摘要
冠心病为本虚标实之证,正虚为本,表现为气血阴阳的不足,邪实为标,表现为气滞、痰阻、血瘀、寒凝等。心脉痹阻是冠心病基本病机特点,可由气滞血瘀、心肾阳虚、气阴两虚、痰湿阻滞等所致,治疗上逐痹通脉贯穿始终,并根据病因和病证不同,相应采取益气活血、益气温肾、益气养阴、化痰祛湿等治法。在方药应用上,重视瓜蒌、薤白应用,强调宽胸散结通阳以行血脉,强调气滞当调,血瘀宜逐,气阳虚当补,阴虚当滋,痰阻应豁,力求"病皆与方相应""证皆与法相应"。
Coronary artery heart disease belonged to the syndrome of deficiency manifestation and excessive root cause.Vital qi deficiency is the root of coronary artery heart disease, and it shows the deficiency of qi, blood, yin and yang. Excess of pathogenic qi is the external manifestation of coronary artery heart disease, and it shows qi stagnation, phlegm blocking, blood stasis and coagulated cold, an so on. Blockade of heart vessel is the basic pathogenesis of coronary artery heart disease. It could be caused by stagnation of qi and blood stasis, yang deficiency of heart and kidney, deficiency of both qi and yin and stagnation and blockade of phlegm-damp. Zhubi tongmai would be throughout the whole process of it's treatment. Meanwhile, according to the different cause of diseases and syndromes, it should take the methods of benefiting qi for activating blood circulation, benefiting qi and warming kidney, benefiting qi and nourishing yin and eliminating phlegm and drying the wetness-evil to cure this disease. On the application of prescriptions and medicines, the treatment of this disease emphasizes the use of snakegourd fruit and longstamen onion bulb as well as relieving chest stiffness to dissipate mass and dredging the yang qi to promote blood circulation. When there is qi stagnation, it is necessary to regulate qi. When there is blood stasis, it is necessary to eliminate the blood stasis. When there is qi and yang deficiency, it is necessary to tonify yang qi. When there is yin deficiency, it is necessary to nourish yin. And when there is phlegm blocking, it is necessary to eliminate phlegm. Strive to ‘all diseases correspond to prescription' and ‘all syndromes correspond to methods'.
引文
[1]杨雪芹,杨爱东,陈丽云,等.严世芸“圆机活法”治疗胸痹临床思维浅析.中华中医药杂志,2018,33(2):574-576
[2]刘宗莲,路洁,王秋风,等.国医大师路志正从湿辨治冠心病学术思想初探.中华中医药杂志,2010,25(3):379-381