基于“体用俱损”论治顽固性高血压临证经验

Clinical Experience in the Treatment of Refractory Hypertension Based on the Theory of “Concurrent Damage of Qi and Body”

摘要: 总结周亚滨教授治疗顽固性高血压(Refractory Hypertension, RH)的临证经验。周教授以“体用俱损”理论为指导，指出RH病机关键在于肝之体用失调，肝用失常则气机郁滞，痰瘀内生，上扰清窍，发为眩晕、头痛；肝体阴血不足则失于濡养，肝阳上亢或阴虚风动。治疗上注重调和肝之体用关系，以调肝用、养肝血为主。临证灵活选用自拟降压汤、逍遥丸、柴胡加龙骨牡蛎汤等方剂加减，并附以经典案例来彰显周亚滨教授从肝辨治RH的临证思路及用药组方特色。

Abstract: Summarize Professor Zhou Yabin’s clinical experience in treating refractory hypertension (RH). Guided by the theory of “the liver governs the body with the help of yang”, Professor Zhou Yabin pointed out that the key to the pathogenesis of RH lies in the imbalance between the liver’s body function and its use. When the liver’s yin blood is insufficient, it fails to nourish properly; when the liver yang is excessive or the liver yin is deficient, wind may be generated; when the liver’s function is abnormal, qi stagnation occurs, leading to the generation of phlegm and blood stasis, which then invades the clear orifices, causing dizziness and headache. In treatment, emphasis is placed on harmonizing the relationship between the liver’s body and its function, with the main focus on nourishing the liver blood and regulating the liver function, while also using methods to eliminate phlegm and resolve blood stasis. In clinical practice, Professor Zhou Yabin flexibly selects his own formulas such as the Hypotensive Decoction, the Xiao Yao Pill, and the Chaihu Jia Longgu Mu Li Decoction for modification, and also provides classic cases to demonstrate his clinical thinking and medication formula characteristics in treating RH from the perspective of the liver.