中医药防治正常高值血压的临床研究进展

正常高值血压发现率逐渐升高的原因是基础医学知识的普及和检验手段的提高,但是如果不加以干预,极大的可能转化为高血压,导致心脑血管患病的风险持续上升。研究表明,正常高值血压人群检测血脂、细胞因子等实验室指标已经发生了改变,给靶器官造成了一定的损害,正常高值血压人群和高血压人群同样需要重视。正常高值血压多属于虚实夹杂之证,与肝、脾、肾密切相关。证型在疾病发展过程中有所侧重,且受体质、环境、年龄等因素影响,不可一概而论。对于治疗方面,常规西药降压尚未纳入指南,运动、饮食、健康教育等仍占主要地位。研究表明在改善生活方式的基础上施以具有中医特色的干预方法,如中药、针灸、代茶饮、八段锦等,干预正常高值血压人群,疗效显著,可以有效降低血压,改善症状,调节体质,保护靶器官损伤,且依从性较好。运用中医治未病的优势,将防线前移,将正常高值血压转变为理想血压意义深远。基于针对中医药疗法干预正常高值血压的研究,发现样本量较小,严谨性有待提高,由于中药和穴位符合机制复杂,有待深入。临床研究干预和随访时间限制,中医药疗法的远期疗效和安全性缺乏有力的证据支持。现对中医药干预正常高值血压的临床研究进行综述,以期为临床及后续的研究提供指导借鉴。

Clinical Research Progress of Traditional Chinese Medicine in Treating High-normal Blood Pressure

The incidence of high-normal blood pressure gradually increased. With the popularization of basic medical knowledge, the detection rate has increased. Without intervention, high-normal blood pressure is very likely converted into hypertension, and the risk of cardiovascular and cerebrovascular diseases will continue to rise. Studies have shown that the blood lipids for detection of people with high-normal blood pressure, cytokines and other laboratory indicators have been changed, causing certain damage to target organs. Normal-high blood pressure people and high-blood pressure people also need to be given attention. Traditional Chinese medicine (TCM) believes that high-normal blood pressure has intermingled deficiency and excess, which is closely correlated to the liver, spleen and kidney. The syndrome is constantly changing and developing in the course of disease, which is affected by physical fitness, environment, age and other factors. With respect to treatment, conventional western medicine for lowering blood pressure has not yet been incorporated into the guidelines, and exercise, diet, and health education still play a major role. Studies have shown that the intervention methods with TCM characteristics are applied in addition to the improvement of lifestyle, so as to intervene in people with high-normal blood pressure, such as TCM, acupuncture, herbal tea, Baduanjin, with a significant clinical effect. These therapies can effectively reduce blood pressure, improve symptoms, regulate physique, and protect target organ damage, with a good compliance. With the advantages in preventing the disease, TCM is of far-reaching significance to prevent disease in advance, and transform high-normal blood pressure into ideal blood pressure. Based on the study on the intervention of high-normal blood pressure with TCM therapy, it was found that the sample size was small and the preciseness needed to be improved. Further research is needed due to the complicated mechanism of TCM and acupuncture. There is a lack of insufficient evidence to support the long-term efficacy and safety of TCM therapy because of the limitations in clinical study intervention and follow-up time. This article reviews the clinical research of the effect of TCM on high-normal blood pressure, in order to provide guidance and reference for clinical and subsequent research.