中医药治疗高血压病研究述评与展望

Review and prospect of traditional Chinese medicine in treatment of hypertension

高血压病是心脑血管事件的重要诱因,已成为全球重大公共卫生问题,给社会带来了沉重的卫生经济学负担。在中国工程院发布的“未来20年我国可预防的重大疾病和健康问题研究”中,高血压病排在第二位。由于高血压病本身的复杂性,很多患者需终身服用降血压药。虽然现代医学在降血压领域已取得长足进展,但因此带来的诸多问题仍未得到有效解决,包括降血压西药的不良反应,长期服药导致依从性下降,高血压病相关临床症状与体质不能得到有效改善等。近10年,中医药治疗高血压病的研究备受关注,是我国中医学和中西医结合研究最活跃的领域,在理论、临床与实验研究方面取得重大进展。研究发现,除平稳降血压外,中医药还具有改善临床症状、逆转危险因素、改善患者生活质量、保护高血压病导致的靶器官损害等诸多优势。该文从指南/标准/共识、临床研究、实验研究、系统评价/Meta分析4个方面,系统梳理近10年来中医药治疗高血压病的国际、国内研究进展,总结中医药降血压循证证据,明确中医药降血压机制,以期聚焦热点、把握方向,为高血压病的中医诊疗与新药研发提供参考与借鉴。

Hypertension,a primary cause of cardiovascular and cerebrovascular events,has become a major global public health problem and caused a heavy burden of health economics on the society.In"the 20 Most Important and Most Preventable Health Problems"released by the Chinese Academy of Engineering,hypertension was ranked the second.Due to the disease complexity,many hypertension patients need to take antihypertensive drugs for life.Although significant progress has been achieved in blood pressure lowering by western medicines,the problems including adverse reactions,poor compliance due to long-term medication,and ineffective mitigation in clinical symptoms related to hypertension remain to be addressed.In the last decade,the research on traditional Chinese medicine(TCM)treatment of hypertension has received much attention and achieved remarkable progress.The TCM treatment of hypertension is the most active area of research with integrated Chinese and western medicine in China.In addition to lowering blood pressure smoothly,TCM can alleviate clinical symptoms,reverse risk factors,improve the quality of life,and protect target organs from the damage caused by hypertension.This article systematically reviews the research progress of TCM in treating hypertension in the last decade from the following four aspects:consensus on guideline,clinical trial,experimental study,and systematic review/Meta-analysis.It summarized the evidence of TCM in reducing blood pressure and clarified the mechanism of TCM in reducing blood pressure,aiming to provide a reference for the TCM diagnosis and treatment of hypertension and the development of new drugs.