黄连解毒汤化裁治疗热毒痰瘀型高血压的药理分析及医案
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摘要
在长期临床实践治疗高血压中,中医药因其具有持久平稳的降压作用、明显改善临床症状、改善血管内皮功能、保护靶器官等优势日益受到重视和应用。黄连解毒汤为清热剂,泻火解毒,化裁治疗高血压(热毒痰瘀型),组方为黄连15 g、黄芩5 g、黄柏5 g、栀子5 g、泽泻10 g、蒲黄10 g、丹参10 g、川芎5 g、赤芍10 g、桃仁10 g、红花5 g、茯苓15 g。部分药物有扩张血管、降血压、化痰利湿和活血祛瘀的作用,全方共用,可清热解毒、活血化痰,效果显著。附眩晕头痛医案一则。
In the long term clinical practice in the treatment of hypertension, traditional Chinese medicine is increasingly received attention and application because of its antihypertensive effect with the advantage of lasting stable, improving symptoms and blood vessel function, and protecting target organ. The huanglianjiedu decoction is used to relieve internal heat. It can purge fire and remove toxic substance. But now we use it to make some changes to treat hypertension(the type of phlegm and blood-stasis and heat toxin). The modified huanglianjiedu decoction consisting of 5 g huanglian, 5 g huangqin, 5 g huangbai, 5 g zhizi, 10 g zexie, 10 g puhuang, 10 g danshen, 5 g chuanxiong, 10 g chishao, 10 g taoren, 5 g honghua, 15 g fuling. Some of these drugs can dilate blood vessels, lower blood pressure, clear damp, expel phlegm and invigorate the circulation of bood. In one word, the formula can purge fire and remove toxic substance, expel phlegm and invigorate the circulation of blood.
In the long term clinical practice in the treatment of hypertension, traditional Chinese medicine is increasingly received attention and application because of its antihypertensive effect with the advantage of lasting stable, improving symptoms and blood vessel function, and protecting target organ. The huanglianjiedu decoction is used to relieve internal heat. It can purge fire and remove toxic substance. But now we use it to make some changes to treat hypertension(the type of phlegm and blood-stasis and heat toxin). The modified huanglianjiedu decoction consisting of 5 g huanglian, 5 g huangqin, 5 g huangbai, 5 g zhizi, 10 g zexie, 10 g puhuang, 10 g danshen, 5 g chuanxiong, 10 g chishao, 10 g taoren, 5 g honghua, 15 g fuling. Some of these drugs can dilate blood vessels, lower blood pressure, clear damp, expel phlegm and invigorate the circulation of bood. In one word, the formula can purge fire and remove toxic substance, expel phlegm and invigorate the circulation of blood.
引文
1.张志伟,岳桂华,张爱珍.黄连解毒汤对自发性高血压大鼠血压和炎症因子的影响[J].中华中医药杂志,2011,26(7):1627-1629.ZH A NG Zhiwei,YUE Gui hua,ZH A NG A izhen.Ef fects of Huanglianjiedu-Decoction on blood pressure and inflammatory factors in spontaneous hypertension rats[J].China Journal of Traditional Chinese Medicine and Pharmacy,2011,26(7):1627-1629.
2.肖倩倩.高血压病的现代中医病因病机探讨[J].中西医结合心脑血管病杂志,2016,14(10):1108-1110.XIAO Qianqian.Etiology and pathogenesis of hypertension in modern Chinese medicine[J].Chinese Journal of Integrative Medicine on Cardio-/Cerebrovascular Disease,2016,14(10):1108-1110.
3.申绎莛,王连志.温胆汤化裁治疗高脂血症(痰瘀互阻)[J].实用中医内科杂志,2018,32(4):66-67.SHEN Yiting,WANG Lianzhi.The treatment of the modified wendan decoction for hypertriglycerdemia(phlegm and blood-stasis)[J].Journal of practical Chinese medicine medicine,2018,32(4):66-67.
4.张志斌,周春刚,陆曙.原发性高血压患者中医证型分布及其与生化指标的相关性[J].辽宁中医杂志,2010,37(6):969-971.ZHANG Zhibin,ZHOU Chungang,LU Shu.Distribution of TCMsyndrome types of essential hypertension and their relationship to biochemical indicators[J].Liaoning Journal of Traditional Chinese Medicine,2010,37(6):969-971.
5.高辉.活血化瘀防治高血压的研究进展[J].现代中西医结合杂志,2002,11(20):2076-2078.GAO Hui.Research progress on the prevention and treatment of hypertension by promoting blood circulation and removing blood stasis[J].Modern Journal of Integrated Chinese Traditional and Western Medicine,2002,11(20):2076-2078.
6.岳桂华,管琳,张效涛.黄连解毒降压汤改善高血压病胰岛素抵抗临床观察[J].山东中医杂志,2004,23(9):529-530.YUE Guihua,GUAN Lin,ZHANG Xiaotao.Clinical observation on improvement of insulin resistance in hypertension by huanglian detoxification and hypertension decoction[J].Shandong Journal of Traditional Chinese Medicine,2004,23(9):529-530.
7.武晓光,王守富.化痰祛湿法治疗高血压病研究进展[J].中医药临床杂志,2012,24(1):81-83.WU Xiaoguang,WANG Shoufu.Research progress in the treatment of hypertension by expectoration of phlegm clearing damp[J].Clinical Journal of Traditional Chinese Medicine,2012,24(1):81-83.
8.庄须伟,周晓明,甄洪亮.活血化瘀法治疗高血压动脉硬化性脑出血的疗效分析[J].中医临床研究,2016,8(18):109-110.ZHUANG Xuwei,ZHOU Xiaoming,ZHEN Hongliang.Curative e?ect analysis of method of activating blood circulation in the treatment of hypertensive arteriosclerosis cerebral hemorrhage[J].Clinical Journal of Chinese Medicine,2016,8(18):109-110.
9.郑冬梅.黄连解毒降压汤治疗高血压病临床疗效观察[J].中国处方药,2016,14(11):95-96.ZHENG Dongmei.The clinical e?cacy of huanglian detoxification and hypertension decoction in the treatment of hypertension[J].Chinese Prescription Drugs,2016,14(11):95-96.
10.卢笑晖,丁书文.黄连解毒胶囊治疗不稳定型心绞痛临床疗效及作用机制研究[J].山东中医药大学学报,2005,29(6):457-460.LU Xiaohui,DING Shuwen.Clinical e?ect and mechanism on treating unstable angina pectoris by huanglian jiedu capsule[J].Journal of Shandong University of Traditional Chinese Medicine,2005,29(6):457-460.
11.张志伟,岳桂华.黄连解毒汤对自发性高血压大鼠血管内皮功能的保护作用[J].时珍国医国药,2011,22(5):1071-1073.ZXHANG Zhiwei,YUE Guihua.Protective e?ects of huanglianjiedudecoction on function of blood vessel endothelium in spontaneous hypertension rats(SHR)[J].Lishizhen Medicine and Materia Medica Research,2011,22(5):1071-1073.
12.张志伟,岳桂华,罗远.黄连解毒汤对自发性高血压大鼠血栓前状态的影响[J].中国实验方剂学杂志,2011,17(2):105-108.ZHANG Zhiwei,YUE Guihua,Luo Yuan.Effects of huanglian jiedu decoction on prothrombotic state in spontaneous hypertension rats[J].Chinese journal of experimental formulations,2011,17(2):105-108.
13.董芹.基于效应成分当量的黄连质量一致性评价[D].成都:成都中医药大学,2016.DONG Qin.Quality consistency evaluation of rhizoma coptidis based on e?ect component equivalence[D].Chengdu:Chengdu University of Chinese Medicine,2016.
14.刘金欣,孟繁蕴,张胜海,等.UPLC同时测定黄芩中黄芩苷、黄芩素、汉黄芩苷、汉黄芩素、千层纸素A[J].中草药,2014,45(10):1477-1480.LIU Jinxin,MENG Fanyun,ZHANG Shenghai,et al.Simultaneous determination of baicalin,wogonoside,baicalein,wogonin,and oroxylin-A in Scutellaria baicalensis by UPLC[J].Chinese Traditional and Herbal Drugs,2014,45(10):1477-1480
15.陈阳峰,钟晓红.黄柏的药理作用及其活性成分提取[J].作物研究,2015,29(5):564-568.CHEN Yangfeng,ZHONG Xiaohong.Pharmacological effects of cortex phellodendri and its active ingredient extraction[J].Crop Research,2015,29(5):564-568.
16.邢增智,陈旺,曾宇.泽泻的化学成分与药理作用研究进展[J].中医药导报,2017,23(15):75-78.XING Zengzhi,CHEN Wang,ZENG Yu.Research progress on chemical constituents and pharmacological effects of zexie(Alisma orientalis)[J].Journal of Chinese Medicine,2007,23(15):75-78.
17.豆甲泰,李胜文.中药泽泻对心血管系统作用的发展研究[J].中外医疗,2012,31(20):191.DOU Jiatai,LI Shengwen.Study on the effect of alisma orientalis on cardiovascular system[J].Chinese and Foreign Medicine,2012,31(20):191.
18.牧丹,苏日那,格根塔娜,等.栀子的化学成分与药理作用研究[J].中国疗养医学,2015,24(1):34-36.MU Dan,SU Rina,GEGEN Tana,et al.Study on chemical composition and pharmacological action of gardenia[J].Chinese Journal of Convalescent Medicine,2015,24(1):34-36.
19.陈彩莲,王桃林,朱流财.蒲黄的药理作用及临床应用研究进展[J].临床医药文献电子杂志,2016,3(8):1577-1578.CHEN Cailian,WANG Taolin,ZHU Liucai.Research progress of pharmacological action and clinical application of puhuang[J].Journal of Clinical Medical Literature.Electronic Edition,2016,3(8):1577-1578.
20.刘宁,刘媛,潘蕾,等.红花的研究进展[J].中国医药导刊,2017,19(5):527-530.LIU Ning,LIU Yuan,PAN Lei,et al.Research progress of sa?ower[J].Chinese Journal of Medicinal Guide,2017,19(5):527-530.
21.王晓敏,高增光,席晓甜,等.红花黄色素注射液对急性心肌梗死模型大鼠低氧诱导因子和血管内皮生长因子的影响[J].医药导报,2016,35(6):570-573.WANG Xiaomin,GAO Zengguang,XI Xiaotian,et al.Effects of safflor yellow injection on HIF and VEGF mRNA of rats with acute myocardial infarction[J].Herald of Medicine,2016,35(6):570-573.
22.朱莉红.红花药理分析及临床应用分析[J].中国现代药物应用,2016,10(16):286-287.ZHU Lihong.Analysis of the pharmacology and clinical application of safflower[J].Chinese Modern Medicine Application,2016,10(16):286-287.
23.王涵,杨娜,谭静,等.丹参化学成分、药理作用及临床应用的研究进展[J].特产研究,2018,40(1):48-53.Wang Han,Yang Na,Tan Jing,et al.Research progress on salvia miltiorrhiza bge of the chemical constituents and their pharmacological e?ects[J].Special Product Research,2008,40(1):48-53.
24.胡大一,马长生,王显.心脏病学实践2010:中西医结合卷[M].北京:人民卫生出版社,2010.HU Dawei,MA Changsheng,WANG Xian.Practice of cardiology2010:integrated Chinese and western medicine[M].Beijing:People’s Medical Publishing House,2010.
25.韩炜.川芎的化学成分与药理作用研究进展[J].中国现代中药,2017,19(9):1341-1349.HAN Wei.Advances in chemical constituents and pharmacological e?ects of ligusticum chuanxiong[J].Modern Chinese Medicine,2007,19(9):1341-1349.
26.Zhang L,Du JR,Wang J,et al.Z-ligustilide extracted from Radix Angelica Sinensis decreased platelet aggregation induced by ADP ex vivo and arterio-venous shunt thrombosis in vivo in rats[J].Yakugaku Zasshi,2009,129(7):855-859.
2.肖倩倩.高血压病的现代中医病因病机探讨[J].中西医结合心脑血管病杂志,2016,14(10):1108-1110.XIAO Qianqian.Etiology and pathogenesis of hypertension in modern Chinese medicine[J].Chinese Journal of Integrative Medicine on Cardio-/Cerebrovascular Disease,2016,14(10):1108-1110.
3.申绎莛,王连志.温胆汤化裁治疗高脂血症(痰瘀互阻)[J].实用中医内科杂志,2018,32(4):66-67.SHEN Yiting,WANG Lianzhi.The treatment of the modified wendan decoction for hypertriglycerdemia(phlegm and blood-stasis)[J].Journal of practical Chinese medicine medicine,2018,32(4):66-67.
4.张志斌,周春刚,陆曙.原发性高血压患者中医证型分布及其与生化指标的相关性[J].辽宁中医杂志,2010,37(6):969-971.ZHANG Zhibin,ZHOU Chungang,LU Shu.Distribution of TCMsyndrome types of essential hypertension and their relationship to biochemical indicators[J].Liaoning Journal of Traditional Chinese Medicine,2010,37(6):969-971.
5.高辉.活血化瘀防治高血压的研究进展[J].现代中西医结合杂志,2002,11(20):2076-2078.GAO Hui.Research progress on the prevention and treatment of hypertension by promoting blood circulation and removing blood stasis[J].Modern Journal of Integrated Chinese Traditional and Western Medicine,2002,11(20):2076-2078.
6.岳桂华,管琳,张效涛.黄连解毒降压汤改善高血压病胰岛素抵抗临床观察[J].山东中医杂志,2004,23(9):529-530.YUE Guihua,GUAN Lin,ZHANG Xiaotao.Clinical observation on improvement of insulin resistance in hypertension by huanglian detoxification and hypertension decoction[J].Shandong Journal of Traditional Chinese Medicine,2004,23(9):529-530.
7.武晓光,王守富.化痰祛湿法治疗高血压病研究进展[J].中医药临床杂志,2012,24(1):81-83.WU Xiaoguang,WANG Shoufu.Research progress in the treatment of hypertension by expectoration of phlegm clearing damp[J].Clinical Journal of Traditional Chinese Medicine,2012,24(1):81-83.
8.庄须伟,周晓明,甄洪亮.活血化瘀法治疗高血压动脉硬化性脑出血的疗效分析[J].中医临床研究,2016,8(18):109-110.ZHUANG Xuwei,ZHOU Xiaoming,ZHEN Hongliang.Curative e?ect analysis of method of activating blood circulation in the treatment of hypertensive arteriosclerosis cerebral hemorrhage[J].Clinical Journal of Chinese Medicine,2016,8(18):109-110.
9.郑冬梅.黄连解毒降压汤治疗高血压病临床疗效观察[J].中国处方药,2016,14(11):95-96.ZHENG Dongmei.The clinical e?cacy of huanglian detoxification and hypertension decoction in the treatment of hypertension[J].Chinese Prescription Drugs,2016,14(11):95-96.
10.卢笑晖,丁书文.黄连解毒胶囊治疗不稳定型心绞痛临床疗效及作用机制研究[J].山东中医药大学学报,2005,29(6):457-460.LU Xiaohui,DING Shuwen.Clinical e?ect and mechanism on treating unstable angina pectoris by huanglian jiedu capsule[J].Journal of Shandong University of Traditional Chinese Medicine,2005,29(6):457-460.
11.张志伟,岳桂华.黄连解毒汤对自发性高血压大鼠血管内皮功能的保护作用[J].时珍国医国药,2011,22(5):1071-1073.ZXHANG Zhiwei,YUE Guihua.Protective e?ects of huanglianjiedudecoction on function of blood vessel endothelium in spontaneous hypertension rats(SHR)[J].Lishizhen Medicine and Materia Medica Research,2011,22(5):1071-1073.
12.张志伟,岳桂华,罗远.黄连解毒汤对自发性高血压大鼠血栓前状态的影响[J].中国实验方剂学杂志,2011,17(2):105-108.ZHANG Zhiwei,YUE Guihua,Luo Yuan.Effects of huanglian jiedu decoction on prothrombotic state in spontaneous hypertension rats[J].Chinese journal of experimental formulations,2011,17(2):105-108.
13.董芹.基于效应成分当量的黄连质量一致性评价[D].成都:成都中医药大学,2016.DONG Qin.Quality consistency evaluation of rhizoma coptidis based on e?ect component equivalence[D].Chengdu:Chengdu University of Chinese Medicine,2016.
14.刘金欣,孟繁蕴,张胜海,等.UPLC同时测定黄芩中黄芩苷、黄芩素、汉黄芩苷、汉黄芩素、千层纸素A[J].中草药,2014,45(10):1477-1480.LIU Jinxin,MENG Fanyun,ZHANG Shenghai,et al.Simultaneous determination of baicalin,wogonoside,baicalein,wogonin,and oroxylin-A in Scutellaria baicalensis by UPLC[J].Chinese Traditional and Herbal Drugs,2014,45(10):1477-1480
15.陈阳峰,钟晓红.黄柏的药理作用及其活性成分提取[J].作物研究,2015,29(5):564-568.CHEN Yangfeng,ZHONG Xiaohong.Pharmacological effects of cortex phellodendri and its active ingredient extraction[J].Crop Research,2015,29(5):564-568.
16.邢增智,陈旺,曾宇.泽泻的化学成分与药理作用研究进展[J].中医药导报,2017,23(15):75-78.XING Zengzhi,CHEN Wang,ZENG Yu.Research progress on chemical constituents and pharmacological effects of zexie(Alisma orientalis)[J].Journal of Chinese Medicine,2007,23(15):75-78.
17.豆甲泰,李胜文.中药泽泻对心血管系统作用的发展研究[J].中外医疗,2012,31(20):191.DOU Jiatai,LI Shengwen.Study on the effect of alisma orientalis on cardiovascular system[J].Chinese and Foreign Medicine,2012,31(20):191.
18.牧丹,苏日那,格根塔娜,等.栀子的化学成分与药理作用研究[J].中国疗养医学,2015,24(1):34-36.MU Dan,SU Rina,GEGEN Tana,et al.Study on chemical composition and pharmacological action of gardenia[J].Chinese Journal of Convalescent Medicine,2015,24(1):34-36.
19.陈彩莲,王桃林,朱流财.蒲黄的药理作用及临床应用研究进展[J].临床医药文献电子杂志,2016,3(8):1577-1578.CHEN Cailian,WANG Taolin,ZHU Liucai.Research progress of pharmacological action and clinical application of puhuang[J].Journal of Clinical Medical Literature.Electronic Edition,2016,3(8):1577-1578.
20.刘宁,刘媛,潘蕾,等.红花的研究进展[J].中国医药导刊,2017,19(5):527-530.LIU Ning,LIU Yuan,PAN Lei,et al.Research progress of sa?ower[J].Chinese Journal of Medicinal Guide,2017,19(5):527-530.
21.王晓敏,高增光,席晓甜,等.红花黄色素注射液对急性心肌梗死模型大鼠低氧诱导因子和血管内皮生长因子的影响[J].医药导报,2016,35(6):570-573.WANG Xiaomin,GAO Zengguang,XI Xiaotian,et al.Effects of safflor yellow injection on HIF and VEGF mRNA of rats with acute myocardial infarction[J].Herald of Medicine,2016,35(6):570-573.
22.朱莉红.红花药理分析及临床应用分析[J].中国现代药物应用,2016,10(16):286-287.ZHU Lihong.Analysis of the pharmacology and clinical application of safflower[J].Chinese Modern Medicine Application,2016,10(16):286-287.
23.王涵,杨娜,谭静,等.丹参化学成分、药理作用及临床应用的研究进展[J].特产研究,2018,40(1):48-53.Wang Han,Yang Na,Tan Jing,et al.Research progress on salvia miltiorrhiza bge of the chemical constituents and their pharmacological e?ects[J].Special Product Research,2008,40(1):48-53.
24.胡大一,马长生,王显.心脏病学实践2010:中西医结合卷[M].北京:人民卫生出版社,2010.HU Dawei,MA Changsheng,WANG Xian.Practice of cardiology2010:integrated Chinese and western medicine[M].Beijing:People’s Medical Publishing House,2010.
25.韩炜.川芎的化学成分与药理作用研究进展[J].中国现代中药,2017,19(9):1341-1349.HAN Wei.Advances in chemical constituents and pharmacological e?ects of ligusticum chuanxiong[J].Modern Chinese Medicine,2007,19(9):1341-1349.
26.Zhang L,Du JR,Wang J,et al.Z-ligustilide extracted from Radix Angelica Sinensis decreased platelet aggregation induced by ADP ex vivo and arterio-venous shunt thrombosis in vivo in rats[J].Yakugaku Zasshi,2009,129(7):855-859.