从脾论治慢性肺源性心脏病水肿  

Study on the Treatment of Edema in Chronic Pulmonary Heart Disease from a Spleen-Centered Perspective

作　　者：董知杨 左婉曌 裴娇 薛美轩 左明晏 DONG Zhiyang;ZUO Wanzhao;PEI Jiao;XUE Meixuan;ZUO Mingyan(Hubei Minzu University,Enshi,Hubei,China,445000;Hubei University of Chinese Medicine,Wuhan,Hubei,China,430000;Xiangyang Hospital of Traditional Chinese Medicine,Xiangyang Institute of Traditional Chinese Medicine,Xiangyang,Hubei,China,441100)

机构地区：[1]湖北民族大学,湖北恩施445000 [2]湖北中医药大学,湖北武汉430000 [3]襄阳市中医医院,襄阳市中医药研究所,湖北襄阳441100

出　　处：《河南中医》2024年第12期1822-1826,共5页Henan Traditional Chinese Medicine

基　　金：湖北省卫生健康委员会2019—2020年度科研项目(WJ2019F097)。

摘　　要：基于“诸湿肿满,皆属于脾”理论,慢性肺源性心脏病水肿发病关键在脾,病机为脾气虚衰,脾阳不温、不运,津液输布失调;脾为肺之母,脾气虚弱,运化失常,肺失滋养,宣发肃降功能失职;脾气、脾阳虚衰,无力制水,水湿内生,日久不愈,导致肾水泛滥,发为水肿。常用胃苓汤、苓桂术甘汤燥湿健脾利水、葶苈大枣泻肺汤与防己黄芪汤泻肺利水、实脾饮合五皮饮温肾健脾消水。水肿可从脾论治,但病机复杂,临证应知常达变,观其脉证,知犯何逆,随证治之。Based on the theory of"all diseases due to dampness characterized by swelling and fullness being associated with the spleen",the root cause of edema in chronic pulmonary heart disease lies in the spleen.The pathogenesis involves spleen qi deficiency and diminished spleen yang,leading to impaired fluid distribution.The spleen,as the mother of the lung,fails to nourish the lung when its transportation and transformation functions are disrupted,impairing the lung′s dispersing and descending functions.Deficient spleen qi and spleen yang weaken water regulation,causing internal dampness to accumulate over time,ultimately resulting in kidney water overflow and edema.So Stomach-Calming Poria Decoction,Poria and Cinnamon Twig and Atractylodes Macrocephala and Licorice Decoction are often used for or drying dampness,invigorating the spleen,and promoting diuresis;Descurainiae and Jujube Lung-Draining Decoction,Stephania Root and Astragalus Decoction are used for clearing the lung and eliminating water retention;Beverage for Reinforcing the Spleen combined with Five-Peel Beverage are used for warming the kidney,invigorating the spleen,and reduce water accumulation.However,due to the complexity of edema pathogenesis,clinical treatment should adapt to changing conditions,carefully examining pulse and symptoms to identify the underlying cause and provide individualized care.

关 键 词：慢性肺源性心脏病 水肿 “诸湿肿满 皆属于脾” 从脾论治 

分 类 号：R259.415[医药卫生—中西医结合]