浅析“心胀”中医辨证论治
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摘要
"心胀"语出《灵枢·胀论》"夫心胀者,烦心短气,卧不安",与扩张型心肌病在病因病机及临床表现上极其相似。心胀病位在心,与肺脾肾三脏密切相关,其发病责之于内外两端,病性虚实夹杂,以虚证较为多见。在治疗上分别采用温补心阳、益气养阴、补气行水、活血利水之法,辨证论治,临证选方,灵活用药在临床中往往疗效显著。为扩张型心肌病的中医规范化治疗提供参考,也为其中西医临床诊治提供新思路。
"Xinzhang" phrase comes from Lingshu· Expansion Theory, "Husband heart swell, upset and shortness of breath, insomnia",and its etiology, pathogenesis and clinical manifestations are very similar with dilated cardiomyopathy. Xinzhang, a disease located in heart, is closely related to lung, spleen and kidney. The cause of "Xingzhang" is on both inner and outer, and the quality is astheniasthenia zheng complications. Deficiency zheng is more common. The treatment based on syndrome differentiation uses methods of warm reinforcing heart yang, supplementing Qi and nourishing Yin, strengthening spleen and benefiting Qi, activating blood circulation and alleviating water retention. The prescription is chosen by syndromes and the use of drugs is flexble, so the clinical effect is significantly. It provides reference for the standard treatment of dilated cardiomyopathy in traditional Chinese medicine, and provides new ideas for clinical diagnosis and treatment in traditional Chinese medicine and western medicine.
"Xinzhang" phrase comes from Lingshu· Expansion Theory, "Husband heart swell, upset and shortness of breath, insomnia",and its etiology, pathogenesis and clinical manifestations are very similar with dilated cardiomyopathy. Xinzhang, a disease located in heart, is closely related to lung, spleen and kidney. The cause of "Xingzhang" is on both inner and outer, and the quality is astheniasthenia zheng complications. Deficiency zheng is more common. The treatment based on syndrome differentiation uses methods of warm reinforcing heart yang, supplementing Qi and nourishing Yin, strengthening spleen and benefiting Qi, activating blood circulation and alleviating water retention. The prescription is chosen by syndromes and the use of drugs is flexble, so the clinical effect is significantly. It provides reference for the standard treatment of dilated cardiomyopathy in traditional Chinese medicine, and provides new ideas for clinical diagnosis and treatment in traditional Chinese medicine and western medicine.
引文
[1]韩丽华,王振涛,莫晓飞,等.“心胀”浅析[J].中医临床研究,2013,5(5):62-63.
[2]曹林生,廖玉华.心脏病学[M].北京:人民卫生出版社,2010:840.
[3]中华医学会心血管病分会,中华心血管病杂志编辑委员会,中国心肌病诊断与治疗建议工作组.心肌病诊断与治疗建议[J].中华心血管病杂志,2007,35(1):7.
[4]陆曙,戴飞.《灵枢》“心胀”浅析[J].中华中医药杂志,2013,28(11):3172-3173.
[5]邓斌.罗陆一教授治疗扩张型心肌病经验拾萃[J].中国中医急症,2010,19(12):2084.
[6]张涛,张琪.孟河医派泻肺法治疗心胀病的临床体会[J].中国中医基础医学杂志,2015,21(8):1014-1015.
[7]赵敬杰,张彩,罗集.扩张性心脏病与HLA-DR基因多态性相关性的研究[J].医学检验与临床,2006,17(6):61-62.
[8]庐少玲,张烁.病毒性心肌炎演变为扩张型心肌病的机制[J].心血管康复医学杂志,2016,25(3):341-343.
[9]古正涛,沈鹰.论“百病生于气也”[J].天津中医药,2008,25(5):388-389.
[10]戴飞,陆曙.陆曙教授治疗心胀病经验[J].中华中医药杂志,2013,28(8):2329-2331.
[11]赵明奇,吴伟康,段新芬,等.四逆汤对阿霉素性心衰大鼠心肌线粒体功能的影响[J].中药材,2005,28(6):486-489.
[12]曾代文,彭成,余成浩,等.附子干姜组分配伍对急性心衰心阳虚证大鼠血流动力学的影响[J].中药药理与临床,2011,27(5):93-96.
[13]谢旻.生脉散合丹参饮加味治疗冠心病60例[J].中国中医药现代远程教育,2008,6(11):1375.
[14]卢军利,赵静文,陈沛林,等.保元汤对冠心病患者血清一氧化氮及一氧化氮合酶的影响[J].河北中医,2013,35(12):1801-1802.
[15]职玉娟,黄水清.黄芪总皂苷对H2O2诱导心肌细胞凋亡的保护作用[J].中药新药与临床药理,2013,24(1):10-13.
[16]刘艳霞,刘在萍,焦建杰,等.黄芪苷Ⅳ对正常和心功能受抑制大鼠左心室心肌力学的影响[J].中草药,2001,32(4):332-334.
[17]邢俊梅,邢俊娥.加味真武汤对慢性心力衰竭患者心功能的干预[J].内蒙古中医药,2011,41(9):12-13.
[18]贾红娥,孟咏梅.实脾散加减治疗老年脾肾阳虚型慢性心衰110例[J].山东中医药大学学报,2012,36(6):496-497.
[19]赵永见,牛凯,唐德志,等.桃仁药理作用研究近况[J].辽宁中医杂志,2015,42(4):888-890.
[20]柯于鹊.丹参对乳鼠心肌细胞凋亡的影响[J].山东中医药大学学报,2001,25(5):376-378.
[2]曹林生,廖玉华.心脏病学[M].北京:人民卫生出版社,2010:840.
[3]中华医学会心血管病分会,中华心血管病杂志编辑委员会,中国心肌病诊断与治疗建议工作组.心肌病诊断与治疗建议[J].中华心血管病杂志,2007,35(1):7.
[4]陆曙,戴飞.《灵枢》“心胀”浅析[J].中华中医药杂志,2013,28(11):3172-3173.
[5]邓斌.罗陆一教授治疗扩张型心肌病经验拾萃[J].中国中医急症,2010,19(12):2084.
[6]张涛,张琪.孟河医派泻肺法治疗心胀病的临床体会[J].中国中医基础医学杂志,2015,21(8):1014-1015.
[7]赵敬杰,张彩,罗集.扩张性心脏病与HLA-DR基因多态性相关性的研究[J].医学检验与临床,2006,17(6):61-62.
[8]庐少玲,张烁.病毒性心肌炎演变为扩张型心肌病的机制[J].心血管康复医学杂志,2016,25(3):341-343.
[9]古正涛,沈鹰.论“百病生于气也”[J].天津中医药,2008,25(5):388-389.
[10]戴飞,陆曙.陆曙教授治疗心胀病经验[J].中华中医药杂志,2013,28(8):2329-2331.
[11]赵明奇,吴伟康,段新芬,等.四逆汤对阿霉素性心衰大鼠心肌线粒体功能的影响[J].中药材,2005,28(6):486-489.
[12]曾代文,彭成,余成浩,等.附子干姜组分配伍对急性心衰心阳虚证大鼠血流动力学的影响[J].中药药理与临床,2011,27(5):93-96.
[13]谢旻.生脉散合丹参饮加味治疗冠心病60例[J].中国中医药现代远程教育,2008,6(11):1375.
[14]卢军利,赵静文,陈沛林,等.保元汤对冠心病患者血清一氧化氮及一氧化氮合酶的影响[J].河北中医,2013,35(12):1801-1802.
[15]职玉娟,黄水清.黄芪总皂苷对H2O2诱导心肌细胞凋亡的保护作用[J].中药新药与临床药理,2013,24(1):10-13.
[16]刘艳霞,刘在萍,焦建杰,等.黄芪苷Ⅳ对正常和心功能受抑制大鼠左心室心肌力学的影响[J].中草药,2001,32(4):332-334.
[17]邢俊梅,邢俊娥.加味真武汤对慢性心力衰竭患者心功能的干预[J].内蒙古中医药,2011,41(9):12-13.
[18]贾红娥,孟咏梅.实脾散加减治疗老年脾肾阳虚型慢性心衰110例[J].山东中医药大学学报,2012,36(6):496-497.
[19]赵永见,牛凯,唐德志,等.桃仁药理作用研究近况[J].辽宁中医杂志,2015,42(4):888-890.
[20]柯于鹊.丹参对乳鼠心肌细胞凋亡的影响[J].山东中医药大学学报,2001,25(5):376-378.