何庆勇运用经方治疗心律失常经验
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摘要
文章叙述了何庆勇老师运用经方治疗心律失常的经验,主要包括谨守病机,辨证求因,指出心律失常的病性为本虚标实。本虚主要为气虚、阴虚、阳虚,标实为水饮、痰浊、热蕴、气结、络阻。立法分明,擅用经方,提出采用益气养阴复脉法(炙甘草汤)、温通心阳法(桂枝甘草汤)、温阳化饮法(苓桂术甘汤)、扶阳利水法(真武汤)、温阳化痰法(桂枝去芍药加蜀漆牡蛎龙骨救逆汤)、和解泻热安神法(柴胡加龙骨牡蛎汤)、行气散结通络法(旋覆花汤)治疗心律失常。何老师力抓主症,活用经方,注重药物剂量比例及煎服方法,形成独特的临床经验,每获佳效。
In the paper,He Qingyong's experiences in the treatment of arrhythmia with classic formula were introduced,including the emphasis of pathogenesis,pattern/syndrome differentiation to search for etiology.Arrhythmia is deficiency in primary and excess in secondary.Deficiency refers to qi deficiency,yin deficiency and yang deficiency.Excess refers to harmful fluids,turbid phlegm,heat accumulation,qi stagnation and collateral blockage.The classic formulas are preferred on the basis of clear determination of treating principles.The following therapies and formulas are used in the treatment of arrhythmia,i.e.the therapy for benefiting qi,nourishing yin and restoring pulse(zhigancao tang),the therapy for warming and unblocking heart yang(guizhi gancao tang),the therapy for warming yang and resolving harmful fluids(linggui zhugan tang),the therapy for strengthening yang and benefiting water metabolism(zhenwu tang),the therapy for warming yang and resolving phlegm(modified jiuni tang),the therapy for eliminating heat and calming down the mind(modified muli tang) and the therapy for promoting qi circulation,removing masses in collaterals(xuanfuhua tang).Prof.He uses the classic formulas flexibly focusing on main symptoms,the ratio of doses and decoction methods.Due to Prof.He's unique clinical experiences,the perfect therapeutic effects are achieved.
In the paper,He Qingyong's experiences in the treatment of arrhythmia with classic formula were introduced,including the emphasis of pathogenesis,pattern/syndrome differentiation to search for etiology.Arrhythmia is deficiency in primary and excess in secondary.Deficiency refers to qi deficiency,yin deficiency and yang deficiency.Excess refers to harmful fluids,turbid phlegm,heat accumulation,qi stagnation and collateral blockage.The classic formulas are preferred on the basis of clear determination of treating principles.The following therapies and formulas are used in the treatment of arrhythmia,i.e.the therapy for benefiting qi,nourishing yin and restoring pulse(zhigancao tang),the therapy for warming and unblocking heart yang(guizhi gancao tang),the therapy for warming yang and resolving harmful fluids(linggui zhugan tang),the therapy for strengthening yang and benefiting water metabolism(zhenwu tang),the therapy for warming yang and resolving phlegm(modified jiuni tang),the therapy for eliminating heat and calming down the mind(modified muli tang) and the therapy for promoting qi circulation,removing masses in collaterals(xuanfuhua tang).Prof.He uses the classic formulas flexibly focusing on main symptoms,the ratio of doses and decoction methods.Due to Prof.He's unique clinical experiences,the perfect therapeutic effects are achieved.
引文
[1]王辰,王建安.内科学[M].北京:人民卫生出版社,2015:229.
[2]冯全刚.中西医结合治疗心律失常临床研究[J].中医学报,2016,31(213):282-284.
[3]李应祥.抗心律失常药物作用于心律失常的效果评价[J].中西医结合心血管病杂志,2014,2(8):32-33.
[4]The Cardiac Arrhythmia Suppression Trial(CAST)Investigators Preliminary report:Effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction[J].N Engl J Med,1989,321(6):406-412.
[5]刘旭东,赵桂芳,何庆勇.何庆勇运用大柴胡汤经验[J].世界中西医结合杂志,2016,11(3):316-318.
[6]吴海芳,尹湘君,何庆勇.何庆勇运用九痛丸治疗急性心肌梗死的经验[J].中国中医急症,2015,24(9):1556-1558.
[7]黄帝内经素问[M].田代华,整理.北京:人民卫生出版社,2005.
[8]汉·张仲景.金匮要略[M].北京:人民卫生出版社,2005.
[9]明·王肯堂.证治准绳(一)·杂病证治准绳[M].北京:人民卫生出版社,2014.
[10]清·唐容川.伤寒论浅注补正[M].太原:山西科学技术出版社,2013:108-109.
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[12]梁·陶弘景.名医别录(辑校本)[M].北京:中国中医药出版社,2013:170.
[13]清·唐容川.血证论[M].北京:中国医药科技出版社,2006:108.
[14]清·张璐.张氏医通[M].北京:人民卫生出版社,2006:292.
[15]张廷模.对仲景方中枳实和桂枝的考证[J].中医杂志,1985,7(559):79-80.
[16]明·张景岳.景岳全书[M].北京:中国医药科技出版社,2011:206.
[17]金·成无己.伤寒明理论[M].北京:中国中医药出版社,2007:34.
[18]仝小林.方药量效学[M].北京:科学出版社,2013:322.
[19]明·张景岳.类经图翼·类经附翼·质疑录[M].太原:山西科学技术出版社,2013:260.
[20]元·朱丹溪.丹溪心法[M].北京:中国医药科技出版社,2012:76.
[21]清·张锡纯.医学衷中参西录[M].太原:山西科学技术出版社,2009:307.
[22]金·刘完素.素问玄机原病式[M].北京:中国医药科技出版社,2011:29.
[23]日·森立之(辑).神农本草经[M].北京:北京科学技术出版社,2016.
[24]元·滑寿.诊家枢要[M].北京:人民卫生出版社:2007:27.
[25]清·唐容川.金贵要略浅注补正[M].北京:学苑出版社,2012:141.
[26]清·叶天士.临证指南医案[M].北京:人民卫生出版社,2008.
[2]冯全刚.中西医结合治疗心律失常临床研究[J].中医学报,2016,31(213):282-284.
[3]李应祥.抗心律失常药物作用于心律失常的效果评价[J].中西医结合心血管病杂志,2014,2(8):32-33.
[4]The Cardiac Arrhythmia Suppression Trial(CAST)Investigators Preliminary report:Effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction[J].N Engl J Med,1989,321(6):406-412.
[5]刘旭东,赵桂芳,何庆勇.何庆勇运用大柴胡汤经验[J].世界中西医结合杂志,2016,11(3):316-318.
[6]吴海芳,尹湘君,何庆勇.何庆勇运用九痛丸治疗急性心肌梗死的经验[J].中国中医急症,2015,24(9):1556-1558.
[7]黄帝内经素问[M].田代华,整理.北京:人民卫生出版社,2005.
[8]汉·张仲景.金匮要略[M].北京:人民卫生出版社,2005.
[9]明·王肯堂.证治准绳(一)·杂病证治准绳[M].北京:人民卫生出版社,2014.
[10]清·唐容川.伤寒论浅注补正[M].太原:山西科学技术出版社,2013:108-109.
[11]汉·张仲景(述),晋·王叔和(撰次).伤寒论[M].北京:人民卫生出版社,2005.
[12]梁·陶弘景.名医别录(辑校本)[M].北京:中国中医药出版社,2013:170.
[13]清·唐容川.血证论[M].北京:中国医药科技出版社,2006:108.
[14]清·张璐.张氏医通[M].北京:人民卫生出版社,2006:292.
[15]张廷模.对仲景方中枳实和桂枝的考证[J].中医杂志,1985,7(559):79-80.
[16]明·张景岳.景岳全书[M].北京:中国医药科技出版社,2011:206.
[17]金·成无己.伤寒明理论[M].北京:中国中医药出版社,2007:34.
[18]仝小林.方药量效学[M].北京:科学出版社,2013:322.
[19]明·张景岳.类经图翼·类经附翼·质疑录[M].太原:山西科学技术出版社,2013:260.
[20]元·朱丹溪.丹溪心法[M].北京:中国医药科技出版社,2012:76.
[21]清·张锡纯.医学衷中参西录[M].太原:山西科学技术出版社,2009:307.
[22]金·刘完素.素问玄机原病式[M].北京:中国医药科技出版社,2011:29.
[23]日·森立之(辑).神农本草经[M].北京:北京科学技术出版社,2016.
[24]元·滑寿.诊家枢要[M].北京:人民卫生出版社:2007:27.
[25]清·唐容川.金贵要略浅注补正[M].北京:学苑出版社,2012:141.
[26]清·叶天士.临证指南医案[M].北京:人民卫生出版社,2008.