国医大师段亚亭运用温肾活血方治疗慢性心力衰竭经验  

TCM Master Duan Ya-ting′s Experience of Treating Chronic Heart Failure with Formula for Warming Kidney and Activating Blood Circulation

作　　者：彭杰[1] 刘凡[1] PENG Jie;LIU Fan(Chongqing Traditional Chinese Medicine Hospital,Chongqing,China,400021)

机构地区：[1]重庆市中医院,重庆400021

出　　处：《河南中医》2022年第3期380-383,共4页Henan Traditional Chinese Medicine

基　　金：重庆市自然科学基金面上项目(cstc2019jcyj-msxmx0091);重庆市科卫联合中医药技术创新与应用发展项目(2020ZY02384)。

摘　　要：国医大师段亚亭教授认为,心肾阳虚为心力衰竭(简称心衰)之本,而瘀血阻滞为其标,间或夹杂水湿、痰饮,治疗以温补心肾为主要治则,活血化瘀应贯穿治疗始终。段老认为临证需四诊合参,中西医结合,拟定温肾活血方治疗慢性心衰,并随证加减。胃肠道瘀血,食欲较差予焦/炒山楂、焦/炒神曲、焦/炒麦芽、焦/炒鸡内金以醒脾开胃;长期情绪抑郁者,可加香附、郁金、柴胡等疏肝解郁,抑郁较重者再加淫羊藿、石菖蒲、巴戟天、乌药等;伴失眠者加酸枣仁、柏子仁、茯神、知母、合欢皮等养心安神;头痛者加羌活、白芷、川芎等;便秘轻症加肉苁蓉、枳壳,便秘重症用生大黄、芒硝、枳实等;腹胀者加木香、砂仁、厚朴等;心衰患者因长期服用β受体阻滞剂、灌注不足、心理因素等原因出现阳痿、早泄、性冷淡等,可酌加九香虫、淫羊藿、巴戟天、覆盆子等。Professor Duan Ya-ting,a TCM Master,believes that the deficiency of heart and kidney yang is the root of heart failure,and blood stasis is its manifestation,sometimes mixed with water dampness and phlegm retention.The main treatment principle is to warm the heart and kidney,and promoting blood circulation and removing blood stasis should run through the treatment course.Master Lao believes that the clinical syndrome should be given a comprehensive analysis of the four examinations,and combined with traditional Chinese and Western medicine.He has established Formula for Warming Kidney and Activating Blood Circulation to treat chronic heart failure,which should be added and subtracted based on the exact syndrome.For gastrointestinal blood stasis and poor appetite,scorch-fried Shanzha(Fructus Crataegi),scorch-fried Shenqu(Massa Fermentata Medicinalis),scorch-fried Jineijin(Endothelium Corneum Gigeriae Galli)to enliven the spleen and improve appetite.For those with long-term depression,Xiangfu(Rhizoma Cyperi),Yujin(Radix Curcumae),Chaihu(Radix Bupleuri),etc.can be used to soothe the liver and relieve depression.For those with severe depression,Yinyanghuo(Herba Epimedii),Shichangpu(Rhizoma Acori Tatarinowii),Bajitian(Radix Morindae Officinalis),Wuyao(Radix Linderae),etc.can be added.For those combined with insomnia,Suanzaoren(Semen Ziziphi Spinosae),Baiziren(Semen Platycladi),Fushen(Sclerotium Poriae Pararadicis),Zhimu(Rhizoma Anemarrhenae),Hehuanpi(Cortex Albiziae),etc.can be added to nourish the heart and calm the mind.For headache,Qianghuo(Radix et Rhizoma Notopterygii),Baizhi(Radix Angelicae Dahuricae),Chuanxiong(Rhizoma Chuanxiong),etc.can be added.For mild constipation,Roucongrong(Herba Cistanches)and Zhiqiao(Fructus Aurantii)can be added.For severe constipation,raw Dahuang(Radix et Rhizoma Rhei),Mangxiao(Natrii Sulfas)and Zhishi(Fructus Aurantii Immaturus)can be used.For abdominal distension,Muxiang(Radix Aucklandiae),Sharen(Fructus Amomi),Houpo(Cortex Magnoliae Officinalis),etc.can be added.For patients with h

关 键 词：慢性心力衰竭 温肾活血方 国医大师 段亚亭 

分 类 号：R259[医药卫生—中西医结合]