摘要
[目的]总结张杰教授运用经方辨治心脏疾病的临床经验。[方法]通过临床跟师随诊、收集整理医案,对张杰教授应用经方辨治心脏疾病的经验进行分析总结,并列举典型医案4则,结合现代医学认识和经典论述,开拓思路,以详细佐证。[结果]张杰教授认为,心脏疾病多是本虚标实之证,即阴阳、气血虚损是其本,寒凝、气滞、血瘀、痰浊是其标,其中以阳气虚损为发病的根本内在原因。临证运用经方主张谨遵经旨,重视阳气;兼顾益气养阴,调和阴阳;不忘守正创新,巧用活血;同时合用时方,相得益彰。所选医案中,张杰教授主以炙甘草汤治疗心律失常、瓜蒌薤白三方治疗心绞痛、葶苈大枣泻肺汤合苓桂术甘汤治疗扩张型心肌病、真武汤合己椒苈黄丸治疗心力衰竭,辨证精准,圆机活法,疗效显著。[结论]张杰教授应用经方辨治心脏疾病经验丰富,独具匠心,对发挥经方治疗心脏疾病的独特魅力、使用古代经方治疗现代疾病以及经方的传承创新具有重要的启示和借鉴意义。
[Objective] To summarize Professor ZHANG Jie’s clinical experience in treating heart diseases by using classical prescriptions. [Methods]Through clinical following up Professor ZHANG, collecting and sorting out medical records, analyzing and summarizing Professor ZHANG’s experience in applying classical prescriptions to treat heart diseases, and enumerating four typical medical records, combined with modern medical knowledge and classic expositions, ideas were developed to provide detailed evidence.[Results] Professor ZHANG Jie believes that heart diseases mostly pertain to root deficiency and branch excess, deficiency of Yin and Yang, deficiency of Qi and blood are the origin, cold coagulation, Qi stagnation, blood stasis and phlegm turbidity are the signs. Among them, deficiency of Yang Qi is the fundamental internal cause of the disease. Clinical application of classical prescriptions advocates following the purpose of the classics, paying attention to Yang Qi, benefiting Qi and nourishing Yin, harmonizing Yin and Yang,not forgetting to abide the right way and innovation, skillfully using drugs for promoting blood circulation, and combining the time prescription at the same time to complement each other. Among the selected medical cases, Professor ZHANG Jie mainly used Zhigancao Decoction for arrhythmia, Gualou Xiebai three decoctions for angina pectoris, Tingli Dazao Xiefei Decoction combined with Linggui Zhugan Decoction for dilated cardiomyopathy, and Zhenwu Decoction combined with Jijiao Lihuang Pill for heart failure, by appropriate and accurate differentiation, formed clinical thinking and applied flexibly, with good curative effects. [Conclusion] Professor ZHANG Jie has rich experience and originality in treating heart diseases with classical prescriptions. It has important enlightenment and reference significance of giving full play to the unique charm of classical prescriptions in the treatment of heart diseases, and using ancient classical prescriptions to treat modern diseases and the inheritage and innovation of classical prescriptions.
作者
王恒坤
张芸旗
张杰
WANG Hengkun;ZHANG Yunqi;ZHANG Jie(The Second Clinical College of Guangzhou University of Chinese Medicine,Guangzhou(510006),China;Anhui University of Chinese Medicine Traditional Chinese Medicine Expert ZHANG Jie Studio)
出处
《浙江中医药大学学报》
CAS
2021年第11期1178-1183,共6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张杰传承工作室建设项目(国中医药人教发[2012]149号)。
关键词
经方
心脏疾病
重视阳气
调和阴阳
名医经验
验案
张杰
classical prescriptions
heart disease
pay attention to Yang
regulating Yin and Yang
experience of famous doctor
proved case
ZHANG Jie
