临界性高血压“审症为先,辨体为参,病证结合”的辨治策略探讨

Discussion on the Differentiation Treatment Strategy of Borderline Hypertension Based on the Theory of"Examining the Symptoms First,Identifying the Constitutions as Reference,and Combining the Diseases and Patterns"

围绕病证结合的临床思维,将辨病、辨证、辨体有机结合,提出临界性高血压的“审症为先,辨体为参,病证结合”的辨治策略。首先以审症辨病为出发点,病名诊断精确而指向性较强者以病统证,病名相对宽泛而病证特征较为模糊者则强调辨体、辨证。注重体质辨识对辨病、辨证的影响,在无症可辨的情况下当以辨体为基础,基于“体病相关”“体证相关”理论从群体与个体层面完善对临界性高血压的认识,有助于识别、预判病证的发展趋势,从而病证结合辨治;在症繁难辨的情况下则需以证为纲、以证统病,再参考体质而立法遣方用药。总结临界性高血压中医临证思路层次清晰且易于掌握的辨治策略,以期为临界性高血压的中医药防治提供可行、高效的参考。

Based on the clinical thinking of combining diseases and patterns,we combined disease identification,pattern differentiation,and constitution identification,and put forward the theory of identifying and treating critical hypertension,which is"examining the symptoms first,identifying the constitutions as reference,and combining the diseases and patterns".Firstly,the starting point of identifying the disease is to examine the symptoms,and those with precise diagnosis and strong specificity will be diagnosed with the disease,while those with relatively broad diagnosis and fuzzy characteristics will be emphasised on identifying constitutions and differentiating patterns.Focusing on the impact of constitution identification on disease identification and pattern differentiation,constitution identification could be the basis when no symptoms to identify,and based on the theory of"constitution-disease correlation"and"constitution-pattern correlation"to improve the understanding of borderline hypertension from the group and individual level,which helps to identify and predict the development of the diseases and patterns;if the symptoms are complicated and difficult to identify,it is necessary to take syndrome as the outline,use the syndrome to unify the disease,and then refer to the constitution to legislate and prescribe medications.This paper summarizes the traditional Chinese medicine clinical differentiation and treatment strategy of borderline hypertension clear and easy to grasp,with a view to provide a feasible and efficient reference for prevention and treatment of borderline hypertension with traditional Chinese medicine.