盐敏感性高血压的中医理论研究进展

Advances in Traditional Chinese Medicine Theory of Salt-sensitive Hypertension

盐敏感性高血压属原发性高血压,其危害已经越来越引起临床的关注,中医学中并没有高血压这一病名,但是根据症状表现,多归属于"眩晕""头痛"范畴,病机可归纳为阴阳平衡失调、阴虚为本、阳亢为标、本虚标实;病因则多由痰、瘀、风、火、虚等引起,病位在脑,与五脏均有关。盐敏感性高血压是由于高盐摄入后所引起的血压水平显著升高,中医学对于盐敏感性高血压的认识十分久远,认为其主要影响为肝、脾、肾三脏,咸属五味之一,主水脏入肾,过量摄入咸味会使肾脏负担过大;咸味摄入后由脾胃运化,后入血走肾,长此以往,脾胃受其热所损,伤津耗气,脾胃运化失司,易被痰湿所困;盐入血而蕴热,肝藏血,长期摄入过量咸味,肝脏会受到藏血之热影响,会产生肝火上逆等。盐敏感性高血压的主要病机为肝火上炎、痰湿困脾及肾精亏虚,中医治疗此根据病机,肝火上炎多以平肝潜阳,天麻钩藤饮加减;痰湿壅盛多补脾祛湿,半夏白术天麻汤加泽泻汤;肾精亏虚多补肾填精;补肾活血方,疗效显著。

Salt-sensitive hypertension is a kind of essential hypertension,its harm has attracted more and more attention.There is no mention of hypertension in traditional Chinese medicine.However,according to its symptoms,it is often classified as vertigo and headache.Its pathogenesis can be basically summed up as imbalance of yin and yang,Yin deficiency as the basis.Yangkang as the standard,Benxu as the standard.Its etiology is mostly caused by phlegm,blood stasis,wind,fire and deficiency.Its location is in the brain,and the pathological changes are related to the five Zang organs.Salt-sensitive hypertension is a type of hypertension with significantly elevated blood pressure caused by high salt intake,and the understanding of salt-sensitive hypertension in traditional Chinese medicine is very extensive.It is believed that its main influence on the viscera is liver,spleen and kidney.Salt is one of the five tastes.The main water enters the kidney and excessive intake.Salty taste will make the kidney overload;secondly,salty taste will be transported by the spleen and stomach after intake,and then blood will be transported to the kidney.In the long run,the spleen and stomach will be damaged by its heat,injury and consumption of gas,and the spleen and stomach will lose its function,which will easily be trapped by phlegm and dampness;thirdly,salt will be transported into the blood and accumulate heat,while the liver will be trapped by blood after long-term intake of excessive salty taste.The influence of heat will produce the adverse effect of liver fire.The main pathogenesis of salt-sensitive hypertension is liver-fire inflammation,phlegm-dampness trapping spleen and deficiency of kidney essence.Therefore,traditional Chinese medicine treats this kind of salt-sensitive hypertension,mostly according to its pathogenesis.The patients with liver-fire inflammation mostly use the method of calming liver and latent yang,combined with Tianma Gouteng Yin,and the patients with phlegm-dampness congestion mostly use tonic.The method of eliminating dampness by spleen is combined with Banxia Baizhu Tianma decoction and Zexie decoction.The patients with deficiency of kidney essence mostly use the method of tonifying kidney and filling essence together with the prescription of invigorating kidney and activating blood circulation.The curative effect is remarkable.