张佩青教授辨证论治冠心病的学术思想
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摘要
张佩青教授是黑龙江省中医药科学院主任医师,全国著名中医专家,从事临床工作数十载,在中医内科疾病、疑难病症,尤其心血管疾病方面积累了丰富的临证经验。本文介绍了张佩青教授治疗冠心病的学术思想,包括对冠心病病因病机,即为寒邪内侵,情志失调,饮食失宜,年迈体虚,劳逸过度而致心脉虚损,并提出了冠心病治疗的四个原则。本文总结其临床治疗经验,虚证辨治当分气血阴阳、辨别虚实,通补兼施,实证辨治当分血瘀痰阻,其治疗收到了满意的效果。
Professor ZHANG Peiqing is a chief physician of Heilongjiang Academy of Traditional Chinese Medicine, a national famous Chinese medicine expert. Professor Zhang has worked in clinic for dozens of years, that has accumulated rich clinical experiences in TCM internal medicine diseases, difficult and complicated cases, especially cardiovascular diseases. This article introduces Professor ZHANG Peiqing′ s academic thought on the treatment of coronary heart diseases, including the understanding of the etiology and pathogenesis of coronary heart disease, which is the heart and vein deficiency caused by internal invasion of cold, abnormal emotion, improper diet, deficiency dueto by aged and excessiveness. Professor Zhang proposes four principles in the treatment of coronary heart disease. This article summerizes the experience of Professor Zhang′s clinical experience, that syndrome differentiation and treatment of deficiency syndrome should be distinguished by qi, blood, Yin, Yang and deficiency and excess. In the treatment, combination of dredging and tonifying method should be used concurrently, and the excess should be treated in distinction from blood stasis to phlegm, that the clinical effect was satisfactory.
Professor ZHANG Peiqing is a chief physician of Heilongjiang Academy of Traditional Chinese Medicine, a national famous Chinese medicine expert. Professor Zhang has worked in clinic for dozens of years, that has accumulated rich clinical experiences in TCM internal medicine diseases, difficult and complicated cases, especially cardiovascular diseases. This article introduces Professor ZHANG Peiqing′ s academic thought on the treatment of coronary heart diseases, including the understanding of the etiology and pathogenesis of coronary heart disease, which is the heart and vein deficiency caused by internal invasion of cold, abnormal emotion, improper diet, deficiency dueto by aged and excessiveness. Professor Zhang proposes four principles in the treatment of coronary heart disease. This article summerizes the experience of Professor Zhang′s clinical experience, that syndrome differentiation and treatment of deficiency syndrome should be distinguished by qi, blood, Yin, Yang and deficiency and excess. In the treatment, combination of dredging and tonifying method should be used concurrently, and the excess should be treated in distinction from blood stasis to phlegm, that the clinical effect was satisfactory.
引文
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[18]郑爽.银杏酮酯分散片对冠心病稳定型心绞痛(心血瘀阻证)心绞痛症状及中医证候的疗效观察[D].哈尔滨:黑龙江中医药大学,2017.
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[20]安莉.通脉复律汤治疗冠心病缓慢性心律失常患者110例的临床效果[J].中国医药导报,2016,13(18):165-168.
[21]唐雪敏,王加红,景颖颖,等.社区中老年居民对冠状动脉粥样硬化性心脏病危险因素认知状况及其影响因素[J].中国医药,2017,12(10):1461-1465.
[22]江楠,刘坤,江仕骏.麝香保心丸和中医辨证论治冠心病的临床疗效观察[J].中药药理与临床,2015,31(1):319-320.
[23]张娜.稳心颗粒联合美托洛尔治疗冠心病室性心律失常的疗效观察[J].中国现代医生,2016,54(23):94-96.
[24]刘嵋松,温富春,纪凤兰,等.中药新药“丹芎救心气雾剂”对胸痹-心血瘀阻证的临床疗效及安全性评价[J].中国当代医药,2017,24(2):4-9.
[25]高思华,王键.中医基础理论[M].2版.北京:人民卫生出版社,2012:73-96.
[26]单书剑,陈子华.古今名医临证金鉴胸痹心痛卷[M].2版.北京:中国中医药出版社,2011:245-250.
[27]陈湘君.中医内科学[M].2版.上海:上海科学技术出版社,2013:89-91.
[2]张琦.金匮要略讲义[M].上海:上海科学技术出版社,2008:99.
[3]张元素,郑洪新.张元素医学全书[M].北京:中国中医药出版社,2006:18,15-16,84-85.
[4] Lemogne C. Coronary artery disease:a strong association with depression and job stress[J]. Rev Prat,2015,65(3):359-360.
[5] Ozturk S,Yalvac HD,Sivri N,et al. Anxiety and depression scores in patients with coronary artery disease and coronary artery ectasia[J]. Int J Cardiol,2015,186:299-301.
[6]黄子天.国医大师邓铁涛学术经验传承研究[D].广州:广州中医药大学,2016:52.
[7]王永刚,奇婧,钟伟,等.冠心病中医病因病机的认识与探讨[J].中医杂志,2015,56(17):1449-1452.
[8]李思铭,徐浩,陈可冀.2013冠心病中西医结合年度学术盘点[J].中国中西医结合杂志,2014,34(9):1029-1034.
[9]赵明芬,安冬青.胸痹心痛病因病机三期论[J].中西医结合心脑血管病杂志,2008,6(7):41.
[10]丁斗,董小君.气元论在胸痹心痛证治中的病因病机规律研究[J].长春中医药大学学报,2010,26(2):160-170.
[11]吕长健.中医治疗冠心病的临床体会[J].临床医药文献电子杂志,2015,2(18):3624.
[12]石志坚.中药治疗冠心病心绞痛的临床分析[J].中国继续医学教育,2016,1(23):15-16.
[13]郑昆,吴嘉瑞,张非非.基于数据挖掘的中医治疗冠心病用药规律研究[J].中国医药导报,2017,14(36):113-116.
[14]杨关林,张哲,张会永,等.血脉病探要[J].辽宁中医杂志,2007,25(11):528.
[15]丁斗.调理心气法在胸痹心痛中的证治规律研究[D].贵阳:贵阳中医学院,2007:6.
[16]惠玲.血府逐瘀汤加减治疗胸痹心痛(瘀血痹阻型)的疗效观察[J].中国临床研究,2016,8(26):57-58.
[17]付明.祛瘀止痛汤治疗心血瘀阻型胸痹[J].中西医结合心血管病电子杂志,2017,5(19):137.
[18]郑爽.银杏酮酯分散片对冠心病稳定型心绞痛(心血瘀阻证)心绞痛症状及中医证候的疗效观察[D].哈尔滨:黑龙江中医药大学,2017.
[19]毛美安.中西医结合治疗胸痹心痛心血瘀阻证103例疗效观察[J].湖南中医杂志,2017,33(5):52-54.
[20]安莉.通脉复律汤治疗冠心病缓慢性心律失常患者110例的临床效果[J].中国医药导报,2016,13(18):165-168.
[21]唐雪敏,王加红,景颖颖,等.社区中老年居民对冠状动脉粥样硬化性心脏病危险因素认知状况及其影响因素[J].中国医药,2017,12(10):1461-1465.
[22]江楠,刘坤,江仕骏.麝香保心丸和中医辨证论治冠心病的临床疗效观察[J].中药药理与临床,2015,31(1):319-320.
[23]张娜.稳心颗粒联合美托洛尔治疗冠心病室性心律失常的疗效观察[J].中国现代医生,2016,54(23):94-96.
[24]刘嵋松,温富春,纪凤兰,等.中药新药“丹芎救心气雾剂”对胸痹-心血瘀阻证的临床疗效及安全性评价[J].中国当代医药,2017,24(2):4-9.
[25]高思华,王键.中医基础理论[M].2版.北京:人民卫生出版社,2012:73-96.
[26]单书剑,陈子华.古今名医临证金鉴胸痹心痛卷[M].2版.北京:中国中医药出版社,2011:245-250.
[27]陈湘君.中医内科学[M].2版.上海:上海科学技术出版社,2013:89-91.