从脏腑气机升降观探讨冠心病病机
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摘要
升降出入是气运动(气机)的基本形式,是人体生长壮老已的根本动力。冠心病与"心主血脉"功能异常直接相关,心与脾(胃)、肝(胆)、肺、肾以经络、三焦为通路,以气、血、津液为物质基础,通过气机(升降出入)相互联系。若气机(升降出入)异常,则脏腑功能失调、津液失布、气血失和,既可引起气、血、阴、阳之虚以致心脉失养;又可产生气滞、血瘀、痰浊、寒凝等病理因素阻于心之血络,引起"心主血脉"异常。因此,气机升降失司是冠心病核心病机。
The Qi activities,including ascending,descending,exiting and entering,are the primary force of human life and development. Coronary heart disease is due to the disfunction of"heart dominating blood and vessels". Heart,on the material basis of Qi-blood and body fluid,has relationships with spleen,liver,lung and kidney through the channel of Sanjiao by Qi activities. Disorders of Qi activities may lead to disfunctions of internal organs,abnormal distribution of body fluid,imbalance of Qi-blood as well as deficiency of Qi-blood and Yin-Yang. Moreover,pathological factors,such as Qi stagnation,blood stasis,phlegm and cold congealing may block collaterals of the heart which result in the disfunction of"heart dominating blood and vessels". In conclusion,disorders of Qi activities are the core pathogenesis of coronary heart disease.
The Qi activities,including ascending,descending,exiting and entering,are the primary force of human life and development. Coronary heart disease is due to the disfunction of"heart dominating blood and vessels". Heart,on the material basis of Qi-blood and body fluid,has relationships with spleen,liver,lung and kidney through the channel of Sanjiao by Qi activities. Disorders of Qi activities may lead to disfunctions of internal organs,abnormal distribution of body fluid,imbalance of Qi-blood as well as deficiency of Qi-blood and Yin-Yang. Moreover,pathological factors,such as Qi stagnation,blood stasis,phlegm and cold congealing may block collaterals of the heart which result in the disfunction of"heart dominating blood and vessels". In conclusion,disorders of Qi activities are the core pathogenesis of coronary heart disease.
引文
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[13]李英琳.议肝与胸痹[J].中医药学刊,2006(2):329.
[14]吴静.《辨证录》从肝论治心肾不交探微[J].山西中医,2008(9):1-3.
[15]高永贵,薛一涛.薛一涛从气机升降论治胸痹验案2则[J].江西中医,2017,48(413):41,47.
[16]姜婷,迟伟峰,于广宇,等.从三焦气化失司论冠心病心绞痛的中医病机[J].中医学报,2015,30(5):684-686.
[17]刘文军,薛燕星,胡东鹏.薛伯寿教授应用升降散的临床经验—薛伯寿继承蒲氏学术思想临床应用发挥[J].中华中医药学刊,2011,29(1):75-77.
[18]隋吉峰,邓虎,陈岩,等.升降散联合血必净治疗气滞血瘀型冠心病心绞痛的临床疗效观察[J].世界中西医结合杂志,2018,13(2):213-215.
[2]张志峰,朱邦贤.《内经》阴阳升降观探析[J].江苏中医药,2009,41(3):13-14.
[3]赵益业,吴焕林,阮新民,等.从五脏相关论治冠心病[J].四川中医,1999(11):12-13.
[4]刘兴方,韩学杰.沈绍功主任医师运用升降理论治疗高血压病经验撷萃[J].中国中医急症,2013,22(3):399-400.
[5]周小明.名老中医刘志明辨治冠心病心绞痛经验总结与临床研究[D].北京:中国中医科学院,2010:38-44.
[6]罗庆盛,杜武勋.气机升降法在治疗胸痹中的运用[J].江西中医药,2012,43(10):9-10.
[7]阎小萍,罗薇,陶庆文.心胃(脾)同治议心痹[J].中国医刊,1999(7):47-48.
[8]吴耀南,谢俊杰,许正锦.路志正教授调理脾胃治胸痹的学术思想浅析[J].福建中医药,2003(5):14-15.
[9]黄盛娜,田俊.田俊主任调理脾胃治胸痹经验[J].中西医结合心脑血管病杂志,2015,13(5):684-686.
[10]刘学法,王燕青.升降理论在心血管病中的临床应用[J].辽宁中医杂志,1998(2):14-15.
[11]陈锋,王文文.再探冠心病从肺论治[J].现代中西医结合杂志,2002(6):547.
[12]张万义.从升补宗气论治老年人心绞痛[J].辽宁中医药大学学报,2010,12(11):6-7.
[13]李英琳.议肝与胸痹[J].中医药学刊,2006(2):329.
[14]吴静.《辨证录》从肝论治心肾不交探微[J].山西中医,2008(9):1-3.
[15]高永贵,薛一涛.薛一涛从气机升降论治胸痹验案2则[J].江西中医,2017,48(413):41,47.
[16]姜婷,迟伟峰,于广宇,等.从三焦气化失司论冠心病心绞痛的中医病机[J].中医学报,2015,30(5):684-686.
[17]刘文军,薛燕星,胡东鹏.薛伯寿教授应用升降散的临床经验—薛伯寿继承蒲氏学术思想临床应用发挥[J].中华中医药学刊,2011,29(1):75-77.
[18]隋吉峰,邓虎,陈岩,等.升降散联合血必净治疗气滞血瘀型冠心病心绞痛的临床疗效观察[J].世界中西医结合杂志,2018,13(2):213-215.