慢性心力衰竭中医辨证思考  

Dialectical Thinking of Chinese Medicine in Chronic Heart Failure

作　　者：袁天慧[1] 吴辉[1] 杨忠奇[1] 龙文杰 宁怡乐 李小兵[1] 汪朝晖[1] 于扬文[1] 冼绍祥[1] YUAN Tian-hui;WU Hui;YANG Zhong-qi;LONG Wen-jie;NING Yi-le;LI Xiao-bing;WANG Chao-hui;YU Yang-wen;XIAN Shao-xiang(Department of International Medical,Department of Geriatrics(Clinical Research Center),The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405;First Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510504)

机构地区：[1]广州中医药大学第一附属医院国际医疗部、老年病科(临床研究病房),广州510405 [2]广州中医药大学第一临床医学院,广州510504

出　　处：《中国中西医结合杂志》2022年第3期355-359,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.81704036);国家重点研发计划“中医药现代化”(No.2017YFC1700304);广东省自然科学基金(No.2017A030310128);广东省首批名中医师承项目(No.粤中医函[2015]20号)。

摘　　要：慢性心力衰竭是由各种心血管疾病发展到最后阶段复杂的临床综合征,是高患病率和高病死率的公共卫生问题。根据中医学辨证体系,慢性心力衰竭基本病机是气虚血瘀水停。考虑到患者具体病情常兼杂有“毒”邪、肝郁脾虚等不同情况,可配合不同治法。对于慢性心力衰竭存在“毒”邪的患者配合使用清热解毒法;对于病情急重或者“毒”邪无所出的患者,可根据“心与小肠相表里”的理论,采用利水清小便中药排除“毒”邪;合并有抑郁焦虑状态的采用疏肝解郁法配合治疗,从整体改善慢性心力衰竭患者的心脏以及身体机能。临床实践显示,以上疗法能够改善慢性心力衰竭患者的心功能、生活质量,降低住院率及病死率,体现了中医药辨证治疗的优势。Chronic heart failure as a end stage of various cardiovascular diseases is a complex clinical syndrome that remains a public health issue with high morbidity and mortality. According to the syndrome differentiation system of Chinese medicine(CM), the basic pathogenesis of chronic heart failure is Qi stagnation, blood stasis, and water retention. In consideration of the patient’s specific condition,such as the symptoms of “toxic”, the symptoms of Gan depression and Pi deficiency and so on, which different treatments have been used with together. When patients with chronic heart failure in clinical feature of “toxic” condition,the clearing heat and removing toxin method could have been used. Based on the theory of “Xin connecting with small intestine”, if the patient with serious condition or “toxic” condition, diuretic herbs could have been used for eliminating “toxic”.When patients combined chronic heart failure with depression or anxiety, the method of soothing Gan and relieving depression could have been used. Heart and body function have been regulated in patients with chronic heart failure on the whole. Clinical practice shows that all above therapies can improve the heart function and quality of life of patients with chronic heart failure, reduce the rate of hospitalization and mortality, reflecting the advantages of the system based on CM syndrome differentiation and treatment.

关 键 词：慢性心力衰竭 辨证论治 清热解毒 清利小便 疏肝解郁 

分 类 号：R259[医药卫生—中西医结合]