高血压病临床决策的思考

高血压病防控形势不理想的现状要求临床决策要有新的科学思维。病因正本清源是基础，应该从生物、社会心理、环境生态等宏观与微观着手，真正把握高血压病这一心身性疾病的本质。临床药物干预是手段，用药诸环节要因人而异，既尊重人体自调适规律又成为有益的修正。随着对高血压病认识的深化，临床决策将永久处于相对不确定之中。思维上临床决策应从非线性思维出发，深刻理解诊疗指南的复杂表述；整体医学观上应有“天人合一”整体观念，统筹分析；同时卫生经济学上应坚持简、便、效、廉的基本目标。

The Thinking of Clinical Decision--making in Hypertension

Since the clinical situation of prevention and treatment of hypertension had not been ideal, the clinical decision-- making （CDM） should be innovated scientific thinking. The origin of hypertension had been considered as psychosomatic disease, the CDM could be begun from different etiologies, such as biology, social--psychology and living environment etc. As major method, the drug of anti--hypertension should be individualized, based on the physiological automatic regularity. With the research progress of hypertension, the CDM should be developed permanently and relatively. In thinking, the CDM should originate from the thought of non--linear thinking and understood complexity expression of the new Chinese guideline of hypertension. In unified medical planning, the CDM should be considered for all concerned, as ＂Heaven and Man as one＂. And in medical economic, the CDM should be practiced in simple, easy medical treatment, beneficial resuits, and low price.