中医药干预高血压合并失眠的发病机制和治疗潜力

摘要(中文译文)

※ 中文译文由 AI 辅助生成,仅供学术参考,请以英文原文为准。

高血压共病失眠（HTN-Ins）是临床常见的共病。HTN-Ins的相关症状对应中医“眩晕”“心悸”“不寐”等疾病范畴。中医药通过调节机体动态失衡，在治疗HTN-Ins方面具有独特的治疗优势。本文旨在总结中医药治疗HTN-Ins的特点，包括单味中药、中药单体、中药复方、中成药及其他中医药相关治疗方法，重点分析中医药治疗该病的相关机制。以“中医药”“高血压与失眠”“高血压合并失眠”“高血压”“失眠”“睡眠障碍”“机制”“临床观察”“随机对照试验”为检索词，检索PubMed、Web of Science和中国知网（CNKI）中截至2026年4月近五年发表的文献。通过文献综述，我们发现天麻、钩藤、川芎、丹参和黄芪等中药常用于HTN-Ins的治疗。槲皮素、山柰酚、木犀草素、黄芩素等中药单体对HTN-Ins的治疗有益。大量中药复方具有显著疗效，包括天麻钩藤饮、黄连温胆汤、桂枝龙骨牡蛎汤等。近年来，中成药也被用于HTN-Ins的治疗，如冠心宁片、复方珍珠调脂胶囊、芪参益气滴丸、舒和颗粒等。研究还表明，中医药通过多种途径发挥作用，包括抑制交感神经系统过度激活、降低相关炎症因子水平、减轻氧化应激、调节肾素-血管紧张素-醛固酮系统（RAAS）、调节下丘脑-垂体-肾上腺（HPA）轴以及调节神经递质水平。这些作用共同产生镇静催眠、平稳降压和血管保护等综合药理效应。中医药通过多靶点、多途径、多层次和个体化策略在HTN-Ins治疗中展现出显著疗效，具有巨大的治疗潜力。然而，仍存在局限性。未来，深入探索单个中药单体的药理机制以及开展中药复方的大样本、多中心随机对照临床试验（RCTs）将是该领域的主要研究方向。

Abstract

Hypertension comorbid with insomnia (HTN-Ins) is a common clinical comorbidity. Symptoms associated with HTN-Ins correspond to the TCM disease categories of xuanyun (dizziness), xinji (palpitations), and bumei (insomnia). Traditional Chinese medicine (TCM) exerts unique therapeutic advantages against HTN-Ins via regulating the body's dynamic imbalance. This review aims to summarize the characteristics of TCM for treating HTN-Ins, including single Chinese herbs, Chinese medicine monomers, compound TCM prescriptions, TCM patented drugs, and other TCM-related therapeutic approaches, focusing on the analysis of the relevant mechanisms of TCM treatment of this disease. Using the search terms "traditional Chinese medicine", "hypertension and insomnia", "hypertension combined with insomnia", "hypertension", "insomnia", "sleep disorder", "mechanism", "clinical observation", "randomized controlled trial", we searched PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) for studies published in the past five years up to April 2026. From the literature review, we found that Chinese herbs such as Gastrodia elata Blume., Uncaria rhynchophylla (Miq.) Miq., Conioselinum anthriscoides 'Chuanxiong'., Salvia miltiorrhiza Bunge and Astragalus mongholicus Bunge were commonly used for the treatment of HTN-Ins. Traditional Chinese medicine monomers such as quercetin, kaempferol, luteolin|, baicalein are beneficial for the treatment of HTN-Ins. A large number of traditional Chinese medicine compounds have significant effects, including Tianma-Gouteng decoction, Huanglian-Wendan decoction, Guizhilonggu-oyster decoction, etc. In recent years, traditional Chinese patent medicine has been used in the treatment of HTN-Ins, such as Guanxin Ning tablets, compound pearl Tiaozhi capsules, Qishen Yiqi dropping pills, Shuhe granules, and so on. Research has also shown that TCM works in a variety of ways, including the inhibiting excessive activation of the sympathetic nervous system, reducing the levels of relevant inflammatory factors, alleviating oxidative stress, regulating the renin-angiotensin-aldosterone system (RAAS), regulating the hypothalamic-pituitary-adrenal (HPA) axis, and regulating neurotransmitter levels. These actions collectively produce comprehensive pharmacological effects, such as sedative-hypnotic activity, stable blood pressure reduction, and vascular protection. TCM exhibits remarkable therapeutic efficacy in the treatment of HTN-Ins through multi-target, multi-pathway, multi-level, and individualized strategies, thereby demonstrating substantial therapeutic potential. However, limitations remain. In the future, in-depth exploration of the pharmacological mechanisms underlying individual TCM monomers and large-sample, multi-center randomized controlled clinical trials (RCTs) of TCM compound prescriptions will be the primary research directions in this field.

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