王守富治疗慢性心力衰竭经验  

Wang Shoufu′s Experience in Treating Chronic Heart Failure

作　　者：张富汉 王守富 于国俊 卢吉锋 ZHANG Fuhan;WANG Shoufu;YU Guojun;LU Jifeng(Henan Integrative Medicine Hospital,Zhengzhou,Henan,China,450004)

机构地区：[1]河南省中西医结合医院,河南郑州450004

出　　处：《河南中医》2025年第4期538-543,共6页Henan Traditional Chinese Medicine

基　　金：国家中医药管理局第七批全国老中医药专家学术经验继承项目{国中医药人教函[2022]76号}。

摘　　要：王守富主任中医师认为,中医之“心水”与西医慢性心力衰竭临床表现相近,慢性心力衰竭之病以中医病名“心水”命名更妥。气虚血瘀为慢性心力衰竭核心病机,病机特征为“气虚、血瘀、水停”。王老师将慢性心力衰竭分为以下证型进行论治:心肺气虚、血瘀水停证,治宜益气补心、活血利水,方选升陷汤合补阳还五汤加减;心脾气虚、血瘀水停证,治宜健脾益气、活血利水,方选六君子汤合五苓散加减;气阴两虚、血瘀水停证,治宜补气养阴、活血利水,方选黄芪生脉饮合五苓散加减;气虚阳虚、血瘀水停证,治宜温阳益气、活血利水,方选参附汤合真武汤加减;心阳虚脱证,治宜回阳救逆固脱,方用回阳救急汤(《伤寒六书》)合急救回阳汤(《医林改错》)加减。Chief physician Wang Shoufu thinks that the TCM concept of "heart edema" closely aligns with the clinical manifestations of chronic heart failure(CHF) in Western medicine,suggesting that CHF should be more appropriately termed "heart edema" in TCM nomenclature.Qi deficiency and blood stasis are seen as the core pathogenesis of CHF,characterized by "qi deficiency,blood stasis,and water retention." For syndrome differentiation and treatment,Prof.Wang classifies CHF into the following patterns:For syndrome of heart-lung qi deficiency with blood stasis and water retention,treatment focuses on replenishing qi,tonifying the heart,activating blood circulation,and inducing diuresis using Modified Raising the Sinking Decoction combined with Yang-Supplementing and Five-Returning Decoction.For syndrome of heart-spleen qi deficiency with blood stasis and water retention,treatment focuses on fortifying the spleen,replenishing qi,activating blood circulation,and inducing diuresis with Modified Six Gentlemen Decoction combined with Five Substances Powder with Poria.For syndrome of qi-yin deficiency with blood stasis and water retention,treatment focuses on tonifying qi,nourishing yin,activating blood circulation,and inducing diuresis using Modified Astragalus Pulse-Engendering Beverage combined with Five Substances Powder with Poria.For syndrome of qi-yang deficiency with blood stasis and water retention,treatment focuses on warming yang,replenishing qi,activating blood circulation,and inducing diuresis with Modified Ginseng and Aconite Decoction combined with True Warrior Decoction.For heart yang collapse syndrome,treatment focuses on restoring yang and reversing collapse using Modified Yang-Returning Emergency Decoction Decoction(from Six Texts on Cold Damage) combined with Emergency Yang-Returning Decoction(from Corrections of Errors in Medical Works).

关 键 词：慢性心力衰竭 心水 气虚 血瘀 水停 

分 类 号：R259.416[医药卫生—中西医结合]