慢性心力衰竭本虚标实证分类方案在病证结合模式中的优势

Advantages of classification method based on syndromes of deficiency in origin and excess in superficiality in combining disease and syndrome for treating chronic heart failure

由于慢性心力衰竭(Chronic heart failure,CHF)具有迁延难愈、证候复杂多变的特点,决定了中药及其复方对CHF治疗应该分阶段、分层次进行,才能体现其多途径、多靶点的综合优势。但目前对慢性心力衰竭的中医证候要素、证候类型及其演变规律尚缺乏统一的认识,疗效无法得到认可,优势无法得以体现,严重制约了中医药在临床中的推广和对本病防治的公信力。基于以上认识,将慢性心力衰竭分为加重期和缓解期两期,加重期以标实证分类,寒热分治;缓解期以本虚证分类,在阴阳、气血辨证的基础上,依脏腑(三焦辨证)进行系统论治。

Chronic heart failure（ CHF） is difficult to cure due to its long course and complex and changeable syndromes. Therefore,the traditional Chinese medicine（ TCM） therapy for CHF should be developed based on the different stages and classifications of CHF,which can reflect its comprehensive advantages of multiple ways and targets. However,there is no consensus about TCM syndrome factors,syndrome types,and syndrome patterns of CHF,so the therapeutic efficacy of TCM is not accepted and its advantages cannot be shown,which significantly restricts its clinical application and its credibility in the prevention and treatment of CHF. Based on the above knowledge,CHF is staged as exacerbation and remission; for CHF in the exacerbation stage,the therapy should be classified according to excess in superficiality and differentiated for cold or heat; for CHF in the remission stage,the therapy should be classified according to deficiency in origin and performed based on syndrome differentiation of viscera and bowels（ Triple Energizer） in addition to syndrome differentiation of yin- yang and qi- blood.