Traditional Chinese medicine syndrome differentiation and treatment on hyperlipidemia based on "pathogenic factors arising from Gao and Zhi"

Hyperlipidemia is a key risk factor for atherosclerotic cardiovascular and cerebrovascular diseases, and its traditional Chinese medicine (TCM) pathogenesis is closely associated with the abnormal metabolism of "Gao" (a thick, viscous fluid that moisturizes and nourishes the skin, muscles, and joints) and "Zhi" (a more solid substance that stores energy and provides warmth). Hyperlipidemia initiates with the impairment of "Kunyuan," namely, spleen-stomach deficiency, leading to insufficient digestion and transportation. Subsequently, it progresses to "Shuyao" dysfunction, characterized by liver and gallbladder dysfunction in regulating qi movement, coupled with impaired ascending and descending functions of the middle energizer, leading to qi stagnation. This, in turn, causes the abnormal transformation of essential substances, leading to the failure of "Gao" and "Zhi" transportation and their transformation into turbid lipids that infiltrate the blood vessels. Ultimately, stagnation congeals internally: turbid lipids transform into phlegm and obstruct the vessels to form stasis, thereby resulting in phlegm-stasis interbinding, which corresponds to atherosclerotic plague in western medicine. In response to this dynamic pathogenesis, a systematic therapeutic principle is proposed: "strengthening earth (spleen) to nourish Kunyuan, activating Shuyao to facilitate Sanjiao (triple energizer), mobilizing Gao and Zhi to expel turbid lipids, and resolving stagnation to unblock collaterals." This approach intervenes at four levels: strengthening and consolidating body resistance, regulating qi movement, expulsing pathogen-dredging collateral, and resolving stagnation-dispersing bind. Based on "pathogenic factors arising from Gao and Zhi," this article systematically expounds the core pathogenesis evolution process of hyperlipidemia, namely "Kunyuan-Shuyao-Gao and Zhi-obstruction and stagnation," which fully embodies the TCM principles of treatment aiming at its root cause and preventing disease from exacerbating.