1.天津中医药大学,天津市静海区鄱阳湖路10号,301617
2.天津中医药大学第二附属医院
zhulinping@tjutcm.edu.cn
收稿:2024-10-31,
修回:2025-02-07,
纸质出版:2025-07-02
移动端阅览
吕霄潼,朱林平,闫景顺等.运用升阳通降法分型辨治高血压病思路[J].中医杂志,2025,66(13):1345-1349.
LYU Xiaotong,ZHU Linping,YAN Jingshun,et al.Syndrome-Based Treatment Strategy for Hypertension Using the Method of Raising Yang and Promoting Descent[J].Journal of Traditional Chinese Medicine,2025,66(13):1345-1349.
吕霄潼,朱林平,闫景顺等.运用升阳通降法分型辨治高血压病思路[J].中医杂志,2025,66(13):1345-1349. DOI: 10.13288/j.11-2166/r.2025.13.008.
LYU Xiaotong,ZHU Linping,YAN Jingshun,et al.Syndrome-Based Treatment Strategy for Hypertension Using the Method of Raising Yang and Promoting Descent[J].Journal of Traditional Chinese Medicine,2025,66(13):1345-1349. DOI: 10.13288/j.11-2166/r.2025.13.008.
以阴阳学说与络病学说为指导,认为阳气升降失调是高血压病的核心病机,结合临床实践提出升阳通降法治疗高血压病。临证分为宗气虚兼血瘀、痰浊瘀阻、肝阳上亢三种证型,分别运用自拟经验方益宗活血汤补益宗气、活血升阳,理宗活血汤豁痰通阳、调气活血,清肝通络饮清肝通络、平肝潜阳。对于特殊类型的非杓型高血压病,在充分认识病机的基础上可采用分时辨治,以期为高血压病的临床诊疗提供思路。
Guided by the theories of
yin
-
yang
and collateral disease, this paper identifies the dysregulation of
yang qi
ascent and descent as the core pathomechanism of hypertension. Based on clinical experience, a treatment approach centered on the method of raising
yang
and promoting descent was proposed. Clinically, three major syndrome types were identified. Firstly, deficiency of
zong qi
(ancestral
qi
)
with blood stasis, obstruction of phlegm-turbidity and blood stasis, and hyperactivity of liver
yang
. Corresponding empirical formulation,
Yizong Huoxue Decoction
(益宗活血汤) was applied to tonify
zong qi
, invigorate blood, and raise
yang
. Secondly,
Lizong Huoxue Decoction
(理宗活血汤) was used to resolve phlegm, promote
yang qi
circulation, and regulate
qi
and blood. Thirdly,
Qinggan Tongluo Decoction
(清肝通络饮) was used to clear the liver, dredge collaterals, and subdue hyperactive
yang
. For special types such as non-dipper hypertension, time-specific syndrome differentiation and treatment can be applied based on a thorough understanding of the underlying pathomechanism, aiming to provide new insights into clinical diagnosis and treatment of hypertension.
中国心血管健康与疾病报告编写组 . 中国心血管健康与疾病报告2023概要 [J]. 中国循环杂志 , 2024 , 39 ( 7 ): 625 - 660 .
刘桂剑 , 程宽 , 朱文青 , 等 . 高血压的药物治疗进展 [J]. 中国临床药理学与治疗学 , 2022 , 27 ( 4 ): 446 - 449 .
马曙东 , 朱若维 , 荆鲁 , 等 . 2010-2022年中医药治疗高血压临床实验性研究的概况性评价 [J]. 中医杂志 , 2023 , 64 ( 7 ): 736 - 742 .
张硕 , 陈震霖 , 唐于平 . 中医药辨治高血压的认识与发展 [J]. 世界科学技术-中医药现代化 , 2020 , 22 ( 12 ): 4139 - 4146 .
熊兴江 , 王阶 . 论高血压病的中医认识及经典名方防治策略 [J]. 中医杂志 , 2011 , 52 ( 23 ): 1985 - 1989 .
徐逸宁 , 周雨昕 , 张淑洁 , 等 . 基于开阖枢理论探讨血压昼夜节律 [J]. 北京中医药大学学报 , 2024 , 47 ( 9 ): 1211 - 1216 .
孙东建 , 蒋卫民 . 血压变异性与中医阴阳学说关系探析 [J]. 山东中医杂志 , 2013 , 32 ( 3 ): 149 - 151 .
STAPLIN N , DE LA SIERRA A , RUILOPE LM , et al . Relationship between clinic and ambulatory blood pressure and mortality: an observational cohort study in 59 124 patients [J]. Lancet , 2023 , 401 ( 10393 ): 2041 - 2050 .
HARVEY A , MONTEZANO AC , LOPES RA , et al . Vascular fibrosis in aging and hypertension: molecular mechanisms and clinical implications [J]. Can J Cardiol , 2016 , 32 ( 5 ): 659 - 668 .
李宏泽 , 于睿 . 以络论治高血压 [J]. 中西医结合心血管病电子杂志 , 2014 , 2 ( 15 ): 197 - 198 .
GILES TD , MATERSON BJ , COHN JN , et al . Definition and classification of hypertension:an update [J]. J Clin Hypertens(Greenwich) , 2009 , 11 ( 11 ): 611 - 614 .
董丽 , 徐厚平 , 罗钢 , 等 . 从“脉胀”认识高血压病 [J]. 中医杂志 , 2018 , 59 ( 15 ): 1288 - 1290 .
李红梅 , 王婧文 , 孙晓婷 , 等 . 络风内动与动脉粥样硬化斑块内血管新生 [J]. 中医杂志 , 2017 , 58 ( 17 ): 1462 - 1465,1472 .
孙兴甲 . 基于氧化应激和血压昼夜节律探讨老年高血压患者中医证型临床研究 [D]. 北京 : 中国中医科学院 , 2024 .
吴蕾 , 郑俐慈 , 陈远彬 , 等 . 基于宗气、元气理论探讨慢性阻塞性肺疾病的病机与辨治 [J]. 中医杂志 , 2023 , 64 ( 14 ): 1440 - 1443 .
张雨晴 , 王蕾 . 黄芪双向调节血压的作用机制研究进展 [J]. 国际中医中药杂志 , 2019 , 41 ( 8 ): 907 - 911 .
ZHAO P , ZHAO C , LI X , et al . The genus Polygonatum: a review of ethnopharmacology, phytochemistry and pharmacology [J]. J Ethnopharmacol , 2018 , 214 : 274 - 291 . doi: 10.1016/j.jep.2017.12.006 http://dx.doi.org/10.1016/j.jep.2017.12.006 .
王元彪 , 沈劼 . 经典名方瓜蒌薤白半夏汤药物炮制品种及处方剂量的文献考证 [J]. 南京中医药大学学报 , 2022 , 38 ( 9 ): 831 - 838 .
张锦 , 徐宗佩 . 清肝通络饮治疗肝火型高血压病30例 [J]. 环球中医药 , 2016 , 9 ( 2 ): 224 - 226 .
周毅萍 , 何新慧 . 从《续名医类案》看古代医家的时间医学观 [J]. 江苏中医药 , 2008 , 40 ( 10 ): 101 - 102 .
0
浏览量
0
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010102007558号