“四型分类”辨治高血压病
|
摘要
高血压病可归属于中医学"头痛""眩晕"等范畴分证论治,但其作为一种慢性病,单纯分证论治不足以构建高血压病的中医理论体系。基于"分类-分期-分证"思想,根据实际门诊病历分析,初步构建高血压病"分类-分期"辨治方案,并结合"态靶因果"处方策略,总结水盛、火盛、寒凝、肾虚四类高血压病的病因病机、辨治要点,同时提出大柴胡汤、葛根汤、当归芍药散等调治高血压病患者内环境状态的"靶方",以及夏枯草、茯苓、茺蔚子、牛膝、天麻、葛根等降血压"靶药"。
Hypertension is often attributed to "headache"and "dizziness"for treatment based on syndrome differentiation in traditional Chinese medicine( TCM). However,as a chronic disease,simple syndrome differentiation and treatment could not build TCM theoretical system of hypertension. Therefore,based on "classification-stagesyndrome"thought and practical analysis of out-patient medical cases,the "classification-stage"scheme of hypertension was preliminarily constructed. Based on "state-target-origin-result"strategy,the etiology,pathogenesis,key points of syndrome differentiation of hypertension with 4 types of excessive water,excessive fire,cold congealing,and kidney deficiency were summarized. Meanwhile,it is proposed that Dachaihu Decoction( 大柴胡汤),Gegen Decoction( 葛根汤),Danggui Shaoyao Powder( 当归芍药散) and other"target formula"for regulating the internal environment of patients with hypertension,as well as antihypertensive "target drugs"such as Xiakucao( Spica Prunellae),Poria,Chongweizi( Fructus Leonuri),Niuxi( Radix Achyranthis Bidentatae),Tianma( Rhizoma Gastrodiae),and Gegen( Radix Puerariae).
Hypertension is often attributed to "headache"and "dizziness"for treatment based on syndrome differentiation in traditional Chinese medicine( TCM). However,as a chronic disease,simple syndrome differentiation and treatment could not build TCM theoretical system of hypertension. Therefore,based on "classification-stagesyndrome"thought and practical analysis of out-patient medical cases,the "classification-stage"scheme of hypertension was preliminarily constructed. Based on "state-target-origin-result"strategy,the etiology,pathogenesis,key points of syndrome differentiation of hypertension with 4 types of excessive water,excessive fire,cold congealing,and kidney deficiency were summarized. Meanwhile,it is proposed that Dachaihu Decoction( 大柴胡汤),Gegen Decoction( 葛根汤),Danggui Shaoyao Powder( 当归芍药散) and other"target formula"for regulating the internal environment of patients with hypertension,as well as antihypertensive "target drugs"such as Xiakucao( Spica Prunellae),Poria,Chongweizi( Fructus Leonuri),Niuxi( Radix Achyranthis Bidentatae),Tianma( Rhizoma Gastrodiae),and Gegen( Radix Puerariae).
引文
[1]葛均波,徐永健.内科学[M].北京:人民卫生出版社,2013:289.
[2]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701-743.
[3]LI YI,YANG L,WANG L,et al. Burden of hypertension in China:A nationally representative survey of 174 621adults[J]. Int J Cardiol,2017,227:516-523. doi:10.1016/j. ijcard. 2016. 10. 110.
[4]李媛.高血压常见药物与治疗方法的研究进展[J].医学理论与实践,2018,31(3):340-342.
[5]韩学杰.高血压病中医诊疗方案(初稿)[J].中华中医药杂志,2008,23(7):611-613.
[6]王清海.论高血压的中医概念与病名[J].中华中医药学刊,2008,26(11):2321-2323.
[7]孙伯扬.高血压病的辨证论治[J].实用中西医结合杂志,1991,4(5):260.
[8]吕志杰.降压延寿汤治高血压病87例临床观察[J].新中医,1990,22(11):22-24.
[9]申春悌,陈炳为,沈春锋.应用循证方法探索古文献高血压病的证候要素[J].辽宁中医杂志,2007,34(10):1400-1402.
[10]沈绍功.沈绍功中医方略论[M].北京:科学出版社,2004:1-5.
[11]余天泰.高血压病辨证施治八法[J].世界中西医结合杂志,2006,1(1):38-40.
[12]中华中医药学会.高血压中医诊疗指南[J].中国中医药现代远程教育,2011,23(9):108-109.
[13]杨映映,逄冰,刘文科,等.基于中医脾瘅理论探讨代谢性高血压[J].北京中医药,2017,36(6):532-534.
[14]仝小林,何莉莎,赵林华.论“态靶因果”中医临床辨治方略[J].中医杂志,2015,56(17):1441-1444.
[15]周强,赵锡艳,逄冰,等.仝小林教授运用大柴胡汤治疗代谢性疾病验案解析[J].环球中医药,2012,5(10):754-757.
[16]梁健钦,熊万娜,罗远,等.夏枯草提取物对大鼠自发性高血压降血压作用研究[J].中药材,2011,34(1):99-100.
[17]宋雪云.钩藤方提取物对自发性高血压大鼠降压作用的研究[J].中国实验方剂学杂志,2012,18(11):216-218.
[18]周谛克,张峻,施云.降压中药的研究进展[J].中医药导报,2007,14(9):91-93.
[19]连凤梅,仝小林,徐立鹏,等.降浊清肝方治疗高血压伴代谢综合征的临床研究[J].中国中医基础医学杂志,2011,17(6):649-650.
[2]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701-743.
[3]LI YI,YANG L,WANG L,et al. Burden of hypertension in China:A nationally representative survey of 174 621adults[J]. Int J Cardiol,2017,227:516-523. doi:10.1016/j. ijcard. 2016. 10. 110.
[4]李媛.高血压常见药物与治疗方法的研究进展[J].医学理论与实践,2018,31(3):340-342.
[5]韩学杰.高血压病中医诊疗方案(初稿)[J].中华中医药杂志,2008,23(7):611-613.
[6]王清海.论高血压的中医概念与病名[J].中华中医药学刊,2008,26(11):2321-2323.
[7]孙伯扬.高血压病的辨证论治[J].实用中西医结合杂志,1991,4(5):260.
[8]吕志杰.降压延寿汤治高血压病87例临床观察[J].新中医,1990,22(11):22-24.
[9]申春悌,陈炳为,沈春锋.应用循证方法探索古文献高血压病的证候要素[J].辽宁中医杂志,2007,34(10):1400-1402.
[10]沈绍功.沈绍功中医方略论[M].北京:科学出版社,2004:1-5.
[11]余天泰.高血压病辨证施治八法[J].世界中西医结合杂志,2006,1(1):38-40.
[12]中华中医药学会.高血压中医诊疗指南[J].中国中医药现代远程教育,2011,23(9):108-109.
[13]杨映映,逄冰,刘文科,等.基于中医脾瘅理论探讨代谢性高血压[J].北京中医药,2017,36(6):532-534.
[14]仝小林,何莉莎,赵林华.论“态靶因果”中医临床辨治方略[J].中医杂志,2015,56(17):1441-1444.
[15]周强,赵锡艳,逄冰,等.仝小林教授运用大柴胡汤治疗代谢性疾病验案解析[J].环球中医药,2012,5(10):754-757.
[16]梁健钦,熊万娜,罗远,等.夏枯草提取物对大鼠自发性高血压降血压作用研究[J].中药材,2011,34(1):99-100.
[17]宋雪云.钩藤方提取物对自发性高血压大鼠降压作用的研究[J].中国实验方剂学杂志,2012,18(11):216-218.
[18]周谛克,张峻,施云.降压中药的研究进展[J].中医药导报,2007,14(9):91-93.
[19]连凤梅,仝小林,徐立鹏,等.降浊清肝方治疗高血压伴代谢综合征的临床研究[J].中国中医基础医学杂志,2011,17(6):649-650.