更多的血液。这就是血压增高的基本过程。

The blood pressure inside the blood vessels is created due to the pumping force from the heart and the resistance in front of the blood movement (at the end of the artery). If the resistance in front of the blood movement is increased, such as upon cold, hungry, pain, stress, the micro blood vessels become contracted, so that the surrounding tissue get less supply of blood, oxygen, and nutrition. Such insufficiency condition triggers the end of nerves in the surrounding tissue, the nerves send signal to the brain, the brain sends directing signal to the heart to beat faster so as to supply more blood to the surrounding tissue. By this way, the blood pressure inside the blood vessels becomes higher than normal due to increased heart beat and increased resistance in the micro blood vessels in the surrounding tissue. Such mechanism ensures the body to supply sufficient blood to the most important organs in the body, such as heart and brain upon the stressful conditions. Apparently, this is a normal adjusting mechanism of blood supply by the body during stress or life crisis condition.    

人处于高度紧张状态时,比如焦虑烦躁压抑,也比如频繁性生活等等,交感神经紧张度增高,周围血管收缩以增加对于心脑肾这些重要器官的血液供应。如果这些刺激持续发生(这正是现代人的生活特征),长期处于收缩状态的血管就会变硬,导致血压持续性升高。

When a person is in stress, such as anxiety, depression, annoyed, or as too frequent sexual activities, the sympathetic nerve system becomes active to cause contract of small blood vessels, for the aim to supply more blood to the most important organs in the body, such as to the brain and heart. If such stressful stimulation continues and happens again and again, the blood vessels that are always under contracting condition, would become hard narrow, to cause continuous high blood pressure condition, which we give the medical term: hypertension.  

 以上的探讨是在血液循环的范畴。而实际上,还会有另外一种情况,就是说血液供应量是正常的,周围血管阻力并不大,但是,周围组织中的组织液过多,过与粘滞,使得血液经过毛细血管转入静脉的过程变缓和迟滞。这种现象可见于水肿,肥胖等。过多的组织液,过大的脂肪细胞,都可以一方面压迫毛细血管造成周围循环阻力增加,另一方面降低氧气,营养成分向细胞内的供氧而造成细胞能量代谢水平下降,细胞处于饥饿状态,向大脑发出求救信号,启动升高血压的机制。

The discussion above is for the blood circulation, in which the increased blood circulation resistance is due to small blood vessel spasm or contract or becomes narrowed. In fact, there could be some other conditions that can also cause increase in the circulation resistance. This means that the blood supply is normal, the blood vessel resistance is normal, but there are too much tissue fluid, or too sticky tissue fluid, such as too much lipids, sugar, or waste material from metabolism, or there are too much bigger fat cells, all of which increase the pressure in the tissue fluid (between the micro-arteries and micro-veins), so as to increase the blood circulation resistance in the tissue. The increased tissue resistance in one side, can trigger the blood pressure-increasing mechanism, and on the other side, also reduce the supply of oxygen and nutrition supply to cells. The energy metabolism inside the cells would be retarded and reduced. The hungry cells would then send signal to the brain asking for more blood supply, so as to increase the blood pressure.  

身体细胞处于饥饿状态,就如在糖尿病时的情况那样。糖尿病是由于细胞不能将血糖转运到细胞内进行氧化供能(由于胰岛素不能和细胞表面的胰岛素受体有效结合的原因),所以细胞缺糖缺能量,就会刺激大脑启动升高血压的机制而使得血压升高。这很可能就是糖尿病出现高血压的原因。如果这种情况属实,那么,现有的降血压的所有方式都是无效的和有害的,因为使用降压药都没有考虑到应该改善细胞缺能量的现实。

That a cell can be in a hungry condition can be seen in diabetes. Because insulin cannot bind to its reception on the cell membrane, blood sugar cannot come into the cells to create energy for cells to use. The hungry cells, including nerve cells, will then ask the body to start blood pressure mechanism to increase blood pressure. This might be the most possible reason for the high incidence of hypertension in the diabetes patients.

以此类推,肥胖病时细胞内脂肪代谢障碍,细胞缺能量,也会刺激机体升高血压的机制而导致高血压。

Similarly, in obesity, for the problem of fat metabolism inside the cells, the cells are in a hungry condition too, so as to stimulate the body to increase the blood supply to solve the hungry, though this is a wrong solution to the fat metabolism to solve the hungry of the cells. 

其它所有能使得细胞内缺血缺氧和能量代谢障碍的原因 (包括维生素缺乏等)都有可能造成高血压。由于细胞内能量代谢的过程复杂,步骤繁多,任何一个代谢过程中的节点出现障碍都有可能导致或糖代谢,或脂肪代谢,或蛋白质代谢的障碍,而使得细胞内能量不足,细胞感受器向大脑发出求救信号,都会使得血压升高。由于造成高血压的原因繁杂众多,所以,到现在为止,西医想找出原发性高血压的单一原因的努力是无效的。

Deduced from this theory, any reason that can cause energy metabolism inside the cells could trigger the blood-rising mechanism in the body. Because the energy metabolism inside the cells are very complex and have many steps and need many enzymes or vitamins to participate, it would then be easy to cause the incompletion of the energy metabolism.

如果组织缺血缺氧缺糖的现象没有通过机体反射性使得血压升高而得到改善,那么,来自于周围组织对于大脑的信号刺激就会持续存在,所以发自于大脑的,作用用心脏和周围血管的,让血压升高的信号也就会持续存在,这就是为什么一旦停服和少服降压药物,血压就会反弹,降压药就需要终身服用的原因 因为降压药并没有作用于血压升高的真正原因。

If the shortage of energy inside the cells continues and if this condition is not corrected by increase in the blood pressure, the signal from the surrounding tissue to the brain would continuously be there and the brain would also continuously send signals to the heart and blood vessels to increase blood pressure. This is why once we stop the take blood pressure tablets, the blood pressure would go up again and the blood pressure tablets have to be taken forever.

血压升高也可能是由于血容量过多,或血液粘滞度增加,或心脏输出量增加所致。如果为了减少血容量而应用利尿剂;为减少血液粘滞度(如高胆固醇血症,高脂肪血症,高血糖症,高纤维蛋白原血症等等)而采用降低胆固醇等的抗代谢药物;为了减少心输出量而用贝达受体抑制剂等,而没有着重解决这些现象后面的原因,血压的降低也就必然只是一时性的。因为增加血容量和心输出量本身就是人体提高血压的措施之一。

High blood pressure can also be due to too much circulating blood volume, highly sticky of blood (high viscosity), or due to high output of blood from heart. If we use diuretics to reduce blood volume, use lipido to reduce blood lipid content, use Beta reception blockers to suppress heart work, surely the blood pressure would be go down in such cases. However, if we do not solve the primary reason for the high blood volume, high blood viscosity, and high output of heart, similarly the blood pressure will go back high after we stop the use these medicine.   At least, this is because the increase in the blood volume and heart output is one of the mechanisms by which our body increases blood pressure, responding to the request by hungry cells.

所以,许多环节和障碍都有可能导致高血压。单纯的利尿,扩血管,抑制心功能等未必照顾到了这许多可能的原因。西医治疗高血压的历史早已经证明了目前这些治疗措施的无效 一旦停药,血压复高,说明治疗并没有治到点子上。结合高血压,肥胖,高血脂,高血糖的相关性之高,比如说,以糖尿病为例子,每十个II型糖尿病病人中就有八个有高血压。

有可能高血压的起始原因就在于细胞内能量代谢障碍上。如果是这样,就好理解为什么现在治疗高血压的措施不得力了。而现行的治疗糖尿病的措施可以降低血中的血糖,但是不能提高细胞内糖的分解利用,所以细胞仍然处于饥饿状态,高血压也就持续存在,而且糖尿病性周围血管疾病也就很难避免 尽管血糖被控制在所谓的正常水平范围内。

Thereforemany reasons can cause high blood pressure. The conventional use of diuretics, the vasodilators, the sympathetic nerve inhibitors, may not really work on the real reasons of the hypertension. This is evidence by the current results of anti-hypertension by conventional medicine – the blood pressure is still high after we stop the use of these medicines.

It is well known that there is high co-incidence between high blood lipids, blood sugar, obesity and the hypertension, as reported that eight out of ten type II diabetes in British has also hypertension. It is possible that the primary reasons for the high blood pressure in the obesity people or in diabetes patients are inside the cells. If this is true, it would be easier to understand why the current way to reduce hypertension in diabetes does not work properly – the current treatment of diabetes can reduce the blood sugar level but cannot improve the glucose metabolism inside the cells. So, the cells are still hungry for energy, though the blood sugar level has been reduced somehow outside of the cells and in the blood. Once the cells are still in hungry, they will continue asking the body to supply more blood to them, so that the higher blood pressure persists. This is why the diabetic neuropathy can still occur even if the blood sugar level is under control.   

 可以说,高血压是机体对于病理状态一种保护机制,就如同人体发热一样,许多原因都可以造成发热,并不能将发热当作一种病,而只能当作一个症状来治疗。和治疗发热不同的是,西医治疗发热比较容易,毕竟绝大多数发热的原因是感染,抗生素的发明使得细菌性感染的治疗比较容易了。就算是病毒感染,随着抗病过程中人体抵抗力提高,人体的淋巴细胞系统,单核细胞系统等也能将病毒清除掉,使发热现象消失。而升高血压的原因恐怕多和细胞内营养和能量的代谢障碍有关,这就不是人体能动用自己的力量就能解决的了的。比如说糖尿病导致的高血压,连糖尿病本身就没有办法治疗。

Now we know that to increase blood pressure is a kind of protective mechanism of our body. It is as a fever. Many reasons can cause a fever, so can hypertension. Fever is not a single disease, nor a hypertension. If a fever is very high, we need to reduce it but we have to also solve the reason that cause the fever, this is true to the hypertension. The difference between the fever and the high blood pressure is: the fever is relatively easier to solve, thanks to the development of antibiotics, which can solve most inflammation caused by bacteria. Hypertension however is not so easy to be solved, since, as we discussed above, the primary reasons for the hypertension is form the inside of the cells. It is due to damage of energy metabolism inside the cells. The hypertension cannot be cured without the cure of the disorder of the energy metabolism.

正由于导致高血压的原始原因,比如精神紧张,性生活频繁等等,都是我们现代人的生活方式,消除这种原始原因本身就已经超出了医学和医生的能力,而治疗继发的二级原因,比如说细胞内能量代谢障碍,目前仍然是西医医学的弱项,所以,高血压的根本治疗对于西医来说是不可能的,病人也就需要终身服药了。

Because some of the primary reasons for high blood pressure, such as stress and frequent sexual activities, are the ordinary life style or pattern of people, to stop such primary reasons is beyond the capacity of medicine or doctors. To treat the primary reasons, such as damage of energy metabolism inside the cells, is still the weakness of modern medicine. For this, to cure hypertension is very difficult or impossible by conventional medicine, so patients have to take medicine forever.  

这里所说的高血压也可能是由于周围组织液中阻力增加以及由于细胞内能量代谢低下,细胞饥饿所引起,并不是目前西医的主流看法。但是,我们可以参考I型糖尿病的临床现象,这种糖尿病的原因是由于体内胰岛细胞不能分泌足量的胰岛素,没有胰岛素,糖就不能分解为能量,细胞内就会出现饥饿,毕竟神经细胞主要是靠糖分解来提供能量的,神经细胞对于糖含量的下降非常敏感。这就如同平常人的饥饿,饥饿初期会心跳加快,血压升高,食欲亢进,心慌不安。这皆为交感神经兴奋的结果。只有到了极度饥饿,神经细胞内糖分耗尽,信号传递能力下降;心肌缺能力,心脏博出下降时,血压才会下降,出现低血糖反应。一旦补充胰岛素,初期的高血压反应和后期的低血压反应皆很快消失。

That the primary reasons for hypertension could be due to increase of resistance in the tissue fluid and due to damaged energy supply inside the cells is not the mainstream idea of conventional medicine yet. However, we can refer to type I diabetes, which is due to the lack of sufficient insulin in the body. The insulin works to make blood sugar transfer into the cells and promote the cells to break down the sugar to yield energy for the cell to use. Due to lack of insulin, the cells will be short of energy. The nerve cells are very sensitive since the nerve cells that mostly depend on the breakdown of sugar inside the cell to get energy. Upon lack of energy, the nerve cells will send signal to the brain, stimulate the heart beat and contract the blood vessels so as to increase blood pressure to increase blood supply to the cells. This is a time when the sympathetic nerves are activated. Only in the later time, after exhaust of the sympathetic nerves and the heart cells have no enough energy to supply its high speed beats, the heart output reduces, the blood pressure reduces. Once being supplied with insulin, either the activation of sympathetic nerves and the increased blood pressure would be quickly returned to normal.

临床上也可见糖尿病病人和肥胖者更容易出现高血压,也支持这一观点。

In clinic, the type II diabetes and obesity person are more tend to have hypertension, supporting our hypothesis.

这种高血压的原因的多样性在中医临床上表现的比较明显。中医治疗高血压并不固定几个单一的方剂,而是不同的人用不同的方剂治疗,能治疗高血压的方剂非常多,但是都并不将血压高作为治疗的目标,而是将人体其它疾病现象作为治疗目标。随着这些疾病的缓解,所伴随的高血压现象也自然得到了治愈。根本不需要终身服药。

That the multiple primary reasons for hypertension can been verified more clear in the practice of Chinese medicine.   Many herbal formula can be used to solve the high blood pressure, where as each herbal formula is suitable for use in each specific body condition. However, none of the herbal formula is designed or set up to treat the high blood pressure alone. When we use these herbal formula to treat other sick conditions, the high blood pressure is returned to normal level the same time. No need to continue the herbal formula to remain the blood pressure in the normal level.

 那么,中医是如何理解和治疗这所谓的高血压的呢?在这里,我们首先要声明,中医有不同的体系,也就是说,都是用草药治病,但是,不同的中医体系对于疾病的认识是不同的,那么对于疾病的治疗手段和草药的立法处方也就很不一样,自然疗效也就很不同了。我们在这里所介绍的中医体系,不是现行中医学院采用的教材中介绍的那种中医体系 (即脏腑辩证,五行辩证体系),而主要是现代中医教育体系中所忽略的和不甚重视的经方体系,即六经辩证体系。

Then, how the Traditional Chinese Medicine (TCM) understand the high blood pressure and to treat the hypertension?  Here we have to, first of all, tell you that there are different TCM systems or TCM styles. That means each system may have its own way to understand the reason of hypertension and use different herbal formula to solve the hypertension, so may the healing results.  The TCM system we talk about here is not the textbook TCM system, which applies Five-organ theory and Five-element theory for diagnosis, but the Six-Jing theory for the diagnosis, which is neglected or almost omitted from the current TCM education system.

中医教材体系将高血压分为肝阳上亢,肾阴不足,阴阳两虚,风痰痹阻和气血上逆等五个证型。其基本思路是,高血压是肝肾阴阳失调,阴虚而阳亢,起病在肝,根源在肾。处方原则为补肾阴而抑肝阳。从临床上看,这样的分型显得非常简单,根本不符合临床高血压病人的分布情况,也根本不能够指导对于那些不符合以上五种证型的病人的治疗,更不必说对于非常多的无症状的病人的治疗了。

In the textbook TCM system, the hypertension is classified into five major syndrome: the Liver Yang arising; Kidney Yin deficiency; Yin and Yang deficiency; Wind-phlegm block and the Qi and Blood uprising syndromes. The basic opinion for it for the hypertension is that the hypertension is the outcome of the Yin and Yang disorder in the Liver and the Kidney system. It is the Yin deficiency that causes the uprising of the Yang. The clinic manifestation shows the disorder in the Liver but the primary root of the disorder is in the Kidney. Based on such understanding of the hypertension, the formula they use is to nourish the Kidney Yin and suppress the Liver Yang.

Such classification appears very simple, easy to remember, however it does not match the actual clinic situation. There are so many patients with hypertension whose symptoms are hardly to be allocated into neither of the five syndromes, not to speak of those of hypertension persons who have almost no any symptoms.  

六经辩证将人体疾病分为六个阶段或叫作六种基本疾病类型,即太阳,少阳,阳明,太阴,少阴,和厥阴阶段。高血压可以表现为所有这些阶段,也就是说,所谓的高血压现象,可以出现在太阳,少阳,或阳明,或太阴,或少阴,或厥阴阶段;或表现为任何两个或三个复合的阶段。用治疗这些阶段的中药,解决了这些阶段的病,而高血压也就会消失。

The Six-jing diagnosis separate most of diseases into six steps, or six phrases, or six diseases. It is the Tai Yang Disease, Shao Yang disease, Yang Ming disease, Tai Yin disease, Shao Yin disease and the Jue Yin disease. The hypertension can be seen either of these six diseases. It means that the hypertension, in the eyes of the Six-jing system, could be a Tai Yang disease, a Shao Yang disease, ……. Or a Jue Yin disease, or the combination of either two or three of these diseases. Use the herbal formula to treat these diseases will also solve the hypertension the same time.  

当然,并不是说每一个阶段就只有一中药方。实际上,每一个阶段都有更具体的临床现象,需要不同的药物治疗。也就是说在六经辩证之后,需要作进一步的方证辩证。但是,常用于治疗这些和高血压有关的方剂也就是大约20 30 个。也就是说,如果测血压发现病人有持续性高血压,而不管是原发性还是所谓的继发性高血压 (包括颈椎病性高血压,肾源性高血压等),一般都按照六经辩证用药,目标并不是降压,而是治疗这六经之疾病。如果病人血压持续高,而又没有明显不舒服,脉和舌象也都没有明显异常,按照无症状高血压对待,以体质辩证为主用药治疗。这是我们治疗高血压的基本思路。

Of course, it does not mean that each TCM disease only needs one herbal formula for the treatment. Each TCM disease can be further more separated into more detail into subgroups. Each subgroup needs more specific herbal formula for the treatment. This means, after verify the major six TCM diseases, we still need to which more specific herbal formula should be used for the treatment. However, the most commonly used herbal formula is between 20 to 30. This means, once we found that the person have continuous high level of blood pressure, no matter it is primary of secondary hypertension, we will make a TCM Six-jing diagnosis. The aim is not to treat the hypertension, but the TCM-diagnosed disease. If the person has continuous high level of blood pressure, but no any clinic symptoms or any evidence from the pulse or tongue, we use body constitution diagnosis (see below). This is our basic consideration for the treatment of hypertension.

由于六经中任何一经的病都有可能伴随高血压,可以说高血压是人体内生命之气流动循环过程中受到了障碍,因为这一点也是人体疾病现象的本质之一。而这所谓的气之循环,生成和消耗的全过程,体内几乎所有的脏器都参与着,并不仅仅属于肾和肝。从脾之运化,肺之肃降,肾之收藏,肝之生发,心之鼓动温煦 (温煦脾和肾),全过程中的任何一环节的障碍都会导致气行不顺而血压升高。而这种障碍的发生必然是人体脏器功能下降,才使得气行发生了障碍。所以,应该考虑高血压是体内的虚和淤滞。

Because the high blood pressure can be seen in any of the TCM diseases, it can be said that the reason for the high blood pressure is a block on the way of the body Qi circulation, which is the nature of a TCM disease. The orientation, the circulation and the completion of the Qi circulation in the body need all the body organs to participate, not only based on the work of the Kidney and the Liver. Either reduced production of the QI, or a block during the Qi circulation, or both, can cause a High blood circulation. The primary reason for the high blood pressure is the weak and the block in the body.

这里的虚可以发生在五脏中任何一脏或多脏,可以是气虚,血虚,阴虚或阳虚。这种淤滞可以是气郁,火郁,痰凝,寒凝,水储,湿滞。所以高血压的基本病理原因和特点是多样性的,而不仅仅是肾虚肝阳上亢那么简单。高血压的复杂性和治疗方剂的多样性在经方治疗高血压的实践中表现的淋漓至尽。

Here, the weakness can occur in any organ, the Liver, the Heart, the Spleen, the Lung or the Kidney (all of these are TCM concept, not the anatomic concept). It can be a Qi deficiency, a Blood deficiency, a Yin deficiency or a Yang deficiency, or the combination of them. The block can be a Qi stagnation, Blood stagnation, Fire accumulation, a Phlegm, a water, a dampness accumulation, or a combination of them. Therefore, the primary reason for a high blood pressure in the body is very multiple and complex, not just related to the Liver and Kidney.

气郁,火郁,寒凝,痰凝等病理产物不见得就一定是全身性的积滞才能引起高血压。局部的积滞也可以影响局部气行而导致血压升高,就如同局部的疼痛也会使得血压升高一样。那么,用草药疗法消除了这些积滞,也就消除了刺激血压升高的原因,血压也就会下降。相反,在西医来说,将高血压看作是全身性的病理现象,而利尿剂,血管扩张剂,beta 阻滞剂等等都是作用于全身的药物,难免会造成众多副作用了。

In addition, such block does not need to be accumulated in the whole body. A local block can also cause the body to start a blood pressure-increasing reaction, just as a local pain can activate an blood pressure-increasing reaction. To remove such block (by the use of herbal therapy) to remove the stimulation, the blood pressure would come down to normal level. On the other side, the conventional medicine regards the hypertension a whole body disease. The use of diuretic, the vasodilator, the beta-receptor blockers, etc, all work on the whole body. No wonder they could create lots of side effect.

一般来说,如果病人头痛,头昏脑涨,头脑不清,后项或后背出僵紧不适,怕冷汗少,体质较强壮,脉浮或不弱,我们多考虑用麻黄系列汤剂,比如说麻黄杏仁石膏甘草汤;葛根汤,麻黄桂枝各半汤,小青龙汤,大青龙汤,等等。

Generally speaking, if the patient feels headache, dizziness, cloudy mind, tightness on the neck and back, feels cold, has no sweat, has floating pulse, and the body is strong, we use herbal formula that contains herb Ma Huang, such as Ma Huang Xing Ren Shi Gao Gan Cao Tang; Ge Gen Tang, Ma Huang Gui ZHi Ge Ban Tang, Xiao Qing Long Tang, Da Qing Long Tang, etc.

如果病人体质较弱,容易出汗,脉浮,常容易过敏,或有过敏性鼻炎等,我们用桂枝系列汤剂,比如说桂枝汤,桂枝加附子汤,或桂枝附子汤,或桂枝龙骨牡蛎汤等。

If the patient is weak in the body constitution, easy to have sweat, has floating pulse, easy to have allergy, or has allergic rhinitis, we use herbal formula that contains herb Gui Zhi, such as Gui Zhi Tang, Gui Zhi Jia Fu Zi Tang, Gui Zhi Fu Zi Tang, or Gui Zhi Long Gu Mu Li Tang, etc.

现在许多中医医生受西医影响不敢用含有麻黄的方剂治疗高血压,因为单味麻黄的药理研究表明麻黄会导致心跳加快,血压升高。其实,问题不在于是否在高血压时能不能用含有麻黄的方剂,而在于中医的辩证是否正确和方剂中是否有避免麻黄副作用的其它草药成分而使得整个方剂本身是安全的。就如同用葛根汤治疗高血压,或用麻杏薏甘汤治疗高血压,由于方子中有葛根或石膏,麻黄的升压作用就变得不重要了。我们必须整体看待药物进入人体后对人体的作用,而不是看单味药的作用。否则,中医就变成了西医,使得需要用这类方剂治疗的高血压变成了不治之症,需要终生服西药,反而还要责备中医不能治疗高血压。

Nowadays, many TCM doctor dare not to use herbal formula than contains herb Ma Huang, for fear that the herb Ma Huang may speed up heart beat and to increase blood pressure. Actually, this worry is not necessary. It does not mean that the herb Ma Huang is absolutely forbidden to use when a person has high level of blood pressure, but means that if the formula contains some other herbal ingredients that could counteract the side effect of the herb Ma Huang. For example in the formula Ge Gen Tang, it contains herb Ge Gen and in formula Ma Xing Shi Gan Tang that contains Shi Gao, but both are well used in person with hypertension. We should pay more attention to the overall effect of a herbal formula inside the body, not the effect of a herb when it is used alone. If we do not consider things as such, we TCM becomes the same as the conventional medicine, which pays more attention to the effect of each single ingredient in a tablet. Also, if we practice TCM as such, the success rate for the treatment of hypertension would be much low and the hypertension becomes incurable in the hands of TCM. The TCM would be blamed unable to solve hypertension.

不可否认,用了这些药物后,血压有可能会一过性升高,甚至会出现烦躁,或流鼻血等反应,但是这些都是机体动员了体内的抵抗力量,开始抗病的反应。一旦用药后出汗,诸症皆失,包括升高的血压。如果我们想真正的治愈高血压,就必须明白血压真正下降到正常和能保持正常之前的机体反应方式而不必对此惊慌。相比于西医降压药的副作用,这种中医治疗的一过性的反应就应该被理解和接受。

No doubt, after use of some herbs, the body blood pressure might be increased shortly and the person may feel kind of annoyed or anxiety, or even has nose bleeding. All of those reactions belong to anti-disease reaction, which has been described in TCM books and verified in clinic too. Once the person has sweat after the drink of the herbal tea, all the symptoms would subside, including the temperately increased blood pressure. We must bear this concept in mind that the body blood pressure might be higher for a short time, before it turns into normal after the herbal treatment.  TCM doctors do not need to worry it and explain to their patients. This is pretty much as the “healing crisis” that we can see during the acupuncture treatment of pain. After acupuncture, the pain might becomes worse, but after half day to one day, the pain would however subside dramatically. Compared to the side effects from conventional drugs and the need of life-long medicine intake of these drugs, such herbal reaction should be much more acceptable.

这类麻黄或桂枝汤类方对于治疗寒邪束表或营卫不和的高血压类型有较好的治疗效果。特别是桂枝类方治疗营卫不和的思路有可能对于治疗II 型糖尿病有很好的借鉴作用,因为糖尿病也可以看作为细胞内和细胞外糖的转运障碍,而桂枝汤本身就是治疗能量在血管内和血管外(即组织液)之间的转运障碍的很好的方剂呢。

It works very good for such herbal formula that contain either Ma Huang or Gui  Zhi or both, if the increased blood pressure is due to the Cold bound over the body surface, or due to the disharmony of the Yin and Wei in the body (Yin means nourishing Qi inside the blood, and the Wei means the defense Qi outside the blood). That the Gui Zhi Tang works to correct the disharmony of Yin and Wei is worthwhile to be considered in the treatment of diabetes, in which the problem is the imbalance of sugar in and out of the cells.

The above conditions belong to Tai Yang disease of TCM.

如果病人处于少阳病阶段,比如寒热往来,口苦咽干目眩,两耳无所闻,两肋下胀满不适,心烦易呕,咽喉不利等,我们会考虑用柴胡类方剂,比如小柴胡汤,柴胡龙骨牡蛎汤,柴胡桂枝汤,柴胡桂枝干姜汤,甚至大柴胡汤等等。我们也可能根据情况用逍遥散,加味逍遥散,柴胡疏肝散等等。对于肥胖,大腹便便的人,用大柴胡汤治疗高血压的机率非常高。

If the person is in Shao Yang stage (has Shao Yang disease), he/she may have shifting cold and hot feeling, bitter taste in mouth, dry throat, dizziness or blurring vision, block feeling in ears, bloating feelin in upper-and-side of abdomen, annoyed and anxiety, coarse throat feeling, we will consider the use of herbal formula that contains herb Chai Hu, such as Xiao Chai Hu Tang, Chai Hu Long Gu Mu Li Tang, Chai Hu Gui Zhi Tang, Chai Hu Gui Zhi Gan Jiang Tang, even Da Chai Hu Tang.  We may also use herbal formula Xiao Yao San, Jia Wei Xiao Yao San, Chai Hu Shu Gan San, etc. For person with obesity and bigger abdomen, the chance to use the Da Chai Hu Tang is very high.  

如果病情为阳明病阶段,可以是阳明经证,也可以表现为阳明腑证。经证者, 身热汗出,烦躁不安,可以白虎汤;口渴疲乏明显者,用竹叶石膏汤。患者三焦积热,眼目赤肿,口舌生疮,外证疮疡,心胸烦闷,大便秘结;胸中烦热痞满,舌苔黄腻,脉数实者,用三黄泻心汤,身冷者,用附子泻心汤。仅仅为胸闷心烦身热者,考虑用栀子豉汤系列。

If the person has the TCM Yang Ming disease, the disease can be either in the Jing stage or a organ stage. For the Yang Ming Jing stage, the person feels hot, has sweat, feels anxiety, dry mouth and likes to drink cold water, we use Bai Hu Tang. If the thirsty is very strong and the person feels low physical energy, we consider Zhu Ye Shi Gao Tang.

If the person is hot, has red and swelling in eyes, ulcer in mouth, fresh red skin rash, anxiety and annoyed, constipation, fullness and bloating feeling in the chest, yellow tongue covering, fast and strong pulse, use San Huang Xie Xin Tang. For such person, if feels cold in the body, use Fu Zi Xie Xin Tang.

If the person feels mostly annoyed and hot inside the chest, we may use Zhi Zi Chi Tang.  

阳明腑证者,患者腹部胀满痛,压之痛,数日不大便,我们会根据病情选用小承气汤,大承气汤,或调胃承气汤。胃肠道一通,高的血压即下降至正常。

For Yang Ming Organ stage, the person feels bloating and fullness in abdomen, which feels painful upon press, no bowel movement for several days, we may consider the use of Xiao Cheng Qi Tang, Da Cheng Qi Tang, or Tiao Wei Cheng Qi Tang. Once the stomach and intestine are opened to pass, the increased blood pressure would return down to normal.

中医太阴病: 当病人比较瘦弱,虚弱,怕冷,腹冷腹胀,容易腹泻,这是太阴病阶段,用理中汤,或附子理中汤,或小建中汤,黄芪建中汤,当归建中汤等等。

If the person has TCM Tai Yin disease, the person is usually weak and slim, fears cold, like warm food and drink, bloating feeling in the abdomen, easy to have loss bowel movement. Use herbal formula Li Zhong Tang, Fu Zi Li Zhong Tang, Xiao Jiang Zhong Tang, Huang Qi Jiang Zhong Tang, or Dang Gui Jiang Zhong Tang.

如果脉沉细而弱,嗜睡,精力不足,为少阴病阶段,常用四逆汤, 金匮肾气丸,真武汤,或炙甘草汤治疗,严重者用白通汤。这种病人烦躁难眠,口干,我们用黄连阿胶汤;伴小便涩痛不利或尿血者,用猪苓汤。

If the person’s pulse feels very deep and thin and weak, and the person likes to lie down without strong ambition to do thing, it is the TCM Shao Yin disease, or the disease in the TCM Shao Yin stage. We may consider the use of Si Ni Tang, Jin Kui Shen Qi Wang, Zhen Wu Tang, or Zhi Gan Cao Tang. For severe case, use Bai Tong Tang. If such person feels very annoyed and hard to fall into sleep at night and have dry mouth and throat, we use Huang Liang A Jiao Tang. If the person has painful and uneasy urination, or there is bleeding from urine bladder, use Zhu Ling Tang.

少阴病阶段是体内阴寒很盛的阶段,由于阴寒盛就容易有虚阳上浮,出现阴盛戴阳症或阴盛格阳症,病人有明显的头痛头晕耳鸣,烦躁不安,面红目赤,手脚冰冷. 这些症状很象教科书中讲的肝阳上亢而用天麻钩藤饮治疗,也可以参考用张锡纯的建瓴汤。而在经方中,阴盛戴阳症或阴盛格阳症而需要用通脉四逆汤。戴阳症和格阳症都属于高血压危象,需要立即治疗。用这些方剂将头痛头晕等症状缓解后,还需要换方继续调治才行。

Shao Yin stage is a stage , in which the body has the most strongest Cold inside the body. Because the extreme Cold, a Yang Qi would be forced to floating at the upper part of the body, to cause the Yin Overwhelming  Yang floating or Yin Overwhelming Yang expelled condition. Patients with these syndromes  feel headache, dizziness, ringing in ears, anxiety, red face and eyes, but cold hands and feet. All of these are similar to the Liver Yan Overwhelming condition as introduced in textbook TCM, and which is asked to use Tian Ma Gou Teng Yin for the treatment. It can also be treated using Jiang Ling Tang.

The Yin Overwhelming  Yang floating or Yin Overwhelming Yang expelled condition belong to Hypertension crisis, and they need to be treated as soon as possible. In the Jing Fang system, we use Tong Mai Zi Ni Tang for the treatment. After release of the symptoms, the high blood pressure condition needs to be treated with other herbal formula. 

如果病人手脚冰冷,除了需要考虑是否为上面的少阴证之外,更多的要考虑为厥阴病。 厥阴病是继少阴病期间人体的阳气随着治疗而来复,所有特点为寒热错杂,手脚厥冷。常用的方剂为当归四逆汤,干姜芩连汤,乌梅汤,和吴茱萸汤。特别是吴茱萸汤,对于有高血压的病人,有明显的头痛头晕恶心呕吐,除了要主要是否为肝阳上亢的天麻钩藤饮的适应症外,特别要注意是否是肝寒上逆的吴茱萸汤证。

TCM Jue Yin disease. If the patient feels cold hands and feet, we need to consider the TCM Shao Yin disease, as well as a Jue Yiin disease. The characteristics of the TCM Jue Yin disease is the co-exist of Cold and Fire in the body and cold hands and feet. The commonly used herbal formula for the Jue Yin disease is Dang Gui Si Ni Tang, Gan Jiang Qin Lian Tang, Wu Mei Tang, and Wu Zhu Yu Tang. Especially the Wu Zhu Yu Tang, if a patient feels headache, nausea and vomit and if the headache is mostly on the top of the head, we need to consider if the headache needs the Wu Zhu Yu Tang for the treatment. 

高血压的病人一旦在血压升高的时候出现了手脚麻木,肢体软弱不利,或口眼歪斜等肢体肌肉运动障碍,就需要考虑高血压危象。 高血压危象是更严重的戴阳证或格阳证。中医教材介绍用大秦艽汤,其实还可以用大小续命汤,或酌情选用黄芪桂枝五物汤等。

Once the patient with hypertension starts to have numbness, weakness on the arms or legs, or have facial paralysis, it should be considered to be hypertension crisis. The hypertension crisis is introduced in the TCM text book to use herbal formula Da Qing JIu Tang. We can also use herbal formula Da Xu Ming Tang, Xiao Xu Ming Tang, or Huang Qi Gui Zhi Wu Wo Tang.

如果高血压病人突然昏迷,意识丧失,牙关紧闭,双手紧握,面红气促,表明为中风。教材上介绍用羚角钩藤汤 (偏热证)。实际上,治疗中风也需要判断寒热,还可以用风引汤(热证), 或候氏黑散(寒证), 甚至用大乌头汤 (更寒)。现在高血压中风的病人一般都是首先被送往医院急诊室急救。实际上,应该让西医和中医同时治疗,各显其能,提高抢救成功率和降低致残率。中医治疗时, 中草药用鼻饲,而同时采用针灸治疗,能快速使病人苏醒,配合治疗。

If a patient with high blood pressure suddenly falls into coma, loss of consciousness, and if the law is tight, the face is red in color, the breath is shallow and fast, it indicates a stroke condition. Textbook introduce the use of Ling Jiao Gou Teng Tang. In fact, for a stroke, we should also verify if the stroke belongs to a Fire or a Cold condition. The Fie type of Stoke, we can use the Ling Jiao Gou Teng Tang, as well as Feng Yin Tang. For a Cold type stroke, we use Hou Shi Hei San, or even Da Wu Tou Tang.

Currently, patient with stroke is send to a hospital for an emergency treatment. Actually,  the TCM therapies (herbs and acupuncture) also work to save the life of stroke patient, to increase the success rate and to reduce the paralysis rate.

高血压中风后许多病人的血压会不再升高。西医对此没有令人满意的解释。 用中医的观点可以这样解释:中风是人体内抗病力量和致病力量最后一次大较量后,人体抗病能力的溃败。这时候,人体非常虚弱,以至于没有能力发动提高血压的能力了。你看中风后的病人,哪一个还能保持中风前的能吃能睡能跑能熬夜的?这一点,也和处于少阴病阶段的高血压病人一样,其血压数值未必多高,甚至有以前高,现在用降压药后还比正常数值低,却反而容易得中风症了。并非只有平素血压很高的出才出现中风。同样的原因,较瘦弱的老年人容易得中风,也是因为这些老年人本身就比较虚弱,难以应付突如其来的各种精神情感和躯体的刺激(如寒冷,暴食,饥饿,性交等的刺激),身体对于发动提高血压以应激的能力已经很低,所以血压高不起来。同样由于身体的虚弱,在这些精神和躯体刺激后,身体内仅有的少量肾上腺激素被很快耗竭,出现心功能下降而亡。

After stroke, a previously very high blood pressure might never be as high as before. This is hard to be explained by conventional medicine. TCM believes that this is because the body condition of a post-stroke patient becomes very weak after a stroke attack, after last strong effort of the body against the resistance in blood circulation (against the reasons that cause the high blood pressure). Their body is so weak to have additional energy to increase the blood pressure again. Do you see any post-stroke who are as same energized as they were before the stroke?

  This phenomenon is similar to patients with TCM Shao Yin disease. Their blood pressure may not be very high, and it might be even lower than normal, but the risk to have a stroke or to have a death is much high than those with higher blood pressure.

For the same reason, a weak and slim patient with high blood pressure tend to have higher chance to get stroke or to die, since their body condition is already very weak, so as not be able to handle any stronger stimulation physically (cold, hungry, heavy labor, big eating or drinking) or emotionally (angry, anxiety, over happy, etc.). Their body under normal condition has no enough energy to increase their blood pressure. They cannot handle even little bit more stimulation since the level of their remaining adrenal hormones in the body are very low now.

中医体质辩证治疗高血压

TCM body constitution diagnosis

以上是对于有症状的高血压病人的治疗。对于血压持续性处于高水平状态而没有任何症状,没有任何血尿异常,也没有中医在舌诊和脉诊上的明显异常的人,如果血压并不是明显的高,建议不要着急采用任何治疗。血压明显高而且持续性高,中医可以按照体质辩证施治。

The discussion above is for the treatment of hypertension with symptoms. Sometimes, a person has high blood pressure but no any symptom, no anything wrong in the blood of urine tests, nor anything wrong in the tongue or pulse during TCM test. For such person, if the level of the high blood pressure is not very high, we recommend not very eager to take any chemical drugs for the treatment but can try TCM therapy. Since the person has no clear symptoms, we then use herbal therapy based on body constitution diagnosis for the herbal treatment.

常见的高血压体质为大柴胡汤体质,其人肥胖,上腹部饱满,压之或有不适感,时时便秘,口臭。

The commonly seen body constitution for a person with high blood pressure is the Da Chai Hu Tang constitution. The person is overweight, fullness in upper abdomen, which feels discomfort or pain upon press, constipation from time to time, and bad mouth odor or odor in the feet.

如果其它身热,怕热,喜欢冷饮,可以用白虎汤。这种人,西方人非常多见。属于火热体质。

If the person feels hot, dislikes hot, likes cold drink, we try the use of Bai Hu Tang. Such body constitution can be seen more among western people. They are the Fire body constitution.

如果其人常怕冷,手脚易冰,易胀满不适或体重很容易增加,面色不佳, 用当归芍药散(重用芍药)。 东方人常见。属于寒性体质。

If the person usually fears cold, dislikes to stay in cold room, likes to drink or eat hot or warm food, the person is Cold body constitution. The hands and feet are also commonly cold and frozen in winter. Such body constitution is more seen in Asia people. They need warm herbal formula, such as Gui Zhi Tang, or Dang Gui Shao Yao San.  

还有其它许多不同类型的体质,需要医生加以辨别,采用相应的治疗。这种按照体质的治疗需要坚持一到二个月,血压多可下降,如果血压还不能下降,就得考虑是否为家族性,基因性血压高,也就是说,对于这个家族来说,这样数值的血压当为“正常”,不必过度治疗,注意观察就可。如果病人以后出现别的疾病,通过将别的疾病按照中医草药疗法治愈后,看血压是否还高,如果仍然较高,就的接受这个血压的相对于这个家族的所谓的“正常”值,毕竟血压的所谓正常值是一个大范围人群中得出的统计学上的相对数值,会有5% 的正常人,其血压比另外95% 的人的血压低,但是他们仍然属于正常人;也会有另外5% 的人,他们的血压数值高于另外95% 的人群,但是也属于“正常人”范畴。我们不应该将这些 5% 的本来属于正常人的人们作为可疑和潜在的病人而给予降压治疗,使得对他们来说本来属于正常的血压,由于医生的强迫而变成了对于他们来说是低的低血压而导致一系列疾病。如果真是这样,该是医生的罪过。

There are some other types of body constitutions which need TCM doctor to verify and to use corresponding herbal formula for the treatment. Such body constitution treatment needs about one to two months. The high blood pressure can usually come down to normal or basically normal. If not, we need to consider if the “high” level of the blood pressure is a genetic. It means that, for this family, such level of blood pressure should be regarded as “normal”. The so called “normal” level of the blood pressure is deduced from a statistic data of a large group of healthy people, among which 90% of their blood pressure values are regarded as “normal”, a 5% of them are lower than the “normal” but they are healthy; another 5% is with their blood pressure is higher than the “normal” but they are also healthy. We should not regard this 5% of healthy people as “sick” people just because their blood pressure is higher than the “normal”. If we do so and force them to take blood pressure drugs, we would make their blood pressure lower than what they should be and to cause extra, doctor-origin diseases. If indeed it is so, we are bad doctor.

如果其人仅仅是情感异常,常觉得焦虑,焦躁不安,容易生气,或情绪低落,担忧过多,或有恐惧感,有受惊史等等,同时血压高,参考我们治疗情感障碍的方法治疗即可。 其中最主要的方剂有黄连解毒汤,三黄泻心汤,附子泻心汤,黄连上清丸,栀子豉汤系列方剂的应用。

If the hypertension person has only and mostly emotional disorders, such as stress, anxiety, depression, frustrated, annoyed, worry, fear, phobia, we also use herbal formula for the treatment. If interested, please refer to our brochure for “the treatment of stress by TCM way”. The most commonly used herbal formula is the Huang Lian Jie Du Tang, San Huang Xie Xin Tang, Fu Zi Xie Xin Tang, Huang Lian Shng Qing Wan, or Zhi Zi Chi Tang, etc.  

如果血压高而连体质辩证都很难,可以按照中医的升降沉浮理论,旋转中焦,以利气在体内之上升和下降,疏通气道运行而降血压,可用平胃散加减。

If it is difficult to even make a body constitution diagnosis, we will apply the Rising-falling theory of the TCM. Based on this theory, we use herbal therapy to activate or to motivate the function of middle stomach area, by which the body Qi can move more easily to go up and fall down to form a complete Qi circulation circle, so as to reduce the increased blood pressure. The most commonly used herbal formula in such situation is the Ping Wei San.

从六经辩证治疗高血压的临床实践来看,高血压并不是一个六经辩证的主证。它应该被看作为是疾病过程中有可能出现的一种普遍的疾病现象。其普遍的就如同疼痛一样,我们不能说疼痛该属于六经的哪一经之病。不能说见到疼痛就能诊断为是哪一经之病。也就是说它的指示性恶寒指标性能很差。

From the clinic practice for the treatment of high blood pressure, apparently the increased blood pressure should not be regarded as a unique or a main symptom for TCM diagnosis. Herbal formula is established not on the presence of a high blood pressure, but on some other symptoms. The high blood pressure can be seen any TCM disease category. It is as common as a pain that can be seen in either TCM disease too. It means that, either the pain or the high blood pressure could be regarded as directing index to a TCM disease.  

草药治疗高血压可以在三五付药内就见效;也可能需要三十到五十付药才见效。取决于病情,也取决于中医医生的能力,但是一般来说,按照以上这些原则治疗,治疗高血压的成功率是很高的。  草药治疗的弊端是每天都得喝药,草药汁比较苦。许多西方人从来没有吃过苦,对他们来说天天喝这种草药汤汁很难。这就要看您的选择了,是选择中医治疗一到两个月,指望能将高血压治愈,还是打算终身服西药,打算承受西药的副作用,包括头晕,疲乏,阳痿,便秘等等。

In practice, the herbal therapy can reduce the high blood pressure within several days, or it may need one to two months, depending on the TCM disease and also on the clinic experience of a TCM doctor. There are still quite a few TCM doctor may tell you that they have no experience in the treatment of hypertension. Based on the clinic experience of the Six Jing diagnosis system, the success rate for the treatment of hypertension is pretty high. Doctors in this TCM system generally speaking do not feel hard to cure a hypertension.

The disadvantage of the TCM herbal therapy is the bitter taste of the herbal tea. Many people who lived in the western world never have a bitter taste in their diet. To them, it is indeed hard to drink the biter herbal tea. This is their choice. To choose to drink the herbal tea for one to two months to stop any medicine for high blood pressure, or to take conventional synthesized chemical drugs for the remaining whole life with many side effects from the drugs, such as headache, dizziness, chronic fatigue, impotency, constipation, chest pain, etc.

我们说将高血压治愈,指的是不再需要服任何药物,血压处于正常值范围。但是这有个前提,就是要改变造成精神紧张的生活环境,多世间事情要能想得开,不要事事计较;还要减少性生活,减少对交感神经的刺激。对于中医来说,过多过度的性生活,不仅有可能导致高血压,早衰,还很有可能是老年痴呆症的原因。如果做不到这些生活方式的改变,高血压的治愈一说就很难说了。这一点适用于对于任何疾病的治疗:没有医生敢说他把你现在的病(任何一种病)治好后,你以后永远都不再得同样的病了,除非他把你得病的这个器官摘除了。比如说治疗胆囊炎,把胆囊摘除后你当然一辈子都不再会有胆囊炎了。可是这是治疗吗?能不能什么器官有病就把什么器官摘掉?心脏病把心脏摘掉,肾炎把肾脏摘掉?对于高血压,该把什么器官摘掉?

That we said to cure the hypertension means to let you do not take any medicine, including the herbs, after completion of the healing program. To reach this goal, there is a prerequisite that the person must change the stressful life style and to reduce the frequency of sex activities. If the person cannot follow these, the normalized blood pressure will surely have high chance to go back high again. No any doctor can promise that, after he normalize your current disease, you will no longer get the same disease later, unless your sick organ has been removed by surgical operation. For example, if you get a gall bladder infection and it was solved by removed surgically. In this case, the doctor dares to tell you that he cured your gall bladder infection forever – of course, you will no longer get that disease since you have no any gall bladder to catch gall bladder infection! For hypertension, which organ(s) can be cut off by surgical operation? 

以上所介绍的是中医的草药治疗。草药疗法也是中医治疗高血压的最主要方法。另外常用的是针灸,特别是对于有明显头痛头晕,恶心呕吐,肢体麻木不利,口眼歪斜,或者中风后偏瘫的病人,针灸有非常好的疗效。很多情况下针灸降压也很快。

Although the herbal therapy is the mostly used therapy in TCM for the treatment of hypertension, acupuncture is another choice, especially if the person has apparent headache, dizziness, nausea, numbness or spasm in arm, hands, leg or feet, of has facial paralysis. It is also very useful in the treatment of stroke or post-stroke conditions. For the stroke, the new idea is to start the acupuncture treatment as soon as possible after the stroke.

对于高血压危象,或者血压非常高的病人,也常用耳尖刺血放血,或十个指尖刺血放血,以便快速降压,解救危象。

Whenever there is a hypertension crisis or a stroke condition, we also use bleeding therapy on the tips of fingers, or on the tip of a ear. It works very fast and very well to reduce the extremely high blood pressure. Acupuncture should be done at least once every other day for one to two months.