基于“心肾相交”探讨冠心病心力衰竭与心肾综合征的关系  

Relationship Between Coronary Heart Failure and Cardiorenal Syndrome Based on"Heart-Kidney Interaction"

作　　者：张定一 李海涛 谢航[2] 王丽辉 陈乾 贾赛蕾 ZHANG Dingyi;LI Haitao;XIE Hang;WANG Lihui;CHEN Qian;JIA Sailei(Henan University of Chinese Medicine,Zhengzhou Henan China 450000;The Second Affiliated Hospital to Henan University of Chinese Medicine/Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou Henan China 450002)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450000 [2]河南中医药大学第二附属医院/河南省中医院,河南郑州450002

出　　处：《中医学报》2025年第5期976-981,共6页Acta Chinese Medicine

基　　金：国家自然科学基金青年基金项目(82104833);河南省中医药科学研究专项课题项目(2023ZY2030);河南省科技攻关项目(212102310339)。

摘　　要：冠状动脉粥样硬化性心脏病(简称冠心病)是冠状动脉粥样硬化引起血管管腔狭窄、阻塞或痉挛,导致心肌缺血、缺氧甚至坏死而造成的心脏病。冠心病最严重的并发症之一为心力衰竭,也是各种原因所致心脏病的终末期。现代医学治疗心力衰竭的基本方法为强心、利尿、扩血管,以防止病情恶化。中医认为,心力衰竭的治疗离不开肾,现代医学也基于心肾之间的相互影响,将其命名为心肾综合征。心肾相交理论体现在心肾水火既济、精血互化、君相安位。冠心病心力衰竭与心肾综合征的关系主要包括二者神经及体液系统调节异常、血流动力学异常、脾胃气机升降异常,临证应以扶阳利水法、益气活血化瘀法、补脾胃调中焦气机法分别治之。Coronary heart disease is a heart disease caused by atherosclerosis of the coronary arteries causing narrowing,obstruction or spasm of the lumen of the blood vessels,resulting in myocardial ischemia,hypoxia and even necrosis.One of the most serious complications of coronary heart disease is heart failure,which is also the end stage of heart disease due to various causes.The basic treatment of heart failure in modern medicine is cardiotonic,diuretic and vasodilator to prevent the condition from deteriorating.According to Chinese medicine,the treatment of heart failure cannot be separated from Kidney,and modern medicine also names it as heart-kidney syndrome based on the interaction between heart and kidney.The TCM theory of Heart-Kidney interaction is reflected in the Water and Fire harmony or Heart and Kidney harmony,the mutualization of Essence and blood and the peaceful relationship between the Monarch and Prime minister.The relationship between coronary heart failure and Heart-Kidney syndrome mainly includes abnormal regulation of nervous and humoral systems,hemodynamic abnormality as well as abnormal elevation of Spleen and Stomach Qi,which should be treated by the method of supporting Yang to expel Water,the method of promoting Qi,activating blood circulation and removing blood stasis as well as the method of tonifying the Spleen and Stomach to regulate Qi of the Middle Jiao,respectively.

关 键 词：冠心病 心力衰竭 心肾综合征 “心肾相交” 

分 类 号：R256.59[医药卫生—中医内科学]