Theoretical foundations of bloodletting therapy for primary hypertension in the southern school of Tibetan medicine: insights from Qinghai-Tibet Plateau medical theory.

Primary hypertension (PH) remains a significant contributor to global morbidity and mortality. While contemporary biomedical treatments are widely utilized, traditional medical systems such as Tibetan medicine provide distinctive diagnostic frameworks and therapeutic modalities. Among these, venesection therapy constitutes a key external intervention, frequently employed in managing conditions corresponding to PH, referred to in classical texts as Trak lung tö tsang (khrag rlung stod 'tshangs, blood-wind proliferation). This narrative review synthesizes evidence from classical Tibetan medical literature and modern clinical and experimental studies, without a systematic search of primary biomedical literature. This study conducts a comprehensive review of classical Tibetan medical literature to elucidate the theoretical origins of venesection therapy as practiced in the southern school of Tibetan medicine, with a particular focus on its application for Trak lung tö tsang (khrag rlung stod 'tshangs, blood-wind proliferation). Additionally, the analysis explores potential theoretical convergence between traditional concepts and current biomedical understandings of hypertension pathophysiology. Clarifying the theoretical underpinnings and scientific relevance of this traditional therapy may contribute to integrative approaches for managing PH, as well as to the scientific validation and the preservation of traditional Tibetan medical practices. This review also aims to inform the development of complementary and alternative therapeutic strategies for the broader management of PH.