“寒温并用”辨治心律失常  

Differentiation and Treatment of Arrhythmias with Combination Method of Coldness and Warmness

作　　者：孙治琪 赵海滨[1] 郜亚茹 王昀 SUN Zhiqi;ZHAO Haibin;GAO Yaru;WANG Yun(Dongfang Hospital Affiliated to Beijing University of Chinese Medicine,Beijing China 100078;Shunyi Hospital of Beijing Traditional Chinese Medicine Hospital,Beijing China 101300)

机构地区：[1]北京中医药大学东方医院,北京100078 [2]北京中医医院顺义医院,北京101300

出　　处：《中医学报》2025年第3期527-531,共5页Acta Chinese Medicine

基　　金：国家自然科学基金项目(82174332);北京市自然科学基金项目(7202126)。

摘　　要：心律失常属于中医“心悸”。既往医家多从伤寒水饮病辨治心悸,而现代人由于不良饮食、不良作息等生活习惯,常见湿浊内生。故临床辨治时不能单从“阳虚水停,寒湿内盛,水饮上逆于心”的角度出发;更要重视湿性黏滞,易阻滞气机,造成津液代谢障碍,与水饮内停合而发病加重心悸的病理特点。基于此,提出“寒温并用”辨治心悸,即伤寒体系结合温病体系,伤寒六经辨证对水饮的论治结合温病三焦辨证对湿邪的论治,采用温阳化饮、芳香化湿等治法,临床应用苓桂剂加减芳香化湿等药物以治疗心悸,予饮与湿邪以出路。Arrhythmia belongs to the category of"palpitation"in traditional Chinese medicine.In the past,doctors often treated palpitation from perspective of Cold injury and Water evil factor injury.However,modern people often suffer from Dampness and Turbidity evil factors due to abnormal dietary and lifestyle habits.Therefore,the clinical diagnosis and treatment cannot only be based on the perspective of"Yang deficiency and Water stagnation,Cold and Dampness as well as Water going up to the Heart";we should pay more attention to the pathological characteristics of palpitation that Dampness is sticky and stagnant,which is easy to block the Qi,causing impediments to the metabolism of Fluids.When combing with Water stagnation,the onset of palpitation is aggravated.Based on this,the"combined method of Coldness and Warmness"is proposed to treat palpitation.In other words,typhoid system should be combined with the system of febrile disease,or the treatment of Water evil factor by the six meridians of typhoid should be combined with the treatment of Dampness by the Three Jiao of febrile disease.The method of warming Yang to dissolve Water and the use of aromatic drugs to dissolve Dampness,etc.should be applied.The modified Ling Gui kinds of prescriptions with aromatic drugs should be used to treat palpitation,by giving the Water and Dampness a way out.

关 键 词：心律失常 “寒温并用” 《伤寒论》 温病 痰饮 湿气 

分 类 号：R259.417[医药卫生—中西医结合]