论通脉法在慢性心力衰竭治疗中的理论依据与应用  

Theoretical Basis and Application of Tongmai Method in Treatment of Chronic Heart Failure

作　　者：赵菁[1] 严士海[1] 王令谆[1] 严冬[1] ZHAO Jing;YAN Shihai;WANG Lingzhun;YAN Dong(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院,南京210029

出　　处：《世界中医药》2024年第11期1649-1652,共4页World Chinese Medicine

基　　金：国家自然科学基金项目(82074320)——基于Keap1/Nrf2介导的线粒体自噬-细胞焦亡信号网络探讨参葵通脉颗粒改善慢性心衰的分子机制;江苏省重点研发计划项目(BE2020727)——基于LC-MS/MS技术探讨参葵通脉颗粒改善慢性心衰气虚血瘀证诊疗标志物的多中心临床研究。

摘　　要：慢性心力衰竭是大部分心血管疾病的最终结局,其5年生存率与恶性肿瘤相当甚至更低。中医学对慢性心力衰竭治疗有多种认识,心病不仅在心,也在血液与血管。致病之“祸”源自血管,血液内的“毒素”长期在血管中运行,逐渐导致血管壁增厚、失去弹性、逐渐硬化,血管通路不畅与心室重塑形成正反馈,不利于慢性心力衰竭的康复。中医学无“血管”之名,只有“脉”。无论气虚、气滞、血瘀、痰浊、寒凝乃至血浊等诸因素,皆可造成脉道痹阻,从而发病。相比传统的强心、养心法,通脉法从整体观的角度,调整气血,通达五脏,有防治慢性心力衰竭的作用。综合运用益气通脉、温阳通脉、理气通脉、化瘀通脉、化浊通脉、利水通脉及解毒通脉等方法,减轻心脏负荷,同时改善血循环,达到开源引流、疏通脉络的目的,以改善慢性心力衰竭的临床症状及延缓病情进展。Chronic heart failure(CHF)is the ultimate destination of most cardiovascular diseases,and its 5-year survival rate is equivalent to or even lower than that of malignant tumors.Traditional Chinese medicine(TCM)has many understandings of CHF treatment and believes that in addition to the heart,blood and blood vessels are the chief culprits of CHF.The cause of CHF originates from the blood vessels.Because the blood“toxin”runs in the blood vessels for a long time,it gradually leads to the thickening and hardening of the vascular walls.The poor vascular route and ventricular remodeling form a positive feedback,which is adverse to the rehabilitation of CHF.Blood vessels are called pulses in TCM.Qi deficiency,Qi stagnation,blood stasis,phlegm turbidity,cold coagulation,and even blood turbidity can all cause arterial blockage and trigger the disease finally.Compared with the traditional methods of strengthening the heart and nourishing the heart,the Tongmai method adjusts Qi and blood to reach the five viscera from the perspective of the holistic view,so as to prevent and treat CHF.The methods of Yiqi Tongmai,Wenyang Tongmai,Ligqi Tongmai,Huayu Tongmai,Huazhuo Tongmai,Lishui Tongmai,and Jiedu Tongmai are comprehensively used to reduce the load on the heart,improve blood circulation,and achieve the purpose of dredging the veins,so as to relieve the clinical symptoms of CHF and delay the progression of the disease.

关 键 词：慢性心力衰竭 心主血脉 血浊 通脉法 

分 类 号：R256.2[医药卫生—中医内科学] R541[医药卫生—中医学]