78例高血压病合并脑梗死患者证候分析与病机探讨  

Syndrome and pathogenesis of 78 cases of hypertension complicated with cerebral infarction

作　　者：陈茹[1] 丁元庆[2] 温雅[3] 黄燕[4] 

机构地区：[1]广州中医药大学,广州510405 [2]山东中医药大学附属医院,济南250011 [3]山东中医药大学,济南250355 [4]广东省中医院,广州510120

出　　处：《中华中医药杂志》2015年第5期1822-1826,共5页China Journal of Traditional Chinese Medicine and Pharmacy

摘　　要：目的:探讨高血压病合并脑梗死(恢复期)的病因病机,拓展脑梗死的二级预防。方法:分析78例高血压病合并脑梗死(恢复期)、83例单纯高血压病患者的临床资料与证候分布特点,探讨高血压致脑梗死的病因病机。结果:在发病年龄方面存在性别差异:男性高血压脑梗死发病年龄早于女性,女性高血压脑梗死多发生在绝经10年后。阴虚阳亢、肝阳上亢是高血压病也是高血压病合并脑梗死的基本病机,风火痰瘀是高血压病合并脑梗死的主要病理因素。结论:高血压病病位主要在肝肾,以肝肾阴虚为本,而发生脑梗死之后,出现了病机、病位、病邪多方面的变化,主要表现为风火痰瘀诸邪气侵入脏腑、经络,即发生了中脏腑、中经络的中风病机变化。对防治高血压病脑梗死而言,男性应早于女性,女性最迟应自围绝经期开始。Objective： To explore the etiology and pathogenesis of hypertension with cerebral infarction （recovery phase）, so as to expand the secondary prevention of cerebral infarction. Methods： Clinical data of 78 cases of hypertension complicated with cerebral infarction and 83 cases with isolated hypertension were analyzed to explore the syndrome and pathogenesis. Results： Gender differences existed in the onset age of cerebral infarction that male was earlier than female, women mostly occured 10 years after menopause. Yin deficiency and yang excess and hyperactivity of liver-yang was the basic pathogenesis of hypertension as well as hypertensive cerebral infarction, wind, fire, phlegm and blood stasis were the main pathological factors of hypertension with cerebral infarction. Conclusion： The disease location of hypertension mainly lies in liver and kidney, based on liver and kidney yin deficiency, while it changes in pathogenesis, disease location and pathogenic factors when after onset of cerebral infarction, mainly performing that the pathogenic factors such as wind, fire, phlegm and blood stasis invade zang-fu and meridians,which is just the pathogenesis of stroke. Men should be earlier than women to prevent or treat hypertensive cerebral infarction, while women should have started since the menopausal transition at the latest.

关 键 词：高血压病 脑梗死 病机 证候 肝肾阴虚 

分 类 号：R259[医药卫生—中西医结合] R277.7[医药卫生—中医内科学]