刘燕池运用滋阴法治疗冠心病经验

LIU Yanchi′s Experience on Treating Coronary Heart Disease with Nourishing Yin Method

心脑血管疾病是目前危害中国人民生命健康的首要风险因素,其中,冠心病发病率与病死率呈现逐年增长趋势。冠心病属于中医“胸痹”“真心痛”疾病范畴。历代医家认为其基本病机为阳微阴弦,而刘燕池教授对冠心病的发病和诊治有独到见解,强调“邪之所凑,其气必虚”,以丹溪“阳有余而阴不足论”为指导,临证以滋阴法为根本大法治疗冠心病,效果显著。具体思路为分补不同脏腑之阴,通过养阴血、清相火,兼通痰瘀之阻,进而使阴阳调和,胸痹得解。因此,该文就刘燕池教授运用滋阴法治疗冠心病进行了多角度探讨:首先阐述了阴虚易成的机理;其次,从阴虚角度深入分析了胸痹的病程,指出阴虚所致的胸痹分为3个阶段:阴虚火热内生,火热内生炼津为痰,阴虚痰凝血瘀;同时,以脏腑划分层次,阐述了治疗胸痹滋阴药物的选用;最后通过验案举隅对刘燕池教授临证诊治冠心病的思路进行探讨,以期从滋阴法角度为冠心病的治疗提供参考经验。

Cardiovascular and cerebrovascular diseases are the primary risk factors endangering the life and health of Chinese people at present,among which the incidence and mortality of coronary heart disease show an increasing trend year by year.Coronary heart disease(CHD)belongs to the category of“chest pain”and“really heartache”in traditional Chinese medicine.The basic pathogenesis of CHD is Yang deficiency and Yin excess.Professor LIU has unique views on the pathogenesis,diagnosis and treatment of CHD.He emphasizes that“where the evil is gathered,the Qi will be deficient”.Under the guidance of Danxi′s theory of“Yang excess but Yin deficiency”,he treats CHD with nourishing Yin as the fundamental method.Nourishing Yin of different organs can be achieved by nourishing Yin blood,clearing ministerial fire and removing phlegm and blood stasis.If Yin and Yang are in harmony,the chest Bi syndrome can be solved.Therefore,this paper discussed Professor LIU Yanchi′s application of the method of nourishing Yin in the treatment of CHD from multiple angles.Firstly,it expounds the mechanism of formation of Yin deficiency.Secondly,from the perspective of Yin deficiency in-depth analysis of the course of chest arthralgia caused by Yin deficiency,we pointed out that the chest Bi syndrome caused by Yin deficiency can be divided into three stages:internal heat due to Yin deficiency,internal fire leading to phlegm,Yin deficiency and phlegm coagulation and blood stasis.At the same time,according to the division of Zang-Fu organs,the selection of drugs for treating chest Bi syndrome and nourishing Yin is expounded.Finally,this paper discussed Professor LIU Yanchi′s idea of clinical diagnosis and treatment of CHD through case studies,in order to provide the reference experience for the treatment of CHD from the perspective of nourishing Yin method.