基于“阳微阴弦”理论探讨破格救心汤在脓毒性心肌病治疗中的应用  

Base on theory of"Yang weakly and Yin string"to approach application of Poge Jiuxin Decoction for treatment of septic cardiomyopathy

作　　者：王铮[1,2] 禄文博 郝如斌 王昱 Wang Zheng;Lu Wenbo;Hao Rubin;Wang Yu(Gansu University of Chinese Medicine,Lanzhou 730000,Gansu,China;Department of Critical Care Medicine,Affiliated Hospital of Gansu University of Chinese Medicine,LanZhou 730000,Gansu,China;Department of Critical Care,Lintao Hospital of Traditional Chinese Medicine,Dingxi 730500,Gansu,China)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]甘肃中医药大学附属医院重症医学科,甘肃兰州730000 [3]临洮县中医院重症医学科,甘肃定西730500

出　　处：《中国中西医结合急救杂志》2022年第2期238-241,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：甘肃省自然科学基金(21JR11RA152);甘肃省中医药管理局科研项目(GZK-2017-15);甘肃中医药大学附属医院科研及技术创新基金项目(ZQN2016-15)。

摘　　要：脓毒性心肌病(SIC)发病率和病死率高,严重威胁患者的生命安全。现代医学尚无针对SIC治疗的统一策略,亦无特效治疗药物,目前中医药或中西医结合救治SIC的经验和临床研究较少。本文结合临床实践,对“阳微阴弦”理论指导下应用破格救心汤治疗SIC的经验进行探讨。通过分析《伤寒论》中“阳微阴弦”理论内涵,阐释阳虚不能温煦心脉是SIC的主要病理环节,临证中当以扶助阳气为主要治则。破格救心汤为李可老中医经验方,全方益气回阳固脱,在心力衰竭疾病的治疗中具有较好临床疗效基础。目前临床及实验研究已证实,破格救心汤具有心肌保护作用,其联合西医常规治疗能显著改善SIC患者的心功能及血流动力学指标。笔者依据张仲景“阳微阴弦”理论,以扶阳法为治则,将临床应用破格救心汤救治SIC的治疗经验进行分析,以期拓展中医药治疗SIC的思路。The incidence and mortality are relatively high in patients with septic cardiomyopathy(SIC),seriously threatening the safety of patients'life.At present,there are no unified strategy and specific therapeutic drug for SIC treatment in modern medicine,and clinical experience and research of traditional Chinese medicine(TCM)or integration of TCM and western medicine for treatment of this disease is also relatively few.In this article,under the guidance of"Yang weakly and Yin string"TCM theory,the authors of this report clinically applied Poge Jiuxin Decoction to approach the treatment of patients with SIC,and in the mean time,generally the conventional western medicine therapy for SIC was also used.By analyzing the theoretical connotation of"Yang weakly and Yin string"in Shanghan Lun,a famous TCM ancient book,the authors according to TCM syndrome differentiation,recognized that the Yang Qi deficiency cannot warm the heart pulse is the key pathological link of SIC,so that supporting Yang Qi should be the main theoretical principle in the clinical treatment of SIC.Poge Jiuxin Decoction is an old TCM doctor Li Ke's empirical prescription,which can replenish Qi and return Yang.It has a relatively good clinical curative effect in the treatment of heart failure.At present,the clinical and experimental studies have confirmed that Poge Jiuxin Decoction has myocardial protective effect,and its combination with conventional western medicine can significantly improve the cardiac function and hemodynamic indexes of SIC patients.Based on Zhang Zhongjing's"Yang weakly and Yin string"theory and strengthening Yang Qi as the TCM principle,the authors analyzed clinical experiences of using Poge Jiuxin Decoction for rescuing patients with SIC in order to expand the thinking of treating SIC with TCM.

关 键 词：脓毒性心肌病 阳微阴弦 破格救心汤 

分 类 号：R54[医药卫生—心血管疾病]