基于“络病理论”治疗冠状动脉粥样硬化性心脏病经皮冠状动脉介入治疗术后经验  

Experience of treating coronary heart disease after PCI based on collateral disease theory

作　　者：吴爽 焦晓民[2] WU Shuang;JIAO Xiaomin

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属第二医院,辽宁沈阳110000

出　　处：《中医临床研究》2023年第27期43-46,共4页Clinical Journal Of Chinese Medicine

摘　　要：总结焦晓民教授从络论治胸痹心痛的经验。经皮冠状动脉介入治疗(Percutaneous Coronary Intervention,PCI)术可有效缓解和改善心脏供血及管腔狭窄等问题,而术后常见的并发症已成为后期调护至关重要的部分。焦教授认为络病理论与冠状动脉粥样硬化性心脏病(简称冠心病)PCI术后并发症在病因、病机、病位、病性、证候等方面关系密切,将冠心病PCI术后归属于中医“胸痹心痛”的范畴,并主张从络论治冠心病PCI术后诸证。在病因病机上,焦教授以术后多虚、多瘀为其主要方面,虚为本,瘀为标。在证型上,因病因病机具有复杂性,故临床证型较多,最常见的证型为气虚血瘀。在治疗上,注重灵活辨证,分清主次缓急,标本同治,虚实兼顾,并强调补虚化瘀通络,气血阴阳兼顾,五脏六腑同调,临床疗效显著。在遣方用药上,焦教授在传统中医辨证治疗基础上,根据中医络病理论,加入益气活血、搜风解痉通络之药,常用的药物有黄芪、党参、当归、川芎、丹参、全蝎、蜈蚣、桂枝、细辛等,常用的药性为温性、平性,常用的药味为辛、甘、苦,常用的药物归经为心、肝,常用的药类为活血类、补益类,同时重视顾护阴津,调养脾胃。焦晓民教授是辽宁省名老中医,在中西医结合防治心血管疾病方面积累了丰富的经验,值得进一步深入继承与挖掘。并附验案1则,以助佐证。Professor JIAO Xiaomin’s experience in treating chest paralysis and heartache from collaterals is summarized in this paper.PCI can effectively relieve and improve problems such as cardiac blood supply and lumen stenosis,and common postoperative complications have become a crucial part of late care.Professor JIAO believes that collateral disease theory is closely related to complications of coronary heart disease after PCI in terms of etiology,pathogenesis,location,pathogenicity,and symptoms.The professor classifies coronary heart disease after PCI into the category of chest paralysis and heartache of TCM,and advocates treating coronary heart disease after PCI from collateral.In terms of etiology and pathogenesis,Professor JIAO regards deficiency and blood stasis as the main aspects,in which deficiency is the root cause and blood stasis is the symptom.In terms of syndrome type,due to the complexity of etiology and pathogenesis,there are many clinical syndrome types,and the most common syndrome type is Qi(气)deficiency and blood stasis.In the treatment,Professor JIAO pays attention to flexible dialectics,distinguish the primary and secondary urgency,treats both the root causes and the symptoms,targets both the deficiency and excess,and emphasizes tonifying deficiency and removing stasis,taking into account Qi-blood-Yin(阴)-Yang(阳),five viscera and six fu-organs,and the clinical effect is remarkable.Based on TCM syndrome differentiation and treatment,according to the theory of collateral disease of TCM,Professor JIAO adds the drugs of supplementing Qi and promoting blood circulation,eliminating wind and relieving spasm and clearing collaterals.The commonly used drugs include Huangqi(Astragalus),Dangshen(Codonopsis),Danggui(Angelica),Chuangxiong(Ligusticum),Danshen(Salvia miltiorrhiza),Quanxie(Scorpion),Wugong(Centipedes),Guizhi(Cassia twigs),Xixin(Asarum),etc.The commonly used drugs are warm and mild in property,and they are pungent,sweet and bitter in taste,and mainly flow into the heart and liver meridians.T

关 键 词：络病理论 冠状动脉粥样硬化性心脏病经皮冠状动脉介入治疗术 名医经验 

分 类 号：R256.2[医药卫生—中医内科学]