吴伟基于“瘀毒致悸”辨治房颤思路探讨  

Discussion on WU Wei’s Thoughts for the Treatment of Atrial Fibrillation Based on the Theory of Stasis-Toxin Causing Palpitation

作　　者：翟惠奇 黎燚华 康亮 余润佳 李荣[2] 吴辉[2] 周小雄[2] 都治伊 褚庆民[2] 吴伟(指导)[2] ZHAI Hui-Qi;LI Yi-Hua;KANG Liang;YU Run-Jia;LI Rong;WU Hui;ZHOU Xiao-Xiong;DU Zhi-Yi;CHU Qing-Min;WU Wei(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2024年第5期1316-1322,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省自然科学基金面上项目(编号:2022A1515220138)。

摘　　要：吴伟教授在辨治房颤过程中,创新性地提出“心-血-脉三位一体论”与“瘀毒致悸”论。认为房颤由瘀毒所致,其病位在心-血-脉,核心病机为“气滞血瘀毒成”。治法当紧扣病机,提倡“从瘀论治,兼以解毒,缓消其毒”,且认为理气活血化瘀便是解毒。方拟桃仁红花煎加减,主要组成药物有桃仁、红花、川芎、延胡索、生地黄、赤芍、丹参、大枣、葛根、甘松、牡蛎、茯苓、玉竹等,并根据岭南之气候与房颤多影响情志之特点,去方中辛烈之品,而加特色解毒药对葛根-甘松以辨病而治。吴伟教授治疗房颤还常配合沐足、针灸、导引等中医外治法和保健法,全面调理,缓消其毒,以复其元。吴伟教授治疗房颤采用中医药精准干预,综合调理,可达到促进症状消失及恢复窦性心律、改善体质等目的,其辨治思路可为房颤的中医药治疗提供参考。For the treatment of atrial fibrillation,Professor WU Wei innovatively put forward the theory of heartblood-vessels trinity and the theory of stasis-toxin causing palpitation.It is believed that atrial fibrillation is caused by stasis and toxin,and affects the heart,blood and vessels.The core pathogenesis of atrial fibrillation is due to qi stagnation,blood stasis and toxin.The treatment for atrial fibrillation should be closely based on the pathogenesis,the therapeutic principles of treating from the perspective of stasis and together by removing toxin gradually is advocated.And the therapy of regulating qi,activating blood and removing stasis is also the way to remove toxin.The medication is based on the modified Taoren Honghua Decoction,which is mainly composed of Persicae Semen,Carthami Flos,Chuanxiong Rhizoma,Corydalis Rhizoma,Rehmanniae Radix,Paeoniae Radix Rubra,Salviae Miltiorrhizae Radix et Rhizoma,Jujubae Fructus,Puerariae Lobatae Radix,Nardostachyos Radix et Rhizoma,Ostreae Concha,Poria,and Polygonati Odorati Rhizoma.According to the characteristics of Lingnan climate and atrial fibrillation mostly being easy to affect the emotions,the pungent drugs in the prescription are usually removed,and the specific herbal pair of Puerariae Lobatae Radix-Nardostachyos Radix et Rhizoma is added to remove toxin according to the differentiation of disease.Moreover,for the treatment of atrial fibrillation,Professor WU Wei also adopts traditional Chinese medicine(TCM)external treatment such as foot bath,acupuncture and moxibustion,and physical-breathing exercise as well as health-care methods for comprehensive regulation,relieving the toxin and restoring the original qi.During the treatment atrial fibrillation,Professor WU Wei follows the principle of precise intervention and comprehensive regulation with Chinese medicine,so as to achieve the purpose of eliminating symptoms,restoring sinus rhythm and improving physical constitution.The thoughts of Professor WU Wei for the syndrome differentiation and treatment of atri

关 键 词：房颤 心-血-脉三位一体 瘀毒致悸 活血化瘀 桃仁红花煎 葛根 甘松 吴伟 

分 类 号：R256.21[医药卫生—中医内科学]