中医药治疗高血压伴认知障碍的研究进展

Research Progress of Traditional Chinese Medicine in the Treatment of Hypertension Complicated with Cognitive Impairment

摘要: 本文综述了中医药在治疗高血压伴认知障碍方面的研究进展。高血压作为常见心血管疾病，是导致认知障碍的重要危险因素，尤其与中年发病及控制不良密切相关。中医认为高血压属“眩晕”“头痛”范畴，病机与肝、肾、脾等脏腑功能失调相关；认知障碍则归属于“痴呆”“善忘”，病位在脑，与肾精亏虚、气血不足、痰瘀阻窍等有关。文章系统总结了单味中药(如川芎、丹参、天麻)及其有效成分在降压与神经保护方面的作用机制，并梳理了针对肝阳上亢、阴虚阳亢、痰浊中阻、瘀血阻络等证型的常用复方治疗策略。此外，还探讨了耳穴压豆、针刺、穴位贴敷、放血等中医外治法在调节血压、改善认知功能方面的临床应用与机制。研究表明，中医药通过多成分、多靶点、整体调节的方式，在高血压伴认知障碍的防治中展现出独特优势，具有广阔的临床应用前景。

Abstract: This article reviews the research progress of Traditional Chinese Medicine (TCM) in the treatment of hypertension complicated with cognitive impairment. As a common cardiovascular disease, hypertension is a crucial risk factor for cognitive impairment, and it is particularly closely associated with onset in middle age and poor disease control. From the perspective of TCM theory, hypertension falls into the categories of “vertigo” and “headache”, whose pathogenesis is related to the dysfunction of Zang-Fu organs such as the liver, kidney, and spleen; cognitive impairment, on the other hand, is classified under “dementia” and “amnesia”, with its disease location in the brain and its etiology linked to kidney essence deficiency, insufficient qi and blood, and obstruction of the orifices by phlegm and blood stasis. This article systematically summarizes the mechanisms of action of single TCM herbs (e.g., Ligusticum chuanxiong Hort., Salvia miltiorrhiza Bunge., Gastrodia elata Blume.) and their active components in lowering blood pressure and exerting neuroprotective effects. It also sorts out the commonly used compound TCM treatment strategies for different syndrome types, including liver-yang hyperactivity, yin deficiency with yang hyperactivity, phlegm-turbidity obstruction in the middle energizer, and blood stasis blocking collaterals. In addition, the article discusses the clinical applications and mechanisms of external TCM therapies—such as auricular point pressing (with beans), acupuncture, acupoint application, and bloodletting therapy—in regulating blood pressure and improving cognitive function. Studies have shown that TCM, through its multi-component, multi-target, and holistic regulation approach, demonstrates unique advantages in the prevention and treatment of hypertension complicated with cognitive impairment, and thus holds broad prospects for clinical application.