顾宁对盐敏感性高血压的中医诊治思路

Gu Ning's Thoughts on Diagnosis and Treatment of Salt-sensitive Hypertension in Traditional Chinese Medicine

顾宁教授认为,盐敏感性高血压的主要病因是过食咸味,病机关键以肾虚为本,标实有血瘀、血热、痰湿之异,病位主要在肾,与肝脾密切相关。结合其发病特点与临床特征,主张将高血压病辨证为肾精亏虚型、肝阳上亢型、瘀血阻络型及痰湿壅盛型进行论治。治疗原则以补肾为主、兼顾肝脾,以期标本兼顾。遣方用药时重视利尿中药的应用,取其利水渗湿、通利小便之功,根据个体情况随证加减,分平肝清热利水、活血利水、滋阴利水等。同时注重患者的饮食习惯调摄,指导患者合理饮食、控盐达标,有效防治盐敏感性高血压。

Professor Gu Ning thinks that the main cause of salt-sensitive hypertension is overeating salty taste.The pathogenesis is deficiency in kidney,excess in blood stasis,heat,and dampness.The disease mainly lies in kidney,closely related to liver and spleen.Combined with its characteristics and clinical features,it is advocated that the hypertension syndrome should be treated as kidney deficiency,liver yang hyperactivity,blood stasis and phlegm turbidity resistance.The principle of treatment is based on tonifying kidney along with liver and spleen,aims to treat both tip and root.When choosing herbs and prescriptions,pay attention to the application of diuretic herbal remedies,with the function of clearing damp and promoting diuresis.According to the individual situation,it can be divided into suppressing hyperactive liver,promoting blood circulation and nourishing yin.At the same time,Professor Gu guides patients to a reasonable diet,using salt to meet the standard,as to prevent the occurrence and development of saltsensitive hypertension.