周杰教授从“心脾相关”论治慢性心力衰竭探析

Analysis on Chronic Heart Failure Treated by Prof. Zhou Jie in Terms of “Correlation of the Heart and Spleen”

周杰教授归纳慢性心力衰竭心气鼓动乏力、血脉瘀阻、痰浊内阻、水饮停聚之病理局面,属因虚致实、虚实交错之证候。其基于"心脾相关"学说,提出脾失健运是促使慢性心力衰竭心气虚证、兼阴虚证、兼血瘀证、兼血瘀水肿证病程发展的关键环节。脾失健运既是导致心气亏虚发生的始动因素,又为痰浊、瘀血、水饮等病理产物生成的关键所在。治疗方面,周杰教授善于从脾脏之角度入手进行辨证论治,处方用药多在健脾益气的基础上进行随症加减,以达到补益心气、化痰泄浊、逐瘀行水之目的,在长期的临床实践中取得了良好的疗效。

Prof. Zhou Jie thought that chronic heart failure （CHF） was caused by failure of heart qi in propelling, blood stagnation, and internal retention of phlegm and harmful fluid. CHF is the mixed syndrome of deficiency and excess. In terms of＂ correlation of the heart and spleen＂, Prof. Zhou pointed that the dysfunc- tion of the spleen in transportation and transformation was the key of CHF differentiated as qi deficiency, com- plicated with yin deficiency, blood stagnation, stasis and edema. The dysfunction of the spleen in transporta- tion and transformation was the primary factor of heart qi deficiency and the key link of the pathological pro- duction such as phlegm, stasis and harmful fluids. In treatment, Prof. Zhou was good at syndrome differentia- tion in view of the spleen theory. The formulas were modified based on the symptoms for strengthening the spleen and benefiting qi so as to tonify heart qi, resolve phlegm, remove stasis and promote water metabolism. The satisfactory efficacy had been achieved in the long- term clinical practice.