胸痹心痛病名与病机  

A Brief Talk about on TCM Disease Name and Pathogenesis of Chest Stuffiness and Pains

作　　者：谢昂[1] 王凤荣[2] 

机构地区：[1]辽宁中医药大学 [2]辽宁中医药大学附属医院心病一科,沈阳110032

出　　处：《实用中医内科杂志》2013年第6期160-161,165,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要："胸痹"最早出现在《灵枢·本脏》,阐述较模糊;汉·张仲景从脉象症状等方面说明,晋·葛洪、隋·巢元方《、圣济总录·胸痹门》、明代秦景明《症因脉治》等将胸痹之名来源归结为胸痹脉象、症候特点、发病原因等。心痛始见于马王堆汉墓帛书《足臂十一脉灸经》《,素问》有"心病先心痛"、"心痹者,脉不通,烦则心下鼓,暴上气而喘",《灵枢·厥病》把厥心痛分为肝心痛、胃心痛、脾心痛、肺心痛、肾心痛,云:"痛如以锥针刺其心";隋·巢元方对心痛病名论述详实,因、证、象等具备;唐·孙思邈、《太平圣惠方》、从治法方药方面给后世医家很大启发;明清时期有更详尽修正,最具代表性是《临证指南医案·心痛》把心痛与胃脘痛、真心痛等从发病部位确切区分。日本人丹波元坚所著《杂病广要》对"胸痹心痛"最早进行了详尽论述,对现今影响颇丰;汉·张仲景将胸痹与心痛合一而述。从脉象、病因、症候等方面看",胸痹心痛"之名更优于胸痹、心痛分而论之。病机乃心脉痹阻、阳微阴弦。＂Chest＂ first appeared in ＂Lingshu the dirty＂,describes a fuzzy;Han Zhang Zhongjing from pulse symptom description,Jin Ge Hong,Sui,Chao Yuanfang, ＂Shengji Zonglu chest door＂,Ming Qin Jingming ＂disorders due to pulse treatment＂ will be named as chest pain,chest pulse symptom characteristics,cause of disease etc.. Heartache beginning in the Mawangdui tomb ＂foot arm ten by Moxibustion＂, ＂Su＂ ＂heart to heart＂, ＂heart impediment,veins not tired heart,drum,storm breathing hard,＂ ＂Lingshu,faint disease＂ the precordial pain were divided into liver,heart,spleen stomach ache heartache,pulmonary heart disease,kidney heartache,cloud： ＂pain such as cone acupuncture heart＂;Sui Chao Yuanfang to name the heartache,detailed,because,like syndrome,with;Tang Sun Simiao, ＂Taiping San Hui Fang,＂ from prescription drugs to physicians of later generations greatly inspired;the Ming and Qing dynasties have more correction,the most representative is the ＂heart＂ guide to clinical practice,the heart and stomach pain,really sad,distinguishing from the diseased parts. Japanese written by Tanba Yuanken ＂miscellaneous＂ to ＂wide to heartache＂ as early as in detail,the influence of a lot;Han Zhang Zhongjing chest pain and heartache together and the. From the pulse,etiology,syndrome, ＂chest pain＂ in the name of more than chest pain,heartache divided. Pathogenesis is the heart vessel blockage,Yin Yang micro strings.

关 键 词：胸痹心痛 病名 病机 各代医家 心脉痹阻 阳微阴弦 黄帝内经 金匮要略 诸病源候论 圣济总录 症因脉治 杂病广要 

分 类 号：R256.22[医药卫生—中医内科学]