中医外治法治疗老年高血压病合并认知障碍的研究进展

A review on treating senile hypertension complicated with cognitive impairment by the TCM external therapy

近年来老龄人口持续增加,老年高血压病合并认知障碍的发病率逐年升高。在中医学中,老年高血压病合并认知障碍多为虚实夹杂之证,其病因病机复杂,临床以肾精亏虚、髓海不足为主。西医学研究发现,会因为衰老可导致脑血流量减少,出现功能障碍,动脉高血压病进一步加剧了这种功能障碍。此外,血压水平和认知功能障碍有所关联的潜在机制可能和大脑中与高血压病相关的β淀粉样蛋白积累有关系。虽然该病的发病机理正处于研究阶段,尚未被完全认识,但是对该病的治疗已刻不容缓。现代医学单纯依靠西药治疗该病并不能达到临床预期,且伴随不同程度的耐药性和不良反应。近年来中医外治法发展迅速,在一定程度上弥补了西药治疗存在的问题和不足,且对该病治疗效果显著。本研究通过检索大量关于老年高血压病合并认知障碍的病因病机以及中医外治法治疗该病的文献研究,发现在脏腑经络学说的指导下,耳穴压豆、穴位贴敷、经穴推拿、针灸疗法作用于人体可使气血得以畅行,培补正气,有效地缓解临床症状且疗效稳定持久,在治疗该病方面具有独特的优势。因于此,文章对老年高血压病合并认知障碍的病因病机及中医外治法进行分析与论述,以期为该病的预防和治疗提供新的思路和方法。

In recent years,the elderly population has continued to increase,and the incidence rate of elderly hypertension with Icognitive impairment has increased year by year.In TCM,elderly hypertension combined with cognitive impairment is mostly a syndrome of deficiency and excess.Its etiology and pathogenesis are complex,and the clinical symptoms are mainly deficiency of kidney essence and deficiency of marrow.Western medical research has found that aging can lead to reduced cerebral blood flow,leading to dysfunction,which is further exacerbated by arterial hypertension.In addition,the potential mechanisms of the association betwee blood pressure levels and cognitive impairment may be related to the accumulation ofβ-amyloid protein in the brain,which is associated with hypertension.Although the pathogenesis of this disease is still in the research stage and has not been fully understood,the treatment of this disease is urgent.Modern medicine relying solely on Western medicine to treat this disease cannot meet clinical expectations,and it is accompanied by varying degrees of drug resistance and adverse reactions.In recent years,the development of TCM external therapy has been rapid,which to some extent compensates for the problems and shortcomings of Western medicine treatment,and the treatment effect on this disease is significant.By searching for a large number of literature research on etiology and pathogenesis of senile hypertension with cognitive impairment and the treatment of the disease by TCM external therapy,the author found that ear point pressing,acupoint application,acupoint massage,and acupuncture and moxibustion therapy,under the guidance of the theory of Zangfu(脏腑)and meridians,can smooth the flow of Qi(气)and blood,cultivate healthy Qi,effectively alleviate clinical symptoms,and have a stable and lasting effect,which has unique advantages in the treatment of the disease.Therefore,this article analyzes and discusses the etiology,pathogenesis,and TCM external therapy of elderly hypertension with cognitive impairment,in order to find new ideas and methods for the prevention and treatment of this disease.