“气-血-脉络”体系下的心律失常射频消融术后复发防治思路探微  

Prevention and Treatment Strategies for Post-Radiofrequency Ablation Recurrence of Arrhythmia Based on the"Qi-Blood-Meridians"System

作　　者：蔡泳源 刘婷 李梦然 闫中敏 牛天福[2] CAI Yongyuan;LIU Ting;LI Mengran;YAN Zhongmin;NIU Tianfu(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing,100053;Shanxi Province Hospital of Traditional Chinese Medicine;Shanxi Institute of Traditional Chinese Medicine)

机构地区：[1]中国中医科学院广安门医院,北京市100053 [2]山西省中医院 [3]山西省中医药研究院

出　　处：《中医杂志》2025年第8期841-845,850,共6页Journal of Traditional Chinese Medicine

基　　金：山西省名中医传承工作室建设项目(SXSMZYGZS010)。

摘　　要：在“气-血-脉络”体系下,指出心律失常射频消融术后复发是以心体受灼、脉络伤损为发病之本,气机失调、血阻热郁为复发前提,虚气内耗、阴伤血少则是病情频发的关键因素,痰瘀兼伏、阴邪凝结为病势恶化的主要原因。基于此,运用自拟十八味通心饮养心通脉复络、适其阴阳,贯彻术后干预全程;自拟清心定悸汤行气宣滞、透热运血,促进早期恢复;自拟培本养心汤益气养阴、和营补血,改善远期预后;十味温胆汤合桃仁红花煎豁痰散结、逐瘀软坚,阻截病势加重,以期为临床工作提供思路。Based on the"Qi-blood-meridians"system,it is proposed that recurrence after radiofrequency ablation(RFCA)for arrhythmia originates from damage to the heart and injury to the meridians caused by thermal burns.Disorder of qi movement,blood obstruction and heat constraint are the prerequisites for recurrence,while internal consumption of deficient qi,yin damage and scarce blood are key factors in frequent episodes.Latent pathogen of both phlegm and stasis,along with condensation of pathogenic yin,is the main cause of disease progression.Accordingly,self-made Tongxin Beverage(通心饮)with 18 herbs is used throughout the postoperative intervention process to nourish the heart,unblock the meridians,restore vessels in balance of yin and yang.Self-made Qingxin Dingji Decoction(清心定悸汤)can be used to promote qi movement,diffuse stagnation,relieve heat and activate blood circulation so as to facilitate early recovery.Self-made Peiben Yangxin Decoction(培本养心汤)can boost qi and nourish yin,harmonize the ying(营)level and nourish blood,thereby improving long-term prognosis.In addition,Shiwei Wendan Decoction combined(十味温胆汤)with Taoren Honghua Decoction(桃仁红花煎)resolves phlegm,dissipates masses,removes stasis,and softens hardness,which can be used to prevent disease aggravation.These approaches aim to provide ideas and references for clinical practice.

关 键 词：心律失常 射频消融术后复发 气血 脉络 

分 类 号：R259[医药卫生—中西医结合]