李妍怡治疗稳定型心绞痛经验  

Li Yanyi′s Experience in Treating Stable Angina Pectoris

作　　者：王欢 董建华[1] 陈雪梅 焦学婷 巩婷[2] 李妍怡[2] WANG Huan;DONG Jianhua;CHEN Xuemei;JIAO Xueting;GONG Ting;LI Yanyi(Gansu University of Chinese Medicine,Lanzhou,Gansu,China,730000;Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou,Gansu,China,730050)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]甘肃省中医院,甘肃兰州730050

出　　处：《河南中医》2025年第3期379-384,共6页Henan Traditional Chinese Medicine

基　　金：甘肃省科技计划联合科研基金资助项目(23JRRA1531);兰州市科技计划资助项目(2023-2-97)。

摘　　要：李妍怡教授认为,稳定型心绞痛患者最常见的体质类型是血瘀质、痰湿质、气虚质、阴虚质和阳虚质,故究其病机不外“虚”“痰”“瘀”,以心之气血阴阳亏虚,肺肝脾肾功能失调为本,以痰瘀互结,气血失和为标。李教授认为,此病要辨清病情轻重,权衡缓急,常主张中医药早期介入治疗,提高疗效,减少不良反应,改善患者的生活质量,以血府逐瘀汤、瓜蒌薤白半夏汤合古方佛手散为底方自拟佛手通痹汤治之,还提倡整体调治,愈后防复。若属肾阴虚难以上济心火,心火盛而致心烦、易怒者,加淡豆豉、栀子等药以清心除烦;若属胸痛日久导致心烦不寐者,可用酸枣仁、远志、首乌藤等药以养心安神;若病程日久耗伤气血,而致神疲乏力者,宜用八珍汤配伍,以补其气血,扶正益气。Professor Li Yanyi believes that the most common constitution types among patients with stable angina pectoris(SAP)are blood stasis constitution,phlegm-dampness constitution,qi deficiency constitution,yin deficiency constitution and yang deficiency constitution.Therefore,the pathogenesis can be summarized as"deficiency","phlegm"and"stasis".The root cause lies in the deficiency of qi,blood,yin and yang of the heart,and the dysfunction of the lung,liver,spleen and kidney,while the symptoms are manifested as the intermingled phlegm and stasis and the disharmony of qi and blood.Professor Li believes that for this disease,it is necessary to accurately assess the severity of the condition and weigh the urgency.She often advocates for the early intervention of TCM in treatment to enhance therapeutic effects,reduce adverse reactions,and improve the quality of life of patients.She has developed a self-made formula called Fructus Citri Sarcodactylis Arthralgia-Unblocking Decoction based on Blood Mansion Stasis-Expelling Decoction,Trichosanthes and Chinese Chive and Pinellia Decoction combined with the ancient formula Fructus Citri Sarcodactylis Powder.She also promotes holistic treatment and post-recovery prevention of recurrence.If it is due to deficiency of kidney yin that fails to nourish the heart fire,and the heart fire is excessive,causing restlessness and irritability,it is necessary to add Dandouchi(Semen Sojae Praeparatum)and Zhizi(Fructus Gardeniae),etc.to clear the heart fire and relieve restlessness.For cases where prolonged chest pain leads to restlessness and insomnia,herbs such as Suanzaoren(Semen Ziziphi Spinosae),Yuanzhi(Radix Polygalae),Shouwuteng(Caulis Polygoni Multiflori),etc.can be used to nourish the heart and calm the spirit.If the disease has persisted for a long time and consumed qi and blood,leading to fatigue and weakness,it is advisable to use Eight-Gem Decoction in combination to replenish qi and blood and strengthen the body′s vital energy.

关 键 词：稳定型心绞痛 佛手通痹汤 李妍怡 

分 类 号：R259.414[医药卫生—中西医结合]