原發性高醛固酮症在中醫理論腎的藏象思維與病機研究

原發性高醛固酮症為引起次發性高血壓最常見的原因，而引起原發性高醛固酮症的主要原因是雙側腎上腺增生，隨著病程演變，患者會有高血壓、高血鈉、低血鉀的症狀出現。本文探討原發性高醛固酮症的中醫病機理論，主要為先天稟賦不足，腎水元陰不足，相火偏旺，致腎上腺失於濡養而代償性增生，而醛固酮分泌增加，乃相火刺激腎上腺所致。高醛固酮轉化為致病的病理實邪，影響腎主五液的功能失調，導致水濕瘀阻於血脈，而引起高血壓。若加上情志內傷，生活壓力，導致肝鬱化火，耗損真陰，更易引起肝陽上亢之證。總之，原發性高醛固酮症為本虛標實之證，以陰虛為本，陽亢為標，而水濕、血瘀為原發性高醛固酮症引發高血壓的主要病理要素。

關鍵字

原發性高醛固酮症；次發性高血壓；元陰不足；相火偏旺；腎上腺增生

並列摘要

Primary hyperaldosteronism was the common cause of secondary hypertension, and bilateral adrenal gland hyperplasia was the main cause of primary hyperaldosteronism. According the illness process change, it will present hypertension, hypernatremia, and hypokalemia. The present will approach and discussed the pathological mechanism theories of primary hyperaldosteronism on Chinese Medicine. The result demonstrated that congenital insufficiency, kidney water and yuan yin insufficiency and minister fire effulgent which caused adrenal gland hyperplasia and aldosterone secretion increased. High level of aldosterone transformed pathological repletion evil which influenced the function imbalance of the kidney governed five fluids and produced water dampness and the blood stasis obstructed the vessels and hypertension will happen. If adding emotional internal damage and life pressing that causing the liver depression and transferring fire, the true yin will be consumed and damaged, and then present the pattern of ascendant hyperactivity of liver yang. In conclusion, primary hyperaldosteronism was a pattern of root vacuity and tip repletion which yin vacuity was the root and yang hyperactivity was the tip. And water dampness and blood stasis was mainly pathological factors of hypertension caused by primary hyperaldosteronism.

並列關鍵字

Primary Hyperaldosteronism ； Secondary Hypertension ； Yuan Yin Insufficiency ； Minister Fire Effulgent ； Adrenal Gland Hyperplasia

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原發性高醛固酮症在中醫理論腎的藏象思維與病機研究

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