张仲景风药复脉法治疗迟脉型心病之机制探析  

Analysis of the Mechanism of ZHANG Zhongjing Rejuvenation Method with Wind Medicine in the Treatment of Late-Pulse Heart Disease

作　　者：王建康[1] 陈璐佳 陈丹 程秀萍 应武江 张徐 WANG Jiankang;CHEN Lujia;CHEN Dan(Ningbo Hospital of TCM,Affiliated Hospital of Zheji-ang Chinese Medical University,Ningbo(315010),China;Dongliu Street Health Service Center)

机构地区：[1]浙江中医药大学附属宁波市中医院,宁波315010 [2]宁波市鄞州区东柳街道卫生服务中心 [3]宁波市奉化区中医医院 [4]宁波市奉化区江口卫生院

出　　处：《浙江中医药大学学报》2025年第3期292-299,共8页Journal of Zhejiang Chinese Medical University

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药办人教函﹝2021﹞270号);宁波市公益性研究项目(2023 S 134);宁波市卫生健康青年技术骨干人才培养专项(甬卫发﹝2022﹞97号)。

摘　　要：[目的]整理挖掘张仲景《伤寒论》《金匮要略》运用风药复脉法治疗迟脉型心病的学术理论和作用机制。[方法]运用《内经》风药理论及历代医家对风药的认识,研究探讨张仲景对迟脉型心病病因病机及风药复脉治法作用机制的认识,并借助现代药理学研究对风药的有效成分作用靶点进行论证。[结果]风致迟脉的病因有外感风邪、内伤肝风之异,风伤心气、邪阻心脉是其基本病机,补心扶正、祛风通脉是其治疗大法,以此总结归纳仲景所创立的风药复脉治疗之法有9型9法,形成系列化治疗构架,分别为调补营卫、祛风散邪法,清上温下、祛风散毒法,益气养血、祛风蠲痹法,通阳散寒、镇摄营卫法,化痰行滞、宣痹通脉法,运脾升清、补气固脱法,温肾益精、激发卫气法,宣肺强心、温化水饮法,祛风通脉、活血化瘀法。风药复脉的作用机制有祛除外风、泄肝祛风、调和营卫、运脾升清、化痰燥湿、活血通络、辛润营血、宁心安神8种,且与现代药理学研究风药的有效成分作用靶点相符合。[结论]仲景风药复脉法自成学术体系,对难治性心动过缓型心脏病辨治有较大的理论指导和临床应用价值。[ObjectiveObjective]To explore and discuss the mechanism of ZHANG Zhongjing’s methods of wind medicine in treating delayed-pulse heart disease by applying the theory of wind medicine in Neijing and the understanding of wind medicine by medical practitioners throughout the history.[MethodsMethods]Summarize ZHANG Zhongjing’s compilation of Treatise on Febrile Diseases and Synopsis of the Golden Chamber,explore the etiology and pathogenesis of delayed-pulse heart disease,as well as the mechanism of wind medicine for restoring meridians,and use modern pharmacological research to demonstrate the effective ingredient targets of wind medicine.[ResultsResults]It was found that the causes of wind-induced delayed-pulse included external wind evil,internal liver wind,wind damaging heart Qi and evil obstructing heart meridians which were its basic pathogenesis.The treatment methods of tonifying the heart and supporting the essence,dispelling wind and unblocking the meridians were the main methods.Based on this,a wind medicine complex pulse treatment method was established,and Zhongjing’s differentiation and medication were classified into 9 types and 9 methods,forming a series of treatment frameworks,including:regulating and tonifying the Ying Wei,dispelling wind and dispelling evil,clearing upper and warming lower,dispelling wind and dispersing toxins,nourishing Qi and blood,dispelling wind and removing Bi,unblocking Yang and dispersing cold,calming the Ying Wei,resolving phlegm and promoting stagnation,promoting Bi and unblocking the meridians,promoting and clearing spleen,invigorating Qi for relieving desertion,warming kidney and nourishing essence,stimulating Wei Qi,promoting lung and strengthening heart,warming water and drinking method,dispelling wind and unblocking meridians,promoting blood circulation and removing stasis.Furthermore,the mechanism of action of wind medicine in restoring meridians was analyzed,including expelling external wind,relieving liver and dispelling wind,harmonizing Yin and Wei,promoting

关 键 词：迟脉型心病 难治性心动过缓型心脏病 风药复脉 张仲景 《伤寒论》 《金匮要略》 基本病机 作用机制 

分 类 号：R732[医药卫生—肿瘤]