毛德西应用天钩六叶汤治疗高血压病经验赏析

Appreciation of MAO Dexi′s Experience on Treating Hypertension with Tiangou Liuye Decoction

目的收集整理毛德西教授应用天钩六叶汤治疗肝阳上亢型高血压的经验。方法通过整理毛德西教授治疗高血压的病案和讲座,结合现代医学研究,总结老师应用天钩六叶汤治疗肝阳上亢型高血压的经验。结果毛德西教授通过多年临床实践认识到肝阳上亢证是高血压病的主要病因之一,而平肝熄风法应是治疗高血压的一个主要治法。相对应的名方天麻钩藤饮是治疗肝阳上亢证的一个很好的方药,但是方中的石决明在煎药时不容易煎煮,有效成分不易煎出,难以发挥最佳疗效,而黄芩、栀子的苦寒,口感不佳,易于伤胃,导致部分患者的耐受性差。毛老遂结合自己多年的临床经验以天麻、钩藤为主药,配以霜桑叶、杜仲叶、银杏叶、罗布麻叶、荷叶、绞股蓝叶等"六叶",组成天钩六叶汤,治疗肝阳上亢型高血压病,取得良好效果。结论毛德西教授应用天钩六叶汤治疗肝阳上亢型高血压病,安全疗效好,值得临床推广使用。

Objective To collect and sort out Professor MAO Dexi′s experience on treating hypertensive liver-Yang syndrome with Tiangou Liuye Decoction(天钩六叶汤).Methods By sorting out Professor MAO Dexi′s cases and lectures on hypertensive liver-Yang syndrome and combining with modern medical research,the author summarized his experience on treating hypertensive liver-Yang syndrome with Tiangou Liuye Decoction.Results Through many years of clinical practice,it is recognized that the syndrome of hyperactivity of liver-Yang is one of the main causes of hypertension,and the method of calming liver and extinguishing wind should be the main treatment of hypertension.The corresponding famous prescription Tianma Gouteng Yin is a good prescription for the treatment of hyperactivity of liver-Yang,but Shijueming(Haliotis diversicolor)in the prescription is not easy to decoct,the effective ingredients were not easy to decoct,it is difficult to play the best curative effect,while the bitter cold taste of Huangqin(Scutellaria baicalensis)and Zhizi(Gardenia jasminoides)can easily damage stomach,resulting in poor tolerance of some patients.Combined with his many years of clinical experience,MAO Laosui chose Tianma(Gastrodia elata)and Gouteng(Uncaria rhynchophylla)as the main medicine,with Sangye(Morus alba),leaves of Duzhong(Eucommia ulmoides),leaves of Yinxing(Ginkgo biloba),leaves of Luobuma(Apocynum venetum),leaves of Heye(Nelumbo nucifera),leaves of Jiaogulan(Gynostemma pentaphyllum)to compose Tiangou Liuye Decoction.The treatment of hypertensive liver-Yang disease has achieved good results.Conclusion Professor Mao Dexi′s application of Tiangou Sixleaves Decoction in the treatment of hypertension with hyperactivity of liver-yang is safe and effective,which is worthy of clinical application.