程晓昱从肾论治老年慢性心力衰竭合并失眠临证经验  

CHENG Xiaoyu's Clinical Experience in Treating Chronic Heart Failure Combined with Insomnia in the Elderly from the Perspective of the Kidney

作　　者：赵梦瑶 程晓昱[2] ZHAO Mengyao;CHENG Xiaoyu(Anhui University of Chinese Medicine Anhui Hefei 230038,China;The First Affiliated Hospital of Anhui University of Chinese Medicine Anhui Hefei 230031,China)

机构地区：[1]安徽中医药大学第一临床医学院,安徽合肥230038 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《中医药临床杂志》2025年第1期62-66,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：安徽省卫生和计划生育委员会中医药领军人才培养对象专项项目(中医药发展秘〔2018〕23号);安徽省中医药学术流派传承工作室建设项目——新安歙北程氏内科流派工作室(NO.18)(皖中医药发展秘〔2021〕30号);安徽中医药大学第一附属医院程晓昱名中医工作室建设项目(中医药发展秘〔2020〕10号)。

摘　　要：慢性心力衰竭合并失眠临床较为常见。程晓昱教授结合多年临床经验认为慢性心力衰竭合并失眠以老年人多见,常因心衰日久,损及肾阳,或年岁增加,五脏渐虚,阴阳失衡,其病位主要在心肾,并可涉及多种脏腑,病机主要在于肾精不足,心肾阳虚,病及他脏,以致其余脏腑阳气俱虚,无以温煦、推动脏腑气机正常运行,化生瘀血、痰饮等病理产物,导致心衰进一步发展。同时,阳气亏虚致营卫失行其道,肾精不足致脑髓失养,元神欠安,最终导致失眠的发生。程教授在临床诊疗中重视“温阳补肾,活血利水”“辨证论治,随症加减”“内外共治,顺应天时”,以达到“阴平阳秘,精神乃治”的平衡状态。Chronic heart failure combined with insomnia is relatively common in clinical practice.Based on many years of clinical experience,Professor CHENG Xiaoyu believes that chronic heart failure combined with insomnia is more common in the elderly.It is often caused by long-term heart failure,which damages kidney Yang,or with the increase of age,the five internal organs gradually become weak,and the yin and yang are unbalanced.The disease is mainly located in the heart and kidney,and may involve multiple organs.The pathogenesis is mainly due to insufficient kidney essence,heart and kidney yang deficiency,and the disease affects other organs,resulting in the deficiency of Yang Qi in other organs,which cannot warm and promote the normal operation of the internal organs Qi,and produce pathological products such as blood stasis and phlegm,leading to further development of heart failure.At the same time,the deficiency of Yang Qi causes the Ying and Wei to lose their way,and the deficiency of kidney essence leads to the malnutrition of the brain and marrow,and the poor spirit,which eventually leads to the occurrence of insomnia.In clinical diagnosis and treatment,Professor CHENG attaches importance to“warming Yang and tonifying the kidney,promoting blood circulation and promoting water”,“differentiation of syndromes and treatment,adding and subtracting according to symptoms”,and“internal and external treatment,in accordance with the time of nature”to achieve a balanced state of“Yin and Yang are balanced,and the spirit is cured”.

关 键 词：慢性心力衰竭 失眠 肾 程晓昱 

分 类 号：R256.23[医药卫生—中医内科学] R256.29[医药卫生—中医学]