基于“阳化气,阴成形”探讨冠状动脉慢性完全闭塞的中医论治  

Treatment of Chronic Total Occlusion of Coronary Arteries Based on the Theory of"Yang Transforms Qi,Yin Forms Shape"

作　　者：贾思涵 连妍洁 尚菊菊[1] 刘红旭[1] 周琦[1] 李思耐[1,3] Jia Sihan;Lian Yanjie;Shang Juju;Liu Hongxu;Zhou Qi;Li Sinai(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010 [2]首都医科大学,北京100069 [3]北京市中医药研究所,北京100010

出　　处：《中国中医急症》2024年第8期1373-1376,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82174106);北京市重大疑难疾病中西医协同攻关项目(2023BJSZDYNJBXTGG-011);北京中医药“十四五”重点专科心血管科(BJZKLC0011)。

摘　　要：本研究基于“阳化气,阴成形”理论,探讨冠状动脉慢性完全闭塞(CTO)的中医病因病机,认为阳虚失运-化气不足-血脉不荣、阴邪凝结-成形太过-血脉不通是CTO的关键病机,以阳气虚衰为本,阴邪(湿邪、痰浊、水饮、血瘀)凝滞为标。治疗上提出温阳化气法是治疗CTO的总则,温肺阳以化宗气,温脾阳以化中气,温肾阳以化元气,结合阴邪偏盛,辅以燥湿、祛痰、化饮、逐瘀之法,以达到缓解症状、改善预后之功,并附验案1则,以期为CTO的中医治疗提供新的思路。Based on the theory of"Yang transforms into qi,Yin forms shape",this study explores the etiology and pathogenesis of chronic total occlusions(CTO)in coronary arteries from the perspective of traditional Chinese medicine(TCM).It posits that deficiency of Yang leading to insufficient transformation of qi and failure to nourish the blood vessels,coupled with excessive formation due to stagnation of Yin pathogens(dampness,phlegm,water retention,and blood stasis),are the critical pathogeneses of CTO.The fundamental aspect lies in the decline of Yang qi,while the manifest aspect involves stagnation of Yin pathogens.In terms of treatment,the principle of warming Yang to transform qi is proposed as the overarching strategy for treating CTO.This involves warming the lung′s Yang to transform primary qi,warming the spleen′s Yang to transform middle qi,and warming the kidney′s Yang to transform primordial qi.In conjunction with the predominance of Yin pathogens,methods such as drying dampness,expelling phlegm,transforming fluid retention,and removing stasis are employed to alleviate symptoms and improve prognosis.An illustrative case is attached to offer new insights into the TCM treatment of CTO.

关 键 词：冠状动脉慢性完全闭塞 阳化气 阴成形 温阳化气法 阳微阴弦 

分 类 号：R543.3[医药卫生—心血管疾病]