基于内生宿邪论治心力衰竭

Treatment of Heart Failure Based on Theory of Endogenous Retained Pathogens

心力衰竭是各种心血管疾病的终末期,严重影响患者的生存质量和预后,因此加强对本病的认识有助于拓宽临床诊疗思维。本文基于内生宿邪角度论述心力衰竭的致病机理和治疗方法,内生宿邪是机体脏腑功能失调和阴阳、气血、津液紊乱而产生的病理产物,与心力衰竭的发生、发展关系密切。心、肺、脾、肾脏腑亏虚是内生宿邪的前提和基础,阳虚积重难返是心力衰竭反复发作、缠绵难愈的根本原因,瘀血、痰浊、水湿乃宿邪发病的病理产物,心脉乃宿邪伏匿场所,外邪引动宿邪是急性加重的诱因。心力衰竭治疗上以扶元固本为主,温补心、肺、脾、肾,兼攻逐宿邪,化痰、活血、利水,急性加重时重祛风利水。

Heart failure is the end stage of various cardiovascular diseases,which seriously affects the quality of life and prognosis of patients.Therefore,strengthening the understanding of the disease will help to broaden the thinking of clinical diagnosis and treatment.This paper discusses the pathogenic mechanism and treatment of heart failure from the perspective of endogenous retained pathogens,which is the pathological product of the dysfunction of zang-fu organs and the disorder of yin and yang,qi and blood and body fluids,and is closely related to the occurrence and development of heart failure.The deficiency of zang-fu organs including heart,lung,spleen and kidney is the premise and basis of endogenous retained pathogens.The long-term accumulation of yang deficiency is the root cause of lingering refractory heart failure and its repeated attacks.The blood stasis,phlegm turbidity and water dampness are the pathological products of the onset of retained pathogens.The heart vessel is the hiding place of retained pathogens.The inducement of acute exacerbation is caused by exogenous pathogens.Mainly focusing on reinforcing the origin and consolidating the root,the treatment of heart failure warms and supplements the heart,lung,spleen and kidney,and combines with attacking retained pathogens,and at the same time dissolving phlegm,invigorating blood and promoting urination,which gives priority to dispelling wind and promoting urination in case of acute exacerbation.