全国名中医张静生从气阴两伤、痰气交阻论治冠心病经验撷摘

National Famous Chinese Medicine Professor ZHANG Jingsheng′s Experience on Treating Coronary Heart Disease from Qi-Yin Injury and Phlegm-Qi Stagnation

冠心病作为临床常见病和疑难病,发病率日益渐增,且呈年轻化趋势,是危害人类健康的严重疾病之一。从中医角度而言,冠心病被一致认为乃本虚标实之证。随着社会的宏观发展与人体生物钟的微观调整,首届全国名中医张静生教授结合自己几十年的临床经验,提出“气阴两伤、痰气交阻”作为早期中期病机论治冠心病,“气阴两伤”为冠心病的发病基础,“痰气交阻”为其致病因素,不荣与不通相兼为患,遂成心疾。总结辨治要领如下:谨守病机、各司其属,即做到“观其脉证,知犯何逆,随证治之”;五脏相通、移皆有次,即冠心病的病位在心,心为五脏六腑之大主,心与肝、脾、肺、肾在五行生克制化和脏腑经络上有着密切的联系,相容相通,移皆有次;攻补兼施、审因用药,补者,扶正也,即益气、养阴、补血、生津,攻者,祛邪也,即化痰、清热、凉血、消瘀,拟用丹参生脉饮加减化裁,为中医药论治冠心病开辟了新的思路和方法。

Coronary heart disease is a common and difficult clinical disease and its incidence rate is increasing and has a younger trend.It is one of the serious diseases endangering human health.From the perspective of traditional Chinese medicine,coronary heart disease is unanimously regarded as a syndrome of deficiency in origin and excess in superficiality.With the macro development of the society and the human body biological clock micro adjustment,Professor ZHANG Jingsheng,one of the first Chinese medicine practitioners in China who combined his decades of clinical experience,proposed“Qi-Yin injury,phlegm-Qi stagnation”as the early and middle stages pathogenesis of coronary heart disease.“Qi-Yin injury”is the basis of coronary heart disease,and“phlegm-Qi stagnation”is its pathogenic factor.The combination of losing nourishment and obstruction can the heart disease.The key of syndrome differentiation and treatment is summarized as follows:observing the pathogenesis and taking the charge of their subordinates,that is,“observing their pulse syndrome to know what goes wrong and choose the formula according to the syndrome”.The five internal organs are connected and every movement has its own order,that is,coronary heart disease is located in the heart.The heart is the master of the five Zang organs and six Fu organs,and is closely related to liver,spleen,lung and kidney in the five elements generation and restriction of Zang-Fu organs and meridians.They are compatible and connected and every movement has its own order.Attacking and supplementing methods are used simultaneously,applying the drugs according to the cause.Supplementing method is for strengthening healthy Qi,that is,benefiting Qi,nourishing Yin,replenishing blood and generating fluid.Attacking method is for eliminating pathogens,that is,resolving phlegm,clearing heat,cooling blood and removing blood stasis.Modified Danshen Shengmai Yin(丹参生脉饮)is applied and it opens new ideas and methods for treating coronary heart disease with traditional Chinese medicine.