从“五脏痿”论治射血分数保留的心力衰竭  

Discussion on the treatment of heart failure with preserved ejection fraction from“five zang-viscera flaccidity”

作　　者：张迪莹 寇兰俊[1] 韩小婉[1] 谢静 邓洪枭 李思绮 潘国忠[1] ZHANG Diying;KOU Lanjun;HAN Xiaowan;XIE Jing;DENG Hongxiao;LI Siqi;PAN Guozhong(The Second Zone of Cardiovascular,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing100700,China)

机构地区：[1]北京中医药大学东直门医院心血管二区,北京100700

出　　处：《中国医药导报》2025年第5期158-161,171,共5页China Medical Herald

基　　金：国家自然科学基金青年科学基金项目(82204856);吴阶平医学基金会临床科研专项项目(320.6750.2022-25-3)。

摘　　要：射血分数保留的心力衰竭(HFpEF)是一种复杂的心力衰竭类型,其病理机制及治疗至今仍面临诸多挑战。HFpEF的多器官疾病进展与《黄帝内经》中“五脏痿”的病机相似,均属于功能“弱而不用”的范畴,其基本病机为气虚血瘀水停、五脏虚热内生,病中首犯脉痿,进一步累及其余四脏,临证时以益气逐瘀、化饮除热为法,调补诸脏为要。强调在疾病治疗中针对不同脏腑受累动态调整治疗策略,为中西医结合治疗HFpEF提供新思路。Heart failure with preserved ejection fraction(HFpEF)is a complex type of heart failure,and its pathological mechanism and treatment still face many challenges to this day.The progression of multiple organ diseases in HFpEF is similar to pathogenesis of“five zang-viscera flaccidity”in Huangdi Neijing,both of which belong to the category of“weak and useless”function.Basic pathogenesis is qi deficiency,blood stasis,and water retention,as well as internal heat generation due to deficiency of five organs,the first symptom of the disease is pulse dysfunction,which further affects the other four organs.During clinical practice,the methods of tonifying qi and removing blood stasis,dissolving fluids and removing heat should be used,and regulating and supplementing various organs should be emphasized.Emphasizing dynamic adjustment of treatment strategies for different organs involved in disease treatment,providing new ideas for integration of traditional and western medicine in the treatment of HFpEF.

关 键 词：射血分数保留的心力衰竭 痿证 虚热 理论探索 

分 类 号：R256.2[医药卫生—中医内科学]