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心力衰竭中医病机探析(1)
http://www.100md.com 2015年9月15日 中外医疗2015年第26期
     [摘要] 心力衰竭在中医中所属的范畴较多,如喘息、心悸、心痹、水肿以及心水等,其基本病机为阴阳两虚及心脉瘀滞,心力衰竭患者虽然阴阳均受到破损,但主要以阳虚为主,并伴有一定的阴虚,其疑难重症为五脏精气虚衰及功能失调。在脏腑病理上,虽然患者的诸多系统均有虚损性的病变,但其病变的重点主要为心肾;在心力衰竭血瘀证中,其病理特点为阳虚致瘀;气虚血滞是导致患者体内水液潴留的主要原因。心力衰竭发病的根本原因为心气虚衰,心气虚衰发展加重的必然环节为心阳虚衰,并且血瘀在心力衰竭病理环节中占据着重要的地位。心衰病之本为因心气虚而导致的心阳虚及心阴虚;心衰病之标为因心阳虚而导致的瘀血、痰浊以及水饮。心力衰竭的主要病理机制为心气虚衰、肾阳亏损以及痰瘀内阻。该研究主要通过对心力衰竭的始动因素、关键病机以及病理进行分析,进而得出心力衰竭的中医病机。

    [关键词] 心力衰竭;中医病机;阴阳两虚;心脉瘀滞;肾阳亏损

    [中图分类号] R541 [文献标识码] A [文章编号] 1674-0742(2015)09(b)-0196-03

    [Abstract] Heart failure in TCM belongs in the category of more, such as breathing, heart palpitations, heart impediment, edema, cardiac edema and, the basic pathogenesis is deficiency of both yin and Yang and the heart blood vessels with,) in patients with chronic heart failure (CHF) although the Yin and yang are subject to damage, but mainly to the Yang mainly, and accompanied by a certain degree of yin deficiency, the difficult and severe as the essence of the five zang organs asthenia and functional disorders. In the pathology of Zang Fu organs, although with many systems have a virtual loss of lesions, but the focus of the lesions mainly for heart and kidney; in blood stasis syndrome of heart failure, the pathological characteristics for the deficiency caused by blood stasis, deficiency of Qi and blood stasis is the main cause in patients with fluid retention. The onset of heart failure root cause of heart qi deficiency and failure, heart qi asthenia aggravate the development of inevitable link for heart Yang decline and blood stasis in heart failure pathological link occupies a important position. The heart failure was due to deficiency of heart qi and heart yang deficiency, and deficiency of heart Yin; sign of heart failure is due to heart yang deficiency and blood stasis, phlegm and water to drink. The main pathological mechanism of heart failure of heart qi deficiency, Yang deficiency of the kidney failure and phlegm and blood stasis resistance.This article mainly through the initiating factor of heart failure, the key pathogenesis and pathological analysis, and then draw the TCM pathogenesis of heart failure.

    [Key words] Heart failure; TCM pathogenesis; Blood stasis; Yin and Yang of the two virtual heart pulse; With Yang deficiency of the kidney

    在临床上,心力衰竭(CHF)属于较为常见的危急重症,其主要是由诸多心血管疾病发展而成,并且其预后效果较差。2001年,美国心脏病学会(AHA)经过统计发现,全美的心力衰竭患者约有500万人左右,并且每年以50万人左右的人数不断上升,每年因心力衰竭而死亡的患者不低于30万人[1]。心力衰竭对人们的生命造成了严重的威胁,目前,心力衰竭的主要治疗方式为药物治疗。中医药在心力衰竭患者的治疗中,不仅具有悠久的历史,还具有良好的治疗效果,对疾病的发展具有延缓作用,提高患者的生活质量[2]。导师赵继福教授从事中医心病研究多年,疗效显著,对心力衰竭的中医病机有自己的见解,现报道如下。 (杨娜)
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