天麻钩藤饮治疗原发性高血压病的研究进展

Research Progress on the Treatment of Primary Hypertension with Tianma Gouteng Decoction

原发性高血压病(Essential Hypertension, EH)作为一种全球性的慢性疾病,其发病率逐年上升,已成为心血管疾病的主要危险因素之一,严重影响人民生活质量与生命健康水平。EH患者需长期口服西药来控制血压,但临床中西药存在副作用较多,对肝肾功能影响较大等弊端,且有诸多禁忌症,导致远期治疗效果差,血压控制不理想。中医药治疗原发性高血压通过辨证论治的方法,主张标本兼顾、缓急同治,具有不良反应少、远期效果平稳、更具个体化等优点。近年来,天麻钩藤饮在防治EH领域展现出较高的应用价值并取得了较为明显的临床效果。该方剂具有平肝熄风、补益肝肾、清热安神等功效,其有效成分众多,可通过多环节、多途径、多靶点干预EH,与当前复杂性疾病治疗的新概念相契合。临床实践证明,天麻钩藤饮加减联用它法或西药治疗可起到协同增效作用。研究还发现,该方剂可以通过调节血管张力、抗氧化应激、抗炎、抑制肾素–血管紧张素–醛固酮系统、调节神经系统功能来发挥效用。本文主要从理论基础、临床研究、作用机制等方面对天麻钩藤饮治疗EH进行探讨总结,以求为今后临床治疗EH开拓思路。As a global chronic disease, the incidence of essential hypertension (EH) is increasing year by year, and it has become one of the major risk factors for cardiovascular diseases, which seriously affects people’s quality of life and life and health level. EH patients need long-term oral western drugs to control blood pressure, but western drugs in clinic have the disadvantages of more side effects, greater impact on liver and kidney function, and many contraindications, resulting in poor long-term therapeutic effects and unsatisfactory blood pressure control. The treatment of essential hypertension with Chinese medicine is based on the method of evidence-based therapy, which advocates the balancing of symptoms and root causes, and the simultaneous treatment of slow and urgent conditions, and has the advantages of fewer adverse effects, stable long-term effects, and more individualization. In recent years, Tianma Hook Teng Drink has shown high application value and achieved more obvious clinical effects in the field of EH prevention and treatment. The formula has the efficacy of calming the liver and extinguishing wind, tonifying the liver and kidneys, clearing heat and tranquilizing the mind, and it has numerous active ingredients that can intervene in EH through multiple links, pathways, and targets, which is in line with the current new concept of complex disease treatment. Clinical practice has proved that the combination of Tianma Hook Teng Drink with its method or western medicine can play a synergistic effect. It was also found that the formula could be effective by regulating vascular tone, anti-oxidative stress, anti-inflammation, inhibiting the renin-angiotensin-aldosterone system, and modulating nervous system function. This article mainly discusses and summarizes the treatment of EH with Tianma Hookteng Drink from the aspects of theoretical foundation, clinical research, and mechanism of action, in order to develop ideas for the future clinical treatment of EH.