从“瘀热论”辨治不稳定型心绞痛的临床经验  

Clinical experience in treating unstable angina from the stagnant heat th

作　　者：路清越 宋耀鸿[2] LU Qingyue

机构地区：[1]南京中医药大学,江苏南京210029 [2]南京中医药大学附属南京中医院,江苏南京210022

出　　处：《中医临床研究》2023年第32期46-51,共6页Clinical Journal Of Chinese Medicine

基　　金：南京中医药大学自然科学基金(XZR2020047)。

摘　　要：不稳定型心绞痛作为急性冠脉综合征的一种,是介于稳定型心绞痛和急性心肌梗死之间的临床状态。从中医学角度来辨析,其隶属于“胸痹心痛”范畴,最早在《山海经》中被提出,从古至今威胁我炎黄子孙生命安全,因其具有发病率高、风险高、病死率高的特点,成为亟待解决的问题,历代医家更是不断探索完善与其相关的中西医理论研究以备发掘更优的诊治思路。国医大师周仲瑛首次提出“瘀热理论”,代替往日仅“瘀”论治疾病的思想,提倡从营卫论治,兼顾标本,瘀热并重,采用凉血散瘀之法,使脉络通畅,气血调和,疾病祛除,并将该理论运用于临床中多种疾病的治疗。宋耀鸿教授基于周老的瘀热论学说,将瘀热理论用于不稳定型心绞痛的治疗中,提倡清补共用,采用滋阴益气、凉血散瘀之法,重视标本兼顾,更加贴合于随着年龄增长,平人阴气自半,阴津渐耗的生理变化,更加贴近现代心绞痛疾病的发生发展变化趋势,在所拟方清心通脉饮的基础上,紧扣清补之法用药加减,临床治疗中屡试每获良效。文章主要介绍宋教授基于周老的“瘀热论”学说治疗不稳定型心绞痛的治疗思路及相关中西医认识,旨在为临床治疗提供新思路。Unstable angina(UA),as a type of acute coronary syndrome,is a clinical state between stable angina and acute myocardial infarction.From the perspective of traditional Chinese medicine,it belongs to the category of chest paralysis and heartache,which was first proposed in The Classic of Mountains and Seas,threatening the life safety of our descendants from ancient times to the present,because it has the characteristics of high morbidity,high risk and high mortality,and has become an urgent problem to be solved.ZHOU Zhongying,a master of TCM,put forward the stagnant heat theory for the first time,replacing the idea of treating diseases only stasis in the past,advocating the treatment of health from the camp,taking into account the specimen,paying equal attention to stasis,and using the method of cooling blood to disperse stasis,so that the veins are smooth,Qi(气)and blood are harmonized,and diseases are eliminated,and the theory is applied to the treatment of a variety of diseases in clinical practice.Based on ZHOU’s theory of stasis,Professor SONG Yaohong applies the theory of stasis to the treatment of UA,advocates the sharing of moistening tonification,adopts the method of nourishing Yin(阴)and invigorating Qi,cooling blood and dispersing stasis,attaches importance to taking into account specimens,and is more in line with the physiological changes of increasing age,ordinary people’s Yin Qi is half,Yin and Jin(津)are gradually depleted,and is closer to the trend of occurrence and development of modern angina diseases.This paper mainly introduces Professor SONG’s treatment ideas for unstable angina based on ZHOU’s the stagnant heat theory and related Chinese and Western medical understandings,aiming to provide new ideas for clinical treatment.

关 键 词：不稳定型心绞痛 瘀热论 清补 经验总结 

分 类 号：R541.4[医药卫生—心血管疾病]