高血压病合并性功能障碍的中医认识及治疗策略

TCM understanding and treatment strategy of hypertension complicated with sexual dysfunction

高血压病及其靶器官损害已成为危害健康的重大公共卫生问题。性功能障碍是现代高血压病治疗中面临的新难题。现代病理生理机制研究表明,高血压病可导致性功能障碍。此外,以利尿剂等为主的三大类降压药也能导致性功能障碍。中医学中,高血压病属于“眩晕”“头痛”“头风”等范畴。对高血压病的中医病机认识,既往多从“肝风”“阳亢”等角度立论,然而,基于对古今文献与医案的深入研究及多年临床实践,发现肾虚为其现代病机关键。高血压病合并性功能障碍属于中医学肾虚证范畴,尤其以肾阴不足常见。既往团队及其他研究表明,滋阴补肾法不仅能有效降压,改善性功能障碍,还能逆转危险因素,以及保护靶器官损害。该文系统论述高血压病合并性功能障碍的中医认识和现代病理生理机制,以及补肾中药(单味药、复方)治疗高血压病合并性功能障碍的临床治疗策略,以期为补肾法治疗高血压病合并性功能障碍提供临床借鉴。

Hypertension and its target organ damage have become a major public health problem.Sexual dysfunction is a new problem in the treatment of modern hypertension.Modern pathophysiological studies have shown that hypertension can lead to sexual dysfunction.In addition,three major hypotensive drugs represented by diuretics can also lead to sexual dysfunction.In TCM,hypertension belongs to"vertigo""headache""head wind",etc.In the past,the understandi ng of the TCM pathogenesis of hypertension was mainly from the perspectives of"liver wind"and"Yang hyperactivity".However,based on the in-depth research on ancient and modern literature and medical records and many years of clinical practice,it has been identified that kidney deficiency was the key pathogenesis.Hypertension complicated with sexual dysfunction belongs to the category of kidney deficiency syndrome in TCM,especially the deficiency of kidney Yin.Previous studies by other research groups showed that Yin-enriching and kidney-tonifying method could effectively reduce blood pressure,improve sexual dysfunction,reverse risk factors,and protect target organs.This article systematically discussed the TCM understanding,modern pathophysiological mechanism,and the clinical treatment strategy of kidney-tonifying drugs(single drugs and compounds)in the treatment of hypertension complicated with sexual dysfunction in order to provide a scientific basis for kidney-tonifying method in the treatment of hypertension complicated with sexual dysfunction.