摘要
对近年来镇肝熄风汤治疗原发性高血压的临床应用及机制研究进行综述。镇肝熄风汤为清代医家张锡纯治疗中风的经典名方,也是现今临床治疗原发性高血压的常用方。据《医学衷中参西录》记载镇肝熄风汤具有镇肝熄风,滋阴潜阳之功效,临床对阴虚阳亢型高血压有一定疗效。高血压的作用机制复杂,虽然用于治疗原发性高血压的药物种类繁多,但是现代西药存在作用靶点单一,不良反应多等问题,中药复方由于多靶点、多途径的治疗特点,在减轻高血压患者的不良反应及改善症状方面发挥着独特的优势。目前对镇肝熄风汤治疗高血压的研究较多,从中医临床实践到实验研究都取得了一定的进展,尤其是胃肠激素等新观点的提出,丰富了高血压机制学说,但是对其治疗原发性高血压作用途径、作用靶点的研究有待深入。基于此,通过收集整理近年来国内外镇肝熄风汤治疗原发性高血压的临床及作用机制的相关文献,发现镇肝熄风汤降压作用的机制主要涉及调节胃肠激素、改善血管内皮功能、改善血管重构、阻断肾素-血管紧张素-醛固酮（RAAS）系统、调控血脂、抑制交感神经活动、改善胰岛素抵抗、干预细胞膜离子通道等方面。基于镇肝熄风汤多途径、多靶点的降压作用,立足于原发性高血压的发病机制及病理生理变化,为中医药治疗原发性高血压提供新策略。
To review the studies on clinical application and functionary mechanism of Zhengan Xifeng Tang in treatment of primary hypertension in recent years. Zhengan Xifeng Tang was a classical famous prescription created by ZHANG Xi-chun in Qing dynasty for treatment of stroke,which is also commonly used in the clinical treatment of primary hypertension in modern medicine. According to Records of Tradition Chinese and Western Medicine in Combination,Zhengan Xifeng Tang has the effect of stopping endogenous wind, nourishing yin to suppress Yang,with a good effect on primary hypertension. The mechanism of hypertension is complex,so although there are so many types of drugs for the treatment of essential hypertension,modern western medicine still has such problems as single target and many adverse reactions. The therapeutic characteristics of Chinese medicine compound of multiple targets and pathways,play a unique advantage in reducing the adverse reactions and improving the symptoms of hypertensive patients. At present,there are many researches on treatment of primary hypertension with Zhengan Xifeng Tang,achieving certain progress from the clinical practice of traditional Chinese medicine to experimental research,especially the new viewpoint of gastrointestinal hormone has enriched the theory of hypertension mechanism. However,the researches on the therapeutic approach and target target in the treatment of hypertension still need to be further studied. According to the literature at home and abroad about clinical application and mechanism of Zhengan Xifeng Tang in treatment of primary hypertension,it was found that its mechanism mainly involved the following aspects： regulating gastrointestinal hormones, improving vascular endothelial function,improving vascular remodeling,blocking the renin-angiotensin-aldosterone system（ RAAS）,regulating blood lipid,depressing sympathetic nerves,improving insulin resistance and intervening ion channel of cell membrane. Based on the hypotensive effect of Zhengan Xifeng Tang in many ways and multiple targets and mainly from the pathogenesis and pathophysiological changes of primary hypertension,this paper provided a new strategy for the treatment of primary hypertension with traditional Chinese medicine.
作者
董蓉蓉
李敏
荆鲁
DONG Rong-rong;LI Min;JING Lu(Eye Hospital of China Academy of Chinese Medical Sciences, Beifing 100040, China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2018年第14期222-228,共7页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金面上项目(81274181)
关键词
镇肝熄风汤
原发性高血压
中医临床
作用机制
Zhengan Xifeng Tang
primary hypertension
traditional Chinese medicine of clinical
functionary mechanism
