从肝气郁滞、络气失和论治高血压病

Treating Hypertension Based on Liver Qi Stagnation and Collateral Qi Disharmony

肝气郁滞、络气失和是高血压病的重要病机,肝气郁滞、络气失和证是高血压病的常见证型,临床多见于高血压病早期,患者血压多不稳定,常受精神情绪因素影响。结合现代研究,其证候表现的内在微观机制与血管内皮功能障碍、同型半胱氨酸水平升高、交感神经系统过度兴奋、肾素-血管紧张素-醛固酮系统过度激活、下丘脑-垂体-肾上腺皮质轴过度激活、性激素代谢紊乱、β-内啡肽水平降低等密切相关。治疗宜以疏肝理气、解郁畅络为法,方选四逆散或柴胡疏肝散加减。

Liver qi stagnation and collateral qi disharmony are the important disease mechanism of primary hypertension.Therefore,liver qi stagnation syndrome and collateral qi disharmony syndrome are common in hypertension,and usually are present in the early stage of hypertension.The blood pressure is usually unstable and is usually affected by emotional factors.According to modern research,the internal mechanism at the microscopic level of the syndrome is closely related to vascular endothelial dysfunction,elevated homocysteine levels,sympathetic nervous system overexcitation,overactivation of renin-angiotensin-aldosterone system,hyperactivation of the hypothalamic-pituitary-adrenal cortex axis,sexual hormone metabolism disorders,and decreased levels ofβ-endorphins.The treatment method should be soothing liver and regulating qi,relieving depression and dredging collaterals,and Sini Powder(四逆散)or Chaihu Shugan Powder(柴胡疏肝散)are usually applied.