冠心病血瘀证辨治  

Differentiation and Treatment of Blood Stasis Syndrome of Coronary Heart Disease

作　　者：刘明浩 张建平[2] 尚新月 杨爱华 LIU Minghao;ZHANG Jianping;SHANG Xinyue;YANG Aihua(Tianjin University of Traditional Chinese Medicine,Tianjin,China,300193;Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin,China,300150)

机构地区：[1]天津中医药大学,天津300193 [2]天津中医药大学第二附属医院,天津300150

出　　处：《河南中医》2023年第9期1317-1319,共3页Henan Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81774016)。

摘　　要：冠状动脉粥样硬化性心脏病(简称冠心病)证候要素前3位是血瘀、气虚、痰浊,血瘀贯穿冠心病始终。血瘀不化,则聚而生毒,毒邪又作为致病因素影响机体,伤及心之血脉,使正气愈虚,应治以益气活血解毒,在活血药物的基础上加连翘、黄连、黄芩、党参等益气解毒之品,防止瘀毒化热。肾为先天之本,元气之根,肾脏亏虚,心肾失交,脉气不充,血脉滞涩,形成血瘀,治宜补肾活血,并辅以健脾。阳虚为气虚之渐,心阳虚衰,寒客脉中,血凝而不行,采用乌头赤石脂丸通阳,并加入石斛、麦冬等顾护阴液。冠心病活动期症状符合“风”之特点,此期应在活血药物中加入羌胡、防风、威灵仙等祛风药,使风散血流。心气虚衰,母病及子,脾气亦衰,致津液难化,聚湿成痰,痰水互结,进一步加重血瘀,用二陈汤加利水渗湿药物,使瘀祛痰消。The top three syndromes of coronary heart disease are blood stasis,qi deficiency and phlegm turbidity,and blood stasis runs through coronary heart disease.If the blood stasis does not dissolve,it will accumulate and produce toxicity,and the toxic pathogen will affect the body as a pathogenic factor,injure the blood of the heart,and make the healthy qi more deficient.It should be treated by replenishing qi and activating blood to detoxify the body,so Lianqiao(Fructus Forsythiae),Huanglian(Rhizoma Coptidis),Huangqin(Radix Scutellariae),Dangshen(Radix Codonopsis),etc.can be added to prevent blood stasis from transforming into heat on the basis of using the drugs for activating blood.Kidney is the innate origin,and the root of original qi.If there are kidney deficiency,heart and kidney disharmony,insufficient pulse qi,blocked blood vessel,blood stasis will occur.The treatment should focus on tonifying the kidney and promoting blood circulation,and supplemented by activating the spleen.Yang deficiency refers to gradual qi deficiency.If there are heart yang deficiency,and cold accumulated in meridians,blood coagulation will occur.So Aconite Main Root and Halloysitum Rubrum Pill can be used for unblocking yang.Shihu(Caulis Dendrobi),Maidong(Radix Ophiopogonis),etc.can be added to protect yin fluid.The symptoms of coronary heart disease in the active period are in line with the characteristics of"wind".During this period of treatment,Qianghuo(Radix et Rhizoma Notopterygi),Fangfeng(Radix Saposhnikoviae),Wilingxian(Radix et Rhizoma Clematidis)and other wind-dispelling drugs should be added to the blood-activating drugs to make the wind disperse and blood flow.If there is heart qi deficiency,and disorder of mother-organ affecting child-organ,leading to inactivity of spleen qi,body fluid retention,accumulated dampness transforming into phlegm,intermingled phlegm and water and stasis will further aggravate blood stasis,so Two Matured Substances Decoction plus drugs for promoting urination and draining dampness can be used to

关 键 词：冠心病 血瘀证 益气活血解毒 补肾活血 扶阳活血 祛风活血 化痰活血 

分 类 号：R259.414[医药卫生—中西医结合]