张军平谨守病机顺应四时方证辨治慢性心力衰竭  

Professor Zhang Junping′s Experience in Treating Chronic Heart Failure Based on Pathogenesis as Well as Prescription and Syndrome in Four Seasons

作　　者：张傲 漆仲文 王铭扬 施琦 付焕杰 张军平[1] ZHANG Ao;QI Zhongwen;WANG Mingyang;SHI Qi;FU Huanjie;ZHANG Junping(The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin China 300381)

机构地区：[1]天津中医药大学第一附属医院/国家中医针灸临床医学研究中心,天津300381

出　　处：《中医学报》2021年第12期2602-2605,共4页Acta Chinese Medicine

基　　金：国家自然科学基金项目(30672734);国家中医药管理局基金项目(JDZX2012140)。

摘　　要：治疗慢性心力衰竭以温通心阳、益气养血法为主,对于射血分数在50%以上,即射血分数保留患者,以育心通阳方为主方以调心养心、育心荣心;对于射血分数低于50%以下,兼有下肢水肿较重、活动受限、不能平卧、胃脘饱满等症状的患者,给予育心化水方以行气利水,温通心阳。同时慢性心力衰竭具有四时证候差异特点,结合四时气候特点及患者病情变化,形成四时辨治心力衰竭方案。遣药组方施以益心春、益心夏、益心秋、益心冬四时方药,取得良好临床疗效。The treatment of chronic heart failure(CHF) is mainly focus on warming the heart Yang and replenishing Qi and nourishing Blood.For patients with an ejection fraction above 50%,that is,the HFREF,the Yuxin Tongyang Recipe is the main prescription to adjust,tonifying,nourishing,and replenishing the heart.For patients with ejection fraction below 50%,severe lower extremity edema,limited mobility,inability to lie on their backs,full gastric cavity,etc.,Yuxin Huashui Decoction is given to promoting Qi and diuresis,warming Heart,and activating Yang.At the same time,CHF has the characteristics of different syndromes in the four seasons,combined with the four seasons climate characteristics and changes in the patient′s condition,the four seasons syndrome differentiation and treatment plan is formed.The four seasons prescriptions of tonifying Heart spring,tonifying Heart summer,tonifying Heart autumn,and tonifying Heart winter were applied to the prescription group,which achieved good clinical effects.

关 键 词：慢性心力衰竭 病机 证候 四时方证 张军平 

分 类 号：R249.27[医药卫生—中医临床基础]