基于“血不利则为水”从痰湿瘀论治慢性心力衰竭  

Treating Chronic Heart Failure of Phlegm,Dampness and Blood Stasis Based on"Blood Stagnation Leading to Fluid Retention"

作　　者：张淑涵 侯平[2] ZHANG Shuhan;HOU Ping(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《实用中医内科杂志》2025年第4期64-67,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家自然科学基金项目(81874403);辽宁省“兴辽英才计划”项目(XLYC1802099)。

摘　　要：慢性心力衰竭(CHF)是大部分心血管疾病的最终归宿,严重影响患者的预后和生活质量。瘀血、水湿、痰饮与心衰的发生发展关系密切,该文基于“血不利则为水”理论从瘀血、水湿、痰饮的角度探讨了慢性心衰的病因病机及基本治法。肺脾肾三脏与“血不利则为水”密切相关,三脏功能障碍,水湿痰饮积聚,促进心衰的发生与发展。慢性心衰的病变过程存在“瘀”和“水”恶性演变,因此活血利水法是治疗慢性心衰的基本治法,同时根据辨证以标本兼治—行气补气,活血利水;从根论治—温补肾阳,活血利水;痰瘀同治—燥湿化痰,活血利水来论治,以期为中医辨治CHF提供参考。Chronic heart failure(CHF)is the final result of most cardiovascular diseases and has a significant impact on patients'prognosis and quality of life.Stasis,dampness,phlegm and water retention are closely related to the occurrence and development of CHF.This paper discussed the pathogenesis and basic treatment principles of chronic heart failure from the perspective of stasis,dampness and phlegm based on the theory that"blood not flowing smoothly becomes water".The lung,spleen and kidney are closely related to the theory that"blood not flowing smoothly becomes water".When these three organs work abnormally,water retention and phlegm accumulate,promoting the occurrence and development of CHF.The pathological process of chronic heart failure involves the evil evolution of"blood stasis"and"water",so the basic treatment principle for chronic heart failure is to promote blood circulation and drain water.At the same time,the treatment should be based on syndrome differentiation,focusing on both the root and the manifestation—regulating Qi and strengthening Qi,promoting blood circulation and draining water;treating the root—warming and nourishing kidney Yang and promoting blood circulation and draining water;treating phlegm and blood stasis together—drying dampness and promoting blood circulation and draining water.The aim of this paper was to provide reference for the treatment of CHF by TCM.

关 键 词：慢性心力衰竭 血不利则为水 活血利水 

分 类 号：R259[医药卫生—中西医结合]