从中医气化理论辨治慢性心力衰竭  

Syndrome Differentiation and Treatment of CHF from TCM Qi Theory

作　　者：崔静[1] 朱林平[2] 樊博雅 梁嘉钰 陈金红[3] 邓芳隽 李晓凤[2] 杜武勋[2] CUI Jing;ZHU Linping;FAN Boya;LIANG Jiayu;CHEN Jinhong;DENG Fangjun;LI Xiaofeng;DU Wuxun(Second Hospital of Tianjin Medical University,Tianjin 300211,China;Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300150,China;Tianjin University of Traditional Chinese Medicine,Tianjin 301600,China)

机构地区：[1]天津医科大学第二医院,天津300211 [2]天津中医药大学第二附属医院,天津300150 [3]天津中医药大学,天津301600

出　　处：《辽宁中医杂志》2023年第12期38-42,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82004329);天津市卫生健康委天津市中医药管理局中医、中西医结合科研课题项目(2019138);全国名老中医药专家杜武勋传承工作室;天津市名中医杜武勋传承工作室;天津市教委科研计划项目(2019SK025)。

摘　　要：目的从中医气化理论出发,分析慢性心力衰竭病因病机及选方用药思路。方法通过研读中医古籍,尤其是《黄帝内经》,整理、总结中医气化理论,结合临床实践,以气化理论分析慢性心力衰竭基本病机,确定慢性心力衰竭治则与具体用药思路。结果慢性心力衰竭基本病机为“以肾阳虚衰为本,寒瘀水互结为标,兼可化热”。其临床诊疗当固肾阳不足之本,除寒瘀水结之标,辨寒热之异。加重期以化瘀利水治标为主,缓解期以温阳固本扶正为要。结论气化理论是中医学认识疾病与治疗疾病的基本思维,以气化理论阐释慢性心力衰竭的病因病机,对于更好地理解寒、水、瘀等病理产物的发生机制,更好地指导慢性心力衰竭临床诊疗都具有重要的临床价值与深远的学术意义。Objective This paper mainly analyzed the etiology,pathogenesis and drug selection of chronic heart failure(CHF)based on the Qi theory of TCM.Methods The Qi theory was sorted out and summarized by studying the ancient books of TCM,especially the Inner Canon of Huangdi.Combined with clinical practice,this paper analyzed the basic pathogenesis of CHF with gasification theory,and determined the treatment principles and specific medication ideas of CHF.Results The basic pathogenesis of CHF is based on the deficiency of kidney Yang,with the combination of cold,blood stasis and water accumulation as the secondary causes,and can also transform heat.Its clinical diagnosis and treatment should be based on the deficiency of kidney Yang,eliminate the symptoms of cold,blood stasis and water accumulation,and distinguish the differences between cold and heat.During the exacerbation phase,the main focus is on resolving blood stasis,promoting diuresis and treating symptoms,while during the remission phase,the focus is on warming Yang,consolidating the foundation and strengthening the body.Conclusion Qi theory was the basic thinking of TCM in understanding and treating diseases.Using Qi theory to explain the etiology and pathogenesis of CHF has important clinical value and far-reaching academic significance for better understanding the mechanism of pathological products such as cold,water accumulation and blood stasis,and better guiding the clinical diagnosis and treatment of CHF.

关 键 词：气化理论 慢性心力衰竭 水肿 

分 类 号：R256.2[医药卫生—中医内科学]