基于“六经病欲解时”理论运用乌梅丸治疗夜间心悸反复发作的经验总结  

Professor Li Changda’s experience in treating recurrent heart palpitations at night with fructus mume pellet based on the theory of"the time of day when diseases of the six meridians tend to resolve"

作　　者：王进[1] 李吉刚 杨宝 李长达[2] WANG Jin;LI Jigang;YANG Bao;LI Changda(Department of Cardiovascular Disease,Zibo Hospital of Traditional Chinese Medicine,Shandong,Zibo 255300,China;Department of Cadre Health Care,Zibo Hospital of Traditional Chinese Medicine,Shandong,Zibo 255300,China)

机构地区：[1]山东省淄博市中医医院心血管病科,山东淄博255300 [2]山东省淄博市中医医院干部保健科,山东淄博255300

出　　处：《中国医药科学》2025年第6期181-184,共4页China Medicine And Pharmacy

基　　金：山东省中医药科研项目(2021M110)。

摘　　要：心悸是临床常见病证,患者自觉心中跳动不适,惊慌不安,常伴胸闷气短、头晕乏力等症状,现代医学中由于各种原因引起的心律失常、冠状动脉硬化性心脏病等疾病皆可从心悸论治,而夜间发作性心悸具有鲜明的临床特点,运用六经辨证,从肝论治心悸具有独到经验,重视夜间心悸与睡眠的关系,重视厥阴病的实质,认为厥阴是逆阴,重视患者体质的辨识,在乌梅丸的应用中,依据厥深热深、水资木长、阳生阴长的机理,应用干姜附子补肾壮阳,红参助长气升,同时应用黄连清火中之邪气,花椒除血热中湿气,应用当归柔肝补血,细辛肉桂入心温经通脉,黄柏清解肾中浮火。肉桂与黄连交通心肾。让升则清,降则宁。Palpitation is a common clinical syndrome.The patients feel uncomfortable and panicked,often accompanied by symptoms such as chest tightness,shortness of breath,dizziness,and fatigue.In modern medicine,arrhythmia,coronary heart disease and other diseases caused by various reasons can be treated from palpitation,while nocturnal paroxysmal palpitation has distinct clinical characteristics.There is unique experience in treating palpitations from the liver by apping the syndrome differentiation of the six meridians.Great importance is attached to the relationship between nocturnal palpitations and sleep,as well as the essence of Jueyin disease.It is believed that Jueyin reverse of yin.Attention is also paid to the identification of the patient’s consitution.In the application of fructus mume pellet,based on the principles of"the deeper the Jueyin condition,the more intense the heat","water nourishes wood and promotes its growth",and"yang generates and yin grows",dry ginger and aconite are used to tonify the kidney and strengthen yang,while red ginseng is used to promote the ascent of Qi.Simultaneously,Rhizoma coptidis is used to clear the pathogenic heat in the the spleen and stomach,and pericarpium zanthoxyli is used to remove damp-heat from the blood.Chinese angelica is applied to soften the liver and nourish the blood,while asarum and cinnamon bark are used to warm the heart,invigorate the meridians,and promote circulation.Cortex phellodendri is used to clear the floating heat in the kidney.Cinnamon bark and Rhizoma coptidis work together to connect the heart and kidney,allowing the ascending energy to be clear and the descending energy to be calm.

关 键 词：心悸 乌梅丸 六经病欲解时 失眠 

分 类 号：R256.12[医药卫生—中医内科学] R285.6[医药卫生—中医学]