程丑夫从气论治风湿性瓣膜病经验  

Cheng Choufu′s Experience in Treating Rheumatic Valvular Disease Based on Qi

作　　者：李霖林 张炜宁 LI Linlin;ZHANG Weining(First Clinical College,Hunan University of Chinese Medicine,Changsha,Hunan,China,410208;Shenzhen Seventh People′s Hospital,Shenzhen,Guangdong,China,518081)

机构地区：[1]湖南中医药大学第一临床学院,湖南长沙410208 [2]深圳市第七人民医院,广东深圳518081

出　　处：《河南中医》2025年第5期718-722,共5页Henan Traditional Chinese Medicine

基　　金：国家中医药管理局“2013年程丑夫名老中医药专家传承工作室建设项目”{国中医药人教函[2013]47号}。

摘　　要：气为生命之本,元气的充盈与正常运行是人体健康的保障,疾病的发生与气机异常密切相关,风湿性瓣膜病病位在心包络脉,以心气虚滞为核心病机,继发痰瘀热邪进一步阻碍气机,气虚形凝而成,故从气论治是治病求本的体现。程教授认为,该病为虚实夹杂,本虚标实之证,治疗以调护元气、祛邪扶正为主要目的,以益气化痰,清热化瘀为基本治法,方用生脉陷胸汤合丹参饮辨证加减。此外,程教授亦善用意象思维来指导临床用药,对于心脏瓣膜病,常选用木蝴蝶或百合入药;顽痰痈脓者用皂角刺;针对瘀热型血管病变者,选用入心经的忍冬藤在清热疏风活络的同时引诸药入经;瘀血顽疾者,常用虫类药,以虫类走窜搜络之性,祛久稽之邪;凡风证诸疾,痉挛诸疾,常用全蝎;若虚人血瘀,常用土鳖虫,可补虚化瘀。Qi serves as the foundation of life,The abundance and proper circulation of original qi ensure human health,and disease development is closely related to qi dysfunction.Rheumatic valvular disease primarily affects the pericardium collateral vessels,with deficiency-stagnation of heart qi as its core pathogenesis.Secondary phlegm,blood stasis,and heat pathogen further obstruct qi movement,ultimately forming a pattern of qi deficiency with physical congealing.Thus,treatment based on qi can address the root cause.Professor Cheng identifies this disease as a mixed deficiency-excess syndrome with root deficiency and superficial excess.His therapeutic approach prioritizes regulating and nourishing original qi,aiming to eliminate pathogens while supporting healthy qi.The fundamental treatment principles include replenishing qi,resolving phlegm,clearing heat,and dispelling stasis,using Modified Pulse-Engendering Sunken Chest Decoction combined with Salvia Beverage.Additionally,Professor Cheng is good at employing symbolic thinking to guide meditation in clinical practice.For rheumatic valvular disease,Muhudie(Semen Oroxyli)or Baihe(Bulbus Lilii)is often used.For stubborn phlegm and abscesses,Zaojiaoci(Spina Gleditsiae)can be used.For vascular lesions due to blood stasis and heat,Rendongtong(Caulis Lonicerae Japonicae)which can enter the heart meridian is used to clear heat,dispel wind,and guide drugs into the meridian.For stubborn blood stasis disorders,insect-based drugs are often used.The nature of insects to move and search through the meridians helps to expel long-standing pathogenic factors.For various diseases caused by wind and spastic disorders,Quanxie(Scorpio)is commonly used.If there is blood stasis in a person with deficiency,Tubiechong(Eupolyphaga seu Steleophaga)is often used,which can both tonify deficiency and remove blood stasis.

关 键 词：风湿性瓣膜病 从气论治 生脉陷胸汤 丹参饮 程丑夫 

分 类 号：R259.425[医药卫生—中西医结合]