胸痹心痛的病名演变  

Evolution of the name of chest obstruction and heart pain

作　　者：杨丽[1] 王彩霞 YANG Li;WANG Caixia(The Third Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shengyang 110003,China;Liaoning University of Traditional Chinese Medicine,Shengyang 110032,China)

机构地区：[1]辽宁中医药大学附属第三医院,沈阳110003 [2]辽宁中医

出　　处：《长春中医药大学学报》2020年第5期854-857,共4页Journal of Changchun University of Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)(2013CB531701)。

摘　　要：古代文献中胸痹心痛的病名有:心痛、真心痛、厥心痛、胸痹、心痹、胸痹心痛、卒心痛、久心痛等。最初的胸痹心痛包括心病、胃脘部疾病和胸腔疾病。《黄帝内经》中胸痹心痛的病名有“心痛”“真心痛”“厥心痛”“胸痹”“心痹”等,将胸腔中疾病统称为“心病”。《金匮要略》首次出现了“胸痹心痛”的病名,将胃病包括在“胸痹”中。《脉经》和《针灸甲乙经》均认为,心病的病位应该在心包络。《诸病源候论》认为,“心痛”“心痹”“胸痹”应属不同疾病,并进行了区分。从宋代开始,有医家主张将真心痛从胃脘痛中分离出来,认为心痛除真心痛外,都是胃脘痛,也有医家认为,心痛就是胃脘痛。明代医家提出了心痛包括心痛与胃痛,心痛中属于真心痛的很少。清代医家开始明确心与胃在解剖本质上的不同,而逐渐将心痛从胃痛中分离出来。《证治准绳》明确指出心痛、胸痛、胃脘痛之别,陈士铎从心痛的病位和症状上与胃脘痛进行了区分。The names of chest obstruction and heart pain in ancient literatures were:heartache,true heartache,convulsion heartache,chest obstruction,heart obstruction,chest obstruction and heart pain,death heartache,long heartache and so on.Chest obstruction and heart pain included heart disease,epigastric diseases and chest diseases at first.The names of chest obstruction and heart pain included:heartache,true heartache,convulsion heartache,chest obstruction,heart obstruction in Huangdi Neijing.The diseases in the chest were collectively called heart disease.For the first time in Jingui Yaolüe,the name of chest obstruction and heart pain was introduced,and stomach trouble was included in chest obstruction.The authors of Mai Jing and Zhenjiu Jiayi Jing considered that the location of heart disease should be in the envelope of the heart.The writer of Zhubing Yuanhou Lun considered that heartache,chest obstruction,heart obstruction should belong to different diseases,and made a distinction between them.Some doctors had advocated separating heartache from gastric abscess since Song Dynasty.They believed that heartache was all gastric abscess besides true heartache,and the prognosis of true heartache was poor.Some doctors believed that heartache was gastric abscess.In Ming Dynasty,the doctors brought up heartache including heartache and stomachache.In the Qing Dynasty,physicians began to clarify the anatomical differences between the heart and the stomach,and gradually separated the heartache from the stomachache.The difference clearly pointed out between heartache,chest pain and stomachache in Zhengzhi Zhunsheng.Chen Shiduo distinguished the difference between heartache and stomachache from the disease and symptoms.

关 键 词：胸痹心痛 胸痹 心痛 真心痛 病名演变 

分 类 号：R256.22[医药卫生—中医内科学]