基于肝主疏泄理论探讨心脏X综合征的证治  

Exploration on Syndrome Differentiation and Treatment of Cardiac Syndrome X Based on the Theory of Liver Governing Free Flow of Qi

作　　者：马至言 胡伊蕾 高翎薇 周曼丽 简维雄 MA Zhiyan;HU Yilei;GAO Lingwei;ZHOU Manli;JIAN Weixiong(College of Chinese Medicine,Hunan University of Chinese Medicine,Changsha 410208,China;Hunan Provincial Key Laboratory of Traditional Chinese Medicine Diagnosis,National Key Discipline of Hunan University of Traditional Chinese Medicine,Changsha 410208,China)

机构地区：[1]湖南中医药大学中医学院,湖南长沙410208 [2]湖南中医药大学国家重点学科中医诊断学湖南省重点实验室,湖南长沙410208

出　　处：《中医药学报》2023年第11期18-22,共5页Acta Chinese Medicine and Pharmacology

基　　金：国家自然科学基金面上项目(81973753);湖南省自然科学基金面上项目(2022JJ30433);湖南中医药大学研究生创新项目(2022CX50)。

摘　　要：心脏X综合征是指具有典型劳力性心绞痛或心绞痛样不适症状,但冠状动脉造影检查提示正常或无明显异常的一组临床综合征,占心绞痛的10%~15%。其发病机制尚不明确,现代临床广为接受的病因是冠状动脉微血管功能障碍造成的心肌缺血。中医学认为心脉气血正常运行依赖于肝木条达疏泄之功,本文基于肝主疏泄的生理特性,提出“肝之疏泄不利”是心脏X综合征的核心病机,以疏利通达肝气为基本疗法,总结中医药治疗经验,以期为心脏X综合征提供更广阔的中医药诊疗思路。Cardiac syndrome X refers to a group of clinical syndromes with typical exertional angina or angina-like discomfort symptoms,but coronary angiography indicates normal or no obvious abnormalities,accounting for 10%-15%of angina.Its pathogenesis remains unknown,however,the widely accepted etiology in modern clinical practice is myocardial ischemia caused by coronary microvascular dysfunction.Traditional Chinese medicine believes that the normal qi and blood movement in heart vessels depends on the normal function of the liver in making qi acting and flowing freely.In this paper,based on the physiological characteristics of liver governing free flow of qi,it is proposed that the core pathogenesis of cardiac syndrome X is“disturbance of freeing qi flow function of the liver”,and that making liver qi flowing freely is the basic treatment.The purpose of this article is to summarize the experience of traditional Chinese medicine treatment in order to provide a broader approach to the diagnosis and treatment of cardiac syndrome X.

关 键 词：心脏X综合征 肝主疏泄 中医药治疗 

分 类 号：R256.22[医药卫生—中医内科学]