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中医中药

中西医结合角度探讨高血压病从肝论治

  • 陈哲 ,
  • 刘德亮
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  • 1.佛山大学医学部,广东 佛山 528225;

    2.深圳市中医院内分泌病科,广东 深圳 518033;

    3.佛山市中医院心血管内科,广东 佛山 528099
陈哲,男,博士,讲师,研究方向:中西医结合内科学

收稿日期: 2024-12-10

  修回日期: 2025-06-11

  录用日期: 2025-10-06

  网络出版日期: 2025-12-24

基金资助

广东省基础与应用基础研究基金项目(2021A1515220177);佛山市自筹经费类科技创新项目(2420001004387)

Treatment of Hypertension from the Liver Based on Integrated Traditional Chinese and Western Medicine

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  • 1.School of Medicine Foshan University Guangdong Foshan 528225, China
    2.Department of Endocrinology Shenzhen Traditional Chinese Medicine Hospital Guangdong Shenzhen 518033, China
    3.Department of Cardiology Foshan Hospital of Traditional Chinese Medicine Guangdong Foshan 528099, China

Received date: 2024-12-10

  Revised date: 2025-06-11

  Accepted date: 2025-10-06

  Online published: 2025-12-24

摘要

 高血压病患病率高,控制率低,是导致心脑血管疾病死亡的重要危险因素。如何综合有效防治高血压病,一直是困扰临床的难题。中医治疗高血压病历史悠久,积累了丰富经验。中药不仅能改善高血压病患者症状,提高生活质量,还能平稳降压,改善危险因素,保护靶器官。在中医理论中,高血压病多归属于眩晕、头痛等范畴,与肝关系最为密切,多倡导从肝论治,以调肝功效为主的中药在临床上取得较好的降压疗效,但从肝论治高血压病的理论内涵还有待进一步阐明。本研究基于中西医结合角度,从调畅情志、促进脾胃运化和胆汁分泌、促进气血津液的运行输布及藏血等功能出发,探讨中医“肝”的本质,从神经系统、消化系统、循环系统等方面分析肝系统失常与高血压病的潜在关系,以调肝中药防治高血压病的临床应用及研究进展为例证,从而进一步阐明从肝论治高血压病的理论内涵,以期为临床运用调肝中药防治高血压病提供理论依据。


本文引用格式

陈哲 , 刘德亮 .

中西医结合角度探讨高血压病从肝论治

[J]. 中国医药导刊, 2025 , 27(11) : 1203 -1203-1207 . DOI: magtech.2024.12.10-00004

Abstract

Hypertension characterized by high prevalence and suboptimal control rates remains a critical risk factor for cardiovascular and cerebrovascular mortality. The development of comprehensive strategies for effective hypertension management persists as a clinical challenge. Traditional Chinese Medicine TCM has accumulated substantial therapeutic experience in hypertension treatment. TCM interventions can not only alleviate clinical symptoms and enhance quality of life of the hypertension patients but also demonstrate stable hypotensive effects modulate risk factors and protecte target organ. Within TCM theoretical frameworks hypertension is principally classified under dizziness and headache with predominant etiological attribution to liver system dysregulation. Current clinical practice predominantly advocates liver-oriented therapeutic strategies and liver-regulating herbal formulations have demonstrated validated antihypertensive efficacy. Nevertheless the theoretical foundation underlying this liver-focused treatment paradigm warrants systematic elucidation. This study adopts an integrative medicine perspective to investigate TCM liver system fundamentals through  functional analysis of its roles in emotional modulation spleen-stomach coordination bile metabolism qi-blood-fluid dynamics and blood storage regulation. Analyze liver-hypertension pathophysiological relationships through neurological mechanisms digestive interactions and circulatory dynamics. Evaluate clinical applications by reviewing research progress of  liver-modulating herbal formulations in the prevension and treatment of hypertension so as to further explore the theoretical connotation of treating hypertension from the liver thereby providing a theoretical basis for clinical application of liver-regulating herbal therapies.


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