基于“标本缓急”理论探讨肺源性心脏病的中医治疗思路  

Exploration of TCM treatment of pulmonary heart disease based on the theory of treating both the symptoms and the root causes

作　　者：赵建 黄新生 贾婷婷 苏和 ZHAO Jian;HUANG Xinsheng;JIA Tingting;SU He

机构地区：[1]内蒙古自治区中医医院,内蒙古呼和浩特010000

出　　处：《中医临床研究》2023年第24期145-148,共4页Clinical Journal Of Chinese Medicine

基　　金：蒙药当贡-3胶囊治疗冠心病稳定型心绞痛的临床研究(JH20180086);“清热化痰散结法”治疗肺心病右心衰竭的临床推广应用(CGZH2018176)。

摘　　要：慢性肺源性心脏病(简称肺心病)多由慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)发展而来,COPD是一种不完全可逆的气流受限性疾病,呈进行性发展。肺心病患病人数多,病死率高,由于其进行性加重的特点,严重影响患者的劳动能力和生活质量。“急则治其标,缓则治其本”为传统中医基础理论,据此分析探讨本病的病因病机,概括为“本虚标实”,本虚主要责之于肺、脾以及肾三脏之虚,亦可及心,标实者,主要责之于痰浊、瘀血以及水饮互结,其中痰浊、水饮、瘀血又可相兼为病,痰瘀日久,蕴而化热,热壅于肺,促使肺胀的发生和发展。肺心病急性期治疗以清热化痰逐瘀为主,兼顾护中焦,缓解期治疗以补肺健脾温肾为主,并重视中焦,最后附典型病案一则。Chronic pulmonary heart disease often develops from chronic obstructive pulmonary disease(COPD),which is an incomplete reversible airflow restriction disease with progressive development.The number of patients with pulmonary heart disease is large,the fatality rate is high,and it seriously affects the patient’s ability to work and quality of life because of its progressive aggravated characteristics.“Treat the symptoms when it is urgent,and treat the root causes when it is not so urgent”is the basic theory of traditional Chinese medicine,based on the analysis and discussion of the etiology and pathogenesis of COPD,which is summarized as“deficiency in origin and excess in superficiality”,the deficiency of three viscera of lung,spleen and kidney is responsible for deficiency in origin,which also involves the heart;phlegm turbidness,blood stasis and water and blood stasis are responsible for excess in superficiality,in which phlegm turbidness,blood stasis and water and blood stasis interact,accumulated phlegm stasis generates heat in the lung,which in turn leads to the occurrence and development of lung distension.In the acute stage,the treatment of pulmonary heart disease is mainly to clear heat and eliminate phlegm and blood stasis,taking into account the protection of middle Jiao(中焦).In the remission stage,the treatment is mainly to tonify the lung,strengthen the spleen and warm the kidney,and pay attention to middle Jiao.Finally,one typical case is attached.

关 键 词：肺心病 急则治标 缓则治本 中医治疗 

分 类 号：R256.2[医药卫生—中医内科学]