蒋健治疗郁证性心悸病经验
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摘要
蒋健教授提出心悸有非郁证与郁证性之分,并有其四诊特点及临床特征:①心悸由"外源性"或"内源性"情志病因所引起,或由情志变化所诱发、加重;②多伴随纷繁复杂的多脏腑、多系统躯体症状;③多有不寐。蒋健教授认为对于郁证性心悸的治疗应从整体辨证,标本同治,在解郁的同时还应根据患者具体情况具体分析,在"解郁定悸"的同时采用补心疏肝、利胆益脾等治疗方式。郁证性心悸其病位在心,与肝、胆、脾三脏密切相关,常伴有气血阴阳失调,蒋教授治疗郁证性心悸病强调"溯本求源",以"从郁论治"为基本法则,调和五脏气血阴阳,共奏解郁定悸之功。
Professor Jiang Jian proposed that Heart palpitation can be divided into two cases,namely,non-stagnation syndrome and stagnation syndrome,and both of the two case show different four diagnosis characteristics and clinical features:①Heart palpitation is caused by "exogenous" or "endogenous" emotional factors,or induced and aggravated by emotional changes;②the disease is always exsiting with complicated multiple organs/multiple system physical symptoms;③insomnia is always the accompanying symptom.Professor Jiang Jian believes that the treatment of Heart palpitation with stagnation Syndrome should be based on the theory of overall syndrome differentiation carry out treatment from the both perspectives of the symptom and the syndrome.In case of dispelling stagnation,the patient′s conditions should be analyzed specifically.The treatment methods can be tonifying Heart,soothing Live Qi,dredging the Gellbladder Qi as well as tonifying Spleen,in addition to dissolving stagnation and palpitation,since the local of Heart palpitation is in the Heart and is closely related to the Liver,Gallbladder and Spleen.The occurrence of the disease is often accompanied with Qi and blood as well as Yin and Yang disorders.In Jiang Shi′s treatment of heart palpitation with stagnation, "seeking the source of the disease" and the basic rule of "treatment from perspective of stagnation" are emphasized.By reconciling Qi and blood as well as Yin and Yang in the five Zang organs,the good clinical efficacy is achieved.
Professor Jiang Jian proposed that Heart palpitation can be divided into two cases,namely,non-stagnation syndrome and stagnation syndrome,and both of the two case show different four diagnosis characteristics and clinical features:①Heart palpitation is caused by "exogenous" or "endogenous" emotional factors,or induced and aggravated by emotional changes;②the disease is always exsiting with complicated multiple organs/multiple system physical symptoms;③insomnia is always the accompanying symptom.Professor Jiang Jian believes that the treatment of Heart palpitation with stagnation Syndrome should be based on the theory of overall syndrome differentiation carry out treatment from the both perspectives of the symptom and the syndrome.In case of dispelling stagnation,the patient′s conditions should be analyzed specifically.The treatment methods can be tonifying Heart,soothing Live Qi,dredging the Gellbladder Qi as well as tonifying Spleen,in addition to dissolving stagnation and palpitation,since the local of Heart palpitation is in the Heart and is closely related to the Liver,Gallbladder and Spleen.The occurrence of the disease is often accompanied with Qi and blood as well as Yin and Yang disorders.In Jiang Shi′s treatment of heart palpitation with stagnation, "seeking the source of the disease" and the basic rule of "treatment from perspective of stagnation" are emphasized.By reconciling Qi and blood as well as Yin and Yang in the five Zang organs,the good clinical efficacy is achieved.
引文
[1]毛家亮,鲍正宇,何奔.心悸、心律失常与心理障碍[J].中国心脏起搏与心电生理杂志,2008(3):203-205.
[2]RAVIELE A,GIADA F,BERGFELDT L,et al.Management of patients with palpitations:a position paper from the European Heart Rhythm Association[J].Europace,2011,13(7):920-34.
[3]杜凌阳,傅正闯.焦虑症和抑郁性神经症的情感及躯体症状比较[J].中国神经精神疾病杂志,2001,27(4):246.
[4]蒋健.郁证发微(十三)——郁证心悸论[J].上海中医药杂志,2016,50(8):5-9.
[5]蒋健.郁证发微(二十八)——郁证纳呆论[J].上海中医药杂志,2017,51(11):6-10
[6]蒋健.郁证发微(二十五)——郁证嗳气论[J].上海中医药杂志,2017,51(8):5-9.
[7]蒋健.郁证发微(二十七)——郁证痞满论[J].上海中医药杂志,2017,51(10):9-14.
[8]蒋健.郁证发微(三十二)——郁证味觉、舌觉异常论[J].上海中医药杂志,2018,52(3):15-20.
[9]蒋健.郁证发微(三十)——郁证泄泻论[J].上海中医药杂志,2018,52(1):5-10.
[10]蒋健.郁证发微(十四)——郁证胸痹论[J].上海中医药杂志,2016,50(9):6-10.
[11]蒋健.郁证发微(十九)——郁证健忘论[J].上海中医药杂志,2017,51(2):5-10.
[12]蒋健.郁证发微(十二)——郁证不寐论[J].上海中医药杂志,2016,50(7):5-8,14.
[13]蒋健.郁证发微(二)——郁证诊断论[J].上海中医药杂志,2015,49(9):3-6.
[14]蒋健.郁证发微(四)——隐性郁证论[J].上海中医药杂志,2015,49(11):4-7.
[2]RAVIELE A,GIADA F,BERGFELDT L,et al.Management of patients with palpitations:a position paper from the European Heart Rhythm Association[J].Europace,2011,13(7):920-34.
[3]杜凌阳,傅正闯.焦虑症和抑郁性神经症的情感及躯体症状比较[J].中国神经精神疾病杂志,2001,27(4):246.
[4]蒋健.郁证发微(十三)——郁证心悸论[J].上海中医药杂志,2016,50(8):5-9.
[5]蒋健.郁证发微(二十八)——郁证纳呆论[J].上海中医药杂志,2017,51(11):6-10
[6]蒋健.郁证发微(二十五)——郁证嗳气论[J].上海中医药杂志,2017,51(8):5-9.
[7]蒋健.郁证发微(二十七)——郁证痞满论[J].上海中医药杂志,2017,51(10):9-14.
[8]蒋健.郁证发微(三十二)——郁证味觉、舌觉异常论[J].上海中医药杂志,2018,52(3):15-20.
[9]蒋健.郁证发微(三十)——郁证泄泻论[J].上海中医药杂志,2018,52(1):5-10.
[10]蒋健.郁证发微(十四)——郁证胸痹论[J].上海中医药杂志,2016,50(9):6-10.
[11]蒋健.郁证发微(十九)——郁证健忘论[J].上海中医药杂志,2017,51(2):5-10.
[12]蒋健.郁证发微(十二)——郁证不寐论[J].上海中医药杂志,2016,50(7):5-8,14.
[13]蒋健.郁证发微(二)——郁证诊断论[J].上海中医药杂志,2015,49(9):3-6.
[14]蒋健.郁证发微(四)——隐性郁证论[J].上海中医药杂志,2015,49(11):4-7.