论“毒邪学说”指导小儿病毒性心肌炎辨治

Treatment based on syndrome differentiation of pediatric viral myocarditis guided by ‘pathogenic toxin theory'

小儿病毒性心肌炎是感受风热毒邪及湿热毒邪致心脉痹阻而发病,其病理演变过程中始终渗透着毒邪致病的特点。疾病早期毒伤心络,治以清热解毒;中期痰、瘀、毒互结,祛痰化瘀则毒散,后期气血阴阳亏虚兼夹瘀毒、复感外毒,虚实夹杂,治则以补虚扶正为大法,调补气血阴阳、化瘀通毒、清热解毒。根据毒邪之来源、毒邪之依附性质,选择不同方剂及中药加减,运用毒邪学说理论指导小儿病毒性心肌炎的辨证论治意义重大,临床疗效显著。

The pathogenesis of pediatric viral myocarditis was blockade of heart vessel caused by wind-heat and dampheat pathogenic toxins, so the pathogenic characteristics of pathogenic toxins always throughout the pathology evolution process of this disease. In the early stage of disease evolution, heart meridian was injured by toxin, and the treatment for this stage was clearing heat and removing toxicity. In the middle stage of disease evolution, phlegm, blood stasis and toxin obstructed in heartcollaterals, and the treatment for this stage was resolving phlegm and blood stasis for relieving toxin. In the late stage of disease evolution, the pathological characteristics of this disease was deficiency of qi, blood, yin and yang accompanying with blood stasis and toxin, further contraction of external evil, and intermingled deficiency and excess, and the treatments for this stage was strengthening vital qi, coordinating yin and yang, harmonizing qi and blood, expelling blood stasis for discharging toxin, and clearing heat-toxicity. The herbs and formulas were selected and modified according to the origin and property of pathogenic toxins, treatment based on syndrome differentiation of pediatric viral myocarditis guided by pathogenic toxin theory was of great significance and obvious clinical curative effect.