基于“通阳不在温而在利小便”从气化不利论射血分数保留的心力衰竭治疗思路  

Treatment of HFpEF from Perspective of Abnormal Qihua Basing on “Promoting Yang Not in Warming,But in Benefiting Urination”

作　　者：董国菊[1,2] DONG Guoju(Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China;National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]国家心血管病临床研究中心,北京100091

出　　处：《中华中医药学刊》2022年第11期5-7,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82074423);中国中医科学院科技创新重大攻关项目(C12021A00903)。

摘　　要：射血分数保留的心力衰竭(heart failure with preserved ejection fraction, HFpEF)是目前最常见的心力衰竭,其西医病理特征和中医病机特点均不同于传统的射血分数减低的心力衰竭。通过梳理中医“通阳不在温,而在利小便”的内涵,总结和拓展其通阳思想在临床的应用,结合气化学说探析饮停于肺导致的气化不利是HFpEF的核心病机,从化饮利水、活血化瘀论治HFpEF实际是“通阳不在温,而在利小便”的进一步拓展和应用,为中医临床诊治HFpEF提供新的思路。Heart failure with preserved ejection fraction(HFpEF)is the most common heart failure at present.The pathological characteristics of western medicine and Traditional Chinese Medicine(TCM)were different from heart failure with reduced ejection fraction(HFrEF).This paper aims to sort out the connotation of“promoting Yang not in warming,but in benefiting urination”in TCM,summarize and expand the clinical application of dredging Yang theory in clinical practice,combine Qihua theory,and discuss the core pathogenesis of HFpEF—abnormal aihua induced by Yin blocking lung.Treatment of HFpEF with warming and promoting water and promoting blood circulation and removing blood stasis is the further expansion and application of“promoting Yang not in warming,but in benefiting urination”,which provides a new idea for the clinical diagnosis and treatment of HFpEF in TCM.

关 键 词：气化不利 射血分数保留心力衰竭 

分 类 号：R259.416[医药卫生—中西医结合]