中医杂志

以“体质-证候-病位相关”思路为主线构建高血压共病的中医认识框架。从共同的体质基础和相近的病机特点来看，高血压共病并非多种疾病的简单叠加，而是在阴虚质、气虚质、阳虚质、痰湿质、湿热质、血瘀质等偏颇体质基础上，伴随风、火、痰、瘀、虚等证候长期交织，并在肝、心、脾、肾等病位网络中逐步外化为不同系统的共病。在此基础上，以心系、脑系、肾系及代谢相关共病为主要类型，对其体质、证候、病位特征进行归纳整合，揭示共性病机与病位偏重的对应关系，并提出相应防治思路。将体质分层融入危险分层以前瞻干预，以证候为枢纽形成益气活血、化痰通络等多病同治策略，构建涵盖体质评估、证候辨识、共病风险分层、中西医协同干预及随访反馈的临床路径，为高血压共病的中医理论建构与协同管理提供参考。

Mainly based on the "constitution-syndrome-disease location correlation" approach, this study constructs a traditional Chinese medicine(TCM) framework for understanding hypertension comorbidities. From the perspective of shared constitutional predispositions and similar pathomechanistic characteristics, hypertension comorbidity should not be regarded as a simple aggregation of multiple diseases. Rather, it is generally rooted in biased constitutions such as yin-deficiency, qi-deficiency, yang-deficiency, phlegm-dampness, dampness-heat, and blood-stasis constitutions, accompanied by the long-term interplay of pathogenic mechanisms involving wind, fire, phlegm, stasis, and deficiency, and gradually manifests as comorbidities affecting different systems through the evolution of disease locations related to the liver, heart, spleen, and kidney. On this basis, cardiac-, cerebral-, renal-, and metabolicrelated comorbidities are taken as the major categories, and their characteristics related to constitution, syndrome, and disease location are systematically summarized to clarify the correspondence between shared pathomechanisms and predominant disease locations, and to propose corresponding prevention and treatment strategies. This framework further incorporates constitution-based stratification into risk stratification for prospective intervention, and takes syndrome as the central link in developing multi-disease treatment strategies such as boosting qi and activating blood, as well as resolving phlegm and unblocking collaterals. A clinical pathway is thereby proposed, encompassing constitution assessment, syndrome differentiation, comorbidity risk stratification, integrated traditional Chinese and western medicine intervention, and follow-up feedback. This study aims to provide a reference for the theoretical development and collaborative management of hypertension comorbidities in TCM.