贾树培教授应用痰瘀同治法治疗冠心病心绞痛经验  

Professor Jia Shupei's experience of applying simultaneous treatment of phlegm and blood stasis in treating coronary heart disease

作　　者：李伟 贾树培[2] 

机构地区：[1]华北理工大学,063000 [2]石家庄市中医院,河北石家庄050000

出　　处：《中医临床研究》2017年第27期1-2,共2页Clinical Journal Of Chinese Medicine

摘　　要：冠心病属中医学"胸痹""心痛"范畴,我国古代医籍中早有相关文献记载并论述。贾树培教授认为本病的主要病机以本虚标实为主,心气虚、心阳虚是本,痰瘀互结为标,饮食不节、情志不畅等原因导致脾胃受损,津液输布失常,终致痰瘀互阻而为胸痹;另,脾胃损伤,水谷精微化生不足,心失所养亦能导致胸痹的发生。痰、瘀是本病发生的主要病理因素,故临床以痰瘀互结为辨证要点。贾树培教授以痰瘀同治为指导,根据痰瘀互结的证候特点及临床表现思想,采用"祛痰活血,通阳开痹"的治法,辨别痰瘀的轻重,权衡治之,同时顺应痰瘀互结证的发展趋势,即使在本病初期也应兼顾活血或祛痰。另外,对于痰瘀互结的辨证施治应重视气机的调理,治痰先理气,气顺则痰瘀自消。选《金匮要略》中"瓜蒌薤白半夏汤"合《太平惠民和剂局方》中"失笑散"进行组方加减,诸药共用,相辅相成,共奏祛痰活血、通阳开痹之功。临证中除熟悉掌握痰瘀互结的辨证施治要点,同时应认识到胸痹病因病机复杂,密切结合患者的证候表现灵活施治,方能取得较好疗效。Coronary heart disease belongs to the category of ＂chest paralysis＂ ＂heartache＂ in Chinese medicine. Ancient Chinese medical records have documented and discussed it. Professor Jia Shupei believes that the main pathogenesis of the disease is mainly based on the false and label. Heart Qi deficiency and Yang deficiency is the origin, with phlegm and blood stasis intermingles. The diet not proper, poor feelings and other reasons lead to the damage of the spleen and stomach; at the same time, the body fluid transmission is disorder, which finally causes the phlegm and blood stasis in the chest and paralysis. Besides, spleen and stomach damage, lack of water and refined grains, heart loss can also lead to the occurrence of chest pain. Phlegm and stasis are the main pathological factors of this disease, so the clinical features of phlegm and stasis are the key points. Professor Jia Shupei is guided by the rule of phlegm and blood stasis and applies ＂Eliminating phlegm and activating blood, activating Yang and inducing obstruction＂ according to the characteristics of phlegm and blood stasis syndrome and clinical manifestations of thinking. In addition, the treatment based on the syndrome differentiation of phlegm and blood stasis should pay more attention to the adjustment of Qiji, the treatment of phlegm, and the elimination of phlegm and stasis. In the selection, Gualou Xiebai Banxia Decoction from Jinkui Yaolue and Shixiao San in the Taiping Huimin Hejo＇u Fang added and subtracted, various drugs complemented each other can achieve good expectorant and blood circulation. In addition to being familiar with the key points of differentiation on phlegm and stasis in the disease, we should be recognized that the pathogenesis of thoracic disease complicated; and the patient＇s syndrome should be applied flexibly, to achieve a better effect.

关 键 词：名医经验 痰瘀同治 心绞痛 中医疗法 

分 类 号：R249.8[医药卫生—中医临床基础]