温阳法治疗慢性心力衰竭研究进展  

Research Progress in Yang-Warming Methodts for Treating Chronic Heart Failure

作　　者：马珍 李飞泽 MA Zhen;LI Feize(Third Clinical College of Zhejiang Chinese Medical University,Hangzhou,Zhejiang,China,310053;Zhoushan City Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Zhoushan,Zhejiang,China,316000)

机构地区：[1]浙江中医药大学第三临床医学院,浙江杭州310053 [2]浙江中医药大学附属舟山市中医院,浙江舟山316000

出　　处：《河南中医》2024年第8期1284-1289,共6页Henan Traditional Chinese Medicine

基　　金：全国名老中医药专家传承工作室建设项目李飞泽全国名老中医药专家传承工作室{国中医药人教函[2022]75号}。

摘　　要：慢性心力衰竭病机以心气心阳衰之脏腑虚损为本,以感受六淫邪气久病成瘀血、痰湿、瘀毒等病理产物为实。综合各家经验,慢性心力衰竭辨证多以复合证为主,阳虚类证型最为常见。临床多采用温阳养心、温阳利水、温阳益气、温阳活血(通络)、益气温阳活血利水的内治法和艾灸、穴位贴敷、奄包热熨等外治法进行治疗,疗效确切。目前,温阳法治疗本病的研究局限于名老中医经验及临床个案报道,样本量有限,中心单一,缺乏治疗后临床随访以考量长期疗效,且各个医家对运用温阳法的组方用药不尽相同,方剂内含药物的作用机制未能完全明确。温阳法与其他治法组成的复合治法在治疗本病时也未有系统归纳和统一,故今后应展开多中心、大样本的中医药临床、动物及药理实验研究,注重追踪随访,对温阳类治法进行系统归纳,制定统一标准,并挖掘温阳类药物的作用机制,从而有力发挥温阳法治疗本病的优势。The pathogenesis of chronic heart failure is based on the deficiency of heart qi and heart yang in the viscera as the root cause,and the exuberance of pathological products such as six pathogenic factors,phlegm,dampness,blood stasis,and toxin as the manifestations.Based on the experiences of various experts,the syndrome differentiation of CHF is mostly complex one,with the yang deficiency type being the most common.In clinical practice,internal treatment methods such as warming yang for nourishing the heart,warming yang for inducing diuresis,warming yang for replenishing qi,warming yang for promoting blood circulation,replenishing qi and warming yang,promoting blood circulation and inducing diuresis,as well as external treatment methods such as moxibustion,acupoint application,and hot compress are often used and have definite therapeutic effects.At present,research on the treatment of CHF with yang-warming methods is limited to the experience of famous TCM practitioners and clinical case reports.The sample size is limited,the study center is single,and there is a lack of clinical follow-ups after treatment to consider long-term efficacy.Moreover,different medical practitioners use yang-warming methods in their formulas,and the mechanism of action of the drugs contained in the formulas is not fully understood.The compound therapies composed of yang-warming method and other treatment methods have not been systematically summarized and unified in the treatment of CHF.Therefore,in the future,multi-center and large sample clinical,animal and pharmacological experiments of TCM should be carried out,focusing on tracking and follow-ups,systematically summarizing yang-warming methods,formulating unified standards,and exploring the mechanism of action of yang-warming drugs,so as to effectively exert the advantages of yang-warming methods in the treatment of CHF.

关 键 词：慢性心力衰竭 温阳法 温阳养心 温阳利水 温阳益气 温阳活血 艾灸疗法 穴位贴敷 奄包热熨 

分 类 号：R259.414[医药卫生—中西医结合]