ABSTRACT
Hypertension is the most important risk factor for cardiovascular and cerebrovascular diseases， affecting the structures and functions of important organs of the body， such as the heart， brain， and kidney. At present， the prevalence of hypertension in China remains high. How to effectively curb the incidence of hypertension and reduce target organ damage in patients with hypertension is an urgent challenge that needs to be addressed. Traditional Chinese medicine （TCM）， by virtue of its unique efficacies and advantages， is increasingly applied around the world. In TCM， "wind" is considered as a major constant factor in the development of hypertension. Some scholars believe that hypertension is located in collaterals， and the lesions of collaterals are also important reasons for the occurrence and development of hypertension. Collateral diseases and pathogenic wind are closely related to the development of hypertension as well as target organ damage in the heart， brain， and kidney. From the six-meridian syndrome differentiation for febrile diseases， "collateral" and "wind" are closely related to the Jueyin， with collateral diseases classified into Jueyin diseases and pathogenic wind beginning in the Jueyin. The occurrence， development， and persistence of hypertension are closely related to Jueyin diseases. The present study analyzed the pathogenesis and treatment of hypertension from "collateral" and "wind" of the Jueyin， and specifically discussed the relationship between hypertension and "collateral" and "wind" of the Jueyin. It is believed that the internal depression of wind and fire in the Jueyin results in the upward impulse of liver fire， and the deficiency of Jueyin can trigger the internal movement of liver wind and stirring wind due to collateral deficiency. External contraction in the Jueyin due to the induction of external wind is the important pathogenesis of the development of hypertension and the damage to target organs such as the heart， brain， and kidney. The therapeutic methods for both "collateral" and "wind" were also discussed based on the primary prescription for Jueyin， Wumei Pills. Six-meridian syndrome differentiation can guide the therapeutic principles for all diseases and inspire posterity. Exploring the pathogenesis and treatment of hypertension from “collateral" and "wind" of the Jueyin is of great significance in guiding the prevention and treatment of hypertension， reducing target organ damage in patients with hypertension， and improving the prognosis of cardiovascular and cerebrovascular diseases.
ABSTRACT
Diabetic nephropathy （DN） is classified into "collateral diseases" in traditional Chinese medicine （TCM）. This study reviewed， analyzed， and discussed the clinical and basic research on DN treatment from collateral diseases in recent years. The main TCM therapeutic principles of DN from collateral diseases are dominated by reinforcing the deficiency and dredging collaterals. Fundamental research showed that the relevant mechanism is related to the improvement of oxidative stress and endoplasmic reticulum stress， reduction of inflammatory responses， coping with microcirculation disorder and vascular endothelial damage， and alleviation of renal injury. The theory of collateral diseases can provide ideas for clinical and basic research on DN and also shows advantages in clinical application. However， the present clinical application of this therapeutic principle is mainly based on the combination of deficiency-reinforcing drugs and blood stasis-resolving drugs. In spite of some overlap， blood stasis syndrome and collateral diseases are not in the same category. Therefore， the current diagnosis and treatment of DN from collateral diseases fail to combine with the changes of collateral vessels， main pathogenic factors， and the changes of the secondary pathogenesis. The application of classic collateral drugs such as pungent drugs， rattan drugs， and insect drugs has not been paid enough attention in syndrome differentiation and treatment. In addition， there is a lack of correlation with clinical symptoms and laboratory indexes in the basic research on the treatment of DN by Chinese medicinal prescriptions. Accordingly， the present study advocates systematic research on DN under the guidance of collateral diseases theory， clarifying the essence of DN in collateral diseases and emphasizing the importance of collateral drugs and microscopic syndrome differentiation in screening target drugs for DN to explore the underlying mechanism of collateral drugs in the treatment of DN， so as to provide evidence for the clinical application of collateral diseases theory and Chinese medicinal prescriptions against collateral diseases in the treatment of DN.