从理法方药论治慢性心力衰竭
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摘要
心气虚乃慢性心衰发病之根本。心气虚而致瘀,瘀血不行而化水、化痰,痰、瘀、水等病理产物反过来进一步耗损心气。痰由瘀来,瘀因痰生,在心衰后期痰瘀互结与心之气虚阳虚相互交错。针对虚、瘀、痰等复杂的病机特点应以补心气为根本,在慢性心衰3期分治过程中灵活运用活血化瘀、祛痰化浊药物。心气虚贯穿整个慢性心力衰竭全程,以补阳还五汤为基础方,在慢性心衰的不同时期运用益气温阳、活血祛痰法治疗。
The heart qi deficiency is the root of the incidence of chronic heart failure. The heart qi deficiency and blood stasis, blood stasis forms fluid retention and phlegm. Phlegm and blood stasis, fluid retention and other pathological products in turn further erode the heart qi. The phlegm is caused by blood stasis, the blood stasis is caused by phlegm, and the mutual knot of phlegm and blood stasis in the late stage of heart failure interlaced with the deficiency of heart qi deficiency and yang deficiency. According to the characteristics of the pathogenesis of phlegm, deficiency and stasis complex it is necessary to tonifying heart qi as a fundamental, flexible use of activating blood and removing stasis medicine and dispelling phlegm and eliminating turbid medicine in chronic heart failure in the process of three stage partition. Heart qi deficiency throughout the whole course of chronic heart failure, on the basis of Buyang Huanwu decoction, in the different stages of chronic heart failure, the treatment of warming yang, activating blood and eliminating phlegm is very effective.
The heart qi deficiency is the root of the incidence of chronic heart failure. The heart qi deficiency and blood stasis, blood stasis forms fluid retention and phlegm. Phlegm and blood stasis, fluid retention and other pathological products in turn further erode the heart qi. The phlegm is caused by blood stasis, the blood stasis is caused by phlegm, and the mutual knot of phlegm and blood stasis in the late stage of heart failure interlaced with the deficiency of heart qi deficiency and yang deficiency. According to the characteristics of the pathogenesis of phlegm, deficiency and stasis complex it is necessary to tonifying heart qi as a fundamental, flexible use of activating blood and removing stasis medicine and dispelling phlegm and eliminating turbid medicine in chronic heart failure in the process of three stage partition. Heart qi deficiency throughout the whole course of chronic heart failure, on the basis of Buyang Huanwu decoction, in the different stages of chronic heart failure, the treatment of warming yang, activating blood and eliminating phlegm is very effective.
引文
[1]郑国玉,张明.从气血水探讨中医药治疗慢性心力衰竭[J].辽宁中医药大学学报, 2011, 13(1):96-97.
[2]陆再英,钟南山.内科学[M].7版.北京:人民卫生出版社,2007:170.
[3]韩额尔德木图,马月宏,王海燕,等.慢性心衰的病理生理及发病机制研究进展[J].中西医结合心脑血管病杂志,2016, 14(12):1349-1352.
[4]章薇.心主血脉的内涵考释[J].中医药学刊, 2004, 22(2):253-254.
[5]张国权.益气活血利水方治疗慢性心衰的临床研究[D].北京:北京中医药大学, 2014.
[6]董晓斌,孔立.慢性心力衰竭的中医病机演变探讨[J].环球中医药, 2011, 4(3):201-203.
[7]尹克春,吴焕林.邓铁涛治疗心力衰竭经验介绍[J].江苏中医药, 2002, 23(7):9-10.
[8]孙广仁.中医基础理论[M].2版.北京:中国中医药出版社,2007:140.
[9]史丹丹,宓余强.非酒精性脂肪肝中医病因病机研究[J].吉林中医药, 2012, 32(6):545-546.
[10]李广浩,楼丹飞,周端.周端治疗慢性心力衰竭经验[J].浙江中医杂志, 2009, 44(10):715-716.
[11]樊冬梅,任宝琦.国医大师任继学救治危急重症验案三则[J].湖北民族学院学报(医学版), 2012, 29(2):54-58.
[12]周文斌,何慧明,聂文娟,等.扶正固本温阳通脉膏治疗阳虚血瘀型慢性心衰临床观察[J].新中医, 2014,46(8):30-32.
[13]宋帮丽,傅春华,方芸芸,等.郭子光治疗顽固性心力衰竭经验[J].山东中医杂志, 2008, 27(9):630-631.
[14]张洋,张艳.张艳教授治疗慢性心力衰竭经验[J].长春中医药大学学报, 2017, 33(6):903-905.
[15]张勤芹,高想,於悦.中医药干预慢性心力衰竭能量代谢重构的研究进展[J].吉林中医药, 2017, 37(1):99-102.
[16]王楚盈,李玉梅,刘畅,等.附子人参有效组分配伍对阿奇霉素致慢性大鼠血流动力学影响及其机制研究[J].中药新药及临床药理, 2015, 26(1):39-43.
[17]张琦,王淼,樊官伟,等.丹参及其活性成分舒张血管的作用网络和差异靶标分析[J].天津中医药, 2016,33(12):705-709.
[18]张晓添,孙飞.补阳还五汤在心血管系统的药理研究及临床应用[J].吉林中医药, 2003, 23(8):49-51.
[19]吴献,彭新明,屈波.益气温阳活血利水法治疗慢性心衰的研究进展[J].中医临床研究, 2013, 21(5):108-110.
[20]夏敏.中医药治疗慢性心力衰竭研究进展[J].现代中西医结合杂志, 2016, 25(20):2278-2280.
[21]马彩艳,童鸿,谢培怡,等.温阳方治疗慢性心力衰竭的临床研究[J].中国临床药理学杂志, 2015, 31(1):5-7.
[2]陆再英,钟南山.内科学[M].7版.北京:人民卫生出版社,2007:170.
[3]韩额尔德木图,马月宏,王海燕,等.慢性心衰的病理生理及发病机制研究进展[J].中西医结合心脑血管病杂志,2016, 14(12):1349-1352.
[4]章薇.心主血脉的内涵考释[J].中医药学刊, 2004, 22(2):253-254.
[5]张国权.益气活血利水方治疗慢性心衰的临床研究[D].北京:北京中医药大学, 2014.
[6]董晓斌,孔立.慢性心力衰竭的中医病机演变探讨[J].环球中医药, 2011, 4(3):201-203.
[7]尹克春,吴焕林.邓铁涛治疗心力衰竭经验介绍[J].江苏中医药, 2002, 23(7):9-10.
[8]孙广仁.中医基础理论[M].2版.北京:中国中医药出版社,2007:140.
[9]史丹丹,宓余强.非酒精性脂肪肝中医病因病机研究[J].吉林中医药, 2012, 32(6):545-546.
[10]李广浩,楼丹飞,周端.周端治疗慢性心力衰竭经验[J].浙江中医杂志, 2009, 44(10):715-716.
[11]樊冬梅,任宝琦.国医大师任继学救治危急重症验案三则[J].湖北民族学院学报(医学版), 2012, 29(2):54-58.
[12]周文斌,何慧明,聂文娟,等.扶正固本温阳通脉膏治疗阳虚血瘀型慢性心衰临床观察[J].新中医, 2014,46(8):30-32.
[13]宋帮丽,傅春华,方芸芸,等.郭子光治疗顽固性心力衰竭经验[J].山东中医杂志, 2008, 27(9):630-631.
[14]张洋,张艳.张艳教授治疗慢性心力衰竭经验[J].长春中医药大学学报, 2017, 33(6):903-905.
[15]张勤芹,高想,於悦.中医药干预慢性心力衰竭能量代谢重构的研究进展[J].吉林中医药, 2017, 37(1):99-102.
[16]王楚盈,李玉梅,刘畅,等.附子人参有效组分配伍对阿奇霉素致慢性大鼠血流动力学影响及其机制研究[J].中药新药及临床药理, 2015, 26(1):39-43.
[17]张琦,王淼,樊官伟,等.丹参及其活性成分舒张血管的作用网络和差异靶标分析[J].天津中医药, 2016,33(12):705-709.
[18]张晓添,孙飞.补阳还五汤在心血管系统的药理研究及临床应用[J].吉林中医药, 2003, 23(8):49-51.
[19]吴献,彭新明,屈波.益气温阳活血利水法治疗慢性心衰的研究进展[J].中医临床研究, 2013, 21(5):108-110.
[20]夏敏.中医药治疗慢性心力衰竭研究进展[J].现代中西医结合杂志, 2016, 25(20):2278-2280.
[21]马彩艳,童鸿,谢培怡,等.温阳方治疗慢性心力衰竭的临床研究[J].中国临床药理学杂志, 2015, 31(1):5-7.