从热(火)毒探讨冠心病的病因病机及辨证论治

Analysis of Etiology,Pathogenesis and Treatment Based on Syndrome Differentiation of Coronary Heart Disease from Heat(Fire)Toxin

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摘要热(火)毒为阳邪,易致热象,腐蚀血肉,这与冠状动脉粥样硬化斑块温度升高、破溃的病理改变特点相符,是冠心病发病的重要致病因素。中医学认为饮食不节、情志失调、年老体虚、气候环境等因素能够导致脏腑功能失调、气血失和,致使瘀血、痰饮、水湿等病理产物形成,蕴积体内,久郁不解,化热成毒,毒损心脉,发为本病。临证之时,应以清热解毒立法,兼顾其病理本质,应证组合疏肝、降火、化痰、利湿、祛瘀治法对胸痹热证进行辨治,常用方剂为景岳化肝煎、龙胆泻肝汤、栀子豉汤、小陷胸汤、甘露消毒丹、旋覆花汤等。 Heat(fire)poison is Yang evil,which is easy to cause heat syndrome and corrode flesh.Heat(fire)poison is consistent with the pathological changes of coronary atherosclerotic plaque with rising temperature and rupture,and is an important pathogenic factor of coronary heart disease(CHD).Traditional Chinese medicine believes that improper diet,emotional disorders,senility and body deficiency,climate environment and other factors can lead to viscera dysfunction and disharmony of qi and blood,resulting in the pathological products such as blood stasis,phlegm and fluid retention,water and dampness,etc..which accumulate in the body,stagnate for a long time,transform heat into toxin,then damage heart pulse,and finally develop into CHD.In terms of clinical treatment,clearing heat and removing toxin should be used as the principle,taking into account its pathological nature.Heat syndrome of chest impediment should be differentiated and treated by combining methods of soothing liver,reducing fire,resolving phlegm,draining dampness and removing stasis.The commonly used formulas are Jingyue Huagan Decoction(景岳化肝煎),Longdan Xiegan Decoction(龙胆泻肝汤),Zhizi Chi Decoction(栀子豉汤),Xiao Xianxiong Decoction(小陷胸汤),Ganlu Xiaodu Elixir(甘露消毒丹)and Xuanfuhua Decoction(旋覆花汤).

作者周宇石李涵张明雪 ZHOU Yushi;LI Han;ZHANG Mingxue(Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China;Shenyang Health Service Center,Shenyang 110031,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China)

机构地区辽宁中医药大学沈阳市卫生健康服务中心辽宁中医药大学附属医院

出处《山东中医药大学学报》 2023年第3期284-288,共5页 Journal of Shandong University of Traditional Chinese Medicine

基金国家重点研发计划项目(编号:2017YFC1700401) 辽宁省特聘教授滚动支持项目(批文号:辽教函〔2018〕35号)。

关键词热(火)毒冠心病饮食不节七情失调肝郁气滞痰瘀互结清热解毒疏肝降火化痰祛瘀 heat(fire)poison coronary heart disease improper diet seven emotional disorders liver depression and qi stagnation integration of phlegm and blood stasis clearing heat and removing toxin soothing liver and reducing fire resolving phlegm and removing blood stasis