李延从脾胃论治冠心病的临床经验  

Clinical Experience of LI Yan in Treating Coronary HeartDisease from the Spleen and Stomach

作　　者：赵志成[1] 刘桉君 ZHAO Zhi-Cheng;LIU An-Jun(The Fourth Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150070 Heilongjiang,China)

机构地区：[1]黑龙江中医药大学附属第四医院,黑龙江哈尔滨150070

出　　处：《广州中医药大学学报》2024年第1期213-218,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学青年基金项目(编号:81703724);黑龙江省中医药管理局中医药科研课题项目(编号:ZHY2022-204);国家名老中医工作室建设项目;黑龙江省中医药科研项目(编号:ZHY10-W36)。

摘　　要：冠心病为临床中常见的心血管疾病,可归属中医学的“胸痹”“心痛”等疾病范畴。李延教授认为本病之病性总属本虚标实之证,以脾虚、脾胃健运失常为本,标实在于痰浊、血瘀、气滞、寒凝等有形实邪痹阻心脉。治疗时重视调理脾胃,重用黄芪、白术、党参、五味子等健脾养心以治本,结合通阳化浊、活血化瘀、疏肝理气、温阳散寒等治法,标本兼治,通补兼顾,使脾气健旺,心气充沛,瘀去痰消,胸阳得以舒展,则心之血脉恢复畅通,胸痹心痛诸症得到缓解。李延教授从脾胃论治冠心病的经验可为中医临床诊治冠心病提供参考。Coronary heart disease(CHD)is a common cardiovascular disease in clinic,which can be classified as“chest qi-obstruction”and“heart pain”in traditional Chinese medicine.Professor LI Yan believes that CHD can be differentiated as the syndrome of deficiency in origin and excess in superficiality,and the deficiency in origin is characterized by the deficiency of spleen and the failure of spleen and stomach in transportation,while the excess in superficiality manifests as the obstruction of visible pathogens such as phlegm turbidity,blood stasis,qi stagnation,and cold accumulation.The clinical treatment should focus on regulating the spleen and stomach,using Astragali Radix,Atractylodis Macrocephalae Rhizoma,Codonopsis Radix,Schisandrae Chinensis Fructus to strengthen the spleen and nourish the heart in order to treat the root cause.Moreover,therapies of activating yang to remove turbidity,activating blood to remove stasis,soothing liver to rectify qi,and warming yang to dissipate the cold can be adopted.Therefore,the symptom and root cause will be treated simultaneously,the unblocking and supplementing effect will be achieved,and then the spleen-qi is vigorous,the heart qi is in abundance,the blood stasis and the phlegm are removed,and the chest yang can be stretched.As a result,the heart vessels are unblocked,and the symptoms of chest qi-obstruction will be relieved.Professor LI Yan’s experience from the perspective of spleen and stomach can provide reference for the clinical diagnosis and treatment of CHD with traditional Chinese medicine.

关 键 词：冠心病 胸痹 本虚标实 脾虚 痰浊 血瘀 调理脾胃 健脾养心 李延 

分 类 号：R256.22[医药卫生—中医内科学]