苓桂术甘汤治疗冠心病心律失常的体会

Experience with Linggui Zhugan Decoction in treating arrhythmia in coronary heart disease

冠心病心律失常属于中医“心悸”的范畴,病机包括气血阴阳亏虚造成心失所养,或痰饮、瘀血阻滞造成邪扰心神,目前相对缺乏针对邪扰心神病机的治疗药物。痰饮所致心悸,应以温化痰饮为大法,首选苓桂术甘汤。该方的要点在于“温”“和”二字,“温”指方剂组成本身药性之“温”,亦需考虑人体的“温度”,“和”则包括时间之“和”,以及与其他的方剂、药物组合使用。结合冠心病频发室性早搏、冠状动脉支架植入术后房性早搏二则验案,对应用苓桂术甘汤治疗冠心病心律失常进行介绍,为临床辨治提供参考。

Coronary heart disease(CHD)arrhythmia belongs to the category of“palpitations”in traditional Chinese medicine.The pathogenesis includes the loss of heart support caused by deficiency of Qi,blood,yin and yang,and the pathogens disturbing the mind caused by phlegm and blood stasis.At present,there is a relative lack of therapeutic drugs for coronary heart disease(CHD)arrhythmia with the pathogenesis of pathogens disturbing the mind.For palpitations caused by phlegm and retained fluids,the method of warming and transforming phlegm should be the major one,and Linggui Zhugan Decoction is the first choice in treatment.The key point of this prescription lies in the words“Wen(warm)”and“He(and,together with)”.The word“Wen(warm)”here refers to the“warm”nature of the prescription itself,as well as the“warm temperature”of the human body.The word“He(and,together with)”includes the“sum”of time and its use in combination with other prescriptions and drugs.Combined with two cases of frequent ventricular premature beats of CHD and atrial premature beats after coronary stent implantation,this paper introduces Linggui Zhugan Decoction in the treatment of arrhythmia of CHD,so as to provide reference for clinical syndrome differentiation and treatment.