杨华教授从肝论治心衰胸腔积液理论探析  

Analysis of Professor Yang Hua s Theory on Treating Pleural Effusion Caused by Heart Failure from Liver Aspect

作　　者：林道斌 张明[1] LIN Daobin;ZHANG Ming(Hainan Provincial Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine,Haikou 570203,China)

机构地区：[1]广州中医药大学附属海南省中医院,海南海口570203

出　　处：《中医药学报》2024年第7期52-55,共4页Acta Chinese Medicine and Pharmacology

基　　金：杨华全国名中医传承工作室(琼财社﹝2022﹞379号);海南省自然科学基金青年项目(822QN476);海南省自然科学基金面上项目(824MS150);海南医学院科研2020年度科研培育基金(HYPY202005)。

摘　　要：心力衰竭(心衰)胸腔积液特别是顽固性胸腔积液的治疗,一直是临床难题。杨华教授基于《黄帝内经》等原文及临床实践,认为该病是心病累及肝,子病及母,母子俱虚所致肝气、肝血、肝阳虚无力疏泄,致使津液不行,泛溢胸腔。在证型上,可辨为肝气虚证、肝血虚证、肝阳虚证。在治疗上杨华教授倡导根据辨证,以黄芪三草汤、萸海方及四物汤等助肝气、温肝阳、补肝血,恢复肝疏泄之功,以消水液。The treatment of pleural effusion due to heart failure(HF),especially intractable pleural effusion,has always been a clinical challenge.Professor Yang Hua,based on clinical practice and classics such as the Huangdi s Internal Classic(Huangdi Neijing),believes it was a heart disease affecting the liver,a disease of a Child affecting the mother.This condition is the result of deficiency of both mother and child resulting in deficiency of liver qi,blood,and yang.In this case,the liver is unable to carry out its free coursing function,giving rise to unsmooth fluid circulation,and the fluid then spreads in the thoracic area,leading to pleural effusion.This disease can be differentiated into liver qi deficiency syndrome,liver blood deficiency syndrome,and liver yang deficiency syndrome.Professor Yang Hua advocates to perform syndrome differentiation first,taking Chinese herbal formulae,such as Huangqi Sancao decoction,Yuhai formula,and Four Substances decoction,to assist liver qi,warm liver yang,and supplement liver blood to restore the function of the liver in its free coursing and eliminate the fluid.

关 键 词：心力衰竭 胸腔积液 水气病 饮证 

分 类 号：R255.8[医药卫生—中医内科学]