从“心与小肠相表里”分期辨治慢性心衰合并肠功能障碍  

Stages Differentiation and Treatment of Chronic Heart Failure Complicated with Intestinal Dysfunction Based on“The heart Is Exteriorly and Interiorly Related to the Small Intestine”

作　　者：张苗苗 路士华[2] 迟莉丽[2] 王震[2] 王彤[1] 程艳[2] ZHANG Miaomiao;LU Shihua;CHI Lili;WANG Zhen;WANG Tong;CHENG Yan(Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学,山东济南250355 [2]山东中医药大学附属医院,山东济南250014

出　　处：《山东中医杂志》2025年第3期291-295,共5页Shandong Journal of Traditional Chinese Medicine

基　　金：济南市科技计划项目(编号:202134024);山东中医药大学附属医院青年科研创新团队项目(编号:2021-02)。

摘　　要：慢性心衰合并肠功能障碍是心衰患者终末期的并发症之一,慢性心衰与肠功能障碍在发生、发展过程中的互作关系日益引起医者的高度关注,但目前本病治疗手段尚有限。基于“心与小肠相表里”理论,并根据本病的临床表现及病机演变规律,提出了早期益气健脾养心,祛湿活络护肠;中期温阳健脾养心,化痰通络安肠;晚期益肾健脾养心,利水疏络固肠的分期辨治策略。旨在应用经典理论与现代研究相结合的方式,探求中医药辨治慢性心衰合并肠功能障碍的可行性及优势,为临床诊治该病提供新的思路和方法。Chronic heart failure combined with intestinal dysfunction is one of the end-stage complications of patients with heart failure.The interaction between chronic heart failure and intestinal dysfunction in the occurrence and development process has attracted increasing attention from medical practitioners,but the current treatment of this disease is still limited.Based on the theory of“The heart is exteriorly and interiorly related to the small intestine”,and according to the clinical manifestation and pathogenesis of the disease,the paper proposes the staged treatment strategy of invigorating qi and strengthening spleen and nourishing heart,dispelling dampness,activating collaterals and protecting the intestine in the early stage of the disease;warming yang,invigorating spleen and nourishing heart,dissipating phlegm,clearing collaterals and stabilizing the intestine in the middle stage of the disease;and tonifying kidney,invigorating spleen and nourishing heart,regulating water,clearing collaterals and strengthening intestine in the late stage of the disease.The goal of this study is to explore the feasibility and advantages of traditional Chinese medicine in the differentiation and treatment of chronic heart failure complicated with intestinal dysfunction by combining classical theory with modern researches,so as to provide new ideas and methods for the clinical diagnosis and treatment of this disease.

关 键 词：慢性心衰 肠功能障碍 心与小肠相表里 分期辨治 心肠同病 心肠共治 

分 类 号：R256.2[医药卫生—中医内科学]