从“轻可去实”论治胸痹心痛  

Exploration on treatment of chest blochage and heartache from"light prescription removing pathogenic factors"

作　　者：张乐松 段君毅[2] 李军[1] ZHANG Lesong;DUAN Junyi;LI Jun(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《上海中医药大学学报》2024年第4期81-86,共6页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家重点研发计划项目“中医药现代化”专项(2022YFC3500102)。

摘　　要：“轻可去实”最早属于药物分类法,后演变为方剂分类法,旨在运用轻解宣散药治疗内伤杂病。至温病学派提出“逆传心包”理论,运用竹叶、连翘、莲子心、菖蒲、郁金、灯芯草等轻灵开窍,透热转气,为轻剂治疗心系疾病奠定了基础。胸痹心痛核心病机为“阳微阴弦”,与风、冷、热、毒、湿等病邪相关,络脉为重要病位,轻剂可宣透阴邪、驱散外邪、疏经搜络;轻剂包含风药,能开通上焦,解表发汗、调和营卫、培补宗气,从多个方面达到养心去邪、通脉宣痹之效,以治疗胸痹心痛。"Light prescription removing pathogenic factors"belonged to drug classification at the earliest,and later evolved into prescription classification,aiming to use Qingjie Xuansan medicines to treat internal medical diseases.The school of seasonal febrile disease put forward the theory of"reverse transmission into pericardium",using bamboo leaves,fruit of weeping forsythia,plumule of hindu lotus,rhizome of tatarinowii sweetflag,common trumeric root,stem pith of common rush,etc.to open orifice lightly and clear away heat to promote qi flow,which laid a foundation for light prescriptions in the treatment of heart system diseases.The core pathogenesis of chest blochage and heartache is"weak yang and wiry yin",wind,cold,heat,poison,wet and other pathogenic factors are related to it,and collaterals are the main disease position.Light prescriptions can disperse yin evil,dispel external evil,and dredge meridians.The light prescriptions contain wind medicine,can open the upper jiao,relieve superficial pathogenic factors to induce sweat,regulate yingqi and weiqi,replenish initial qi,from many aspects to achieve the effects of nourishing heart to expel evil,and dreging meridians to disperse obstruction,in order to treat chest blochage and heartache.

关 键 词：胸痹心痛 轻可去实 轻剂 风药 

分 类 号：R256.22[医药卫生—中医内科学]