高血压兼变证湿盛风引病机论

Pathogenesis of Hypertension with Transmuted Syndrome as Internal Wind Caused by Excessive Dampness

高血压兼变证即高血压病日久伴发的靶器官损伤疾病,与中医学中的中风、胸痹、心悸、水肿、厥证等有关,“湿”和“风”是高血压兼变证的关键证素。结合中医学病机理论,总结全国老中医药专家学术经验继承工作指导老师董其美辨治高血压兼变证的临床经验,提出高血压兼变证病机演变“湿盛风引”论,即:湿为兼变证之源、风为兼变证之引,风引痰瘀戗犯心脑、风引水饮凌心射肺、风引水湿外溢为肿、风引火上炎伤阴为悸。并提出治眩必治风,风宁眩自平;治眩必治湿,湿去兼变止的论治思路,以及实脾土、燥脾湿、化痰浊、祛水饮以治其源,益肝肾、平肝阳、清肝火、消风势以治其引,和祛瘀血、清火源、理气郁、和诸脏以治其挟的论治法则,开拓高血压病“既病防变,已变防衰”的中医药二级预防思路。

Hypertension with transmuted syndrome is a disease of target organ damage associated with hypertension over time,which is related to stroke,chest paralysis,palpitation,edema and syncope in traditional Chinese medicine.The theory of“excessive dampness”and“internal wind”are the key elements of hypertension with transmuted syndrome.Combined with the theory of the pathogenesis of traditional Chinese medicine,the authors summarized the clinical experience of Dong Qimei,the instructor of the inheritance of academic experience of famous traditional Chinese medicine experts,in the treatment of hypertension with transmuted syndrome,and proposed the theory of“internal wind caused by excessive dampness”in the evolution of the pathogenesis of hypertension with transmuted syndrome,that is,internal wind guide phlegm and stasis offend heart and brain,it lead to fluid attack heart and lung or overflow the swelling,it guide fire upward injury yin and cause palpitation.It is also proposed that the treatment of vertigo must be treated with internal wind,vertigo will get better when calm the internal wind,and the treatment of vertigo must be treated with dampness,transmuted syndrome will alleviate when remove dampness,and other treatment ideas.To treat the origin of the disease by reaching spleen,removing stagnation of dampness and spleen,eliminating phlegm,dispelling fluid retention;to treat disease triggering by benefiting the liver and kidney,calming the liver,clearing away the liver-fire,calming the endogenous wind;to treat the concomitant symptom by dispelling stasis,clearing heat,regulating qi and relieving depression,harmonizing the organs,and to open up the idea of secondary prevention of hypertension by traditional Chinese medicine,which is“disease transformation prevention and transmission of diseases to prevent damage to positive energy”.