从经典火神学说论治胸痹  

Treatment of thoracic obstruction from the classical“Huo-Shen”theory

作　　者：薛晨 张灵洁 刘金豹 韩官君 Xue Chen;Zhang Lingjie;Liu Jinbao;Han Guanjun(Jinzhong Hospital of Traditional Chinese Medicine,Jinzhong Shanxi 030600)

机构地区：[1]晋中市中医院,山西晋中030600

出　　处：《山西中医药大学学报》2024年第10期1151-1154,共4页Journal of Shanxi University of Chinese Medicine

基　　金：2023年度山西省中医药科研课题立项计划(2023ZYYB090)。

摘　　要：胸痹相当于西医学“冠状动脉粥样硬化性心脏病”“心绞痛”,其基本病机为“阳微阴弦”,根本病因为“阳虚”。火神派以阴阳为纲,提纲挈领、执简驭繁对疾病的根本病机进行快速辨别,治疗原则上重视补助肾阳,主张“阳主阴从”的核心思想,治疗方法上擅用、广用、专用附子,治疗过程中详辨“阴火”假热之象,临证注重扶助机体阳气,尤其善用大剂量附子使阳气迅速复原。郑钦安强调“扶阳”是重要原则,可从上游解决根本“动力”问题,痰浊、瘀血、水饮等下游问题可迎刃而解。四逆汤为温补心肾、通脉止痛代表方,正合胸痹“阳微阴弦”之病机,临床运用四逆汤加减治疗胸痹,疗效显著。通过对火神派主要学术思想、用药特点进行探究,并结合胸痹病因病机,论述运用火神派学说治疗胸痹的作用机制,其理论意义和现实价值值得每一位中医学者探究。Thoracic obstruction is equivalent to coronary atherosclerotic heart disease and angor pectoris in western medicine.The basic pathogenesis is“Yang-Wei-Yin-Xian”,and the fundamental disease cause is“Yang deficiency”.The“Huo-Shen”School takes Yin and Yang as the principle,and makes a quick identification of the fundamental pathogenesis of the disease by focusing on the main points and grasping the simple ones.The treatment principle attaches importance to reinforcing kidney-Yang,and advocates the core idea of“Yang being the master of Yin”.In the treatment method,Fuzi is widely used.During the treatment,the image of false heat caused by“Yin-fire”should be identified in detail.In clinical practice,attention should be paid to supporting Yang-Qi of the body.It is especially good to use large doses of Fuzi to quickly restore Yang-Qi.Zheng Qin′an stresses that“supporting Yang”is an important principle,which can solve the fundamental“power”problem from the upstream,and then the downstream problems such as phlegm turbidity,blood stasis,and retained fluid can be solved easily.Sini Decoction is a representative prescription for warming and tonifying the heart and kidney,dredging vessels and relieving pain,which is exactly in line with the pathogenesis of Yang-Wei-Yin-Xian in thoracic obstruction.The clinical application of modified Sini Decoction in the treatment of thoracic obstruction has a remarkable effect.Through exploring the main academic thoughts and the medication characteristics of“Huo-Shen”School and combining with the etiology and pathogenesis of thoracic obstruction,this research discusses the mechanism of“Huo-Shen”School theory to treat thoracic obstruction.Its theoretical significance and practical value are worth exploring by every TCM scholar.

关 键 词：火神派 扶阳 胸痹 

分 类 号：R256.22[医药卫生—中医内科学]