基于营卫理论对冠状动脉粥样硬化性心脏病的论治探讨  

Discussion on the treatment of coronary atherosclerotic heart disease based on the Ying-Wei theory

作　　者：姜佳慧 李思琦[2] 陈利浩 杨旭娜 顾文博 陈泽宇 南寒 JIANG Jiahui

机构地区：[1]辽宁中医药大学,辽宁沈阳110000 [2]辽宁中医药大学附属医院,辽宁沈阳110000

出　　处：《中医临床研究》2024年第29期100-104,共5页Clinical Journal Of Chinese Medicine

摘　　要：冠状动脉粥样硬化性心脏病(简称冠心病)为心内科的常见疾病,随着我国进入老年化社会,冠心病的发病率逐年上升。中医治疗冠心病除应用脏腑辨证等常规辨证外,还可从营卫角度辅助辨证。《难经》记载:“损其心者,调和营卫。”营卫与心主血脉功能密切相关。中医认为:一则心主血脉,脉管收缩舒张与血之化生皆与营卫息息相关。营卫调和,脉道通利;营卫失和,血脉凝滞不通,久及心脉则发为胸痹。营气与现代医学中血管内皮分泌的活性物质及激素可调节血管舒缩、改善血流的作用类似;卫气与血管外膜滋养血管、淋巴管及肾上腺素能神经调节血管舒缩及血流的作用类似。同时,脉络学说也以营卫为切入点,提出了营卫与血管内外皮的相关性。二则心主神,营卫与心神所化之血同源。营卫化源充足调和,则心神得养,情志调达愉悦,气机通畅;若营卫亏欠或不合,则心神失养,人易焦虑、紧张,情志不畅,此为胸痹发生的重要原因之一。营卫调节情志影响胸痹的过程与现代医学所说自主神经对冠心病的影响机制极为吻合,营卫相互依存转化、对立制约,与心脏交感和迷走神经相互依赖,营卫昼夜循行规律与自主神经节律性调节,皆有相似之处。因此,临床上可从“损其心者,调和营卫”的角度干预冠心病。Coronary atherosclerotic heart disease is a common disease in cardiology,and the incidence of the disease is increasing year by year with our country entering an aging society.Traditional Chinese Medicine(TCM)treats coronary heart disease from the overall concept of evidence-based treatment.In addition to conventional treatments such as syndrome differentiation of Zangfu viscera(脏腑),it can also assist the treatment from the perspective of Ying(营)and Wei(卫).According to the records in Nanjing(《难经》),“Heart disease needs to be treated from Ying-Wei”,Ying-Wei is closely related to the function of heart of governing blood vessels.TCM believes the first is that heart governs blood vessels.Vasoconstriction and relaxation,and blood production and transformation are closely related to Ying and Wei.When Ying and Wei are harmonious,the blood vessels are unobstructed.When Ying and Wei are out of harmony,the blood vessels are stagnant.It is easy to develop chest impediment in a long run.The function of Ying Qi is similar to that of active substances and hormones secreted by vascular endothelium in modern medicine.The function of Wei Qi is similar to that of vascular adventitia,lymphatic vessels and epinephrine.The second is that the heart governs the vitality,and the Ying-Wei is closely related to the vitality.If the Ying and Wei are harmonious,the vitality will be nourished and the emotion will be happy.If the Ying and Wei are not in harmony,the vitality will be lost,and people are prone to anxiety and emotional distress,which is one of the important factors for the occurrence of chest impediment.The process of Ying-Wei regulating emotion and affecting chest impediment is very consistent with the mechanism of autonomic nerve affecting coronary heart disease in modern medicine.Therefore,clinical intervention of coronary heart disease from the perspective of Ying-Wei can improve the quality of life.

关 键 词：营卫理论 营卫不和 冠状动脉粥样硬化性心脏病 

分 类 号：R256.2[医药卫生—中医内科学]