基于“毒损脉络”学说的病机新视角探讨高血压病的防治

Discussion on Prevention and Treatment of Hypertension from the New Perspective of Pathogenesis of Toxin Impairing Vessels and Collaterals

基于中医“毒邪致病”的内涵、高血压的传统病机及现代医学发病机制等,探讨高血压的“毒邪致病”病机。认为在高血压的发生发展过程中,由于机体阴阳失调、气血失和而产生的肝阳、肝风、肝火、痰浊、瘀血等病理产物蕴久稽留不去,可酿生“风毒”“火毒”“痰毒”“浊毒”“瘀毒”等毒邪,这些毒邪可损伤脉络,进而对机体各脏腑器官造成损害,并介导各种临床并发症的发生。基于“毒损脉络”病机,临床防治高血压时可以从“毒邪”着手,紧扣“毒损脉络”之病机,以“未病防毒,已病祛毒,祛毒护脉并重”为治疗原则,采用“解毒或祛毒”“活血与护脉”治法。基于“毒损脉络”病机防治高血压,可为中医药防治高血压及其并发症提供新的思路和方法。

This paper discusses the pathogenesis of“toxin inducing illness”in hypertension from the perspective of the connotation of“toxin inducing illness”in the field of traditional Chinese medicine(TCM),the traditional pathogenesis of hypertension and the modern medical pathogenesis of hypertension.It is believed that during the occurrence and development of hypertension,the pathological products of liver yang,liver wind,liver fire,turbid phlegm and blood stasis that are caused by the disharmony between yin and yang and disharmony between qi and blood would accumulate and retain for a long time,and lead to the formation of toxic pathogens of wind toxin,fire toxin,phlegm toxin and stasis toxin which will damage the vessels and collaterals.The toxin pathogens will also cause the injury of the internal organs of the body and result into the occurrence of various clinical complications.Based on the pathological mechanism of“toxin impairing vessels and collaterals”,clinical prevention and treatment of hypertension should start by toxic pathogens,and should closely follow the pathological mechanism of“toxin impairing vessels and collaterals”and the therapeutic principle of“preventing the formation of toxin before the illness,removing toxin during the illness,and paying equal attention to removing toxin and protecting the vessels”.The therapies of“detoxifying or removing toxin”and“activating blood and protecting vessels”can be adopted.The method of prevention and treatment of hypertension based on the pathogenesis of“toxin impairing vessels and collaterals”will provide new ideas and methods for the prevention and treatment of hypertension and its complications with Chinese medicine.