从风论治冠状动脉痉挛  

Treatment of coronary artery spasm based on Wind theory

作　　者：贺群慧 李治兵 王宁宁 张萌[1] 黄斌[2] HE Qunhui;LI Zhibing;WANG Ningning;ZHANG Meng;HUANG Bin(Henan University of Chinese Medicine,Henan,Zhengzhou 450046,China;Department of Cardiovascular Medicine,Henan Provincial Hospital of Traditional Chinese Medicine,Henan,Zhengzhou 450002,China)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南省中医院心内科,河南郑州450002

出　　处：《中国医药科学》2022年第3期87-90,共4页China Medicine And Pharmacy

基　　金：河南省中医药科学研究专项课题(2019JDZX017)。

摘　　要：冠状动脉痉挛发病急骤,发无定处,休作有时,与风邪之性相合。基于“象思维”概念,可将冠状动脉痉挛病机归于动风。现代药理研究证实,大多祛风药具有解痉扩冠之效,为从风论治冠状动脉痉挛提供了科学支持。冠状动脉痉挛属祖国医学“胸痹心痛”畛域,根据心风来源不同,冠状动脉痉挛病机可分为热毒动风、虚风内动、外风引动内风,在治疗中可相应地运用熄风宁脉法。然风属阳邪,日久化燥,故治疗时还需兼顾气、血、津液。风邪久伏者当以虫类药祛风通络。本文结合中医古籍、当前药理研究进展及临床经验,论述从风论治冠状动脉痉挛的治疗思路,为风药治疗本病提供一定的理论参考,在辨证论治基础上加用风药,可凸显中医药治疗在减少冠状动脉痉挛发病次数和预后上的优势。The onset of coronary artery spasm(CAS)is acute with indefinite site and regular resting and attack,which is consistent with the nature of wind pathogen.Based on the concept of"Xiang thinking",the pathogenesis of CAS can be attributed to the wind movement.Modern pharmacological research has confirmed that most wind dispelling drugs have the effect of spasmolysis and coronary artery expansion,which provides scientific support for the treatment of CAS based on Wind theory.CAS is the boundary of"chest obstruction and heartache"in Chinese medicine.According to the different sources of heart Wind,the pathogenesis of CAS can be divided into stirring wind due to toxic heat,endogenous deficient wind,and external wind induced internal wind,and the method of stopping endogenous wind and quenching pulse is applied accordingly in the treatment.However,wind is a Yang evil,which turns into dryness over time,so it is also necessary to take into account Qi,blood and body fluid during the treatment.In cases where the wind pathogen has been in the patient’s body for a long time,insect drugs should be used to expel wind and dredge collateral.With reference to ancient medical books,current advances in the pharmacological study and clinical experience,this paper elaborates the treatment thoughts of treating CAS based on Wind theory,so as to provide theoretical reference for wind medicine in treating this disease.This paper also discusses that the addition of wind medicine on the basis of syndrome differentiation and treatment highlights the advantages of traditional Chines e medicine in reducing the incidence number of CAS and improving prognosis.

关 键 词：冠状动脉痉挛 风药 熄风宁脉法 辨证论治 

分 类 号：R259[医药卫生—中西医结合]