从“血脉”论治高血压的理论探析
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摘要
从《内经》血脉理论出发,阐明高血压是因痰、瘀、虚等病理因素导致脉道壅滞或堵塞,脉内压力增大而形成一种血管疾病,用血脉辨证取代传统的脏腑辨证能更准确的解释高血压的生理病理。现代医学根据疾病不同阶段,多以改善血液质量(抗炎、抗氧化等),防治血管病变(保护血管内皮功能、抑制血管重塑等)两大方面治疗高血压,这与中医血脉理论指导下辨别病位,采用治血、治脉的辨证疗法不谋而合。现将血脉理论与临床实践相结合,介绍高血压形成的病机及高血压血管病变的实质,并提供从血脉论治高血压的临证依据。
The test starts from Neijing Xuemai theory and clarifies that hypertension is caused by pathological factors such as phlegm, blood stasis and deficiency,which can cause pulse stagnation or blockage, increasing the vein pressure to form a vascular disease.It is more accurately explained the physiology and pathology of hypertension using Xuemai theory insteading of the traditional viscera syndrome.According to the different stages of the disease,we used to improving the blood quality(anti-inflammatory,anti-oxidation,etc.),preventing and treating vascular lesions(the protection of vascular endothelial function,inhibition of vascular remodeling,etc.) to treat hypertension,which is almost the same as the way to identify the disease locationand treat blood and veins by Xuemai theory. Combining Xuemai theory with clinical practice, we introduced the pathogenesis of hypertension and the essence of vasculopathy of hypertensionto provide a basis for the treatment of hypertension from blood and vessels.
The test starts from Neijing Xuemai theory and clarifies that hypertension is caused by pathological factors such as phlegm, blood stasis and deficiency,which can cause pulse stagnation or blockage, increasing the vein pressure to form a vascular disease.It is more accurately explained the physiology and pathology of hypertension using Xuemai theory insteading of the traditional viscera syndrome.According to the different stages of the disease,we used to improving the blood quality(anti-inflammatory,anti-oxidation,etc.),preventing and treating vascular lesions(the protection of vascular endothelial function,inhibition of vascular remodeling,etc.) to treat hypertension,which is almost the same as the way to identify the disease locationand treat blood and veins by Xuemai theory. Combining Xuemai theory with clinical practice, we introduced the pathogenesis of hypertension and the essence of vasculopathy of hypertensionto provide a basis for the treatment of hypertension from blood and vessels.
引文
[1] 中国高血压防治指南修订委员会.中国高血压防治指南[S].中华高血压杂志,2011,19(18):701-743.
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[10] 朱灵妍,周端.“心主血脉”理论与肾素-血管紧张素-醛固酮系统生物学网络的相关性探讨[J].广州中医药大学学报,2016,33(6):875-877.
[11] 黄培红,靳利利,李典鸿,等.复方芪麻胶囊对气虚痰浊型单纯收缩期高血压患者血压及炎症因子的影响[J].河南中医,2011,31(6):620-622.
[12] 张珍珍,王清海,靳利利.脉胀理论与高血压血管保护策略[J].中华中医药杂志,2015,30(4):1316-1318.
[13] 徐彤彤,武琦,吕祥威,等.马来酸依那普利叶酸片对H型高血压患者血清瘦素水平的影响[J].中国实验方剂学杂志,2013,19(10):291-294.
[14] 李莹鸿,靳利利.高血压的中医辨证治疗[J].长春中医药大学学报,2014,30(2):247-249.
[15] 李莹鸿,靳利利,黄培红,等.复方芪麻胶囊干预治疗对H型高血压患者同型半胱氨酸、瘦素水平的影响[J].中国中西医结合杂志,2017,37(6):676-679.
[16] 丁元庆.有关血脉理论几个问题的探讨[J].山东中医杂志,2015,34(4):245-247.
[17] 宋翠荣,张海峰,庞胤,等.诱导性一氧化氮合酶在动脉硬化中的作用[J].医学与哲学,2010,31(8):49-50.
[18] 邵子月,史虓悦,陈磊.内皮素与高血压相关性的研究进展[J].中国现代医药杂志,2017,19(8):92-94.
[19] 史振羽.复方芪麻胶囊对老年ISH患者动脉弹性的影响[D].广州:广州中医药大学,2014:32.
[20] 张珍珍.基于PVAT/Adiponectin探索复方芪麻胶囊对高血压血管损伤的影响[D].广州:广州中医药大学,2015:74.
[21] 赵英强,柳威,蔡晓月,等.松龄血脉康胶囊对自发性高血压大鼠PPARγ调控机制的实验研究[J].中国中西医结合杂志,2013,33(9):1236-1241.
[22] 吴伟,王创畅.“五诊十纲”中医临床新思维探讨[J].中医杂志,2014,55(6):455-457.
[2] 王清海,陶军,陈利国,等.高血压中西医结合诊治方案建议[J].中西医结合心脑血管病杂志,2015,13(5):664-666.
[3] 张会永,张哲,杨关林.《黄帝内经》“血脉”理论发微[J].中国中医基础医学杂志,2011,17(6):596-598.
[4] 于世杰,于文达,杜韬,等.《黄帝内经》血脉理论探讨[J].中华中医药学刊,2011,29(4):912.
[5] 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.
[6] 杨传华,卢绪香.“血脉理论”视角下高血压病中医病机探讨[J].中医药学报,2014,42(6):4-6.
[7] 靳利利,李典鸿,黄培红.王清海教授对高血压中医概念的认识[C]//中华中医药学会心病分会学术年会暨北京中医药学会心血管病专业委员会年会论文集,2011.
[8] 王玉民.从《内经》血脉理论探讨血压形成的生理机制[J].辽宁中医杂志,2013,40(5):910-911.
[9] 高学敏,张德芹,陈可冀,等.松龄血脉康胶囊“血脉同治”组方理论探析[J].中西医结合心脑血管病杂志,2015,13(6):708-710.
[10] 朱灵妍,周端.“心主血脉”理论与肾素-血管紧张素-醛固酮系统生物学网络的相关性探讨[J].广州中医药大学学报,2016,33(6):875-877.
[11] 黄培红,靳利利,李典鸿,等.复方芪麻胶囊对气虚痰浊型单纯收缩期高血压患者血压及炎症因子的影响[J].河南中医,2011,31(6):620-622.
[12] 张珍珍,王清海,靳利利.脉胀理论与高血压血管保护策略[J].中华中医药杂志,2015,30(4):1316-1318.
[13] 徐彤彤,武琦,吕祥威,等.马来酸依那普利叶酸片对H型高血压患者血清瘦素水平的影响[J].中国实验方剂学杂志,2013,19(10):291-294.
[14] 李莹鸿,靳利利.高血压的中医辨证治疗[J].长春中医药大学学报,2014,30(2):247-249.
[15] 李莹鸿,靳利利,黄培红,等.复方芪麻胶囊干预治疗对H型高血压患者同型半胱氨酸、瘦素水平的影响[J].中国中西医结合杂志,2017,37(6):676-679.
[16] 丁元庆.有关血脉理论几个问题的探讨[J].山东中医杂志,2015,34(4):245-247.
[17] 宋翠荣,张海峰,庞胤,等.诱导性一氧化氮合酶在动脉硬化中的作用[J].医学与哲学,2010,31(8):49-50.
[18] 邵子月,史虓悦,陈磊.内皮素与高血压相关性的研究进展[J].中国现代医药杂志,2017,19(8):92-94.
[19] 史振羽.复方芪麻胶囊对老年ISH患者动脉弹性的影响[D].广州:广州中医药大学,2014:32.
[20] 张珍珍.基于PVAT/Adiponectin探索复方芪麻胶囊对高血压血管损伤的影响[D].广州:广州中医药大学,2015:74.
[21] 赵英强,柳威,蔡晓月,等.松龄血脉康胶囊对自发性高血压大鼠PPARγ调控机制的实验研究[J].中国中西医结合杂志,2013,33(9):1236-1241.
[22] 吴伟,王创畅.“五诊十纲”中医临床新思维探讨[J].中医杂志,2014,55(6):455-457.