刍议冠心病的气血津液辨治  

Qi,Blood and Fluid Differentiation and Treatment in Coronary Heart Disease

作　　者：李圣耀 徐浩[1] 史大卓[1] 

机构地区：[1]中国中医科学院西苑医院,北京市海淀区西苑操场1号100091

出　　处：《中医杂志》2017年第4期300-302,共3页Journal of Traditional Chinese Medicine

基　　金："十二五"国家科技支撑计划(2013BAI02B01);中国中医科学院博士研究生创新人才培养基金(CX201602)

摘　　要：气血津液共同化生于中焦脾胃,功能上相互依存,因此,气虚、气滞、血瘀、痰浊等气血津液的病理改变也常相因发生。"血不利则为水"概括地说明了气血津液的病理因果关系,将其用以阐释冠心病的发生发展,认为冠心病常见病因皆可引起气的生成或气化功能失常,进而导致"血不利",所化之痰水又与血液有形成分互结形成斑块,使管腔狭窄阻碍血液运行,而致心脉不通,"不通则痛";心失所养,"不荣则痛";痰瘀互结日久化热酿毒,则蚀脉伤肌,变证丛生。治疗应补气兼顾理气,活血不忘化痰,恰当配伍清热解毒药,可望在减少冠心病心血管事件方面获得较好的疗效。Qi,blood and fluid are all transformed and produced in spleen and stomach in the middle energizer.They depend on each other functionally,so Qi deficiency,Qi stagnation,stasis,turbid phlegm and other pathological changes of Qi,blood and fluid always result from each other. ＂Poor blood flow always resulting in water retention＂,summarily describing the pathological causality of Qi,blood and fluid,is used to explain the occurrence and development of coronary heart disease（ CHD）. The authors think all the common causes of CHD could lead to the aberration of Qi generation or Qi transformation,and then result in ＂poor blood flow＂,and the generated phlegm water could bind with the visible components in blood,generating plaque,resulting in lumen stenosis that obstructs blood circulation. The cardiac vessels then become obstructed,and ＂the obstruction causes the pain＂; the heart loses its nourishment,and ＂the malnourishment causes the pain＂; the long-time combining phlegm and stasis could transform into heat and toxin,then eroding the vessels and muscle,and the deteriorated syndromes occur. As for the treatment,Qi should be invigorated as well as regulated,and activating blood should be accompanied with dissolving phlegm,and heat-clearing and detoxifying drugs could be added to reduce cardiovascular events in CHD.

关 键 词：冠心病 血不利则为水 痰瘀互结 瘀毒 清热解毒 

分 类 号：R259[医药卫生—中西医结合]