郑东海医案:心脏神经官能症治疗病例  

ZHENG Donghai’s experience in the treatment of cardiac neurosis

作　　者：许嵘天 林秋彤 郑东海 XU Rongtian

机构地区：[1]北京中医药大学,北京100029 [2]北京伟达中医肿瘤医院,北京100023

出　　处：《中医临床研究》2024年第20期48-51,共4页Clinical Journal Of Chinese Medicine

摘　　要：心脏神经官能症又称神经性血管综合征、功能性心脏不适等,属于神经官能症的一种特殊类型,目前病因尚不明确,西医对其无特异性的治疗方法,多以稳定心率、防止瘀血、阻断靶点与受体结合为主,引发的情志性后遗症较多,临床疗效不理想。中医对于心脏神经官能症独特的认知和辨治方法为临床治疗提供了新的方向。传统认知上,结合患者体质辨证论治,多从肝郁、肺虚、阴虚等方面入手,可取得良好疗效。而郑东海教授认为因气机逆乱、阳虚水泛为先,水饮之邪上泛和阴阳不相顺接而形成心脏神经官能症,需秉承易水学派“怡情志,调升降”的理论,采用舒畅患者情志,调理气机,温化水饮,交通阴阳的基本方法治疗。临证时,郑教授使用四逆散合真武汤,不仅可以调畅一身气机,使阴阳之气相互顺接,升降相接,还可以防止因阳气亏虚无以温化水液,导致水饮之邪随逆乱之气机上凌于心。从临床效果来看,中医药治疗心脏神经官能症不仅可以较迅速地缓解症状,更可以恢复人体的正常功能,保障患者正常的生活,疗效显著。文章中介绍郑东海教授治疗心脏神经官能症的学术思想,并附病案一则。Cardiac neurosis,also known as neurovascular syndrome and functional heart discomfort,belongs to a special type of neurosis,the etiology is unclear,and there is no specific treatment method for it in western medicine.Most of the treatment methods are to stabilize the heart rate,prevent blood stasis,and block the binding of the target and the receptor,with not ideal effects.The unique recognition and treatment methods of traditional Chinese medicine for cardiac neurosis provide a new direction for clinical treatment.In traditional cognition,combined with the patient’s constitution and TCM syndrome differentiation,the treatment mainly starts from liver depression,lung deficiency,and Yin(阴)deficiency,which can achieve good curative effects.Professor ZHENG Donghai believes that the disorder of Qi(气),the deficiency of Yang(阳)and the overflowing of fluid are the first,and the excessive overflowing of fluid is not compatible with Yin and Yang,resulting in cardiac neurosis.Therefore,adhering to the thought of Yishui school,“delight in emotion,adjust the rise and fall”theory,the basic method of treating this type of cardiac neurosis is to relax the patient’s emotions,regulate Qi,warm fluid,and communicate Yin and Yang.on clinical ractice,Professor ZHENG uses Sini San(四逆散)plus the Zhenwu decoction(真武汤),which can not only adjust the Qi novement,make Yin and Yang connected with each other,but also prevent the failure of the Yang Qi deficiency to warm the fluid,resulting in stagnation of fluid and Qi in the heart.From the perspective of clinical effects,traditional Chinese medicine can not only relieve the symptoms of cardiac neurosis more quickly,but also restore the normal function of the human body and ensure the normal life of patients,with significant curative effects.In this paper,Professor ZHENG Donghai’s theory of treating cardiac neurosis with Sini San is introduced,and one case is attached.

关 键 词：心悸证 水气凌心 阴阳不相顺接 气血亏虚 心脏神经官能症 

分 类 号：R256.2[医药卫生—中医内科学]