基于血脉理论探讨高血压辨治

Discussion based on the Xuemai theory of treating hypertension

高血压作为一种心血管综合征,血脉的病理变化是高血压发生及进展至关重要的环节,也是贯穿高血压始终的主要病理现象,这一客观现象符合中医学理论从血脉病角度对高血压病理生理的认识即"起病于气,气耗痰生,血瘀不行,痰瘀互结,久病及肾"。高血压发生主要与情志失节、饮食失调、劳倦内伤及体虚年高有关。从血脉病角度认识高血压,其病位在血脉,久病与肾相关,不同于"眩晕病"原有的病位在清窍的观点。本病病机无外乎虚实两端,实者气逆、气滞、痰浊、血瘀,虚者气虚、肾亏,总病机在于气血失和、脉道瘀阻,治则为调气和血、通利血脉。诊治之时当审症求因,参研病程,谨守病机,根据气血阴阳虚实分别施以降气、理气、益气、化痰、活血、补肾等通脉之法。

Hypertension as a cardiovascular syndrome, pathological changes of Xuemai is a vital process to the progress of hypertension and the main pathological manifestation of the whole disease stage, which is in line with the Xuemai theory of TCM ＂onset in qi, qi consumption leads to sputum, blood stasis, phlegm, chronic illness affects kidney. ＂ Emotional fluctuations, eating unhealthy fatigue, old age and physical weakness lead to the occurrence of hypertension. From the angle of cognition of hypertension blood disease, the disease in the blood, chronic illness and kidney related, different from the ＂vertigo＂ original disease in qingqiao view.The disease pathogenesis is divided into deficient syndrome and excess syndrome two categories, one is inverse qi, qi stagnation, phlegm, blood stasis, one is deficiency, impotence; the total pathogenesis is disharmony between qi and blood, blood clogging. The treatment principle is promoting qi and blood circulation, dredging Xuemai. Doctors should follow the principles of treatment, according to the actual situation ofyin, yang, qi, blood, deficient and excess, using the method ofjiangqi,regulating qi, tonifying qi, reduing phlegm, invigorating the circulation of blood, tonifying kidney.