丁书文教授对冠心病辨证辨病治疗特色

Therapeutic feature of professor DING Shu-wen on coronary heart disease combining syndrome differentiation with disease differentiation

介绍了丁书文教授在治疗冠心病危险因素,或者伴随心律失常,或者发展到心功能不全、心肌病阶段,或者介入术后仍然胸痛不解者等方面的经验。丁师认为在临证加减时应辨证与辨病结合,总以辨证为主,可以合理恰当的吸收现代医学成果。丁师认为在治疗冠心病合并高脂血症时用药可分3种:一是针对健脾、补肾用药,二是吸收现代医学成果选取降血脂的中药,三是针对痰瘀化热伤络病机选用清热解毒药物;在治疗冠心病合并高血压病时当分期治疗;在治疗合并心律失常时当以益气养阴为主加减用药;在治疗合并心肌病及介入术后仍然胸痛不解者,亦当详细辨证,根据病机,对证治疗,合理加减用药。

This article introduced the treatment experience of professor DING Shu-wen in these aspects： treating the risk factors of coronary heart disease, complicated with arrhythmia, developing to cardiac functional insufficiency, myoeardiopathy stage, and still chest pain relentless after coronary artery intervention. In professor Ding＇s opinion, the treatment should base on combined syndrome and disease differentiation, especially syndrome differentiation. Modern medical results should be absorbed properly, too. The concrete contents are as follows： first, the medicine for coronary heart disease complicated with hyperlipemia can be classified into three types： 1 Spleeninvigorating and kidney-nourishing Chinese herb medicine. 2 Lipids lowering herbs proved by modern medicine. 3 Chinese herbs of clearing heat-toxin aimed at pathogenesis of phlegm-stasis-heat impairing collateral. Second , stage treatment should be applied in coronary heart disease complicated with hypertensive disease . Third , invigorating qi and nourishing yin is the major method in treating coronary heart disease associated arrhythmia. Fourth, patients still with persistent chest pain after coronary artery intervention should be treated according to syndrome differentiation and rational use of medicine.