高血压阳气亢逆病机理论的建立与实践  

Establishment and Practice of Pathogenesis Theory of Hypertensive Yang-qi Hyperactivity and Reverse

作　　者：张磊[1] 姜枫[1] 李运伦[2] ZHANG Lei;JIANG Feng;LI Yunlun(Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学附属医院,山东济南250014 [2]山东中医药大学,山东济南250355

出　　处：《山东中医杂志》2023年第9期905-912,共8页Shandong Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(编号:81974561);国家自然科学基金面上项目(编号:81774242);山东省自然科学基金博士基金项目(编号:ZR2017BH091);国家中医药传承创新中心项目(批文号:发改办社会[2022]366号)。

摘　　要：系统总结中医学对高血压的认识,赋予肝阳上亢新的内涵,构建高血压阳气亢逆新病机理论;提出阳气亢逆是高血压病理机制中的关键病机,贯穿了高血压发生、发展及证候演变的全过程。高血压初期多为纯实无虚,为肝阳上亢证;日久耗伤肝肾之阴,致阴虚阳亢,则发展至中期,虚实夹杂,为阴虚阳亢证;久延不愈,阴损及阳,则病至后期,形成阴阳俱虚(偏阴虚)证;以上三个阶段皆存在阳气亢逆之势,但是不同的阶段引起阳气亢逆的机制各异,可根据不同阶段的病机演化随证治之。并从肾素-血管紧张素-醛固酮系统(RAAS)激活、血管内皮功能紊乱、胰岛素抵抗等方面揭示了高血压阳气亢逆证候群的生物学基础。Systematically summarizes the understanding of hypertension in traditional Chinese medicine,endoses liver-yang hyperactivity with new connotation,and constructs a new pathogenesis theory of Yang-qi hyperactivity and reverse in hypertension.It is suggested that Yang-qi hyperactivity and reverse is a key pathogenesis in the pathological mechanism of hypertension,which runs through the whole process of the occurrence,development and syndrome evolution of hypertension.In the early stage of hypertension,most of the symptoms are liver-yang excess and pure solid syndrome without deficiency,for the syndrome of liver-yang hyperactivity.After a long time,the yin of the liver and kidney is damaged,causing yin deficiency and yang hyperactivity,then it develops to the middle stage,and the deficiency and excess are mixed,which is the syndrome of yin deficiency and yang hyperactivity.If the disease is not cured for a long time,yin deficiency damages yang and the disease develops to the later stage and leads to the formation of yin and yang deficiency(partial yin deficiency) syndrome.Yang-qi hyperactivity and reverse runs through the above three stages,but the mechanism of Yang-qi hyperactivity and reverse is different in different stages,and can be treated according to the pathogenesis evolution of different stages.And revealed the biological basis of the syndrome group of hypertension Yang-qi hyperactivity from the aspects of renin angiotensin aldosterone system( RAAS) activation,vascular endothelial dysfunction,insulin resistance and so on.

关 键 词：高血压 阳气亢逆 病机理论 藤菔降压方 钩藤玄参方 益肾降压方 

分 类 号：R259[医药卫生—中西医结合]